A recent discussion amongst IMMDA (International Marathon Medical Directors) physicians described the following recent cases of successful resuscitations at different races around the world:
* A 35-year-old healthy firefighter died 500 yards before the finish at the 2011 Chicago Marathon.
* A 33-year-old male running a half-marathon dropped at the 12-mile mark, 3:10 into his race. The morning of the race, he had drunk two energy drinks and a grande coffee, and used two caffeinated gels. Cardiac catherization revealed a small lesion (less than 20%) but otherwise clean coronaries.
* A 42-year-old woman running a marathon dropped at the 24.5-mile mark, 4:10 into her run. She had drunk two large coffees and had three caffeinated gels. Her cardiac cath also showed clean coronaries.
* A 26-year-old male also running a marathon dropped at the 25.5-mile mark, 3:25 into his run. He had taken two caffeine pills plus coffee the morning of his race, and also had clean arteries on cardiac cath.
More cases were discussed. We also noted that the press always goes to the deaths at these events, not to the many more numerous successful resuscitations. And with these successful resuscitations, we can interview the patient and find out what they did that might have contributed to their collapse.
More and more of these runners have clean arteries and report having consumed more than the 200 mg recommended limit of caffeine (that is the amount in about two cups of diner coffee.)
Coincidence? We think not.
IMMDA is putting together a research project to examine this question as well as a “code rate” of how many people actually are successfully resuscitated per number entered. (We know that 1 in 50,000 marathoners die, statistically, worldwide.)
Meanwhile, I am preaching to all of you running a marathon or half-marathon: There is no downside to limiting caffeine to less than 200mg on days of a long run or race of 10-K or more.
Tell your friends. Get the word out. Please. Until we know more, it just seems to be the right thing to do.
I will keep you up to date as more evidence is discovered.
Lewis G. Maharam, MD, better known as Running Doc, is the author of Running Doc’s Guide to Healthy Running and is the medical director of the Rock ‘n’ Roll Marathon series and the Leukemia & Lymphoma Society’s Team in Training program. He is past president of the New York Chapter of the American College of Sports Medicine. Learn more at runningdoc.com.
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