Patients Talk

Pacemaker Patient Rises to the Ironman Challenge

Some people who have a heart condition become resigned to the idea that they may not be able to do all the things they want to do.

Each person is different. Talk to your doctor to understand the amount of physical activity that's right for you before you begin any exercise or activity plan.
	Talk to your doctor about important safety information.

But not Julia Engel. Julia has had a pacemaker since she was a high school senior. In July, at age 44, she completed her first Ironman® Triathlon. A triathlon is a demanding race made up of three parts: a 2.4-mile swim, a 112-mile bike ride, and a 26.2-mile run, all in one day.

Julia's journey began as a high school student who wanted to run track but couldn't because of a heart condition. “My parents were always worried – understandably,” she said. Her doctor recommended a pacemaker, which is designed to "pace" the heart to beat at a normal rate. Pacemakers treat abnormally slow heartbeats.

“And even after getting my pacemaker, it was scary, not knowing what was to come,” Julia said. Her heart doctor told her it would best if she didn't run.

But the devices improved with each replacement she received. Julia and her doctor worked, over time, to take advantage of new capabilities in pacemakers. After several years, Julia's doctor told her she could begin running. She ran her first marathon (a 26.2-mile race) in 1996, and went on to compete in four more.

Each person is different. Talk to your doctor to understand the amount of physical activity that's right for you before you begin any exercise or activity plan.

Then, in 2002, Julia suffered a setback. An infection in the “pocket” where her device was implanted led to a 12-day hospital stay. To clear the infection, she went through four surgeries and had a blood clot.

It was a difficult time, but Julia's outlook stayed positive. “I've had these things happen, and it's just part of it. It's a small price to pay to have my life,” she says.

After her hospital stay, Julia said, “I came home and thought, ‘What do I do with this body now?' ” After checking with her doctor, she began physical therapy to regain strength in her shoulders and arms. The exercises she began included yoga and swimming. She began going to her local pool, and at age 40, began swimming as seriously as she had previously run and bicycled. It was also at the pool that she met her husband-to-be, Doug.

After she became confident of her swimming skills, it occurred to her that she might be able to compete in a triathlon. “I had always liked to run and cycle, so the idea of a triathlon appealed to me,” she said.

With Doug, a two-time Ironman finisher, Julia competed in a few triathlons that year. “After that, the idea of the Ironman intrigued me,” Julia said. “Personally, I knew that to complete the Ironman would be a huge milestone in my life.” With Doug's encouragement, she made the decision and registered, as required, a year before the race.

She began working with a coach, who went with Julia to her heart doctor. Her doctor conducted tests and the three of them talked about what training at such a high level might mean for a pacemaker patient. “They did an echo test, and EKG, and they tested the pacemaker. My doctor talked with other colleagues, and in the end, they couldn't find a reason for me not to do it,” Julia said.

So in November 2006, the intense training began. A group of 25 people from Julia's hometown of Charlotte, North Carolina, often trained together. Their routine included three-hour runs once a week before work and eight-hour training sessions on Saturdays. “Friends and family were understanding about our lack of free time on weekends,” Julia said.

As spring approached, Julia, Doug and the Charlotte Ironman training group intensified their efforts. Weekly swimming sessions, a half-Ironman race, a weekend training camp, and a 112-mile bike race gave Julia skills and competitive experience she knew she would need for the big race in Lake Placid, New York, in July.

Julia and Doug (see photo above) arrived in Lake Placid three days before the race. They took time to tour the city, meet other Ironman athletes and do some light training. The evening before the race, several members of the Charlotte group gathered for a pre-race meal of chicken, steaks, pasta, potatoes, salad, grilled vegetables, and desserts.

The next morning, the entire experience began to sink in. “Heading to the starting area and seeing all the other athletes was when I felt the emotions of the whole year of training start to catch up to me,” Julia said. “The discipline, the relief…all of it started to hit me.” But she knew she had to brush emotion aside and stick to her race plan to meet her goal of finishing the race in under 14 hours.

Julia just after crossing the finish line at the Ironman Triathlon in July, 2007.

During the event itself her focus was narrow. “Every few minutes I'd do a body check, and monitor my hydration and nutrition,” she said. “When you're in the race, you need something simple as a mental trigger to keep you going, and my coach had it down to one word for me: ‘Believe.' ”

All her training and discipline paid off. Julia finished the Lake Placid Ironman Triathlon in 13 hours, 59 minutes and 58 seconds. Her husband had to pull out of the race when his bicycle broke and he was unable to repair it on the course. But he was waiting for her at the finish line as one of the “catchers” who wrap finishers in blankets and help them off the track, after covering 140.6 miles in one day. It was at this point, Julia said, that she finally let the tears of joy flow.

Julia said the Ironman experience changed her outlook. “I'm glad I can say I did it,” she said. “I had to prove to myself, after all those years of being told I couldn't do things, that I could finish a race at that level.”

So what's next for Julia? “I want to share my experiences. The Ironman is extreme, but it shows others who have pacemakers—especially young people—that they can have a normal life.” Asked if she had any advice for others who might think that having a pacemaker keeps them from living fully, she said, “Don't give up on your dreams. Your device is an enhancement to your life, not a hindrance. Just believe.”

Note: Individual symptoms, situations, circumstances, and results may vary. Please consult your physician or qualified health care provider regarding your condition, appropriate medical treatment. The information provided is not intended to be used for medical diagnosis or treatment or as a substitute for professional medical advice.

Talk to your doctor about important safety information.