A runner's heart

“You’re going to be as good as new or better. Before you know it, you’ll be running sub five-minute miles again.” I had to encourage Lydia. She was an Olympic athlete with a wonky heart. Who would have thought that a 23-year-old athlete would develop a heart problem. I guess it was genetic. She said her grandmother had a similar problem at an early age. I didn’t know she had contacted her birth parents. The terms the doctors used were beyond my comprehension, but I understood rhythm abnormality and heart block.

“Yes, but it’s my heart. I will never be the same. My grandmother died when she was thirty-five. My whole identity has been as a runner since I was twelve. It’s going to be hard to adjust. Who’s heard of someone my age with a pacemaker? I’m not even sure I will survive the procedure. The doctor says I will probably need an ablation now. If I don’t make it, know that I love you and mom. Thanks for adopting me.” Lydia was tearful as she responded. It broke my heart. I was frightened for her.

We had adopted Lydia when she was six months old out of the Ukraine. She had been a happy and active baby and child from the get-go. She ran before she walked or even crawled. Judy and I could not keep up. We would chase her around the house and later outdoors. Fences could not contain her. We lived on a rural property in Santa Fe. She would climb the fence by age five and would be found running miles down our country road. As she grew into a long legged thin blonde teenager, she began to win local ten Ks and half marathons. She was the star of her high school cross country team and soon a state champion. Several colleges recruited her, but she chose a scholarship at the University of New Mexico to be close to home. She liked their law school and planned a career as a human rights lawyer. That was my girl. She always had a big heart. It’s ironic that it’s failing her. She was a great big sister to Tommy and Teri and was always the first to volunteer for chores around the property. Compassion and drive were her calling cards. We always knew she would be successful. She was not afraid to volunteer for causes that sometimes alienated her more conservative friends. Woman’s rights, gun control and climate change were just some of them. Her growing celebrity as a runner gave her credibility and gained her access to politicians and the media. When she qualified for the Olympics, she used it as a platform for her many causes. I was so proud of her.

Watching her race in high school and college was one of life’s pleasures. She made running look easy with a gazelle-like stride. There was no rabbit setting the pace for her. She started and finished at the front. No one could keep her torrid pace. Not only did she not fade at the end, but she also managed negative splits. Whereas her fellow runners looked exhausted at the end of the race, Lydia looked fresh and was beaming as she crossed the finish line. If they allowed us, Judy and I would be on the sideline ready to congratulate and hug her. By her second year in college, we were joined by Ben, her boyfriend. He was a second-year law student and clearly in love. He was also a runner but not Olympic caliber. I was happy to see that his ego did not prevent him from being totally supportive of Lydia and her accomplishments. They had big plans, but Lydia’s Olympic career was their priority. She won gold in her first Olympic marathon and was training to capture gold in three different events this coming year. Sponsors were flocking to her. She insisted they all contribute to her favorite causes. Lydia was a woman of principle.

I was working on the property on a Saturday when my cell phone rang. It was Lydia. At first, I thought it was a poor connection. Then I realized Lydia was sobbing. My girl did not cry!

“What’s wrong honey?” I knew it had to be something pretty disturbing. It took several seconds before Lydia composed herself and was able to speak.

“Daddy, something is really wrong. I couldn’t run fifty yards without getting winded. I have a tight feeling in my chest and I’m lightheaded.”

Lydia hadn’t called me Daddy since she was ten years old. I knew she was frightened, and the situation was serious. I had to think and answer fast. “Lydia go to the emergency room now and if the tightness continues, call 911. If Ben’s nearby have him drive. I will get to Albuquerque as soon as I can. Hang up now and get going. Better still call 911. Mom and I will be there in an hour. Keep in close contact. We love you, Lydia.” My heart was in my mouth. I ran into the house, quickly briefed Judy. After gathering a few things, we jumped into the car and drove as fast as we could to Albuquerque. By the time we were within a few miles of the city, Ben sent us a text. Lydia had been admitted to the ICU and the doctors were talking about a procedure. He didn’t elaborate. Judy and I were in a high anxiety state. I’m sure I exceeded the speed limit and ran several stop signs on the way to the hospital. It took us what seemed like an eternity to get past all the checkpoints in the hospital and ICU. When we finally were escorted to Lydia’s room in the ICU, we were dismayed by the crowd of doctors around her bed. It was a cardiologist and his entourage. My brother was a doctor and he had told me about the pecking order in teaching hospitals. Residents and students had to learn but did they have to crowd into my little girl’s room? I couldn’t tell the chief from the Indians, so I introduced myself, hoping, the cardiologist would identify him or herself. A youthful bespectacled balding man in a white lab coat, reading an EKG strip, looked up and greeted me.

“Hi, I’m Dr. Sinclair, your daughter’s cardiologist. Lydia is having some rhythm problems with her heart and is dropping beats. In medical terms she has atrial flutter and a second-degree heart block. I think we can fix everything with ablation. There is a remote possibility she’ll need a pacemaker. Don’t worry, I think Lydia will be able to continue her pursuit of gold in a few months. We are all rooting for her. She’s a legend around here.”

I understood about half of the doctor’s comments but was reassured by his last few words. Still, I needed clarification. “Thanks doctor but what is an ablation? Also, what is her long-term prognosis? Isn’t it unusual for someone so young and fit to develop heart problems?”

The doctor smiled, turned to Lydia and patted her hand as he addressed me. “There are multiple electrical pathways in the heart. Sometimes, people develop renegade pathways that cause rhythm problems. During ablation we cauterize and short circuit those pathways with a catheter we run through an artery. It’s effective ninety-five percent of the time. Recurrence is rare. For whatever reason, endurance athletes, even young ones are predisposed to these rhythm problems. Lydia also has a genetic predisposition. My guess is that Ukraine did not have the medications or procedures available that we do today when her grandmother had her problems. Lydia has an excellent prognosis.”

I still was not completely satisfied and had more questions. “What are the risks of this ablation? Also, you mentioned a pacemaker. How likely is she going to need one?”

Dr. Sinclair turned, faced me and shook his head. All the members of his entourage or his little ducklings shook their heads in unison. They seem to mimic every one of his movements.

“There is less than five percent chance of stroke, heart attack, bleeding or valve damage. Don’t worry, I haven’t had a patient who suffered any adverse effects yet. As I mentioned before, the ablation should take care of the rhythm and heart block problem. In the rare chance, the heart block persists, we will have to consider a pacemaker.” The ducklings all nodded their heads in unison.

I was reassured and somewhat amused by the sycophantic entourage. Judy and I walked over to Lydia and kissed her. That brings us back to where this story began. It was clear Lydia was catastrophizing and wasn’t reassured by the doctor’s words. I had to console her.

“Honey, I know this is scary and traumatic for you. The doctor said that it’s unlikely that you will need a pacemaker and your prognosis is excellent. You’ll come through this ablation with flying colors and be back on the track in a month.  You are not your grandmother, and this is 2023 and medical care in in the USA.” My heart broke as I watched my tough little girl break down crying.

“I’m scared Daddy.”

Judy and I hugged Lydia. To be honest, I was scared for her but couldn’t let on. An attendant soon arrived and pushed Lydia out of the ICU to a procedure room. Judy and I were soon joined by our other children, Teri and Tommy, as we sat in the waiting room. Ben had been there the whole time. He was inobtrusive but obviously concerned. We joked with each other to relieve the tension. I was on pins and needles. Two hours seemed to be a lifetime. Finally, a sleeping Lydia rolled by en route to the ICU. Eventually, Dr. Sinclair appeared, dressed a green scrub suit with a big smile on his face.

“She did fine. Her block and rhythm problems resolved with the ablation. She’ll be on blood thinners for a month and then she can resume running. I’ll be rooting for her at the Olympics.

I stood and shook his hand. “Thanks Doc. We appreciate everything you’ve done. When can we see Lydia and when will she be discharged?”

“She should be waking up now and if her heart monitor shows a stable rhythm, she can be discharged in two hours.”

We were thrilled. Judy and Teri immediately stood and walked into the ICU. I waited for my turn. The ICU policy was only two visitors at a time. I couldn’t help wondering about the five-person entourage that accompanied Dr. Sinclair. Oh well, I’d get my turn. Judy and Teri returned after ten minutes. I was dismayed by their expressions.

“What’s wrong Judy? Is Lydia, okay?”

Teri was quick to answer. “That was not my sister in there. Someone sucked out her soul.”

Teri tended to be a bit dramatic, so I turned to Judy and asked: “What does that mean?”

Judy pursed her lips and frowned. “As far as I can tell the procedure was a success, but Lydia is angry and irrational. She doesn’t believe her condition has improved and thinks everyone is lying.”

That didn’t sound like Lydia, but I had to see for myself. Tommy and I went into the ICU. Just as we neared Lydia’s room, we saw a nurse running out. When I tried to question her, she lifted her hand to silence me and ran to the phone. Tommy and I rushed anxiously into Lydia’s room. We found her half dressed with her IV catheter and monitor wires hanging by the bedside. She had a wild look in her eyes. She looked up as we entered and spat out: “I’m getting out of this fucking place now!”

Whoa! My daughter never talked or acted this way. What was happening? Was it the result of the procedure or a medication? Just as I tried to calm Lydia and prevent her from leaving, Dr. Sinclair entered the room.

“What’s wrong Lydia? Everything went fine. You’re as good as new.”

“You’re lying and I need to leave.” Lydia was trying to walk past us, but Tommy was restraining her.  When she finally sat on the bed, Dr. Sinclair put his hand on her shoulder and tried to reassure her.

“Lydia, I think you are having a side effect from the sedation. Everything went fine. Rarely patients can have transient delirium and hallucinations from this medication. Lie back, take deep breaths and it should pass. I’m going to give you a Xanax, it should take care of your anxiety.”

Lydia reluctantly took the Xanax and dosed off.  I sat by her bedside and Tommy returned to the waiting room and updated Judy and Teri. Fifteen minutes later, Lydia awoke and was back to being her sweet self.

“What happened Dad? I have a vague memory of being a bitch to everyone and the doctor reassuring me that everything went fine.”

I smiled. I had my baby back. “You had a side effect from the medication but you’re as good as new. Training can resume in a month.”

The rest of Lydia’s hospital stay was a blur. Despite Lydia’s protestations and Ben’s insistence that he could take of her, we drove her back to the family home in Santa Fe. She stayed with us for one week and then returned to Albuquerque under the watchful eye of Ben. Three weeks later, she resumed running. Her first few attempts were rocky. Any shortness of breath brought fears of a recurrence of her heart problems. She monitored her heart rate obsessively. Any slowing made her panic. She had PTSD. Still, she persisted and over the next few months got herself into peak running shape.

We all attended her first competition since the event. It was a half marathon. Lydia looked great from the start. She led the pack from the start to finish. We came down from the stands just as she crossed the finish line. To my dismay, she fell as she broke the ribbon. She was face down when I reached her.

“Lydia….?”