cardiac rehabilitation

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100th parkrun celebration. Runners not dressing down!

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Lorna’s and Michelle’s joint 100th parkrun (Lorna in red and Michelle in multi colour tutu. Various wings were worn and a lot of talking undertaken during the run. Coffee, tea and cake in the cafe afterwards. All very enjoyable. I was surrounded by running ladeeees and had to watch my P and Qs (an English expression meaning “mind your manners”, “mind your language”, “be on your best behaviour”. It’s not easy, I can tell you! I have to suppress the urge to be ridiculous at the best of times. It’s an ongoing battle since most of the time I think that’s a legitimate response.

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Cambridge parkrun was attended by a rhinoceros seen here menacing two fairies who have become detached from the magical community. No clever comment offered here. See how grown up I am?

Parkrun was a bit of a no score draw for me. I’m still 90 seconds down on my usual times and yesterday I felt tired. Today I went for a nine mile run and felt much better. I borrowed Lorna’s Garmin and clocked exactly 9 minutes a mile as an average. I wasn’t pushing hard and I felt quite relaxed. The problem running with heart disease is the medication (bisoprolol and Ramipril) acts as limiter on the amount of effort the heart can undertake. In practice the difference between running comfortably and running to capacity is rather small ie I don’t run much faster when I put in maximum effort.

The attack by a knife wielding man at Leytonstone Underground station yesterday who apparently shouted “This is for Syria” as he stabbed and assaulted a random person (presumably) and threatened others before he was Tasered and subdued by police, was a disturbing and frightening incident. The police are regarding it as a terrorist act, provisionally, but I note that BBC reporters included the possibility of his behaviour resulting from mental ill health. His physical movements and manner certainly gave that impression.

Since a high percentage of people regard themselves as citizen reporters and can easily video scenarios played out before them and share via social media, we can all enjoy the unfolding drama with detachment and  the safety of distance. Over and over again as with this incident. We can also see how bystanders, or people passing, act. This ranges from running off in terror to standing gawping or even walking over closer as if the danger was occurring on a screen. If news isn’t accompanied by explicit film or images, it loses its impact compared with news that is.Video can be repeated endlessly and shamelessly, as it was with 9/11.

A large proportion of of news presentation, these days, is devoted entirely to exploiting our emotions. It’s cheap, voyeuristic and cynical. The police themselves are complicit in this approach and freely make available video of subsequently convicted suspects being questioned. They also permit the making of sycophantic TV programmes following traffic cops and docile fly on the wall documentaries about themselves. News has been receiving a substantial make over for several years. There’s less news, it’s dumbed down and it’s more likely to be presented as emotive entertainment. We can all feel sorrowful and pretend we care.

Must leave you now. Going to watch that emotionally uplifting Nordic noir TV crime prog, The Bridge.

 

 

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An increasing circle of running friends

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Last Saturday at Wimpole Estate parkrun. The weather was excellent, we all had a good run and then had coffee and homemade cake to celebrate a 100h parkrun.

Six years to the day, today, since I had my heart attack at 58. Within 3 hours, I was stented, returned to the ward, spent two nights in hospital, discharged home to the care of my wife, Lorna and began a period of recuperation and recovery. I attended an excellent rehab programme at Addenbrookes hospital in Cambridge consisting of a series of cardiac, diet and lifestyle talks and later physical rehabilitation in the hospital gym where it was a sobering sight seeing very ill or disabled people struggling to recover. Concerning the national uptake for cardiac rehabilitation, Addenbrookes was one of the highest at 46% (that is, 54% of suitable cardiac candidates declined the opportunity). 12 planned sessions of increasing, monitored activity. I enjoyed these sessions and had complete confidence in the experienced staff (cardiac rehab nurses, sports scientist and dietician).

My only serious criticism of the Addenbrookes cardiac care path was the absence of psychological and emotional focus in the rehab programme and particularly the impact on close family. Probably my experience of a myocardial infarction wasn’t typical. I quickly self diagnosed I was having a heart attack, I didn’t experience pain, I wasn’t frightened, I had complete confidence in the ambulance crew, the paramedic and the hospital staff. Unfortunately it was very different for Lorna who wasn’t with me at the time and had to make her own way to the hospital and wait a long time for information about me. It was a far more traumatic experience for her. Subsequently, the rehab programme seemed to marginalise the family and didn’t appear to recognise that some patients were depressed, anxious or frightened,

Overall, I feel lucky to have had a cardiac episode in the Addenbrookes/Papworth Hospital area. Even when I made a discreet complaint (to the cardiac rehab nurse) about the arrogant and rude attitude of a registrar at an out patient appointment, it was sorted out quickly and without fuss.

Six months later, I discovered Cambridge parkrun which had started 5 weeks previously and I’ve never looked back. Running didn’t stop me having a heart attack but it furnished me with a level of fitness that allowed me to recover and continue running at a satisfactory level which includes 10ks and half marathons. That’s more than good enough.

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Alive and Running February 16 2015

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Cambridge junior parkrun yesterday morning. They’re off, just over a hundred of them, running in muddy conditions and loving it. I volunteered as timer but this changed to photographer (or one of them).

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Seems to be rather a lot of adults running with their offspring and some of them are checking their watches. Good job it’s not competitive, isn’t it? You can clearly see how enjoyable it is for the children and they are constantly cheered around the course.

10366205_869057729799568_7495588904252193199_n On Saturday we went down to East Londinium and did Valentines Park parkrun in Valentines Park on Valentines Day for their 4th anniversary. Follow? I’m standing next to Joe who is marginally taller, marginally younger and marginally faster than me. You could say I’m living on the margins! We met up with some old work pals and friends from Cambridge, ran the race, had coffee in the large park cafe and then walked to a Wetherspoons pub in Ilford for a brunch. The food was surprisingly good and inexpensive.

We liked Valentines parkrun. Gill (not in the picture) also runs there. She is the sister of my Cambridge ex running rival, Mike and coincidentally someone I vaguely knew at work when I lived in East London (and had yet to come across Mike). Gill is also known to three of my children who also run sporadically at Valentines.

It’s Cambridge half marathon in 3 weeks. I’m back to full fitness but not running speedily. This is due to –

1. Being slightly overweight.

2. The cold weather.

3. Inconsistent running.

4. Taking my cardiac medication at different times before the run (possibly).

However on the longer runs I’m finding it easier. Yesterday I did 11.25 miles  comfortably and didn’t feel tired afterwards. As I loped along I thought how lucky I am to be able run such a distance, run regularly and take part in races despite having had a heart attack four and a half years ago. Since I was fit before my cardiac “event”, I regained my fitness levels relatively quickly. Of course I was highly motivated, my family were completely supportive and in Cambridge, the cardiac rehabilitation service was excellent and I had received treatment very quickly. But I was surprised that the take up rate for rehabilitation was only around 44-46%. Apparently this is regarded as a high. It consisted of a series of specific talks and physical rehab in the hospital gym conducted by cardiac rehab nurses, a sports scientist, dieticians and others over a period of several months. I found it extremely helpful. Why wouldn’t you take it up unless you had your head in the sand! Ah…there’s the answer.

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                                                                   Cambridge in the summer. Please bring it on…..quickly.

 

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Aliveandrunning November 16 2014

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I should have been running the St.Neots half marathon today but my lingering, three week old cold and no training scuppered it. I did do Cambridge parkrun yesterday, and last week, plus I ran a 10k race two weeks ago but these were more than manageable given my level of running fitness. I haven’t been out with the club for three weeks and there have been no training runs. So a bit of running but not much. Before my heart attack five years ago, I definitely would have run the half marathon today despite the cold and insufficient raining. In fact, I wouldn’t have given it much thought. Now, I give it a lot of thought. It’s great to be running at the same level as before the heart attack (despite the baleful effects the bloody cardiac medication has on my running). I describe it as baleful only in the sense that it restricts my speed and effort. I have to accept that overall it probably has a positive effect on my heart health (see how I have to qualify the (possible) benefit I am receiving?. Am I not incorrigible in this respect? Do I not have a shipping container stuffed full of caveats?) Recent research suggests that placebos have a very good health benefit (among many others, see Mind Over Medicine:Scientific Proof That You Can Heal Yourself by Lissa Rankin). I’m rehearsing a conversation with my GP.

Me:Pretty please, Doc, take me off my heart medication and prescribe placebos instead!

GP: I fail to see the rationale behind this idiotic request.

Me: The current prescription is slowing down my running which won’t be the case with placebos.

GP: You want me to take you off meds which strengthen and regulate your heart so you can run faster?

Me: You’ve got it Doc! Current research points to a measurable benefit in a given condition even if the person is fully aware that they are taking an inert placebo. I believe a placebo would be very good for my heart health. You gotta believe as well, Doc. Together we can do it. I’ll keep you fully informed of my parkrun times.

GP: Request denied with knobs on. Next patient, please!

Note to family : only joking!

I’ll go for a leisurely, longer run this afternoon. It’s chilly but not cold, will probably be raining, will definitely be dank, dark and overcast but I’ll just take it on the chin.

I wore trail shoes for yesterday’s parkrun. Unlike last week when a number of people fell and injuries included a broken ankle, I didn’t hear of anyone coming to grief. I wasn’t far off my old times so I mustn’t complain. I was thinking about placebos as I went around. See how beneficial they can be!

I picked up the above books in the Emmaus (homeless charity) store which, conveniently, is less than a mile from me. The Rare Words book is good to dip in to, if you like words. It means you are a logophile (not a lover of wood fires). Not much, if anything, on etymology, though. Of course, If you are a Sun, Star or Mirror reader I don’t think you need a vocabulary greater than 500 words so don’t bother (gratuitous insult of the day).

Grumpiness! Very much under rated, very much maligned. Far better to call it discernment or sagaciousness. It should be recognised as an art form and as an academic subject. Should this be offered, one might be able to do a Phd in Grumpiness. It would certainly appeal to people over a certain age.

WP_20141115_001  This ailing walnut tree continues to fascinate me. Despite its appearance, it soldiers on and had a good canopy of leaves this year.

I listened to the excellent The Life Scientific  (BBC Radio 4 this week , available as a podcast on iTunes) and heard Professor Dave Goulson talk about preserving bumble bees in the UK. He set up the Bumblebee Conservation Trust and has done a lot of work on the reasons for the decline in bee populations. Very interesting and positive. I think one of the focuses of my therapeutic gardening project will be on creating a bee, butterfly and bird friendly environment. Must pull my finger out!

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Aliveandrunning October 16 2014

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An innocent bowl of porridge you might think, and you’d be right. I mix in raisins and sprinkle cinnamon and nutmeg on the top. It’s delicious and I’m sure it does me no end of good. But yesterday was a dark day indeed. I unwittingly put garam masala on my porridge instead. My first mouthful was my last! I took a leaf out of the footballers’book when they want to convince us they’ve been fouled. I threw myself to the floor and rolled over and over convulsively as if I had ingested cyanide. Ms Alive and Running, who didn’t at that point appreciate the trauma I had undergone, asked if I had inflicted a paper cut on myself again. I really suffer for my porridge habit.

Running with Cambridge and Coleridge running club a couple of nights ago. We ran 1k x 5 times with 3 minute breaks with 2k in  warm ups and getting to the circuit. It’s very different running in the dark and riskier in terms of upping the chances of ricking your foot. But I like it. I’ve never fallen in the dark but I do tend to fall in the daylight possibly because I’m not concentrating sufficiently. This happens about 2-3 times a year. I’m due for a fall now. I may indulge in a bit of hubris because, as we all know, pride comes before a fall.

Cambridge parkrun this coming Saturday and it’ll be my 200th! I started at parkrun no.6 at Cambridge in 2010 after I finished the Addenbrookes Hospital cardiac rehabilitation course (which was precipitated by my heart attack in August 2009). I’ve done most of my runs at Cambridge and I’ll be the first of the regular runners to reach 200 (and hopefully 250, when I’ll receive a special tee shirt with magic powers from parkrun central and a congratulatory card from the Queen). Tomorrow I’ll bake a cake or two to eat with pals after the race.

In just over two weeks I’m doing the Bonfire Burn 10k at Histon. A couple of years ago this race was the occasion of the worst weather I have ever run in. It was very cold with a ferocious  wind and driving rain. The race was delayed and I was under dressed for the elements. I nearly abandoned the race after 2k but then I started to feel a little better and finished it. St. Neots half marathon is in 4 weeks and I started training today and ran for 45 minutes. Running motivation is reduced at the moment but after 20 minutes I physically felt much better and began to enjoy it.

When I go to the checkout at Tesco, I try to chose someone who doesn’t slavishly follow the Tesco scripted conversation ( I went to a Morrisons recently and the check out person looked around 80. She didn’t greet me, scanned the items quickly and gave the impression she had a life outside of serving supermarket sheep like me. How refreshing.) Anyway, back to Tesco. I went to someone I could regularly rely upon to be less than politically correct about her employer and difficult customers. She immediately gave thanks for only having another 55 minutes before she toddled off home. She made several derogatory remarks about the odd behaviour of previous customers and then gave me a flamboyant master class in how to open those pesky Tesco flimsy carrier bags. Having demonstrated the knack, and with  other waiting behind me, she handed me an unopened bag and said “Now you do it”. Folding her arms, she proceeded to watch me. Possibly it might be easier to go to go to a script compliant person next time.

The Conservative Party. What a bunch of shits, bigots and unpleasant, unkind people.

 

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Aliveandrunning June 17 2014 Juneathon Day 17

 
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Into Cambridge city centre today. I took  the opportunity, as anyone would, to snap some bookshops because in 25 years or perhaps 5 years, they will have disappeared into history. “Books” will be downloaded directly into our heads as we sleep and we will awake with the full memory of the pleasure of the contents. Physical books will be regarded as unnecessary fire hazards which attract contaminating, throat choking dust, and the broad coalition government of the Daily Mail party, UKIP and Best Do AS You Are Told Alliance will ban them. The American Psychiatric Association  will categorise physical book reading as an unhealthy fetish and advise psychosurgery if the patient persists with his/her deviant behaviour. We follow suit in the UK.

Anyway, that’s the future. Let the unreconstructed enjoy today. I have included T.K. Max because this was where Borders had a three floor store before it went bust. I liked this large shop.It had a fantastic range of magazines, a good coffee shop, a wide range of books, comfy chairs and a relaxed atmosphere. After my heart attack 5 years ago, I couldn’t reach the second floor  because it was only accessible by stairs which I wasn’t permitted to use. I was disproportionately put out despite the relatively short ban.

I seldom go into the Cambridge University Press bookshop. Too many titles I would like to own, and expensive.

Heffers is Cambridge’s premier shop for bibliophiles, both for the general reader, the specialist  and students. A lovely, big, sprawling store with very knowledgeable staff.

Out road running with Cambridge and Coleridge this evening. We did 6 x 3 minutes with decreasing recovery from 5 mins to 1 minute. We stopped to a loud whistle so all speeds were catered for. We then returned to the position  from where we started, or where we reached at the 3 minute whistle. Then back home for fish and chips, baked beans and salad, accompanied by delicious flat bread. Alas, no Brussels sprouts!

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Aliveandrunning May 17 2014

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Our new pond  is proving to be a source of  endless fascination. I created it last summer and bought  aquatic plants that needed to be brought  into the house to over winter. I put them back successfully at the end of March and now they are taking off with the warmer weather. The pond has been quickly colonised by all sorts of interesting bugs, a couple of frogs  and at least one sizeable newt. Today some  dragon flies turned up, stayed around  the pond area and appeared to be mating. All this is  entertaining, very enjoyable  and relaxing.  I think  building a pond would prove to be a good method of reducing and managing stress. It can be creative and provide a sense of achievement. It doesn’t sound  riveting, perhaps, but it can be and often is. You’ll gain respect for the smallest of pond creatures and feel excitement when you spot the larger ones. And you can claim maximum mindfulness points!

I went for a long run yesterday, training for the new Flaming June half marathon, which is local to me, in Impington.My training regime is to carry on running as I would normally do but add 3 x 13.2 mile runs in the month leading up to it. I did the first one 5 days ago and perhaps I should have left longer time for recovery. I feel tired today but not overwhelmingly. Tomorrow I’ll do parkrun and on Sunday I’m running a 7.7 race at Willingham, a village about 6 miles away.

A couple of days ago, BBC news posted an item on their website  concerning the possible effects of endurance training on the heart, particularly with reference to older runners and triathletes http://bbc.in/1kfomk2  Apparently intensive and prolonged training, and the consequent lowering of the heart beat down to 30 per min and lower, can result in dangerous heart arrhythmias. Previous research has indicated that intensive training can stress the heart by causing multiple small tears to the heart muscle leading to recommendations limiting exercise  to around 2 to 2.5 hours per week. I seldom see any reference to people who already have  diagnosed heart disease or have experienced a heart attack. After my heart attack 5 years ago my cardiologist saw no reason why I shouldn’t run another marathon. When I checked out current thinking with the cardiac rehab team 6 months ago, the advice hadn’t changed.

 

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Aliveandrunning February 22 2014

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A tolerably good Cambridge parkrun today. The sun shone in a bright blue sky and it was chilly rather than cold. Nevertheless, I wore a long sleeved top and a light jacket with tracksters (plus gloves initially). I’ve no doubt the extra clothing has a mildly torpid effect on my running ability. I feel much freer and fitter in the warmer weather above 14-15C plus. I don’t mind running in the heat although with parkrun, which starts at 9am, the temperature is never a big issue.

Lorna volunteered as back up time keeper AND took all the hi viz bibs and jackets home to wash, at least 40 of them. Each of the Cambridge runs needs upward of 40 volunteers and at the moment they are having difficulty filling the positions. Today we had a rare, stern address at the start, informing the assembled runners that the future of Cambridge parkrun was in jeopardy unless more people volunteered and didn’t leave it until the organisers were tearing their hair out which was happening each week.

309 took part in the run today and I came in at 129 in a time of 24 mins 41 seconds. My ex-arch rival Mike finished 80th in 22 mins 57 seconds. He is now a Zeus like figure living on Mount Olympus while I am a minor deity inhabiting one of the forgotten little Greek islands dependent on sailors blown off course for company. Still, the days are getting warmer, and like a wronged and injured gun fighter (Clint Eastwood, for example) I feel myself getting stronger and preparing to take revenge. Oh yes, it’s only a matter of time before my adversaries will be scorched by my slip stream as I pass them like a dragster. Won’t everyone be surprised when I deploy my parachute on the finish line to bring me to a halt. They will beg to know the secret of my success and I won’t be slow to tell them : an increase in Brussels sprouts consumption and a new wonder breakfast: broccoli porridge.

A well known parkrunner, Terry, in the 65-69 age bracket, walked the 5K course just two weeks after having a heart attack, taking around 55 minutes. An act of defiance in the face of a life threatening illness probably but not very sensible,  I suspect.

My son and daughter, Dan and Isobelle, both got personal bests at Valentine’s parkrun. Dan is now sub 20 mins and Isobelle was less than 30 seconds slower than me. Great running, children, but remember, it’s participation and setting a good example by running alongside and supporting the slower runners, that’s ultimately important. Not getting a fast time. Remember that and slow down for the next five races, kids.

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Aliveandrunning Janathon January 13

Day 13. A short run of 2 miles a day should be achievable for most Janathon runners, if they are sufficiently motivated. It doesn’t take long and you have the option of before or after work. I might add that a run after you reach home in the evening is an excellent way to wind down and begin to relax your body. Of course, when I was in paid employment, I seldom managed to go running in the evening but it’s a nice standard to apply to others.

An uneventful 2 mile run just before dusk. It was a cold and sunny day. I should have run sooner but I was busy fixing old clay pantiles to my garage roof. I did this successfully and also fixed some guttering so I had a small but perfect sense of achievement when I set out. Tomorrow I’ll be road running in Cambridge, in the evening, with the club.

I’m very confused concerning the reports I’ve read about the amount of running undertaken and the effect on the heart. In the Observer Tech Monthly yesterday, part of an article by Catherine de Lange entitled What Science Says About The benefits Of Running (not available for sharing) discussed running and repeated the same evidence I have heard on other occasions. A study of 20,000 people in Denmark over years found that those who ran lived on average for 6 years longer than those who did not. The biggest benefits came from running between on hour and two and a half hours a week, over two or three sessions, at a comfortable pace. There is speculation that long periods of vigorous physical activity, over an hour or two, puts too much strain on heart muscle, causing it to stretch and tear, which – over years – can lead to stiffening and scarring. One 2011 study found higher levels of fibrosis, or scarring, in the heart muscle of competitive endurance athletes aged 50 or over, compared to others of the same age. It  suggests moderate intensity running in small doses – of about 30 to 50 minutes at a time. Some argue that excessive running  can cause increased calcium plaque build up in the heart, which increases the risk of coronary heart disease.

I had my heart attack 4 months after running the London Marathon, aged 58. I don’t believe that my running regime, before marathon training, contributed to heart disease. I’m well aware of factors that almost certainly did and over many years. I think my level of fitness helped me to recover quickly and allowed me to return to my prior running ability. I could physically do a marathon again and I would enjoy the challenge but I do think it would be asking too much of my heart, given I have established heart disease. OK, no more marathons then. I can live with that (no pun intended) but what about half marathons which would still exceed recommended running levels? I currently run about 3 hours a week. If I do a half marathon, the training will increase for a period of time? Is this OK for me or risky? I don’t know. How about asking a cardiologist? Well, apart from an out patient appointment after discharge from hospital, you never see a cardiologist again. You are prescribed NICE  guideline cardiac medication and are monitored by your GP. There’s not deemed to be a problem if you don’t experience troublesome symptoms. I may give the cardiac rehab nurses  or sports scientist a ring.They provided an excellent 12 week rehab programme after my heart attack and work closely with the cardiologists. It would be good to speak to other runners who have heart problems and hear what advice they have been given concerning mileage and duration.

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