Trying to come back but not sure to what.

About a month ago a pacemaker was implanted. I was cardioverted 4 days ago. Three days after release from the hospital I did some slow treadmill running. I kept it up until (8 days) several PM recipients and a nurse described in detail what happens if I get an infection. So I stopped. Two days later my doc returned me to running. Only limitations were to not swing my arms to wide because I might dislodge a lead. I ran mostly 5 miles a day and last Thursday I ran 7.5 miles easy with a few stops. My strength is returning but I am not there yet. During the run I wore a running vest. In the last mile or so the vest irritated my skin near the PM. The next day was the cardioversion. After the cv, the doctor was conerned about a couple of red streaks near the area of the incision. I told him it got irritated from a running vest but he said we don't play around when it involves a heart. He placed me on antibiotics along with blood thinners I was alreayd taking. I was rebandaged. He said don't wear a running vest anymore. I did get checked yesterday and it was confirmed that I do NOT have an infection. He replaced the bangage and wanted me to continue taking antibiotics (even though I don't have an infection). I ran later that day and completed a slow 5k and did the same this morning. I will do the same tomorrow and probably before I see my doc on Thursday. I was more upset today with not the PM or the recovery from its implant but with a chronic muscle pull at the top of my left hamstring/butt area. I'm stuck at 5.0 mph (12:00 pace). I guess I've been dealing with cardiac issues since childhood but it never sunk in until I was placed on the surgical table. It was always bunched together with pulled muscles, fractures and everything else that I've hurt or damaged when I ran over the past 46 years. I used to run ultras. I can barely make those 7 or so miles  running slow... I guess the damage caught up with my age (63). The PM makes me feel that much older. It will be a while before my self-image catches up with my physical condition(s). Thanks for letting me rant. No need to respond. It let me see what I am thinking about as I recover.


11 Comments

Not sure what you're asking here...

by AgentX86 - 2019-12-10 22:16:51

A couple of points.  Yes, infections are a big deal, so better safe than sorry (by a long shot).  Continuing antibiotics is normal incase you have another infection, you want to wipe it out completely.  Stopping antibiotics before taking the full course is how antibiotic-resistant diseases get started.

Yeah, taking up running that quickly was pretty dumb.  You weren't given instructions in the hospital?  They give a long list of dos and don'ts and a timetable for getting back into your life.  They're not trying to make you miserable.  They're trying to save you a lot of grief, possibly your life.

Though you don't say, since you were cardioverted, I assume you have Afib (or flutter).  You do know that endurance sports are the only known cause of Afib.  There is a lot of Afib out there that's not caused by endurance sports but there the link between these two is positive.

Heart...

by runpacer - 2019-12-11 00:21:31

I pulse dropped to 25, hence the pacemaker. I have a long history of atrial flutter. When the pulse started to drop, the flutter went from episodic to constant. It is gone (for now). 

I did not have an infection. The doctor thought I did but as he saw three days later, it was irritation from wearing a runner's vest. One part of the vest comes right down over the incision area where the pacemaker is. That is why he said, don't wear it anymore. I agree with him. I'm still taking the antibiotics anyway. I will ask on Thursday if I need to continue. 

Yes, you are correct. It was dumb of me to start running so soon after surgery.

Good

by Pacer2019 - 2019-12-11 00:25:18

To get it off your chest .... I hear where you are coming from.  I jumped back into my sport.  In the middle of playing I hit a wall and felt like absolute trash . I made my way to my vehicle and slowly drove home.

once home I sat in the driveway for a good while then made my way home and in bed. 
 

one conclusion I reached was why I was so anxious to resume my sport ?

was I afraid I was going to lose my conditioning in a few weeks ?

was I trying live in denial thinking if I ignored my situation it was going to go away ?

one night I was playing a match and was huffing and puffing ...I called a timeout telling my opponent I needed a drink of water . 
 

he looked me in the eye and said "you know we aren't getting paid to do this right ?"

that comment stuck with me .....

tomorrow I am going to have my device interrogated ....I am told my setting may not be conducive to the level of activity I am used to.

i have data I have gathered from pre PM and current.  It shows my heart rate used to range from abiut 120-165 when I was avctive at my sport.

now it shows it ranged from 90-130.  Maybe I'm not getting enough blood to support my exertion? 
 

point being my expectations were unrealistic ..... I needed so time to recover BUT also to eduate myself and gain understanding.

im excited about tomorrow and what lies ahead for me 

Muscle damage from prolonged exercise is cumulative

by crustyg - 2019-12-11 03:46:47

It's tough having to accept that we're not 21 any more, and you have my best wishes.

Tim Noakes bible, 'The Lore of Running' spends some time discussing the evidence that there's only so much endurance exercise that our muscles can take before the cumulative damage begins to become apparent.

You say that you used to run ultras -'respect' to you, Sir.  I only ever had the courage for half-marathons (lots of good excuses, but that's all they were), so you have to look back on the memories with fondness and keep exercising at a much lower level.  Injuries only get worse without rest and one of the things that professional athletes have that we don't is access to expert physios who *enforce* proper rest and recovery periods.

You have to be patient - although we both know how difficult that is.

And yours was a very charming rant!

infection

by AgentX86 - 2019-12-11 08:17:58

I got that your incision wasn't infected but there is the possibility that you had in infection or bacterial disease somewhere else. If you start an antibiotic the first critters to die are the weakest, then the not so weak. If you stop taking the antibiotics in the middle of the prescribed course, anything left over will be more antibiotic resistant. In this way you're filtering out the weak strains and growing the more resistant strains. This is how we get antibiotic resistant diseases. So if you're EVER prescribed antibiotics, take the whole regimen no matter how you feel. It really is important.

Thanks

by runpacer - 2019-12-11 08:37:26

Thanks to everyone. Your insight and understanding helped. I'm terrible with rest and recovery. I will definitely continue meds. I am only running (jogging) slow 5ks for now... that is my morning coffee. 

patience!

by Violet West - 2019-12-11 16:25:17

It took me about 5 months after PM implantation (after about 3 years of dealing with disabling AFIB) to get my head out of my ass and remember how not to be sick.  

It may not take that long for you, but understand it's a process, especially if you did not have a chance to really mentally adjust to the prospect of a PM prior to implantation.  

Be patient and do baby steps.  Not everything has to snap back at once. 

endurance sports are the only known cause of Afib?

by Violet West - 2019-12-11 16:26:54

Agent X86 -- what?  I was told my AFIB was caused by uncontrolled sleep apnea.  For sure I have never in my life practiced any endurance sports.  

 

BTW, how are you? I've been worried. 

Sleep apnea

by AgentX86 - 2019-12-11 16:53:00

Yes, there is a correlation between sleep apnea and Afib but the link between endurance sports and Afib can be shown. Long periods of high heart rates cause enlargement of the heart, which cause fibrosis.  Bang, Afib.

I've not seen a causal relationship between sleep apnea and Afib. Statistical link, sure, but I haven't seen the causality.

That's  not to say that it's the only cause. Indeed in many cases there may not be a cause. Or the cause may be choosing your parents poorly.

?? I've been here, probably more than some would like.

 

well then

by Violet West - 2019-12-11 18:54:15

@ AgentX86 - good

Obstructive sleep apnea...

by crustyg - 2019-12-11 19:18:40

... is a small print cause of R ventricular hypertrophy, which can lead to VF / SCA.

In theory, at least, it can also cause R atrial enlargement, and this might be a mechanism for producing AFib.  Not something that I know much about.

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