Go Easy On Your Heart!

After having two Pericarditis situations in successive years (2014 and 2016, there was no 100k or 100miler in 2015) of the Northburn100 miler I think it’s important to share some information.

Below is a post written by Ben Winrow, Doctor, endurance athlete, mountain runner and sufferer of Pericarditis. People please beware!

Pericarditis is an inflammation of the heart outer membrane caused by a viral infection – can be agitated by extreme exercise!

I am writing the following  in response to what happened to me and seemingly another runner during the NB100. I am a Doctor specialising in ED and ICU. I do not listen to my own advice and am as obstinate as any other ultra runner but I need to make people aware of what can end not only your race but also any form of endurance exercise.

So I suppose I should begin at the beginning.

I used to be fat, obese actually. BMI 32, waist 37 inches, out of breath walking up stairs. I purchased a road bike with my first paycheck post university and didn’t look back. I began running soon after I had lost a large amount of weight – well actually I did a duathlon – 12km run, 42km ride and 12km run – having never run before I thought, ‘how far could I take this’. Three months later I ran a 64km ultra in the Welsh hills in the UK. I finished 40th/80 and felt awful, anterior tibial tendinitis, right sided ITB issues, vomiting when I got home – no idea about fluid/food/training etc. I did finish though.

Over the following 2 years I trained, ran, trained, ran, trained, ran (and cycled) to see how far I could go.

I finished my first 160km with 4000m climbing 2.5 years after I first put on running shoes – finishing in 20 hours and 29th/270.

I have run ultras in Nepal at altitude, placed in races in the UK and felt invincible.

I signed up to the NB100 having finished 2nd in the 100km. I trained hard…..I mean really hard. I altered what I ate – I got down to 5% body fat, and 68kg. I pushed my limits…….hard.

Average weeks would be 100-130km running, 250km cycling and 5km swimming. I was smashing all my PB’s, I was KOMing all over the place on Strava. I felt invincible.

I ran my fastest ever mountain marathon as a training run at the Big Easy, I placed 7th in the Shotover Moonlight marathon, again as a training run. I placed 9th/300 in a 56km fell race in Devon. I was mentioned in UK trail running magazines, the pre race report for NB100 as a potential podium and also by Matt Bixley (legend) – I was feeling on top of the world, my world, which was running and endurance training.

I entered race day and started as if I was going to win – its all I wanted.

1 month prior to the race – I had a head cold (my wife was sick also – it comes with working in a hospital – she was a lot worse than I was) it lasted 2 days – I didn’t have body aches and so I continued training. I did not let up in my schedule at all. I look back on this time as foolish.

I look back at my training log 2 years later and realise a pattern – I could not run uphill at all. I remember running my usual hill runs that were never an issue and I would be pulling myself up with a stick wondering why my heart rate was going to 180, I couldn’t control my breathing and I could not maintain an effort at all. I had no chest pain, I had no other issues and because I was tapering I never tried to push it on the flat.

I distinctly remember Terry Davis phoning me and talking about being on fire with my form and not to get sick. (Also cautioning against not over training!! Edited. Terry)

That’s fine, I thought, I only had a tiny cold for 2 days and I feel fine right now.

Race day.

I felt awesome, I was the lightest I had ever been, I had nutrition sorted and my pack was epic and light. Everything was going to happen as I had visualised in my head so many times – I wanted the glory and I wanted to win. (Did not listen RD who told him to start out easy!)

I set off on the run at 6:30 miling. I ran all the ups and before the first check point, took the lead – I remember it well and the feeling was amazing. I got to the top of the first climb and was traversing the top thinking that I was feeling great but I was finding it difficult to put and effort in again – like some of the previous training runs.

I began the descent of the first loop, leading the NB100!! and then I got a strange pain underneath my shoulder blade on the left. I had never had it before, it was sharp and painful and it felt muscular. I mentioned it to the many runners that overtook me as it worried me but I carried on. I love descending and to have people overtake me on a descent worried me also.

I finished the first loop feeling sick, tired, out of breath and the pain had gone from my back through to the front of my chest. I mentioned to my wife that something wasn’t right. I knew it deep down but I wanted to win – why wasn’t this going to plan? What was going on? I left for the second loop in 5th I think – I was unable to walk uphill without significant pain in the shoulder blade, my heart rate went through the roof and I couldn’t eat. The pain then went to my jaw.

I have never felt like I was going to die before but I felt like that in that moment. I remember waking up on a rock and wondering how I had gotten there (I must have collapsed) I then did some test runs – If I walked the pain wasn’t that bad but even running downhill with little effort put in it was like being stabbed in the chest. I mentioned this to the next checkpoint – I said that my legs were feeling awesome, my body was great but the pain in my chest is NEW, NOT LIKE ANYTHING ELSE, and I think I am going to have to stop – they radioed the medic and the medic then pulled me from the race.

I cried sitting in the mud, looking at the lake wondering why it had gone wrong and whether I was actually having a heart attack or dying or whether I was just being a pussy.

An ambulance was called (I was mainly concerned that I was not going to get to use my new headtorch!!!) and an ECG showed that I either was having a massive heart attack or I had a condition known as pericarditis.

Dunstan and then Dunedin Coronary care were the next ports of call. An ECHO, a cardiac MRI and ECG’s later and viral/exercise induced pericarditis was the diagnosis.

It was a mixed bag of emotions.

No exercise for 6 weeks – not even walking fast. I put on 10kg and felt unfit and unwell.

That was 2 years ago.

Recovery is a bitch – I genuinely thought I was going to die, which I haven’t but the purgatory of not knowing how far to push yourself again is just as menacing.

I began with short runs and rides and slowly built. I have since cycled 300km non-stop and did my first running race of 34km last month (which was awful and way too hot!!) but I am getting back there – not as capable as I once was but getting back there.

I plan to come back and finish what was started 2 years ago in 2017.

Next time however I will be sensible.

I suppose this post is cathartic, to understand what I went through, to get it out there and also to warn others.

I felt invincible and unstoppable. Even as a Dr I knew that with severe colds you need to rest but I didn’t hold much by what I had. Having said that, when reading my training log all the signs were there and I didn’t listen to my body. During the race I didn’t listen to myself either. Winning and recognition became too much.

Given that what happened to me has happened to another runner it should be said that if you are planning to do the NB100 or any long distance event please know that the race will be there next year, listen to your body and if you have been ill with a viral illness or chest infection in the 2-4 weeks prior to it, please consider doing it the year later – it is not worth the 2 years of recovery and inability to do anything at all rather than the waiting for a little while, resting and coming back stronger.

The hardest thing to get over is the mental aspect of it – I had an ECHO today that showed no difference and physically I feel great again but every niggle, every muscular ache, I wonder – is it coming back? It is this not knowing that kills me every time I go for a run – will this be my last?

I have since done so much reading on ultra running and cardiac health – if anyone wants a detailed synopsis of this reading I am happy to provide it but it is hard to read if Ultras are your passion!!

I consider myself lucky to be able to run and cycle again – I know personally of people who have continued running and training with colds that have been left with cardiomyopathy and find it hard to climb stairs.

PLEASE – look after yourself, look after each other and listen to your body – remember, the first rule of mountain climbing is to know when to turn back. The mountain will be there long after we are gone.

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