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Micah True autopsy information (Read 1869 times)


Best Present Ever

    I think this is a much better discussion of the autopsy report: http://news.runnersworld.com/2012/05/10/the-micah-true-autopsy-explained/

     

    True's heart wasn't enlarged due to thickening (hypertrophy) but dilation (it was big and floppy).   Also, I find it annoying that the person in the OPs link speaks sarcastically about the choice of "natural" as manner of death.  I get that he's trying to make a point, but it appears (if the runner's world article is correct) that he's wrong. And even if he weren't wrong, it is a  silly argument.  

    bhearn


      From the first link:

       

      "Those with HCM often have a severe thickening of the left ventricle of the heart, and True’s autopsy does clearly state this. This condition, known as left ventricular hypertrophy (LVH) can eventually result in cardiomegaly –an enlarged, inefficient heart."

       

      From the second link:

       

      "In the case of True, whose left ventricle was reported to be "dilated and enlarged," we're looking at the most common form, dilated cardiomyopathy. ... There's an enlargement in the size of the heart due to dilation of the tissue, not due to increased thickness of the wall of the ventricle. The effect is a thin and enlarged heart wall that, like an overstretched water balloon, is too thin to contract effectively to pump blood to the rest of the body. The total volume of the heart is increased, but only because the wall of the heart has become thinner."

       

      So wait. Which is it? The more I read the more confused I get.

        I thought this was an odd statement coming from a medical student but your profile explains it all. Big grin

         

        I'm not a medical student, but thats not to say that a medical student wouldn't understand the concept of a "positive feedback loop" or use the term in practice, when in fact the body is actually a big system of feedback loops.  I used the word oscillating since most people wouldn't know the difference between a positive and negative feedback loop.  Looking at your professoin, I also understand why that would statement would pop out to you.  Wink

          From the first link:

           

          "Those with HCM often have a severe thickening of the left ventricle of the heart, and True’s autopsy does clearly state this. This condition, known as left ventricular hypertrophy (LVH) can eventually result in cardiomegaly –an enlarged, inefficient heart."

           

          From the second link:

           

          "In the case of True, whose left ventricle was reported to be "dilated and enlarged," we're looking at the most common form, dilated cardiomyopathy. ... There's an enlargement in the size of the heart due to dilation of the tissue, not due to increased thickness of the wall of the ventricle. The effect is a thin and enlarged heart wall that, like an overstretched water balloon, is too thin to contract effectively to pump blood to the rest of the body. The total volume of the heart is increased, but only because the wall of the heart has become thinner."

           

          So wait. Which is it? The more I read the more confused I get.

           

          Sounds like he True had a big stretched out balloon of a heart.   His heart muscle wall was very thin with a huge LV chamber annd had trouble filling with blood when he was dehydrated.   Think of one of those Mylar balloons when deflated, all floppy looking... rathar than a rubber balloon which will shrink in size when deflated.

           

          This is different from Ryan Shay, who (if I recall correctly) had an actual thickening of the heart wall with his enlarged heart. 

           

          In both cases, their hearts are actually larger than normal.  In the True's dilated case, its a big stretched out floppy mylar balloon.  In Shay's, it is thick and inflexible like a bicycle tire.

            From the first link:

             

            "Those with HCM often have a severe thickening of the left ventricle of the heart, and True’s autopsy does clearly state this. This condition, known as left ventricular hypertrophy (LVH) can eventually result in cardiomegaly –an enlarged, inefficient heart."

             

            From the second link:

             

            "In the case of True, whose left ventricle was reported to be "dilated and enlarged," we're looking at the most common form, dilated cardiomyopathy. ... There's an enlargement in the size of the heart due to dilation of the tissue, not due to increased thickness of the wall of the ventricle. The effect is a thin and enlarged heart wall that, like an overstretched water balloon, is too thin to contract effectively to pump blood to the rest of the body. The total volume of the heart is increased, but only because the wall of the heart has become thinner."

             

            So wait. Which is it? The more I read the more confused I get.

            I'd just read the RW article then came here and saw this one. That was my reaction also. I wonder if the actual autopsy is available anywhere.

             

            I'm hoping Spaniel can get some response from his contacts.

            "So many people get stuck in the routine of life that their dreams waste away. This is about living the dream." - Cave Dog


            Best Present Ever

              The actual autopsy report, or the summary of it at least, is at the end of the OP's link.  Looks like both discussions of it are wrong, as the autopsy report says the condition was neither hypertrophic nor dilated cardiomyopathy.  

                The actual autopsy report, or the summary of it at least, is at the end of the OP's link.  Looks like both discussions of it are wrong, as the autopsy report says the condition was neither hypertrophic nor dilated cardiomyopathy.  

                 

                Yeah, so I take back my second comment about dilated hearts.  The actual autopsy report said it best.   I still generally agree with Dopplebock, running all day every day at the age of 58, alone in the mountains , only with a bottle of water and a bag of corn was a recipe for disaster. 

                L Train


                  So I haven't read Born to Run, am not an ultrarunner and clearly know nothing about the guy.  The bag of corn thing was a regular thing?  And he really ran like 6 hours every day with a bag of corn?  I wonder what he consumed while not running though, there's no discussion of that. 

                   

                  If this can be attributed to running, then it would seem that this is one of those hyper-extreme situations.  Not even DB runs 6 hours each and every day, and I think he consumes calories like nobody's business.  I'm just not sure any of us mere mortals can take anything from this. 

                   

                  xor


                    Can I do it at 45-46 if I eat pop tarts and hostess lemon pies instead of a bag of corn (realizing that a not insubstantial ingrediment in crap food is... corn)?

                     

                    Yes, that's a joke... but there's a bit of sincerity in there too.  Eating "right" has taken second priority to eating "enough" to get through the miles at many points over the years.  As I look back on many weekends of multiple long races and various midweek trail runs, it is a shocking amount of over-engineered crap that is going down the pipe.  Then again, "a bag of corn" is the opposite direction completely from eating 20 gels and chew packs and weird energy bars that only marginally relate to food. 

                     

                    SPEAKING OF BORN TO RUN: How much do we really know about what Mr True was running and eating?  See, a lot of B2R was not-really-true.  I mean, it was true stuff that had been hyperbole'd and made into good story material.  That became the big frustration I had with it... people were taking it as a work of nonfiction. And it kind of wasn't.

                     

                    northernman


                    Fight The Future

                      Obviously, these sorts of cardiac sudden deaths of long distance runners are very rare, so it's probably not possible to generalize to the rest of us, in terms of what is the healthiest approach to keep going as long as we can (over the years, that is). But it does make you wonder a bit. I almost always do my runs on an empty stomach after all night fasting, so I can keep training my body to run when it's glycogen depleted. Could be it's healthier to have a bit of breakfast first.... but who knows for sure?

                      LedLincoln


                      not bad for mile 25

                        FWIW, it was supposedly a bag of chia seeds, not corn that he carried on his runs.  I'm sure there was corn and a lot of other stuff in his diet when he returned home.

                        LedLincoln


                        not bad for mile 25

                          Obviously, these sorts of cardiac sudden deaths of long distance runners are very rare, so it's probably not possible to generalize to the rest of us, in terms of what is the healthiest approach to keep going as long as we can (over the years, that is). But it does make you wonder a bit. I almost always do my runs on an empty stomach after all night fasting, so I can keep training my body to run when it's glycogen depleted. Could be it's healthier to have a bit of breakfast first.... but who knows for sure?

                           

                          1000 of us can run daily for ten years on an empty stomach, and 1000 after a good breakfast.  Which group you're in will have to be randomly assigned.  Volunteers?

                          xor


                            I dunno how much research has been done regarding the whole idea that running on an empty stomach trains you to run better in a glycogen depleted state.  (I eat before I run.  I eat while I run.  I do the same thing at races.)

                             

                            JimR


                              clearly it was the sandals


                              A Saucy Wench

                                I almost always run fasted.  Just because I've tried many things over the years and there is nothing that really sits well and I run better fasted. Much better.   Hell some days I get up, run, lift, take the kids to school, run again, run errands.  Then I eat. 

                                 

                                And if I die before SRL that will mean.....nothing. 

                                I have become Death, the destroyer of electronic gadgets

                                 

                                "When I got too tired to run anymore I just pretended I wasnt tired and kept running anyway" - dd, age 7

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