Dare To Be 100: Too Many Steps

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As a kid I was always very active kicking, throwing, chasing, being chased, catching schussing. etc. but I never really ran for running's sake. Until my wonderful dad died when I was 39. I crashed, clinically depressed , but as a physician informed about the fact that exercise was clearly the best treatment for depression, so I took up running.

The Boston Marathon was the only open running event of international consequence. It was legendary, and back then it was public with no qualifications. So I was enough of a Walter Mitty to reach for it. I entered. I started to run slowly around my neighborhood in Ked sneakers and cut off jeans. More and more, and more and more. Then the authorities in Boston initiated qualifying times. I felt deflated as I was, and am, too slow to meet even the slowest standards. But simultaneously a group of us doctors under Ron Lawrence's leadership proposed a deal to the organizers of the Boston Marathon that in exchange for providing medical oversight for the runners we would be granted a small number of at-large entries. Like a flash I was on it, and so I was lined at to the start of the Boston Marathon in April 1971. I finished in five hours, five minutes wiped out but proud as hell. My depression far back.

That effort thereby spawned a yearly effort. Thereafter, I ran a marathon every year for 42 years, including the bomb splattered Boston Marathon, 2013. My annual marathon and its training became my religion. All year long, rain, snow, hot, cold wherever; three times a week without fail, 3 miles Wednesday, 3 miles, Friday, 10 or more on Sunday depending or the anticipated marathon. Subsequently I have run a marathon in New York, Athens, London, Las Vegas, San Francisco, Australia, Boston many times, Big Sur, my favorite. I was slow, but steady. No injuries held me back.

I adopted this addiction to running into my medical practice, and held that all of my patients should move more. Running also infected my family. My wife became a notable senior female marathoner even doing the Western States 100 mile trail run. All four of my children have done marathons, and two of my nine grandchildren have as well collecting their thousand dollar bounty check in the process. I'm leaning on the seven others to step up to the starting line.

But then last Fall I found that my heart was beating erratically. I had had no heart trouble of any sort. It had always beat rationally like a metronome for 85 years. No pain but its pattern of atrial fibrillation meant that my heart was only beating at 80% of its capacity. Too easily short of breath, too easily fatigued. I hated it because I have always been the drum major in the health parade. No misstep was ever tolerated, I never missed a day of work except when I pulled off my Achilles tendon in my 30s.

Consequently, I surveyed all of my cardiology colleagues and friends. Almost all of them urged me simply to learn to live with it. My fibrillating heart was certainly never to be fatal, only debilitating. However, "living with it" is not a philosophy that I could accept.

So last November I turned my heart rhythm over to a well recommended cardiologist in San Francisco to perform an ablation. Ablation consists of threading wires up to the core of the heart and singeing, cauterizing, hopefully catching the irritable spot. I had hoped that this effort would integrate the chaotic rhythm. I was very disappointed when it did not work.

But fortunately several weeks later at my never miss Wednesday morning Stanford Medical Grand Rounds one of our recent recruits, Dr. Sangiv Narajan, addressed us on his new technique of ablation for atrial fibrillation. He effectively said that the prior approaches were charades with only marginal chance of success. I quickly signed onto his operative schedule.

l consequently am now scheduled for my ablation the day after tomorrow.

I'm fearless with great confidence in Sangiv, with the only concern being the eight hour anesthesia that it requires. I crave to have a normally beating heart again, to recapture my heart's pumping capacity.

My sleuthing into atrial fibrillation reveals that it is very common in endurance athletes. My hypothesis holds therefore that all my decades of marathoning delivered quarts of blood through my heart that served to stretch it, and effectively remodel itself, resulting in the tenting of the septum where the conducting fibers run.

I think that the ancient Greeks said something about a Golden Mean not too little but not too much. Here I am at age 86 having taken too many steps along the way. The next time around I will be more restrained in my activity.

With all the attention being paid to achieving 10,000 steps per day it may be appropriate to issue a small bit of caution. I plan to revisit my philosophy after the ablation is successful, so stay tuned for readjustment.

I hope that Sangiv is up to the task.