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Yes, it can be done
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I recently had the pleasure of meeting Russell Windwood, a guy with severe COPD and an amazing athlete from Australia who recently ran the New York City marathon. But more about that in a minute.
The real reason for this post, or for that matter the reason this website exists in the first place, is to tell the Asthma/COPD world and the world at large, that YES, even people with the severest forms of lung disease do compete, and finish both half and full marathons…. some of them even complete Triathlons!
If you’re stumbling on my blog for the first time, you read the above correctly. I have very severe life-long asthma wit a baseline lung function of only 28%. And I have completed not one, but 9 full marathons and 12 half marathons in just the past 8 years. Why did I do them? Because I wanted to see if I could. And while it’s rare for someone like me to do marathons, it certainly is not impossible. I know several people with similar lung function who have done the same. Some have enough completed Ironman events.
But don’t just take MY word or it, or be swayed by all my shiny metals, take the word of some of the worlds most respected lung doctors words who’ve examined me inside out. My medical history is well documented and review-able to all who feel the need to have proof of my claims. But will seeing my actual medical records make you any less skeptical? I doubt it. We naturally assume that if a person has serious lung problems, there’s no way they can do these types of endurance events.
In my case it’s important to note that I didn’t run any of these marathons. In fact, I can’t run at all, I just don’t have the lung capacity to do so. But I found through years of experimentation that I could condition myself to walk at a moderate pace for increasingly longer periods, so that’s how I trained for those races and that’s how I completed them by walking them fast. Of course, I can’t walk as fast as a runner can run, but I still cover the same 26.2 mile marathon distance and it only takes me about twice as long. (my fastest time for completing a marathon is 6:48).
OK, so back to this amazing person I met. I admit that like many, I was a little skeptical when I first read about him and his claims to have completed an Ironman and several marathons, despite having stage 4 COPD with an FEV1 of under 30%. As a Respiratory Therapist who has worked the field for a long time and as a person who has also lived with severe asthma since birth, I thought how on earth is that possible? How is it that this person with lung function equivalent to mine, is able to RUN (not walk) 26.2 miles, bike 180 kms and swim 2 miles in a single stint, while it took every bit of strength, effort and a full year of constant training just to walk a single marathon? How is it that he can run a marathon in 6 hours, seemingly without breaking sweat, when I can barely WALK a marathon in 7 hours and almost die in the process? Is it because he trains harder? is mentally stronger? Or is completely exaggerating the severity of his lung issues?
It took me awhile to figure this out, but here’s the deal. While we both have severe lung disease, mine is almost pure asthma, but Russell”s is mostly COPD. Both are chronic obstructive lung diseases, but the physiology of each disease is different. And while both of these conditions cause breathlessness, the sensation of breathlessness (what we call dyspnea) is often perceived differently in people with COPD than in people with severe asthma. How do I know that?
Well, Ive trained and done several races with people who have severe COPD , and when asked, they often describe their breathlessness much differently than I describe mine. They often report it as a feeling of becoming increasingly tired and fatigued, of being lightheaded, like breathing through a narrowed straw, etc. My breathlessness on the other hand, and that of most asthmatics, feels like someone put a plastic bag over my face and pulled it tight. I can actually feel my airways tightening or closing up. And even though my O2 sats will often remain pretty normal while this is happening, I feel like Im suffocating to death. So why is that? Shortness of breath is shortness of breath, right? Well, not exactly.
There’s more involved here than just the way we perceive breathlessness or a low FEV1 . Equally important is what CAUSES the breathlessness that one experiences? This is where we get back the physiology of the different diseases. In disease like severe COPD and Emphysema, there’s often destruction of the lung sacs (alveoli) that allow oxygen to enter and the fuel the body. As this destruction advances, it becomes harder for the body to oxygenate and eventually the person will need supplemental oxygen to keep their O2 sats up. O2 desaturation if bad enough leads to a feeling of tiredness, of breathlessness, of windedness, but not necessarily that of tightness or suffocation. COPD sufferers also have to deal with air trapping, which makes one feel breathless as well. In asthma however, there is rarely destruction of the alveoli, so oxygenation is usually not a factor in causing breathlessness. The sensation of breathlessness is asthma is almost always a result of the small and large airways becoming blocked, narrowed and/or tightening up. Hence the feeling of a more sudden, more intense feeling of suffocation.
My breathlessness limits how far and fast I can walk, but everyone is different and that’s the main point of this story. In hind site I think my initial skepticism about Russel’s claims, especially his ability to RUN long distances, stemmed from a feeling that if his claims were true, then my own accomplishments, amazing as they may seem, are surely inferior. After meeting Russell in person, I see that that’s not the case. Russell’s disease effects him much differently than mine effects me. With the help of his doctors and a personal trainer, Russell found that by maintaining a high heart rate(between 150-160 bpm) while training, that he’s able to maintain his O2 saturation and feels less short of breath.
Of course, many chronic lung disease suffers have elements of both diseases in varying degrees, which makes figuring out the exact cause of breathlessness even more tricky. But with accurate history taking, diagnosis and and examination of complete pulmonary function tests we can usually narrow it down. I believe it’s this difference in the type and cause of dyspnea, that at least partially determines how an athlete will tolerate an endurance type event such as a marathon.
Those of us with severe lung problems who have achieve seemingly impossible fitness feats, are able to do so, not because we are super human, but because we work extraordinarily hard at it. We’ve conditioned our bodies to maximize the efficiency of breathing and have gradually build up the physical endurance required to get the job done. We’ve learned not to let our breathlessness control or limit us in what we can or cannot achieve. We’ve learned how to break down the mental barriers that impede progress. We identify a problem and then we fix it, or adapt the best we can. Nothing mysterious about that.
http://breathinstephen.com/
Source: http://breathinstephen.com/yes-it-can-be-done/
