Despite undergoing a bypass surgery in 2012, 52-year-old Santacruz-based stockbroker, Nisarg Vora, is preparing for the upcoming 21-km marathon. He tells us how.Two and a half years ago, while undergoing a routine health check-up, I discovered that my stress test results were negative. Doctors recommended I see a cardiologist, almost immediately, who suggested that I undergo an angiography. Turns out, with two major blockages, my condition was such that a bypass was my only option. Within 10 days, everything changed.From being able to climb four flights of stairs swiftly, I was reduced to slowing down my pace. My sweet intake was cut down and I was advised to steer clear of fried snacks. With a positive attitude and the support of my family, I was able to bounce back soon enough. However, I returned to my regular routine with a few constructive lifestyle changes.In April 2014, I learnt that a friend who is in his 40s, had run the Satara Hill Marathon the previous year. This prompted me to give running a shot. The friend suggested that I join a running group. Initially, I was reluctant because although I had been a brisk walker, I rarely attempted running, or even jogging. Besides, I was 52 years old.But, my coaches Suchita Varadkar and Dr Ajinath Kharat from the Top Gear running group egged me on. They ensured that I always ran with them or other seasoned runners.The first few weeks were exhausting. While fellow participants could perform 10 Surya Namaskars, I would manage only three or four at a go.I would train for three days. Mondays were reserved for exercises to loosen up, condition and strengthen muscles, and ensure flexibility. We started with easy shoulder rotations and then scaled up to core exercises.During the first few sessions, I was advised to go easy on myself. I would walk at Carter Road promenade or the Bandstand Fort, back and forth, while the rest of the group ran the distance. Gradually, I started running with a few halts.Three weeks later, I attempted a 3.5 kilometre non-stop run across the bylanes of Bandra. I would often find myself out of breath. I completed my first 7 kilometre run in July within 60 minutes.Yet, I would run only on flat surfaces and walk on gradients (Pali Hill, Mount Mary's Kane slope). Slowly, I started making small attempts at running on the slopes.August onwards, we started training on Sundays, which are set aside for long runs. In fact, Saturday night outs are currently a complete no-no for me. We start at 5.45 am with warm up exercises, followed by running, and wind up each session with a few stretching exercises, which ensure that there is no wear and tear of muscles. It prevents injuries or pain, and improves athletic performance.In these months of preparation, I have further cut down my sweet intake - I indulge in chocolates and ice-creams once in a while - and have largely stuck to a healthy vegetarian diet comprising home-cooked vegetables, dal, rice, chaas and roti. For breakfast, I eat oats. I have also started including flaxseeds and walnuts in my diet.While on the run, I satiate myself with bananas, dates and electrolyte powder packets, which spike my energy levels instantly. Fortunately, I do not suffer from diabetes, hypertension (high blood pressure) or hypercholesterolemia (high levels of cholesterol in the blood).I feel safer sprinting with a professional group, and I'd strongly recommend first-time runners do the same. My fellow team members' constant encouragement has kept me motivated.You can also try wearing a heart monitor metre.Running isn't easy. One is prone to several injuries. Therefore, Monday sessions are considered sacrosanct. Over time, my endurance has gone up; I feel fresher, fitter and definitely breathe lighter. I run at an average of 7 km /per hour. In fact, last week, I ran 20.30 kilometres - from Bandra's MIG Club to Poonam Chambers in Worli - in two hours and 50 minutes. I am still 0.70 kilometres shy of my target.I hope to reach the finish line within three hours on Jan 18. Wish me luck.- Patient should undergo a thorough clinical examination by a cardiologist before or after surgery.- The ejection fraction (the efficiency of the heart) should normally be 50-60 per cent. Those with less than 45 per cent should avoid running the full marathon. This should be confirmed by taking an echocardiogram.- ECG should be taken to see if there have been attacks or ischaemia of the heart.- It is also recommended that patients undergo a treadmill exercise test or a stress thallium test to ensure that the grafts of the bypasses are patent.- Holter monitoring should be done to ensure that no rhythm disturbances occur in a patient.- After having qualified as fit on the basis of clinical examination, ECG, Echo, Holter monitoring and stress test, it is preferable that the patient undertake a supervised rehabilitation programme on treadmill, bicycle ergometer to condition his heart to take part in the marathon. Several of these patients are diabetics and an appropriate dose of anti-diabetics should be prescribed to see that they do not become hypoglycemic while running the marathon.- The clinical examination should also evaluate whether the surgical incisions are healed and a chest X-ray should be taken to ensure that there is no collection of fluids in the lungs.- Dr Dev Pahlajani, Cardiologist at the Breach Candy Hospital(As told to Reema Gehi)