Is It Safe To Do a Triathlon After a Heart Attack?

tri picture

There is a reason you hear about people dropping dead during these events.  Heart attack or not, endurance events put a significant strain on the body, particularly the heart.  If you are going to train for and compete in one of these events, it’s important to understand your underlying cardiac condition and always consult your doctor.  It’s also important to be naked, play guitar and train with “friends”.

Silly Mamil

I am not the only middle-aged guy contemplating one of these events.  There are so many of us out there that we even have a nickname:  Mamils (middle aged men in lycra).  According to an article in Bloomberg, the average age of competitors in these event is on the rise.  The 40-60 year age bracket now holds 32 percent of the membership in USA Triathlon.

Sinking Mamils

study published by the Mayo Clinic found that the death rate for triathlons is about twice that of marathons because of the overall intensity, particularly during the swim event.  In a triathlon, the swim event is first.  Swimmers pumped full of adrenaline swim on top of each other as they position for the lead.  The panic, physical exertion, and lack of oxygen can be lethal.

The Bloomberg article mentioned above is an excellent resource and goes into much more detail on the risks.  I recommend reading this if you are contemplating one of these events.

Stupid Mamil

So why am I doing this?  Because I am a stupid!  Also, because I have two good friends to compete with, I need something new to keep me engaged, and I like the challenge.  I am already biking and running, what’s the harm of a little swim?  I outline my approach to exercise in a previous post if you are interested in reading more.


Trinewbie is great site full of training advice and programs geared towards first time competitors.  I actually completed one of these events back in my smoking days, prior to the heart attack.  That one was done with little training.  This time around, I will l somewhat follow the 10-week program on the Trinewbie site.

If you haven’t had a heart attack and are not exercising, hopefully my participation in this event has appropriately shamed you.  As always, check with your doctor before competing in one of these events.


Khan, Natasha, and Shannon Pettypiece. “Men Over 40 Should Think Twice Before Running Triathlons.” Bloomberg. N.p., 21 June 2013. Web. 19 July 2014.

James H. O’Keefe et al. Potential Adverse Cardiovascular Effects From Excessive Endurance Exercise. Mayo Clinic Proceedings, Volume 87, Issue 6 (June 2012) DOI: 10.1016/j.mayocp.2012.04.005

Photo credit: guneyc / Foter /Creative Commons Attribution-NonCommercial-ShareAlike 2.0 Generic (CC BY-NC-SA 2.0)

My Heart Attack Anniversary – 7 Years Later

Me at the Beach

I missed a very important anniversary last week.  July 1st marked 7 years since my cardiac arrest, heart attack and bypass. As the author of a heart attack blog, it’s a little odd that I missed my own anniversary.  On the other hand, I was at the beach enjoying time with my family.  Celebration enough.


No, I won’t be writing about the seven deadly sins – maybe what led to my heart attack.  Instead,  a quick post to highlight the 7 things I am most grateful for on this lucky anniversary:

  1. Being alive
  2. Having a wonderful family
  3. Having great friends
  4. Having a healthy lifestyle
  5. Having the ability to relax
  6. Having a job that provides for my family and I
  7. Having the experience of death

I didn’t put a lot of thought into this list and number 7 may seem a little strange.  I am sure it will evolve and grow over time – at least to 8 by this time next year. That’s it for now – Paul

How to Stay Motivated After a Heart Attack

army motivation

Was I motivated to stay healthy after my heart attack?  Of course I was – for awhile.  I changed my diet, joined a gym, and started running.  Then, the same lack of self-control and discipline that fueled my first heart attack started to creep back into my life.  I began binging on junk food, became too busy to go to the gym and became too bored with running.  I was not spiraling out of control (yet), but I had lost the motivation to “move”, to be healthy.

Movement is a medicine for creating change in a person’s physical, emotional, and mental states.” – Carol Welch

What is Motivation?

In layman’s terms, it’s the desire to do something.  I want to be healthy, therefore I eat right and exercise.  It’s pretty simple on the surface, but there are many theories and models devoted to understanding motivation.  For our purposes, let’s focus on just two – intrinsic and extrinsic motivation.

Intrinsic Motivation

Intrinsic motivation comes from within and is based on the enjoyment of a task or a belief that it is the right thing to do.  For example, I really enjoy eating vegetables and running.   I also believe eating right and exercising is the right thing to do.  Based upon my enjoyment and beliefs associated with these tasks, I stay motivated to do them because they are a part of who I am.

If eating right and exercising were part of who I am, I would not have had a heart attack at 41.

Extrinsic Motivation

As the name implies, extrinsic motivation is based on external factors – primarily rewards or punishment.  Rewards are awesome, and punishment (or guilt) has fueled my personal development since childhood.

In the green vegetable/running example above, extrinsic motivators or rewards might be improved appearance and health.  The punishment for not eating right and exercising is another heart attack (or death).

Which is more Effective?

Based on my examples, you might say extrinsic motivation is superior.  However, research indicates that intrinsic motivation is more effective long-term.  So we focus on intrinsic motivation, right?  Not entirely.  As with anything in life, there needs to be a balance.

An article on HealthCentral discusses the need for a balanced approach.  Intrinsic motivators keep you going in the long run, but extrinsic motivators get you started and keep you moving in the short-term.  Check out the article for more detail.

Enough Psychobabble, How Do I Motivate Myself?

You form habits.  Early on, rewards are going to help.  Exercise and eating right improve physical appearance.  Who doesn’t want to look better?  But let’s face it, even if you had a heart attack at a “younger” age, you are still probably past your physical prime.  Looking good will only take you so far.

In order to stay motivated long-term, you need to make the mental shift.  You need to envision yourself as a healthy person.  Healthy people do healthy things.  Before you know it, you enjoy doing healthy things.  Congratulations, you are intrinsically motivated.

To put the plan into action, try the following:

  1. Set goals – Goals need to be measurable and obtainable.  I will lose 2 pounds a month.  Not I will have six pack abs.
  2. Schedule activities – I put my morning workouts on my Google calendar.  I also build exercise into activities I am already doing (riding my bike to work).
  3. Measure performance – Take before and after pictures.  They are very motivating!  There is also a lot of cool wearable technology out there to track fitness goals.
  4. Provide rewards – Recognize when you achieve goals.  If all goes as planned, you may need some new clothes.  Or, a Fitbit may be in order.
  5. Enjoy – Make sure you are doing something you enjoy.  Running sucks, try biking or swimming.

Most people can’t understand how surviving a heart attack isn’t motivation enough to be healthy.  I get that, but I also know how difficult it can be to break old habits and form new ones.  Start with a decision, take action, repeat.  If that doesn’t work, get the dude in the picture above to start yelling at you.


Nelson, Lisa. “Getting Heart Healthy: Motivation to Change Your Habits.” N.p., n.d. Web.

Photo credit: United States Marine Corps Official Page / Foter / Creative Commons Attribution-NonCommercial 2.0 Generic (CC BY-NC 2.0)

heartgeek Exposed!


I would like to start off by saying happy Father’s Day to all the dads out there.  I am going on a bike ride this morning and then relaxing with the kids all day.

I found out that I’m a pretty bad father. I make a lot of mistakes and I don’t know what I’m doing. But my kids love me. Go figure. —Louis C.K.

Now on to heartgeeky stuff.

My 15 Minutes

I was interviewed earlier this week by WTOP, a Washington, D.C. radio station.  The reporter was doing a story on the rising trend of heart attacks and heart disease in younger people.  She found my blog and reached out, saying “You are just the guy I am looking for”. As a result, couple of audio clips aired during the morning drive hours and an article appeared on the WTOP website.  Just like that, heartgeek is a exposed.  I am expecting a call from Oprah at any moment.

Many friends and co-workers were caught off guard when they heard my voice on the radio.  Up until  heartgeek, I maintained a very low profile on the internet and social media.  I wasn’t even on Facebook until this March!  Now here I was talking on the radio and laying out some extremely personal information on a blog.  If people hadn’t heard my story before, they certainly know it now!

A great benefit from this sudden exposure was finally connecting with other people who have gone through a similar experience to me.  People found the blog and then shared with me their cardiac stories.  I learned how others are successfully living with heart disease and also what has been a challenge.  This was the interaction I had hoped for when I started heartgeek!

It’s Not Just Me

One email I received that really stood out was from a guy who wrote and told me he read the blog and it scared the crap out of him.  I do enjoy scaring people, but my goal with heartgeek is to motivate.  Not surprisingly, I heard from a few people that motivation is a problem in cardiac recovery.  Having heart disease at a young age means staying on top of your health for a long, long time.  That in itself can crush motivation.

I received quite a few emails on the benefits of a vegan diet in both preventing and reversing heart disease.  I received recommendations to watch the “Forks and Knives” documentary, read Dr. Caldwell B. Esselstyn, Jr.’s book “How to Reverse & Prevent Heart Disease” (I have already purchased) and visit the Happy Herbivore blog.  Each of these sources describes how a plant-based diet can not only prevent heart disease, but also stop the progression and reverse heart disease.  Former President Bill Clinton follow’s Dr. Esselstyn’s program.

There were a couple of recommendations for Dr. Ornish’s Lifestyle Program.  This one looks interesting and is something I will spend time reading up on.  I also received a recommendation to read Mark Bittman’s book “Vegan Before 6”.  Mark is a food writer/author as well as a columnist for the New York Times.  In my house, we already rely on his “How to Cook Everything” cookbook and I like the fact that his approach provides the best of both worlds.

These are all great recommendations and I am sure to experiment with each of them.  I will also try P90X3 at the suggestion of one reader.  What sticks with me most from all the email I received is each writer’s desire and actions to live a happy and healthy life despite having heart disease.

Let’s Keep It Up

A community is starting to form, let’s keep it up.  I do a lot of research geared towards improving my health and I learned quite a few new things from this initial wave of interaction.  There are new diets, lifestyle changes, and exercise programs that I need to check out.  The only way to continue to learn is to share information.   Please join the email list, send emails, and most importantly, leave comments and engage with other readers.

Can I ask a favor?  Leave me a comment below regarding topics for future posts.  Based on the input I received so far, I am thinking we need one on motivation.  I would love to hear from you.

Finally, thank you for all the engagement over the past week.  It’s been great to interact with other heartgeeks!

The Head and the Heart

Its All In Your Head

When I had a heart attack at 41, a number of thoughts went through my head, and none of them were very good.  An inventory of my mental state post heart attack:  shock, panic, guilt, anger, denial, fatalistic acceptance.  Interestingly, that was also my pattern of thought about most life matters pre-heart attack.  Must be the Irish in me!

Let’s take a look at each one of my my mental reactions in a little more detail before diving into the connection between the head and the heart.


Holy crap, what just happened?  I didn’t remember going into cardiac arrest or having a heart attack.  In fact, I didn’t wake up for a couple of days.  As the fog cleared and I was informed of my condition, I really could not believe what had just happened to me.  With my family history and reckless lifestyle, I anticipated clutching my chest at some point in life – just not at such a young age.


I’m going to die!  I was hooked up to a bunch of machines and had tubes coming out of every orifice of my body.  They even made new orifices to stick tubes into!  They told me I needed open heart surgery.  What about my family?  I have a three year old and my wife is pregnant with our second child.  How am I going to pull through and support my family?   I still needed to work for another 25 years!  A million thoughts like this went through my mind.


What have I done?  Everyone around me offered tremendous love and support and I felt like I deserved none of it.  I put myself in this situation.  I knew my family history with heart disease.  Yet, I chose to smoke, drink like a fish, eat like crap, and sit on my ass.  Now I had put the future of my family in jeopardy.  Bad Paul.


Why me?  Early anger was mostly directed at myself.  Why did I make such stupid choices?  How could I be so reckless and irresponsible?  Not being a fan of self-directed anger, I moved on to directing my anger towards others.  Why are other people making healthy choices and living happy lives?  Yes, I was resentful of healthy and happy people (who isn’t?).

Denial/Fatalistic Acceptance

Carry on, nothing to see here.  Another trait I learned from my Irish parents. I am not sure why I am so obsessed with my Irish heritage right now.  Here is a great quote from a recent Lonely Planet guidebook that may explain it all:

The Irish – fatalistic and pessimistic to the core – will shrug their shoulders and just get on with their lives.

That’s me.  Strap on the blinders and go!

Fix the Head, Fix the Heart

There is a head-heart connection and for me it is the key to preventing my second heart attack.  I couldn’t fix my heart until I fixed my head!  So what was wrong with my head?  A pretty loaded question.  I found a New York Times article, “Why Smokers Still Smoke”, that offers an interesting theory.

the personality trait that distinguishes smokers from nonsmokers is their relative inability to delay satisfaction and respect long-term considerations (like their health). In other words: it’s their poor self-control.

Bingo! Not only did I lack poor self-control, I completely ignored any personal responsibility for my actions.  Here I was in my mid-forties, and I suddenly realized I was responsible for the rest of my life.  I was responsible for preventing my second heart attack!  Without this mental shift I truly believe I would be dead right now.

So how did I come to make this obvious but elusive mental shift?  By taking an honest inventory of my life.  Where had I been and where did I want to go?  This is not an easy exercise for someone like me who preferred to let life happen.  Once I discovered a morsel of self-control and realized I was responsible for my actions, I found doing the right thing became much easier.

Action Needs a Plan?

Say what?  Doing the right thing became easier when I finally started to set goals and make plans.  Remember the process of deciding where I wanted to go with my life?  In my compromised situation, it was pretty easy – I wanted to live.  Instead of putting on the blinders and seeing what life brought me, I needed to set a goal and make a plan.

My immediate goal was to get healthy.  But how do I make that happen, how do I translate a goal into a plan and then into action?  Keep it simple (stupid).  Here is what worked for me:

  1. Set a goal
  2. Make a plan
  3. Share the plan
  4. Execute

Exercise seemed like a good place to start if I wanted to get healthier.   I plotted out my exercise program on a calendar.  I shared my plan with my family and friends to make sure there was a built in method of accountability.  Then, I just did it.

Guess what, it worked!  Fixing my head may not fix my heart, but I have a feeling it will go a long way in preventing my second heart attack.

Check your head!


Eyal Ert and Eldad Yechiam. “Why Smokers Still Smoke.” New York Times, July 26, 2013. Accessed June 7, 2014.

Why Get CPR Certified?

CPRBefore I answer that, let me ask a question.  How can a cardiac arrest survivor and self-proclaimed HeartGeek not know CPR or how to use an automated external defibrillator (AED)?  I go around preaching about heart health, gratitude and doing the right thing, yet I wasn’t equipped to help someone experiencing a cardiac emergency.

Time for HeartGeek to man up and get some CPR training!

Chain of Survival

First a little history.  I survived a cardiac arrest because of the quick actions of my wife and the early medical attention I received from EMTs and doctors.  In my case, a near flawless execution of what is known as the “chain of survival”.

The chain of survival significantly increases the chances of survival for someone who experiences a cardiac arrest, heart attack, or stroke.  The five links or steps in the chain are:

  1. Early recognition and call for help, such as dialing 9-1-1
  2. Early CPR
  3. Early defibrillation
  4. Effective advanced life support
  5. Integrated post-cardiac arrest care

Step one is a no brainer and is typically well  executed.  Step two is where things start to go awry.  Sadly, only about 30% of cardiac arrest victims get CPR from a bystander.  Think that could have something to do with less than 10% of out-of-hospital cardiac arrest victims surviving?

Paying it Forward

I signed up for a CPR/AED class provided through the American Red Cross.  My class was instructor led, lasted three hours, and provided a lot of hands-on practice.

After some brief overview information, we jumped right in to the hands-on part of the agenda.  There were only about a dozen people in my class and we were paired up into teams.  With our partners, we practiced assessing the scene and and preparing the victim to receive aid.

Now it was time to bring out the manikins (you don’t practice CPR on each other).  I had a good idea of what to do here, but going through the paces made me feel more confident that I could pull it off in a real-life situation.  There are three simple steps for CPR:

  1. Give 30 chest compression at 100 beats per minute (see Stayin Alive)
  2. Give two rescue breaths
  3. Repeat

We next moved to the part of training I was most interested in, use of the automated external defibrillator (AED).  If you are like me, use of the AED is the most frightening aspect of providing assistance.  Shocking a loved one or total stranger with a device you have never used before is intimidating.  Rest assured, it’s not as hard as it sounds.

It is necessary that you make sure the victim is not in water and make note of any body piercings (or any metal) or medical patches.  Fire up the AED and it will provide audible step-by-step instructions.  When placing the patches on the victim, avoid those piercings and medical patches if you found any.

The AED will analyze the heart rhythm and make a determination to proceed with a shock.  Next, clear the area, push the button, and the shock is delivered.  At this point, continue CPR until assistance arrives.

The class concluded with instructions for dealing with choking and head/spinal injuries.  I will let you learn more about those in class.

So Why Get CPR Training?

Because four out of five cardiac arrests happen at home.  The life you save will likely be someone you know and love.  Also, it’s easy and it’s the right thing to do!  And yes, I can save your life.