MARATHON RECOVERY
After heart surgery, an athlete gets back to running marathons
A year and a half ago, Alex Glarakis wrapped up a 19-mile run and headed directly to a party at the Greek church he attends.
“We started dancing and dancing and dancing, and before I knew it I was on the floor,” the 64-year-old IT security specialist at IBM said.
Glarakis hadn’t bothered to eat after his run, so when he passed out, he at first blamed improper nutrition or dehydration. A friend gave him some Gatorade. He felt better, danced some more and drove home. But when he woke up the next day feeling sick, he wondered whether something was seriously wrong.
“I said to myself, ‘Oh, my gosh, I broke my heart. I have to go to the hospital,’” Glarakis says.
Glarakis went to the emergency room, but doctors found nothing wrong. Unconvinced, he visited his primary care physician, who noticed a slight abnormality and referred him for more tests.
What that next round of examinations revealed shocked both Glarakis and his doctors: The runner, who had no history of heart disease, had complete blockage in one artery and partial blockage in another. He needed surgery — and by no means should he be walking, much less running.
Glarakis underwent double bypass surgery in February 2017, slamming the brakes on a routine that had included hours-long runs. From his hospital bed, all he could think about was getting back to his mission of running a marathon on every continent.
“I was dreaming of the day I would run. I was running in my mind every night,” he says.
Athletes who have suffered a significant heart event, such as a heart attack or bypass surgery, should ease back into training, says Dr. Craig Siegel, a sports cardiologist at Heart
Hospital of Austin at St. David’s Round Rock Medical Center, which studies the hearts of athletes. A competitive swimmer himself, Siegel understands the need athletes feel to get back to exercising, but it’s important to take a break from rigorous training to let the heart heal, he says. As a general rule, he recommends a three-month hiatus. (Always consult with your doctor about any activity you plan to undertake.)
“Our goal as sports cardiologists is not to disqualify people, but to figure out a way to keep them doing what they love doing,” he says.
Doctors directed Glarakis to a 12-week cardiac rehabilitation program at St. David’s Round Rock Medical Center. The 36 one-hour sessions included supervised exercise and educational programs covering stress and diet. At first, Glarakis walked just 10 minutes at a time. He built on that time and distance. Before he finished the program, he underwent a maximum stress test.
Such a test, Siegel says, can boost the confidence of an athlete who might feel trepidation about getting back to brisk exercise after a heart problem.
“We push them as hard as we can, because the reality is when we’re training, we push ourselves pretty hard as athletes, regardless of our ability,” Siegel says. “If there is a problem or limitation, we can pinpoint it.”
While exercise proves beneficial in the long term, it also presents a slight increase of risk in the short term — whether it’s during training or at a marathon. “There’s always a bit of uncertainty, like an NBA player coming back from injury,” Siegel says. “At the end of the day, we subscribe to shared decision-making.”
Sometimes, athletes pick up where they left off. Others shift gears, such as switching from full marathons to halfmarathons. “What we tell them is to use common sense,” Siegel says. “If you’re not feeling it that day, there’s always another race. You’ve got to listen to your body.”
Not all the patients Siegel works with have heart disease. The sports cardiology program at St. David’s Round Rock Medical Center monitors and evaluates athletes with cardiovascular problems or potential problems and is designed to help them get back to doing what they love. Siegel sometimes sees patients who have noticed a drop in performance or other symptoms that may or may not be heart-related.
“With athletes in particular, they’ll say, ‘I’m having trouble hitting these intervals. They used to be easy, but now I’m struggling.’ There are many variables involved, and it’s not always the heart,” Siegel says.
Metabolic testing can help those athletes determine their threshold, a number that changes with training and age and provide a good baseline for future comparison.
Glarakis, for one, is back to covering long distances. Earlier this month, he logged a 21-mile training run. He says he’s moving as well as he did before the bypass and recovers from intensive exercise intervals more quickly than he did before the surgery.
On Aug. 11, he’ll line up at the start of a marathon in Kenya. It will mark the fourth race in his mission to run a marathon on all seven continents. (He’s already logged marathons in Austin, Greece and New Zealand.) He hopes to knock off the next two continents in January, when he flies to Antarctica for one race and Chile for another. That will leave just one continent to go, Asia, and he plans to race there later in 2019.
“I love it,” he says. “Until the day I leave this world, I want to be up and running, even if it’s just 1 mile an hour.”
At the hospital, Siegel remains supportive but realistic.
“I’ve told (Glarakis) the warranty may not apply,” Siegel says. “Some of these events are pretty extreme and put stress on the body. But if it’s something really important to him, then do it. That’s what it’s all about.”