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fat buddha




Joined: 13 Jul 2004
Posts: 2546
Location: rural Zuzzex

PostPosted: Thu Jan 24, 2019 12:26 pm    Post subject: Reply with quote

hi Laufmann - apologies for my slow reply but I've been away skiing and only got back yesterday.

reading your symptoms, it does sound like it could be AF but there are many heart imbalances and many have different symptoms. a good way of checking if it's AF is the following - a) do you have extended periods of irregular HR (arrythmia) like a heart flutter?, and b) if so, monitor your HR over a period and if it's jumping all over the place then it's very likely to be AF. an ECG would be the easiest diagnosis - so I would HIGHLY recommend you go see your GP at the earliest to discuss in more detail and get some tests done nipping it in the bud now will prevent a stroke possibility - I ignored the symptoms and ended up with one - and believe me, you don't want that.

from my view, I'm much better now. I had a cardioversion done in March which put my heart back into normal sinus rhythm and it's stayed that way since so I am now AF free. getting back to my previous fitness levels is hard work but getting there slowly. I'm still on the drugs but discussing the regime with my GP at the mo (follow up on Monday).

I also had a follow up echocardiogram in late December and my left ventricular function has now normalised although my left atrium is still slightly dilated but better than the previous echo.

so - in summary - please go get yourself checked out asap. you really can't afford to feck around with possible heart problems or they'll jump up and bite you hard.
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Laufmann




Joined: 17 May 2010
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Location: Peak District exile

PostPosted: Sun Feb 03, 2019 4:50 pm    Post subject: Reply with quote

Hi FB, my turn to apologise for delay in replying.

Glad to see you are making progress. Have noticed your comments over the years and a declaration a while back about a return to racing, which I assume was somewhat compromised by what you have been through.

I am being checked out, as even my head in the sand, "I have been to the GP once in the past 13 years, I am sure I am ok" attitude, had a reality check since I posted. I was doing a 10k race and as usual started sprightly and feeling perfectly ok. 1.5 k in and the switch went off. Stupidly I carried on, hoping that I would recover at some point as I had done in the past. I didn't. It was the most difficult race I have done for years (12 min miling seemed impossibly hard!) and could barely speak at all at the finish. I felt pretty bad for the rest of the day, but have been fine since. However went straight back to the GP & was at the hospital last week. ECG slightly peculiar, but poss peculiar to me rather than anything to worry about. But everything combined was enough for me to be having scan & ultrasound in about 6 weeks. So just have to wait for a date to come through, and been told to cut back on the running for now and not to book any iron distance races.

Not sure I am ready to put my feet up just yet, so hopefully it will not come to that.
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fat buddha




Joined: 13 Jul 2004
Posts: 2546
Location: rural Zuzzex

PostPosted: Mon Feb 04, 2019 12:12 pm    Post subject: Reply with quote

Hi Laufmann

Good to hear you're being checked out - hope all goes well for you and whatever is causing the issues isn't that bad - just be bloody careful and if you notice any issues when training stop.

Quote:
Stupidly I carried on, hoping that I would recover at some point as I had done in the past. I didn't. It was the most difficult race I have done for years (12 min miling seemed impossibly hard!) and could barely speak at all at the finish.


Here's a tale. A guy I worked with was doing a 10mile off road race at the end of 2016 - fit as a fiddle and very able (sub 1:15 half marathon), aged 40, no previous history of illness - and 9.5miles in he collapsed with severe chest pain. He was lying 2nd - picked himself up and carried on - and finished 5th. Then collapsed again, vomiting, and St Johns started to look after him. A little later his partner finished her race (3rd female), took one look at the guy and instantly called 999 - she just happens to be an A&E sister and recognized the signs of a heart attack. Within an hour he was at a local major hospital having a stent inserted into a cardiac artery - he was lucky that the hospital was within 15mins of where this happened, or he might have died. Loads of follow up investigations and no absolute cause for why it happened. Lucky lucky boy!! He's back running but has given up the intensity of racing - he just mentally can't face it.

For me, I'm not sure I'll race again as I'm sure I can never get back to the fitness I had a couple of years ago - if I can't compete to the standard I want, I won't race. I gave up playing rugby at 40 'cos I didn't want to slowly go down the teams - I was still playing 1st XV and never saw myself seeing my days out in the 2nds or 3rds so gave up. The same with triathlon - no compete, no race. I'll just focus on keeping fit and enjoying triathlon from a TO point of view - giving something back as a ref.

my drug regime has changed - different beta-blocker (previous was making we wheeze when exercising), lower dose of statin (my cholesterol is 2.9!), and a different once-a-day anti-coagulant (saves the NHS a few quid but still gives me protection). in time, the beta-blocker and statin may go, but the ant-coag is there for life.
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Laufmann




Joined: 17 May 2010
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Location: Peak District exile

PostPosted: Tue Feb 05, 2019 7:48 am    Post subject: Reply with quote

Certainly food for thought, and genuinely making me check my attitude, so thanks.

On a good day, I feel like I did before, and the part of my brain that sees a major part of my identity as an athlete (reinforced by all my non athletic friends' attitude of part admiration, part incredulity of the stupidity of doing things like iron distance races), wants to tell me that it was just a blip which I have now got over. I have always told friends and particularly aged relatives, who insist my activities must be bad for my heart, that I have been competing hard for so long, that if there was any problem, it would have been found out by now. But I guess that is the point of your cautionary tale; you are alright until suddenly you are not.

It will be hard to let go, if that is what has to happen. I am not particularly keen on road marathons, and having got my sub 3.00 at London (which always had a very special atmosphere) in my 40s, I decided I would not do it again until I was in my 50s. They came and went without me entering. Last year I decided to do a one-off marathon again instead of part of a tri, and got well inside the qualifying time. "London, here I come" (2020), I thought. But maybe not. Less than a month later, I had the first serious episode (the previous incidents had been fairly transient and easy to ignore).

So I am not making any assumptions yet, and will wait to see what the outcomes of the tests are, and back off intensity in the meantime. I will do what you advise, and what I have not done in the past, just stop if I have an episode when running. So thank you for the voice of reason.

I can see how that medication regime of yours would compromise your performance as I assume that would result in less haemoglobin and a reduced delivery system. I think I would be able to continue to enjoy the activities if I end up in the same situation, but have always found the focus of races a good motivation to get me off my arse and out into the cold etc. Maybe it will be time for me to give back a bit more too; certainly a bit more marshalling in the meantime.
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Lloydy75




Joined: 21 Mar 2013
Posts: 112

PostPosted: Tue Feb 05, 2019 5:50 pm    Post subject: Reply with quote

I came across this thread as doing a bit of research as I've went into AF about 3 weeks ago. I was hoping it would go away but it didn't and I'm 53 and have been at this endurance stuff for years.

I was going to have a cardioversion straight away but we couldn't quite pinpoint went it started as it didn't happen during a training session so they aired on the side of caution and I'm able to have it anytime from tomorrow. I had all the scans and they said physically the heart is fine it and it's an electrical problem and should be able to resume my normal training but with the research, I've done I know there's a good chance of it returning.

My resting Hr elevated to between the mid 50s to mid 60s, 63 as I type, and around 90-100 walking around. I'm on a daily anti-coagulant.

I was recommended a brilliant book, The Haywire Heart: How too much exercise can kill you, and what you can do to protect your heart.

Anyone reading this, if you have any symptoms get them checked out!
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fat buddha




Joined: 13 Jul 2004
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Location: rural Zuzzex

PostPosted: Wed Feb 06, 2019 3:20 pm    Post subject: Reply with quote

Quote:
I can see how that medication regime of yours would compromise your performance as I assume that would result in less haemoglobin and a reduced delivery system. I think I would be able to continue to enjoy the activities if I end up in the same situation, but have always found the focus of races a good motivation to get me off my arse and out into the cold etc. Maybe it will be time for me to give back a bit more too; certainly a bit more marshalling in the meantime.


the beta-blocker makes the heart beat more slowly so at high exertion you can't really deliver sufficient oxygen (via Hb) to allow the muscles to work at a rate they'd like so you basically run out of steam. it's a bugger but rather that than any other issue. the anti-coag just reduces stroke risk but has the side effect of a greater risk of bleeding out in a major trauma - so I need to be more careful cycling (in case of fall) or around power tools and sharp things! I carry a medic alert tag in case of accident.

you could always give back a bit by becoming a TO?? it's not a bad way of staying involved - we (Mrs FB is also one) enjoy it and now gives us the chance to get to major international events (went to the World Final at Gold Coast last year on the TO team).
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fat buddha




Joined: 13 Jul 2004
Posts: 2546
Location: rural Zuzzex

PostPosted: Wed Feb 06, 2019 3:32 pm    Post subject: Reply with quote

Lloydy75 wrote:
I came across this thread as doing a bit of research as I've went into AF about 3 weeks ago. I was hoping it would go away but it didn't and I'm 53 and have been at this endurance stuff for years.

I was going to have a cardioversion straight away but we couldn't quite pinpoint went it started as it didn't happen during a training session so they aired on the side of caution and I'm able to have it anytime from tomorrow. I had all the scans and they said physically the heart is fine it and it's an electrical problem and should be able to resume my normal training but with the research, I've done I know there's a good chance of it returning.

My resting Hr elevated to between the mid 50s to mid 60s, 63 as I type, and around 90-100 walking around. I'm on a daily anti-coagulant.

I was recommended a brilliant book, The Haywire Heart: How too much exercise can kill you, and what you can do to protect your heart.

Anyone reading this, if you have any symptoms get them checked out!


AF is pretty common amongst endurance athletes for an, as yet, unknown reason but we usually survive it better as our hearts are in better condition than couch potatoes and once you're out of AF you can carry on but maybe at a reduced level after a period of re-adjustment.

I had my cardioversion back last March and am now in normal sinus rhythm, so for me, CV seemed to work OK - for many however, it does fail and AF returns. the fall back if more intervention is required is ablation but hopefully I can avoid that. I had a follow up echocardiogram done in December and the conclusion was that my left ventricular function is now back to normal, although my left atrium is still dilated but less so than the last echo and it's very very unlikely it will return to normal now. all good news really.

there is quite a useful online forum for AF - https://healthunlocked.com/afassociation - although it's populated with those who are usually worse off than us simple cases of AF and either need continual intervention and/or varying drug regimes. it can be pretty depressing in there so after an initial period on there doing research about what happened to me, I don't go there now.
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Laufmann




Joined: 17 May 2010
Posts: 175
Location: Peak District exile

PostPosted: Wed Feb 06, 2019 9:40 pm    Post subject: Reply with quote

Lloydy75 wrote:
I'm 53 and have been at this endurance stuff for years.


fat buddha wrote:
AF is pretty common amongst endurance athletes for an, as yet, unknown reason


I have seen this in relation to AF, and that there is a higher incidence in older endurance athletes than would be expected. But I wonder about this. I might not have AF as have some testing ahead of me yet, but symptoms are very similar to those described; going fine and then power switch abruptly turned off. In normal life I am fine, and I presume most of the AF athletes are too. In other words, without the high intensity exercise, non the wiser, and if the problem was going to be come out anyway, it would probably be when somewhat older. So not necessarily as a result of the years of exercising, it could be the exercising just shows what would be there anyway for some people as they get older. Also, it is a relatively recent phenomenum for people to be competing seriously into their 50s & 60s and beyond.

Thanks for the references.
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fat buddha




Joined: 13 Jul 2004
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Location: rural Zuzzex

PostPosted: Thu Feb 07, 2019 10:58 am    Post subject: Reply with quote

Laufmann wrote:
I have seen this in relation to AF, and that there is a higher incidence in older endurance athletes than would be expected. But I wonder about this. I might not have AF as have some testing ahead of me yet, but symptoms are very similar to those described; going fine and then power switch abruptly turned off. In normal life I am fine, and I presume most of the AF athletes are too. In other words, without the high intensity exercise, non the wiser, and if the problem was going to be come out anyway, it would probably be when somewhat older. So not necessarily as a result of the years of exercising, it could be the exercising just shows what would be there anyway for some people as they get older. Also, it is a relatively recent phenomenum for people to be competing seriously into their 50s & 60s and beyond.

Thanks for the references.


you could be right there about the underlying problem is waiting to happen if you overwork the heart as you get older. there have been various US studies done that seem to intimate that high intensity exercise is not good for cardiac health in older athletes but the results seem to be fairly inconclusive. and I think in comparison to the general population, us athletes who develop AF are still in the minority so it may not be seen as an important area for research.

whatever the cause is, it's a bugger when it gets you so I guess all we can do is advise is that people keep an eye on their heart and if in doubt, go get checked out.

at least as my cardiologist advised, while I stay on the drugs I'm "safe" - it's if I stop them that I would have problems.
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Lloydy75




Joined: 21 Mar 2013
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PostPosted: Thu Feb 07, 2019 5:39 pm    Post subject: Reply with quote

Defo need to get checked out with any of the symptoms.

And that book, The Haywire Heart shows many examples of top athletes that have had conditions and some chose to carry on with some serious consequences.
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Cotswold 113 14
Ocean Lava Wales /Lanza 14 18
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fruit thief




Joined: 18 May 2006
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PostPosted: Thu Feb 07, 2019 10:28 pm    Post subject: Reply with quote

Have just bought the haywire heart - thanks for the recommendation.

Edit, just finished reading it. It's quite technical, I think you'd have to be interested in the subject personally or professionally to enjoy it. I found it very thought provoking- in 40s and 50s might high level exercise stop being healthy and start being unhealthy?

Almost all the athletes in the case studies in this book say they think they did too much volume, for too long, at too high intensity. And often while dealing with stressful jobs- burning candle at both ends. However there were no balancing interviews with athletes who have not developed heart problems. And in my work I see a lot of people with heart rhythm problems who have never been near a pair of running shoes. So I'm still open minded.

Personally can see sense in a shift away from competitive towards health-oriented aspects of exercise as age advances, think this is how I may play it. Like Zinn says, the only people who care about your time as a masters athlete, are other masters athletes.

Anyone else thinking this way?
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Laufmann




Joined: 17 May 2010
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Location: Peak District exile

PostPosted: Sat Mar 02, 2019 7:04 am    Post subject: Reply with quote

fruit thief wrote:

Personally can see sense in a shift away from competitive towards health-oriented aspects of exercise as age advances, think this is how I may play it. Like Zinn says, the only people who care about your time as a masters athlete, are other masters athletes.

Anyone else thinking this way?

Not sure that any of my non competing friends have ever been bothered by my times at any age. I have always enjoyed the activity for its own sake, but the focus of a race is very motivating. I am not sure that I would want to just participate in a race instead of competing in it. But I might be forced to re-evaluate when my tests are completed...
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