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Horrendous decline in running ability

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 mike lawrence? 01 Jul 2020

Am slightly desperate hence posting this! A few years ago i was running a parkrun and after half a mile  felt normal but within a few seconds felt completely drained and had to stop for some minutes. After 5 minutes i was fine for the rest of day. Over the last few years this became more common, particularly when i increased the load by speeding up to overtake or going up a hill. I could feel when this was coming on, i literally felt my whole battery was rapidly draining but if i immediately went down to a very slow jog for ten minutes then i could speed up. I also found if i started off my run very slowly for 15 minutes  i could then increase speed back to normal. Over lockdown i was running 90 minutes cross country and doing gentle hill intervals using this very slow start and that worked ok. Now however i seem just able to do a 45 minute run very slowly and feel shattered all the way round, very depressing and feels not worth doing either for fitness or enjoyment. I'm having rest and varied running days so it doesn't feel like overtraining.

I went to the doctor when this started happening and had a blood test  but nothing came back. I've just been back and had another blood test and an ecg, she is also putting me in for a lung x-ray. No results yet. I thought it might be exercise induced asthma but the doctor and pharmacist think thats unlikely. It doesn't seem temperature or seasonally related. I just had a glucose test and that came back 5.6 so not fantastic but not diabetic.

Has anyone ideas?

thanks for reading

mike

 DancingOnRock 01 Jul 2020
In reply to mike lawrence?:

Get an ECG. 

 Neil Williams 01 Jul 2020
In reply to mike lawrence?:

This is the naughty way, but if you suspect asthma and you know someone who has a standard blue inhaler, borrow it (obviously sanitise very carefully before and after at present or borrow one that's not got much left and bin it afterwards!), inhale 4 puffs or thereabouts and go for a run.  If it works, then that's your answer.

I had an experience very similar to yours, though when I "run out" I always end up heavy breathing - does that happen to you?  It turned out it was asthma, most likely post-viral, but the investigations had reached stalemate (i.e. we know it's happening but not why) so me taking that action allowed it to be moved on to a conclusion - I told the doctor of my experience and they booked in all the asthma related tests.

Asthma wasn't originally suspected for me because I don't have proper asthma attacks - it's just shortness of breath.  We went mostly down the heart route which took some time and found nothing at all other than a quite low resting pulse rate which is not unusual for runners.

By the way, if it is asthma and you end up getting a preventer, don't be afraid to ask to try different ones, they have different side effects and different levels of effect overall.  Most notably I find that anything involving beclamethasone (e.g. Fostair - but also the likes of Beconase) makes me depressed - basically I end up tearful for no reason at all about an hour after taking it - it was bizarre and quite unpleasant until I worked out what was causing it.

Post edited at 14:07
1
 robert-hutton 01 Jul 2020
In reply to mike lawrence?:

I have had the same at various times, and mostly it's because I have put on weight, I do hope it's nothing more serious.

 Andy Hardy 01 Jul 2020
In reply to mike lawrence?:

What's your heart rate doing when you run out of gas?

 Michael Hood 01 Jul 2020
In reply to mike lawrence?:

Definitely support Andy's question.

One potential suspect is atrial fibrillation - obviously when you're running your pulse rate is higher. What's it like when you get this "running out of gas"? With AF, rather than gradually decreasing, your pulse will stay very fast (and maybe irregular) for much longer than normal, but there is a huge variation in how long before it goes down.

An ECG won't show AF unless it's actually in progress, when it is in progress an ECG is pretty definitive; there are I believe some easily seen ECG characteristics.

My experience of AF - I had several episodes but these appear to have been "caused" (or at least greatly exacerbated) by the amount of a particular drug I was taking - although I may have some residual risk. An example, it happened to me a couple of times whilst walking in the lakes. I'd come down a slope to a col and set off up towards the next summit and all of a sudden any upwards progress would become desperately difficult - like those films of high altitude climbing with no supplementary O2. Level or downhill would not be great but progress was still possible. Bit breathless, fluttery chest, very high pulse rate not coming down. Usually back to normal after 20 minutes and then as if nothing had happened. Sometimes lasted for a couple of hours (most of the way down Scafell Pike wasn't a lot of fun). Also sometimes happened (up to an hour) after running (or orienteering).

Get yourself checked out (you seem to be doing this) and keep notes of whenever it happens and any details you become aware of to see if you can establish any patterns.

Make sure you're properly hydrated - I suspected that this was a contributory factor.

In reply to Andy Hardy:

Heartbeat doesn't seem particularly high though i've just been using a phone app to check so will try to borrow a proper monitor. I will try to borrow an asthma inhaler and try it out. Interesting about the emotional effects of one, never heard that before.

thanks for the interest,

mike

 SouthernSteve 01 Jul 2020
In reply to mike lawrence?:

I suspect you need a 24-48 hour monitoring (halter) ECG or ECG on a treadmill if the ECG is going to be useful. A single ECG might be quite normal between episodes. An echo might also be useful. I would see a cardiorespiratory consultant. I presume you have no direct or referred pain (angina) during these episodes as that would be a red flag and you should seek more urgent help. 

Le Sapeur 01 Jul 2020
In reply to mike lawrence?:

There is a noticeable fitness decline after the age of 45. Can it be something as simple as age? 

1
 DancingOnRock 01 Jul 2020
In reply to Michael Hood:

I think that’s probably a bit extreme but an ECG would spot any irregularities. 

 wbo2 01 Jul 2020
In reply to mike lawrence?:what did the blood test look for?  Did it include glandular fever? 

Ecg is a good call.  So is an accurate pulse meter so you can see what's happening?  Just very tired, or lactate build up?

Are you anywhere near a university with a good sports science department?  Do you have a training diary, and someone to show it too?

 wbo2 01 Jul 2020
In reply to mike lawrence?:also I think asthma is unlikely as it really hits breathing in my very limited experience,  but am not convinced it isn't overtraining

 Michael Hood 01 Jul 2020
In reply to DancingOnRock:

> I think that’s probably a bit extreme but an ECG would spot any irregularities. 

Hopefully so, from what OP says about his heartrate I don't think it sounds like AF.

 daftdazza 01 Jul 2020
In reply to mike lawrence?:

Have you had any illness symptoms? I had a similar decline post glandular fever, I went from regular fell running to not being able to walk up a small hill and the initial fatigue lasted 6 months, followed by multiple short relapses over 2-3 years.  Thankfully things did eventually get back to normal, pretty brutal illness to get for anyone into endurance sport, your symptoms sound similar to how I suffered  but hopefully it's not what your suffering from.

Maybe not glandular fever given your age? But fatigue from similar fatigue inducing illness such as Lyme's?

Post edited at 21:34
 SouthernSteve 01 Jul 2020
In reply to SouthernSteve:

holter - not halter

 dangermouse79 01 Jul 2020
In reply to mike lawrence?:

Sorry to hear about the problems you've been having.

The first thing I would suggest is don't get your medical advice from the internet!

This could be any number of things affecting your heart or lungs.

A few possibilities:

  • Irrregular heart rhythm -AF or SVT -physically check your pulse when this happens, don't rely on a monitor as it will likely misread -is it racing? is it irregular?
  • Undiagnosed cardiac disease -vavlvular/cardiomyopathy/coronary (coronary less likely in absence of chest pain)
  • Undiagnosed lung disease -loads of possibilities but asthma does not sound likely based on the symptoms
  • Subclinical pulmonary emboli (blood clots on the lungs) -have you had any blood clots (esp DVT) previously? Any recent calf swelling? Of note, Covid is known to increase the risk of blood clots forming in some people, so if you have been infected it might increase the risk of this possibility.
  • After effects of subclinical Covid-19
  • Anaemia (will be excluded by the blood tests your GP has done)

I would suggest you await the results of the tests already done, and if nothing comes up then push your GP for referral to an appropriate specialist (cardiology, respiratory or a general physician). Tests they might consider, depending on history and examination and initial results, include 24 hour ECG, Echo (ultrasound of heart looking at valves and function), CTPA (CT scan of the chest to exclude PE, would also show up any evidence of interstitial lung disease).

FYI I am a doctor, but not a specialist in this area.

Best of luck and hope you get some answers.

DM

In reply to dangermouse79:

DM and everyone else,

Thanks for all your replies. I'll follow up with my doctor and see what she thinks.

Thanks again,

mike


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