I Think I Broke It
I have a Ferrari 1955 410 Superamerica with a 5.0 liter V12 engine, 335 hp and triple Weber carburetors. I used to drive it really fast, but the years and the miles added up. I had to have the engine rebuilt. The mechanic cautioned me to control the throttle and engine RPMs during the break in period. I wasn’t meticulous about following his advice. There are different schools of thought on how to handle a new engine, I rationalized. In the end, I don’t know if it was my fault or just a coincidence, but the car broke down. I took it back to the mechanic. He was able to get it going again, but he told me that the car should never be driven faster than 55 mph. I have to decide if it is worth owning a high performance sports car, even an old one, that can only go so fast.
Okay, so I don’t really own a sports car, I own an 18 year old Toyota pickup truck. It’s just an analogy. But my all-original body parts were manufactured in the same year as the 410 Superamerica. Recently, my heart required a rebuild of sorts. Broken strands of muscle that provided support for one of my heart valves were replaced with Gore-Tex thread. Soon after, I was feeling pretty good. I was ready to get out on a desert road, open it up, and burn off some of the gunk. My surgeon said, “Let your body be your guide.” Ann said, “Don’t overdo it.” A couple of female friends offered the exact same advice. Two schools of thought on breaking in a new heart.
A few weeks ago I had significant pain in my chest and shoulders. It felt a little like muscle soreness from way-overdoing a weightlifting workout, but I hadn’t touched any weights. My doctor suggested that it was probably pericarditis, an inflammation of the tissue that surrounds the heart. It is apparently a common after effect of surgery. He told me to take over the counter anti-inflammatories, and he told me it would pass. He was right. After about a week, the pain dissipated, and was gone completely in a few days. I began to feel really good. I started running again, tentatively, intelligently, conservatively. I used a treadmill, allowing me to control all variables. I took my pulse at regular intervals. The episodes of arrhythmia seemed to occur less frequently. I felt, finally, that I might be firing on all cylinders. I gradually added volume and intensity to my workouts.
It was about this time that I stopped taking blood thinners, and starting wearing a hospital-issued heart monitor (to be worn for 30 days, 24/7). On my second day with the new monitor I did a 400 meter repeat workout on the treadmill, eight reps with a short jogging recovery period between reps. I wondered if someone was reviewing my EKG readout, and if they might be able to guess what I was doing based on the pattern of my heart beat.
The pain started again the following day. It was subtle, gradually moving from my shoulders to my chest. It became intense if I breathed in deeply. It became worse every day, to the point that I was reaching for the pain killers that they gave me after my surgery, the ones I never had to use.
Did the workout cause the pericarditis, or was it just a coincidence? I’ll never know for sure, but the result was that I felt a lot like I did right after my surgery: weak and fragile. When the second round of chest pains eventually went away, I was terrified of doing anything that might cause them to return. I was equally terrified of forever losing the capacity to run fast. So far, the fear of pain has won out. I have lost all motivation to run. I haven’t even tried to jog since that day on the treadmill.
After the third week on the heart monitor, my cardiologist called me. He’d been reviewing the readout, and he told me that my heart was frequently either in “afib” or “atrial flutter.” This was not a surprise. I was often aware of the arrhythmia, but I did my best to ignore it, and hope that it was occurring less frequently. My doctor was not so confident. “I think we should treat it aggressively,” he said, “because of your age.” Fuck you.*
One option is medication, but he knew I would object to that. That leaves the surgical option, the “ablation” procedure. The upside includes the fact that it is relatively non-invasive, it might not even require an overnight in the hospital, and there is the possibility that it will cure my condition. On the downside, I’ll probably be on blood thinners again for several months, and likely hooked up again to this annoying heart monitor. I’ll know more when I get a chance to meet with the doctor. My cardiologist has made a referral to the surgeon, but I haven’t heard from her yet.
Every day is a gift, and I occasionally need to remind myself of that. The day after tomorrow my 30 days is up, and I’ll have at least a temporary respite from the heart monitor. For the moment, the only pill I take is a baby aspirin. I feel fine walking, even when my heart, like most of the rest of my body, has no sense of rhythm. I’m focusing more on flexibility and balance, things that I often neglected as a runner. I tried bouldering for the first time, and had a blast. I’ll probably go again, before the next round of blood thinners starts. And through all of this, I am grateful to live in a time when medical science can give me at the least the hope of living a long and active life. If only medical science were as proficient as all the women I know at giving recovery advice.
*In fairness, subsequent conversations with my doctor made it clear that his comment about my age was a reference to my relative youth, not the opposite. He thinks the afib will get worse, and he thinks I'm likely to live long enough for that to eventually become a problem.