Only three weeks ago Bob Pohl ran the Baltimore half-marathon alongside his son and thousands of others. But he doesn't remember the event, because he suffered a heart attack 200 feet from the finish line, collapsing among the sea of runners.
Racers stopped to hold his head and check his pulse. The medical tent just happened to be mere yards away from where Pohl lay lifeless on the pavement and medical staff tended to him immediately.
Pohl woke up two days after the race in the intensive care unit, wearing a hospital gown and tubes that connected with machines. He is the first to note how lucky he was to be surrounded by so many knowledgeable people who reacted so quickly.
"As a runner, you're out there by yourself all the time," said Pohl of Marriotsville, Md. "It could have happened while I was alone. Just to be around medical professionals -- I was very lucky."
While Pohl had always stayed active and ate a healthy diet, he said he did not pay nearly enough attention to his health background.
"It was age catching up to me," he said. "I needed to be more religious about following up with my family history."
Pohl said he had visited a cardiologist a few years before his heart attack. While he was aware of slightly high cholesterol and blood pressure levels, with a family history of both, he assumed he was offsetting his genetic disposition as an avid runner with a healthy diet and lifestyle.
But sometimes, experts say, it still just isn't enough.
"Too much is made of exercise and eating the right thing," said Dr. Gordon Ewy, director of the University of Arizona Sarver Heart Center. "The most important thing is to know your blood cholesterol. Many individuals think all they have to do is eat right and exercise, but if you have the wrong genes, you may have high or abnormal lipids. Your total cholesterol divided by HD (good cholesterol) levels needs to be 3.0 or less."
After the age of 40, an American male has a one in eight chance of going into cardiac arrest, Ewy noted.
"It is the major cause of mortality in the U.S," said Ewy. "In most, it is due to occlusion of a coronary artery, the same thing that causes a heart attack, and often caused by exertion or stress."
Doctors immediately cooled Pohl's body by performing therapeutic hypothermia to delay the "chemical reaction that causes injury to organs when the blood supply is cut off," Dr. Michael Witting, an emergency department physician, told the Baltimore Sun. Without the process, the body often recovers, but the brain never does, he said.
"The added stresses and high heart rate put strain on the heart and arteries," said Dr. Christopher Cannon, a cardiologist at Brigham and Women's Hospital in Boston. "Although his being fit helps lower his risk, it doesn't eliminate it."
"Also sometimes people exercise a lot, but have high cholesterol," continued Cannon. "Often, the plaques that cause heart attacks are small and don't link blood flow … But then the small blockage ruptures under the extreme stress, and bingo."
Doctors expect a six-week recovery from Pohl. On Wednesday, he walked outside for 13 minutes with his wife Karen by his side. While the recovery ahead may be a slower pace than what he's used to, Pohl has every intention of throwing on his sneakers and hitting the open road again -- when doctors say he's ready.
"Go to the doctor, find out about your family history, get those tests done and ask questions," said Pohl. "It's your body and life, so you shouldn't feel bad or shy about it."
"Life is such a treat," said Pohl. "I've been given a real gift here and I want to make the most of it."