I’ve been a very occasional poster, but have lurked for 3 or so years now and been impressed with the quality of some of the advice I have seen – I’m hoping there are some ST’ers out there with the interest and experience to comment on my situation.
Male, 52, 6’0”, 180 lbs
Winter/spring ‘06/’07 – substantially increased training volume, lost 50 pounds, got faster in all disciplines; still a slow runner, so trained for my first ever marathon in Nov ’07 as way to overcome this; didn’t do very well, but finished and a month or so after was running at a much better pace – 10 mi runs in 92 – 93 minutes, tempo runs @ 7:30ish (told you I was slow)
Early Jan ‘08 had patella mistracking from some static lunges, stopped running but did low-intensity swimming, cycling and aqua jogging. Had a physical at the end of Jan to be able to get a referral to an orthopedic specialist for knee pain, and was diagnosed with A-fib. Knee recovered and continued training; did notice something amiss as I couldn’t sustain tempo or faster pace; was cardioverted in early April and started Lisinopril, and by summer got to my best fitness ever. Then went back into A-fib end of July; cardioverted a 2nd time early August and started on Tikosyn (dofetilide), 500mcg 2x daily. Seemed to have no ill effects initially, my training paces held up. Did 2 triathlons in September, wasn’t happy with either as I just couldn’t push myself, but both in pissing rain and I was cold, so that could have been it. Did much more aggressive training to try this marathon thing again, and had my best training runs ever – 10 to 12 miles at slightly faster than 10:00 pace, followed by 4 to 5½ miles at 8:15 to 8:30 pace. Completely bonked in the actual marathon in early November – by mile 18 I was actually starting to pass in and out of consciousness while running, so I stopped and attempted to walk for a bit – cramped so hard and completely that I was effectively paralyzed for a good 5 minutes. Then was able to walk some and eventually hitched a ride back to my car. Never had anything like that happen to me before.
And I have been feeling crappy and performing poorly ever since. Never had the bounce back and feeling of easy running after a recovery period – once in a while feel “normal” and start out a decent distance pace, but can’t hold it for an hour, and fade badly. Tried tempo pace twice, after a mile I’m dying. Mostly just feel slow from the get-go, some days fatigue comes very quickly and I’m walking after a couple of miles. I’d say on average a little more than a minute per mile slower than last year when I do complete the distance I set out to do. Can’t stay with the group ride at all this year, and swimming sucks as well. Endurance is usually O.K., I can run for 2 hours, cycle for 3, swim 4000yds, etc., but pace is way off.
Two significant changes compared to last year – A-fib incidences, 1st one caused some enlargement of atrium which then came back down; and Tikosyn, although I had some really good training sessions before the marathon.
As it stands, I need the Tikosyn because I went back into A-fib without it; I can’t just live with the A-fib because it causes fairly rapid enlargement of atrium and I can’t do the training intensity I want; next step would be some form of ablation, but I’m hoping to avoid that because there is always some risk. I haven’t seen any listed side effects of Tikosyn that explain what I’m feeling. If that’s it at all - maybe there was some permanent change in pumping volume? Still can’t help feeling it’s something to do with chemistry - as a noted poster has said, fatigue is biochemical.
Just looking for some things to discuss with my cardiologist. He has an excellent reputation in this region; he’s a little bit at a loss for why I feel why I do, but then again maybe he’s never had a patient as active athletically as a triathlete can be. Curiously, he’s done some digging around, and found studies that suggest that it is the athletic activity in the first place that can trigger A-fib. Bummer.
Thanks for reading,
Brian