I felt some chest discomfort on a run in April this year. I’d never felt anything like it. I slowed down to walk and it went away, and I continued my run. But it kept coming back every time I ran, or swam, or rode my bike to work. That’s when I contact my friend, the cardiologist at Mayo in Rochester, MN. He suggested I might have “walkthrough phenomena stable angina,” which is ischemia that gets better when you slow down and the coronary arteries dilate, allowing a return to exercise.

Dammit. I didn’t want to hear that. I was able to get appointments with local physicians and cardiologists after convincing them that my BP as measured at a supermarket BP tester was high.

I’m 50. I’ve taken care of myself and done plenty of endurance sport events. I’m not going to list out my results, but I’ve had some decent times. But mostly, I’ve been taking care of myself and working out hard for at least 42 years now. I grew up swimming and picked up running and tri after college.

I had a normal exercise EKG on the stress test, with results that indicate my risk for MI is really low. I could have kept running after 11 minutes, but decided to stop. Blood tests indicate that I have slightly elevated LDL (103). The true diagnostic test was the CT-A, which revealed that I have an Agatston score of 323 and blockages in my coronary arteries. This is all a betrayal, it seems, or all the years of hard work and eating well. It just shows that I can’t outrun or out swim heart disease. At least I have had warnings and I’m on baby aspirin and a statin.

Right now, I’m at a loss. I’ve set up my life around working out and planning for events, and now I’m sorta scared. I don’t run far from home, and I carry my phone and ID in case the big one hits. At least if I’m in the pool, there will be lifeguards around. I don’t feel like I can go swim OW anymore.

I’m adding long walks just to keep moving. I don’t want to back down, but it seems like that’s the direction I’m headed.

This sucks.

I am working with the team in Scottsdale (which works really well for me, I grew up a few miles from the clinic... but live in Seattle now, but all my family is still there.)

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Team Zoot

Yes, it sucks, no doubt, and I totally feel for you, and I can completely understand what you are going through. I didn't get the chance to be scared "before the big one hit", I just woke up in the ICU and they told me about it, and then got to be scared out of my mind for the next few months.. scared I would go to bed and not wake up. My wife also gets to jump into the "scared" world with me :-O. But... I can tell you that things do get better with time as you learn more and wrap your head around things. Yes... you have some risk, but as I understand it (and I am by no means an expert) the statin will help lower the risk of a plaque breaking loose and causing a blockage... so it lowers your risk to a degree and you don't need to live in fear. The best thing about your story is that you have knowledge... you are under the care of a cardiologist and they can work with you to monitor how things are going. And if you have a cardio friend at Mayo, then I'd say you are well covered.

My MI/Cardiac Arrest was in Feb of 21... I raced a sprint in Aug of 21... that seemed totally insane at the time, and I went slow, didn't push myself, cried the entire time (and still somehow managed to win my AG)... it was the best thing for me to go and do, but seriously one of the most frightening things I have ever done. My wife was there and watched over me during the race (having a Garmin 945LTE helps!) It took me over a year before I could go out and run by myself out of fear that something was going to happen. Pools were terrifying... open water was simply not going to happen. But I have come a long way with overcoming the fears... and really accepting that the risk of something happening again remains low (or at least as low as we can make it). I raced Oceanside this year... 30 mins slower than normal, but I didn't care (didn't help that I pretty much cried for 13 miles on the run... just too many emotions), then I went out and raced Oregon 70.3... decided to do it a few days before the race, just needed to go out there and have the wind in my face, tackle my fears and outrun my demons. I think I love racing now more than I did when I was competitive... because it is just a much bigger deal in my head. I am now okay with open water swimming all alone, but I only do it if I have someone on the shore that has eyes on me and I use a buoy. I'm racing Washington 70.3 in a week... I will be slow as my fitness isn't what it was before my event, but I am not out there to qualify for worlds, now I am out there to keep chasing the demons and overcoming the fears.

Sounds like you have done everything right (which is exactly what my cardiologist said to me... he told me not to change a single thing in my life)... so work with your cardiologist and come up with a plan that works, one that makes you feel comfortable, and then make sure you have someone watching over you when needed (I have no idea why that made a difference to me... but just knowing my wife was watching the screen of her phone while I was out on the bike, etc... just gave me some level of peace.) The team at Mayo can do a full fitness workup for you, (VO2Max, etc), my guess is they are going to tell you to keep moving and that you are doing it right and that the risk is less than most people walking around this planet.

Statins are a mixed bag... many people are against them, but I do think they do more good than bad, but I don't think they are great. I am trying to get moved over to a pcsk9 inhibitor just to minimize the statin risk (and lower my LP(a)... but not there yet. Many people will tell you that LDL doesn't really matter... but of course many will say it is a big factor. Lots of info out there and it can be overwhelming to figure out what the best path forward is. One thing I have learned is that people are VERY passionate about their position on everything so there is a lot of noise.

Keep moving forward, you are doing it right.

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Team Zoot

Hey 140-

How are things now?

Sorry....I've been "away" for a while, and haven't really been paying much attention to ST.

I completely agree with Greg. Time helps. My experience, thoughts, and feeling as I went through my events are pretty well documented above. There were certainly those days early on where I was a bit freaked out, one might say. I remember vividly the first time I ventured out away from the house solo. Early on, there were many nights I laid awake...kind of afraid, that if I went to sleep I might not wake up. Good conversation with my doctor about my risks was key for me. It took a while to internalize and accept as truth---time.

Everyone's experience is different, of course. I did get a completely new set of plumbing---so, there was very little real risk of another event---not zero, though. But, I did have the arrhythmia and all those new sensations in my chest from the surgery...that left me constantly cognizant of things. I wore a 24/7 heart monitor for a month (after I thought I'd felt chest discomfort again), as well---I wonder what people thought see a 52 year old man running down the street shirtless with a thing stuck to his chest? I didn't leave the house, or my family's watchful eyes for several months. But, as I built up a new set of "this works ok" experiences, gradually the worry faded into the background. I made steady use of the treadmill, first walking, and eventually running.

Anyway, how is your mental state, today? Your post was ~6 weeks ago. Have you been able to make any ground, mentally?

-tch

I guess it's time for an anniversary post? Today marks 3 years since I had surgery.

To be honest I completely forgot until my daughter reminded me about an hour ago. I guess that says something....its not always in the forefront of my mind anymore. But, I'd be lying if I said it wasn't EVER.

Once upon a time, when I was in the thick of things the good Dr Dale said to focus on "today", then next week, then next month. Or something like that. It was what I needed to know at the time. I will be forever grateful to him for his support here and elsewhere.

Neverthess, today I just go run whatever I want to. I don't give it much thought. Sometimes I ease into it a bit more than I would have when I was younger... But, that's probably a good thing regardless. :=) That said I've still found my MaxHR a couple times already this year, and I'm holding my own in the 100/100 this year. This will be the first time I've actually completed it since 2018/2019.

I'm quite blessed to be still be able to do these things.

3 years?

Boy does time go fast these days...Good that you continue to do well, but I already knew that--



Keep on keeping on, Tom. You deliver tons of sage advice right here on ST. And congrats on 100/100-I am so far behind but life/work continue to get in the way.

Don't blame work. It's all that zwifting and stupid swimming you keep spending your free time on! ;o)