Runner's World (UK) - - Special Report -

I’d just turned 65 and de­cided to get a heart checkup. The big­gest pre­dic­tor of heart dis­ease is ad­vanc­ing years, my grand­fa­ther had a heart at­tack in his 50s and I’d started read­ing those ar­ti­cles ar­gu­ing that high-mileage run­ning could per­ma­nently dam­age the heart. A run­ner for 50+ years, I’ve com­pleted 75 marathons and 110,000 life­time miles.

I aced my EKG and echocar­dio­gram, but then came the shiny, black im­age of my coro­nary artery cal­cium (CAC). ‘See the white spots around your heart?’ my car­di­ol­o­gist said. ‘That’s cal­cium in your ar­ter­ies.’

That cal­cium was choles­terol plaque turned solid and meant I had ath­er­o­scle­ro­sis (or coro­nary artery dis­ease). If I also had softer choles­terol plaques lin­ing my ar­ter­ies, they could rup­ture and cause a heart at­tack.

Since I had no symp­toms – short­ness of breath, high blood choles­terol – I was told not to panic. And since I had no angina pain, I could still run. I was pre­scribed statins to fur­ther lower my blood choles­terol, and as­pirin to pre­vent blood clot­ting.

I left 10 min­utes later feel­ing light­headed, dizzy. Scour­ing the web proved less than re­as­sur­ing: my cal­cium score meant an up to seven times higher car­diac event risk. A mil­lion ques­tions buzzed through my brain. Should I stop run­ning? What should I tell my wife and chil­dren? I felt paral­ysed.

In the fol­low­ing days, I took my pulse morn­ing, noon, night and es­pe­cially af­ter run­ning. When I de­tected sev­eral skipped beats, I in­sisted on a test for heart rhythm

is­sues. I wore the scan­ner for 36 hours. The re­sults were com­pletely un­re­mark­able. My heart seemed OK, but my mind was still a wreck. I lived, and ran, in a cesspool of scary ru­mi­na­tions.

MONTHS LATER, I vis­ited Dr Paul Thomp­son, a world-renowned car­di­ol­o­gist (and 28time Bos­ton Marathon fin­isher) who has been study­ing run­ning’s risks and ben­e­fits for half a cen­tury. I begged for more tests. I wanted data that would an­swer my ul­ti­mate ques­tions: should I keep run­ning? Would I live longer if I stopped?

Thomp­son an­swered pa­tiently: ‘ You’re do­ing fine and more tests aren’t likely to tell us any­thing im­por­tant.’ He also told me about seven-time Bos­ton Marathon win­ner Clarence Demar, the first life­long run­ner to have his heart au­top­sied ( he died, aged 70, from bowel cancer). Demar had some coro­nary artery block­age, but his ar­ter­ies were two to three times larger than av­er­age, leav­ing plenty of room for healthy blood flow. Thomp­son said my ‘ hoses’ prob­a­bly had a sim­i­lar abil­ity to ex­pand. Ex­er­cise trains ar­ter­ies to di­late when more blood is needed, so even with some plaque block­age, blood can still eas­ily pass through.

Then we talked more philo­soph­i­cally: Why do I run? What does it add to my life? ‘Telling you not to run would take me off the hook,’ Thomp­son ob­served. ‘But I don’t want to re­move any­thing that adds joy to your life. It’s my job to tell you I don’t think the risk that you’ll have a heart at­tack while run­ning is very great. It’s your job to eval­u­ate the ben­e­fits.’

Since re­ceiv­ing my CAC re­sults, I’ve fin­ished four Bos­ton Marathons and run 20- 30 miles ev­ery week. I’ve also ab­sorbed much from Thomp­son from the psy­cho­log­i­cal-emo­tional realm. ‘Med­i­cal knowl­edge has made in­cred­i­ble progress,’ he said, ‘but there’s still so much that we don’t know. Doc­tors and pa­tients need a tol­er­ance for am­bi­gu­ity.’

In other words, there are no guar­an­tees. Stuff hap­pens. When we run, we run risks. We could sprain an an­kle, get hit by a bus or die from a heart at­tack. We might also form a world-chang­ing idea or gain a greater ap­pre­ci­a­tion for the great­est mir­a­cle of all – our own ex­is­tence. I now draw strength from apho­risms that 50 years ago I dis­dained. I’d rather wear out than rust. I don’t want to be one of the ‘cold and timid souls who know nei­ther vic­tory nor de­feat,’ as US pres­i­dent Theodore Roo­sevelt so pithily put it.

My runs are re­lax­ing again. I don’t fo­cus on my heart­beat and don’t take my pulse af­ter­ward. I just run. I’m get­ting older and slower, which I hate, but I ac­cept that I can’t change the tra­jec­tory of my life. And I know this for sure: ev­ery run is a new ad­ven­ture, and ev­ery mile is a gift.

Bur­foot won the 1968 Bos­ton Marathon at the age of 21

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