Training Plan Completed

Sixteen weeks have passed since I started my Chicago Marathon training plan and it's finally time to toe the line.    My dream of qualifying for the Boston Marathon is a longshot.   A recent 5K  race time has McMillan's running calculator projecting a 3:48:20 marathon (I need to run 3:54:59) finish time, but last Sunday's 10K only projects to a 4:02:10 finish.    Below are this years best race times and McMillan's projections based on those times.

Brick Road Mile - 8/6/2014 :7:04 (3:59:01)
Shamrock Two Mile - 3/15/2014 : 15:20 (4:09:25)
Run for the Grapes 5K - 9/28/2014:   23:26 (3:48:20)
Five Mile mark of Cosie Laurello 10K: 41:37 (4:04:33)
Cosie Laurello 10K - 10/5/2014 : 51:37 (4:02:10)
Hermes Cleveland 10 Miler - 4/26/2014: 1:27:34 (4:05:48)
River Run Half Marathon -9/7/2014 : 1:55:05 (4:02:12)

At this point I still haven't decided on a race strategy.    One option is to just go out and run at 8:58 pace and hold on as log as I can.   There is no 3:55 pace group in my corral, so I thought of starting at the front of my corral and catching up with the 4:00 pace group in the corral in front of me

Race officials project 1.7 million spectators on the course but for motivation, I've decided to dedicate each mile of the marathon to special  people who have been influential in getting me to where I am today.

Mile 1 - Dr. Anil Patel  for saving my life.   Dr. Patel took the time to be thorough with me following a routine colonoscopy that revealed no abnormalities.     During the post procedure follow up, he asked if I had any other issues or concerns.     I told him that I played in an adult baseball league and that in recent years when I would run the bases, I would get extremely winded and would need significant recovery time before I was breathing normally again.    I had dismissed it as the asthma problems I have had most of my adult life.    Dr. Patel thought it prudent for me to have a stress test to rule out any coronary issues.   The stress indicated some irregularities that might be a sign of coronary artery disease.   A subsequent CT scan and heart catheterization confirmed a 70% blockage in my left anterior artery (the widow maker) 

Mile 2 – Dr. Cliff Packer – Cliff was my baseball teammate and a doctor at the VA in Cleveland.    When I told him I was going in for a heart cath, he insisted I call him afterwards.    He looked at my results and made the suggestion that I consider an alternative to the bypass surgery that the doctors at the Cleveland Clinic were recommending.    He turned me on to the teachings of Dr. Dean Ornish and Dr. Caldwell Esselstyn who each had conducted separate studies on the subject of reversing heart disease through diet and exercise.

Mile 3 – Dr. Caldwell Esselstyn – The doctor and author of the book “Preventing and Reversing Heart Disease” whose lifestyle plan I eventually chose.    Learn more about his teachings at heartattackproof.com.    Dr. Sprouts as he is called by his peers, advocates eating nothing with a face or a mother, eliminate all oils from the diet,  eating lots of whole grains, fruit and vegetable along with 30 minutes of vigorous exercise per day.

Mile 4 - Jim Smith – (The axe murderer) Jim was one of the first runners I connected with when I started running.   I met Jim online through DailyMile.com and he frequently commented on my daily postings, offering encouragement and advice.    When we agreed to meet up one Sunday afternoon for a run, Carol just knew he was some sort of deviant.     

Mile 5 -Warren Dillaway –Warren is always willing to slow down to help a back of the packer.  Warren is probably the most influential person in the promotion of our sport in the entire county. 

Mile 6 - Thom West – Like Warren, whenever I was the lone turtle in group ADR runs, Thom would never hesitate to drop back to keep me company.    He always seemed to know when to back off if I was struggling and when to push me if he sensed I had something left in the tank.

Mile 7 - Don Gill- The Encyclopedia.    I've learned more about running from Don than anyone else.    He’s always there for welcome advice and encouragement.    Before every big race Don always calls to wish me luck and he calls again soon after the race to find out how I did.

Mile 8 - Denver Haught – Training partner extraordinaire.    Denver and I are close (he’s a little faster) in speed and is my perfect training partner.    He joins me on my hard days (tempo runs and cruise intervals).    There are days I push him and days he pushes me and then there are days we carry each other.   One thing that is guaranteed, when Denver and I run, we are both exhausted if and when we finish the run.

Mile 9 - Drew Smith – The pace setter.    Drew refuses to let me finish ahead of him even in long slow runs.     If we go out for a tempo run with a target of 8:00 minutes he’ll push me to 7:55.    If my plan calls for 8:30 miles, we have to run 8:25.  I set three PRs running with Drew this past winter and they were all during training runs.

Mile 10 – Amy Bodnar and Elizabeth Bodnar – My running nieces.   Amy started this insanity.    Since Amy lived on the west coast we didn’t see her very often.   One year at a family reunion I noticed that she had become like myself a little pudgy (to be kind),  at the next reunion she was this slim, trim hotty preparing for her first half marathon.   We finally got to run together at the Detroit Marathon and toughed it out together under some pretty grueling conditions.   Lizzy started running about the same time I did and is a great motivator for me.    I would make a breakthrough in training and think I had a chance to keep up with her only to find out she improved equally as much.   Keep setting the bar higher Lizzy.

Mile 11 – Heather Harmon, Crystal Stoneman, Brenda Long, Mary Beckwith,  Lisa Haytcher, Giovanna Kustala – Long run partners.   “My Girls” and I have logged a lot of miles together this past year.   Many a Saturday morning I was content with blowing off a long run but I knew my harem was getting up to run with me so out the door I went. 

Mile 12 - Lexi Meaney – My early race partner.     When I first started running it was Lexi’s first year running cross country.     It took me six months before I could beat her.    She always used a strategy of begging me to slow down.   She would claim that her side hurt or she couldn’t breathe and convince me to walk for just a minute.   It never failed when the finish line was in sight though she could sprint like Usain Bolt and cross the finish line just before me.

Mile 13 - Alyssa Meaney – Lulu, Grand Daughter #2 hated running when we convinced her to try a 1 mile kids run.   I think that’s changed now as she seems to be enjoying her first year in cross country.   She has shown steady improvement.   I’m looking forward to the day when she catches me.

Mile 14 - Angela Bodnar-Meaney  - The unofficial ADR race photographer was convinced I had a death wish when I started running.     She convinced her husband Brad to start running so that he could keep an eye on me in case I had a heart attack during a race (as if he was going to make a difference).

Mile 15 - Brad Meaney – Brad first started running on orders from my daughter.   Brad was side by side with me in my other marathon attempts and practically carried me across the finish line.  It wasn't long before he got the bug and started serious training and has become a pretty darned good runner himself.

Mile 16 – My Daily Mile Friends – Lisa Kiser, Jean Smolka, Chris Bamberger, Robin Stewart and Deb Roberts.    During my first couple years of running I logged all my workouts on DM and my online friends’ constant encouragement kept me training.   If there was a day that I didn’t quite feel up to running, I would see their posts and out the door I went.

Mile 17 - Nicholas Bodnar – All year long I had to get up at 4am so I could meet Nick at the Y for our morning workouts.    The spinning and weight lifting we did together  added an important new dimension to my conditioning which helped stay injury free even though my mileage has increased dramatically over the previous couple years.

Mile 18 – Eric Riesterer – Eric joined me on some pretty tough tempo runs and track workouts.   I would be feeling like I couldn't run another step and he would tell me I was looking good or something like only one more lap, or two more minutes.

Mile 19 - Chrissy Tobias – My main motivator.    What an inspiration.    The first year that I ran, Chrissy was always beating me (barely).     It wasn't until late in that first season that I was finally able to catch her and that took an all-out kick passing her just before the finish line.   The next season, I got the upper hand and finished just ahead of her in most of our contests.    I like to think beating me this year was some of her motivation to train like she has the past year.   I can only dream of beating her again, but she knows I’m going to try like hell.

Mile 20 - Steve Wychock – My Guru.    Always available when I need advice or rehabilitation.   I’ll keep telling myself during this difficult mile what Steve always tells me.   “It’s not painful, It’s uncomfortable”

Mile 21 - Kim Kreider –Kim is the most amazing runner I know, always one of the first to congratulate you on a good run and say just the right things when I’d get those feelings of self-doubt.   

Mile 22 - Jesse Sharp – For setting such a high bar for me to shoot for.    Jesse and I were in the same age group until this year, and when I see him consistently finishing in the top five against runners many years his junior he proves to me that my advanced years is not an excuse to not be able to compete with the elite.

Mile 23 - Erik van't Veer and Dan Loose -  Two of the most dedicated runners I know.   Through the mileage challenges we had this year they've shown me the kind of work that is required to attain the lofty goals that we have in common.    When I coached baseball, I used to tell my players that hard work was no guarantee of success but without it they had no chance.    These boys have put in the work and experienced disappointment despite the work that they have put in.    They keep persevering, Erik has been rewarded with his BQ and I’m certain Dan will get his very soon.

Mile 24 - Flo Bodnar – I’ll be counting on Mom to be sending me strength from above when things really start getting tough.     At an early age, mom instilled in me an old world work ethic and encouraged me to “Dream the Impossible Dream, to fight the unbeatable foe……TO RUN, where the brave dare not go".

Mile 25 - Carol Bodnar  - My biggest fan and best friend.    When I made the decision to change my lifestyle, she was terrified that I was making the wrong choice but helped me stay on track.   Together, we went from living the life that most people in the western world live,  high fat, meat centered meals with little exercise to a life with daily exercise and a oil free vegan diet.    I’ll bet most of you are thinking our meals must be totally tasteless, but Carol is always creating exciting new recipes.    It would have been absolutely impossible for me to travel this journey without her by my side.

Mile 26 - The Almighty for blessing me with good health, good friends and a second chance at life.

Rising Cholesterol - Good?

Had my six month follow up with my primary care physician and things are continuing to improve.   A first glance at my blood test results had me a little concerned.    My total cholesterol levels had risen from a minuscule 118 to a borderline high of 145.    The American Heart Association recommends that total cholesterol of less than 200 mg/dl is desirable, however heart disease guru Dr. Caldwell Esselstyn suggests that total cholesterol of less than 150 mg/dl is heart attack proof.

My 27 point increase in total cholesterol is not necessarily a bad thing since the increase was attributable to a 27 point increase in my (good) HDL.    My LDL (bad) actually stayed the same at 48. An LDL value of less than 100 mg/dl is considered desirable by the AHA.   As a result, my doctor cut my statin dosage in half for the 2nd time in a row and gave me the ok to start weaning myselft off my very low dose of beta blocker.

More good news

Today was my first visit with my primary care physician who had refused to cut my dose of statin drugs used to manage my cholesterol.    A visit with my cardiologist in January resulted in his recommendation that my statin usage be cut in half and to have my cholesterol levels rechecked in three months.

Well three months have passed and so did I,  the cholesterol test that is.   Total cholesterol dropped from 128 to a new low of 118.    Disappointedly my good HDL decreased slightly from 64 to 60, but my LDL dropped even more from 54 to 48.    Dr. Mikhail had to do a double take of the cholesterol numbers when I told him that Dr. Rimmerman agreed with my request to reduce my Lipitor dosage and my cholesterol numbers continued to approve.    I had been lobbying Dr. Mikhail to think about cutting my meds with me claiming that my improvement was a result of my diet and exercise program and him saying that it was attributable to the aggressive drug therapy.

Now, perhaps he is convert and will encourage other patients with coronary artery disease to consider lifesytle changes as the main course of treatment for their disease.

First visit with new cardiologist.

I met today with Dr. Curtis Rimmerman of the Cleveland Clinic.  I was referred to Dr. Rimmerman by the highly acclaimed author Dr. Caldwell Esselstyn.   After reviewing my records and seeing the progress that I have made over the past 2 plus years, he acknowledged that a significant part of my improvement can be attributed to the lifestyle changes I have made.

I questioned (or grilled) him on the need for all of the medications I am currently on in hopes that the lifesytle changes I have made and am committed to maintaining would warrant reducing the dosage or perhaps even eliminate some of those meds.

Current Medications:

Metoprolol is a beta blocker.  Beta-blockers are one of the most widely prescribed class of drugs to treat hypertension (high blood pressure) and are a mainstay treatment of congestive heart failure. Beta-blockers slow the heart's rate, thereby decreasing the heart’s demand for oxygen. Long-term use of beta-blockers helps manage chronic heart failure.  

A little over a month ago, I had run out of this drug without realizing it.   My doting wife always laid out my medications every morning but her dad had a serious health issue and was in the hospital.   The doctors would not release him unless he had someone at home to take care of him, so it was off to Florida for her.    While she was gone, I ran out of pills in a bottle that was labeled Levothyroxin.    When I called the doctors office for a refill, I was told that I needed to have bloodwork done and visit the doctor before they would write a refill prescription.   Since I had an appoint schedule two weeks away I would just wait.   What I didn't know is that my wife had put my beta blocker into an old thyroid bottle because of the easy open cap.   What followed was rather significant change in my running workouts.    I found that my heart rate on easy runs which would normally be around 145 were now pushing upwards of 160 and that after 3 or 4 miles I just didn't have the energy to run any further.   When I resumed taking the beta blocker after my visit to the doctor, my runs when the other way.   I would run out of gas after only a mile or so and my heart rate was not even reaching 130.    After being back on the metoprolol for a couple days, my training runs returned to normal.

Levothyroxin, a thyroid hormone, is used to treat hypothyroidism, a condition where the thyroid gland does not produce enough thyroid hormone. Without this hormone, the body cannot function properly, resulting in: poor growth; slow speech; lack of energy; weight gain; hair loss; dry, thick skin; and increased sensitivity to cold. When taken correctly, levothyroxine reverses these symptoms. Levothyroxine is also used to treat congenital hypothyroidism (cretinism) and goiter (enlarged thyroid gland).   Hypothyroidism has a link to coronary artery disease, so we are leaving this one alone until we can get my TSH levels back to normal.

Lipitor or Atorvastatin is used along with diet, exercise, and weight loss to reduce the risk of heart attack and stroke and to decrease the chance that heart surgery will be needed in people who have heart disease or who are at risk of developing heart disease. Atorvastatin is also used to decrease the amount of cholesterol (a fat-like substance) and other fatty substances in the blood. Atorvastatin is in a class of medications called HMG-CoA reductase inhibitors (statins). It works by slowing the production of cholesterol in the body to decrease the amount of cholesterol that may build up on the walls of the arteries and block blood flow to the heart, brain, and other parts of the body.

Since my LDL has been lowered below the target of 70 and I am committed to a plant based diet that have virutally no dietary chloesterol we agreed to cut the dosage in half for three months, then retest my lipid levels again.

Aspirin interferes with your blood's clotting action. When you bleed, your blood's clotting cells, called platelets, build up at the site of your wound. The platelets help form a plug that seals the opening in your blood vessel to stop bleeding.
But this clotting can also happen within the vessels that supply your heart with blood. If your blood vessels are already narrowed from atherosclerosis — the buildup of fatty deposits in your arteries — a fatty deposit in your vessel lining can burst. Then, a blood clot can quickly form and block the artery. This prevents blood flow to the heart and causes a heart attack. Aspirin therapy reduces the clumping action of platelets — possibly preventing a heart attack.

I argued that the plant based diet and exercise program I've been on for the past two years has been successful in opening up the narrowed blood vessels and is no longer needed.    My only proof was the vast inmprovement in my cardiovascular fitness.    I'm able to run much farther and faster with a lower heart rate than when first diagnosed.   The good doctor would rather see clinical proof before taking me off the aspirin so it stays....For now.

Annual Checkup

Met with Doctor Yasser Mikhail today for my annual checkup.   I was a little disappointed that I couldn't convince him to reduce my dosage or eliminate some of my medications.    After my initial consultation with my cardiologist Dr. Shaym Bhakta, he wrote this to my then primary care physician Dr. Anil Patel.

"I agree with the medical therapy that you are doing.   I would continue aspirin indefinitely in him.   I would recommend that his beta blocker be continued primarily for blood pressure control.   Given that William's blood pressure is well controlled and he is currently asymptomatic, I would recommend against up titrating his beta blocker to avoid causing side effects.    

I would recommend treating his hypercholesterolemia to an LDL of less than 70.   I would recommend increasing his astorvastatin as needed to achieve the goal LDL"

Since my current LDL level (54) has dropped well below the target of 70, I felt that at minimum we would start weening me off the statins.    I am convinced that my rising HDL (good) and dropping LDL (bad)  is mostly the result of my lifestyle changes where the good doctor is of the opinion that it is the result of the medical (drug) therepy.

If my own research is correct that statins can lower cholestorol levels 30% over a 5 year period then my potential would be to reach a level of 110.   My LDL levels have dropped from 157 to 54 (66%) in only 28 months.  

Of note in my latest blood work.

TSH levels have almost doubled since July.   TSH is a indicator of thyroid function.

Also taking a big jump is my AST levels an indicator of liver function.    One of the potential side effects of statins is damage to the liver.   Generally the alarm isn't sounded unless AST levels rise to 3 times the upper limit.   It is also common for AST levels to be unusually high for distance runners, especially after intense workouts.    Since I had a very intense interval workout immediately prior to having my blood drawn, I'm not going to be too alarmed over the higher AST levels.   

Here's an excerpt from a Running Times article addressing high AST levels

AST and ALT are enzymes that are evaluated by many of the multiple blood panels commonly ordered by physicians. Although they are considered to be “liver tests”, these enzymes are produced by a number of tissues, including muscle. A hard workout or long run will commonly increase the level of a number of blood tests, sometimes to very significant levels. I recommend that runners do not have routine blood tests performed within a few days of a hard workout or race. This can prevent a lot of unnecessary worrying.

The complete article can be read here. 

Sadly, my cardiologist that I liked so much, left for a new position and I need a new one who supports my choice of treatment plan.    I called Dr. Esselstyn's office for a recommendation and he called back to refer me to Dr. Curtis Rimmerman at the Cleveland Clinic.   I have an appointment to see him on January 2nd.

2 Year Progress

Haven't met with the doctor since December but did have bloodwork done and numbers continue to look very good.

Total Cholesterol rose 5 points but the bad (LDL) dropped 4 points and reached the target level of 70.   Good (HDL) increased 4 points and is now only 9 points from exceeding the LDL>

TSH levels which we have been monitoring closely dropped slightly.

On the running front.   No new PR's this season yet but times in all races have improved over the same races of a year ago.   

Completed my first full marathon in May and plan on running another in Detroit in October.

One thing I've noticed this year is that most of my races are averaging a heart rate of 159.   Don't know how to interpret that, but thought it noteworthy to mention here.

Meeting Dr. Esselstyn

Last night,  I attended a speaking engagement of Dr. Caldwell Esselstyn.    Dr. Sprouts as his colleagues have fondly named him, is the author of the book "Prevent and Reverse Heart Disease".   His work at the Cleveland Clinic has earned him quite a bit of notoriety and he was even consulted by President Bill Clinton after the president's 2nd heart attack.    After listening to him speak and seeing the evidence he provided, I am even more convinced that my heart disease is the result of a half century of eating the traditional western diet that gets over half it's calories from fat.

Initially I had adopted a modified version of Dr. Dean Ornish's heart disease reversal diet which like Dr. Esselstyn's program restricts fat calories to 10% of total calories.    Dr. Ornish's program allows fish and small amounts of oil.   Dr. Esselstyn's program is oil free and strictly plant based.   Nothing from anything that has a face or a mother.   According to Dr. Esselstyn's research, it is his opinion that oils (which derive 100% of it's calories from fat) damage  the endothelium (the lining of the arteries) making them like Velcro for collecting plaque.

You can learn more about preventing and reversing heart disease at the good doctors website at http://www.heartattackproof.com