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This week I had my latest appointment with the cardiologist, this time for a echocardiogram stress test to determine whether my elevated calcium score was having any impact on blood flow to my heart.

Going into this test I wasn’t too concerned. Although it was the elevated calcium score that first set off warning bells for my GP and resulted in him referring me to the cardiologist, from the get-go the cardiologist said the atrial fibrillation (AF) he discovered by chance was far more of a concern. But better to be safe than in heart failure.

I wasn’t 100 per cent sure what to expect in this test. I knew I’d be on a treadmill and that the medical team would be taking some readings before, during and after exercise, with the amount of effort gradually ramping up.

I imagined it to be similar to the stress tests that are used to calculate maximum heart rate and VO2 max readings, but it was much more gentle. I didn’t even have to break into a run in my test, whereas in the VO2 max tests, as I understand it, the speed and incline gradually ramp up until your effort maxes out and you have to stop.

For my test, I was led into a small room by two cardiac sonographers. I stripped to the waist and they took my blood pressure, recorded my height and weight and shaved my chest. They then hooked me up, via 10 electrodes, to the electrocardiogram (ECG) machine.

This machine monitored my heart rhythm during the test, and it once again confirmed I’m still in AF. In fact, my rhythm was a bit all over the place. At one point one of the sonographers thought the exercise had shifted me back to a normal sinus rhythm, but the cardiologist pointed out that wasn’t the case.

Once hooked up to the ECG they turned down the lights and I lay on my left side on a bed with my left arm raised above my head. One of the sonographers, Jess, then started imaging my heart using a machine similar to those used by midwives on pregnant women.

Jess explained this process looked at the structure and function of my heart, and established a baseline. She measured the volume and size of each chamber and the structure of each valve.

One of the key purposes was to determine if there were any blockages that would suggest the stress test might result in a heart attack. Thankfully she found none of those. This process took about 15 minutes and to be honest I could happily have drifted off to sleep, except Jess kept tilting me this way and that in order to get the images she needed.

Once she’d done that, she took six short one-heartbeat videos of my heart to see how it was operating at rest. She explained that once my heart rate was elevated at the end of my treadmill stint, I’d have to hustle back to the bed and get into the same position so she could take the after versions of those six clips while my heart was still working hard - and she only had about a 60-second window to complete this.

Jess wrote up a report on what her initial work had shown, then the cardiologist and the other sonographer came back into the room so we could start the stress test.

This involved walking on a treadmill, while hooked up to the ECG machine which was showing my heart rhythm and heart rate. Normally the speed and incline of the treadmill is increased every two minutes, but because they judged me to be fit, they reduced the interval to one minute.

This was quite flattering until I realised my status as “fit” was relative to a bunch of heart patients, most of whom were well and truly my senior. Still, I’ll take it!

The treadmill started very slowly, then both ramped and sped up each minute. I could see my heart rate steadily climbing. The sonographers told me most people last until the middle of the third increase, but I got through six full minutes.

Towards the end of the test the doctor was asking me how exhausted I was, on a scale from one to 10. Even at the end of the test I was only at about an eight - I was still walking albeit a fast walk. But the intention wasn’t to work me to complete exhaustion, rather to get my heart rate to the point where it was under stress.

So after six minutes I leapt off the bed, resumed my prone position and Jess took the after images. The hardest part of the whole thing was holding my breath, while I was trying to recover, so she could get what she needed.

While I lay there getting my breath back, the doctor had a quick look at the before and after images, then left me to get dressed.

When I joined him in his consulting room, he told me the good news is that my heart is strong. Whatever calcium build up I have, it’s not preventing my heart from performing as expected under stress. So while not surprised, I was happy with that.

But he said the atrial fibrillation still needs to be dealt with. Two options - drugs or a procedure called an ablation. This involves running catheters from your groin up into your heart.

These collect some information on the electrical activity in the heart, then effectively apply a reset to halt the AF. That sounds like fun, doesn’t it!

The procedure has a better than 70 per cent success rate for people who have intermittent AF, but sadly for me that success rate falls for people whose AF has been persistent for some time.

So the next installment of this grand adventure is to talk to another heart specialist about the pros and cons for my situation.

Marathon effort

I know the newsletter is called Trail Runner and trails are certainly my preference, but I admit I do still love marathons and half marathons on the road.

With Sydney becoming a World Marathon Major this year, I couldn’t resist signing up. The race is on 31 August, and my training block, now I’m (mostly) over my UTA50 busted ribs, starts next week.

Running a marathon, or a half, can be daunting if you’ve never done it before. If this is an ambition you harbour, the ideal scenario is to work with a coach who can set you up a program and keep you accountable.

But that’s not an option for everyone (I’ve never had a coach). As an alternative, a quick search will turn up a range of marathon plans for a range of abilities. Looks like the Sydney Marathon had these for the 2024 edition. It’s a 16 week program, so you could apply this to a race simply by adjusting the dates to suit.

This year it looks like the Sydney Marathon is offering free access to the ASICS Runkeeper Go app for people who join the Sydney Marathon group in the app. This is offering what they call a free, personalized 16-week training program.

I’m not doing either of those things. Instead, I’m going to use the Nike Run Club app and the soothing, encouraging tones of Coach Bennett and his fellow coaches.

I’ve not done this before so it’s new territory for me, but I know people who swear by it. And you can follow my progress right here because I’ll be reporting back week by week on how I find it

Upcoming Events

There are way too many events for me to list everything that’s happening around the country, but here is a selection of upcoming races (with a bias towards South East Queensland).

The Running Calendar website is a great source if you want a comprehensive understanding of what’s available around Australia.