Sunday, February 20, 2011

Monday Rundown Part 2: Be Still My Beating Heart

Ok, so I don't want my heart to be still, but it could slow the heck down. I have a naturally fast heart rate. My "resting" heart rate when awake is in the 70s. Most athletes run in the 40s-50s. When I did my VO2 max testing, we found that I don't get anaerobic when running until a heart rate of 192. My target heart rate during a race is in the mid-190s. Bottom line, my heart is fast.

Several years ago, I was seen for palpitations. I wore a monitor, and was found to have periodic early heart beats called PVCs (Premature Ventricular Contractions). They are not dangerous, but can be annoying. Each beat after one of these abnormal beats tends to be more forceful, and in people who are symptomatic there is the sensation of your breath being taken away.

Once every six months or so, starting in 2005, I would have a brief episode of SVT (Supraventricular Tachycardia). This is a heart rhythm that is more annoying for me than dangerous, but becomes an issue if it impacts your lifestyle. Once every six months isn't really an issue. Mine was always happening during or after exercise, and always when I bore down or had a "vasovagal" (i.e. bending over to untie my shoes or to stretch). The second I stood up, I went into a rapid heart rhythm.


Working with cardiologists, I have the benefit of running things by a doc. I had decided that it wasn't worth medication or intervention yet. Things went downhill a bit in the past 6 months. It started with IronGirl in August. While treading water waiting for the swim start, I emptied my bladder. (This sounds gross to non-triathletes, but to the rest of us is totally natural). Just the act of bearing down a bit while exerting myself (basically it splits a heartbeat into two heartbeats) caused me to go into SVT. My heart rate went from 120 to the 190s. I had to decide then and there whether to race or not. I decided to try, taking it easy on the swim. Eventually the rhythm "breaks", going back to a normal rhythm. It broke midway through the swim and I was able to keep going.

I had several more episodes this fall and winter....
- Once while doing planks at the gym after a workout. I stood up and there I went. I feel fine in the 190s when it is a normal rhythm, but absolutely crummy when it is abnormal.
- On the treadmill in the gym at work (I was a dummy on this one, because I didn't get an ECG while it was happening even though I was in the hospital. It would have helped me identify the rhythm).
- Christmas Eve while sitting at dinner (after some wine). This is the only time it has happened when not exercising, and took longer to break than usual.
- Once while walking briskly from my car back to my office

This past Wednesday, I went running with my marathon buddy Katy. It was going to be an easy 3.4 mile run outside (it was a beautiful day). We got to the halfway point, 1.7 mi away from work. I had a cramp in my toe, so I put my foot up on a post to stretch. When I put it back down and took a few steps running, my heart was off to the races. Again, I was in the 180s while running and felt like I was pushing it but felt fine. Suddenly I was 208 and felt awful. I tried to jog and hope it would break, but then my arms got heavy and I felt like I could pass out. We walked for a few minutes, then I tried again. I tried to bear down and break the rhythm, but I couldn't. Eventually I decided that I would rather stay in the rhythm and actually get an ECG. We walked/jogged back to work, and I went straight to the ER. I told the ER doc (a friend of mine) that I needed an ECG right away, and then she could register me. I wouldn't sit down until they were ready for the ECG- I actually walked in place to keep it going. (This sounds crazy perhaps, but I hit the point where I needed an answer). So we got the ECG. My heart rate had slowed down to 147, but it was still an abnormal rhythm. We had an answer, and the cardiologists I work with thought they would need to give me medication to convert the rhythm. Thankfully the rhythm broke (which I knew it would). Of course the ER staff was awesome to me, which makes all the difference in the world. Have I mentioned that I love the people I work with? (Thank you Emily, Angela, UJ, Paula, and of course Darcie!)

So I've hit the point where I have to do something. While this isn't life-threatening it is impacting my quality of life. The choices are medical therapy or ablation. I meet with an electrophysiologist (cardiology version of an electrician) who I know and like on Thursday. He is moderate in terms of aggressiveness, which I appreciate. This will be a big decision to make.

Medication: (Beta Blocker)
Pros: Non-invasive, relatively inexpensive each month, relatively effective, may help with my migraines though did not work when I had them as a child
Cons: Cost over time, Being on a cardiac medication indefinitely, lowers the heart rate and the ability of the heart to respond to exercise- this means my heart rate zones may change and it may affect my endurance (other side effects include fatigue, decreased libido, etc....as if being a Mom and working full time doesn't already cause these).

Intervention: (Ablation)
Pros: 95% effective at getting rid of the arrhythmia, No medications needed, curative rather than treatment
Cons: Invasive procedure (a catheter is placed into the femoral vein and fed up to the heart, the irritable tissue is ablated), 1% or so risk of needing a pacemaker (lower risk in people under age 45). I don't know yet what the recovery time is for the procedure, and what it would mean for racing.

So I have a lot to think about. I'm composing my questions for Thursday, and I may give the meds a month before I make any decisions (I started the Beta Blocker last week). Since this isn't life-threatening, just bothersome, I have time to make a decision. Trying to stay upbeat (no pun intended) about this one. I am so thankful for Tommy being supportive through all this, and for Katy who I know was mortified I might drop during our run on Wednesday but didn't get freaked out. Of course I'm doing a crummy job in terms of my "Healthy in 2011" goal, but what can you do?

Monday Rundown: Things That Go Fast

This week's rundown is inspired by some new finds, and the past week's events. On Wednesday I ended up in the ER for my rapid heart rate (6 times in 6 months). I'm doing a whole separate post on this so that I can share some fun stuff. Things that go fast.....

The Athletes at Rev3 Costa Rica:

I can't wait to hear more about this weekend's races in Costa Rica. I have been living vicariously all weekend through the Rev3 live coverage. It sounds like it was a hot weekend, but a great race. Congrats to all the finishers! Trakkers Teammate Andree won her age group in the Sprint, and I am waiting to hear about her Half Iron race today. Trakkers/Rev3 pro Courtenay Brown won the Sprint race overall, and Brian Fleischman and Richie Cunningham has 3rd and 4th place finishes in the Olympic race.

My New Blender:

Inspired by my teammates, I got a blender so I could start making smoothies. My favorite smoothie includes frozen bananas, chocolate protein powder, peanut butter, skim milk, and a cup of spinach. My husband and kids are completely grossed out by the last ingredient, but you honestly can't taste it. I just need to figure out something to eat about two hours later because I am always hungry again.

My New Avia Bolt IIs:

I can't wait to try these out. They came last week on the day I ended up in the hospital, so I didn't have a chance to test them out. I am hoping for a good run this week. They are really lightweight, with a high back to allow you to get them on easily in transition. They are also an awesome red color.

My son's cars on his new carpet:

Many thanks to my dear friend Kathi for "repurposing" some of her sons old toys. My son is loving driving them around...especially because there is a police station, firehouse, and hospital.

How fast I put on my new Recovery Pump when I get home from work:

The Recovery Pump is an awesome compression system which promotes venous blood flow during recovery. It helps with the removal of metabolic waste and lactic acid after exercise. They have been particularly awesome this week after some very long days at work. (This picture was taken during the first use, before they were inflated).

"What Would You Do?"

There is a show on ABC that uses a hidden camera to asses what people would do in an ethically challenging situation. (These include witnessing bullying, having underage kids ask you to buy them alcohol, etc.). I don't generally watch the show, but I feel like our week has been one long "What would you do?". Work was crazy all week- the full moon and lots of sick people led to ridiculous numbers of patients. Some of them were interesting cases, so that made it stimulating.

I blogged last week about our experience coming home from a birthday party and coming up on an accident. We stopped and helped with a little girl who had a bad laceration on her face until EMS and Fire arrived.

Later in the week, Tommy had an experience where he went to pick the kids up from school and saw another father banging on a car window. Tommy went to help. The two of them could not wake up the man in the car (doors were locked). Tommy was ready to break into the car (which was running) to get the man out, when he woke up. When he rolled down the window, it was apparent he was under the influence. He was checked out by EMS to ensure that there wasn't an underlying medical condition (some things like Diabetes can mimic a drunken state), and the police were called. The school administrator was asking Tommy's opinion on what to do. Should they call the mother to get the child. He let them know that under no circumstances should she go with her father. The police dealt with the situation (who knows how many times this might have happened before?!), but I told Tommy how thankful I am to be married to someone who acts rather than walking by. Talking to my good friend (also a Mom at the school), we discussed the fact that we are usually so distracted (thinking about what to make for dinner, getting laundry done, work stuff, etc)that we might not have noticed anything out of the ordinary. I would like to hope I would have seen the guy sleeping in his car, but I don't know. I'm glad someone did, and that hopefully he gets the help he needs.

Then yesterday, we witnessed a road rage incident that could have gone really badly. I was (allegedly) sleeping while we drove home from the playground and lunch. I woke up when Tommy made some comment about someone driving erratically (he said the Mustang ahead of us had passed him "like I was standing still"). Then the guy cut across three lanes to the left turn lane. He was at a red light, and the guy he cut off pulled behind him and threw open his door. The Mustang driver saw in his rear view and jumped out of his car. They were in each other's faces yelling, but jumped back in their cars when the light changed. Thankfully there was no physical violence. Meanwhile, I had my phone out ready to call 9-1-1. Tommy joked that I was ready to tape the fight for Youtube. I can't say I would have jumped in to break up the fight, but at least reported it to the police and let them deal with it.

The full moon has definitely led to some crazy happenings. Last week I mentioned a book that I really enjoyed reading called "The Unthinkable: Who Survives When Disaster Strikes and Why". The main premise of this book is that in a crisis, 10% of people do the right thing, 10% of people do the wrong thing, and 80% freeze. If your brain has never encountered the situation or a similar one before, it doesn't know how to react, and gets stuck cycling through your memories to figure out what to do. It is why people stayed in their staterooms on the Titanic...they didn't know what to do so they froze, why Capt. Sully was able to land his plane so amazingly on the Hudson...because he had practiced what to do. I can't say that I would react in every situation, but I think that Tommy's job as a firefighter and mine as an NP lend themselves to us being more likely to respond. We are used to crisis mode. (Or perhaps it is your personality that causes you to get into a job like that). Regardless, I would like to think we did the right thing when needed this week, and I hope we aren't tested anymore in the coming week. I met a new friend (over a beer with the girls on Friday) who is a teacher. I was decompressing about the week and she said that she would be more than happy to jump in if someone needed an "Emergency Tutor", but aside from that she didn't have much to offer. Sometimes just getting the right help there is the best thing someone can do.

So next time you witness a situation that doesn't seem right....do you respond or do you walk away?

Monday, February 14, 2011

Monday Rundown: A Few of My Favorite Things

In honor of Valentines Day, I thought I would share a few of my favorite things. Some of them are pretty darn obvious, but some are random things that make my life easier, or just plain make me happy. One of these days I need to do a blog of all my favorite tri things (especially after I try out some of our new sponsors' products this season). For now, this is a pretty random smattering.
My Family:







What can I say? My whole family rocks! (I will post all about our Florida vacation soon). Tommy and I agreed years ago not to go overboard on Valentines Day, but the cards from him and the kids make me happier than any gift ever could.

My Team:
Team Trakkers and Rev3 Tri are amazing. I can't wait for another season with these folks. My teammate Andree said it best in her blog: " My teammates?? Hands down the greatest group of people, and your support and encouragement has meant so much to me. It is cool to think that I may never have crossed paths with many, but now can call them close friends." I completely agree. We race together, email and tweet a LOT, and they were there for me through some rough times this fall. I can't wait for the season to start. Rev3 puts on the most family-friendly races out there...I can't wait to check out Knoxville and South Carolina, and head back to Quassy and Cedar Point.



The Hidden Garden Book Club:
This awesome group of women got together ten years ago (starting with a group of people living on Hidden Garden Lane), and we have been having a blast ever since. I am fortunate that my Mom, Sister, Aunt, Daughter's Godmother, and lots of other awesome friends are in the group. Did I mention these ladies helped plan my sister's wedding in 21 days? They are incredible (Laura cooked the rehearsal dinner with my Uncle Rob), Beth baked the cupcakes, Joanne helped with flowers, Nermin interviewed caterers and found the dresses with us, my Uncle Rob and Aunt Marianne hosted the whole thing..... This group of ladies has been there "for better or worse, in sickness and in health", and I love them! (Even if we spend more time drinking wine and eating than actually discussing a book!). Yes, the Cow Hat is an honorary book club member. At the wedding, anyone wearing the hat was sporting "Haute Cow-ture".




My Stylist Tracey:
This chick rocks, literally. She has a side gig as stylist to several of the "hair bands". Her stories are awesome. If you can deal with someone who tells it like it is, Tracey is a blast. My hair is the bane of her existence (as Tommy once described, it is "fine and limp"...we had a conversation about the fact that "limp" isn't a word you use to describe your significant other). It doesn't do ANYTHING. Once a year or so, she gives me the curly look (only she can get my hair to hold curls for more than an hour). I was fortunate that after my cut and highlights this Saturday, she curled it for our tri club banquet. It is fun to have sassy hair once a year! You can check out Tracey and Salon 4 here.


The Unthinkable:

This book may seem morbid, but my co-worker and I actually used this book as a springboard for a disaster preparedness conference at the hospital. I can say with confidence that I think this book is one of the few that might actually save your life. It addresses the science behind why people survive in a disaster, and gives lots of good tips (peppered throughout the text). Did you know that just reading the safety card (no matter how often you fly) on every flight, and counting the number of rows between you and the exit, can increase your chance of surviving a plane crash dramatically? Our book club read it, and I gave it as a Christmas gift to just about everyone one year. Read more about it here.

Erika Robuck:

Erika is a local author. Her first novel, Receive Me Falling, is great historical fiction alternating between modern-day Annapolis and the island of Nevis at the end of the slave trade. She actually came to our book club and discussed it with us. Cooler still, she asked us to pre-read her new novel, Hemmingway's Girl, and provide suggestions. It is another amazing book, and I can't wait until it is officially published.

Washington Post Columnist Petula Dvorak:
Every time I see Petula Dvorak's picture on the front page of the Washington Post Metro Section, I get excited. She is the Carole Sharpless of columnists. Like Carole (my team Mom and fellow blogger), what she writes either makes me laugh hysterically or cry. Petula has kids, and I can ALWAYS relate to her columns about being a Mom, wife, woman.... You can read today's very entertaining column about Valentines Day here.

Wonder Woman:

I've mentioned Wonder Woman's comeback in our house this Winter. The kids got seasons 2 and 3 on DVD for Valentines Day. I love that there is no blood and gore, no foul language, and Wonder Woman is an awesome role model for girls. Can't wait to start watching Season 2!

My Kipling Wallet:

This one seems random, but when my good friend Catherine visited last year I HAD to have her wallet. I ordered one for myself, and absolutely love it. Plenty of space for things, and easy to move from my purse to backpack to wherever. (I've even carried it by itself- the side pocket is large enough for my phone, which is the size of a small laptop). I seriously recommend this wallet for everyone who can't seem to cram their stuff into a tiny one.

Bathroom Dance Party/ Pajama Jammie Jam

Nothing says family bonding like dancing and singing like no one is watching. We have a blast. Now that the kids are getting too big and too old to shower together, we have evolved from Bathroom Dance Party to the Pajama Jammie Jam. We laugh, we dance, we sing (I try). Last night, Tommy was boasting that he knows the boy and girl parts to "Gotta Go My Own Way" from High School Musical 2. At least he owns it. ;) Our favorite song of late is Pink's Raise Your Glass. Watch it here.

Ok...that was more than a few. After a very long and stressful day at work, it was fun to think about some of the people and things that make me happy. I hope everyone has had a wonderful day!

Sunday, February 13, 2011

Wow- What a Weekend

This weekend has been chock-full of some awesome moments and a few sad ones. It has been quite a roller coaster, but I'm very thankful to have spent wonderful time with my family. On the Eve of Valentines Day, I was reminded of what I hold dear. Some friends and family are going through very rough times, so they are weighing heavy in my thoughts.

On Saturday, I went to the memorial service for a patient of mine who passed away. He spent a lot of time in the hospital over the past several months, and we got to know him well. His memorial was a relaxed yet amazing remembrance of his life. He was a joker. Once, when he was ill enough to be in Intensive Care, I asked him how he ended up in Maryland after growing up in New York. His response? "Prison". While I hated to see him in the hospital because it meant he wasn't doing well, I enjoyed visiting him every day. His friends and family shared wonderful memories and laughed a lot. I was glad to learn more about him and the man he was. I feel fortunate for the patients I meet and who often touch my life in more ways than they know.

Today was a roller skating birthday party. My husband was a competitive roller skater as a kid, and I love watching him skate on wheels or blades. I can hold my own, but he makes it look effortless. They allowed bikes on the rink, so our son got to ride while we all skated. It was a harder workout than my trainer ride this morning, but we had a great time.



Heading home from skating, I asked Tommy to swing by Target (of course my list of 5 items turned into 25). We got on route 50 (an eight-lane highway) to head home. This wouldn't be our normal route but we rerouted on our way to Target. After just a few minutes, we saw a sea of brake lights. We came upon an accident (a woman had swerved to miss something in the road, smashed through the guardrail, crossed 4 lanes, and hit the Jersey Barrier). No EMS/Fire were on the scene yet, but there was a State Trooper. Tommy kept driving slowly, and then we saw someone holding an injured child. It has been 14+ years since the days when Tommy and I rode the ambulance together, but watching him with children even back then showed me his compassion and his kindness. So today we stopped. The little girl was 7. She was ok, but had a major (and I mean major) laceration to her face. We worked with other bystanders to take care of her until EMS got there. Another bystander was holding her, and kept telling her that the doctors would use "butterfly glue" to make her better. When Tommy and I talked later, we felt badly that while this person was being helpful, she honestly set her up to feel disappointed when she got to the hospital. Unfortunately, she was facing a lot of stitches.

Another bystander was kind enough to talk to our kids (who were safe in the car)while we were busy. They had a million questions on the ride home. We talked a lot about what would happen if we were in a similar situation, and how if we were ever in an accident and had to go to the hospital in separate ambulances, we would ALWAYS find them. They just need to trust the healthcare providers and police/firefighters to take care of them until we get to them. For the parents out there, this is a good conversation to have with your kids if the opportunity presents itself. (Of course you hope it never happens). Passengers in a car are often separated for transport to the hospital after an accident- letting your kids know that they can trust those taking care of them is vital, especially in a stressful situation.

To decompress this evening, we held one of our favorite activities....the Pajama Jammie Jam. The kids sang and rocked out to everything from Pink ("Raise Your Glass"), to John Denver ("Country Roads"), and Miley Cyrus ("The Climb"). Of course my son was dancing in his Batman cape and his underwear. I am so thankful for the moments when I can just be totally absorbed in my family, and laughing with Tommy about their latest antics.

Whew! Thanks for letting me share....

Tuesday, February 8, 2011

Monday (Tuesday) Rundown: Trakkers 2011

Ok, this rundown is all about my team! Have you ever been a part of something where you look around and think "Wow, I am so lucky they picked me!"? (I actually think that often about my husband, too. He was "the one that got away", and I got him back). Anyway, I digress (and no steroids anymore to blame it on). This team is amazing. Our pros are incredible! You can read all about them here. What always amazes me most is how Charlie Patten and Sharpie manage to create such a team when we are all over the country. Our newbies are incredibly enthusiastic. I am getting awesome tips on training, healthy eating, and lots of motivation from my awesome teammates. So what is new in 2011?

Rev3 partners with the Ulman Cancer Fund:
This is really cool. The Ulman Cancer Fund and Team Fight work to support young adults with cancer. Even cooler, they are based in Maryland. Ulman actually put on the Half Full Triathlon (my 70-mile race this past October). Many of my tri club friends race for Team Fight, and I'm so excited that we get to support them as part of the Rev3 family. Rev3 Provided the timing, bike racks, and other support for Half Full, but they are extending even more support through fundraising, etc. The enthusiasm around this with our team and Rev3 is incredible.



Rev 3:
On top of amazing philanthropy, Rev3 puts on incredible races. I CAN'T WAIT to race and volunteer. Thanks to my awesome teammate Laura, I am planning some serious road-tripping this season.
We are driving to Knoxville in May, and Anderson, SC in October, plus Laura's home turf for Quassy (CT) in June. (Not to mention my road trip to Cedar Point in September). Lots of driving and lots of fun. (Many thanks to my hubby for supporting these adventures).

New Kicks:
Our team shoes will be from Avia this year. They have some seriously snazzy running shoes. I ordered my first pair of Avia Rhythm running shoes to test out as a training shoe (I am long overdue, and while I found great racing flats last year I didn't ever find an ideal training shoe).


My Training:
This is still a slow-but-sure process. Off of the steroids I was taking (think "sinus infection", not "doping scandal"), my knee is starting to ache some. I'm thinking I pushed a little too much when I was on the steroids and feeling great. I got in my first swim in two months today, I'm up to 120 minute indoor trainer rides (though it was a bit more painful this weekend), and 4-6 mile runs. It still isn't as consistent as I would like, but I am making progress. I went ahead and registered for Rev 3 Quassy, Cedar Point, and SC, so I'm hoping things continue to progress.