I love running. I love the freedom, being amongst native bush and birds along the trails, and of course the solitude. And too the camaraderie of running with a like minded bunch of fellow runners.
Reading last month about Winton Rufer suffering a heart attack while riding a Lime scooter has prompted me to share my concerns around my recent diagnosis of heart disease, and to make a call for help. Despite knowing that a third of the male population in NZ will die from heart disease, I feel strangely alone.
In October last year I was diagnosed with Coronary Artery Disease. Yes, heart disease. A disease that afflicts one third of the population. Known to be irreversible. Unseen yet chronic.
Where once I just had a risk factor (high LDL cholesterol), now I have irrefutable evidence of thickening and calcification of my coronary arteries. That’s like the seashells we saw on the beach at Christmas. Crunchy underfoot. Not rubbery like the fresh seaweed nearby, nor how I would expect an artery to look and feel. According to the radiology report I’m in the worst 3% of men. An elite club! Sadly, I’ve always wanted to belong to the running elite. The specialist I was referred to put me on a treadmill stress test and the results ironically show I am well above-average fitness for my age. Nevertheless, no matter how good the tuning of the engine, if the fuel line gets blocked, it’s game over.
All these tests and statistics somehow serve to dull the fear that I face. Like the sword of Damocles hanging over my head, the fear of a rupture, a clot, a heart attack or stroke and likely sudden death accompany me, like a secret shadow everywhere I go, and especially when I am running.
So too the statin and aspirin. Taken daily they allow me to avoid facing the reality of my condition and put a wrapper around the dull ache of fear growing within. What do these drugs really do? They don’t treat the cause, and they won’t cure me, not like an antibiotic for infection or chemo for cancer. No, despite the plethora of web ads that promote foods that will clean your arteries (it seems the web has a fascination for cleaning products), once plaque has formed, like the barnacles on the side of an old boat, it is there for good.
When I got the news, I was in a café with my wife and daughter. We were on our way to the Twelve Apostles, a trip we had been looking forward to for many years. The sms from the doctor read, “…elevated risk. Please call to make an appointment to discuss”. I had recently done a calcium score CT scan. Based on my age and LDL cholesterol level (20 years of high LDL – probably an over functioning liver according to my GP), a scan was recommended, and so I duly made an appointment at Auckland Radiology. It was a big machine, a bit like the time travel machine from the sci-fi shows I watched as a kid. The test was over and done in less than 5 minutes. What would I do differently if I could go back 20 years?
So, how should I respond? If I have a tenfold increase in risk of heart attack from a clot forming (travel insurance premiums seem to indicate this), then there is a ten-fold greater chance of me collapsing unconscious while running. Should I then alter my exercise regime? Is it foolhardy to go running alone, or for that matter to do any activity alone? Should I therefore only travel work in places where there would be a person chancing upon me within 60 seconds of me keeling over? Should I ask a colleague to accompany me to the loo to check that I’m ok? Maybe I should carry a device that detects that I’ve fallen and am lying unconscious and can call emergency services with my GPS coordinates.
And even if I do run with others, is it fair to push this burden onto them? That I could fall unconscious at any moment?
I care about my family and want my daughter to grow up with a father (at least until she is 25). I have a modest life insurance (thankfully) and am generally prudent. My kiwisaver is in the conservative fund.
Yet where does prudence end and irrational fear take over? Where does my belief in providence and faith in my creator end and personal responsibility begin? Both are important, but would going for a trail run alone be reckless? Or would it be a celebration of life and the glorious land that we live in?
Statistically, my life could end suddenly any number of ways. A vein in my brain could rupture. One of the impatient drivers on the Waikato Expressway could lose control trying to jump the queue by overtaking dangerously and collide head on with me as I travel south one morning on my daily commute. I could be sucker punched by a testosterone fuelled thug as I cross Queen St. Or I could get bowel cancer or melanoma and die a slow painful death.
Winton Rufer suffered a close call. He was lucky there was a passer-by who witnessed him collapse, called emergency services and asked another passer-by to help with CPR. If Rufer had been alone, all would be over. Interviewed by a reporter while recovering in hospital, Rufer said his Christian faith means he’s not fearful of death. But waking up to see the worry on the faces of his family and friends showed the father-of-two that he wanted to be around longer for them and to keep promoting soccer. “I’m really lucky to still be alive, and I’m glad I am because I love what I’m doing and am passionate about the game.”
As I began, despite knowing that a third of the male population in NZ will die from heart disease, I feel alone. Are you a runner in my situation? Can you identify with the fears I express?
I want to know dear reader how you who are fit, enjoy the outdoors and solitary pursuits deal with the sword of Damocles over your head. How do you deal with the aspirin, the daily statin and side effects? How do you deal with the fear of having a sudden heart attack more than 2 minutes away from help?
When I shared my concerns recently with my GP, he wasn’t able to offer much advice. Though he did say that I would likely feel chest pain or angina as a warning sign. Should I avoid ever being alone, make sure I carry a phone wherever I go (and make sure I stay within coverage)?
Or should I carry my life lightly with palms upheld? Not with a sense of recklessness, but with a sense of gratitude, and with a heightened urgency to live wholly, to love through the pain barrier, to look up in wonder more often, even if it means going up a bush track to get a good view.
Paul Kalanithi in his bestseller “When Breath becomes Air”, writes that he would never talk life expectancy with his patients. “How long do I have doc?” “Long enough to live well.” I know that statistically my life expectancy has dropped. Does this mean I will have fewer years to fill with new experiences? Or on the other hand more years to live focussed on what is truly important – my family, my growing sense of purpose and calling, and leaving a legacy of good in my community.
Whatever, and however I answer these questions, one thing I am certain of, I don’t want to face these questions alone.