By Neil L. Cook, Coach@SLB-Coaching.com
Former President Clinton suffered from a coronary “incident” with symptoms including chest pain and shortness of breath. An angiogram revealed partially occluded coronary arteries and coronary artery bypass graft surgery was scheduled. Remember, Clinton is a runner! Genetics, diabetes, smoking, sedentary lifestyle, high cholesterol, stress and diet are all risk factors for coronary artery disease. Shouldn’t running delay the onset? A runner is anything but sedentary. Runners learn to monitor their bodies and understand what is going on while under the stress of running, whether it is racing or an easy run. Even without a heart rate monitor, runners learn to go by perceived exertion, taking into consideration the heat, humidity, past training, fitness level, pace…you get the idea. We know our bodies. So how does chest pain go almost unnoticed or mistaken for indigestion? Perhaps it’s because we, as runners, have learned to push our bodies and ignore a certain level of discomfort or pain. How could a runner, experienced marathon runner, believe that any chest discomfort could possibly be heart related? We’re healthy, right? If something doesn’t feel right...don’t ignore it.
Two years ago this past July, Dr. Marc Wallack was training for the NYC Marathon. It was to be his fifth NYCM. In his late fifties and at the top of his profession, he dismissed the chest pains as indigestion. He took some antacids and thought nothing more of it. When the chest pains continued for a fourth day and traveled to his chin, he became concerned. He went to work the next day where he is the Chief of Surgery at St. Vincent Catholic Medical Center in Manhattan, a cardiac center and a Level One Trauma Center. He spoke with Dr. Coppola, a cardiologist about his pain. Upon hearing Marc’s symptoms, Dr. Coppola began testing and treatment immediately. A stress test, ECG, blood work, echocardiogram and finally an angiogram was performed. His surgery was scheduled for the following day in one of the very rooms at St Vincent’s that he himself has performed surgery. So, he was familiar with the staff and knew that Dr. Samuel Lang, who would perform the open heart surgery, is a highly experienced and skilled cardiac surgeon. He knew he was getting a great operating room team. He was fortunate, as it appears Clinton is, because there was no heart muscle damage. There were occluded coronary arteries that needed to be bypassed in order to supply the heart with adequate blood flow and oxygenation. Without this surgery, a myocardial infarction, commonly known as a heart attack, would be inevitable, resulting in irreparable damage to the heart muscle and impairment of heart function. Damage to the muscle is something no one wants to see happen, especially a highly driven marathon runner.
Marc will turn sixty a week after this year’s NYC Marathon; it will be his fifth marathon. Yes, he is training for the marathon again! The operation was a success and Marc has been exercising regularly for two years by running on a treadmill three to four days a week and working with a personal trainer. He’s strong, thin and in excellent shape – he looks like a true runner. Watching him run, no one would ever guess what he has been through.
He is training again, but not without problems. There are the usual marathon training problems we all encounter but in addition Marc has to cope with problems unique to post open heart surgery. Marc was not able to run outside. The thought of running in Central Park – the place where he first realized he was on the verge of a heart attack – is, understandably, extremely frightening. He made the decision to come back and run the NYC Marathon, which is a big goal to set after cardiac surgery, but the next step would be even more challenging – overcoming his fears and concerns of going back to running outdoors where his symptoms occurred just over 2 years ago. He knew he needed to do long runs and to run outside in order to accomplish his marathon goal. That’s when he contacted me. We talked about his goal of finishing his fifth NYC Marathon, his open heart surgery and his fears. How many people would pick such a huge goal, both physical and mental after recovering from cardiac surgery? His goal choice is a true sign of determination and courage. Can you imagine what it must be like? Your heart isn’t getting enough blood and oxygen to do its job and the only cure is to graft veins from your leg to your heart. Scary? You bet! And, remember Dr. Marc Wallack is a surgeon.
My strategy was to provide a crutch for Marc during his runs in Central Park. The plan was for me to cycle alongside him, providing electrolyte drinks, energy gels, timing his runs, telling him when to take a walking break, when to slow down and when to speed up. Mostly, I’d be there for him – his security blanket – during those runs. He wouldn’t be alone. We were going to follow his past marathon training plan, gradually increasing his long runs until he was able to run for three and a half hours. He would then feel confident in his ability to finish the marathon. My strategy would be to keep him moving forward, but to keep him in a comfortable zone most of the time. I would regularly check on his status – physical as well as mental. We didn’t have a lot of time – three months to go from a 30 minute run to a 230 minute run. I was confident we could do it. Before his surgery he had already proved himself a marathoner four times. Marc was determined to complete the marathon. I needed to make sure he did. Keep in mind, he is obviously a highly driven type A personality - being Chief of Surgery is high pressure job which deals with life and death on a daily basis. High stress job – that’s an understatement for sure. I know that anyone who is this driven in their profession, can surely overcome the post surgical obstacles and see the marathon goal to its finish. A tough task for him, no doubt, but understanding where he is coming from and seeing that he is certainly a strong, goal oriented person gave me great confidence in his ability to meet this goal. This was to be a rewarding and truly exciting challenge for both of us!
So, we talk. We talk about running in NYC – I’ve been doing it for 26 years. We talk about the logistics of the NYC Marathon – getting to the start, fueling, extra clothes, the bridges, the crowds and the runners. I’ve run the NYC Marathon 13 times. I’ve watched it change from a race of fewer than 3,000 runners to over 30,000 runners. I’ve started with the local elites and at the back of the pack. I’ve run it fast and I’ve run it slow. I have run it with extremely competitive time goals and I’ve run it just to see the city and the neighborhoods and high five the kids and listen to the bands along the route. However, there is one, almost unconceivable way that I have never had to run it – with the fears and concerns of being a post cardiac surgery runner. We talk about fueling, clothes, and hydration. We talk about the hills, bridges and crowds. Marc doesn’t show his fear, he can talk about his fear, but you need to look closely to see it. If you look closely, you will also see the joy - the joy of a second chance at life and a fifth chance at running the New York City Marathon!
Marc has taught me a new appreciation for running. I’ve struggled lately with my own running, doing the miles and staying focused has been difficult. But, I’ll run with Marc this year. I’ll be at his side for 26 miles, 385 yards. I won’t have time to worry about finishing the marathon myself; I’ll be making sure Marc makes it to the finish line. Marc has a second chance; I’m going to be there every step of the way.