Thursday, May 31, 2018

Trace us back, trace us back

Every couple of years, a group of friends from college plan a reunion in the Utah desert. For various reasons I missed the last two, so it had been six years since I've seen many of them. I suppose it's an anomaly that we bother to get together at all, but we all agree that life would be more dull without the "Terra Firma" crew on the periphery. Terra Firma was the name of an conservationist club at the University of Utah. On a whim I walked into a meeting one afternoon in 1998. That weekend, I joined an eccentric but entertaining crew on a camping trip in the San Rafael Swell — to document illegal ORV use, of course. And also adventure in the desert. My life has not been the same since. 

Here some of us are in October 2002, about to drop into Quandary Canyon. At this point I was co-living with nine other folks in one four-bedroom house (we called it the "Terra Firma Commune." But we weren't cultish, just cheap.) Every weekend we were traveling, to the desert or the mountains, to camp and hike. At that point in my 20s I had become world-weary, with a demanding job, a long commute, a few more career ambitions and a mountain of fears. This photo of Quandary Canyon always makes me smile, because I remember exactly how I felt in that moment. I was not happy we were about to descend into a scary slot canyon. I was anxious and terrified and probably would not have subjected myself to such misery had I not been so influenced by my friends. Sometimes I imagine what my life might be like had I never met them. I probably would have followed the neurotic inclinations of my young adulthood into a stressful work life and damaging addictions (I mean more damaging than cycling and running.) I'm endlessly grateful for the folks who dragged me — often kicking and screaming — into the world of outdoor adventure.

Now we're all near or over 40, with a lot of children in the mix. For that reason we reserved a family-friendly group site along the Colorado River north of Moab. I arrived Saturday evening — having purposely shown up a day late to skip the group river trip — to a temperature of 95 degrees with high winds. The camp site looked like an abandoned war zone — overturned and collapsed tents, tarps tangled in the tamarisk, everything covered in sand. The group of nearly 40 adults and children returned after battling the wind for more than nine hours. Everyone was fried, but we still sat down in sun-faded camp chairs and picked up where we left off ... has it really been six years? Or 20 for that matter? It feels like we were doing this last weekend.

On Sunday, against all of my current neurotic inclinations, I was coerced into joining a smaller crew who hadn't tired of river rafting after nine grueling hours the previous day. They were day-tripping a segment of the Colorado River known as the Moab Daily, with incredible scenery and a few small rapids. Although my early adventures with the Terra Firma crew stoked many of my passions, I also picked up a few abiding phobias. To this day I am terrified of moving water, to the point that I start having mild panic attacks and my mind goes blank and I make bad decisions. It's difficult to explain this phobia to people who know me as "the crazy one who rides bikes across Alaska." They assume I must be fearless. They couldn't be more wrong. So I have to retell my harrowing stories, even to friends who were there for the mishaps. They agree my fears are justified. Still, I *know* that the Moab Daily is a non-issue, and also that several 2-year-olds had managed the trip the previous day. I relented. My friend Craig joked that I had been "baby-shamed" into going on a rafting trip.

The Moab Daily was fun — really, this is the best way to spend a day in the desert when temperatures are in the 90s. I also can't deny that my heart was racing and my peripheral vision began to darken every time the enormous raft rolled over tiny riffles. It was a struggle to hold it together. I had to focus on my breathing. What is wrong with me? During the last rapid, Chris was rowing and asked everyone if we wanted to hit the big hole. I said nothing, but admitted to the crew that I was going to duck into the bow for this one. The raft dove in and the nose hit bottom, plunging me briefly into a caldron of water and causing the rear of the raft to fold over. Micah was thrown into the dry box and badly bruised her shin. An attachment to the oar lock broke, and Chris urged me to unhook the spare oar quickly. So I had to hang over the side of the boat, watching whitewater rush by my face as I fiddled with buckles and straps in a situation that felt urgent. Although this confession will invite more justified baby-shaming, I'm actually really proud of myself that I held it together and didn't black out, the way I did on an ill-advised "I'm going to be brave before the Tour Divide" Westwater rafting trip in 2009. But this trip did show that my phobia has not improved much since then. There won't be any packrafting in my near future, at least not before therapy. When we told the story of our Moab Daily incident around camp, Craig said, "It's always you." 

On Memorial Day the group made breakfast and said goodbyes. I headed out for a solo ride on a segment of the Kokopelli Trail that I remember as my favorite from that one time I rode it in 2009 — Onion Creek. The creek was running high, which made for lots of splashy fun early in the ride. (The fun kind of splashy fun, not whitewater rafting splashy fun.)

I was feeling a bit rough — maybe too much time in the sun? — but enjoyed the steep struggle spin up to Polar Mesa. The views from the rim are always worth it.

I'd been away from Internet and cell phone reception for two days — pure bliss — so hadn't checked recent weather reports. I assumed it would be mid-90s and breezy like the previous two days, so I packed four liters of water, some snacks, and not much else. Temps were coolish for my 10 a.m. start, and then dark clouds moved in. Sprinkling rain brought drenching rain and then, near 8,000 feet, a fierce hail storm. I bundled up in my 2-ounce wind shell, pulled my buff over my head, and huddled under a pine tree. As my core temperature trickled downward, I decided it was better to keep moving by climbing upward rather than retreat on a 12-mile rolling descent. So I kept pedaling into the storm, shivering, and a little bit frightened. This I had not expected.

The storm moved on and the temperature shot upward — back to being almost hot and humid. Early summer in the desert. I should know better. I should also prepare better. I know this. The Castle Valley connection provided a nice opportunity to unravel five hours of straining, shivering effort by coasting nearly the same distance in one hour, back to sunshine and the highway. Pure bliss.

Beat was going to fly into Salt Lake on Thursday to run the Bryce 100 this weekend, so I opted to come up a few days early rather than drive all the way to Boulder and back. I'd hoped to squeeze in a hike with my dad, but he took a bad tumble on Mount Olympus last week. It was a freak incident that happened just 10 minutes from the trailhead upon return. He doesn't remember what caused the fall, but his friend turned around to see him tumbling down the rocky slope. Dad was unconscious for three minutes before he came to. With help from his friend, he was able to walk out with numerous head wounds, a concussion, a broken wrist, bruised ribs, and bruised legs. The photo he texted me was gruesome. Happily he will make a full recovery, although he's bummed about four to six weeks of a broken wrist during the height of hiking season.

If friends ever wonder about the origin of my clumsy streak, well ...

Since I had a bike with me, I took a more rare opportunity to ride in the Wasatch Mountains. On Wednesday I decided to ride the trails over South Mountain and climb American Fork Canyon as far as I could muster ... I'd never been up that way, not even to Tibble Fork Reservoir, in all my years as a Utahn.

This is a beautiful climb. It was another hot day — 86 degrees — so I packed all the water and all of my rain gear. There were thunderstorms everywhere, but they all managed to miss me. Figures.

Grind, grind, grind, from 4,500 feet all the way to 9,000. I enjoyed the verdant green baby aspen leaves and fast-flowing creeks. Traffic was light, but at one point I was passed by two men on four-wheelers who wanted to chat and had lots of questions. Nice guys, really, but I was working a 15-percent grade on loose gravel, and not up for wasting my wind on words. I tried to be polite as I gasped out answers, and they continued on their way. When I reached the top about a half hour later, they were beside themselves. "We just got here, too!" one exclaimed. "Did you really pedal that whole hill? All the way from Tibble Fork? That must be ten miles! Better turn around here. Over this knoll, the road goes way, way down. I don't think you want to climb two mountains today."

I still rode over that knoll, just to see the other side — Heber Valley. Next time, I will ride that descent and find another awesome climb to return home. I also took some time to briefly explore the ridge trail, but it was a rough moto trail — deep moon dust and fall-line grading. (I don't know if motorcycles are allowed on these trails. They definitely use them, based on tracks in the dust.) It was one of those trails where I'd be much happier without a bike. Still, I vowed to explore the singletrack next time, too.

The nostalgia trip was complete that evening when I visited my best friend from high school and met her wiggly pack of 4-week-old whippet puppies ... so adorable. Of course when we get to talking, it's about skipping school and playing in sand dunes that have been buried under reservoir water for nearly 20 years already. Somehow, regardless of the timeline, you just pick up from the start without missing a beat. It's a uniquely cathartic experience, spending time with the people you knew when you were young. Life's relentless forward motion slows down for a moment, allowing space for a wealth of memories to encompass us. It's a welcome reminder that yes — we've lived.

Friday, May 25, 2018

Thyroid update 4

 I haven't posted one of these updates in ten months. However, the Internet informed me that today (May 25) is "World Thyroid Day." I've found benefit from reading about others' experiences online, so this seems a good day to bring my blog up to speed.

In summary, I was diagnosed with Graves Disease in February 2017. This is an autoimmune condition that attacks the thyroid gland and causes it to overproduce hormones to toxic levels. The mechanism that causes this is poorly understood, but an improper balance of thyroid hormones has a negative impact on nearly every function in the body. Thyroid hormones regulate the metabolic rate of all cells, as well as the processes of cell growth, tissue differentiation, and reproductive function. Symptoms of thyrotoxicity can be widespread and dangerous — the worst leading to heart failure. When I was diagnosed weeks before the 2017 Iditarod, I was warned under no uncertain terms that participating in a remote endurance race could kill me.

The experience has been a humbling reality check, putting to rest whatever remaining endurance-racer delusions of grandeur I managed to carry into my mid-30s. However, compared to many cases I've read about online, my experience with thyroid disease seems relatively minor. I managed to stay fairly high-functioning throughout, and I wasn't pressured into having my thyroid radiated upon diagnosis. This is actually the default treatment for many Graves patients — a gland that is necessary for life is deemed too unruly and removed, so the patient must depend on synthetic replacement hormone to the end of their days, with varying degrees of adaptation. There are worse things, I know, but I strongly did not want this treatment if I could avoid it. Happily I found an endocrinologist who not only decided that thyroid ablation wasn't necessary, but understands my passions and doesn't believe I need to give up adventures or endurance racing.

I'm being treated with a medication that blocks thyroid hormone conversion in the liver. Whenever a friend teases me for "doping," I point out that any thyroid treatment — whether blocking or replacing hormone — is going to make any normal person feel really bad. Emphasis: Extra thyroid hormone is not performance enhancing. It's quite the opposite; this is one of those things that needs to be perfectly balanced, and it's annoyingly specific to the individual. When I started treatment, I needed to take a considerably high dose, which does have negative side effects and over time can damage the liver. The hope is to bring down levels quickly, which in turn decreases antibodies, until eventually the thyroid can function normally without medication. Adjusting to these fluctuations has been a mostly unfun rollercoaster ride, but I continue to move in the right direction under an acceptable timeline.

Earlier this month, I reached the holy grail for Graves patients — normal TSH! TSH is a pituitary hormone that encourages the thyroid to produce more, so people with hyperthyroidism generally have none. My T3 and T4 both fell in the low range of normal, so my medication has been halved again — I'm now taking 1/6th of what I started with 15 months ago. I'm always nervous about a dose change, because there's usually an adjustment period for several weeks following. But my doctor thinks I may reach remission within four months. If this happens in that September-October range, and I'm still feeling good, I think I'll have to celebrate by committing to the 2019 Tour Divide. ;-)

Living in the "normal" range has been quite a revelation. Although outwardly I complained about my most prominent physical symptom — shortness of breath — the mental and emotional symptoms were quietly more disturbing. Before diagnosis in early 2017, I experienced strange brain fogs that occasionally settled in when I tried to read or write. I'd lose my train of thought and often not be able to return to whatever I was working on for the rest of the day. There were some really odd episodes when I started to wonder whether I was experiencing early-onset dementia ... for example, I was at the grocery store and grabbed a jar of mustard off the shelf, then had a lapse, for several seconds, when I couldn't read the label and couldn't fathom what I was holding. When I "came to," the realization of that cognitive lapse was jarring. I also had mood swings that boosted bouts of anxiety or depression. Back then, my thoughts often drifted to disturbingly dark places for no discernible reason. I blamed the political and cultural climate. There is some merit to this, but world affairs have not improved since last year, and yet my outlook is so much rosier. It's funny, really, when you realize how fervently we cling to an unwavering sense of identity, when so much of our intellect and emotion is based in our dumb body chemistry.

So, yes, it's been a while since I had a cognitive lapse, and I'm in an overall better mood. Yay! Like my other symptoms, it has not been a steady rise. There are continued ups and downs, and I don't anticipate just being better forever, as easily as that. But the overall improvement is encouraging.

As for my main physical symptom — breathing difficulties — that's also improved significantly. But this is also a messy thing. Along with thyroid disease, I also have allergic asthma — a separate autoimmune condition. The way my thyroid condition affects my heart results in general breathing difficulty that reduces my ability to exercise. However, I also experience occasional exercise-induced asthma attacks from constricted airways. There's research that shows that people with one autoimmune disease become susceptible to others, often during periods of illness or high stress. Anyway, I believe the allergic asthma came first, but has really ramped up in recent years. I'm also being separately treated for this condition with immunotherapy (allergy shots), so I'm a regular pin cushion with enough daily medications and supplements to fill a pill case. And you know what — I'm okay with this. As allergy season ramps up, my symptoms — which also include the usual itchy eyes, sneezing, etc. — remain greatly reduced compared to last year. Yay Western medicine!

One of my benchmarks for good breathing health is "effortless PRs," which I continue to reach ... admittedly by putting a small amount of effort into them. But I'm no longer a gasping mess — I actually feel quite good when I'm pushing myself. Again, I don't expect to feel this way always — I've had a number of downturns in the past 15 months, and no reason to believe this is over. But for now, this mountain air is filled with oxygen, and it tastes so good.

Two other metrics that I can track more easily than hormone levels are heart rate and blood pressure. My resting heart rate was never at the crazy levels you hear about from some Graves patients. But I used to see 85-95 bpm; it now falls closer to 60. I didn't even realize I was having blood pressure problems until this past January, when I applied for a prescription and was denied because my blood pressure was too high. The nurse took several readings before encouraging me to come back the following morning before coffee, where it was still registering 130s/100s. I've been monitoring my blood pressure ever since. It looked bad through February, but has improved significantly since I returned from Alaska in April.

Then there's the metric everyone will ask you about — weight. Some people with hyperthyroidism lose a ton of weight. A few gain weight. It's not always the instant high metabolism some think it is. My weight has remained fairly stable throughout my illness and recovery. Although I intend to address any big changes, I haven't done much about it yet (I'd like to focus on achieving mental sharpness and good breathing first, thank you.) However, I was a bit alarmed when I came home from Alaska in early April and realized I'd put on eight pounds in a month. I've assumed normalizing my thyroid would pack on some weight, but this was happening more quickly than I expected. Then, during the past six weeks, I lost most of this amid my usual routine. There's probably something to be said about how much inflammation develops during a tough endurance race, and how long that takes to recover. Anyway, I continue to believe that weight is not necessarily a good health metric, except to gauge how bad for your body endurance racing really is. ;)

There are a few other symptoms that have improved greatly in the past few months — insomnia, hair loss, hives on my shin and ankles, and muscle weakness (okay, that could have been caused by endurance racing, too.) It's funny, because as my nighttime sleep improves, I've picked up more daytime fatigue — again, I view this as probably more "normal" than symptomatic in the other direction. I also find myself feeling cold when sitting around, and again, it probably just means that I've not as overheated as I once was.


After an encouraging visit to my endocrinologist on Thursday, I celebrated with one more jaunt up Trail Ridge Road in Rocky Mountain National Park. I'd been led to believe they weren't opening the road until Friday, but to my dismay it opened two hours before I arrived Thursday afternoon. Traffic was already thick — not ideal, but at least drivers in national parks are generally courteous. Still, I don't see myself making this trip again this year, unless it's to ride the gravel of Old Fall River Road before it opens in July.

The weather was typical Colorado springtime — lovely at intervals, and then a squall would move in, the temperature would drop 20 degrees with blasting 40mph headwinds, followed by a burst of rain. Then it would be lovely again.

I was amazed how much snow had disappeared since I was here two weeks earlier. I guess my window for spring snowshoeing closed during the broken toe episode. Summer is here, but that's okay. I have to admit that the weather in these mountains frightens me, and I'll miss this relatively benign season. Winter is for 75mph west winds and avalanches, and summer is for microbursts, hail and lightning. Fall is probably a good season to plan big efforts, after monsoon but before the snow.

Beat installed new tires on our road bike, "Sworxy," so I took it out for its first ride since late 2016. Oh, how I missed this bike. So nimble and fast, if a bit squirrelly. Without even trying, and despite a huge backpack (see aforementioned fear of mountain weather) and blasts of wind, I cut more than a half hour off my climb time verses the mountain bike two weeks ago (16 miles of near-constant climbing from 8,000 to 12,000 feet — that's pretty much Jill heaven, right there.) This time last year, I felt like I could barely breathe at 12,000 feet, at any level of effort. The improvements are no doubt only noticeable to me, but I find them staggering.

My overall health and fitness cycle for the past year and a half would put late June at the bottom of a slump, so it will be interesting to see how I hold up this month. Either way, I am grateful for every good day I receive. Good health is priceless. 
Sunday, May 20, 2018

Mist season

It's been one of those perfect weeks of spring, where decidedly "Un-Colorado" weather settles in for a few days — long enough to saturate the dry ground, but not so long as to wear out its welcome. Some of the "300 Days of Sunshine" proponents might disagree, but I enjoy this short season of gray mist. It reminds me of my favorite long runs in California, or the rose-colored glasses I now have for Juneau. I loved this misty weather even when it was 38 degrees and pouring, and I opted to go to the gym instead of enduring a sloppy bike ride — because you don't need to get needlessly coated in cold mud to appreciate spring hydration.

 The animals seem to be enjoying spring as well. Deer and turkeys have taken over the place, hummingbirds returned in force, our outdoor goldfish are full of vigor after their winter stupor, and neighbors are posting photos of a mountain lion family on the prowl all over the neighborhood — which may explain why the deer are bedding down so close to the house. I also encountered my first black bear of the season, while driving home on Thursday. A small bear, he appeared to be hanging out more or less in our driveway before I startled him, and then watched his adorable bear paws bound along the edge of the road before he veered into the brush. My parents were visiting at the time, so I went inside to warn them — just in case they had any food in their car.

Our friends Dan and Amy from Alaska visited earlier in the week. So it was a busy week where the weather was often rough and I didn't get outside all that much, except for the afternoon before my parents arrived on Wednesday, when summer made an appearance. There wasn't a cloud in the sky and temperatures nudged past 80 degrees, so I slathered on multiple applications of sunscreen — still not enough to avoid second-degree burns along my wrist, arm, and a sliver of my lower back — packed three liters of ice water and a sandwich — which I neglected to eat after getting too wrapped up in making good progress over a six-hour ride with a deadline — and borrowed Beat's cross bike for a blistering fast ride on still-muddy gravel and gravel-strewn pavement.

It will probably surprise no one but myself that I fell in love with the cross bike. Beat has owned this bike for more than a year, and I'm just now trying it out. I've always been a cross/gravel skeptic because they seem like bikes that are just a little worse at everything. A road bike is better on pavement, and a mountain bike is more fun and comfortable on dirt, even non-technical dirt. Shortly after we moved to Colorado, when my breathing issues were at their worst, I abandoned my road bike because I physically could not pedal it up some of the steepest grades near our home. Back then, even my low-geared mountain bike would stall out on the Flagstaff Road grinders, and I'd crawl into a nearby ditch to catch my breath and sometimes cry a little bit. These were bad times. I didn't talk about them widely, because I was ashamed.

My sometimes-decimated and still-unpredictable fitness is the reason the road bike hasn't been ridden in two years. Now it needs new tires and a little work before it can reasonably be used again. After two years of grinding away on knobby tires and studded tires and loaded fat bikes and bikes with suspension, the cross-bike intro has been a startling revelation. This bike demands so little of me to fly up gravelly hills and 25 miles of rollers along the Peak-to-Peak Highway. There was a 12-mile descent where I could pedal much of the time — my mountain bike is geared so low that I usually have to lazily coast, often while freezing my butt off because it's winter, for 45 minutes. I was buzzing by the time I met Beat in town, because it's not every day I can enjoy so many miles and so many hills with so much scenic goodness for so little effort.

The following morning I was sporting an embarrassing patchy sunburn to meet my new primary care physician. The physical went well — most notably, my blood pressure has dropped to 108/68 after regularly hitting 138/100 for much of February. When I mentioned this to an observing nurse practitioner, she said, "Well, you're probably more active now than you were during the winter." Yeah, about that.

But, really, it's satisfying to identify as healthy ... for now at least. The doctor graciously agreed to examine the toe I broke three weeks earlier, and concluded, "you're probably okay to run." I expected more caution than that ... I'd been dutifully limping around in my orthopedic sandal until recently, and the toe still hurt. These doctors I manage find ... always encouraging me to go wild and take chances. Where are all of the supposedly conservative medical providers all of my athletic friends seem to complain about? Anyway, since removing the buddy tape, I've noticed that my previously curled and crooked pinkie toe has actually straightened a bit. The once-sideways nail, which is already ruined from constant pressure against the side of my shoes, now faces upward. Genetics left me with bad toes, and injury actually fixed one of them.


With the doctor's blessing, I was able to squeeze in one hike with my dad — a conservative five miles along the gradual west ridge trail to Green Mountain, walking slowly while wearing my ancient hiking boots. Dad was patient with me as I ambled along, grumbling about toe pain. Only later did I realize that if I remove the buddy tape, my toe doesn't hurt at all — I was probably wrapping it too tightly. But it was nice to spend a couple of days at home with my folks, even if our adventures were underwhelming. It seems as though I'm either injured or sick or recovering from surgery every time they come to visit.

 Beat went out for a long run on Sunday in prep for the Bryce 100 in two weeks. I was filled with FOMO — last spring I was doing my own long runs before the Bryce 100, and I admittedly miss compulsory adventures. The optional ones are okay, I guess. The weather had again turned sloppy and cold, so I donned the big boots for a hike up the west ridge to Bear Peak. At the summit, I felt so good that I continued down Shadow Canyon to wrap around the Mesa Trail to Fern Canyon, having forgotten how long that route really takes — it turned my one-hour hike into almost four. But my toe felt fine, and it was fun to splash through ankle-deep mud in the big waterproof boots and breathe in cool, humid air.

Fern Canyon, with its 1,800 feet of climbing in 0.85 miles, is always a fun fitness test. I pushed it a little and missed my PR by just five seconds. Five seconds! This was intended to depict tired satisfaction ... yay, I haven't been running in a month, and it's wet and muddy and I'm wearing heavy boots, but I almost got it.

As this cold front came and went with the lowest temperature registering a balmy 37 degrees, it's time to accept that winter is truly over, and the window for hopeful instances of late-spring snow has closed. This is always a somber realization for me ... summer is coming. But it's nice to head into the hot season feeling healthy, if a bit aimless, for now.