Last fall I found myself struggling to stay awake throughout the day. I was sluggish, foggy, disoriented, and was finding it difficult to get through busier days at the clinic and my workouts.
In early November, I found myself relaying my symptoms to my doctor. She seemed concerned after I told her that the first thing I thought about after waking in the morning was, “When will I have time to take a nap today?”
Alongside the more recent complaints of extreme fatigue, I relayed to her that I had been experiencing lightheadedness, prolonged recovery time, and feeling like I was going to pass out during my workouts. These particular symptoms had been present for quite some time, but had worsened over the previous months so I figured I would mention them. I had been training pretty consistently for just over 2 years at this point, and was concerned that the symptoms weren’t improving, and that my progress had stalled.
For those of you who aren’t oriented with CrossFit, there are benchmark workouts that are notorious in the community. One in particular that raised my concerns is called Karen.
Karen is heinous. 150, 20 lb. medicine ball throws to a 10′ target on the wall, for time. Bleh.
I had performed this workout within the first few months of starting CrossFit, and it killed me. I finished in an unimpressive eleven and a half-ish minutes, and couldn’t walk right for three days.
Fast forward two years and Karen came up on the board as the workout of the day. In the midst of a post-traumatic, flashback induced flop sweat, I centered myself. I KNEW that there was no way it could be worse than the last time, and that in fact it should go much more smoothly. I would finish faster than before, and be revered by my fellow CrossFitters for a new personal best!
I was wrong. I got crushed. I could not breathe. I had to rest a ton. I had finished with a WORSE time than my first go around at nearly 13 minutes.
Something HAD to be up.
After talking to my doctor about this, she decided that while she had me captive she would run an EKG. I had a couple of these in the past and nothing ever came of them, so I wasn’t concerned.
One of her assistants ran the test, looked at it, and then ran it again.
She took the readouts of my heart rhythm out of the room to have my doctor look at them. This all seemed routine until the assistant came back in one more time to re-run the EKG. My curiosity was definitely piqued at this point.
My doctor returned after reading the third result and let me know that while it looked like I was currently having a heart attack, she was sure that I wasn’t but needed to confirm. She called a colleague of hers who confirmed her thoughts that I had an abnormal-normal heart rhythm called early repolarization phenomenon.
This particular abnormality is not life threatening, but she was concerned about its presence in association with my other symptoms, so I was put on exercise restriction until further tests could be done.
If you’ve ever had to go from a fairly active lifestyle to one where you are advised not to do anything that makes you the slightest bit lightheaded then you know my pain.
Blood was drawn, and referrals were made to a cardiologist and I laid in wait.
The blood results came back first, and it turned out that I was vitamin B-12 deficient which explained the excessive fatigue I had been experiencing more recently. I started supplementing right away and my symptoms began to improve. I was still on exercise restriction until I could get in to see the cardiologist, so I had no idea if my exertion related symptoms had improved.
After a couple of weeks of decreased oppressive sleepiness, I was getting antsy about getting back into the gym. Thankfully one of my patients has a cardiologist as a father who was able to squeeze me in last minute.
He confirmed the diagnosis of benign early repolarization and lifted my exercise ban. Hallelujah! While he wasn’t concerned about me working out, he still wanted to investigate my workout related complaints.
I was scheduled for a stress echocardiogram where I was run on a treadmill while wearing a heart monitor, and also had video taken of my heart to see how it functions. It came back normal.
I was asked to wear a Holter monitor for 24 hours with explicit instructions to work out on that day. Which was awkward, and I got light headed, and dizzy, and took a long time to recover afterwards, but I did it. It also came back normal.
The last test I was scheduled for was a plain ol’ echocardiogram. I was hesitant to go in for this last test. If you’re anything like me then you’re probably thinking, “They already got video of your heart. What more could the possibly get from this test?” You’d probably also be exhausted from the last 5 weeks of medical tests. You’d probably decide that you didn’t need to go in for that last test and try to cancel it.
Thankfully, the doctor’s assistant would convince you otherwise, and you’d go have that test.
I came to find out that the stress echo doesn’t look at your entire heart after all! This became even more apparent after it took the technologist 45 minutes of repositioning of her camera, and my body to get all of the images she needed. (As a side note, I have to say that even with my knowledge of human anatomy and training in reading diagnostic imaging, I had no clue what we were looking at 90% of the time. Mad props to you heart sonographers out there!)
So I continued working out, feeling the same, expecting to hear that this test was also normal, but as you can probably guess by now, it wasn’t.
The doctors had found out that I had (and have had since birth) a defect in my aortic valve. Typically, the valve that opens up into your aorta (which delivers oxygenated blood from your heart to the rest of your body) has three triangular flaps. These flaps allow blood to flow from your heart freely when open, and keep it from back flowing and increasing pressure when closed.
My valve has only two semi-circular flaps. The condition I was diagnosed with is called Bicuspid Aortic Valve Disease (BAVD) and is apparently one of the most common heart defects in the world!
There are a lot of variations of this condition, with associated conditions which make it more or less inconveniencing to life threatening. Fortunately for me, it was determined that I have the most benign version of the defect and while my symptoms may progress, it is unlikely that I will be debilitated or die because of it.
My doctor let me know that there is a small chance that I will have to have the valve replaced at some point 20 or 30 years down the line based on how healthy my heart was shown to be from the other tests. Which is awesome, but lead me to having some other questions — Do I need to change my diet to be more heart protective? Do I need to stop working out? What other lifestyle factors do I need to consider?
Fortunately he was able to quell most of my concerns, but did let me know that there is an associated defect with BAVD called aortic coarctation, which if present could mean that I could no longer do heavy weightlifting. This would be a HUGE bummer, because I have really fallen in love with it over the last couple of years.
I have yet to go get the test to see if I have the other defect, but the follow-up appointment is very soon. I’ll definitely be hoping for the best, but will also be happy to get the final say about what things I should be doing for the sake of my health going forward.
At this point, I’m still lifting heavy things on a fairly regularly basis. I still struggle a little bit with the workout related fatigue, lightheadedness, and prolonged recovery, but I know what these symptoms are related to now. There’s comfort in that I suppose. Comfort in knowing that while the symptoms I’m experiencing are a bit bothersome, they aren’t an indication of something life threatening. Comfort in knowing that my limitations in training are explainable, and comfort in knowing that the symptoms I have aren’t just in my head.
That’s my story up to this point and hope you enjoyed reading it! I’ll be sure to update this if/when I find out anything new, but until then I’ll just keep tryin’ to kick life’s ass one day at a time.
If you take anything away from reading this, I hope that it is that you should take any odd symptoms that you have been experiencing seriously. Follow the diagnostic process all the way through, even if you want to quit because you aren’t getting any answers. Be an advocate for your health and ask your doctor any questions you have, even if they seem a bit trivial.
Be well.
UPDATE!
After my cardiologist reviewed my chest CT they did NOT find any evidence of aortic coarctation, which means I get to keep doin my thang at the gym!
Woop woop!