2021 Marathon Race Report

The last time the Honolulu Marathon was a live event was in 2019, just before the world went into lockdown for COVID-19. This was the race that convinced me there was something wrong with my heart and got me to get a referral to see a cardiologist. 

It was around mile 10 that year, running up Kilauea to the Aloha gas station, that I noticed my heart rate (HR) was high, and I felt funny. I started to run/walk, based upon HR, until around mile 13, when I decided I might end up with a heart attack so I walked the rest of the way. 

This year I knew I was in trouble by mile 4 but carried on two more miles trying to get things under control. By the time I got to the park at mile 6 I knew there was no point in continuing.

Right after the 2019 race I started working on what was going on, and ended up seeing a cardiologist who is himself a runner, and suffers from the same thing. The preliminary diagnosis was supraventricular tachycardia (SVT). Literally that just means a rapid HR, but the key thing is a HR much higher than it should be.

When I mentioned that one reason I started walking at mile 13 was out of fear of suffering a heart attack, he assured me that in my condition a heart attack was extremely unlikely. The way he put it was that since I was able to continue walking briskly, a heart attack was not going to happen. Genuinely comforting and welcomed news.

To help pin down the diagnosis he had me purchase a Kardia portable EKG and carry it with me on my runs. When I felt like I was having an episode I was supposed to take a reading and email it to him. For two years I have carried that thing on every run. I never felt as bad as I did that day but I took a few readings and sent them in. No SVT. I didn't think so.

At the same time he switched my calcium blocker to one that can mitigate the occurrence of SVT. Within a week or two I felt the effects. No more pounding heart. The problem was, it made me dizzy. Very dizzy. So we switched that to a good old fashioned water pill. The result was great blood pressure numbers and still no sign on SVT. At my last checkup in September we agreed everything was working fine.

After two years of regular exercise, including a self-curated marathon on October 10, 2020, as part of that year’s Ironman Virtual Kona week, I never had an episode. For this year’s marathon I chose to carry my own drink power, seven packets of Precision Hydration 1000 packets, and some Hammer gels. (I like the Precision Hydration gels and used them during long training runs, but they are too bulky to carry in the race.  The drink power, in contrast, is super compact and easy to carry.) That plus my phone took up all of my storage space, so I left the Kardia behind. 

So, the lesson here is that I need to carry the Kardia to ward off evil spirits.

I wish it were so simple! I am kicking myself for missing a rare opportunity to capture an SVT episode EKG, as that might help with diagnosis. Oh well, there is no going back.

My race plan was based on looking over old races and my recent long runs. I put in a lot more miles this year than I have in a long time, including a second long run on Tuesday morning. This is where being a slow runner makes advice for “normal” runners confusing. 

A traditional marathon training plan will progress the weekly long run distance out to an 18 to 20 mile peak a few weeks before the race, then taper a bit. At my marathon pace an 18 mile run would take five hours. I can’t recall the last time I did that, but when I did I was a basket case afterwards. 

Since then I have found recommendations, all related to triathlon, to cap the long run at three hours. Being a senior athlete this is even more important. The really useful adaptations happen after two hours, and fall off after three. From then on the risk of an overuse injury outweighs any benefit. I knew I was looking at a long day, at least seven and a half hours, so I decided to push the duration a little in order to build endurance and confidence, while watching out for ill effects. 

I prescribe my runs by duration. Here are my build period Sunday long runs. Note there was an additional 1:30 - 2:00 hour run on Tuesday morning, to build off of the Sunday run.

Looking back over this year, a few things stand out that ought to be mentioned here. In April I ran the Hapalua Half Marathon virtually in several one hour loops in Kahala. I used my car as an aid station, finishing with a lap around Diamond Head, just like the real thing. I kept the pace low, my marathon training pace, same as I did for the Ironman I did in October 2021, because I was not trying to win anything. The entire thing, with some leisurely aid station visits, came in at a 20:06 pace, actually a bit faster than my planned 21:09. No issues.

Soon after that our Javanese gamelan began to meet, and sitting on the floor after a year off put my back seriously out of whack. A big shout out here for Mike Zanoni, my acupuncture guy, and Sonya Waiser Souza, once my masseuse and now my Zoom PT. The back pain continued through May, with a cat bite infection thrown in as well. I started back into training in June, adjusted to include a regular morning flex routine. In August there was a surge in COVID-19 hospitalizations. I did not want to risk a bike crash and the resulting visit to the ER, so I moved my bike workouts to the turbo trainer. 

In September I started running in a new pair of Hoka One One shoes and my left ankle/heel got inflamed. I knew I had a left leg articulation issue (Sonya and Mike both helped with that, too, way back when) but it has not been a problem in years. Now, all of a sudden, I was limping after my long runs. I did some in-person PT work at East Oahu Physical Therapy, and will restart that now that the marathon is done. In the meantime I switched to Bondi Hokas and no more pain. Throughout this episode I did not reduce my mileage – I stuck to my plan, even in the rain.

One big win for me was how I improved my gait and economy. Okay, I admit my economy is still terrible, but it has improved a lot. A year ago I struggled to run slowly. Often, the best I could do was zone 3. To get any lower I had to walk. I finally got down into a steady zone 2, and eventually just at the top of zone 1. This is right where you want to be for long, slow, distance (LSD) work, the cornerstone of the 80/20 method I follow. I used to cringe when I heard a running coach talk about the difference between the slow run pace and a marathon pace, because for me they were one and the same.

In late October I began to think about what my marathon goal pace should be. I knew I could run faster than my long run pace, but how much faster? I started experimenting with race pace on my Tuesday morning runs, after the turn around at Kawaikui Park. I found that I could easily get 17:00 min/mi with only a small, manageable increase in HR. The result was a target power of 143 watts, give or take, so 140-145, HR around 133, smack in the middle of zone 2. In comparison, average power for the outbound portion of that run, about 2.5 miles, was 111 watts and a 20:45 pace, HR 125. My marathon PR is 7:26. It looked to me like I could easily beat that this year. 

Another change for me this year – let’s call it an improvement – is my increased emphasis on pacing by feel rather than the numbers. I got really good at guessing what my power or HR was before looking at my watch.

Add to that a new belief that we can push ourselves to do more than we think we can. For this race that applied to the second half. I was absolutely sure I would have a great run out to Hawaii Kai, and that it was the return that would be the challenge. That long, slow, uphill grind from the bay to Kawaikui Park, a route I ran numerous times in training. I kept reminding myself to remind myself that I suddenly feel tired because of this false flat uphill section. Just shorten the stride and keep going.

My plan was to do a full 10 minute walking warmup, then an easy pace (130 watts) to Nuuanu Ave, walk up that and wave to Santa in front of Murphy’s, then start my race pace (143 watts) after we turn onto King Street (1.8 mi, about 35 min from the start.) Then rely more on feel than the numbers.

It wasn’t long after that when I knew I was in trouble. I felt much worse than I should have. My HR should have been around 133. It was 150, even 155. I could feel my heart pounding in my chest, as if I had just run a three minute max uphill repeat. Respiration was also high. Too high for zone 2, but not like the end of a hill repeat when I would be gasping for air. More like a tempo run. 

Here is a zoomed-in section of my run which covers the stretch I just described, about 30 min. long, from when I started running at race pace until we turned down Piikoi Street. This is basically flat. I run with a 4/1 run/walk. There was one four minute run segment, then a slow-down at the first aid station, then four clean run segments. Looking at just the last four run segments we get

I started a little fast, then hit my planned pace for the next two segments. During that time I began to feel bad. I switch my watch to the HR display and was shocked and disappointed to see it up in the red zone at 154 when it should have been in the blue zone, mid 130s. This confirmed what I felt.

I went back and compared the same segment with my 2019 race, where SVT did not show up until later. I was not using run/walk so the data is for the entire segment.

From that point on I was trying to keep it together while at the same get my heart under control. I walked some of the run segments, and I slowed the runs to my very comfortable training pace. I even poured a cup of water over my head. Nothing worked. By the time I reached Kapiolani Park and the 6 mile point I knew it was not going to get any better. I also knew I could finish by walking, but I really did not crave another finisher’s medal that much. I decided to cut my losses and call it a day.

It’s a bit over a mile from the park to where Pattie and I were staying with a friend for the weekend. I texted her to let her know I was done early and walked back. For about another hour my HR held at 100-110, where normally it would be 70-80, and I could feel my heart pounding. This never happened after a training run.

Why did I decide not to run at my slow run training pace? If I had, would I have finished without the SVT episode? Maybe. The reason was that I want to do better next year. I want to go back to Hawaii Island and finish Honu with time to spare. If that goes well, I want to do a full Ironman. Cozumel is the standout. This race was to be, more than anything, a chance to push up against those feelings of overwhelming fatigue and just keep going, hard, no matter what. I know I trained well, and planned well. Now, I am deeply troubled that my heart might not up reliable. 

Here are some screen shots from the TrainingPeaks app on my phone, comparing three charts from the race and my last long run on 11/28. Note the difference in the scales, especially for HR. I think they speak for themselves.

Last Long Run vs. Race

Chart	Nov 28	Dec 12
Stats
Zones
Peaks