Saturday, February 18, 2017

Too much is not enough

A crushing heat wave settled in this week, melting the last of the ice from the small ponds in our back yard. For the first time in three months, I knelt beside the pond and sprinkled fish food into the water. Two-dozen goldfish swam to the surface and sluggishly nibbled at the flakes. I watched with fascination. They spent three months hidden beneath a thick sheet of ice, in a pond so small that I wondered if it could freeze solid, and I hadn't fed them since November. Yet there they were, as healthy as ever. I felt strong appreciation for these hardy little fish, matched in an instant by disgust in my own fragile body.

Shortly afterward, I slathered my arms and legs in sunscreen and went for a walk. That's what I've been doing since I found out about my wonky thyroid levels: going to the gym, and hiking — short distances and nothing strenuous. Strangely, or maybe not strangely, I've been feeling symptoms to a deeper degree. Knowledge has made my head even more foggy, my body even more jittery. I think this escalation of symptoms is psychosomatic, so I stare at my hands, willing them to hold still. They never do.

Seventy degrees felt unconscionably hot, and I'd lost my will to even bother. Still, as it always has, hiking does improve my mood. I hiked my way through a difficult breakup in Juneau, back in 2009. At the time I was fairly certain I would be alone for the rest of my life, and embraced mountains as a solid if indifferent companion. Maybe I'll hike my way through this most recent breakup with my health. (I know, poor health is likely temporary, but it never really seems like it in the midst. Just like solitude at the end of a relationship.)

I have been sad about dropping out of Iditarod. I know, of course I know, that it's such a small loss in the scheme of world events and even my own life. I want to believe this emotion is not my own, but the dastardly work of wonky hormones. Right now, though, it feels like a threshold crossed. The end of something.

Sweat beaded on my skin as I picked my way through tangles of fallen trees to South Boulder Peak. Implausibly, given that it's been virtually summer for at least two weeks, the ridge was still coated in ice. I continued anyway, even after a man coming down the mountain warned me that the trail was too treacherous. I didn't feel like being careful, so of course I fell. A few yards later, I fell again. Blood glistened on my shin. I was angry, with myself of course, and plopped down on a boulder just fifty feet shy of the actual top.

The afternoon was so warm that I could stop as long as I wanted. So I sprawled out and turned up the iPod. Earlier in the week, I realized my playlists were hurting my feelings, so I refilled one with music I mostly listened to before I started endurance racing. Near the top of South Boulder mountain — just far enough from the actual peak to concede I hadn't fully climbed it — I nearly dozed off listening to early-90s Catherine Wheel songs:

"Always, Always.
Bye bye long day.
I need to sleep so much.
Nineteen hours straight.
Too much is not enough."

Again I thought about those tough little goldfish, who I think I've grown to love, and how they survived the winter without any help from me.

"It's going to be fine," I said out loud, sitting up. "Shake it off, shake it off." My hands were still quivering. I felt a little bit dizzy and hand't brought any food with me. It crossed my mind that I could take an unlucky slip at just the wrong place on the upcoming, treacherously icy downhill, and that could be the end. It was just as plausible, maybe even more plausible, than my heart stopping in the Alaska wilderness. Life is fragile. Maybe I have an autoimmune disease and maybe my lifestyle is to blame, but I don't regret a thing.

The downhill hike passed without incident. Still, I remained little out of it. As if in an instant, the sun began to set. Beautiful pink light filtered through the trees. 

"Needle stings and blisters breaking.
 Swinging moods and conscious fading. 
All the things you dream while spinning 'round. 
Always it seems to bring you, bring you down."

Wednesday, February 15, 2017

Thyroiditis

Bear Peak, during a Sunday hike. I had new info about my health, and felt both better and worse than I have in a while.
Just over two weeks ago, I was having dinner with friends in Fairbanks a few hours before heading to the airport. We were at a Thai restaurant with harsh lighting, and I was describing my exercise woes to friends I hadn't seen in a while. The quick explanation is: "I can't breathe when I exert myself, really, at all. It doesn't take much before I start gasping and become dizzy, and sometimes I have to sit down. I used to be able to run entire 50Ks with an average heart rate in the 160s, and now I rarely hit that number before I'm breathless." Corrine, who is a family doctor, looked over at me and said, "You know, your thyroid looks enlarged."

That set off a series of medical visits, and the latest was to an endocrinologist today. I'm very lucky to have good health insurance (thanks Beat!) and medical providers who sympathize with my desire to participate in the ITI, so they fast-tracked me through several tests ahead of the race. This much now is known — I have an autoimmune disorder, currently guessed to be Hashimoto's Thyroiditis but possibly Grave's Disease or both. My immune system is attacking my thyroid, which in turn is flooding my body with hormones that stress it out, all of the time. Hyperthyroidism. It's bad — my heart is stressed, muscle tissue is breaking down, I'm nervous and dizzy, my mind is foggy, and I'm frequently short of breath.

It explains quite a bit. The exercise intolerance is only part of what's been worrying me, but I haven't mentioned my other issues to anyone, for fear that I was losing my mind. Bouts of anxiety at odd times. Waking up in the middle of the night drenched in sweat and shaking. Sudden tremors. Staring blankly at a computer screen until my vision blurs and I can't quite remember how to read. Occasionally feeling like my heart is racing out of my chest while I'm wheeling a cart around Safeway, and wondering if this is when I'm finally going to have the heart attack I've been half-expecting. If this is all the result of a wonky thyroid that can potentially be fixed — and not early onset of heart disease or dementia — that would be fantastic.

What's not fantastic is the timing. If I'd caught this months ago, I might be in a better spot right now. But it's now ten days before the start of the ITI, my body is still flooded with thyroid hormones, and my heart is in real danger. Dehydration and fatigue could set off a thyroid storm that could quickly become life-threatening were I not able to seek immediate medical attention, which would be difficult if I was, say, somewhere remote like the Alaska wilderness. Heart damage is likely. Heart failure is a possibility. It's not remotely worth the risk.

So I have to drop out of the Iditarod Trail Invitational. This has been more distressing than I expected, given how uncertain I've been about the race, because of how bad I feel during and after heavy exertion. The decision is still sobering. It's not fun to know that my body is broken. As I told my friend Corrine, I almost preferred it when I believed my symptoms were psychosomatic, something to overcome with the power of positive thinking. My mind has been drifting to increasingly dark places recently, and I'd been counting on the rejuvenating power of the Iditarod Trail to reset my head. Now it's just me and my anxiety and my inability to concentrate, walking as slowly as possible because I've become frightened of my own heart.

But I can believe it will get better. Beat certainly believes it. He's already threatened to sign me up for coaching so I can crush the Tour Divide in 2018. This makes me laugh. But to feel normal again — just normal, like I used to feel before summer 2015 — would be amazing.

Thyroid wasn't even on my radar three weeks ago, but obviously I've done a lot of Internet reading in the past week. This is a great essay from the Guardian by a novel writer with Grave's Disease: (Link here.) Her hyperthyroidism is clearly much worse than mine, but I related to many of her experiences. A sentence in her lede especially struck me:

"All this I recall with wonder, for that moment has crystallised in my memory as youth’s last day before, at the age of 34, old age struck me like a brick in a sock."

I too have a moment when old age struck me like a brick in a sock. I was 35 years old, and it was a hot June day in 2015, somewhere in southern Wyoming. I looked across the beige desert and felt nothing, knew nothing, saw nothing. I was sick, yes, quite sick with bronchitis. And I was fatigued from this difficult multiday mountain bike race, the Tour Divide. But there was something else, something deeper, pulling me inward. I knew it then, but I didn't understand.

Here's hoping medication can reset my body. If I do in fact have two different autoimmune disorders, they're going to be that much harder to manage, and then surgery may be necessary. Hopefully I'll know more in the next few days. 

Sunday, February 05, 2017

Another week

I stopped posting my weekly training logs at the end of December, after deciding that they were more demoralizing than motivating, and "training" was probably hurting more than it was helping. I'm still getting out 15+ hours each week, lifting twice a week, and generally doing what I was doing before. And ever since the Fat Pursuit, I've felt progressively better. I still have occasional battles with shallow breathing, and realized that I might be overcompensating by taking it too easy. For the most part, thought, things have been going well.

A long-time blog reader recently contacted me about my "Running on 3 Cylinders" post, and completed the car analogy. I laughed at his observations:

"A car analogy is apt since we humans are a thermodynamic (a heat engine) — funny, we convert our fuel about just as efficiently. Going on with the car theme, a gasoline engine needs three things in the right amount and at the right time for oxidation (combustion) to take place (spark, fuel, and air) since you have plenty of spark (that’s kinda of understatement) and it seems plenty of fuel (Sour Patch Kids comes to mind) your oxygen intake is constricted as you have documented. So I think you're firing on all cylinders but just running low on HP (like a restricter plate in Nascar.) Your torque curve is still awesome (anaerobic muscle contraction.) Your aerobic respiration threshold is probably lower in your power curve for the time being, but training at altitude can increase your VO2 Max."

Anyway, it's been a great week of low-horsepower non-training. On Monday I was still in Fairbanks and trying to catch up on some work, so I went for a lunchtime run. My friends live at 1,500 feet, where the temperature was 5 above zero. I set out wearing a single layer — luckily packing several more — and descended 800 feet into the Goldstream Valley. After about a mile on the lower trail, my legs and shoulders went numb. "Maybe it's not 5 degrees down here," I thought. Actually, it was -15. This photo happened after I put on more layers, than loped along for two more hours. Toward the end of an attempted loop, I failed to find a trail connection and decided to "shortcut" back to the road. Turns out waist-deep snow is no shortcut. It took about twenty minutes of lunging like a seal before I swam to safety. Note to self: This is even more difficult with a bike.

On Wednesday I was back in Boulder and submerged in a weather pattern I'm told is very atypical for the Front Range — as in once-in-a-decade atypical. Heavy inversion with fog and freezing rain, with temps dropping into the teens in the valley and soaring into the 40s above 9,000 feet.

I set out for a mountain bike ride and ended up at 8,000 feet on Sugarloaf Road around 4 p.m., where temperatures were in the low 20s and it was raining. Actually raining. It was a light, misty rain, but it froze to everything it touched, including me. That 3,000-foot descent on black ice was a sphincter-clencher, even with studded tires, and I was so very very cold. I could have brought more layers, but what do you even wear for freezing rain? I just gritted my teeth and bore it.

The freezing fog did make for some beautiful scenery. It was still hanging around on Thursday when Beat and I went running at Walker Ranch. The temperature was about 15 and there was light misting ice in the air. 

I wore Icebug shoes, which have built-in carbide studs on the soles. I learned too late that they weren't going to cut it on hard ice, which covers at least 60 percent of the Walker Ranch trail right now. Despite being careful, I still skidded on a steep descent and fell hard onto my right knee and shoulder. It was incredibly painful, and I writhed on the ground for three or four minutes while calling out Beat's name — although he was too far ahead to hear me. After I pulled myself up, I continued to wobble in place until a deepening chill forced my hand, and I was able to limp out without incident. The knee was swollen, but the brunt of the impact happened below the joint, where a big goose-egg bruise formed. It hurt, but at least I wasn't injured.

By Friday the fog cleared out and temps warmed up substantially. Yes, I was disappointed.

Riding Friday and Saturday on ice, slush, and mud.

On Sunday, Beat and I went snowshoeing on Niwot Ridge. Beat towed his heavy sled and broke trail. As usual, I just tried to keep up.

The wind was incredible — gusting to at least 50 mph on the ridge. It was strong enough to push me backward on the snow crust as I flailed and fought to retain forward motion. Breathing proved difficult — the headwind seemed to rip the breath from my lungs, and I had one episode where I couldn't stop gasping. Then I started crying, because this kind of thing scares me, every time. This was always my fear during the Iditarod last year, because these episodes appear to be self-perpetuating, and strong winds make it hard to control anything.

Later, when I turned my back to the wind and lowered my head to buffer the blast, this particularly strong gust tore the sunglasses right off my face and whisked them into oblivion. #$&! you, West Wind.

Still, it was a useful outing — particularly for Beat, who had an excellent quad workout, and learned that he doesn't like flexible poles. I gained more insight into my breathing episodes with a hope that I'll better learn to control them (avoiding the shallow breathing and hyperventilating.)

It's interesting approaching this year's Iditarod. I have all of the same fears, and more, now that I have a slightly better idea what I might face out there. Still, I can't wait to be out there.