Running and Heart of the Matter

July 10, 2021

It was Saturday March 22, 2015. Day to run Sleepy Hollow half marathon in this sleepy town which was made famous by Washington Irving and his writings of short stories such as “Rip van Winkle” and “The Legend of Sleepy Hollow.” This was supposed to be my “comeback” to race of longer distances in a hope to revive my rather slow running status since past few years. I was reasoning my slow running with my old age of being 59 and not a spring chicken anymore, not enough training and no speed workouts. All these seemed obvious reasoning at that time, because it never entered in my mind that I could be having health issues. I thought, after all, I am a runner, fit and healthy – I am invincible!

The half marathon course is hilly and goes down to the banks of Hudson river and back up through the town. I was not feeling right that day – my chest felt heavy and could not breath easy. I thought it must be that lingering cold I am trying to get rid of since last few days is impacting my performance today. But as the race progressed, I was getting more and more uncomfortable and started to walk and run during last 4 miles or so. I finished in time of around 2 hours 20 mins. This is the first time my half marathon took me over two hours! Yet, I was happy that I was able to finish and soon I will feel better and can run faster times during upcoming spring and summer races.

Five days later – It was Friday March 28, 2015. I woke up at 5 AM with heaviness in my chest, and difficulty breathing. I proceed to take shower, hoping to go to work, bring my computer home and work from home. On my way to work, I stopped at Dunkin Donut shop as usual and started to head to my work. As I came near Nyack Hospital, something inside me told me to go to emergency room and get checked out. So Instead of going over the Tappan Zee bridge, I tuned in to the emergency room.

I was hooked to EKG machine right away, and within few second, they took me off from EKG saying “Sir, you are having a heart attack and we will have to transfer you to Good Samaritan Hospital (half a marathon distance away) right now. They started prepping me up for the transfer, shaving my chest to make me ready for the cath. Lab.

It was still not hitting me as this being a serious event. It was mainly because I was not having sharp chest pains as I have seen in movies being portrayed for heart attack scenes. So, while I was waiting for the ambulance crew to arrive, I first called my manager’s landline to let him know I will not be in the office, but will see him on Monday instead. Then I called Anju to let her know to come to Good Sam hospital where they are taking me because I was having a heart attack. Knowing her worrying nature, I assured her that it is a mild one and I should be fine. When I told this to my co-workers a year later, they said I was a workaholic! I said why? The response – Because I called my manager first and then my wife!

Although it was Friday morning rush hour, the ambulance had its sirens blasting and lights flashing, it was relatively fast transfer. As I was rushed into the cath. lab., the staff was uplifting me with cheering words like “you are now in the place where we will take care of you”

Dr Arvind Agarwal was on duty. I know him personally because he treated my parents. Although Dr. Shridhara was my cardiologist, they both are part of the same practice. I felt relived that Dr. Agarwal will have my history charts soon and he all will be fine.

I started talking to Dr Agarwal by saying “Dr., please fix me well because in few months (Dec. and April) I have to walk my two beautiful daughters down the aisle” Dr. was not interested in talking to me but started catheterization process right away after watching the monitors for my heart condition.

After inserting one stent into my left anterior descending artery (LAD), he said “your artery is totally, completely blocked. But this stent will now open up the blood flow and you should start feeling ease in your chest and easy breathing.”

I was having a widow-maker event! The widow-maker is a massive heart attack that occurs when the left anterior descending artery (LAD) is totally or almost completely blocked. The critical blockage in the artery stops, usually due to calcification, stops all the blood flow to the left side of the heart, causing the heart to stop beating normally.

As scary as this was, I started to wonder why was this not picked up during my visits to Dr. Shridhara? While I was passing stress tests, my artery was getting clogged due to increase amount of cholesterol level in my body. I was not following his instructions to get on statins, thinking hey, I am a runner, and I can control my cholesterol by running and no need to take this medicine which will make me cramp during my runs – the major side effect of statins which I was aware of, and I did not want it to hamper my running.

Dr. Agarwal said my overall fitness played a big role in my fast recovery and ability to withstand the trauma. He said we will work slowly toward running again. I may not post seven-minute miles anytime soon, but I can get back to light running soon. He says beyond that is a negotiation.

I think it’s a nice way for him to say, ‘We’ll see.’

I now have a defibrillator implanted in my chest to shock my heart back into rhythm if it goes into sudden cardiac arrest – a condition of my heart due to massive heart attack that caused ejection fraction dropped from 75 to 45. It was uncomfortable in the beginning, but oddly, I don’t even notice that it is there. I feel more content and at peace now than before my incident. And best of all, I am alive and have full use of my arms, legs and vital organs. The docs wanted to make sure that if my heart ever goes into fibrillation due to low ejection fraction, then it’s there and it will kick in and provide shock to my heart to kick-start it again.

I am sharing this experience with you – and specially with my running, biking, swimming friends – so you can relate to, and may help you not take your health and condition for granted.

Six year later, I am 65. I do have a family history of heart disease. My dad had a stent put in by Dr. Agarwal 20 years prior, and my mom had undergone quadruple bypass surgery. I’ve heard plenty of tragic stories. I was at the Olympic Marathon Trials in 2007 in the Central park volunteering at a water station when Ryan Shay died, the highest profile heart related fatality in our sport since Jim Fixx, who helped launch the first running boom, dropped dead on a run in 1984. Jim Fixx suffered a heart attack at age 52 while on a run in Vermont~ An autopsy revealed he had serious blockages in all three coronary arteries. Ryan Shay, died as a result of structural defect known as heart scarring. He was only 28.

In most recent memory, Alberto Salazar, suddenly and shockingly, he was felled by a heart attack on June 30, 2007 that nearly killed him. As the news flashed across the Internet, the running community felt spasms of fear and disbelief. How could this happen to a former distance star who had won three straight New York City Marathons and was still young (48), trim, and running 25 to 30 miles a week? Runners hadn’t felt this spooked since July 20, 1984–the day Jim Fixx died while running in Vermont.

Every time I think about it, I can’t believe how blessed I am that this miracle took place. It’s very sobering. For a few days after the event, I was going to sleep at night wondering, “Am I going to wake up in the morning?” We take waking up every morning for granted, right? I don’t anymore. And it is even harder for my wife, when I am either traveling for business or we are apart overnight. Before the heart attack, I never texted her “good morning” from Germany, Spain, or wherever I was on this planet, but after the event, I make sure that the text is the first task I perform to let her know my heart is still ticking. It’s a peace of mind for her.

Now I’ve gotten over that and moved on to the reality of my situation–knowing that I’m going to face this again, maybe from my heart, maybe not. Maybe I’ll see it coming, maybe I won’t. But it’s going to come again. And that makes you think, Are you prepared? It forces you to delve into every part of your life. You think about things you’ve put off, regrets you might have. You begin to ask: Do I have some unfinished business? Have I let old disagreements get in my way? Have I left certain words unspoken to my brothers, father, sister, friends?

And it makes you think: You know what? I’m going to take care of all this stuff now. I’m going to start crossing things off my list. I feel so lucky that this happened, because now I see things much more clearly.

Here is the thing: Before this, I went to my doctors, but ignored their prescriptions of statins because I was not willing to let that affect my running performance. I thought I was invincible. I’ve asked a lot of my running friends and found this kind of thinking in athlete’s mind is not uncommon. I think everyone should get checked out regularly, even if you feel totally healthy like I did.

I don’t think anyone should be scared. I think you should be aware. That’s why I’m talking to you about what happened to me. Runners need to know that it can happen to anyone, even if you’re in great shape. They need to check their blood pressure and cholesterol, and to know their family history. And if anyone’s really worried, they should consult with their doctor and consider an exercise stress test.

Hope this is helpful.