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.