Thursday, October 25, 2018

Attempts to define the slump

I feel like I'm crawling out of the bottom of my latest slump. Which, though predictable, is always a relief. I know there are worse things, and I don't want my blog to become a chronicle of this nothing ride on an endless loop. But I have been trying to summarize my concerns for a note to my doctor, and this blog has always been a good place to clarify my thoughts. I promise, blog, this will be the last I write about this ... for a few weeks at least ...

The best analogy I've come up with is a basin of water. My fitness and sense of wellbeing is the water that gradually fills up the basin, then drains again at intervals. When the basin is full, I feel strong and upbeat. Metrics I can measure — such as resting heart rate, blood pressure, the stats from my bike's power meter, and PRs on Strava — all improve. My outlook brightens, which I'll just clarify to mean my mind shifts from "crushing pessimism about the future of humanity" to "glimmers of hope boosted by beautiful things in nature." My sleep patterns improve. My concentration improves. My creative efforts open. I'm a happy person.

Then, slowly, the basin begins to drain. The first symptom I notice is more frequent instances of insomnia. Often a rash breaks out on my lower legs and feet during this time. My moods become more volatile, and this is where I experience random flashes of anxiety. Like a moody teenager, I have more difficulty concentrating and controlling distractions. I waste far too much time scrolling through Twitter and stewing in my crushing pessimism. I hate everything I've ever written, and admittedly slip into periods of not being all that productive, unless self-editing and liberal use of the delete button counts. When I check my resting heart rate and blood pressure, both have spiked, perhaps because of unfounded stress.

The breathing difficulties come last, and are really only at their worst for two to three weeks each time. But for me, they're bad. Hills that I could race up two months ago, I can now barely soft-pedal in my lowest gear and cadence. I become dizzy and need to take breaks. Fatigue is not how I would characterize this sensation. It's more like an obstruction in my cardiovascular system, removing most of the oxygen before it can reach my brain and muscles. This often results in gasping and trying to deepen each breath, but I suspect the straining does more harm than good. I don't test my moving heart rate nearly as often as I should, but when I check my pulse, it's usually not that high ... perhaps 140 or 150, when a true near-max effort for me should be above 180. But I feel maxed out. These efforts do not leave me tired afterward ... more like frustrated, because I can hardly get a good workout when I am fake-maxed-out. I still have all of this muscle memory and endurance in my body, but the perceived lack of oxygen makes me feel as though I'm suddenly, completely out of shape.

The pipe that moves this water in and out of the basin is an entity completely unknown to me. For a time I thought the force draining my health was asthma, but that doesn't quite fit, because I have good weeks in the spring and bad weeks in the dead of winter. My allergy treatments are going measurably well, my other symptoms are far milder, and yet I still struggle with breathing. In early 2017 I was diagnosed with an autoimmune disease that causes overactive thyroid. This seemed like a perfect fit — all of the symptoms I experience during my slumps fall in line with symptoms of hyperthyroidism. But every lab test since I started treatment has shown steady improvement. Now my numbers indicate I am "euthyorid," i.e. normal. I like to believe that my experience of these slumps has improved since I started asthma and thyroid treatments — undulating toward normalcy. But again, the metrics don't quite bear this out. My resting heart rate and blood pressure have been similarly spiked in January-February, June and October since I started measuring regularly at the beginning of this year. My Strava stats during these months are similarly bad.

I acknowledge that I could focus on lifestyle changes, but I am a skeptic in this regard. It seems like the things I can control don't really matter. I have felt fantastic during an intensely strenuous week of hiking in Italy when I climbed 50,000 feet while subsisting solely on coffee, pizza and Snickers Bars. And I've felt terrible during weeks where I did two or three short runs while increasing my protein intake and limiting sugar. I've been on fire at 14,000 feet and sputtering at sea level. During every slump I try something new — quitting dairy, taking new supplements, renewing focus on weight-lifting over my favorite outdoor cardio exercises. These experiments never stick, because eventually I feel good again and lose motivation. My latest experiment is CBD capsules, to treat anxiety. I've felt significantly better and had no anxiety episodes since starting this, and since they seem to have no side effects, I'm a fan ... even if it's just placebo effect. But they're expensive, and I imagine my motivation for these will wane as well.

At this point, I'm inclined to believe I'm not going to solve the mystery of the slumps without significant hypnotherapy. If I am doing this to myself with the power of negative thinking, I really need to learn how to harness this mental energy toward positive abstractions, because I'd probably win the lottery. Taking the long view, though, my overall health is mostly fine. I can learn to live with these hiccups, even if I never learn how to control them. The problem is that I still have a desire to be an endurance athlete, and train for big events. Training hardly seems purposeful when my fitness just resets to zero every few months, and my best chances for success seem to hinge on the date I choose to start my adventure. These slumps also seem to strip much of the joy out of my life. On top of increased anxiety and pessimism, I lose my best outlet for peace — hard, meditative efforts in nature. When my breathing is bad and I feel dizzy, all of that joy is taken from me. I'll never find it no matter how long I battle, or how slowly I move. I have tried.

Anyway, I am going to attempt to condense these thoughts and present them to my doctor. I expect she'll just give me a quizzical look and suggest I see a therapist. And that's fine. It feels better just to lay it out there. And I'm looking forward to the next upswing. I enjoyed reasonable breathing and a beautiful morning on Rollins Pass Road with Betsy yesterday:

The weather this week has been warm — temperatures in the 70s most days. It was 45 degrees and calm when we started pedaling from Rollinsville at 9 a.m. I was overdressed with tights and gaiters, although I was glad to have them later. Even though we had some big storms earlier this month, I expected to see almost no snow left on the route. But some has held on, especially in shaded areas at lower altitudes.

The higher altitudes had been blown mostly clear, and we endured much bouncing on babyheads, which was jarring after all of the smooth if strenuous sailing on packed slush. I love the scenery on Rollins Pass Road, and it's the only bike-legal route amid hundreds of square miles of wilderness. But the combination of a gradual and interminable railroad grade with slow maneuvering over and around rocks makes for a tedious ride. I told Betsy that I'm good for one or two trips per year, once memory of the tedium wears off.

Only taking photos on the smooth sections were I could actually hold my camera while pedaling.
Rollins Pass Road does have good winter potential, and I'm open to testing out conditions throughout the season. Or returning on foot. Really, it's all about spending time in these mountains. We stood at the edge of an overlook, gazing out at a dramatic play of sunlight and clouds over James Peak, and mused that we could spend all day up here. Especially when it's warm, windless, and eerily quiet in the shoulder season. Then we raced down the mountain, as we both had tasks scheduled for the afternoon. Betsy was really running late, and we averaged more than 20mph on the final seven miles of gradual descent. I was riding a studded-tire fat bike at 8 psi with fairly low gearing, so I had to spin like crazy to keep up. It almost felt like sprinting, and it felt really good. 

10 comments:

  1. FWIW, having an autoimmune disease increases your chances of having another. You might consider persuading your doctor to test you for lupus - complete testing would include a chest x-ray, which is probably a good idea regardless. Anyway, sorry for the unsolicited advice, and good luck with everything :)

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    1. I appreciate the advice! I am in need of new ideas. I have considered the possibility of another autoimmune disease and intend to ask my doctor about this.

      I also better understand why people take on the expense of naturopaths and flip their whole lives around to cope with symptoms that traditional medicine can't explain. As an evidence-seeking skeptic I haven't gone down this path yet, but I don't write it off, either.

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  2. I'm a CBD believer. It has helped me sleep when nothing else worked. Well worth the expense IMO. I'm sure you know what you are talking about re a slump. But I wonder if you are considering the fact that, well, there are just off days. You perform at such a high level that maybe sometimes it just is going to feel off? I suspect you know this already. Autoimmune stuff is weird. My athlete friend has suffered chronic fatigue for three years now. And she seems to be getting better now. With no apparent reason.

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    1. If poor exercise tolerance was my only symptom, I'd be willing to accept "off weeks" or even chronic overtraining syndrome as the cause. The shifts in mood and mental health are the symptoms I find more worrisome, and physical symptoms such as the rashes and night sweats show me that it's not *all* in my head, unless I can conjure those as well.

      Autoimmune disease is strange. I think the way thyroid disease is treated seems especially backward — addressing only the main symptom and not touching the organ-destroying antibodies. Not even acting like they matter. I'm still grasping to understand the mechanisms behind this.

      Having a disease that affects hormones is also strange, because there's so much interconnectivity in hormones. But my research in this regard has only led to an expanding universe of holes. It does seem that much of the interconnectivity in our bodies is not well understood by anyone. It bothers me that mental health and physical health are treated as separate entities.

      I have half a mind to just go try one of those hormone detox programs, even though I believe they're self-pacifying snake oil. Just to see what happens. Problem is, if I go in believing nothing will happen, nothing is probably what I'll experience, and I have to drop a lot of money and give up anything fun for a few weeks just for that privilege.

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  3. I hesitated to recommend this; the last thing you need is another dead end or false hope. But...my wife (age 73 and has had thyroid issues severe enough that it kept her on the couch) began taking this liquid supplement two years ago and has experienced remarkable changes, energy upshift, stamina, ambition...and on and on and on. She has shared it with several friends, and all of them swear by it and continue to use it.
    It's called AminoSculpt by Health Direct. Now I am among the most cynical skeptics out there, but have witnessed her transformation first hand. Yes, it could be snake oil...the effect could be placebo. But desperation judges not method nor madness. If it works, for what ever reason, even placebo, well, who cares. You might consider trying a month's worth. If it works...or helps, great. If not, just discontinue and move on.
    I hope there is a "bottom" to this well you are fighting to climb out of. Your struggles and your writing about them are helping so many people...more than you might ever realize. Sometimes there is no "cure;" I hope that's not true for you. But improvement...more distance between the cycles between the physical and mental highs and lows, that's what we all pray that will come your way. Never quit fighting...keep your "goals" warmed on the back burner, and keep believing.
    mark

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    1. Thank you. I appreciate the encouragement and the tip. I trust your wife's experience and your assessment so I will definitely give this product a try.

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  4. I also have an autoimmune disease plus a few other chronic issues, and I have times a lot like those that you describe -- except that I get lethargic and depressed rather than anxious. Anyway, I have chipped away at feeling better for the past decade. I replaced doctors who didn't seem to listen to me or try to help me. I kept adjusting meds etc. And making sure that I get enough sleep. I can't say what helped me but I have far fewer times when I feel like that now. -- My advice is to keep trying to make things better via medical doctors (and remember that snake oil can actually make you worse). Either the passage of time or a medication adjustment might make things better. You are still not too far away the times from when your thyroid issues were measurably terrible... so your body may still be healing. I hope that those bad times shrink for you.

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    1. I appreciate you sharing your experience. The nebulous symptoms do seem very common, and everyone finds their own way of managing them. I agree that I shouldn't try everything under the sun.

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  5. I don't know if Suicide Basin in Juneau was doing its sudden draining every year or two when you were there, but the general term is a great word: jökulhlaup.

    It might be faster than your metaphorical basin drains, but if not, you have a name for it!

    Don't be too quick to discount allergies outside of spring and summer. Indoor allergies are common, and outdoor ones can kick up with changing weather. A warm, wet period can cause stuff to "blossom." Cold, dry windy weather can stir things up--from trees or grasses that are above the snow.

    Last winter I had bloodshot eyes and a stuffy nose at -20 F after cutting bent-over birch trees. The fine sawdust from the frozen wood caused enough reaction I had to start wearing goggles, even though fogging is a problem.

    Do you have some room-sized HEPA filters in your house? I started running mine year 'round and it's helped.

    Tom
    Fairbanks

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  6. j√∂kulhlaup — love it. I remember reading about Suicide Basin, but I haven't witnessed this phenomenon.

    I've been tested for numerous indoor allergy and turned up negative for everything major — mold, dust, etc. But I am constantly stuffed up. I assumed this was part of thyroid disease, but it might be worth exploring the possibility of other allergies.

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Feedback is always appreciated!