Andersen Family – April 2015 photo courtesy of Still Memories photography
UPDATE 9/15/17: For everyone looking to discuss their Myocardial Bridges, Ben (you’ll recognize him from the comments) has set up a site specifically for this purpose. Join the conversation at the Myocardial Bridge Community forum. Thanks Ben!
Vomiting at a finish line isn’t exactly unheard of. In fact, spectacular displays of bodily fluids are half the fun of watching sports! (Is it just me or is Paula Radcliffe’s popping a squat to drop a load still one of the best sports photography moments ever? Or maybe I’m just gross. Whatever.) Usually it means you’ve pushed yourself to your very limit, pumping out every last bit of effort (and breakfast). But when I “left it all on the field” – technically a parking lot outside my gym – a few months ago, I felt neither proud nor accomplished. I didn’t even have the energy to laugh at myself, which is usually the last respite for people puking on their own running shoes. All I felt was awful. That, and crushing chest pain.
I drove myself home, collapsed on the couch, and when I finally had enough energy to pick up my phone, called my doctor. He told me to come in right away.
Did I mention what grueling workout I’d done that had so undid me? Zumba. ZUMBA. Yes, an hour-long aerobics class (albeit a super fun, hip-swiveling, stripper-squatting dance party of an aerobics class) so exhausted me that I had to lay flat down for two hours afterward, crying with pain. Sadly, this wasn’t the first time it happened. You may recall that I’ve been having weird attacks of chest pain ever since moving to Colorado two years ago.
Usually they start about 15-20 minutes into any type of cardiovascular exercise, like running, kickboxing, circuit training or Zumba. It starts out just feeling tight in my chest. I can still breathe fine and my muscles don’t feel overly fatigued. If I keep going, the tightness will increase into pain and then eventually severe, crushing pain – sometimes to the point where I vomit. Once I stop exercising it can take hours for the pain to go away and I’m exhausted way beyond what one would expect for my fitness level and the activity I was doing. (Ex: Running a 10K knocked me out for six hours afterward.) I’ll often have to sleep it off.
At first my doc thought it was exercise-induced asthma but after three separate inhalers failed to provide relief we moved on to bigger, badder things. I was checked for cracked ribs, symptom-less pneumonia and, for a hot second, pericarditis – an infection in the sac surrounding my heart. Finally, after a year of no good answers I had a stress echocardiogram that involved me sprinting bra-less on a treadmill trying to force my heart to do something funky. (I still hate you, lab techs. I may have tiny boobs but they still bounce!) Which it didn’t do because my body enjoys publicly humiliating me. Actually I think they didn’t let me run long enough to get the chest pains to kick in. But when that didn’t show anything wrong with me, my doctors agreed that the problem was mostly likely in my head. So even though I still had questions – like why did it only hurt when I exercised and why only since I moved to Colorado? – I went along with it because, let’s be honest, I am kind of a hypochondriac.
They sent me away with official permission to ignore the pain and do whatever I wanted. Which was cool since that was pretty much what I do anyhow. I love working out! I love hiking and biking and running and kick-boxing and circus tricks and yoga and Krav Maga and… basically anything that’s not swimming! I didn’t want to give any of that up! But do you know what will really make you hate exercising? Having crushing chest pain any time you try and sustain a high heart rate.
The past year has been like living in a Skinner box. Any time I start to work up a decent sweat, my chest starts to feel tight, I feel nauseated and dizzy. If I push through it and keep going, the chest pain will worsen until I literally cannot stand up anymore. And then there’s the vomit. It’s humiliating. It’s demoralizing. It’s insane (I’m a fitness writer who can’t fitness!). But most of all it just really, really hurts. Unlike the last time I got grounded from exercise, this time I can see the damage being done to my body and I can’t ignore it.
I ran the Bolder Boulder 10K (the world’s largest!) on Memorial Day with my hot husband. I was fine because he made me keep it nice and slow!
So after this last puke-tastic Zumba class I finally decided that “you’re imagining things, go away” wasn’t a good enough answer. And thankfully this time my doctor agreed with me and said maybe there was a small chance I had coronary artery disease and referred me to a cardiologist who specialized in sports (which in hindsight might have been his nice way of saying “you’re imagining things, go away and bother someone else”). After over a month of waiting, I finally met the world-famous doc. He told me that if I had coronary artery disease then he was a singing chipmunk and did some more tests.
It turns out I have a myocardial bridge. Probably*.
This is a condition, present from birth, where one of the arteries goes through the heart muscle instead of over the top of it. So every time the heart contracts, it closes that artery and temporarily deprives the body of oxygen. When I’m at rest, it’s not noticeable because the heart muscle relaxes between beats and allows blood flow to resume. But when I’m taxing my heart, like during intense exercise, the heart can’t catch up and the pinched artery causes a severe lack of oxygen which can lead to myocardial ischemia (where you have pain, fatigue, numbness from lack of oxygen) or acute coronary syndrome (like a mini stroke). In rare cases, according to this one study, it can lead to sudden death.
And that’s about all I know about it because there’s not much literature or research on it. (This article from the Texas Heart Institute is probably the most comprehensive info out there.) According to my doc, it’s pretty common – about 5% of people are born with it – but the vast majority of those people never know they have it and it causes no symptoms, generally because the “bridge” is so shallow. But for some of us the muscle covering the artery is thicker and causes problems. He added that I probably have had mild symptoms from it my whole life but they didn’t cause a problem until I moved to Colorado and living at 6,000 feet above sea level was enough extra strain on my already taxed heart to cause the extra pain. Oh that and he pointed out that I’m getting older, which apparently also strains your heart. (I turned 37 last week! That’s not that old, right??)
The treatment for a myocardial bridge is almost as elusive. Apparently there is a surgery they can do but he told me that no responsible surgeon would do it on me because it’s open heart surgery and they only do that on the most severe cases. As long as it’s only bothering me during intense exercise he told me to count my blessings and avoid intense exercise. He also said if it worsens in the future they can put me on blood pressure meds like beta blockers or calcium channel blockers – an option I didn’t want to pursue right now as my blood pressure is already ridiculously low (I’m a fainter!) and lowering it further would create a whole new set of problems.
So I walked out of his office with a prescription to keep my heart rate low (under 145 ish). That means no more running, kickboxing, martial arts, spin class or most of my other favorite activities. For the rest of my life.
I cried. A lot. Not gonna lie. While it was a relief to know what was the deal is – and it really does explain all my symptoms – it means that a huge part of my life and my personality is gone from me. Then I gained 12 pounds in two weeks. I don’t know if it was me eating my feelings or what but now I have tight pants to deal with on top of everything else. (I’m trying to be gentle with myself on that front. For my birthday I went shopping and bought two new pairs of jeans so at least I could breathe while I figure this all out.)
But then I got over myself. For all the things I “can’t” do, there are way more that I can. I can lift weights, dance (lightly), walk, play with my kids, ice skate and (probably) do circus tricks. Hiking, one of my all-time loves, is still open to me. And living in the gorgeous Rocky Mountains gives me plenty of opportunities to do it!
We took the kiddos hiking in Estes Park over the 4th of July holiday and it was so gorgeous it felt other-worldly.
You can’t see what my t-shirt says but I it’s a picture of a film camera (like the kind from the 80’s). The caption says “And that’s when I snapped” which I thought was funny enough at the thrift store to buy it as a workout shirt but the real humor ended up being having to explain over and over again to every child in a 1-mile radius what this “camera” was, why it didn’t look like a phone and what “film” is. Maybe 37 really is that old…
And as far as disabilities go, my heart thing is pretty minor. Lots of people deal with chronic injury, illness or other problems that are way more life-impacting and still manage to lead healthy, happy, balanced lives. So I can’t run anymore. Big deal. I’ll be fine. Yeah it stings a little to hear friends talk about their next big race and how they’re hoping to PR or how amazing their Spartan team and know that I can’t join them. But that’s a small thing in the grand scheme of life. Plus, perhaps this will help me make fitness a more balanced part of my life instead of the over-arching theme of it.
So why am I posting this now? First, it’s been almost a year since I updated this blog. You may recall that I gave up daily posting because my first job (raising my cute kiddos) and my second, paying, job (writing for Shape, Reader’s Digest, Women’s Health, Redbook etc.) made this blog too much to keep up. But that doesn’t mean I haven’t missed you all so much! And all the little notes you guys have been sending me have seriously made my day!! I love that you still remember me and care what happens to me. So I did want to give you an update. Other than this health thing, my life is going amazingly well. The kids are growing up to be happy, healthy, interesting and incredibly hilarious little people that make me smile every day. I’m so glad I am here for all the moments. And professionally things are going well too. I’ve got more freelance work than I can handle.
Second, I’m posting this because I’ve been super frustrated with the lack of information about myocardial bridges so I’m hoping that this will get high enough in the Google-verse that medical professionals and other sufferers can share their experiences with this too! The only case study I found online was a 40-ish man who was super into fitness and who DIED of his myocardial bridge. It freaked me out. So I’m posting this to let other people know that at least this girl is still alive and doing great:)
So now I’m asking you guys: I know many of you have a chronic condition that you have to deal with – how do you plan a workout that accommodates that? Mentally, how do you deal? I’d love to hear all your stories too and learn from you! (Or just give me an update on how YOU are doing! I want to hear everything!!) Also, ANY information about myocardial bridges is much appreciated!!!
*The “probably” is because he said he was “95 % sure” that was the problem. Maybe there’s no such thing as 100% sure in medicine?