Thursday, January 14, 2016

Rusted wheel

Photo from Jamye Chrisman Photography
This is a photo of me and my friend Bill Martin at the start of the Fat Pursuit last weekend. We had a great time fretting during the pre-race hours and then riding together for all of five minutes before Bill and everyone else faded ahead of me, into the sunset. Seeing Bill was one of my favorite parts of the weekend. We first met shortly after I moved to Missoula in 2010, and bonded over our mutually oddball adventurelust. How many people will agree to leave from work on a cold October evening, ride bikes up a mountain until they hit snowline, keep on riding, get really chilled because it's October and 18 degrees outside, start pushing when the snow becomes too deep, reach the top, share lukewarm soup, and descend over fresh mountain lion tracks to return to town at midnight, on a work night? Bill was nearly always up for such nonsense, and at the time I didn't even realize how lucky I was to find such a kindred spirit in close proximity. He contributed to making 2010 one of the most memorable years of my life (meeting Beat also had a large influence on tipping the scales to "best year.")

Although I moved away five years ago, Bill and I still manage to reconnect about once a year at endurance races. It reminds me what I value most about this hobby of mine — the community.

This week I have been questioning my future in this realm. Endurance racing has been a struggle, and for the most part a failure, for the better part of a year now. Starting with my "altitude sickness" in the 2015 Fat Pursuit (same symptoms I had this past weekend, though slightly less obstructive), the "kennel cough" of my Alaska coast tour (It was a lung crud. I was coughing up gunk left and right), the Tour Divide pneumonia, more breathing attacks during UTMB, and finally the 2016 Fat Pursuit. It's an ongoing problem. But it's not exactly a typical medical problem. I'm faced with having to go to a doctor and say, "I'm having a lot of trouble with my breathing, but only when I engage in strenuous efforts for 12 hours or more."

"Um ... so don't do that."

Next week I'm returning to see the allergist I visited in October. She's a highly recommended asthma doctor, but when I went to see her a few months ago, I was starting to come around from the Tour Divide crud and believed I was on the mend from illness. She listened to my assessment about having pneumonia during my summer "bike trip," being wheezy and weak from July through September, and feeling much better in October — which would be consistent for recovery from pneumonia. Then she tested me for allergens and determined I was highly allergic to grass pollen and cats. Since those allergens were absent from my life at the time, she recommended I return in April to start immunotherapy.

Clearly there's more to it than a one-time illness. Ahead of my visit next week, I wrote out the long saga of every breathing attack I can remember over the past year, the contexts, and my reason why I'd like to seek aggressive treatment as soon as possible. I'm only hoping this allergist takes me seriously, or can refer me to a pulmonologist who'd be willing to conduct more tests. Even if the tests reveal something, it's doubtful there's a quick cure-all. Asthma medications could be helpful, or not. My symptoms have many of the markers of exercise-induced asthma, but because they've only happened in extreme situations, a doctor might not be convinced there's anything wrong with me. To be honest, I'm still a slight skeptic that there's anything actually wrong with me. I'm a believer in placebos and I also believe in the power of psychosomatic symptoms. Maybe my primitive mind/subconscious finally found a way to stop me from engaging my oddball adventurelust — by making me feel like I'm trapped in my worst fear. My worst fear is drowning. I fear this so much that I would give up endurance activities permanently, without regret, if I believed breathing difficulties were an inevitable part of the landscape. Regardless of the physical dangers — and yes, of course those matter — the experience of this state is the biggest de-motivator of all.

I was wrecked after 92 miles and 18+ hours in the Fat Pursuit. Not in a tired, hungry, sore legs kind of way, but in a sleepy, raw throat and chest, pounding headache kind of way. Despite many doses of ibuprofen, caffeine, water, electrolytes, tea, etc., I could not shake that headache. It persisted through Tuesday night. Yes, this can be a symptom of spending time at moderately high altitudes. You know what else can cause a three-day headache? Being low on oxygen for 18+ hours because your airways are constricted.

I stayed with my parents in Salt Lake City through Wednesday morning, and then returned to California. On Monday and Tuesday I was able to get out for a couple of short hikes with my dad. Besides a desire to get out in the mountains, I also wanted to test my breathing in high-altitude, cold air. It wasn't too bad. At a moderate pace I did not become winded, although my top end has been lopped off entirely. Moderate paces are really the best I can do right now — I can sense there isn't enough oxygen to push any harder. This is what I experienced for weeks after the Tour Divide as well. As long as I kept my breathing and heart rate under control, I was fine. Any surges into Zone 4 quickly pushed me over the edge, into the gasping zone, and it tended to deteriorate from there. I feel that hard edge in my breathing again now.

This was reinforced today when I went out for a run at home in California, elevation 300, temperature 57 degrees. I tried my routine, hilly loop that I've been running each week at sub-9-minute pace. Today I felt winded at 11-minute pace. Just the way it is. This is how I unravel my fitness, one endurance race at a time.

But at least I went to some very nice places while hiking with my Dad:

 Returning to Big Cottonwood Canyon on the Broads Fork trail.

 Mill B North trail, early on a chilly Tuesday morning. Due to my work schedule, we had to leave at 7:30 a.m., when temperatures were still in the single digits.

 Dad still rallied even though cold temperatures are not his favorite. I believe his words on Sunday were "I hate the cold." He's probably plotting his snowbird move to the desert right now. He turned 63 on Wednesday!

Dad does love snow-hiking, though, because he can bound effortlessly down trails that are rooty and rocky during the summer, and not pound his joints. After hiking a mile in tracks on Mill B, we broke trail for about a half mile before we found newly broken trail — by a moose. The moose trampled all the way up the switchbacks, resulting in a postholed, ankle- and hip-twisting mess that we gave up on after another half mile. "Moose make the worst trails," I whined. Dad found it amusing.

I remain hopeful there's a better solution to my breathing problems than "Um ... so don't do that," and that I'll know more next week. 

7 comments:

  1. I had to give up long distance running after my second marathon and knee surgery. Running long distances was what I loved more than anything (thankfully I discovered long distance hiking). I hope you don't have to give up what you love the most. But, optimism, I think there's probably a fix.

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  2. I discovered your blog about a year ago and really enjoy it. My husband has read some of your books and enjoyed them as well.

    I'm a hypnotherapist with a specialty in sports/performance anxiety so I see a lot of this sort of thing. But I also see a lot of people for weight loss who have lots of health issues so over the years I've spent a lot of time educating myself about all manner of health and nutrition. I'm not an expert, don't give out specific health advice and I prefer to deal with the mental side of things but it's crucial to look at health issues from all sides. Again I've only been reading for a year or so but I can tell you that most health issues are not purely psychosomatic and there are many red flags here that point towards underlying health issues. Certainly there is a mental aspect but I would strongly recommend working on your physical health. Overstressing the adrenals, too much sugar and highly processed carbs and nutrition problems in general (at least at races, I'm guessing about your daily diet), sleep deprivation, antibiotic use, travel stress, these are all things that can lead to compromises to gut health/health problems in general. And happily all very easy to fix. Sort of. We're all individuals so it can take some time, experimentation and research to figure out what you need to do to heal yourself.

    Recently there was an interesting article about Katie Compton who struggled with health issues, including exercise induces asthma, for 10 years and ultimately ending up finding the answer herself (she has the MTHFR gene mutation, not something a conventional doctor will routinely check for, she had to ask for the test to be done). The key point here is that she had to do the research herself and figure out what to ask the doctor for and she did it by listening to podcasts relating to health and nutrition. http://cyclingtips.com/2016/01/katie-comptons-painful-path-back-to-world-cup-podium/

    Trouble with this is that it's time consuming and can be overwhelming. So much stuff out there, so many rabbit holes to go down. One place to start might be Endurance Planet. As it happens Tawnee has a podcast from last month about allergies/asthma: http://www.enduranceplanet.com/the-sock-doc-allergies-asthma-digestion/ (you might want to fast forward to about 15 minutes or so in to avoid some talk about shoes). Her interviews with Phil Maffetone are interesting as well. And this is just a suggestion for a starting point, ultimately you'll find your own way. I like Tawnee because she's managed to hack her own health issues, has a lot of good guests and is good at asking interesting questions and getting good info. out of them.

    You also might want to find a good Functional Medicine practitioner (some are MD's, some are not) who will look at things in a more holistic fashion, is more likely to know which tests to run and has more extensive knowledge of nutrition, lifestyle, etc.

    Mental issues can arise from health problems for sure but in your case I'd strongly suggest looking into the physical aspects of your health and get those under control, then see what mental aspects, if any, remain.

    Good luck! You seem like the sort of person who's going to be able dig deep and ask the questions you need to figure this out.

    Elayne

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    1. Thanks Elayne. I appreciate you taking the time to weigh in. I am considering how I might approach factors that are within my control, such as my diet and daily exercise routine. I suspect finding my own way will take a lot of trial and error, and it feels a bit overwhelming right now.

      As you point out, everything about our health is intertwined, from diet to sleep to physiological and psychological stress, so it's quite difficult to determine which threads to cut or rearrange. Others have suggested everything from cutting wheat out of my diet (a common food allergy for those sensitive to grass pollen) to green tea and honey every night. Of course there's also cutting out sugar and dairy, taking a long period of rest to "reset the adrenals," etc. I'm open-minded about all of this, as well as skeptical. It often seems like there are millions of different avenues to address issues, and we either stumble on the one that works for us, or convince ourselves we have.

      So perhaps I am clinging to my "placebo effect" convictions, but I also acknowledge that I have not successfully managed my breathing for a year now, so I need to start accepting it's beyond my control. I'm grateful for any information I can find, and hearing from others who have dealt with similar issues. Thank you for the thorough response.

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    2. Yeah, it is overwhelming, and the idea is not to pick one thing to focus on but rather to look at health as a whole. Why not just do all the healthy things? The lowest hanging fruit is probably diet. Never mind cutting out this specific thing or that, just start with real whole food and get rid of all the man made food and sugar. Replacing wheat crackers with gluten free crackers is not going to move the needle, you're just replacing crap with different crap. Try eating real food and see how you feel. Easy peasy. Sort of. Experimenting is fun, I'm always working on my nutrition.

      However not everyone loves to geek out on nutrition like I do and a good Functional Medicine practitioner will take a lot of the guess work out. A good one will take an hour or more to get background info., maybe recommend testing for whatever issues they may suspect, come up with a nutrition and lifestyle plan tailored to your issues.

      Elayne

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    3. I had the great honour to race against Katie in a UCI Cyclo-cross in Milton Keynes last year. I can confirm that the woman is incredible. I also don't think that anyone in the UK (or Belgium for that matter) forced her to break more than a Zone 3 heart rate. I hope you find an answer, Jill, no matter who finds it for you.

      I can't express the relief I felt at being diagnosed with my Pulmonary Embolism last year and the sheer joy and freedom the solution has brought me this year... I just wish I could shake this cough now!

      Good luck.

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  3. Anonymous8:46 AM

    great pics!

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  4. After the first paragraph I teared up ... miss you Jill. We will ride/hike/whatever together for a longer period of time next time. See you soon. Now time to go warm up my toes. Yes, another 'after work thingy'.

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