prevention

Faster doesn't always mean healthier

By Nan Kappeler April 3, 2008 -- In the spring of 1996, just one mile into his usual six-mile lunchtime training run, the unthinkable happened to Joe Nedza. Suddenly, at just 45 years-old, he felt an incredible pressure on his chest he describes as “an elephant sitting on him.” He turned around, returned to work, and had a buddy drive him to the hospital. Hours later, he lay embedded in a spider-web of wires and electrodes attached to his body, thinking his triathlon career was over. Nedza, now 57, is fortunate. After months of cardiac rehabilitation for his heart, the Newport Beach, California resident was able to return to training and racing—on a restricted and monitored schedule.

George Wright wasn’t as fortunate. Just a month after a second place finish in the 60-64-year-old agegroup at the Hawaii Ironman, he suffered a major cardiac complication while cycling. He was pedaling up a steep hill in Orange County, California when, without warning, he suddenly fell off his bike. Resuscitation attempts by paramedics on the roadside failed. The 63-year-old master’s triathlete died in a friend’s arms.
Triathletes who appear to be in perfect physical shape, who are able to swim, bike and run hundreds of miles a week at high intensity levels, are experiencing a barrage of cardiac problems, frequently with little or no warning and often during activity. This can be surprising to many of us, who always thought exercising gave us a longer life—not less.

“We tend to think that if we exercise more, we will be healthier. But in general, this is not true,” said Dr. John Homan, a Newport Beach, California internist and sports medicine certified physician. “If you look at high level athletes, they aren’t the healthiest.” Dr. Greg Thomas, a triathlete and cardiologist with the Mission Internal Medical Group in Mission Viejo, California was not surprised to hear of an athlete having heart problems. Thomas said the myth that athletes were immune to heart problems dates back to more than 30 years ago, when it was unheard of that a runner or athlete could suffer from a heart attack. Then, after marathoner and author Jim Fixx died while running, it was proven that athletes are not immune. So why is this happening to us? We're people who are obsessive over every morsel of food we eat, map out weekly workout regimens and sacrifice countless hours to staying fit.

Some researchers attribute these cardiac problems to something called “heart cell death”, which occurs during strenuous activity. It’s like having a small heart attack while your heart is working wonderfully to get you a PR. The reason this happens is still unknown. One popular theory suggests that during stressful activity, the adrenal glands release increased levels of adrenaline and noradrenaline. A presence of more of these hormones, is thought to cause the coronary arteries to constrict, resulting in localized cell death within the heart. This has sometimes been observed during prolonged exercise. One study of Hawaii Ironman finishers found that 9% displayed elevated levels of these hormones.Another report from Peak Performance, an online information source for athletes, said an athlete who participates in a strenuous test of endurance lasting about three hours or more has an increased chance of dying during the event and for 24 hours following the activity. The athlete has more of a risk of dying after exercise than a cigarette-smoking, sedentary lay-about who spends the same 24 hours drinking beer and watching TV! Thomas said the chances of an athlete having a heart attack is more a matter of probabilities. There are a few things you can do to protect yourself on the road. Looking at your family history will help you to determine if you are at risk. “If your parents had a history of heart attacks, then your chance is greater,” said Thomas. He recommends a stress test for athletes over 40 who have increased risk factors, (such as heredity) and emphasizes, “Because of exercise, an athlete will have a decreased chance of heart disease, because exercise is a preventative measure.”

The good news is most athletes who have survived a heart attack can return to racing, if they can pass a stress test. “Most people do pass and can return to racing, but must heed to the most unthinkable doctor’s order. If someone is passing you-let them go,” said Thomas. He adds that most heart patients are scared enough to heed his advice. As it turns out, Nedza had a partial blockage of his heart and was given a drug to dissolve the clot called “TPA”. Several days later he passed a treadmill test and was sent home to begin a home walking program. His doctor immediately set limits for him, which included wearing a heart rate monitor to keep his heart rate under 85% while exercising and was forbidden to push to exhaustion. Nedza said he tried to say positive and focused on his program. Beginning with one mile, he gradually increased his distance and pace and was soon running 1-2 miles a day at a slow pace. Several weeks later his doctor urged him to return to the sports he loved, but at a moderate pace. Within six months, he had increased his running speed, began swimming and riding his bike and was planning to do his first post-heart attack triathlon. Shortly after, Nedza, a hard-working lawyer, transferred from a high-volume criminal calendar to a more manageable branch court and retired in late 2005. He continues to have heart check-ups every six months and a yearly treadmill test to check for blood flow irregularities. Workouts today consist of swimming, weight training, running and cycling at a moderate pace with his wife and friends training for local sprint races. Over a decade later, Nedza continues to abide to his doctor’s orders, but admits it’s hard to hold back when people are passing him. But he’s living with the restrictions and thankful he’s got a second chance.

Nan Kappeler is a freelance writer who resides in Orange County, California. She is also the founder and owner of Lickety-Split triathlon transition mats. www.fasttransition.com.


Triathletes and Heart Attacks
Faster doesn't always mean healthier By Nan Kappeler April 3, 2008 -- In the spring of 1996, just one mile into his usual six-mile lunchtime training run, the unthinkable happened to Joe Nedza. Suddenly, at just 45 years-old, he felt an incredible pressure on his chest he describes as “an elephant sitting on him.” He turned around, returned to work, and had a buddy drive him to the hospital. Hours later, he lay embedded in a spider-web of wires and electrodes attached to his body, thinking his triathlon career was over. Nedza, now 57, is fortunate. After months of cardiac rehabilitation for his heart, the Newport Beach, California resident was able to return to training and racing—on a restricted and monitored schedule. George Wright wasn’t as fortunate. Just a month after a second place finish in the 60-64-year-old agegroup at the Hawaii Ironman, he suffered a major cardiac complication while cycling. He was pedaling up a steep hill in Orange County, California when, without warning, he suddenly fell off his bike. Resuscitation attempts by paramedics on the roadside failed. The 63-year-old master’s triathlete died in a friend’s arms. Triathletes who appear to be in perfect physical shape, who are able to swim, bike and run hundreds of miles a week at high intensity levels, are experiencing a barrage of cardiac problems, frequently with little or no warning and often during activity. This can be surprising to many of us, who always thought exercising gave us a longer life—not less. “We tend to think that if we exercise more, we will be healthier. But in general, this is not true,” said Dr. John Homan, a Newport Beach, California internist and sports medicine certified physician. “If you look at high level athletes, they aren’t the healthiest.” Dr. Greg Thomas, a triathlete and cardiologist with the Mission Internal Medical Group in Mission Viejo, California was not surprised to hear of an athlete having heart problems. Thomas said the myth that athletes were immune to heart problems dates back to more than 30 years ago, when it was unheard of that a runner or athlete could suffer from a heart attack. Then, after marathoner and author Jim Fixx died while running, it was proven that athletes are not immune. So why is this happening to us? We're people who are obsessive over every morsel of food we eat, map out weekly workout regimens and sacrifice countless hours to staying fit. Some researchers attribute these cardiac problems to something called “heart cell death”, which occurs during strenuous activity. It’s like having a small heart attack while your heart is working wonderfully to get you a PR. The reason this happens is still unknown. One popular theory suggests that during stressful activity, the adrenal glands release increased levels of adrenaline and noradrenaline. A presence of more of these hormones, is thought to cause the coronary arteries to constrict, resulting in localized cell death within the heart. This has sometimes been observed during prolonged exercise. One study of Hawaii Ironman finishers found that 9% displayed elevated levels of these hormones.Another report from Peak Performance, an online information source for athletes, said an athlete who participates in a strenuous test of endurance lasting about three hours or more has an increased chance of dying during the event and for 24 hours following the activity. The athlete has more of a risk of dying after exercise than a cigarette-smoking, sedentary lay-about who spends the same 24 hours drinking beer and watching TV! Thomas said the chances of an athlete having a heart attack is more a matter of probabilities. There are a few things you can do to protect yourself on the road. Looking at your family history will help you to determine if you are at risk. “If your parents had a history of heart attacks, then your chance is greater,” said Thomas. He recommends a stress test for athletes over 40 who have increased risk factors, (such as heredity) and emphasizes, “Because of exercise, an athlete will have a decreased chance of heart disease, because exercise is a preventative measure.” The good news is most athletes who have survived a heart attack can return to racing, if they can pass a stress test. “Most people do pass and can return to racing, but must heed to the most unthinkable doctor’s order. If someone is passing you-let them go,” said Thomas. He adds that most heart patients are scared enough to heed his advice. As it turns out, Nedza had a partial blockage of his heart and was given a drug to dissolve the clot called “TPA”. Several days later he passed a treadmill test and was sent home to begin a home walking program. His doctor immediately set limits for him, which included wearing a heart rate monitor to keep his heart rate under 85% while exercising and was forbidden to push to exhaustion. Nedza said he tried to say positive and focused on his program. Beginning with one mile, he gradually increased his distance and pace and was soon running 1-2 miles a day at a slow pace. Several weeks later his doctor urged him to return to the sports he loved, but at a moderate pace. Within six months, he had increased his running speed, began swimming and riding his bike and was planning to do his first post-heart attack triathlon. Shortly after, Nedza, a hard-working lawyer, transferred from a high-volume criminal calendar to a more manageable branch court and retired in late 2005. He continues to have heart check-ups every six months and a yearly treadmill test to check for blood flow irregularities. Workouts today consist of swimming, weight training, running and cycling at a moderate pace with his wife and friends training for local sprint races. Over a decade later, Nedza continues to abide to his doctor’s orders, but admits it’s hard to hold back when people are passing him. But he’s living with the restrictions and thankful he’s got a second chance. Nan Kappeler is a freelance writer who resides in Orange County, California. She is also the founder and owner of Lickety-Split triathlon transition mats. www.fasttransition.com.