Adventures in hypoxemia

 I'll be honest. I thought getting back on my bike was going to be a more joyful experience than it's been. On Monday I set out for a four-hour ride that felt wonderful, at first. But as the miles wore on, I slipped into indifference, which deteriorated further into a dark mood not unlike despondency. I was pretty bummed out. Why? I had no idea. The ride had gone reasonably well. I wasn't particularly strong, but I didn't struggle, either. My hand didn't hurt at all. My breathing was steady and the faucet in my face turned down a few notches even though I've been off antihistamines since last Wednesday. It was a beautiful if slightly warm day, and my route was full of new and beautiful scenery. So what was wrong?

Shortly after returning home, I checked the measurements on our pulse oximeter. My blood oxygen saturation was at 88 percent, with a recovery heart rate of 115. After just a few more minutes that number rose to 90 percent, and within a half hour it was back at my more typical resting measurement, 94 percent. My mood had vastly improved as well.

 In general, blood oxygen levels below 90 percent are considered low. During exercise, dips below 90 percent can indicate a maxed-out effort, which is typically what forces people to slow or stop because they're "out of breath." I've experienced this, but I also seem to be adapting to lower oxygen levels. Now I wonder how much time I'm spending in the 80s, without realizing it. I don't feel great but I also don't feel terrible, so I keep going. But it can't be good. Less oxygen is never good.

After the weird bike ride, I set out today to test my blood oxygen levels during a six-mile run to Bear Peak. I realize this is an unscientific experiment, but I thought it would be interesting to compare the numbers to how I felt:

I checked the oximeter ten or eleven times during the run, and took photos of the readings. For some reason a dark strip obscured the screen in most of the photos. I'm not sure why. So I'm only posting the photos where I remember the numbers. This is from mile 1.5. Oxygen saturation was 89 percent, heart rate in the 150s. For the most part, I felt fine.

 This was the lowest reading I saw, and only briefly, about halfway through the steep climb. Mile 2.8. Oxygen saturation 86 percent. I was beginning to feel dizzy and would have stopped soon to catch my breath anyway. I don't remember my heart rate at the time.

 At Bear Peak, after resting for about two minutes. Mile 3. Oxygen saturation 92 percent, heart rate 136.

Shortly after returning home from the six-mile run. Again, I felt a bit down in the dumps immediately afterward. But this run was only 90 minutes long, so time spent at low oxygen levels was minimal. I perked up quickly. (A cold soda helped.)

Blood oxygen saturation is typically lower at high altitudes, so my resting readings of 94-96 percent are right around normal. Still, I worry about those dips during exercise. Operating at lower blood oxygen may be harmful to my organs and brain. But I'm already working at what I consider moderate intensities. My heart rate would indicate this as well. If I go much easier, I'll have to give up cycling and hill-climbing altogether. Maybe become one of those Nordic walkers clicking along a flat bike path with trekking poles.

Anyway, I am going to see an asthma doctor on Wednesday. Since I recently moved, I'm basically back to square one in regard to testing for allergies and lung function, then moving forward from there. I suspect these tests will check out as normal, as I don't have issues while resting. Exercise still seems to be where most of my breathing difficulties arise. So it may take a while to weed out all of the potential causes for shortness of breath and find any real solution. It does bum me out to realize that I can't be "happy" while exercising because I'm running low on oxygen. And it bums me out more to wonder whether hard efforts might have long-term health implications, and thus become something that I need to avoid.

In the short term, I'm considering working on breathing techniques to maximize my oxygen intake and CO2 exhalation. A combination of altitude, allergies, and past respiratory illnesses may all play a role in my problem. I feel like I did well when I was using a daily maintenance inhaler (I haven't since April), so I'll bring that up with my new doctor. I'm also looking forward to the departure of grass pollen and other allergens that are clogging up my sinuses to such a degree that I haven't had a sense of smell since early June.

On a positive note, after four months off a bike, I was able to ride for four hours on Monday and my butt didn't hurt one bit! It's my one superpower — iron butt — but it rarely lets me down. I'll get this breathing thing figured out. I may start posting about it more often, mainly because it's helpful to have that record to refer back. 

Not-so-triumphant return

On Monday morning, I pumped up two completely flat tires, added lube to the dusty chain, tightened the stem, installed pedals, and sat on a bike saddle for the first time in four months. Although tentative as I rolled out from my driveway, a smile spread across my face as I coasted down the first hill. I was riding my bicycle. It's a simple but fathomless joy that I think only cyclists and 6-year-olds understand.

The smile admittedly faded some as I ground the pedals up a three-mile climb, with dust swirling in the hot wind and my underdeveloped quads straining under the workload. My right hand only recently became useful again, so my whole arm all the way to the shoulder is significantly weaker than the other. I've improved my grip with hand exercises, but that doesn't do much for biceps and triceps, which were burning by the time I reached the next descent.

My hand surgeon said I should be able to start riding again six weeks after surgery, and so July 18 was the date I'd been looking forward to since June. She told me to stick to flat pavement at first, but there's only a few miles of pavement close to home, and absolutely nothing is flat. Still, the gravel road climb went okay, and my grin returned on the second descent.

"I can probably ride a few miles out the trail."

The Homestead Trail is actually just an old doubletrack with a few eroded ruts, but for the most part it's smooth, evenly graded, and as non-technical as a "trail" can possibly be. I took that "yay bikes" selfie on the climb, and started downhill feeling rather pleased with the comeback ride. My wrist didn't hurt at all, there was no numbness, and I'd received the best confirmation that surgery worked. I was healed!

Old habits returned and I accelerated quickly on the descent, eyes wide and grin spreading when suddenly the bike flipped end-over-end. I still don't know why I crashed. There was nothing on the trail to hit. My best guess is that my brain hasn't adjusted to my arm strength imbalance, and I made some tweaky move with the steering that launched me over the handlebars. Or I'm just woefully out of practice. Whatever the reason, I was crumpled beneath my bicycle and struggling with my stupid bad arm to lift the damn thing off myself. Just like that, all of my joy flipped a complete 180 to crushing bewilderment.

This was one of those stories I wasn't going to tell anyone, because it was such a devastating emotional blow at the time. I had to tell Beat because my arm was torn up with new trail rash and there were several new bruises to add to the patchwork across my legs. But I didn't want to admit this to anyone else. I've had an inordinate number of running crashes in the past few months, and then there was the return of breathing difficulties, and now that I can finally ride a bike again, well, I can't even do that right. I pretty much suck at everything. Why do I suck at everything? I sat on the dirt for several minutes, crying and berating myself. I knew this was childish and unreasonable, but sometimes it's better to just let it all out, especially when there's no one else around to witness embarrassing meltdowns. Physical pain does help release the emotional stuff.

Now that it's five days later, I do feel better about it. I haven't gained much confidence, but I realize it's not going to come back instantaneously. Four months is a long time, especially since my last cycling experiences were in Alaska, and now that I think about it, my last dirt ride also ended in a crash (when the front rack came down on top of the wheel one week before the Iditarod.) I took the mountain bike out again on Wednesday and stuck more closely to pavement — specifically, the climb up Flagstaff Road. With 2,000 feet of climbing in 4.5 miles, Flagstaff closely resembles the profile of another road I used to ride regularly in California, Montebello. Flagstaff does differ in that it's more gradual at the bottom and becomes unconscionably steep for the most of the last 1.5 miles, but I figured it was a good place to compare performances. Well ... I don't really want to talk about that either. It was a little pathetic. There were some low-oxygen dizzy moments. Temperatures were in the low 90s and my face was oozing because I'm off antihistamines ahead of another skin allergy test next week. But I did it, and I didn't put a foot down. It's got to get better, right?

After Wednesday I needed a break from the ego bruising (plus my shoulder and arm are quite sore), so I've been running since then. I will get back on a bike soon enough. The universe approves, as evidenced by this double rainbow over our backyard.

South Boulder Peak, perfectly framed by the rainbows. I love afternoon thunderstorms — as long as I'm somewhere safe while they're happening — so I'm enjoying the arrival of monsoon season.

On Friday I traveled down to Colorado Springs to give a short talk about winter bikepacking during a "Bikepacking 101" event at Cafe Velo. My friend Dave Nice planned the event, and there was a great turnout. It was fun to chat with folks about cycling in Alaska, a subject of which I never tire. Several folks came up afterward and said they enjoyed hearing me talk about it so exuberantly, even though to them it sounded grueling and horrible. People have said this to me in the past. I once gave a video interview for an exercise science course at Stanford, and still hear from the instructor about how much her students love the segment. Joy is infectious. It's what sustains me when I'm down on myself for clumsiness and wheezing, counting the days until winter.

Anyway, since I was driving all the way to Colorado Springs but didn't have much extra time, I figured I should check out the iconic Manitou Incline. The incline is an old cable car track with the rail ties still in place, forming a staircase that gains 1,900 feet in 0.8 miles. I was not all that impressed with the steepness because in Boulder we have rocky trails that are just as steep (Fern Canyon), and most photos I've seen of the Incline were not that interesting. Still, when in Colorado Springs ... it seemed like one of those things I had to try once. I had to sit in Denver I-25 traffic and then pay ten dollars for parking in Manitou Springs, which made me grumpy. But all of that melted away once I started marching up the steps.

View from the top — actually, it was quite scenic and I was surprised. The climb was fun as well. Some of the steps are knee-high, but for the most part the steep ascent is evenly graded, which assists in steady breathing and focused forward motion. I took it fairly easy and stopped to take a couple of photos, but this would be a fun spot to return for PRs. Too bad I live two hours away.

Let's see how I can embarrass myself this week. It can only get better, right?

Hard as rock

 This past weekend, Beat and I traveled to Silverton for his third running of the Hardrock Hundred Endurance Run. This hundred-mile loop through the San Juan Mountains is particularly revered in ultrarunning culture for its "wild and tough" reputation, and also the family-like community that has formed around the annual event. Thanks to its desirability, Hardrock has a small army of volunteers to put together a race where runners enjoy extensive support and five-star service at aid stations that are only accessible on foot. But even more than that, Hardrock and its mountains have an ethereal quality that draws people back year after year, and makes it so appealing that the odds of getting through the lottery as a first-time applicant now border on hitting it big in Vegas.

 It was difficult to gauge how excited Beat was for Hardrock this year. He's had a somewhat rough few months of training, adapting to a new climate and altitude along with the demands of a new house and job. With his annual Alps 200-mile double-header coming up in six weeks, he grumbled about putting together the speed for a "sprint" race like Hardrock — mostly a joke, but with an element of truth. I imagined he'd put it together anyway, as Beat doesn't often fail — actually, I don't recall him failing even once in the six years I've known him. Even so, he was nervous after coming down with the stomach flu a week ago, with residual gut issues that were still bothering him the night before the race.

I was looking forward to crewing Beat and supporting other friends in Hardrock, which is a fun crowd to hang out with and a beautiful place to spend a few days. Still, I have my own health and fitness issues right now that are causing angst, which only amplifies when I'm around this environment. When greeted by friends who I mainly see at ultras, I always received two questions: "What are you training for right now?" and "Are you pacing Beat?" I'm not training for anything technically because the only event on my calendar is the 2017 ITI, and I'm not even back on a bike yet following hand surgery. And I'm not pacing Beat because I can't keep up. Really. Even for 10 miles at Beat's 100-mile pace. Don't tell me, "You can do it." I can't. Really.

Why can't I keep up? Because I can't breathe. I need to slow or stop after I become winded when my heart rate spikes into the low 150s, which is terribly frustrating because just two years ago I was running full 50Ks with an average heart rate of 162. So basically I'm in Zone 3, barely working my cardiovascular system, but I still can't breathe. Pushing harder doesn't improve my fitness — I actually think it's made things worse. But my endurance is still good so I no longer enjoy the satisfaction of tired muscles or fatigue, because really the only things getting much of a workout are my lungs. This is frustrating. I'm working on figuring it out — allergies and asthma are likely to blame. But for now I don't really know, so there's angst.

 Anyway, even with my pathetic fitness, I could still crew for Beat and squeeze in a few beautiful hikes in the San Juans. After the pre-race stuff on Thursday afternoon, I had four hours to kill before dinner, so I went for a quick jaunt up Kendall Mountain, a 13,000-foot peak above Silverton. Because of the time constraints, I put in a solid effort, scrambled the final 400 feet to the summit, and still made it back only seven minutes late. I was feeling pretty good about myself until I compared my time to my previous outing on this 12-mile "run" in 2012, when I was a full 38 minutes faster. Damn you, Strava.

 Crewing for a race like Hardrock is demanding, even though I was only planning to hit four of the five allowed aid stations. While runners traverse rugged trails, support crews without adequate off-road vehicles or driving skills are required to drive for two and a half hours all the way around the mountain range just to bridge two places that are 27 miles apart. Between the travel and the supply replenishing and the waiting, it's difficult to find time to eat or sleep. But I always make time for adventures. In Telluride, I hoped to hit the trail early and hike backward on the course so I could watch race leaders descend into town. As a hopelessly awkward person, I view the flowing strides of talented mountain runners as a dance, as beautiful as any human movement. However, the course into Telluride followed a different route than it did in 2012, and I didn't realize it until I'd hiked for more than an hour to the top of Bridal Veil Falls. This was very disappointing, but not enough to turn around.

 Instead I hiked toward Black Bear Pass, which turned out to be a rugged but heavily used jeep road. Stepping off the road for a steady stream of rented Rubicons, breathing their dust and finally just venturing overland to avoid them, put me in an admittedly bad mood. This all culminated after I turned around and had one jeep shadow me for almost an hour — nearly three miles — as I hiked downhill. I kept looking over my shoulder so I could step off the road to let them by, but they weren't moving any faster. Yes, it was a steep and rocky route and they probably weren't experienced off-road drivers, but still. Three miles an hour. I would probably go nuts if forced to sit in a vehicle moving that slowly.

 At least Telluride was a fun aid station. I sat on the grass with a group of friends and had a nice picnic with some of Beat's snack food and Perrier. Beat came into the aid station on schedule and looking strong, but said his stomach was already bothering him quite a bit. I anticipated a long night of force-feeding him chicken noodle soup, and got the stove ready at the next stop in Ouray, which Beat hit just before dark. He was still doing well — at least he wasn't yet barfing like he was in 2012, but continued to feel nauseated and unable to eat. I heated up coffee at a picnic table as an attentive volunteer came over to take orders, then brought several plates of food. When I praised the aid station service, he urged me to leave a positive review on Yelp. Hardrock is an awesome event.

 After Ouray I caught an hour and a half of sleep in our tent/homeless encampment in Silverton before I woke up in a panic, unable to breathe. This was actually my first experience with shortness of breath while sleeping, and it was a little scary. The inhaler does help quite a bit in these cases, which leads me to believe more and more that I am dealing with chronic asthma that may be worsening.

The drive out to Grouse Gulch is unfun, as I really dislike piloting a vehicle on narrow roads with dropoffs, ruts, and rocks. I decided that if Beat ever races Hardock again, I will bring a mountain bike and make it my personal challenge to reach the aid stations before him — although I wouldn't be able to carry a cooler on my bike. The temperature was in the mid-30s and there was a strong breeze, so I put on puffy pants and made all of the other crewpeople jealous. Beat came in around 4 a.m. looking pale, and I tried to coax him to eat soup and quesadillas. This photo is my friend Steve arriving with his pacer, Harry, around 7 a.m. He was having breathing problems, so I loaned him my inhaler. After the breathless episode while sleeping, I felt nervous about parting with it, but I really hoped it would save his race. Unfortunately, his breathing problems became worse and he decided it would be unsafe to go beyond the next aid station. This was a smart decision.

 After my California friends left, I spent a few hours languishing at Grouse Gulch while debating whether to hike to Handies Peak. My breathing was getting worse, I didn't have an inhaler, and with the limited sleep and lack of real food, I was feeling pretty lousy. Ultimately I decided not to go, and instead watched the back-of-packers leave the aid station close to the cutoff. It is inspiring to witness the determination and grit of the Hardrockers.

 I swung over to the final aid station, Cunningham Gulch, where I still had quite a few hours to kill. I decided I could hike slowly up the gulch toward an area called Highland Mary Lakes. My breathing was rough, and I didn't have the inhaler which made me anxious, but this was a fantastic place to visit. Pretty quickly this trail takes you into the high alpine, where one can traverse any number of high ridges along sparkling blue lakes with stunning views of the Grenadier Range.

 I hiked to a high point and sat for a while, enjoying the breeze at 12,600 feet. This year was the hottest Hardrock on record, and temperatures in the 80s can feel downright blistering at these altitudes. I remain amazed at all the folks who completed the race this year. I think managing heat issues for this distance is much more difficult than cold weather and rain (I am basing this opinion on my experience last year at UTMB, when temperatures hit 36C.) However, no one missed the lightning storms.

 Beat arrived in Silverton just after 3 a.m. Sunday morning., after nearly two days of nonstop traveling. He actually looked pretty fresh.

Kissing the hardrock is part of the tradition — rituals like these are another aspect of Hardrock that make it more of a community than other events. Proud of him!