Wednesday, April 30, 2008

The Kiss

A few weeks ago I had a client suffer a major heart attack.

He didn't know it, and walked around for a few days after, before another one nearly killed him. Hearing about it just scares the hell out of me. I couldn't believe it even, as he was very dedicated to his training. I was worried I might have killed him! Luckily that wasn't the case at all.

His name is John, "Hammo". He's incredibly positive, dedicated to his goals, and loves to write, so of course after this experience he sat down and typed away. Here's the story of Hammo's heart attack(s), as told by him. I think you'll enjoy this... He wrote it both with humor and education, and that is why I share it here. He calls it, The Kiss.

Coach Vance


The heart is a muscle that acts like a pump to move blood throughout the body. To function properly, the heart must receive oxygen. Oxygen is supplied to the heart by the coronary (heart) arteries that wrap around the surface of the heart. When coronary artery disease (CAD), is present, blood flow through the arteries can be reduced. When this happens, the heart muscle may not receive enough oxygen, and chest pain may be felt.

CAD is caused by the build-up of fatty substances, such as cholesterol, that collect along the lining of the coronary arteries, in a process known as atherosclerosis. You may hear this referred to as a “plaque,” “lesion,” “blockage” or “stenosis.” This means that there is a narrowing in the artery caused by a build-up of substances, which may eventually block the flow of blood. Because the coronary arteries supply oxygen-rich blood to the heart, untreated blockages can be very serious and can lead to a heart attack, or even death. Over the course of a person’s lifetime many influences can cause one or more of your coronary arteries to become narrowed or blocked.


I find it amazing the power of the mind, and what it is able to achieve through one’s lifetime. I distinctly remember when I was 18 years old; I told myself I wanted to be in better shape when I turn 40, than I was back then. I always wanted to be that person who was in shape, active, and had something to live for. If I really dig deep, I am sure those thoughts and goals came from growing up with an ill father who had Coronary Heart Disease (CAD), heart attacks, bypass surgeries, cancer, stokes, etc.

Sometimes a decision is made within that remains dormant for many years, only to spring into action when the timing is right, or when one finally decides it is the right time.

At the age of 41, I far surpassed my goals I stated when I was a young lad; I am very physically athletic, weigh 158 lbs, body fat 7% (+ or - .5%), train 15-20 hours a week for triathlons, eat extremely clean, drink mainly water, drink 1-2 glasses of wine once every two weeks; pretty much living as healthy as I possibly can. In fact, I thought I was living so healthy that the thought of a Heart Attack never even was within the scope of my Doppler radar for well over 5000 miles, then……………………..

Prelude to the Kiss:

April 14th, 2008 (Monday)

I awoke Monday morning with a light training schedule on the calendar. I had an easy 1.5-hour bike ride in the morning, followed by some sprint drills in the pool later on in the afternoon for about 30 minutes. I rode my bike on my indoor trainer on Karl’s balcony (business partner) in Laguna Beach, as Stacey and I were watching his house and cat for the week. The balcony overlooks the Pacific Ocean, which is a breathtaking. It’s funny how the backdrop scenery reminded me of the gay exercise videos that showcases some fitness star and their posse’ of background flunkies imitating their movement in sync.

After work, I met Stacey at the gym to do my 30-minute swim to conclude my daily scheduled exercise plan. During my swim, I felt a very minor dull ache in my left shoulder, coupled with a slight shortness of breath. I did no even give this two seconds of my attention, as I am used to muscle fatigue due to my rigorous training schedule for an upcoming triathlon. I had just put in an 18-hour week, so I was a bit fatigued even prior to the swim.

April 15th, 2008 (Early Tuesday morning)

I went to bed early the night before to get a good night sleep. All of a sudden I awoke at 3:00am with my left shoulder, upper left chest muscle, and left lat muscle in pain. I knew right then and there that I tore a muscle from overuse! I knew in my core it was a muscle tear, for I experienced a pulled groin and was hospitalized for it some 18-months prior to this; so believe me you, I knew what a torn muscle feels like, and the pain associated with it!

For the next three hours, I was popping Vicodin, aspirin, moving from bed to bed, taking showers, walking; virtually anything to alleviate the pain. I recall being curled up in one of the spare beds and was moaning, “Please go away, please go away, please go away”. In my mind this evil pain was affecting me, and this chant was my way of warding off the evil spirits. The only way for this pain to temporarily subside was to get up and walk around; yet, I had already popped three Vicodin, and all I wanted to do was to lie down which seemed to intensify the pain. I felt like I was spiraling down the proverbial rabbit hole and didn’t know what to do. By 6:00am, I virtually passed out from mere exhaustion, and slept in till around 9:30am.

*I am sure if you are still reading this, you may be thinking: “Hammo, Why in the hell didn’t you go to the emergency room then and there to figure out what was causing this pain?” or, “Hammo, don’t be a dumbshit, don’t you know these are classic signs of a heart attack” Well, don’t be to pre-judgmental and sit at home being an armchair quarterback; remember, that the thoughts of this being the pre-cursors to a heart attack, or a heart attack itself was no where on my Doppler Radar. In addition, through this process, I learned that I actually have a high level of tolerance to pain.

I emailed Jim Vance, (Triathlon Coach), that afternoon and told him that I am going to take the next couple of days off from training because of the torn muscle in my shoulder area. He asked me what happened; yet, my only logical response was that I tore a muscle from overuse.

As the day progressed, the pain seemed to slowly migrate into my upper chest region; yet, not nearly the same sort of pain I experienced the night before. That evening I took a two more Vicodin so I could get a good night’s sleep.

April 16, 2008 (Wednesday – Also my daughter’s birthday!)

Today my shoulder pain definitely moved into my upper chest area. I was starting to think “For F**k’s Sake!” I was now going into the mental mode of I must have some sort of lung infection going on, for it was difficult to take a deep breath. At this point, I did recall a shortness of breath when I was swimming on Monday, which seemed odd being as cardio fit as I am.

Stacey and I drove back down to Laguna Beach to check in on Karl’s cat and to spend the night down at the beach.

Wednesday evening my upper chest pain moved down into my lower lungs. I drank some Nyquil and popped a couple of aspirin in an effort to get a good night sleep.

Lessons Learned

1) Listen to your body!

2) If you have any kind of pain or shortness of breath in the lungs or chest area, DO NOT IGNORE IT!

3) If you have any known family history of CAD, and you experience any unusual shortness of breath pain in your upper chest, torso, jaw, shoulder, back, jaw, neck, or lat muscle; these pre-cursors could be the first signs of an upcoming cardiac event. IT DOES NOT MATTER HOW HEALTY YOU THINK YOU ARE! WE HAVE ALL HEARD OF JIM FIXX (Famous Runner), OR OTHER YOUNG COLLEGE ATHLETES DROPPING DEAD ON A BASKETBALL COURT.

The Kiss

April 17, 2008 (Thursday)

En Route (Phase 1)

I awoke this morning at approximately 7:20am with the pain embedded in my lungs; I spoke to Stacey and we both agreed that I might have some sort of ‘walking pneumonia’. I distinctly remember saying that I think that I need to go see a doctor, for I was just not feeling very well and things were not going away by themselves. I asked Stacey to call my general practitioners office in Temecula and to make an appointment this morning. She called and said that they do not open till 8:00am; within 5 minutes I said “We need to Go!” We dressed, grabbed my pillow, and off we went to drive over the Ortega Hwy. En Route I called my Dr’s office and had an appointment set for 10:00am.

As we were going through Dana Point, Stacey noticed an Urgent Care and suggested that we stop; yet, after a quick self assessment (yeah, like I am a real professional in this department at this time) I thought “No, it’s okay, let’s just drive to Temecula, for there was no traffic what’s-so-ever.”

Doctors Office

Upon arriving at the doctor’s office, my doctor had a day off and the PA would see me. I was not feeling very well at this time, as I had no energy. The PA asked me what seems to be the problem in which he listened to my chest, and quickly ordered an ECG (Electrocardiogram). As I was hooked up to what seemed like 100 wires, I asked Stacey to take a picture with her cell phone; she looked at me like I had three heads, but she relented and took the picture. Upon reading the results of the ECG and conferring with another doctor, he suggested that I go down to Fallbrook Hospital and go to the emergency room so they can do a full workup. The PA said that I might have an infection of the heart lining which is causing me this pain, and that I could not be treated as an out patient at the doctor’s office. So off we went in search for the answers at Fallbrook Hospital.

*If you live in the area, you may be wondering why the PA said go to Fallbrook instead of a hospital in Murrieta. I can only surmise it may have had to do something with my insurance, or the doctors office affiliation with Fallbrook Hospital; that, and I did not have the where-with-all to question the doctors advice.

En Route (Phase 2)

As we were driving to Fallbrook Hospital (approximately a 25 minute drive), I was apologizing to Stacey that I may be ruining a perfectly good day by having to wait in a hospital emergency room for 3-4 hours, just to see a doctor who would give me some magic pills, slap me on the ass and say “follow up with your doctor in 2-3 days”. Along the way, I was making phone calls for work, and directing Stacey where to go and just managing with my current situation.

Lessons Learned:

1) If you have any symptoms relating to shortness of breath, pain in your upper chest, torso, jaw, shoulder, back, or lat muscle; this could be the first signs of an upcoming cardiac even

2) If you suspect the above as even a remote possibility, GO STRAIGHT TO A HOSPITAL EMERGENCY ROOM! Trust me, they will put you in front of line and you will avoid the misery of a 3 hour wait in the waiting room

3) I should have requested ambulatory services to Fallbrook if I suspected a cardiac event.

Fallbrook Emergency Room

Stacey dropped me off at the front door to the emergency room as she was going to park the car. Upon entering, I spoke with the receptionist and before I knew it, I was quickly whisked away to the back where I was practically being stripped naked with wires being attached to me once again. This was all happening in a blink of an eye, even before Stacey had the opportunity to park the car and enter the emergency room.

As I lied there, everything was happening very fast, nurses were around me, doctor was making frantic phone calls, and all the while I was still thinking ‘What the f**k is going on?’ The nurses started to explain that I was going to have an angioplasty balloon and what not, and told me to relax and that everything was going to be okay. When the doctor returned, I asked him ‘What’s up’? He said that I was having a Cardiac event and that they are looking where to send me via Life Flight (i.e. helicopter). I mentioned that the other doctor at my general practitioner’s office said that it might be an infection of my heart lining; the emergency room doctor looked at me and said “No, you are having a heart attack right now”

*At that moment in time I was thinking to myself “This doesn’t hurt, why is everyone fussing and being frantic”. As I reflect back I now realize that I was being pumped full of medication which included Morphine and Nitroglycerin; therefore, my perception of the situation was somewhat distorted.

Lessons Learned:

1) Never panic no matter what the emergency is, everyone else was doing that for me.

Life Flight

Within 10 minutes a Life Flight Helicopter had arrived to transport me to Western Regional Medical Center in Santa Ana where there was a specialized ‘Cath Lab’. Once I was prepared for the flight I was casually chatting with the crew inviting them out to Skydive Elsinore, and asked them if they knew so and so, how many flight hours the pilot had, and even asked the pilot if he knew where he was taking me? He said “Not really; yet, I’ll figure it out”. As I moved from one gurney to the next, I was placed on this hard, uncomfortable one for the helicopter ride. As we all know, all helicopter rides are a smooth as butter! (Yeah right!)

I guess it was not until I was in flight that I started surmising the actual situation here. (Remember I was pumped full of morphine) Here I am lying in the back of a life flight helicopter as a patient, and know all too well that they do not Life Flight people who stub their toes, (Duh, is this why they call it Life Flight). I did not panic on the inside, as I knew I was in good hands and that deep down inside everything was going to work out.

*Thank god I have insurance, for I am going to estimate that this helicopter ride did not come cheap. I am going to make the following assumptions: 1) Helicopter Ride - $10,000.00 2) Max altitude – 500’ a.g.l. 3) 1000’ of field elevation difference between hospitals; therefore, I believe that I am paying approximately $7,500 per every thousand feet gained or lost for this ride to altitude, but the experience PRICELESS! (My math is probably off, but who cares?) Anyone who now complains about rising ticket costs in the skydiving industry and has a problem paying $24.00 for a lift ticket to 12,500’, please come see me as I will gladly exchange fares with you!

Lessons Learned:

1) Always be insured, even if it is for major medical, for you never know what can happen

2) Insurance can be a determining factor on where you are sent in an event of an emergency, and that can mean a ride in Life Flight versus an ambulance.

3) Never complain about the price of a full altitude jump ticket.

Cath Lab

Upon arriving to Western Regional Medical Center, I was quickly rushed into the Cath Lab. The Cath Lab is a specialized room with lights, cameras, x-ray machines, computers, and every other high tech equipment that modern medicine can offer.

As I was now transferred to the operating room gurney, I was curiously looking around the room in awe of where I was. In my mind, I was in the billion-dollar cardio room waiting to be worked on. I was watching all the people in the room and was assigning names to what they were doing. There was: Computer Dude, Nurse attending the monitors, Oriental guy managing the weapons and tools department, and then there was SHAVER GUY! SHAVER GUY came right at me with his newly sharpened implement of hair removal. When doing angioplasty, they enter your Femoral artery, which is located on your hip flexor, conveniently located near the ol’ crotch-ola, and from what I had now gathered; they do not want any unnecessary hair follicles in the region. SHAVER GUY was right there taking care of my business as I was squirming like a fish out of water! He kept saying “you need to relax”, and in my dubious drug inhibited state I responded “I am trying, I am just ticklish as hell!” If I only knew before hand that this was going to be a beauty contest, I would have taken care of my action well before this event.

As soon as shaver guy was finished, I rotated my head, and there was my Dr. ready to perform his feats of magic. I was in no position to check his credentials or ask him how many times he has done this procedure before.

Lessons Learned:

1) If you can ever predict a cardiac event, it may not hurt to take care of your action so that you to are cleanly shaven. This will help you avoid the SHAVER GUY.

The Procedure

I really had no idea how the procedure is done; yet, all I know was that I was given a local anesthetic in my hip area, and I am fully awake during the whole ordeal. There were three large monitors adjacent to the gurney, along with an odd camera encased in a rectangular plastic box which rotated over my chest cavity as the Dr. commenced with his duties. In addition, everything was encased with clear plastic sheets in the event that I sprung a major leak in the process.

It was so surreal, as the Dr. entered my femoral artery, I was watching everything on the three large monitors! I remember when I was a kid watching a show called something like ‘Journey to the Inside of your Body’, or something of that sort. I was lying there looking at my own heart as if I was watching it being done on someone else (What a trip). I saw exactly where the main blockage was (100% blocked), and watched as he inflated the angioplasty balloons and implant the Stent.

*I came to understanding that I could of never of had when I was watching the monitors as the Dr. was in my heart. Everything that I have heard of in the past all of a sudden really made sense to me now: Eat low fat foods, don’t smoke, no drugs, exercise, low cholesterol diet, etc. When you actually see the blood flow to your heart muscle, and you really think of the actual size of the diameter of the arteries, it really appears that the habits we develop throughout life will help us, hurt us, or actually kill us.

**What is a Stent? Stents are devices that can help to reduce the risk of re-narrowing of the treated artery following an angioplasty procedure. Stents are small steel tubes that are implanted into a coronary vessel and expanded to fit the size, shape and bend of the vessel wall, propping it open to help prevent further blockages. Hammo’s version: It is a small stainless steel, flexible tube that looks like a Chinese finger trap which works in the reverse direction. The Stent adheres itself the artery wall which acts like rebar does for the framework of a building.

During the procedure, I asked the doctor to just go and take care of the other one, which was 75%, blocked; yet, he said “no, that would be much too risky to do both arteries during the same procedure”. My inside voice was saying “come on doc, I know what I am talking about, let’s just knock it out!”

The actual procedure did not last anymore than 30 minutes, in which I thought I was out of the woods. The main blockage was taken care of, so I was sure the second procedure to clear the 2nd blockage was going to be a breeze……… I thought!

Lessons Learned:

1) Don’t watch the monitors during an angioplasty procedure if you are squeamish in any way.

2) Trust the doctor.



The Dr. said I officially had two heart attacks (One being massive): One in the Fallbrook Emergency room, and one during my second procedure that I did not talk about in this write up. I believe that I had three major events, for what happened on Monday night (April 14th) was as much painful as anything I experienced up to the Angioplasty/Stent procedure. I believe that I was actually living for two days with my heart in such distress condition, that I am counting my lucky stars that I am still here today!

There was much more that occurred during my hospital stay, and during my second procedure that I did not discuss in this write up; yet, if you are interested in learning about the whole picture, I will be more than happy to do an additional write up. In the follow up, I will discuss post Heart Attack recovery, changes in lifestyle, and ongoing tests well into the future so I will never have to go through an event like this again, along with additional educational information.

Hammo Out!

Monday, April 14, 2008

Best Advice I Can Give

Someone asked me for the best advice I could give someone training for a race, be it cycling or triathlon. Here it is...

1. ALWAYS wear a helmet.
2. ALWAYS carry your ID and health insurance info. (If you don't have health insurance, GET IT! If you ride enough, one day you'll need it.)
3. ALWAYS carry a cell phone for emergencies, when riding.

That's my best advice. It may not sound like much, but if you follow it, it may just save your life, or someone you ride with, one day.

Coach Vance

Friday, April 11, 2008


If you're doing Wildflower, especially for the first time, you have to read this article!!!

Coach Vance

Friday, April 4, 2008

Sea Otter Classic Anyone?

If you're thinking about doing the Sea Otter Classic, you should check out TrainingBible Coach Trevor Glavin's preview on the event at his blog. It's got a lot of great information:


Coach Vance

Thursday, April 3, 2008

TrainingBible Coaching Open Water Swim Clinic

Reposted from Jeff Vicario's blog...

Presented by TrainingBible Coaches Jim Vance & Jeff Vicario

Are you doing well in the pool, but having issues with your open water swimming? Want to make a big leap in your race performance? Come to the TrainingBible Open Water Swim Clinic presented by Jeff Vicario and Jim Vance and learn the skills Jim used to win 2 Amateur World Titles, and professionally with 3rd overall at the 2006 Ironman Florida.

After this simple clinic, we ASSURE you will know the skills to be faster in the open water for your next race, without any more effort than you’re already giving! No matter what your swim ability, advanced or novice, this clinic will help you!

Topics Covered:
Basic Swim concepts and techniques
Surf Entry
Surf Exits
Swimming straight in the open water!
Turning at buoys
Transitioning quickly - out of wetsuits, goggles, etc.
Pack swimming – dealing with crowds
Dealing with choppy water, big waves
Small tricks of the trade to help you swim FASTER!


Sunday, April 20th 2008

1:00 - 3:00pm (clinic begins at 1pm!)

Where: Bay Shore Ave and E 2nd Street, Long Beach. Click map below for directions.

Bring everything to swim in, wetsuit, goggles, etc. Don't forget your chaffing cream, as this will be a workout as well!

Cost: $40 per person, ($30 for Tri Club Members!)

Trust me this is no ordinary Ocean 101 Clinic, we'll go over every detail from A to Z. RSVP to reserve your spot, clinic will be capped at 20 people to keep instructional quality high. Email Jeff Vicario at or Jim Vance at to reserve your spot.

More information about Jeff and Jim and their coaching/racing background can be found at