FALSE START #K - MARCH 2016 by David E. Ortman

A Real False Start

In July 2013, I won the National Senior Games (Cleveland/Berea) 400m in the M60 world leading time of 56.78. Nineteen months later, on February 3, 2015 (and ten days before I was scheduled to join a Syracuse Chargers Track Club M60+ 4x4 Relay at the Millrose Games in New York City), I was hauled off by ambulance due to a heart attack. A heart attack is a real false start. In fact you don’t even get to get in the blocks.

The Past
For decades I've had very brief episodes of chest, neck, and jaw tightening. It lasts about 10-20 seconds or so and may occur once every year or two, but never during any athletic event (or I would have cranked up the alarm bells). This happened when I was sitting quietly and after 10-20 seconds went away. (This may or may not have been something called inactive angina). I’ve also had an erratic heart beat to the point where the Red Cross wouldn’t let me donate blood. There is a long history of heart attacks and strokes on my father’s side of the family, so none of this was a surprise. I’ve had a 24-hour EKG monitor, as well as a stress-test with negative results. Before our son was allowed to participate in high school athletics, he had an echocardiogram, to check out his heart irregularities. I was not on baby aspirin (although I am now), but would recommend asking about this with your doctor.

The "Event"
Super Bowl Sunday, 2015. For the first time the very same chest and jaw tightening hit me while jogging and lasted a bit longer. But by the time I walked home and laid down for a bit it went away. I went to a Super Bowl party and things seemed back to normal. Monday was fine. Tuesday, I went up to the community center to work out and after about a minute on the treadmill, all these same symptoms hit with tightness in the chest. But this time the pain level kept rising. I managed to walk five blocks home, and again, it seemed to dissipate. So the symptoms were identical to what I've experienced off and on for short periods for decades, but again, this time it was while exercising, and it lasted a lot longer and hurt a lot more. But when I got home I pretty much laid down on the couch to see if it would pass. Our daughter came home from work and went into a slight panic given my pale look. After an unsuccessful attempt (of course) to contact my own doctor, I finally got a hold of a consulting nurse, who advised calling 911. I popped an aspirin and told our daughter to make the call. The sirens arrived with the medics and fire fighters (apparently there are so few fires in Seattle that all fire fighters are sent out on every 911 call just so they don't get rusty), and hooked up an EKG machine. They determined that I was having an "event." They shifted into high gear, lifted me out of the house, into the Medic van and off we went - straight to the Cardio Unit at Virginia Mason. They found a 95% blockage in the heart artery (although someone pointed out that it always seems to be a 95% blockage). The other two arteries looked o.k. In other words, this was the classic heart attack. In medical verbiage, the blockage was in the Left Anterior Descending (LAD) artery, also known as “the widow maker.” An attempt to insert a catheter in the Radial wrist artery was unsuccessful. They then switch to the groin Femoral artery and were able to thread a catheter up to the heart and install a stent. The procedural was done with only local anesthesia at the point of entry. At no time did I feel any movement or indication that something was being inserted into my heart. The heart imaging before and after the stent are impressive and show what happens to the heart muscle when blood supply is cut off. After two days in the hospital I was sent home with a drug regime and told I could do “brisk” walking. Four days later I flew to WA D.C. and did a lot of “brisk” walking around our nation’s Capitol.

The drugs included: Aspirin 81 mg 1 in morning

Clopidogrel 75mg One in morning (for a year). Clopidogrel is a blood thiner and lowers the change of blood clots. Possible Side Effects: Bleeding which can be serious and sometimes lead to death.

Lisinopril (initially 2.5m, later upped to 5.0 m) One in morning. Lisinopril is used to treat high blood pressure. Possible Side Effects: change in thinking clearly and with logic; feeling weak, lightheaded, or dizzy; shortness of breath; upset stomach or throwing up; deadly liver problems; headache

Metroprolol 25 mg (initially 0.5 tablet twice a day, later changed to 25 mg – 1 in morning Metroprolol is used to treat high blood pressure. Advisable to avoid alcohol. Possible Side Effects: Depression; change in thinking clearly and with logic; memory problems; bad dizziness or passing out; slow heartbeat; shortness of breath; feeling tired or weak ; throwing up

Atrovastatin 80 mg One in evening. Astrovastatin is used to lower cholesterol. No breastfeeding; No grapefruit juice. Advisable to avoid alcohol. Avoid foods that are high in fat or cholesterol. Possible Side Effects: Feeling very tired or weak; muscle pain, tenderness, or weakness; bad and sometimes deadly liver problems; upset stomach or stomach pain; joint pain.

Nitroglycerin 0.4 mg if needed for pain

Also, unprescribed Co-Q10 (100 mg) for the first four months and continued intake of fish oil (1000 mg) for the placebo effect (I’m a big believer in placebos). My medical drug regime could be labeled performance reducing, certainly not performance enhancing. I lost 15 pounds after the first month. Do I need a TUE for any of this? After bumbling through the WADA wesbsite, I finally had to call them up and have them look up each drug. Only Metoprolol (a betablocker) on the WADA website comes up for archery - but not track and field.

Prior to the heart attack I would run my sprint repeats when my heart rate dropped to 120 bpm. After the heart attack, I couldn’t get my heart rate above 120 bpm, no matter how hard I ran.

After three months, I had an echocardiogram, which seemed to show no obvious heart muscle damage. After a year, I was taken off all but the aspirin and Atrovastatin, as the blood pressure meds had driven my blood pressure down to 54/40. I noticed that it took at least 10-15 minutes to get "warmed up" during training,likely due to the blood pressure meds. Perhaps this will go away, now that I've been able to ditch the blood pressure meds.

Were there any heart attack indicators? It is hard to tell. After the July 2013 National Senior Games in Berea, OH, where I won the M60 LJ, 2nd in the HJ, and won the 400m (during which I strained a hamstring) I was not able to properly train for the 2013 WMA-Porto Alegre (Brazil) championships in October (although I did place 2nd in the M60 HJ and 4x400m Relay, 4th in the 300m Hurdles, and 5th in the Long Jump).

In March 2014, I came up just 16 points of the American Record in the M60 Indoor Pentathlon in Boston. A subpar 1000m in the last event was disappointing. During summer 2014 meets, my 100-200-400 times also seemed subpar, although moving up the age ladder is certainly also a factor. In 2015, I was working my way back into shape for a Millrose (NYC) M60+ 4x4 relay and the March Indoor Nationals in NC when I got decked on February 3.

A Year Later
After discharge from the hospital and some recuperation, I started with some summer all-comers meets and by August was able to get my 300m Hurdles time down to 46.88, 6th best M60 time in the world for 2015. Much to my delight, the Syracuse Chargers Track Club M60 relay team members that I had to call shortly before the 2015 Millrose Games to tell them I was in a hospital bed, invited me back for the 2016 Millrose Games. Thanks to Mark Cleary and USATF, the Millrose Games masters 4x4 relays are part of the Masters Invitational Program. So on February 20, 2016, a bit more than a year after my heart attack, I was in New York City at the Millrose Games, running lead-off in the M60+ 4x4 relay. I ran a 62.30 leg (not as fast as I had hoped, but the fastest leg of all five M60+ teams). Two weeks later, I was able to win the M60 200m, take 2nd in the 60m, 3rd in the high jump, and 4th in long jump at the 2016 National Masters Indoor Championships in Albuquerque, March 4-6. But times and places don’t matter nearly as much as just being able to run and jump in the first place.

The Future
Just as we continue to see amazing performances by masters athletes with hip and knee replacements, it turns out there are other masters athletes competing with defective hearts. One M70 Albuquerque athlete, Roger Assink, was profiled in the March 6, 2016 Albuquerque Sunday Journal. In 2009, Assink, who did not run track in either high school or college, had heart-bypass surgery, due to 90 percentage arterial blockage. He did not have a heart attack. Rather, his blockage was discovered by tests during recovery from broken bones sustained in a softball collision. Assink took a bit longer to get back on track, taking 2nd in the M65 200m and 3rd in the 60m at the 2011 Masters Indoor Nationals and 3rd in the M70 200m and 4th in the 60m at the 2016 Masters Indoor Nationals.

I know several other masters athletes who have problems with their “tickers.” Perhaps we all should be wearing T-shirts that say, “I Track and Field. Not Dead, Yet!”

(c) Copyright 2016, David E. Ortman

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