Fake it ’til you make it

Scott and me after the White Bear Lake 20-mile race on September 12 (also our wedding anniversary). I had heart surgery again on September 24.

Last year after I finished cardiac rehab, I joined the hospital-affiliated gym and signed myself up for personal training. I knew from rehab that the accountability that having a training appointment scheduled would provide was crucial. I worked with Stephanie and Laurie for six months, then just Stephanie over the summer.

I loved going to training. I liked working really hard and they enjoyed having a client/patient without medical limits. It was all good.

And then I landed in surgery again, and combined with the two weeks of testing leading up to that surgery, and a week out of town to help my brother after his heart attack, it has now been at least ten weeks since I’ve been to training.

Not surprisingly, they wondered why. And Stephanie started asking. Never too much, always careful and caring, but I didn’t reply.

So after far too long I finally wrote this email explaining where the heck I’ve been, and begging, at the end, for help. I need that accountability again, now more than ever. It’s time.

After I sent it I thought maybe some others are wondering, too, where the heck I’ve been, or why I never wrote about having to miss the marathon, or how my recovery is going. So here it is. This is why.

Letter to my trainer

Hi Stephanie,

I’m sorry I have been so uncommunicative. I do think I’m finally starting to feel a little bit more like myself, though I’m so frustrated with how slow the process has been this time.

I’ve described the last three months to otherse as a one-two-three punch. First, my younger brother had a heart attack at age 32, one year and two weeks after mine. Not kidding. I completely freaked out and melted down – after all I’d done and learned I couldn’t keep him safe, and likely not myself either. Or my sister, or my kids or his kids or hers. What is wrong with us? Somebody better have some good answers this time . . .

So I was already a wreck and then my baby started kindergarten and now I’m all alone all day every day. This is not helping. Punch two.

Then I ended up in surgery again. This time 75-80 percent block in my LAD; punch three.

I diagnosed this myself: I was having pain when running and slowing down. It was getting harder, not easier, and I knew it. I probably knew it for a few weeks (remember when I was complaining about slowing down?). The signs were all exactly the same as before my heart attack. I called Dr. Murad and we started testing and testing and testing until he found it. He actually had to use his 3D camera during angio to find the problem. No other test, including 2D angio, showed it. So, we caught it in time to prevent an LAD (aka widowmaker) heart attack, and once again, running saved my life.

And then Dr. Murad told me no more marathons. And no more babies. His tune changed from “you can do anything, I want you to live your life” to “your body creates and deposits plaque at a very fast rate that cannot be explained by high cholesterol alone,” and he said we had to be even more aggressive with the treatment and that there are now limits to my life. Punch three. I’m very sad about losing my distance-running identity, and while I was more prepared for the no-kids rule, it is still a limit. I went from no limits to “know limits.”

In the hospital we decided I didn’t need rehab. I felt fine (having run 20 miles 12 days before my surgery) and I’ve already learned all that they can teach me. I expected to be right back in Exercare. I really was in a pretty good mood about it all and thought I had perspective. Ha.

What I didn’t expect was the pain. Wow. It had never felt like this before or after my heart attack or surgery. I could hardly do anything. It was acute pain, ache, pressure, different every day. I probably drove Dr. Murad nuts calling and texting him. It lasted for weeks.

When he suggested a run to test it out, I was excited to try, but the pain was exactly the same as pre-heart attack, pre-surgery. I didn’t like this and neither did he. He put me on slow-release nitroglycerin, which has helped, and said to wait a while longer.

In the seven weeks since my surgery I have had about 3 or 4 pain-free days. I have done some running, 2-4 miles, sometimes with someone, sometimes alone, maybe about 10 times. I have had two pain-free runs. We might call this punch four – or total knockout.

I’ve had an appointment with Dr. Murad and we discussed the pain and its causes at length. Given how well he cleaned out my arteries, the large LAD stent he put in, and the fact that he stress-tested me twice while in the cath lab, he is sure the pain is not dangerous. It is from the trauma of the surgery (I was in the lab for two hours) and from what he called Endothelial Dysfunction, an outcome of my aggressive artherosclerosis. It was reassuring to know that as long as I can handle the pain, it is not going to hurt me; I just have to be even tougher than before. But my confidence has taken a huge hit.

So what do I do now? I have mused aloud to Scott that I should just schedule three training sessions a week for as long as it takes to build my confidence back up. I need the accountability (obviously) because I’m not going to do it on my own. (I have been going to yoga, though, and those few runs. Last week was my best week -three runs and one of them was four miles.)

So let’s do that. Do you have three openings a week? I’m available between 10 a.m. and 2 p.m. I would need to be done by three to get to school pickup at 4 p.m. Yoga is Wednesdays at 10 a.m., so if we could avoid that would be ideal. Saturday is also an option.

Dr. Murad said we don’t have to scale back my intensity for any reason other than what I’m comfortable doing and if I can manage the pain. (It is so odd to force myself to ignore pain after all these months of reacting to every twinge.)

That’s the short-ish version of the story. I know, intellectually, that I need to get there and I need to build both my body and confidence. I just need to be forced to drag my messed up emotional self to the door. My brother says this when he doesn’t want to run: Put on shoes, step on porch, put on shoes, step on porch, put on shoes . . . and I’ve used that to get moving sometimes. Sometimes you just have to fake it ’til you make it, right?

Thanks for worrying about me and keeping me accountable. Let me know when I should come in and I will see you soon!

Jen

Now that I’ve shouted this plan from the rooftops, I’m even more accountable. I’ll let you know what happens next. Thanks for worrying about me and being with me through this journey.