Heart Attack to 10K (part 4.22) - Starting all over again 6 years on

Part 4.22 - STARTING ALL OVER AGAIN 6 YEARS ON

(Phase VI - sustaining a healthy life-style)

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

I delayed writing this 'end of cardiac year 2022' review, the 6th anniversary since my cardiac rehab heart assessment on 30th Jan 2017, partly because I only published my last blog a little over a month ago which covered most of my tribulations through the year, but also to be able to assess what impact my latest DC cardioversion in late January combined with starting the Amiodarone treatment (antiarrhythmic drug) has made on my health and well being.

As covered in my last blog [see part 4.21], 2022 has been a year of frustration and decline largely due to spending a great chuck of it from early May in persistent AFib (atrial fibrillation), a total of 260 days in fact in two episodes divided by my first cardioversion in August [see part 4.21]. This has greatly impacted my will and ability and to get out and exercise for most of the year, with my running restricted to just 5km at my local 'Wycombe Rye parkrun' on a Saturday morning [see part 4.20]. This is a massive drop from my peak where in 2020 I ran over 1023km with several runs of up to 20km mainly cross country up and down the Chiltern hills on my own during the Covid pandemic (pictorial record), this has come crashing down to a measly 300km in total throughout last year (and 162km of that was in the first 13 weeks) as I struggled to motivate myself due to the severe fatigue that comes with AFib.

Total runs in 2022, distance in km (red markers are AFib episodes)

During this prolonged AFib episode, I started to track how long I was in the 'Fitbit' exercise zone's, whether I was exercising or not and found the results fairly interesting. These are personalised based on your cardiovascular fitness and age, the lowest being the 'fat burn' zone which for me kicks in at a heart rate of 78bmp and fairly typically I could be above that threshold up to 10 hours per day. Strangely this seem to become more erratic after my first cardioversion and increase following an angioplasty and stent in Sept. to being constantly over 10 hours with the peak recording of 20:15 coming a couple of weeks later - that's the equivalent of nearly a whole day walking briskly on the treadmill .... including while I was asleep!

Exercise zones in AFib and not

Starting on the Amiodarone significantly reduced these times which came down to around 3 to 4 hours per day and since a having successful 2nd cardioversion on the 26th January where I have remained out of AFib, I have only been above one hour on only 3 occasions in 15 days despite regular low impact exercise, and the highest of these was only 1:18 with my resting heart rate falling from 70bmp to 42bmp over the same period. Prior to starting on Amiodarone my heart rate with AFib was up in the region of 80-95bmp (hence the reason I was permanently in or above the 'fat burn' zone).

With my resting heart rate now down in the low 40's it has become difficult to achieve even the lowest exercise zone level and I find I have to work a lot harder with more effort just to get to 78bmp - brisk walking doesn't do it. Time is proving to be another problem as by evening I'm just too lethargic and tired to exercise and usually drop off to sleep watching the telly, possibly after a short burst on the treadmill when I can force myself. This drop in activity is also showing up in my calorie burn rate where the minimum target I set myself a few years ago is 2800kcal per day averaged out over a week (with the intention to lose weight), so far since the cardioversion, I have failed to hit this target on about half the days.

 

Hours over 78 bmp since the start of persistent AFib up to 27th Feb 2023

Due to my low heart rate the Cardiologist has reduced both my Bisoprolol (beta blocker) and Amiodarone (antiarrhythmic) by half, but so far, I haven't noticed any real difference.

So how has all this affected my progress (edit -what progress?) since this time last year?

My weight is not a lot different in last year, though that is not really a good thing as it is hanging around just below my 'obese' weight. This is particularly disappointing as I was determined to see a reduction over the past year and I think there were positive signs of this around March before the persistent AFib took hold. It's really getting frustrating when I look back and see how well I was doing up to 2019 (pre AFib) and I was really hopeful to follow a similar line again. Lack of exercise and lost of motivation are the main causes here, but not being very disciplined with diet is also a factor which I must improve on.

Weight chart (kg)

My calorie burn rate is much the same as last year as well which is above my target level but I think this hides the real truth. With AFib comes a higher resting heart rate and thereby a higher calorie burn for doing absolutely nothing as covered in the 'Fitbit' exercise zones above. The earlier part of the year I would exercise with more intensity to achieve my target calorie burn whereas during the persistent AFib episode achieved about the same while being far less active as is highlighted by my total step count, down by an average 3,200 steps per day and distance ran which has gone from 931.5km in 2021 to just 299.5km over the last year - a long way from my peak  in 2020.

post Covid parkrun times

While writing this blog I have unfortunately reverted back to AFib, in all I was AFib free for about 16 days. In that time I managed to get in 2 parkruns and my finishing times notably improved though were still a fair way behind my pre-persistent AFib days. I put this down to a loss of fitness and I was hopeful to start picking up on extra short runs in the evenings and rejoining the FIT Xtra again, especially after another confidence boosting cardiac rehab in December - I just feel so deflated right now.

At the moment I don't know the what the next cause of action is and will be seeking advice from my cardiologist. It would be nice to think as the Amiodarone hasn't kept me out of AFib that I could stop taking this. Although I am assured the risks are pretty low, I'm still concerned regarding the many horror stories I have read on several support forums about the 'life threatening' side effects of this drug and don't fancy getting pulmonary toxicity (lung damage) which can be irreversible and even fatal or any other of the long list of nasty side effects associated with it [see part 4.21]. 

My hope now is that I might be referred for an ablation as soon as possible.

ADDENDUM 13/02/23:
Almost as soon as I published this blog I flipped back to normal sinus rhythm, the first time I have reverted back without intervention since 18/04/22, I was in AFib for about 23 hours. I did not expect this so maybe the Amiodarone does have some benefit after all.
I am to return to 200mg Amiodarone to help prevent returning back into AFib and if my low heart rate becomes a problem, then stop taking the Bisoprolol.

 

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

My full story - from heart attack to half marathon:

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
Part 4.4 - Falling heart rate: fitter or hibernation? (Phase IV - sustaining a healthy life-style)  click here
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 4.9 - 3 Years On, Ragged Radnage and Pete's bolus journey (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

 

Next:

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