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Tuesday, April 8, 2008

An ultra runner in the emergency room


I have been battling with a chest infection for the last month. I finally seemed to be winning after a week of antibiotics and even having the chance to run a 20 miler on Saturday. The run was slower than normal but it was fun to be out in God's creation running with friends. Sunday was a casual family day with church and hanging out with friends.

Then on Monday, when biking into work, I had sharp pains on the left top part of my chest. Hmmmm. Lasted for about a minute and then faded away. Deep breathing made the pain worse.

This repeated around 11 am. Thought nothing more about it. Did a casual lunch run with my running buddy Rick with no issues. Finished up my work day and prepped to head to the kid's track practice, when I was hit with the pain again. Then I made the first of my mistakes: I looked up the symptoms on-line :-)
With the symptoms and with just finishing the antibiotics for the possible chest infection, the web MDs were telling me that I might have an infection of the pericardium (the sack around the heart) called pericarditis. Not good from what I read. So trying to be responsible, I phoned Trisha and then phoned the doctor's office. Relayed my symptoms and was informed to head to emergency room...bummer.

My running buddy Dave gave me a ride to the ER, and I once again tell my little story and very quickly I am sitting down getting my vitals taken. Everything seemed to go well: normal blood pressure and heart rate...for me. And therein lies my next mistake: my normal resting heart rate set off all kinds of alarms for the triage nurse. My resting heart rate is 38-41 bpm. 10 years of distance running will help do that for you :-) This worried the triage nurse (bradycaridia) but we never talked about me being an ultra runner. The result: back into the bowels of the hospital with a nasty hospital gown on. EKG was next, then a chest x-ray and blood work. From the x-ray, the doctor could see that I have an enlarged heart. The doctor knew at this point that I have done a fair bit of running but he could not tell whether my heart was enlarged from the exercise or from an infection. So we finished off with an echocariogram: an ultrasound of my heart. This was really cool to see my heart valves in action and, using Doppler, the blood moving around the four chambers.

Test results: no pneumonia, no infection or swelling of the heart, no leaky valves, no anemia, and minimal heart enzymes in the blood (no heart attack). Nothing. Just got to take my health insurance out for a spin.

So what caused the chest pain: likely a irritation of the lining of my lungs possibly from the infection...nothing conclusive. What to do about it: nothing really. Rest for a couple of days and take some Motrin/Advil. Running is fine and running the Boston marathon poses no risk.

The short of it is that I have a very healthy, enlarged heart with a low resting heart rate. And I have learned my lesson to always state right up front that I am an ultra runner if I ever go to the emergency room again.

9 comments:

Brian Eberly said...

Whew!!!

Corriedawn said...

I've had the same experience with a low resting heart rate and very low blood pressure.. when I am running a lot its regulary 80/50.. normally its 90/60.. so when I passed out last summer in the lobby of OHSU, the paramedics almost had their own coronary when they they checked my vitals.. I never did find out why I passed out, but I did remember to tell them I was a runner, so was able to bypass the ride to the ER (it might have helped that I was wearing my Hood to Coast t-shirt) and by the way, I was at OHSU having my son's cast removed, not for my own medical condition..

Glad to here you are fine!!

Corriedawn Greiling-Fritsch
Portland, OR

Christian said...

Few years ago I laid down for bed and had terrible chest pains. Short of it is I called Ask a Nurse, told them my symptoms and was told those are signs of a heart attack, head straight to ER. I told them I was a long distance runner, very healthy, I am sure it was something else...I was told heart attacks don't play favorites, get there ASAP!

After a check of the vitals, and an EKG I was released with a heavy dose of Ibuprofen and a case of pericarditis.

olga said...

I set up a few alarms when was doing a medical procedure 3 years ago and on all kinds of machines hooked up. They eventually had to turn off the sounds on those machines (too annoying, long procedure). Had to laugh about 38 bpm.

Nick Edgar said...

Glad to hear you're OK.

Rooster said...

Every time I do something like this Bill asks me if I am looking for attention. :) Ha, ha, glad everything is good and your on the mend for Boston

Darin Swanson said...

yep...I need to find faster and cheaper ways to get extra attention :-)

Matt said...

Darin, glad you're still among the living.

I had a pretty nasty case of pneumonia last year that knocked me out after Mac Forest, complete with chest pain (pleurisy?) that almost knocked me out at mile 20 (until a handful of Advil brought me back, which was probably a bad idea in hindsight).

I still have some residual pain that flares up occasionally after or during a hard run. I think even after the infection clears, there can be some residual swelling, and/or perhaps some residual tissue damage that can cause some swelling and painful rubbing between lung and other tissue. For me it's usually worse if I get dehydrated, which makes sense.

Several times it's freaked me out enough to go back to the doctor. Usually after a web-search on my symptoms too. :-) Three days before Hagg Lake this year the pain got really bad, after an easy six miler, and I was freaked out, back in the doctors office, getting a chest x-rays and blood work and the like... After all that the doctor said I was fine, and advised to take a couple ibuprofen and enjoy the run. I magically felt a lot better after that.

BTW, when I had pneumonia (infection in the lungs) I had a nasty fever and my resting heart-rate was above 80 BPM. The heartrate didn't set off any alarms with the doc until I explained that this was 2x normal. :-)

rick said...

Good advice on letting the doctors know about the long distance running thing. Godspeed on Boston. Thanks for stopping by. Yes Olga does need to learn the use of sunscreen but I doubt she'll listen.