[at-l] WILL WE SUFFER FROM OUR RUNNING/HIKING???: Your EKG.

[sloetoe@yahoo.com (Sloetoe)]

 From: "Dave Solomon" <runforsmiles@hotmail.com>
Subject: WILL WE SUFFER FROM RUNNING ULTRAS???

> Friends,
> Once and for all, I want to know what the outlook is for those
who run ultras in regards to physical health.  So many of my
friends (one who is an exercise physiologist) and family are
constantly warning me of all the bad long-term physical effects
that ultra running may have on my body.  I love running ultras,
however, these warnings certainly concern me.  After all, we
must admit that ultrarunning is certainly NOT a normal sport.
It travels well beyond the realms of physical fitness.  So,
EVERYONE please chime in and lets create an in-depth discussion:
Exactly how much long-term harm are we doing to our bodies by
running ultras???

### Interesting that this would come up about now. A month ago,
I had a regularly-scheduled annual physical. I am 42 years old,
6'1", 155 lbs, don't smoke, occasional drinker/hasher[!], I take
no prescription medicines, and since hearing of the awful cycle
between dehydration-joint/tendonal irritations-NSAIDS-further
dehydration, and then of dehydration-NSAIDS-liver and kidney
stresses, I have minimized use of NSAIDS with
glucosamine/chondroitan and assiduous stretching *and* have
maintained strick attention to staying well hydrated when
running/hiking long.

Pretty much answers the question, eh? And I'm the Picture of
Health, right? Oh, I am also one of those rudely gifted types
who runs half or even a third of the weekly miles compared to
those with whom I finish races, whether 5k or ultra. (And for
the record, I truly am grateful for this gift, each and every
time I run.)

"But that's not The End of The Story..."

Leading up to the month of October:

August: backpacking the AT from Vermont through New Hampshire's
White Mtns with my 8 year old twins, pretty steady at
10-12m/day, over a 3+ week period. A big effort in drought
conditions so unrelentingly hot and humid that 1800 mile
throughhikers were dropping out. Yow.

September: I had had a pretty steady diet of 3-5x/week runs of
3,5,7 miles over lunchtime, on urban concrete (sidewalks) or a
pretty interesting semi-cross-country course over solid stone
park "benches" and up and down a river embankment, just getting
down to a 5 mile on-the-flat time barely under 32:00. (That's
pretty respectable for me, so I'm feeling "fit.")

October's lunchtime runs were much reduced/wiped out by
busywork, but the weekend schedule (usually "zero" unless I'm
targeting a race), went like this:
September 28: (MMSF) 20+m on trail (moderate); 6m (hard) hash
run

October 5: zero

October 12: 4th?/1st Masters in DINO 15k trail race (hard); then
4m? (easy) hash run/walk.

October 19: Mountain Masochist 50m, in 10.5 hrs. Due to work,
etc, managed only 4,4,0 hours of sleep in nights prior to race,
including the 600mile drive; fell asleep while running[!!!] from
32m-42m. Then drove three hours after race to give presentation
on "Backpacking With Children" the next morning. Poor attendees.

October 26: 13th/3rd Masters at Morgan-Monroe State Forest 13.1m
trail race (hard).

November 2: 3rd/1st Masters at Owen-Putnam State Forest 50m
trail race (hard) 10.5 hours. It was a *very* tough
ten-and-a-half hours (MUCH tougher than the sleepy Mountain
Masochist effort) and really took it out of me.

November 8th I have the physical. I push (*push*) for an EKG
(none yet on file), and for a stress test, and warn the doc of
the potential for funky findings on the blood panel and EKG. (I
recognize the prior month's efforts as perhaps a lifetime
maximum, and want to capture these findings in my med. file as a
part of the baseline, should I become incapacitated sometime in
the future and not be otherwise able to explain these things in
some medical emergency.) At this time, the resting EKG is
normal, but a stress test is scheduled for December 3rd, and
blood is taken.

November 11, I attempt to run Indiana's (50m) Knobstone Trail.
Made it 20 miles before legs just flat "gave out." Made it to
50k point and stopped. (10 hours flat, for you locals...) It was
a good pace we had chosen, though, and a 15 hour 50 mile time is
doable for the solo, unsupported runner.
http://osl.iu.edu/~tveldhui/albums/2002/knobstone/
(Again, for the record, we stopped because the old man of the
group (yours truly), was flat out of gas. Todd came in third at
Berryman this year; fellow hasher Russ (a sub-3-hour marathoner)
was 15k series champ for IN trail races this year. These guys
are no slouches.)

A week later comes a call from doctor's office. *Must* schedule
follow-up blood work, as results indicate elevated liver output
consistent with liver cancer, recent major heart attack, chronic
alcohol abuse, ..... OR (as I find out from the Internet!) FROM
EXTENDED ATHLETIC EFFORTS. Blood drawing scheduled with Stress
Test December 3rd.

December 3rd stress test (Bruce Protocol) stopped at transition
from Level 4 to Level 5. I haven't cracked a sweat yet. While
heart rate indicated aerobic exertion (just hit 80%), and BP in
expected range (don't recall #/#), overall trace, to make a long
story short, indicated pronounced left ventricular hypertrophy
(big heart) consistent with advanced heart disease, congenital
defect, ....... OR FROM EXTENDED ATHLETIC EFFORTS. Respiration
and heart rates' recovery from exercise were relatively
quick.....

An Echo/Stress test scheduled for the next morning, and the EKG
showed the same thing as the day before. I am waiting (STILL)
for the official "results," but I did notice that not once did
the echo guy start back from the screen with surprise and,
pointing wildly, blurt "Whoa, nurse, come check *this* out!!!"
(which I'll take as a good sign.) BTW, started on a 6-week(?)
speed work emphasis the next day, and as expected, brought the
heart rate up rapidly and easily to 90+%. Going to be a rough
couple of weeks while I *reacquaint* my legs with speed....
These are the first steady (and weekday) runs since September,
and the first speedwork since April[?].

CONCLUSION:
We've all heard about those athletes who presented cardiac
anomolies to the medical establishment, but if you're like me,
you'd never guess that your own modest running/hiking could
produce anything even mildly curious. So I saw the (rather
unique) conjunction of this fall's running efforts as my best
opportunity to get on record how my blood and/or cardiac profile
might look under athletic duress, and pushed my GP doc to get it
done. GLAD I DID, because the numbers as presented might
indicate Very Big Problems (to borrow from Pooh) to any
physician looking it over without that knowledge in hand, and
you could end up cracked open by someone seeking to solve
problems you don't have. (The GP kept admonishing me "I have
never *seen* results like this from someone of your age and
conditioning!" All the warnings from me in the world would not
get through to him, it seems...)

BOTTOM LINE TAKE-HOME POINT:
If you are somehow incapacitated (car accident, illness, etc)
and cannot speak for yourself to explain test results that
indicate major problems, you should have a stress test on file
to support a physician's alternative hypotheses as to your state
of health and the resulting appropriate course of care.

If you want to read more, I can recommend
http://www.physsportsmed.com/issues/2001/03_01/estes.html

http://www.physsportsmed.com/issues/1999/09_99/cant_ans.htm

http://pcvc.sminter.com.ar/cvirtual/cvirteng/cienteng/ceeng/cem3901i/ipellicc/ipellicc.htm

http://sportsmedicine.lsumc.edu/Sports/Soccer/Cites/Cardio.html

Two journal articles, available from pdf.s, from urls that
Google gave up...
"Interpreting the Electrocardiogram" Juvet, Chan, Wald;
University of Toronto Medical Journal, v77n1, December1999.
and
"Physiologic Limits of Left Ventricular Hypertrophy in Elite
Junior Athletes: Relevance to Differential Diagnosis of
Athlete's Heart and Hypertrophic Cardiomyopathy" Sharma, Maron,
Whyte, Firoozi, Elliot, and McKenna; Journal of the American
College of Cardiology, v40n8, October 16, 2002.

These are all fairly decent sources, although my web search has
been pretty time-limited. (And I would welcome your good
sources...) Giving hard copies of these pieces to your doctor,
and insisting that they become part of your medical record,
would be a good idea.

And lastly, and lest anyone think I pooh-pooh the importance of
getting *any* anomoly checked out, I offer the journal of
long-time DRS lister Peter della Famina:
http://homepage.mac.com/contours/_Cardiology/Conclusion.html

Please:
Get your blood/stress ekg on file, be a patient patient, and
run/hike in health.

Sloetoe
(aka "Capt. Beefheart")



=====
Spatior! Nitor! Nitor! Tempero!
   Pro Pondera Et Meliora.

__________________________________________________
Do you Yahoo!?
Yahoo! Mail Plus - Powerful. Affordable. Sign up now.
http://mailplus.yahoo.com