Tuesday, July 3, 2007

Risk Assessment

What are the medical risks involved in running an ultramarathon? Recently I've pondered this only because my wife planted the thought in my head. There are the obvious things, blisters, dehydration, twisted and torn ligaments and I'm prepared for all that. We train so that we know these things before race day.

But what about the less obvious. In our own sport recreational runners die from heart attacks every year either on the course or shortly after. The onus is ours to get congenital heart defects and genetic predispositions checked out prior to endurance events but there is still always risk.

Jim Fixx , the person touted responsible for the modern day running boom died while running a victim of a genetic predisposition to heart problems. The story goes that all the signs were there but he chose to ignore them.

But if you have no family history or even a slight history such as one parent or one grand parent out of four do you bother?

I, myself have been dogged by a higher than normal amylase count (~120ppm). The flag is 100 and I am consistently in the range of 110 to 125. My doctor sent me for every test in the book, including sending me to a gastroenterologist. Now amylase is a liver enzyme, so the knee jerk reaction was alcoholism. Of course I drink on occasion. So for a brief time I cut out alcohol out of my life and got re-tested. No change. Let it be known that my doctor was not greatly concerned as he has seen amylase results in the thousands. Widen the scope a bit and re-test. I was tested for every liver enzyme and the only one that was consistently high was Amylase. What I did learn was some other markers in the blood are directly related to how hard I have run the previous couple of days.

AST – goes up after a hard runs but goes down after a week of not running.
CPK (creatine phosphokinase)–goes up after long runs but goes down after a week of not running. It's an enzyme found in muscles and the heart and is a sign of muscle damage from exercise but more commonly in heart attacks.
(Okay, it wasn’t a week it was 5 days I’ll only go so far in the name of medical science)

Now my wife is one of those people who will look into WebMD and other web based medical reference websites. I love my wife with a passion but she is no medical professional. Whatever these sites say is the primary cause of the elevated levels she immediately associates with my case. That being said, I was and am still in her eyes an alcoholic runner with congenital heart problems. Without a medical background myself I must take the wife-doctor’s warning every time I crack a cold one. I’ve just about given up telling her when I’ve had a blood test because the results never change and I’ve just about given up going for the same old tests. The worst are the urine collection tests. I tell myself if I was a gold medal winning athlete I’d have to pee in a jug too, so I grin and bear it.

So I had the last test a week ago I suppose I should go see my doctor for the results. If nothing changes I’m using this as ammunition for a clean bill of health. Wish me luck!

1 comment:

  1. A medical post! I nearly jumped up and down with glee.

    Yes, both AST and creatinine kinase are tests that will be high if you are using your muscles for exercise. You got it....it's about muscle breakdown, not necessarily in a bad way, but it just means your muscles are being used. Might also check your lactate level as it has a lot to do with the muscle breakdown. Could parallel the high Cr Kin and AST.
    That's my professional medical opinion.

    That is all.

    Good bye.