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chest pain

Still Don’t Officially Know What’s Wrong with Me – and I Don’t Care Anymore

I love my running shoes.

I love my running shoes.

I am officially over my medical mystery. I don’t even want to think how much time I’ve spent in doctor’s offices and hospitals or how much money I’ve spent on medical tests related to my chest pains, dizziness, fatigue, and night sweats. And we still have no idea what’s wrong with me.

My cardiologists (all three of them) determined I have a hole in my heart but it’s a congenital defect that shouldn’t be causing my symptoms. My primary care doctor drew nine vials of blood and ran every test he could think of – CBC, thyroid, hormones, Epstein-Barr, other random illnesses – and everything came out negative or normal.

I’m annoyed that trying to do the right thing and take care of myself yielded no actionable results. It disrupted my marathon training and left me unprepared so I couldn’t finish the race. I feel like I wasted my time and I am frustrated that I don’t have any answers except what’s not wrong with me. I’m done doing this process of elimination. I’m ready to call it and apply Occam’s Razor. I say I have reoccurring costochondritis, fatigue from the fact that I work myself into the ground on a regular basis and have depression, dizziness from low blood sugar from my eating disorder, and night sweats caused by anxiety. I changed my linens and took the blanket off my bed so I’m cold when I tuck myself into bed at night, but it seems to be decreasing my night sweats so that’s good enough for me.

My Race Shirt for Rock 'n' Roll Arizona Marathon 2015

My Race Shirt for Rock ‘n’ Roll Arizona Marathon 2015

I’m ready to say “fuck it” and get back into cycling and running. When I go on The Undeniable Tour for two weeks, I plan to go running in every city I stay in. I am a much more balanced person when I work out on a regular basis.

Just in case some things really wrong with me and they just haven’t found it yet, I still don’t leave the house without my Road ID strapped to my left wrist. That way, if I collapse or something, my bracelet will contain the information the emergency medical team should know about my medical history.

Will I try to train for another marathon? I’m not sure. I workout more consistently when I have a race on my calendar and a training program to follow, so I’m looking for a race to train for – either a 10K or a half marathon. I’m contemplating doing a half marathon trail run in June. That could be really fun. We’ll see what happens.

Cleared to Workout Again

. . .and there was much rejoicing.”

For those of you who haven’t been following the drama related to my heart, I started having chest pain after long runs in November. After seeing to cardiologist’s and having two ultrasound, a stress test, wearing a heart monitor for 24 hours, and getting a transesophageal echocardiogram (TEE), they diagnosed me as having a congenital heart defect called patent foramen ovale (PFO). However, my heart defect apparently is not the cause of my pain or the dizziness, fatigue, or night sweats I’ve been having.

My doctors aren’t sure what’s causing my symptoms but they’re pretty sure it’s not a cardiovascular problem so my first cardiologist said I was allowed to work out again and took me off the beta blockers. (Did you know that beta blockers are the only banned substance in archery?) I made an appointment to see my primary care doctor to run blood work to see what else is going on in my body. In the meantime, I’m working out!

Still Smiling after Running 3 Miles - Feb. 14, 2015

Still Smiling after Running 3 Miles – Feb. 14, 2015

And it feels so good to exercise again!

On Saturday morning, I took myself for a 3-mile run, probably at a 10-minute/mile pace. My body could definitely tell that it hadn’t worked out in a while. My chest hurt for most of it but not enough to get me to stop. My legs held up great. (I would be surprised if it turns out I have a bad case of costochondritis – which I’ve had off and on since I was 11 – plus another medical condition that’s causing the other symptoms. Costochondritis is an inflammation of the chest wall that hurts like a bitch that there’s not much they can do about it.)

I took myself for a bike ride on Sunday. I meant to do 10 or 12 miles but I ended up doing 14.5. My quads and butt muscles got a work out. I didn’t realize how steep Galvin Parkway is through Papago Park – thankfully I rode up the hill at the beginning of my ride so I can coast down it on the way home.

One of the best parts of working out again is it giving up my mind a chance to rest and let ideas flow through it. There is no way I can act on an idea while I’m running or riding – not even a chance to send myself an email – so my thoughts have an opportunity to tumble around in my brain and develop in a non-directed organic way. It’s the closest thing I have to being creative. It was very nice to have that mental respite again.

My return to running couldn’t have come at a better time. I’m going to the Dad 2.0 Summit this weekend in San Francisco (blogging conference for dads). I’ll be speaking with them about the legal dos and don’ts of having a blog. It looks like there’s going to be a group of us going for a run together one of the mornings. I hope our route includes at least one hill.

I Still have a Defective Heart – But That’s Not the Problem

So here is the update about my heart.

My doctor called me late on Tuesday afternoon to let me know that the transesophageal echocardiogram (TEE) showed that I have a hole in my heart (PFO) but there is no blood flowing where it shouldn’t be. My doctor said unless I have a stroke, I don’t need to have the hole patched. I seem to be one of those people who have a heart defect, but it is not problematic.

GRRR by Meghan Dougherty from Flickr (Creative Common License)

GRRR by Meghan Dougherty from Flickr (Creative Common License)

The good news is my fatigue, dizziness, chest pain, and night sweats do not appear to be caused by a cardiovascular problem. The bad news is I’m still having the symptoms and we don’t know why.

So it’s back to the drawing board. I made an appointment with my primary care doctor and we can attack this problem from a new angle. I suspect he’ll order blood work to see if my numbers have changed from my last full physical. I may ask him to throw in a hormone test to see if it might be early menopause. I called my other cardiologist to ask if I needed to keep taking the beta blocker. (Remember: I’ve never had high blood pressure.) His office called me to say that he wants to see me for a follow-up. Perhaps he’ll have some suggestions about what else could be causing the problem.

Since my heart defect isn’t causing my symptoms and my symptoms didn’t show up until I was running 15 miles at a time or more, I hope I can start working out again soon. Before I started training for the marathon, I was running 22 miles and biking 19 miles a week. I was doing two 4-mile runs and two 6.5-mile runs each week. I’d like to get back to that.

It’s frustrating to feel like part of my life is on hold. Part of me wants to say “fuck it” and do whatever I want whether that’s running the hills when I’m in San Francisco for the Dad 2.0 Summit, taking a high intensity step aerobics class, or treating myself to a few hours of trampoline tumbling. I don’t like being told that there’s something I can’t do. I definitely plan to have a candid conversation with my doctors about being more active while we figure out what’s wrong with me.

In case you are wondering, no, I haven’t become completely reckless. And yes, I make sure I’m wearing my Road ID before I leave the house, just in case.

Marathon Training Week 17 Recap – Tapering Down

no. 17, somewhere down the jaisalmer highway by nevil zaveri from Flickr

no. 17, somewhere down the jaisalmer highway by nevil zaveri from Flickr

It’s the second to last week of marathon training and my training program has me tapering down before the race.

I was supposed to run on Tuesday, Wednesday, and Thursday, but I got too busy to run on Tuesday, so I rearranged my schedule. It’s been a challenge to make time for running lately. The temperature has warmed up again, but I’ve been busy with work so by the time I have time to run, I have to either run in the dark or use the gym at my complex. The gym is convenient but I don’t like running on machines. Running outside is more fun, has better scenery, and my options are to walk or run. In the gym, it’s boring and I have the option to switch from the treadmill to the elliptical, and even to the stationary bike.

On Wednesday, I did 6 miles in the gym – 2.5 on the treadmill and 3.5 on the elliptical. The treadmill makes my shins hurt and the elliptical makes my feet go numb. I’ll admit it was pretty boring staring at the walls and the machines. On Thursday, I ran 4 miles outside. I could tell my legs weren’t as used to running on pavement as I would like but it still felt good. I had some chest pain in the first mile, but it settled down by the end of the run.

I had my last long run on Saturday – 8 miles, and I ran them outside. It felt good to be out running in the first light of the day. My body didn’t fully appreciate it. I had a little shin pain starting around Mile 3 and some arch pain by Mile 4. I was already planning on getting both calves taped for the race and I think I’m going to get my left shin, arch, and post-tib taped too. I’m going to look like I have bionic legs. My chest hurt a bit from the beginning of my run and got worse around Mile 6.  Focusing on my running form seemed to help keep it in check and it was never bad enough where I thought I should stop or walk for safety reasons.

I have the No Pants Light Rail Ride on Sunday so I’ll be walking all over Phoenix before and during the ride so that will be my substitute for cross training. I don’t wear a GPS or a pedometer so I won’t know how  far I’ll walk but I’ll be walking and standing for the better part of 5 hours.

My plan for my last week of training and rest for the marathon is to make sure I stretch, foam roll, and use The Stick on my lower legs every day. I need my calves to be as limber as possible. I’ve heard stories about lots of runners having to stop during the last few miles to stretch their calves. There is a slight incline on the route starting around Mile 20 so I want to make sure my legs are ready for it.

Weekly Totals:
Running:  14.5 miles
Elliptical:  3.5 miles

Marathon Training Week 14 Recap: Getting Back in the Saddle

14 by Steve Bowbrick from Flickr (Creative Commons License)

14 by Steve Bowbrick from Flickr (Creative Commons License)

For those of you who have been following along, my marathon training program for Rock ‘n’ Roll Arizona 2015 has not been going to plan. So far there has been chest pain and night sweats, medical testing, finding out I have 2 holes in my heart, 2 new medications, and walking my mile for the last 3 weeks. Many of my teammates have suggested that Rock ‘n’ Roll Arizona 2015 isn’t my race, but it looks like my race might be salvageable.

Last week had a disappointing start. I tried to walk 5 miles on Tuesday but I was so tired and weak that I could only manage 3. I didn’t even bother trying to walk the 9 miles on my marathon training program on Wednesday.

Thursday morning had me back in my cardiologist’s office for my test results. That’s when I found out that I have 2 holes between my atriums and he put me on a low-dose beta blocker and referred me to another cardiac specialist to determine if having atrial septal defect is causing my problems. He also said I could run again. I managed to run/walk 5 miles on the treadmill that evening in just under an hour.

I was scheduled to run 14 miles on Saturday and my plan was to run on the treadmill at my complex again so I wouldn’t be far from home if it got too hard to I started having chest pain. To my dismay, both treadmills were not working. (What are my HOA fees paying for again?) I opted to do my miles on the elliptical in 2 sets of 7 miles. My toes were numb and my legs were a little wobbly by the end but otherwise it was fine. I finished in just under 2 hours. My pulse never felt like it was getting excessively high.

I’ve become such a wimp about the cold. Earlier in my training I was off cross training on my bike at sunrise, but now it’s chilly in the morning. It was sunny and warm by the afternoon but unfortunately I had other obligations then. (I should probably adjust my schedule when I can if I want to work out outside.) Instead I hit the gym at my condo again and did 7 miles on the elliptical.

Next week, I’m scheduled to do 2 5-mile runs, a 10-mile run, and a 20-mile run. My plan is to run/walk all of them in the real world, but I’m considering finding some type of loop for the 20-mile run so I won’t risk getting into trouble and being 10 miles from home.

Totals for the week:
Running/Walking/Elliptical: 29 miles
Biking: 2 miles

I Still Have a Defective Heart

Atrial Septal Defect - Image from Wikipedia (Creative Commons Image)

Atrial Septal Defect – Image from Wikipedia (Creative Commons Image)

Let me start this post with a correction: I misheard my cardiologist last week. I thought he said I have a ventricular septal defect. He actually said I have an atrial septal defect. Today when we went over the results of my tests, he told me I have, not 1, but 2 holes between my atriums.

The human heart isn’t that big. How is it possible that I have 2 holes in one little area?

The rest of my tests were unremarkable. Nothing unusual showed up when I wore a heart monitor for 24 hours and my stress test looked good. Overall, my doctor is unsure what’s causing my symptoms – the chest pain, the fatigue, and the night sweats. He prescribed me a low-dose beta-blocker and said I can go back on ibuprofen for pain. (Yay!) My beta blocker dose is so low my pharmacy had to special order it. Since I’m so small, my doctor’s having me only take half a pill every other day for the first five days to see how I adjust to it. (He said it could make me tired.)

My cardiologist also referred me to another heart specialist to evaluate whether my heart defect is causing my problems and whether they should be surgically sealed. Apparently this guy specializes in these types of defects. I hope it doesn’t take weeks to get an appointment. If my defect should be patched, they go in through the groin, not open heart surgery. That was good to hear.

My doctor said I’m allowed to try running again. I was pretty nervous to see how my stamina is after not running for nearly 3 weeks. I was slated to do 5 miles today and I opted to do it on the treadmill where I could control my speed. I ended up doing a run/walk combo and finished in 53:58. I think that’s a good start. My chest hurt a little bit at first but settled down by mile 3.

I’m scheduled to do 14 miles on Saturday and I think I’ll do it on the treadmill again where it will be easier to manage speed, take breaks, and have snacks. For now, my plan is to keep following my marathon training program, but modify it by walking and running my miles as needed.

Marathon Training Week 13 Recap: Walking Sucks

This was a challenging week of training. I saw my cardiologist on Monday and he said I could only walk, not run until we got the results of the tests he ordered (ultrasound, stress test, and heart monitor). There are two main challenges with walking: (1) it takes a lot longer than running and (2) it’s boring!

Walking with Heather

Walking with Heather

I’m still sticking to Hal Higdon’s marathon training program for novices, but walking my miles. I hope I can still do Rock ‘n’ Roll Arizona in January.

Monday: Rest Day.

Tuesday: I had work commitments early in the morning so I opted to do my 4 miles in evening – on the treadmill. That thing still feels like a human hamster wheel. Maintaining a 4 mph pace was pretty challenging.

Wednesday: I walked 9 miles today. It took 2.5 hours. It’s so frustrating that I can’t run. I think it’s starting to make me batty.

Walking with Lawton & Oscar

Walking with Lawton & Oscar

Thursday: I was scheduled to walk 5 miles today but I ended up walking 5.4. I did it first thing in the morning which made it less painful. I also had my stress test that morning, so I had to be caffeine-free for 24 hours and not eat for 4 hours before the test, so taking a walk kept me occupied.

Friday:  Rest Day.

Counting Loops

Counting Loops

Saturday:  I walked 19 miles today, and it took over 5.5 hours to finish it. I walked from my place to ASU Tempe campus, walked 4 loops around campus, and then home again. My friends Heather and Lawton (with her adorable dog Oscar) joined me for part of the walk which made it much more bearable – Thanks so much! Every time I finished a looped, I marked it on my wrist with a Sharpie pen so I wouldn’t lose track of myself. I kept myself energized with water, GU Chomps, and an energy bar.

Here’s another reason why walking sucks – when you’re walking long distance, you feel the pain of your first miles before you’re done with your last mile. When I run, I’m done after a few hours and I’m home before the pain sets in. My hamstrings were killing me by the time I got home.

Sunday:  Yesterday’s walk gave me heat rash on both my feet and ankles – sexy I know. The last thing I want to do is put on socks or shoes. I’m technically supposed to do cross training on Sundays, but I walked 19 miles yesterday. I’m not doing anything today. (I think the heat rash is nature’s way to saying I’m not meant to be a long distance walker.)

I’ll see my cardiologist this Thursday. So far he’s said I have a hole in my heart and that my heart skips beats. I hope he’ll know what’s wrong with me and that he says I can run short distances so I can alternate running and walking for the rest of my training and through the race.

Weekly Totals:
Running:  0 miles
Walking:  37.4 miles
Push-ups:  0 push-ups

I Have a Defective Heart

Who has two thumbs and a heart defect?
This guy!

Ventricular Septal Defect (VSD) - Creative Commons Image from Wikipedia

Ventricular Septal Defect (VSD) – Creative Commons Image from Wikipedia

I feel like I’ve been living at my cardiologist’s office this week. I was in this morning for my stress test when my doctor pulled me aside to share some news about my ultrasound. (That raised a big red flag since I wasn’t expecting any results until next week when all my tests were done.) He told me that I have ventricular septal defect (VSD), better known as a hole in my heart. It’s a genetic defect where there’s a hole between the ventricals of your heart. My doctor said ~10% of the population has it, and not everyone has health problems as a result, so we don’t know if mine is causing or contributing to my chest pain at this point.

(Of course you know the moment I got out of my doctor’s office, the first thing I did was call my parents and say, “It’s all your fault.”)

Then he reminded me not to run this weekend – I can walk instead.

Once I was done talking with my doctor, I got to have my stress test – that’s the one where you run on the treadmill with electrodes attached to your chest. They gave me a half gown thing to wear over my electrodes, but I was in a sports bra and I have no modesty issues so I opted to run without it. I had 8 electrodes on my chest and a blood pressure cuff on my arm where my tech periodically took my blood pressure. We had to go up four levels to get my heart rate up high enough – the speed and incline increased with each level. At each level, the machine produced an EKG printout. When it got challenging, the real issue wasn’t the speed, it was the incline. My calves and hamstrings were burning. I’m glad it only took 14 minutes to get through this.

The worst part about doing a stress test is you can’t have caffeine for 24 hours before the test. I popped a caffeine pill the moment my test was over.

My Holter ECG

My Holter ECG

After my stress test, they stuck a Holter ECG on me for 24 hours. It’s a heart monitor with 5 electrodes that connect to a recorder box that clips to my hip. When I saw the box, my first thought was “1990 called. They want their pager back.” With all these cords hanging off me, I feel like I’m wearing 5 iPods. For the duration of this test I’m not allowed to shower or sweat and they gave me a log to record any pain, dizziness, or other symptoms. I ‘m afraid one of the electrodes will come loose so I keep pushing on them. I probably look like I’m molesting myself. We’ll see how easy it is to sleep with this on my body.

I’ll see my doctor next Thursday to get the results of all my tests and hopefully he’ll have a proposed plan of action to deal with my pain. Until then, I’ll still train for the Rock ‘n’ Roll Marathon, but I’ll be walking my miles.

Ultrasound!

Heart and Heartbeat by ThrasherDave from Flickr (Creative Commons License)

Heart and Heartbeat by ThrasherDave from Flickr (Creative Commons License)

No, I am not with child.

I had an ultrasound on my neck and heart to try to figure why my chest hurts and why I wake up in  a puddle of my own sweat halfway through the night.

Getting an ultrasound is a pretty simple procedure – you just lay there while the tech puts goo on the ultrasound wand-thing and slides it over your skin. They had me take off my clothes from the waist-up and put on a paper tank top that was open in the back. (I wonder if they only give paper gowns to women.)

The tech started with the ultrasound of my neck arteries. Because I had to have my neck stretched, I couldn’t watch the screen. He periodically turned the sound on to listen and/or capture the sound of my heartbeat. The first time he did it I giggled. I instantly realized this was probably the only way I was going to hear a heartbeat during an ultrasound of my body because I have no plans for procreation.

After he finished scanning my neck, I asked how it looked at he only said, “I think you’ll live through the weekend.” We moved on to my heart ultrasound and I got to start laying on my side, which was awesome because I got to watch the monitor. The female tech put some electrodes on my chest that monitored my heart too, which was cool to see my heartbeat going across the screen.

Of course, I couldn’t understand anything I was seeing. I swear sometimes my heart looked like the face of a deep ocean fish and sometimes it looked like The Blerch from The Oatmeal. I’ve decided I have an alien in my chest.

We finished the scan with an ultrasound of my chest while I lay flat on my back. It was interesting to hear the differences in how my heart sounded depending on how I was laying and where the tech was holding the ultrasound wand.  Sometimes it sounded eerily similar to a theremin. (Think of the original Star Trek theme song.)

Hat tip to the Cardiovascular Institute of Scottsdale for handling female modesty well. When the tech needed to scan my chest, he just ripped a small hole in my gown instead of asking me take it off. Modesty is a non-issue for me, but I can see how other patients would appreciate this.

Of course the tech couldn’t tell me anything from my scan, though when I told him I was getting all my test results next Thursday, he said, “Good.” So maybe he saw something on my ultrasound, but if he did, it can’t be that bad because he didn’t seem to mind that I’ll be waiting 10 days to get the results.

New Mystery: Why Does My Chest Hurt?

My new drug of "choice."

My new drug of “choice.”

As many of you know, I’m training for the Rock ‘n’ Roll Marathon Arizona in January. Unfortunately, I haven’t run a step since November 29th. I feel fine when I run but I started having chest pains after my long runs. After the second time it happened, I felt like a giant lumberjack stomped on my chest while wearing his work boots and then kicked me in the ribs. The night sweats are a bitch too. I woke up soaking wet halfway through the night last night.

I saw my general practitioner who referred me to a cardiologist. They couldn’t get me in for a week so I had to walk last week’s miles. Do you know how boring it is to walk 8 miles?

My friend Bill warned me that I would look very out of place at the cardiologist’s office – and he was right. The only person who looked close to my age was a woman who was there with her father. All of the patients were at least 25 years older than me.

My doctor seems like he knows what he’s doing. He asked a ton of questions, took lots of notes, and listened all over my torso. To my dismay and frustration, he didn’t have any answers for me yet, and if his has any hypotheses regarding what’s wrong with me, he didn’t share them. He created a solid-sounding plan of action to figure out what’s going on:

  • Ultrasound of my neck and heart
  • Stress test (that’s the one where you’re on the treadmill)
  • Heart monitor for 24 hours
  • Prescription for Prilosec in case there’s an acid reflux issue
  • He told me to switch from ibuprofen to acetaminophen (Tylenol)

I think taking me off ibuprofen is evil. Every woman I know (except those with stomach issues) swears by it. It’s the cure-all for everything – headaches, cramps, sore muscles, etc. I was not happy to hear that instruction. When I filled my prescription, I bought the biggest bottle of acetaminophen in the store. Between the headaches I’ve been having and the pain I get in my legs from working out, I’m going to need it.

My doctor echoed my general practitioner’s instructions that I can walk but I shouldn’t run until we figure this out. All of my testing is this week, but I won’t have my follow up appointment to get the results until next week. So I will be walking for the next 10 days – including the 18 miles I’m scheduled to do this weekend. 18 miles of walking?! This is going to suck.

Since I deal with the world and my life through blogging and social media, I’ll be documenting this whole process.