Thursday, February 21, 2019

The Middle: The Ups and Downs of Sharing

“Life can only be understood backwards; but it must be lived forwards.”  ~ Soren Kierkegaard
If you give away too much, you suffer a loss because "too much" implies more than you should give for your own well being. If you give too little, you may feel cut off from others. The balance is hard to find.


Over the past three weeks I have experienced everything from support and attempts to understand, to condemnation and writing me off as one of the walking dead. It's been hard, very hard. I'm angry as hell. I'm angry this is happening. I'm angry that people claim to "understand" when they can't possibly understand. And when I tell them this, they get defensive and dismiss my reaction. They attempt to tell me that I will be fine. Some wish to dismiss the truth of what this all might mean, for me (not for them because this shit will never happen to them). Some wish to use my situation as inspiration to do what they can do while they can do it - and that's great and it's something I've encouraged people to do since starting this blog in 2011 - so that's fantastic that they're doing it -  except for the inference (due to the timing of these constant proclamations) that I'm done for and fucked. It's great to inspire, but not at the cost of ones life. I guess no one listened before.

Maybe I'm just being sour about the whole thing. But, hey. I have a right to be pissed off at the wold right now.

On the other side there's the silence from some. Some just can't deal. I'm a pretty normal person. I'm healthy. I generally live my life with gusto and go after what I want. I take pretty good care of myself. I do things most others my age cannot even fathom. And yet, this is happening to me. We need to distance ourselves from such glaring examples of human mortality.

So, I've gone back and forth on this: Share...don't share...share...don't share.  The fact that I've shared so much, that I've exposed my soft vulnerable spots, and that some have taken the opportunity to poke or kick those vulnerable spots I chose to expose, well, that's just mean.

And I can't help but feel that some will follow along just to witness my downfall. There is the "watching the train wreck" impulse in many. They want to follow along. But it's like watching another crappy Netflix series.

I took a risk sharing as much as I did, and perhaps if things turn out well I will return and tell my story after the fact. But telling it while I'm going through it has proven dangerous and painful and eye opening in a very hard way. Yes, I've received a lot of support, and I thank those who offer it. But those who have chosen to be mean cut into a painful place that I hope no one out there has to discover in themselves.
“To dare is to lose one's footing momentarily. Not to dare is to lose oneself.” ~ Soren Kierkegaard
So for now I will focus on me and those who are closest to me. I wanted to share my story only because I thought maybe someone else out there is like me, and maybe someone out there could learn from my example. But I guess I'm wrong.

To paraphrase Socrates, it is better to make yourself as good as possible rather than building yourself up by silencing, laughing at, and cutting down others. As Socrates faced his death, condemned for speaking awkward, uncomfortable truths, he warned those who condemned him: "[T]he easiest and noblest way is not to be crushing others, but to be improving yourselves" (Apology) It is better to stand for something and to say it, to use your life as an example, than to constantly shut down those who take the risk, speak out, and share their truth. Most, it seems, don't want to hear it.

Until later...


Thursday, February 14, 2019

The Beginning: The Teacher Appears

“The world is full of obvious things which nobody by any chance ever observes.” ~ Arthur Conan Doyle



I stand waiting for my turn at check in, the imaging waiting room is packed on a Friday afternoon. The woman behind me, at least 10 years younger than me, is laboriously breathing in and out. In and out.  Out of the dozen siting in chairs, waiting for various scans, I'd estimate that about 90% of them look sick. Very sick. Some in wheelchairs. Some hooked up to oxygen canisters. Many with a glazed over, dazed look in their eyes. 

It is almost 3 p.m. and I have not been allowed to have any caffeine for the whole day. Now, I don't drink a lot of coffee. I have one not-so-large mug in the morning and that's it. But, take that away from me and I feel the withdrawal effects. Add to this not being able to eat for three hours (yes, I know that's not very long, but it is for me!), and I feel rather a mess. My head is throbbing and my blood sugar feels like it has bottomed out. 


A nurse approaches me asking me if I'm here for a TM stress test, and we make our way to the "nuclear medicine" side of things. She attaches a bunch of electrodes to my body, holding all the wires together with a belt fastened just a bit too tight around my belly (I hate things strapped to me when I run!) places the pesky O2 reader on my index finger - the doctor comes in, asks me a few questions and then informs the nurse, "This is going to take a while. We need to put her through the paces". He looks at me and says, "This could take 20 minutes. Are you okay with that?" "Sure" I respond. What are my choices? 


So we start at a fast walk, picking it up gradually. I am feeling just a bit out of sorts - lack of caffeine and low blood sugar is not a good combo for me. Add in the tail end of the flu and a still fairly compromised respiratory system, and things could get ugly fast. But things click along. Things speed up and the angle increases at distinct intervals. Every few minutes the nurse wraps my arm with the blood pressure sleeve as I try not to fall. God, this is tedious, I think to myself.  Due to all the straps attached, I have to run while holding into the front bar. The whole damn thing feels so awkward and unnatural. Meanwhile as I'm trying to keep my shit together the doctor is chit-chatting with me - talking about Leadville and the peaks he's bagged there, asking me questions that I can barely answer without completely falling flat on my face and becoming one of those pathetic YouTube TM fail videos...This is me, potentially!




So at some point I am gasping for air and the doc says "We'll be cutting things back in a minute" as I fight to keep it together for just one more minute. The TM slows, the angle drops, and I'm walking again. 


As the doctor enters data into the computer he comments, "This is what's called a "negative" test. You're in the top 1% for your sex and age, but given what you do, I'm surprised it's that low."


"Could that possibly be due to still recovering from the flu?" I ask.


"Absolutely. Make sure you tell the cardiologist that when you see him."


I leave, get more blood drawn and make my way home. Still with zero answers. Every test thus far, save the echo, has been negative or normal. Now I have to sit and wait another week for my appointment with the cardiologist. Waiting waiting waiting...


Over the past week I've continued to run. I'm keeping the pace easy. I'm wearing my heart rate monitor (something I rarely do). I'm keeping things at about 10 miles or less. Everything feels just fine. The juxtaposition of my echo results and my empirical experience is just so hard to reconcile.

“You can’t go back and change the beginning, but you can start where you are and change the ending.” ~C.S. Lewis

My date with the cardiologist is on Valentines Day. How appropriate. I get up early since I'm not sleeping well anyway and head out for an easy five miles with the dogs - just in case I'm told I can't run anymore, I want to get this run in. It is early and quiet. I hear a few meadowlarks bringing in a beautiful morning. It's a peaceful, wonderful, soul calming run. I try to take it all in. Just in case. 
“Anyone who has lost something they thought was theirs forever finally comes to realize that nothing really belongs to them.” ~ Paulo Coelho
Anxiously I wait in the small examination room. Dr. Drake knocks and walks in. I stand up, we shake hands and then sit back down. 

He asks, "So, where did this all start? What brought you here?"


"Do you mean, why did I have the echo?"


"Yes."


So I tell him the story: about the past year, possibly two, of coughing, which became more noticeable and bothersome over the past 10ish months. About the inhaler prescribed that seemed to do nothing...about the races and training runs where I had no issues...about the races and training runs where I was wheezing and hacking...the negative pulmonary function tests...the nasal steroids that seemed to help, until they didn't...about the symptoms when they happen...and that the echo was ordered just to "rule out" possible heart issues that might be the cause...I explained that I've never had heart pain or strange feelings...no fatigue...no water retention...and on and on. I tell him that the issues feel like they originate in my sinuses. But then the echo results came back...


We talk more about my running, and I admit that I am not very good at taking recovery time between big races probably because I tend to feel pretty good shortly after - Yes, some general fatigue and soreness, which I always allow time for, but never experiencing weird swelling or other typical issues that many other runners often claim to experience. And, in fact, I have remained uninjured through all of this for many many years.


He then looks at my record: 

"So you quit smoking in 1985 after just a few years of smoking."

"Yeah. College. I still ran though." 

He chuckles.

"How about alcohol?"


"So." I begin. "I think this has been an issue. Once I started looking at what "moderate" means I realized that moderate means a very small amount compared to what I thought it meant. To be honest, I've been thinking about this for several years, and wondering if I might be overdoing it, self-medicating to deal with stress - though that's just a lame excuse - but, yeah. When I actually started thinking about it, I realized that it's not been healthy in any sense - even though everyone around me would call it very moderate."


So, we dig into this some more. For my size, 5'5'' and 110 lbs, going beyond moderate and healthy is surprisingly easy. 


"With women in particular," He notes, "I would say the majority of these cardiomyopathy cases, have an alcohol component. I've had patients who had two glasses of wine a night and had cirrhosis of the liver. The question is: How large are those glasses, or even one glass?"

I joke about all the lame drinking memes out there and how they all just feed into the general acceptance of excess, and most of us don't even question it, or if we do, we fight to dismiss the thought as quickly as it enters our consciousness.

"Well, I've had no alcohol in two weeks, almost 3 really, and I can say one thing: I feel a gazillion times better even though I thought I felt good before - I actually didn't. And it's not just physical, it's psychological I've been working on letting things go and I think not drinking has helps with that as well."


He looks at me hard and asks: "So you just stopped after the echo results?"


"Yes. If this is the wake up call I had to have, then so be it. But I just really hope I can turn it around."


Sometimes a teacher appears, ready to teach you a lesson you may not realize you need to learn, only to come to understand that it's the most important lesson you've learned thus far. You may not welcome the teacher at first, but if you listen closely you will feel the deepest gratitude. Sometimes what can kill you can also save you. At least that's my hope.


He explains that he thinks, but can not be certain as time will tell how things respond, that this can be repaired, fixed, reversed.  He agrees with me that the heart issue is a red herring concerning the cough, and that it does indeed sound like a sinus issue. He explains that addressing the heart damage will take months, not weeks. I will need to be on a medication that blunts the effects of adrenaline on my heart, since in these cases the body sometimes over responds by demanding more of the heart when the heart needs to rest and recover. I need to monitor my blood pressure (which is quite low). And I need to wear my HRM when running and keep things very easy, 70% or below. He suggested no long races or runs for now. After I get settled on the medication, I will be hooked up to HR harness for 24 hours to see how things go during a typical day. After three months I will have another echo to see where things are. Then we will proceed as needed.


He explains: "I do think that alcohol is a factor here, along with possible chronic over-training (meaning that I train a lot over time, not that I over-train at any given time). And the combination may be the issue."


Of course, I want things to happen faster. Three months. Three months is not a lot in grand scheme of things, but still. It means no Boston this year. I was trying to get 10 consecutive years. This pretty much shoots that goal to shit. But, this is my life I'm dealing with. It also means that Miwok 100k is out. Plans to run Behind the Rocks 50k again, also out. 


But, all of this really doesn't matter. What matters is seeing my daughter grow up. What matters is maybe returning to health and running with a new approach to it all. What matters is growing old, I hope, with my husband. What matters is being here for my friends. What matters is the future, the real future, not just the next 3 months or 12 months, or 18 months. I will do anything for that amount of time, or more, if it means being given another chance. 


Now, all of this could amount to nothing. It is still possible that the cause is not what we think and that this is not reversible, and that thought terrifies me. But for now I choose to be hopeful and do everything in my power to give myself the best possible chance at getting my life back.


This Saturday I may cry because I'm not running Black Canyon 100k. On Patriots Day I will most certainly cry, missing what should be my 7th Boston. In May I will have to miss a race I have wanted to run for years. This all really really sucks. But if this is the teacher I need to have appear at this moment and this is the lesson I must learn, I also welcome it. 


To be continued...

Wednesday, February 6, 2019

Cracking My World Wide Open: A Cautionary Tale

"Our life is frittered away by detail. Simplify, simplify." ~ Henry David Thoreau
It's funny how you start noticing things about the world around you that normally go unnoticed or just passed over and dismissed until something changes, and you become almost hypersensitive to that very thing. We live in a culture (the US, mostly) that idolizes "doingness". People love to boast about how much they can get done. How uber busy they are 24/7, go-go-go, do-do-do - getting shit done. This is the hero's journey in modern day America. In 1980s self-help speak, this was often referred to as living as a "human-doing". This is not "being".  We look to others who seem to "do it all" and place them on a pedestal of heroic valour. I constantly see folks on social media boast about how they wake up, off and running - doing all the things - and then crashing into bed and starting all over again the next morning - What matters most is all the doing. All that matters is getting shit done.

We work hard, we play hard, and then we sometimes party hard.


Perhaps I have succumbed to this way of thinking. I have goals and I know I don't have forever, so, it's now or never. But, somewhere along the way, I've become a human doing. Yes, I do enjoy my doings, but, there is more to life that doing and busy-ness.


Add to all the things we "choose" to do, those stresses we don't "choose", specifically, but deal with because we care about others. These are the kinds of stresses that are not really in our control: Concerns about one's children, dealing with an aging parent, etc. We can help, but we can't control the outcome. These "uncontrollable" stresses take the greatest toll of all. And some people have more deal with than others.


And sometimes existential uncertainty, slaps you in your oblivious face, wakes you up, in a cold sweat, and the question dawns on you: "What the F%ck am I doing?"


These things happen slowly, insidiously, over time. You don't even notice all the small steps that you are taking to a place you don't even want to be. Then you are there. You look back and wonder: "Am I living in a Talking Heads song???"


I am here to begin documenting something that I am choosing to share, to not live inside myself and my grief and my fear. This is part journaling and part sharing for the sake of others who may experience similiar things - things that can make someone feel alone, isolated, terrified, confused, defeated, regretful, sad...the list goes on forever.


Here is the beginning of this journey:

For the past year plus (I can't really remember when it all began) I've been dealing with some odd coughing issues, intermittently, usually mid-runs or after runs. It doesn't always happen and there seems to be no weather, season, distance, intensity correlation. In February 2018 I emailed my doctor because I found myself hacking for hours after a few runs and she prescribed me a rescue inhaler: "Sounds like you have exercise induce asthma". This based on no physical exam, or anything beyond that email.

And so things clicked along as I trained hard for The Canyons 100k. The issue was very hard to track or anticipate and I really couldn't tell whether the inhaler helped or not (note: I was also never told how to use the damn thing!!).


I made it through training with some odd but not alarming episodes.  Except for one run, out on the trails where I had to walk for about 3 miles to get things to settle down (that was a first and a bit scary because I was a bit far out for my own comfort), things were manageable. I ran through snow, and ice, and wind, up and down mountains, day after day. My aim for that cycle was to get 12,000-15,000 feet of gain per week, which, I learned, is damn hard during the winter!


I ran Behind the Rocks 50k in Moab: zero breathing issues

I made it through the monsoon of Boston 2018. No coughing. No issues.
Twelve days later I lined up for The Canyons 100k. It's a pretty tough course, with 15,000+ feet of gain and 15,000+ feet of loss. 
And, it kind of scared the shit out of me. I did have some breathing issues, but I managed them and finished the race with the time I needed for my 4th WSER qualifier.



After that I tried to recover so that I would be ready for Leadville 100 training. Did I allow myself enough recovery time? Probably not. I realize, in retrospect, that I was a bit burned out post-Canyons. This would bite me in the ass come July when I really needed to train and just didn't want to.


Go-go-go. Do-do-do.


Life is busy. Work is always there. Family demands are always there - And that right there should be a red flag: family "demands".  In some cases, concerning my not immediate family (mother) the demands are high and thankless. It can drain you dry. Just recently I did the math and realized that for the past 12 years, since my father passed, this has been a major source of uncontrollable stress that causes sleepless nights and anxiety. But what get's lost in the mix of all those "musts" are the things that bring one joy. Going for a hike with my daughter while not being barraged by my buzzing phone in my pocket. Watching a movie at night without people constantly pinging me  - needing me. Always needing me.


A Red Flag Waving: Three weeks ago I sit on the boardwalk at Mission beach, enjoying the biggest soft serve cone on the planet.



We are flying home that afternoon but I am still technically "on vacation". As I sit there enjoying the sights and sounds of the beach, and the warm sun shining on my winter starved skin, my phone keeps buzzing me. I glance at it from time to time. At some point , disgusted, I placed it face down on the step next me. We then get up, hit the arcade one last time, where my daughter finally wins that elusive stuffie from a claw machine on her first try (Yeesh. The trip is now a success :P  ). We return to the car, and head off to a used bookstore before a last museum stop and then the airport. Well, at some point I realize that I do not have my phone. I can't remember where I last had it, and honestly, I've never lost it before (and I travel a lot!). I keep seeing myself slap in, face down, on that concrete step. So, we make our way back to the beach. I have everything on that damn phone so losing it, while not the end of the world, would be a major pain in the tuckus. The phone is not where I left it. Uggggg. I ask at the ice cream stand if someone, by any chance, turned in a phone. The two young women looked at me oddly, then one says, "What does it look like?" Sure enough, they have it. I thank them emphatically. So grateful - but losing it also makes me aware of just how much I am tied to it, and how much stress that relationship-of-sorts costs me every waking hour.


I need to make a change.



******************************************

So, being driven and focused is great. Going after your goals and dreams, is commendable. Living a good life, however, is not just about all the doing-ness in it. It's not all about the accomplishments and the badassery that so many admire and try to emulate.


Sometimes it is better to do less than more.

Sometimes doing less is more.
Sometimes slow is better than fast.

Sometimes doing absolutely nothing, which is something, is better than doing anything else.


So, one way to manage stress, for me, is to run - to be out in nature, by myself, thinking through things and having the mental and physical space I need. This has been my go-to for decades. But when running also becomes a stress, something is seriously out of whack with the Zeitgiest.


So here enters the other insidious side of the "play hard, live large, and party happy along the way" culture I find myself immersed in: Drinking culture.


I've watched, observed, followed, and analyzed the curious juxtaposition of running and drinking (completely unscientific observations over time). It seems that the running population tends to weigh heavily on the hearty drinking side of the scale. We have 'beer runs'. We have 'beer miles'. We have beer after races even if it's only 10 in the morning. We have beer after long training runs. Most running social occasions and most races involve beer. We 'reward' ourselves with a drink. We deserve it. We read all the 'research' that backs up our view that beer (or wine, or pick your drink of choice) is good for us, always in moderation though. That's what we say. We share articles on FB proving that alcohol is in fact (it's a FACT, really!!) not only okay but good. And we cheer on the guy running 100 miles chugging a beer at every aid station.


Running and beer. Beer and running. They seem to just go together.




Group runs end at pubs.

Races end with beer.
Long training days - yeah, more beer.
A stressful day: God, I just need a glass of wine or a beer.
A good day: Have a beer to celebrate...etc.

We share the jokes:



And laugh it off. We share it all over the interwebs. Our friends cheer and chuckle. We encourage each other.

And one day becomes the next. It's just a glass here, and there, and then again, why not tonight - and, uggg, that call with mom has me ready to scream... I want to shut out the world and relax, for just a couple hours. Turn off my damn brain. Stop the stress.


The ultrarunning community tends to come down on two very opposite ends of the drinking spectrum: Those who are "sober" (usually former addicts) who have channeled their addictive personalities into running, and those who proudly share their excesses in both drinking and running. They "run to drink".  Most live upstanding lives - work, family, hard running, etc.  A lot of us believe that running allows us to  get away with sins that would kill our sedentary friends.


Well, it ain't so. 



***************************************************

A Cautionary Tale: Where is this all taking me? Well, it has, I believe, taken me to a very scary place. A place I would love to help others avoid. If I can share my story, maybe it will help wake others up before it happens to them.

Last week, as I fought off the flu, I had to go in for an electrocardiogram to rule out a cardiac cause for my ongoing coughing issues. Note: I am pretty functional. I ran a 100 miles in brutal conditions (with a PR) in November with minimal coughing. I've been training for the Black Canyon 100k since the end of November (again, was that adequate recovery???. Probably not!). I've had a couple pulmonary function tests and they have shown nothing. Well, the echo results, as the terrifying email reported, were "not good" per my doctor: "reduced cardiac function". This is called "heart failure". Yes. Heart fucking failure. Now, to be honest, that sounds a lot worse than it is, at least for now, but it is very serious stuff!
 It's also given the general name "cardiomyopathy". Google that and you will start to shake and cry and nash your teeth at the curses that the gods have bestowed on you. Your life will change in an instant and none of it will make any sense. You do not experience shortness of breath and decreases exercise tolerance. You do not experience leg and foot swelling. You do not experience any of the symptoms of heart failure, and yet...here you are. The organ you both value above all others and the organ you take for granted day in and day out, is not doing well. You receive the most jarring and unwelcome wake up call you can fathom.

The question is: Will this be what I need to save my own life? Or is it too late? Or, is this just bad luck and it's all out of my control?


There is such a thing are cardiac fatigue, but this is still a subject of much speculation. I do not have "athlete's heart". That could be good or bad. Who knows yet. But I am convinced that stress is killing me - I remember screaming this at my mother a year ago. She dismissed it as histrionics. I'm done with that. I'm a worrier - I need to learn how to let things go - that's in progress. AND I have been "self-medicating" via alcohol. I don't drink a lot, but it's too much. I've known this for a while but when you are entirely functional and dealing with life, it's easy to keep dismissing that little voice saying that something isn't right here. The truth is that "moderate" drinking, especially for women, amounts to much less than most actually drink. For a woman, cardiac alcohol toxicity is shockingly low. One pint of IPA (usually a higher alcohol %) is about a third to a half of a small woman's weekly allotment in the "moderate" zone.




Obviously we all need to make these choices for ourselves. It never occurred to me that I might be killing myself with my seemingly moderate consumption. My increasing reliance on it for "relaxation" was actually the most concerning for me - but had I looked a little deeper, I would have probably listened to that little voice sooner.




So, I still have many tests ahead of me. I had to pull out of Black Canyon 100k since the chance of dying right now is a bit high on the risk scale for me, and for now my running future is very up in the air, never mind my very life. I am still allowed to run. But I am choosing to take some non-structured time. If I feel like running, I run. I run as far as I want to, up to 10 miles which my doctor agrees is okay "for me". I am letting things go, or trying to. I am setting boundaries at work. I am trying to re-cultivate some of the things I enjoy that I've missed through all my driven busy-ness these past ten years. 
And, I have decided to stop drinking completely for some time to come. Perhaps for good. I don't know yet. 

I pray that my heart can be healed, can recover, and that I can return to the running I love. Our heart is the most important muscle in our body, and yet we treat our quads and hamstrings with much greater regard and concern and care. We feel them. When they are sore we rub them and rest them. But we don't feel the soreness in our hearts - we don't give them massages and warm baths. When we sleep, our hearts keep working. They never stop, until they do. Only then are they noticed.

I am sharing this only because I feel that I am not so unusual. I am like so many out there. We rarely learn from the experiences of others, but perhaps someone out there, who feels as I do, or did, will take heart and change course before it's too late.


Time will tell how this goes. My number one desire it to stay alive for as long as possible for my daughter. If it weren't for her, I believe I would feel differently about things.


To be continued - I hope...

Tunnel Hill 100: Living as if Living Matters

I wanted to title this "Running After Heart Failure".  I like the ambiguous way it can be read.  However, I can be superstitious,...