With One Lung Tied Behind my Back Jarrell 1
You’ve probably read many stories about running a marathon so I won’t bore
you to tears with all the things like how nervous I was lining up for the Houston
Marathon or the massive crowds or the humidity or any of that stuff you’ve heard
The story I want to tell you will be a little different than most stories you’ve read
about running and if you were looking through binoculars from the roof of the
Convention Center at the start of the Houston Marathon Houston and zoomed
into the man in a dark grey Brooks running shirt that is standing behind the girl
with the 4:30 pace balloons, you’d see me about to run my first marathon on beta
blockers, which is a medicine used to treat hypertension.
Beta Blockers (I’m taking Bystolic) are usually not prescribed for endurance
athletes since they work by reducing your heart rate and that makes it hard to
run. It’s like running with one lung tied behind your back, reducing the amount of
oxygen that your body gets. But then the next question you’d be asking is why an
endurance runner needs to take hypertension medication in the first place. So
That’s me earlier this year sitting uncomfortably exposed in a hospital gown on
one of those examination tables at the doctor’s office. My wife wanted me to get
a complete physical since I had turned 50 years old. I had been a fairly skittish
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patient most of my life and since for the twenty years we had been married, I had
So there I sat with the blood pressure cuff around my arm and I could feel my
heart start pounding harder and I started sweating a little.
I knew the reading was going to be high so when the nurse said, “150/80”, I
wasn’t that surprised. What did surprise me is that she returned shortly with a
portable EKG machine and it showed I had an anomaly that the doctor was
“Your blood pressure is higher than I’d like to see it,” the doctor said when he
came in. “And it looks like your heart is working a little harder than it should be.
See this blip here”, he said pointing to the EKG readout. “It shouldn’t come up
I always had high blood pressure when going in for physicals so I told him I
had “cuff-reaction” – that I ran a lot and wasn’t overweight but he wanted me try a
beta blocker anyway: “If you have a stressful job, you probably have higher
readings during the day than you think”, he said. “And I’d like you to go in for an
echo cardiogram – I’ll have them call you.”
Let’s even back up some more and I’ll recap how I got into this situation in the
first place: not handling stress well, good food and drink. In that order.
After my exam, I remember the first time I took a 10 mg Bystolic tablet, I woke
up in the morning to run my daughters to school (they ride their bikes) and I felt
like I had lost half of my cardiovascular system. The change was so severe that
my whole life flashed before my eyes. Not my real “life” with my family and jobs
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and bills but my other life as a runner – the life that I live running in the mornings
and taking long runs on the weekends. The life I live uploading data from my
Garmin GPS to the computer so I can track how many miles are on each pair of
shoes and the life I live with my friends training for the next marathon and the life
The beta blockers brought down my blood pressure but I could no longer run
without feeling extremely winded. I went from fairly average runner averaging
around 4 hours in my annual marathon (3:54 PR), to feeling out of shape and
With my reduced capacity since taking a beta-blocker, I went from being
leader/encourager from near the front of my Saturday morning running group, to
And then I got the call. It was from the cardiologist’s office and they had an
appointment for me to come in for an echo-cardiogram stress test. The nurse on
the phone said I could just wear comfortable clothes and shoes, that no athletic
gear was needed since I’d just be walking fast on a tread mill.
I asked about if I should continue to take my blood pressure medications
before the test and got the standard cover-your-bases answer: “If your regular
doctor prescribed medication for you to take, you should continue to take it
So I arrived at the cardiologist’s office in North Dallas with a full dose of beta-
blockers in my system. When I entered the office, I noticed how differently the
office was laid out as opposed to the clinics I’ve been to up until then. The
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reception area was more like a lawyer’s office with wood paneling and furniture
that didn’t look like it had been stained with 5-years’ worth of patients with
And the exam room was twice as big as they usually are with a nice view of
the Dallas skyline. The nurse took my blood pressure and pulse rate but then
hesitated. She took it again and said something about my pulse being low
(around 50) and she wanted to recheck it.
When the doctor came in, he had my EKG results from the first doctor and
asked me how it was going. I told him the story about my history of “cuff
reaction”, that I was a runner, but my primary-care doctor saw something on the
“This EKG isn’t necessarily bad. Especially if you are a runner,” he said. “We’ll
have to see if there are any blockages though. Just don’t break my treadmill.”
I told him he really didn’t have to worry about that because I was at a reduced
The nurse led me into dimly-lit room with a treadmill next to medical equipment
and soon I was attached to the cables and the test started. The doctor was
asking me about my running, and also shared how his daughter had just run her
first marathon. The treadmill increased speed and incline and the doctor
continued to ask me questions. I could tell he was seeing if I could talk when
running, something I used to be able to do but was definitely struggling to do at
With One Lung Tied Behind my Back Jarrell 5
The nurse took my blood pressure up until I was at a full gallop, sweating
profusely. The doctor encouraged me to keep going, that the machine had finally
gotten my heart rate up enough to be able to get a good reading. He asked me to
keep going and after several minutes the treadmill reduced speed and I was led
back to the exam table for one last look at my heart with the probes.
I can tell you I was glad that treadmill finally started winding down and I could
get off of it. I had expected a nice walk on the treadmill and it had turned in to a
long sprint for my life (my runner’s life that is).
After the test, the doctor said there wasn’t any blockage and that there were
“50 or more options” for blood pressure medications and we’d just have to find
one that worked so he put me on Cozaar and I left his office encouraged that I
could have both: good endurance and also low blood pressure.
A week or so after getting off the Bystolic and on the Cozaar I got sick with
strep throat and the doctor at the clinic measured my blood pressure at 160/80. I
didn’t count this as a real reading but then had another encounter with the
medical establishment (rains it pours) and it was 155/80 so it appear the Cozaar
wasn’t working and got back on the Bystolic figuring I’d rather have half of my
cardiovascular system and continue to live (my real life) then harm myself in the
I was fairly happy with running with one lung tied behind my back until later
that summer when my friends and I started training for our annual marathon. On
one hot and steamy Saturday morning I had such a horrible 12-mile run, feeling
light headed and winded most of the last miles, that I vowed to call the doctor for
With One Lung Tied Behind my Back Jarrell 6
a change in my medication which I did but never heard back from my internist
(my primary care doctor) so I called the cardiologist and left a message with his
It had been several weeks and I hadn’t heard back from either doctor so I
continued to train for the marathon through the summer and while not completely
back to normal as far as times and effort levels, I thought I had reached a
workable level so when the cardiologist finally called back (of course at the worst
time ever while riding to lunch in a car with 4 of my co-workers on a Friday), I told
him that I had been struggling running on the Bystolic but was feeling better
about it so we decided not to change anything at that point.
It wasn’t until the last two long training runs before the Houston marathon that I
started questioning if I had made the right decision to stay on beta blockers. For
the last 10 or so years, I would drop back and encourage the runners in our
group that were struggling but now those same guys were dropping back for me.
And the last two miles of the 20-miler we did before Houston felt more like a
death march than something I do for a hobby.
Houston would be the first marathon that I was scared about not being able to
finish. For the last 16 or so I’ve run, I’ve usually been concerned about my time
or pace or how ugly or pretty the finish would be but never about catching the
Personally, the setup to running Houston couldn’t have been better: driving
down from Dallas with a good friend, perfect weather, sound sleep the night
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before, all biological systems working well, and at peace emotionally and
The first part of the course went up a long highway overpass but the course
seemed very scenic, flat, and well attended by spectators. And even at mile 20 I
still had gas in the tank and felt fairly optimistic about things turning out well.
It wasn’t until mile 23 that things started going gray and then I got passed by
Jack Lipponcott who was running his 38th Houston marathon. I started taking
some long walks through the water stations and finally had to start singing Chris
Cagle’s country song, “I breathe in, I breathe out, and put one foot in front of the
other” while I did the marathon shuffle to the end. I finished in 4:50 – my slowest
I go back and forth about trying some other medications or even trying to get
off hypertension drugs completely. Even though I probably could get my blood
pressure down some by diet, I think I will always struggle with cuff-reaction and
possibly having high blood pressure under stress so we’ll see how this next
year’s marathon training cycle goes since my running life plays a big part in my
real life and I need to take care of both of them.
Empfehlung des RKI zum Vorgehen im Falle einer Benachrichtigung der Flughäfen über krankheitsverdächtige Passagiere aus Ländern mit Übertragung des neuen Schweinegrippevirus (Influenza A/H1N1) beim Anflug auf Deutschland Stand: 26.04.2009 18:10 Die vorliegenden Empfehlungen basieren auf dem begrenzten, sich jedoch rasch entwickelnden Kenntnisstand zum Auftreten von Fäl en mit dem
Informationen zur Beihilfefähigkeit der Aufwendungen für Arzneimittel nach § 6 Abs. 1 Nr. 2 BhV ab 01.09.2004 Im Artikel 2 Abs. 3 der 27. Allgemeinen Verwaltungsvorschrift zur Änderung der Beihilfevorschriften istfestgelegt, dass die Regelungen des § 6 Abs. 1 Nr. 2 und des § 17 Abs. 3 Satz 2 BhV an dem Tag inKraft treten, an dem die nächste Änderung der Apothekenbetriebsordnung in Kraft