Heart Attack to 10K (part 4.4) - Falling heart rate: fitter or hibernation?

PART 4.4 - FALLING HEART RATE: FITTER OR HIBERNATION?
(Phase VI - sustaining a healthy life-style)

"Nothings going to happen unless you make it happen."

I didn’t really have any intention to continue with this blog beyond the first year but like in real life, my fitness campaign keeps rolling on so must the chronicles (or so I’ve been told by my blog fan). 

Picking up from where we left off, my next parkrun on 3rd Feb. became a bit of a ground breaking occasion. It all started like any previous – a combination of jogging and walking when feeling the onset of angina but suddenly at about 3km I picked up a fairly comfortable stride and managed to keep going for the next 1km without pulling up when a fellow runner saw how I was pushing myself and offered to help me to the finish line.

We jogged the last 1km together and finished in 33:09, just 18 seconds behind my best time. At about 2km this was the longest distance I had ran non-stop since starting parkrun and having a running-buddy really helped me to find a more steady pace as well as giving me the drive to carry on. We arranged to meet the following week where he promised he could get me all the way around without stopping, I doubted this as I had already been trying to increase the length of my jogs and failing but I am really pleased that Andy King went on to prove me wrong.

That afternoon was the 6 month reunion of FFIT team 1 [see part 4.1] so we all descended on Adams Park to watch the mighty blues take on Carlisle United from the comfort of a box provided by WWSET – and what a classic match that turned out to be. But before all that we had to have our weigh-in and belly size measured (to check we hadn’t strayed from the straight and narrow) and it was quite pleasing to hear Sam’s exclamations of surprise as she logged down my reduced measurements. In the match Wycombe scored two quick goals in succession to take a 2-0 lead into half-time but early in the second half the game was turned on its head when Luke O’Nein got sent-off for hand ball (come on ref, that was ball to hand surely!!), Carlisle score the resulting penalty and take control of the game, two further goals put the visitors 3-2 ahead and in the driving seat as we go into injury time but up steps Paris Cowan-Hall with a diving header with just seconds to go 3-3! .... But it doesn’t end there, that is almost forgotten as in the time added on to the time added on Marcus Bean, (who never ever scores) lashes home an unstoppable volley from just outside the area! – The stadium goes berserk as Bean takes off down the line running in a bouncy motion waving his arms to a position right in front of where we are all sat, the rest of the team eventually catch up with him and pile on top. It was a moment to remember and a fitting end to a really good day where the new friendships found through FFIT were once again reunited.

Match highlights .... click here

It was time to visit the Urologist who again seemed happy with the MRI result, my blood test came out at 6.0 which about my average (or stable as they put it) over the last few visits and the only thing of note was another appointment in 3 months’ time.

For the next parkrun I again met up with Andy King and took a whole new approach to the run going more for endurance rather than speed, attempting to get around the course without stopping for the first time. We started near the back of the pack and let all the runners’ pull away while we set of at a gentle pace. We continued at this steady pace up to the 'steps of doom' (a steep bank about half way around) where Andy allowed me to walk up the side and for the stretch of a few yards along the top of the bank where I could catch my breath from the exertion of climbing the slope. From there we picked up the pace slightly and with Andy driving me on, completed the course in 36:04. This was my 4th slowest time on the 12 runs so far but the 1st I could really consider as a non-stop run! Andy is yet another inspirational person I can add to the growing list of people to have helped me over the past year since my heart attack and I am totally indebted to him for driving me on and giving the belief that I am capable of jogging 5km, when I start slacking on my own I just imagine him running alongside giving it a lot of verbal abuse encouragement!

Since that run I have further fine-tuned my preparations and jogging methods and came up with the following advice for fellow angina sufferers:


RUNNING WITH ANGINA:

This is a routine I have come up with to suit my own condition since I first started parkrun back in last Oct., at that time I was running until I got angina, walking until it went and repeating all the way around. I can now jog the full course keeping just below my angina threshold and by pacing myself, regularly achieving new PB’s.

Following a light breakfast and medication, I start the day with gentle warm-up exercises and stretches at home before going down to the parkrun, Katie on Wycombe Sound radio usually plays music that is perfect for this and all the while not forgetting to drink plenty of water. I normally street park so that I have to walk a distance to the start and arrive on the Rye about 8:30. This allows me to acclimatise to the weather conditions, particularly during the colder spells, and I like to keep moving & stretching once there, I have usually done about 3000 steps before the run.

My target is to jog the course non-stop (and try to beat that elusive sub 30 minutes), I start towards the back and at a reasonable/easy pace. It usually takes me about 1.5km to find a good running/breathing rhythm but once found I like to keep going and then gradually build up the pace overtaking the slower runners around me. There are a few gentle slopes on the Rye course, I take these easy but try not to stop. The only place I will deliberately walk is at the steps (just over half way around) where I walk up the bank to the side of the steps, at the top I will take my first puff of GTN spray to help recover from the exertion and start jogging again trying to pick up the pace for the last 1km, I will use the GTN spray again by Bassetsbury Manor to allow for the final hard push to the finish. I may have other puffs if I start to feel the onset of angina but otherwise prefer to avoid it and rather regulate it by slowing my pace slightly until feeling the pain ease. 

If running on my own I don't check my time on the course or set time targets. I will run to the best of my ability and feel that by checking the time would just put extra pressure on me to go faster especially if the time is looking good. However I will start the clock at the start and stop it at the finish, only checking it once I have recovered from the run. If running with Andy, he will take time checks and regulate the pace to try and get the best time, is does tend to make me run to my limit though.

It is a definitely an advantage if you can find a good running buddy, some-one who can motivate and pace you. I have been lucky in meeting up with Andrew King who helped me achieve my first non-stop run simply by slowing the pace, once cracked I have continued the non-stop runs but with improved finishing times, again Andy can get that bit extra out of me. Another good tip from Andy is break the run into smaller chunks (especially in the later stages), aim for the next tree/bench/litter bin or whatever, when you reach that then aim for the next one. 

An offshoot to the parkrun is that I set-up a WWSET-FFIT running club and now have some 11 runners signed-up who take part in the Wycombe Rye parkrun and I believe more in other local runs. It’s not that we meet and pound the streets in the evening but every time a runner appears in parkrun results table there is a link to the FFIT web page [link] and this is just another small way of spreading the word and raising awareness of the good work they do, it also helps to bring both FFIT and parkrun closer together and I share the weekly team results table on the FFIT group facebook page.
 
Since using my Fitbit, I noticed that the calorie burn rate does not necessarily follow that of the step count, it is possible to burn higher calories by other exercise means. This was particularly noticeable when doing a bit of home plastering and my calorie burn was above target while my step count was abysmal.

I’m not sure how, but somewhere on the Fitbit I managed to find a way to set the calorie burn level. I seem to remember there were three levels to lose weight where you record your food intake and measure your calorie burn or exercise intensity (i.e. calories in v calories out). I opted for the middle range which gave a calorie burn target of 2736 per day. I’m not one for logging down every piece of food I eat but thought if I could consistently achieve the burn target and keep eating sensibly then I shouldn’t be far off where I want to be and for the most part was within a few calories of this target with my current step plan anyway. As my main goal was now to lose weight I decided to shift my main focus from step counting to calorie burn and it became my new SMART goal to hit the 2736 calories coupled with a minimum 10,000 steps on my pedometer each day.


Back on the parkrun I continued to follow Andy's advice and jogging the complete course but gradually with improved my finishing times - 34:58, 34:25, 33:37 (my 60th birthday run in an unexpected snowfall) and then a run of 3 new personal best times of 32:43, 32:17 and 31:57. The following week however really took me by surprise though. I had to attend a funeral in Taunton on the Friday so decided to stay over-night so I could go onto Yeovil for what was becoming an important fixture in Wycombe’s league run-in for a promotion spot.

This gave me the opportunity to try a different parkrun, so on a misty and damp 14th April morning I made my way to the Taunton's Longrun meadow. Laying alongside the River Tone, the park acts as a floodplain and walking across from the Tesco car park it quickly became obvious that the conditions were at best abysmal after some rainy weather, the grass areas was bog like with large muddy puddles lying across all the hard path ways. Still undeterred, I join the rest of the 285 runners at the open barn where Kirk (Taunton's very own Douglas) explained that the course had to be rerouted to miss the wetter parts of the park (I’d dread to think how bad they were and can only assume they went through the river!). 

The new course was to be 2.5 laps around the meadow and started along a long narrow path beside the open barn. I started near the back so it took a little while to get going, this probably suited me as I found the run fairly comfortable slowly picking up the pace as the field gradually spread out and despite having to run through muddy puddles, I think the shorter laps helped as well as I came in unexpectedly to the finish in 191st place in by far my best time to date at 30:40. I am still amazed how I achieved this on what was a congested start and having to splash through several muddy water jumps on an unfamiliar course but it gave me new hope and I was now within touching distance of that sub 30 minute finish - I just need to take that form into Wycombe, but preferably without the water features!

My next visit to the Urologist, this time over at Amersham hospital as my tour to visit as many hospitals as possible continued, was becoming quite routine with my PSA this time reading 5.4, it had now reached a point where the Urologist was happy to discharge me back to my GP.

With all my extra fitness, it still came as a surprise to see a drop in my resting heart rate. Since getting the Fitbit for Christmas I had been recording a pulse in the mid 40’s and as it began to drop to the lower 40's I became a little concerned and wondered if I was slipping into hibernation, so I visited my GP who said not to rely on the Fitbit but take series of readings on my blood pressure monitor. These just confirmed what Fitbit was showing with the occasional reading dipping as low as 36 and an average of 40.1.

About the same time, I had to visit Wycombe hospital for a surgery pre-operation appointment. This part of the story began back in October 2017 when I had an abscess on my back passage which I had the pleasure of showing to my GP. After the failure of couple of courses of anti-antibiotics, she referred me to Stoke Mandeville hospital saying it was a fistula-in-ano and that it wouldn't heal itself and would require surgery. At that time surgery was dismissed as I was on anticoagulant tablets and my Cardiologist wasn't keen for me to stop them, so the whole procedure was put on hold - It was becoming a right pain in the bum, especially during some of the floor exercises at FFIT Xtra!

By the time we got to the pre-op appointment in April 2018 my resting heart rate was around 40 and this was picked up by the nurse who was concerned that my pulse could go lower under the general anaesthetic, but after consulting with the anaesthetist he was happy to proceed with the operation which is due to take place within the next week of posting this blog. 

It seemed strange that my improved fitness levels was now starting to cause problems and in an attempt to raise my heart rate to the lower 50's my GP reduced my dose of Bisoprolol (a beta-blocker used to suppress the heart rate and in doing so lower blood pressure) from 5.0mg to 2.5mg. This failed to make any difference so I again visited my GP where the nurse further reduced the dose, this time to 1.25mg. Again, this has made no difference and my heart rate is still currently in the low to mid 40's.

To celebrate the first anniversary of starting FFIT, Sam arranged for all the FFIT teams to come together for a walking football session on the Adams Park pitch. Some-one had forgot to turn off the sprinklers so a couple of small-sided pitches were strategically placed to try and avoid getting wet, this is probably just as well as it reduced the amount of space needed to walk chasing the ball. I have been interested in trying out walking football for some time but by god was it tiring and a great test of discipline trying to resist the urge to chase after a loose ball. I had muscles I didn't even know I had aching for days after, but it was really enjoyable fun with a great bunch of guys.

A routine visit to Harefield hospital at the end of May for my angioplasty clinic led to the Cardiologist saying that he was pleased with my progress. I had explained all I was doing, i.e weekly circuit training with FFIT Xtra, weekly 5km parkrun, approximately 13,000/14,000 steps per day etc. to which my wife argued she felt I was overdoing it, but he replied "keep doing what you're doing" and that marriage guidance wasn't in his remit. He wasn't overly concern about my low heart rate and agreed that it was probably down to the increased fitness levels but did mention bradycardia (a condition where the heart beats lower than 60 bmp) in his clinic letter and would just like to put me on a 24 hour ECG monitor to assess my heart further, so rather than discharging me there and then said to come back in 6 months' time.

On the parkrun I seem to have hit a little bit of consistency, following the Taunton run I struggled on the next Wycombe run on an exceptionally warm morning but since then have had 6 finishes within the 30-32 minute range including a new personal best of 30:32, again with a little help from my good running buddy Andy King.
(on the graph the light blue dots represent new PB's)

Like last year [see part 4.2], my daughter Katie and I are again raising money for Hearts & Souls. This is a local charity that has my full support having benefited first hand from the service they provide to cardiac rehabilitation in South Bucks in both 2013 and 2017. We shall be joining the group again this time for a 5 mile walk from the Spade Oak around the Chiltern hills and Thames path. I know 5 miles may not sound a lot but this is so much more about raising funds for what I consider a worthwhile cause rather than some personal challenge, I'm already doing plenty of them. 

I belong to a few cardiac medical forums and a common concern that crops up time and again is the feeling that over exertion could lead to a heart attack and whether all the aches and pains are to be expected. I can relate to these doubts and fears and know from my own experience just how cardiac rehab can restore confidence and belief in your own ability and help you move forward. For more information on either Hearts & Souls or cardiac rehabilitation see Part 3 of this blog [link below].

Please help us to help today's cardiac victims by donating however large or small here ... https://www.justgiving.com/fundraising/peter-katie-jemmett



Heart attack to 10K pictorial record - click here

Thank-you for reading and I would love to hear your thoughts on any subject I have covered, please leave your comments below or email me at peterjemmett@aol.com



Previous:
Part 1 - That fateful day. (Phase I - heart attack)  click here
Part 2 - Back home & drama at White Hart Lane. (Phase II - home recovery)  click here
Part 3 - They tried to make me go to rehab, I said yes, yes, yes please. (Phase III - cardiac rehabilitation)  click here
Part 4.1 - Getting FFITer and Harefield & Heartbreak hill revisited (Phase IV - sustaining a healthy life-style)  click here
Part 4.2 - Walking for heart & soul & finding parkrun (Phase IV - sustaining a healthy life-style)  click here
Part 4.3 - End of year 1 round-up and assessment (Phase IV - sustaining a healthy life-style)  click here

To come:
Part 4.5 - Pain in the bum, going senile and sub 30! (Phase IV - sustaining a healthy life-style)  click here
Part 4.6 - Sub 29, attack of the AKI and 1 year old (Phase IV - sustaining a healthy life-style)  click here
Part 4.7 - Pushing the boundaries (Phase IV - sustaining a healthy life-style)  click here
Part 4.8 - Bling, bling, bling, two 10K's and a 5K. (Phase IV - sustaining a healthy life-style)  click here
Part 4.10 - Coping with COVID-19 and what they say (Phase IV - sustaining a healthy life-style)  click here
Part 4.11 - Living in the lock-down (Phase IV - sustaining a healthy life-style)  click here
Part 4.12 - Plus and minus 3.5 years; heart attack to half marathon! (Phase IV - sustaining a healthy life-style)  click here
Part 4.13 - Is it worth the risk? (Phase IV - sustaining a healthy life-style)  click here
Part 4.14 - Mixed bag through Covid (Phase IV - sustaining a healthy life-style)  click here 
Part 4.15 - Getting back in the groove (Phase IV - sustaining a healthy life-style)  click here
Part 4.16 - Reintegrating back into society (Phase IV - sustaining a healthy life-style)  click here
Part 4.17 - Get that crazy rhythm (the low down on AFib) (Phase IV - sustaining a healthy life-style)  click here
Part 4.18 - The 5 year itch, time to cut the CRAP! (Phase IV - sustaining a healthy life-style) click here 
Part 4.19 - The last word (Phase IV - sustaining a healthy life-style) click here
Part 4.20 - Persisting with parkrun (Phase IV - sustaining a healthy life-style) click here
Part 4.21 - Stuck in reverse (recap of 2022) (Phase IV - sustaining a healthy life-style) click here
Part 4.22 - Starting all over again 6 years on (Phase IV - sustaining a healthy life-style) click here
Part 4.23 - God bless the NHS (Phase IV - sustaining a healthy life-style) click here
Part 4.24 - What I can, when I can (Phase IV - sustaining a healthy life-style) click here