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The Honolulu Advertiser
Posted on: Wednesday, December 13, 2006

Runner gets more than second wind

By Michael Tsai
Advertiser Staff Writer

On his way to the hospital after suffering a cardiac arrest at the finish line of Sunday's Honolulu Marathon, 39-year-old Japanese runner Koji Takano had one thing on his mind.

"I was in the ambulance and I thought that I didn't finish the race," Takano said through an interpreter. "I kept saying, 'Bring me back to the race so I can finish!' "

Takano, who was revived at the scene thanks to a newly purchased mobile defibrillator, returned to the scene of his near-death yesterday morning to receive his finisher's certificate from Honolulu Marathon Association president Jim Barahal.

Takano, a pharmacist from Kitatachi City in Tokyo who had completed 14 previous mara-thons, had finished the 26.2-mile race in a speedy 3 hours, 56 minutes and 34 seconds.

Seconds after crossing the finish line, his heart stopped.

Takano said he started feeling "strange" after the 30-kilometer mark (18.6 miles) but continued to run. "Everybody says that in the marathon, after 30K anything can happen," Takano said, still wearing his hospital wristband. "I thought it might be jet lag. My sleeping had been off."

About 30 yards from the finish, Takano, feeling increasingly ill, started walking. But, as he approached the finish line, he heard Japanese runners and spectators from the crowd urging him on with cries of "ganbatte!" ("do your best") and he ran the final few yards.

Race doctor Lawrence Rotkin noticed Takano struggling and rushed over to ask if he needed assistance — then Takano collapsed — no pulse, no blood pressure, no respiration.

"He flatlined," Barahal said.

Fortunately, the medical staff was equipped with a portable defibrillator at the finish line. The machine confirmed Takano's reading then delivered a powerful electric shock.

Nothing.

The machine delivered another shock. This time, Takano's body responded with spontaneous respiration and movement. By the time Takano was loaded on the ambulance headed for Straub Hospital, his blood pressure had returned to 180/90.

Takano's wife, Tokiko, who also ran the marathon, was unaware of the situation when she crossed the finish line 45 minutes later. She said she was getting a post-race massage when a staff member from her tour group found her and told her the news.

Barahal estimated that having the defibrillator on hand cut a crucial two minutes off the medical staff's response time.

Barahal said he met with other marathon officials last month to discuss their ability to respond to medical emergencies after reading about a runner who died of a heart attack at this year's Marine Corps Marathon in Washington, D.C. Last year, the marathon had one portable defibrillator on hand at the finish line. "I felt that what we had in place was inadequate at that point," Barahal said.

And so the association ordered eight additional defibrillators, which arrived two weeks ago and were stationed at different points along the course. Barahal said the fact that the staff had received training on the machines so recently contributed to the effectiveness of their response to Takano's situation.

Barahal said that while he was not familiar with the details of Takano's case, most cases of cardiac arrest in athletes under 40 are related to hypertrophic cardiomyopathy, a thickening of the heart muscle.

In addition to the Marine Corps Marathon, runners have also collapsed and died in the Twin Cities Marathon, the Toronto Marathon and the San Francisco Marathon this year.

In 2002, 33-year-old Grant Hirohata-Goto died of apparent heart failure after crossing the finish line at the Honolulu Marathon.

Takano said he will consult with doctors in Japan when he returns, and also intends to continue running marathons. He hopes to return next year for his ninth Honolulu Marathon.

At yesterday's presentation at Kapi'olani Park, Barahal told Takano: "You are the most amazing finisher in this year's race ... maybe ever."

Reach Michael Tsai at mtsai@honoluluadvertiser.com.

Correction: Koji Takano finished the Honolulu Marathon in 3 hours, 56 minutes, 34 seconds. An earlier version of this story contained an incorrect time.