‘Something Was Not Right’
When I came home from California after my heart problems at the Wildflower race in May of 2009, I saw a sports doctor to get some blood work done. He felt I should see a cardiologist due to the drop in my heart rate. All the other symptoms including hyperventilation were not necessarily caused by the heart, but the drop in my heart rate indicated something was not right with my most vital organ. I met with one of the best cardiologists in Denmark who works with elite athletes. After a routine ultrasound examination — an echocardiogram — he wanted to run several other tests. The leak looked to be moderate in size, and my left ventricle was a massive 74 millimeters in diameter, which is very big, even for a world-class endurance athlete, but we needed more data to figure out how bad it was.
The following months were filled with uncertainty and worries. It was unclear whether I needed valve replacement through open-heart surgery, which is a complex and massive procedure, and it was unclear whether I could continue as an athlete, which was our family’s primary income at the time. At the same time, my wife’s father was in the final stages of terminal prostate cancer, with only months left to live, which obviously affected all of us deeply. On the sunny side, but on an equally life-changing level, my wife, Mette, was nine months pregnant with our second child. The emotional burden was beyond words. We talked, hugged and gave space to process all that was going on.
On May 29, I was scheduled for a transesophageal echocardiogram, where the doctors inserted an ultrasound probe through my throat into my esophagus, just behind the heart, to get a better look at the condition of my heart valve. Needless to say this was a very uncomfortable examination. While I was being sedated and gagged with a tube the size of a garden hose, Mette stayed with me even though she went into labor and drove me home despite her contractions. After 28 hours in labor, she gave birth to our wonderful daughter Marie.
More tests followed: various echocardiograms, heart stress tests, a two-day monitoring for arrhythmias and an MRI of the heart, which is extremely complicated as the bugger won’t stand still. By the end of June, the doctors had a good overview of my condition. My leak had grown to a moderate size, which meant that 20 percent of the blood returned to the heart with each beat. My aortic diameter had also grown to 45 millimeters, which was in the gray zone in terms of doing sports, but not indicative of the need for immediate surgery. The bigger leak put more pressure on my heart during exercise and at rest, which had caused the left ventricle diameter to increase by 10 millimeters since February. Needless to say, the doctors advised that I stop elite sports immediately and start lowering my training by doing one to two hours of moderate-intensity training a day. Over time we would see whether that relieved enough pressure for the ventricle and aorta to shrink, or whether I needed valve replacement surgery. The insecurity continued, but the first follow-up showed clear signs of improvement, which continued to the point where my numbers a year later stabilized at less than what they were during my career.
No one knows why the leak or my heart suddenly grew. The only study I found done on elite athletes with a bicuspid aortic valve suggests that my high levels of training had no influence on its development, so this may have happened regardless of my triathlon career. But once the leak grew to a moderate stage, serious training was no longer possible and I considered myself lucky that reducing my training was all it took to stabilize my condition. Going forward I don’t know whether the leak or the diameter of the aorta will develop again anytime soon, or whether it will remain like this for the rest of my life. I still exercise and enjoy being out in nature, but I’m not allowed to train hard or race anymore, which is fine by me. After all, I have experienced more than I ever dreamed of in my professional career, and I can still be active at a level I enjoy.
As my case shows, having something go wrong with your heart is not like having to deal with a jumper’s knee or a sprained ankle. It touches some of your deepest fears when you consider that the organ you depend upon every second of your life may fail. It took months before I understood how afraid I had been during the incident in Wildflower and the months that followed. It took even longer before I was able to trust my body again and convince myself that my heart is just a muscle like any other. If my condition worsens I know I have a great family and great doctors who can help. No matter what life I am handed, I know that my attitude, not the circumstances I live under, determines my happiness and quality of life.