Wednesday, June 16, 2010

In-Depth Discussion Today With Doc About Running During My Pregnancy

After two weeks of some fretting, some heart rate monitoring, a lot of self-analyzing, and a wide variety of comments from friends, I sat down this afternoon with my Obstetrician to discuss in detail the level and speed of running I can continue during the pregnancy.  At my last appointment, she had declared the one-size-fits-all rule many doctors follow that your heart rate can't go over 140, and we'd agreed to check my heart rate to see where I fell.

Going into this appointment, I sat down at the computer this morning and compiled a 3-page document to lead the discussion with my doctor.  It included
  1. my training history over the last year so she could really visualize where I've come from,
  2. the heart rate data I'd collected throughout the last two weeks,
  3. other things I had been doing since our last appointment to improve my probability of getting to run
  4. online research I had done about exercising during pregnancy for those who were active pre-pregnancy
Yes, I truly am that analytical.

When the doctor sat down, I started with telling her that I understood where the 140-heart-rate rule had come from - she doesn't know I wouldn't do something stupid like run 10 miles in the middle of the day in the heat, or that I wasn't lying or exaggerating about my training history.  But I told her that I've been a model patient (perfect blood pressure, a healthy weight, no complications, no defects spotted with the baby) aside from the complications we know from the first pregnancy would arise from my fibromyalgia, but again, the running has helped keep the effects of that condition at bay.  So I asked her to go through all the info I had prepared and decide what were the right heart rate and other exercise guidelines for ME in particular.

She was great listening and discussing each item with me.  Immediately she expressed a "wow" at the monthly mileage summary of my training over the last year.  I laughed and said, "See, I don't know that it's not always getting communicated how much I've been running over the last year.  I'm not one of those who saws they are a runner but are doing a couple miles only a couple days a week!"

In the end, she agreed to the detailed compromise I suggested with the caveat that she was agreeing to it now but things might and will change throughout the pregnancy.  Here's what I presented on the paper that she agreed to...

• Would like to compromise on the strict 140 bpm rule with the following:
  • Stick with a pace that is about 160-165 bpm,
  • Have walk breaks every 3 to 5 minutes of running, walk break length of 1-2 minutes, whatever gets it back below 140 bpm
  • Always wear a heart rate monitor with all exercise.
  • Limit distance – no half marathons, but up to 1 hour of exercise (5 miles).
  • Always keeping perceived exertion no higher than an 8 on a 1-10 scale.
  • Mix in lower heart rate training like elliptical, Zumba fitness, and other classes like yoga and pilates rather than running every day.

Additionally, the doctor made notes in my chart and we agreed that I'll help us remember to discuss in detail my exercising and heart rate data at each and every pre-natal visit, and I'll be having more ultrasounds routinely to monitor fetal development.
 
We also discussed an item she brought up which I had already mentioned in a previous blog post and had on my 3 page report for the doctor - my caloric intake.  I've left another pound in the last two weeks.  She's not concerned, but I was already aware that I have to work on upping my calories to account for the 300-500 I'm burning several times a week.


While some who ran through pregnancy suggested I get a second opinion or a new doctor, I love this doctor (she delivered my first child also), and this proves why she's great.  She was willing to change her opinion with further information provided and she truly listened to what her patient was trying to explain!

Happy Running All!

8 comments:

  1. I am very happy for you! It sounds like you have a great doctor who listens to you. I think your peace of mind is more important than anything right now. Stress and worry isn't going to help the baby or your fibromyalgia.

    Now... go enjoy this pregnancy! When are you going to show us belly pics?? :-)

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  2. That's really great, sounds like you have a great doctor. Now be safe and enjoy! :)

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  3. I wish you all the best and hope everything works out well with your running and pregnancy.

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  4. Hooray!! I am so glad that you were able to work out a compromise and set your mind at ease. I can't imagine how frustrated you must have been in the last couple of weeks. I will have to keep this approach in mind if/when I find myself in a similar situation! ;-)

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  5. I'm so happy for you!


    Way to go in prepared to talk with the doc. And good for her for being willing to compromise!

    Great job and happy running!

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  6. Yay! I'm glad you found a suitable compromise. Its good that your doctor took the time to listen to you! If she hadn't I would have advised you to see another physician not because she didn't agree with you; but because listening to a patient is the most important part of medical care!

    Only the patient truly knows their body and what's "normal" for it. The doctor's job is to use that assessment to provide care for the patient. If she had been unwilling to listen it would have said volumes about her work ethic.

    Let us know how pregnancy running suits you!

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  7. I'm tickled to hear about the compromise, Libby! If nothing else, this should be a lesson to a lot of runners when dealing with a professional...and a lesson to professionals when dealing with a client (and this includes us coach-types, too!)...

    You can never have too much open, honest communication in this kind of relationship. I'd rent my mother to the gypsies if every athlete I've worked with were honest with me about their goals, aspirations, past history, injuries, time limitations, and motives for doing what they do.

    Kudos to your doc...and a tip of the running cap to you for working toward a mutually comforting resolution. Hugs from MB & Suz.

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  8. Thanks, everyone, for the comments. And to Michael... your comment made me cry. Towards the end of the appt with my doc, I told her that the abdominal pain that mentally traumatized me first pregnancy had started a little in the last two days. I appreciate that, while most docs would panic because abdominal pain in most moms is an awful sign, she calmly said that's the muscular or fascial pain from your growing belly and your fibromyalgia, we'll just keep an eye on it. And I said the words OUT LOUD for the first time, which made it so much more real, "I'm scared." And she listened. It really was great. She said reassuringly, "Well, keep running, and we'll see if that helps it out any!" It is very hard to have these frank discussions because you have to be extremely aware of how you are thinking and feeling and then be able to communicate it. I have to say that having this medical condition since I was about 13 has taught me that one GOOD thing out of all of it.

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