Monday, February 27, 2017

The 2017 Iditarod Trail Invitational

The 2017 ITI started at 2 p.m. Sunday at the edge of Knik Lake. I was there, but rather than standing next to a loaded bike and bubbling with nervous excitement, I was on the sidelines. I've mentioned this before, but I'm pretty bummed about missing the race. I need to get over it. I'm in Alaska, enjoying gorgeous scenery, and visiting friends. To be honest, though, the prospect of an Idiatrod Trail adventure is one thing that's kept me optimistic through all of my issues over the past few months: Anxiety over the world's current state of affairs, increasing brain fog, poor writing efforts, and diminishing physical capacity. Now that I know the likely cause, I have a potential solution to my issues. This is reason for optimism, but I still have the anxiety and the brain fog without the release of physical activity and joy of adventure. I've been taking it fairly easy. This just makes me feel worse. 

I learned last week that I have Grave's Disease. It's an autoimmune condition that's thought to affect people with genetic predisposition, and possibly triggered by bacterial and viral infections. Like most autoimmune conditions, it will never go away on its own. Diet and a few lifestyle changes are on my radar, but Graves Disease requires treatment, one way or the other. The initial path is to experiment with medications. My hormone levels tested high enough to justify an aggressive dose of methamizole, which I've taken every morning for a week. The drug supposedly has some nasty side effects, but those haven't yet hit. To be honest I don't feel any different yet, but it's a hopeful path even if not ideal. 

Those last two paragraphs were difficult to write, and I'm am struggling to go back and read them. My brain fog is actually pretty bad today. One of the effects of hyperthyroidism is difficulty focusing for more than a few seconds. When reading, I scan through a line on a page, lose my place, and fail to find the next line. By the time I've gone searching for it, I mostly forget what I'd already read. This struggle with reading is recent and intermittent, but it freaked me out to an extent that I didn't tell anyone or even conduct a Google search — "I'm losing my ability to read" — for fear it would make it so. I worried that I was losing my mind. Maybe early-onset dementia. And that would be so, so much worse than losing my physical capacity. 

 Well ... I really didn't start writing this post to complain about my health issues. But it seemed prudent to given an update. I believe this is getting better. I'm having a bad day today, possibly because my general anxiety is up. It's inevitable when Beat starts the Iditarod. This is Beat's sixth year on the Iditarod trail, and his fifth attempt to Nome. He's seen and survived just about every fearsome possibility. But I can't help myself. I worry about him. And it sets off these lousy hormone issues that wreck my brain and my body.

But everything is fine, of course. Beat is out there plugging along and mostly enjoying himself, although the first days are always hard. He's still recovering from a cold that prompted him to bring a small pharmacy with him to the start. He frets about congestion and foot pain. Actually, he's like this initially every year, before he settles in and develops that groove that's always made him unstoppable.

 I've been involved with the Iditarod "family" for nine years now, and the pre-race activities are always a fun reunion. In this photo Beat is talking to Loreen Hewitt, who is vying for the 1,000-mile hike this year after reaching Nome on the Northern Route in 2014. She's nearing 60 and still perfectly healthy for such an endeavor. I'm terribly jealous.

Beat doing his best "Blue Steel." Behind him is Tim Hewitt, who is riding a bike this year. Tim seemed to be heavily regretting this decision while eating pre-race lunch at Knik Bar. So far trail conditions appear to be softer than recent years, but rideable. Tim is anticipating awful trail conditions beyond McGrath, which is why he's packing those snowshoes. I tried to talk him out of bringing them, then changed my mind. I've tried it, several times, and concluded that it's more annoying than helpful to push a bike in snowshoes on bad trail. Snowshoes don't help a biker in deep snow, either, because the bike still sinks, and then the front wheel has to be lifted from a higher angle. (I can only lift my own bike by getting underneath it, so the last thing I want is to be higher than the bike.) However, snowshoes could help if Tim snowshoes hikes ahead and effectively breaks his own trail, in which he could then push his bike. That's a nightmare scenario as well, but then again all scenarios are nightmare scenarios in three feet of new snow, like they dealt with in 2015.

 The start, with Pete Ripmaster forging ahead in the lead.

 Beat, looking much more relaxed than he claimed.

 The field crossing Knik Lake. There are 20 runners out of the field of 82 this year. The majority are participating in the 130- and 350-mile races. Six or seven plan to go beyond McGrath.

A half hour after the race started, I set out on the old Fatback bike (I brought this bike to Alaska rather than risk theft of the race bikes.). Admittedly my comfortable "non-strenuous pace" only netted about 4 mph on the mashed-potato surface, so I rode a little harder in order to catch up to Beat before hours had passed. I caught up to the only 1,000-mile skier, Moses, at 3-Mile Hill. His sled was absolutely massive.

 Another runner on the trail. Temps were warm — around 29 degrees, and the weather was cloudy with light flurries. Pretty blah weather. But better than the first day last year (when it was 38 degrees and raining.)

 Catching up to Beat, finally. This is likely to be the last time I see him for a month, if all goes well.

Bye Beat! I'm planning to spend this time in Alaska, although I still need to decide exactly what I'll be doing. I travel to Juneau tomorrow, and I'm looking forward to returning to this isolated city where I lived for five years, which in my memory will always remain the best and worst of all. This time will be great to reconnect and reflect, if I can get my brain back. If things are going well for Beat and my anxiety goes down, I think that will help.

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.