In four days, I’ll run a trail full of memories

I blinked my eyes, surprised and confused at what I saw. My duty as a medical intern just finished and it was the first time in 24-hours that I went out of the hospital.  This was in 1991 and we still didn’t have cellphones, iphones, Twitter or Facebook. Most of us didn’t have cable TV with CNN either.  So I wasn’t prepared for what I saw.

Photo credit: nl.wikipedia.org

It was already eight o’clock in the morning yet the sky was dark and everything was covered with a white material I wasn’t familiar with. It was as if we had a snowfall. (Note: The Philippines is a tropical country and we NEVER have snow.)

Then I heard the BAD news: Mount Pinatubo, a volcano fifty miles north of Manila has erupted. That white material was volcanic ash.

Actually, there were volcanic explosions occurring since about two months back and people already started to evacuate. 

Maybe it was my youth or my very difficult intern job, but I wasn’t aware about those things.

On June 15, Saturday, Mount Pinatubo erupted.  Lasting nine hours, it was the second largest volcanic eruption on earth in 100 years. 

A giant cloud rose twenty miles in the air and spread a 2-inch layer of ash and sand over a 30-mile radius. The air filled with white ash so thick it reduced visibility to almost zero.

Photo credit: explorevolcanoesnow.com

 Look at this world-famous photo. I’m happy to say that the photographer lived to show it to us 🙂

Photo by Albert Garcia, photo editor of Manila Bulletin. He won the grand prize in the prestigious World Press Photo Contest, a first for a Filipino photojournalist, for his compelling shots of Mt. Pinatubo’s fury. This photo was chosen as one of Time Magazine’s “Greatest Images of the 20th Century.” National Geographic Magazine included it as one of “Best 100 Pictures of the 20th century”.

To make matters worse, we also had Typhoon Yunya. The volcanic ash mixed with rain and then carried by the wind blanketed Luzon, the Philippine’s biggest region. More than 800 people died and the economic destruction was staggering.

That day, June 15, 1991 became known as Black Saturday.

I remember this painful incident because four days from now, I will be joining the Mount Pinatubo Trail Run.

I’ve done a full marathon, four half-marathons, and many shorter races.  But, this will be my FIRST trail run.

This is what awaits me:

Mount Pinatubo Crater. Photo credit: tonetcarlo.wordpress.com.

 

The crater at a closer view. Photo credit: pinoyphotography.org
River crossings. Photo credit: runvocate.blogspot.com
Sapang Bato Trail, Pinatubo.Photo credit: jazzrunner.wordpress.com

I’m glad I registered for this race.  It’s going to be an extraordinary event I’m sure. For then we will run remembering that painful event in our history. More importantly, we will run appreciating how resilient the Filipinos are:

often hurt, but not crushed;

sometimes in doubt, but never in despair;

and though badly troubled at times, not destroyed.

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Hubby, Hypertension, and Dr. Dimples

As I said in my previous posts (click here and here), my runner-hubby has just been diagnosed to be hypertensive.

This morning, he had his first check up with a cardiologist, Dr. N. G.  Thankfully, he was very knowledgeable about hypertension in athletes.

Also, he had the cutest dimples. Too bad I was too shy to ask him to pose for my camera. I should have explained that it was for this post.  After the check up, I asked hubby if he thought the dimples were cute.  He said he didn’t notice. Haha!

Hubby’s cardiologist’s dimples look like these! Really!
Photo credit: zimbio.com

Anyway, hubby’s ECG, Stress Test and Laboratory Tests are all within normal except for a slightly elevated Creatinine (See below).

Diligently, hubby came prepared with his five questions:

1. Why did I develop hypertension despite the fact that I exercise regularly?

Genes, age, diet, excess weight, stress.

2. If I have to take medications, will they affect my running?

Dr. Dimples prescribed Telmisartan.

  • Its side effect profile is favorable for athletes
  • rarely, can cause a sudden decrease in BP after exercise potentially leading to dizziness or fainting (so a cool down is imperative)
  • effect can be decreased by Ibuprofen (hubby’s favorite medication for his muscle pain)

3. Can I still run? 

  • for the next 3 weeks, closely observe your BP response to the medication
  • if hypertension is controlled, you can run as before. (This made hubby very happy!)
Hubby got one of these on his first marathon. He wants to add a second before the year ends.

4. What should I do about nutrition? Hydration?

Follow the DASH Diet

  • more vegetables, fruits, whole grains,nuts,  fish, chicken
  • no or very little red meat, sweets, added sugar, sugary-drinks
  • maximum of four egg yolks a week
  • low salt (sodium not to exceed 1,500 mg/day). Refer to pages 22-26/64 of the DASH Diet booklet.

Note: The lower your salt intake is, the lower will be your BP.

For hydration:

  • Water, Sports drinks okay
  • Do not take potassium supplements  or salt substitutes containing potassium (Telmisartan already increases potassium in the body)

5. Will I ever be cured of this?

  • We hope so.
  • However, studies are not on your side: Because of the hardening of tje arteries due to aging, patients in their 50’s usually have to take meds for life.  (Hubby is 49).

Addendum:

Creatinine is slightly elevated.

Creatinine

  • a chemical waste molecule that is generated from muscle metabolism.
  • produced from creatine (a molecule of major importance for energy production in muscles)
  • transported through the bloodstream to the kidneys
  • filtered out in the kidneys
  • disposed in urine
  • increased levels may be an indication of impaired kidney function.
  • impaired kidney function can cause hypertension

  • slightly high Creatinine may just be because hubby is an athlete.  (Runner’s World has an interesting forum discussion on this . Click here.)
  • monitoring is necessary

Dr. Dimples also ordered an Echocardiogram  to check for heart enlargement.

Okay, that’s it. Hubby is hopeful that he will overcome his hypertension.

Let’s see what happens in about 3 weeks when hubby visits Dr. Dimples again.

P.S. Lest you think wrongly about this, I still think hubby is cuter than him. 🙂

5 Questions Hypertensive Athletes Should Ask Their Doctors

Hubby, an avid runner and newbie biker has just been diagnosed to be hypertensive, as I told in my previous post.

He already had his laboratory tests. Tomorrow, he’ll see his cardiologist and will be asking the doctor these important questions:

  1. Why did I develop hypertension despite all my running?

Somehow, we already know the answer this.

Although hubby runs regularly and doesn’t smoke nor drink, his age and genetics are against him. He is 49 and the risk for hypertension increases with age. His mother is hypertensive.

The rest is related to his lifestyle.  Although he lost more than 15 pounds over the last year, he is still overweight. Why? Because of his diet.

Although he does not always eat like this, look at what he had after his biking session last week:

Hypertension on a plate: High calorie. High fat. High salt.

We should really take this seriously now: Exercise cannot be taken as a passport to eating anything and everything you want.

 2.   Can I still run? How much exertion is safe? What precautions do I need to take?

Regular exercise will surely help control his hypertension. But how much and how often is safe?

 3.   If  I have to take medications, will they affect my running?

Some medications affect sports performance and some may even dangerous . Some affect the body’s electrolytes. Some slow down the heart rate leading to post-exercise dizziness in some athletes.

 4.   What should I do about nutrition and hydration?

 5.   Will I ever be cured of this hypertension, or is this for life?

Many questions that require careful answers.

Are we over-reacting?

I don’t think so.

Hypertension, when uncontrolled ups the chances of heart attack, stroke, or sudden death.  We don’t like that.

What we need is a lifestyle makeover.

We want to be able to run for many more years.

We want more of these:

Happy after finishing a  half marathon earlier this year

How about you? Are you hypertensive? Have you been checked within the last year?

Most of the available information I found on the web deal with hypertension on people who are sedentary. I found one for those who are already physically active but still have high blood pressure.  Although it’s dated 2002, I think it’s still useful. Click here.

For us who are doctors, we can refer to these:

Managing Hypertension in Athletes and Physically Active Patients by the American Association of Family Physicians, 2002.  Click here.

Hypertension in Competitive Athletes by American College of Cardiology, 2005. Click here.

Position Statement on Exercise and Hypertension by the Sports Medicine Association, 2011. Click here.

I am a pediatrician and hypertension is not in my line of expertise. Please tell me if there are newer and more appropriate recommendations. Please. Thank you.

Related Posts:

Despite All my Running, I’m Still Hypertensive

Hubby, Hypertension, and Dr. Dimples

Despite All My Running, I’m Still Hypertensive

That’s what hubby told me this afternoon when I asked him why he looked so depressed sitting alone in the kitchen.

These past few days, he has been having bouts of  light-headedness. His blood pressure  readings were 140-150 / 90-100, usually in the mornings.

(For adults: Normal BP=120/80.   Pre-hypertensive=130/85.   Hypertensive=140/90. For a Blood Pressure Chart, click here.)

In denial, hubby said that those readings were probably just flukes.

I don’t smoke. I don’t drink. I lost more than 15 pounds over the last year. I run regularly and I’m fitter today compared to several years ago. I had medical clearance and ran a full marathon five months ago.

HOW CAN I HAVE HYPERTENSION NOW?

Hubby in his office, miserable about the readings.

Daily monitoring, however, just confirmed the sad reality. He is hypertensive.

Despite all his running, hubby cannot change important risk factors like his genes and age. Add to that his work-related stress, the many years of carnivorous-eating  and his being overweight. One year of running cannot erase the many years of indulgence.

Photo credit: webmd.com

So, off he will go tomorrow for check up and some tests:

Lipid Profile, Electrolytes,  Liver Function, Kidney Function, Blood Sugar, ECG and Chest x-ray.

Having said all these, I’m confident that with clearance from his doctors, hubby will continue  running  and it will help lower his Blood Pressure. In time.

We’ll see what happens with his check up and tests.

My BP’s okay but I’m doing the tests, too. Better safe than sorry.

How about you, are you hypertensive? If not, have you been screened for it?

The latest recommendation is to have an annual screen starting at 18 years old. Target BP is 120 / 80 or lower. Really.

Stay well, everyone!

Related posts:

5 Questions  Questions Hypertensive Athletes Should ask their Doctors

Hubby, Hypertension, and Dr. Dimples

You may find this article helpful: Athletes and High Blood Pressure by heart surgeon and avid triathlete Dr. L Creswell.