Let's back up.
I finished the marathon feeling pretty good. I was tired and sore, but nothing that I wasn't expecting. I ate a banana, downed a bottle of water and had a cookie. Over the next hour everyone else came across the line and we all hugged and did fine. We went back to our friends' house, showered and decided to take a nap. Still feeling fine! But... I woke up from the nap feeling really bad.
I was nauseous and achy and drowsy. I figured that it would pass so we went over to some other friends' house for a bbq and some food. I proceeded to spend the next 2 hours alternating from hovering ineffectively over the toilet and slumped on the couch. I couldn't make myself eat, drink, talk or throw up. Moving was a pretty significant challenge, as was sitting upright.
(Note from Kat: Justin was sick to his stomach, shaking, and nearly incomprehensible. He couldn't laugh at a joke or answer simple questions. When he talked, his speech was delayed and nearly whispered. It was impossible to get him to eat and hard to get him to drink. We pushed fluids and salts on him for three hours before I decided to take him to Urgent Care because he was not improving.)
The decision was made that I could not make the drive back to Seattle even as a passenger and that a trip to the hospital might be a good idea. Once at Urgent Care (which everyone assured us was faster than the Emergency Room) we quickly were bumped to the top of the line to see the triage nurse and were then given a "First Available Bed" flag. At this point my hands were tingly, I was hyperventilating (I deny this...but everyone else felt I was (Note from Kat: He was. But not in that girly way.)) and I couldn't really carry on conversations. Amusingly enough my nursing vocabulary was intact and my ability to give a full history was still present. Yay for school!
Shortly thereafter I was in a hospital bed and the doctor decided that even though I'd been going to the bathroom regularly all day and had been drinking fluids all throughout the marathon that I was likely dehydrated. I'm not disagreeing, I'm just saying I'm still a bit baffled as to how it happened. So Kat being the loving partner she is, sat by the bedside for 3 hours while they pumped fluids in through my arm. Since I'd had some tightness in my chest after finishing the marathon they decided they'd also run an EKG for fun.
Guess whose heart was undergoing early repolarization? Generally it's considered benign, but they decided to run some enzyme tests just in case so they could be sure I wasn't having a heart attack. I chewed some aspirin and waited for more labs to come back. Surprise! Elevated CPK! CPK is an enzyme in skeletal and cardiac muscle and when those muscles die the enzyme leaks into the blood. Not one to be half-assed about anything, my CPK was 1177% the normal upper bound. So what that tells us is that either my skeletal muscle (my legs) had been turned to pulp. Or I had a heart attack. This worried my doctor a little bit although he was reasonably sure that the damage was caused by running for 26.2 miles...not an unreasonable assumption!
The second lab that he had ordered was my troponin. Troponin is an enzyme specific to cardiac muscle, so if it's in your blood then your heart has suffered some damage. Elevated troponin too! Nevertheless after consulting with a cardiologist they felt that the elevation was not significant enough to warrant a heart attack but that it was likely the result of, you guessed it, running 26.2 miles. This proved to be a not entirely unfounded assumption as pointed out by a study published in the New York Times in December.
“The runners (41 men, 19 women) had normal cardiac function before the marathon, with no signs of troponin in their blood. Twenty minutes after finishing, 60 percent of the group had elevated troponin levels, and 40 percent had levels high enough to indicate the destruction of heart muscle cells,” according to the article. “Most also had noticeable changes in heart rhythms. Those who had run less than 35 miles a week leading up to the race had the highest troponin levels and the most pronounced changes in heart rhythm.”
(Note from Kat: We're in that "less than 35 miles a week" group.)
Be that as it may, I've been recommended for a echocardiogram in about two weeks, just to be on the safe side. I'm sure that I didn't have a heart attack, but I think this eloquently points out just how much stress a marathon puts on your body.
YAY FOR MARATHONING!!!
Posted on April 30, 2007 @ 10:07 PM | 5 comments
Comments:
Congrats on the marathons and I hope you improve soon. (Health wise that is)
By 
running42k, at
4:25 AM, May 01, 2007
HOLY CRAP!
I think I'll just keep on sitting on my ass...
Glad you're OK.
By 
lazylightning, at
8:36 AM, May 01, 2007
Glad to hear that you survived! Sounds like a bit more medical excitement than one normally wants in their life.
Sorry that I didn't get in touch with you guys while you were in town, I guess I wasn't checking my blogs regularly enough :) Kristin's BFA show was monday evening, it would have been fun to show you the show!
By , at
11:19 AM, May 01, 2007
ok Justin, no heart attacks just cause we didn't drive you to Eugene...jeez! Hope to see you guys soon and with healthy hearts.
Amy
By , at
11:59 AM, May 01, 2007
wow, scary. Hope everything is really ok.
Good job on the marathon!
By Allie, at
9:37 PM, May 01, 2007
