DAVE MCGILLIVRAY: HEART DISEASE Q&A

ROAD RUNNERS CLUB OF AMERICA

Dave McGillivray is one of America’s most honored and respected runners. No flash-in-the-pan success story, he dropped out of his first Boston Marathon as a teenager. But he has since finished 46 in a row, emulating an early hero--”Old John” A. Kelley, who completed 58 Bostons in his illustrious running career.

McGillivray, 64, practically invented charity running in the U.S., always seeking to connect his fitness and good health with those less fortunate. He completed his first transcon run (3,452 miles; 80 days) in 1978, finishing in a packed Fenway Park. The run promoted and collected donations for the Jimmy Fund. Two years later, he finished his first of nine Hawaii Ironman Triathlons. All told, McGillivray’s runs, triathlons, swims, bikes and associated efforts by his company, DMSE Sports, have raised more than $50 million for charity.

In 1981, he formed DMSE Sports, an event management company that today works on a number of the country’s biggest road races, including New Balance Falmouth Road Race and TD Beach to Beach. Since 2001, McGillivray has also held the position of race director of the Boston Marathon.

Over the last 5 years, McGillivray’s life and running have followed an arc he never anticipated or wanted--that of a heart-disease runner. This path led, last October, to triple bypass, open heart surgery.

Typically enough, McGillivray has accepted his condition as just another of life’s challenges, as well as another way to inform and help his fellow runners.

In the interview for RRCA, he discusses the twists and turns of the last five years, as well as his hopes for the future. And, yes, that includes a 47th consecutive Boston Marathon run in April.

Amby Burfoot I was fortunate enough to observe your maximal treadmill stress test at Mass General Hospital in early December. You looked good. What was that day like for you?

Dave McGillivray: It was very exciting and positive. It gave me confidence that I could continue my Boston Marathon streak in April. I was scared beforehand. I’ve had a lot of stress tests, and they’re never any fun. You push, push, push until you’re totally exhausted. You run til you drop.

I was worried that I might feel the same chest discomfort as earlier in the year. That would have been a bit depressing. But it never happened. I got tired, but I never felt anything in the chest. I felt the way I used to feel years ago when I was running.That told me that I made the right decision when I chose the bypass surgery in October. It was gratifying. I felt like I aced my final exam.

AB: How has it been going since then? How much running have you done?

DM: Early on, I was making real good progress. I feel like I have now hit a little plateau, but I am confident I’ll get through this, too. It takes patience, and I know that. I’m running (and walking a bit) about 4 to 5 miles a day. I could do more, but I’m just not going to push it yet, as it has only been 12 weeks since my surgery. I’m really looking forward to April.

AB: How far do you expect to push your training before Boston? What kinds of limits have been suggested by your cardiologist?

DM: I haven’t been given any limits. I’m just running as I feel. I could and want to do more now, but I’m just going to hold off a little while longer.

AB: When did you first realize you might have serious heart disease?

DM: In 2013 I was having difficulty breathing at the beginning of runs. It would last 10 to 15 minutes or so, then I would walk a bit, then continue running. It felt like I was running at altitude. Given my endurance history, this was embarrassing to me. I didn’t look forward to my runs anymore. I didn’t want to run with anyone else, which was a bit sad in itself. I wanted to protect “my little secret.”

I proceeded to have all sorts of heart and pulmonary tests. The good news was that nothing was detected. The bad news was that nothing was detected. I knew I came from a family with a history of heart problems, particularly high cholesterol levels, so I started taking a statin. But my symptoms continued.

Eventually my cardiologist, Dr. Aaron Baggish, a serious marathon runner and co-medical director of the Boston Marathon, ordered a CAT scan and angiogram for me. The result, in his words, showed “severe blockage and chronic ischemic heart disease.” The word “severe” jumped out at me. Really? Me? Someone who has covered 150,000 miles since he was 12 years old? That came as quite a shock to me.

AB: What did you do next?

DM: After some “heart to heart” discussions with my doctors, we decided I would make several major lifestyle changes. I had always figured that runners burned off anything and everything they ate, so I never paid much attention to my diet. I also believed that sleep was vastly overrated.

For the next five years, I didn’t put any unhealthy foods in my mouth. I lost 27 pounds very quickly, and it wasn’t long before my total cholesterol dropped by 100 points. In 2014, I ran better than I had run at any time in the previous 20 years. I even did my ninth Kona Ironman Triathlon after an angiogram showed a 40 percent reduction in my artery blockages. I felt like I was almost “out of the woods.” So the next two years, I basically maintained my training and performances.

Then in 2017, when I decided to run the World Marathon Challenge—7 Marathons, 7 Continents, 7 Days—I increased my training substantially. I ran more than 100 miles in a week a number of times, and in October I finished the Bay State Marathon in 3:45.

In early 2018, I completed the World Marathon Challenge, and it all went well. At that point, I was pretty much convinced that I had outrun the heart problem. I had made a lot of changes that produced a number of good results, so I hoped I was in the clear.

AB: Yet nine months later, you were having open-heart surgery. That’s quite a drastic change of course.

DM: Yeah, it was a tough year. In March and April, I began to notice that my breathing had turned labored again on training runs, and I had some chest discomfort. I went back for more stress testing, an echocardiogram, and pulmonary tests. They all turned out fine. Finally, in early September, I had another angiogram at Mass General. I didn’t know what to expect, but was really hoping that it would reveal even more reduction of heart blockages. I had devoted the last five years of my life to medications, improving my diet, taking supplements, getting healthy amounts of sleep and generally following the best exercise-and-health routines. I figured I deserved a reward for the commitment.

Instead, the angiogram revealed that I had one major artery with an 80 percent block and two others at 40 to 50 percent. The news sent my mind spinning out of control. I’m not normally very emotional, but I broke down and cried. I’ve heard runners who say they wouldn’t mind checking out while on a run. I’ve always thought it would be a lot nicer to die in your sleep at 110.

On one level, I couldn’t believe that I hadn’t been able to change my disease. I was also thinking about the private-public question. I felt embarrassed that someone in my position, with my history, had this degree of heart disease. But I also felt a responsibility to share the news, because then maybe I could help others who were in a similar situation.

AB: You also had to make a big decision about the next step in your personal encounter with heart disease.

DM: Right. Basically, I could do nothing, I could have stents inserted, or I could opt for open-heart bypass surgery. I had a long talk with a heart surgeon who performed triple-bypass on my sister several years ago. We reviewed my family history. I had two grandfathers who died of heart failure, a father who has aortic valve disease and five bypasses, a brother with a stent, and another who had a stroke recently, and my sister with her bypasses. It’s hard not to conclude that my family’s genetic makeup is stacked against me. It wasn’t something that I could simply run away from.

After the long discussion, I had one final question for the heart surgeon: Did all my running cause this disease? He answered with an emphatic “No.” In fact, he said the opposite was more likely. My running had helped me avoid a major incident despite the significant blockage.

At this point, I felt that bypass surgery  was the smartest and safest choice for someone who wanted to keep running.  I told myself: I’ve done some pretty good running the last five years despite the blockages; imagine how good I’m going to feel after I get my “pipes cleaned.” The surgery was performed on Friday, October 12--almost exactly five years since I was first diagnosed with heart disease in 2013.

Before choosing surgery, I asked my cardiac surgeon if he thought I’d be able to jog comfortably through this little race I enjoy doing every April. His answer was perfect. He didn’t say Yes, and he didn’t say No. He said, “I’d be disappointed if you couldn’t.” That was all I needed to hear.

AB: How was your recovery from the surgery?

DM: I was home four days later, not too shabby. So I think we can say that while fitness can’t prevent heart disease, it can certainly help you recover faster. In the hospital, I focussed totally on what I was told, and making sure that I followed orders. I didn’t even turn on my laptop for four days--some kind record for me. When they let me get out of bed and begin walking around the ward, I think I set a new world record for the Mass General Indoor Mile (20 laps around the 8th floor).

Once back at home, I continued to follow orders. They told me it was okay to begin with very slow walks, up to a mile. After six weeks, I was doing 3 x 1-mile “intervals” per day, but believe me, they weren’t fast. I kept everything very easy. I’ve had one mantra: Play by the rules! Play by the rules! I told myself that the closer I followed my instructions, the better my chances of getting to the Hopkinton starting line in April. In late October I had a blood test with my lowest cholesterol reading ever.

A couple of days before the stress test, I snuck out to run an easy mile or two. I was worried I wouldn’t be able to run at all. I figured there was no sense in going to the hospital and getting tested if I was only going to last a couple of minutes. Actually, I didn’t feel very good on that trial run. I think I was tense, nervous, scared. You don’t have open-heart surgery and not be scared.

So the practice run made me even more concerned about the stress test. Fortunately, I felt really good during the test, especially after I relaxed and got more accustomed to the treadmill.

AB: What are your hopes for April 15?

DM: First I hope that we’ll have a safe marathon for the 30,000 runners and the millions of spectators. As for my own run, I’ll be feeling blessed that I can toe the start line again in Hopkinton, like I got a second chance. Last  year was miserable, not just the weather, but the way I felt. I actually put a defibrillator in the car that my brother was driving to accompany us. I was scared.

I had a bad family history, and I made some bad choices, but in my mind, I believe that running saved me. This year I plan to run Boston with gratitude that I can still run. I used to enter Boston as a competition. This year it will be a celebration.

AB: What’s the message that you’ll be giving your fellow runners based on this experience?

DM: Every runner should understand that fitness and health are not the same thing. They’re connected in many ways, and higher fitness almost always means better health, but you can also have a long exercise history and still develop heart disease, like me.

We all need to listen to our body, pay attention to symptoms, and seek medical care when appropriate. I have personally known at least a half dozen runners who went out for a run and didn’t return. If I can prevent one runner from that fate …. I’m no hero or Superman--not a Michael Jordan or Tom Brady--but one of my missions now is to bring greater heart-health awareness to more runners. I want to help runners to be both fit and healthy.