Rollins Pass

 It's been a bad week for breathing. Just about on cue after I had allergy testing done last week, the weather service released day after day of allergy alerts, warning of very high levels of grass pollen. Of course I don't know how closely related my breathing difficulties are to my allergies, but despite new medications, it's been a low-functioning week. Two miles into a bike ride on Saturday, I experienced something close to an asthma attack and cut it short. The same happened two miles into a run on Sunday. This was after turning down invitations for fun mountain adventures because I didn't think I could handle anything more than a four-mile run (turns out I couldn't.) Who am I becoming?

The emergency inhaler helps temper the urgency I feel when I over-exert myself. But it doesn't quite open up my breathing. I still have that tight, breathing-through-a-straw sensation to a certain degree, and I don't seem to process the oxygen needed for even moderate aerobic efforts. If I become dizzy once, it's difficult to recover. When I speak of over-exerting myself, I basically mean exerting myself. Walking is fine. Running has mixed reactions. Biking, for which I'm out of shape and can't regulate my efforts as well, has been the most messy.

Although I feel somewhat assured that my rapidly declining fitness is linked to allergies that I am both working to treat and waiting to go away, I can't be certain. Lately, being outside leads to feeling bad, which is a strong de-motivator to engage in activities I love. It's a little scary, to be honest, and may have resulted in some crying in the shower after a horribly failed Sunday run. But there's also some acceptance about making it work if this is my new status quo. I realize that unless I feel a real risk of passing out (not usually), I can still muddle along in the outdoors.

 There's a long jeep road to Rollins Pass that I've looked forward to riding for months now. It's one of the few places nearby where one can ride a bike on dirt over the Continental Divide. Although I'd previously visited Rollins Pass on foot, I relished the beautiful views and was excited to return. Since there was some improvement to my breathing on Monday and Tuesday, I took an opportunity on Wednesday to take my long-neglected mountain bike on a tour.

 The road to Rollins Pass is winding and gradual, but also quite chunky. Finessing around all those rocks keeps speeds low, which also keeps exertion down. It's a pretty good route for an asthmatic person who's just getting back into biking after four months. The long, long railroad grade eventually climbed to a railroad tunnel that had partially collapsed. There was a nice trail around it to the left, which I didn't discover until I returned. Instead, I hoisted my bike up the slope to the right, where the descent was actually a bit gnarly. It involved skittering down on very steep, loose dirt, wedging my shoe against a rock for leverage and then nudging the overturned bike downward. There was an unnerving drop-off just a few feet away.

 From there, the track continued climbing up large chunks of loose gravel, which had the effect of riding on rollers that continually spun me backward. I walked most of this to avoid hitting the red line, but it was still hard. I'd taken a few breath-catching breaks earlier in the ride, but my breathing actually opened up as I climbed above timber line. Riding this ridge at 11,700 feet, I continued to feel stronger — even risking those deep, lung-filling breaths, which felt amazing. Perhaps all I need is more of this clear, thin, relatively pollen-free mountain air.

 Return on the old railroad trestles. I love old mining roads and mountain railroad grades. Maybe I'll make a future project out of touring a winding network of these roads across Colorado.

 The perfectly nice trail around the tunnel, which I missed the first time. This short piece of singletrack renewed interest in riding Colorado Trail. But no, I don't love rocky technical riding or mountain hike-a-bike (especially the downhill variety.) I would like to hike the Colorado Trail someday, though. Maybe fast-pack style if I ever get my fitness back.

The tunnel as seen from below. The descent down the eastern side Rollins Pass is tedious — a continuous grade perfect for coasting at about eight or nine miles per hour, but rocky enough that you can never really open it up. So basically I sat on a bike not pedaling for ninety minutes, while trying to protect my still-tender hands, arms, and shoulders, but taking a bit of a beating despite my best efforts. Not unlike riding a slow-moving jackhammer. I'm sure better riders blast down that road without fear of hitting a rock at the wrong angle or skidding out on the chunder, but I am not really there right now (nor do I think I ever was.)

Still, I enjoyed this ride and think I should do more of this, rather than fret about whether I'll ever be fit enough to race again. 

More on being allergic to summer

Beat's hummingbirds. There's so many that we've been going through 1.5+ liters of sugar water per day.

 The asthma doctor had great reviews and seemed very nice, but I could tell that he wasn't necessarily going to be sympathetic to my cause. He worked through the usual questions, but a slight frown appeared on his face as I explained my "problem."

"I just get winded so easily. Sometimes while walking up my stairs at home, I have to slow because my breathing feels so constricted that I become dizzy. I do twenty-mile runs, feeling like I can barely breathe for most of the time, holding back so I don't have an attack. Yet I don't feel tired or sore after I stop moving, so there's no indication that I'm overdoing it. I use my emergency inhaler at least once for most of my workouts. I think it does help. It was never like this a year and a half ago. Not before I had pneumonia last summer."

"You do twenty-mile runs?" he asked.

"Well, yes," I said. "I just have a lot of trouble with more intense exercise. Even moderate intensity. I really start to feel bad."

I could only guess what the doctor was thinking. Clearly I'm still capable of doing things that 95 percent of the population doesn't do, and that no one really needs to do, so what's the problem? A lung function test showed my lungs are operating at 102 percent of the average for someone my age and weight. A chest X-Ray turned up normal. My resting heart rate is high (78! High 70s are what I've seen a few mornings in a row when I checked first thing. In California, my resting heart rate was always in the high 50s / low 60s.) But my blood pressure is good.

I got the sense that I might get shoed away with only a renewed emergency inhaler prescription, but I pressed for a skin test by expressing interest in starting allergy shots after I return from Europe in September. I had one done last October in California, which was informative but somewhat unremarkable. This Colorado-based test was impressive enough that the nurse demanded my phone so she could take a picture.

Those middle rows pretty much say "grass is poison to you." The rest can be translated as "You're mostly okay with indoor allergens such as mildew and dust mites. You could languish away in a moldy basement for the rest of your life and be fine, but don't go outside!"

Anyway, the doctor agrees that I'm a likely candidate for allergic asthma that's mainly induced when I am exercising outdoors. He said it would be a good idea if I returned to using the maintenance inhaler I used from February to April, as well as a steroid nasal spray for my very bad nasal congestion. I'm glad to try these treatments as I believe they will help me feel better when exercising, although of course there are still many unknowns. I may not have asthma. For several reasons I hope I do, because although asthma can be a life-long disease, it is also treatable. What isn't necessarily treatable are birth defects like a patent foramen ovale (a hole in the heart, which one blog reader told me may effect as much as 20 percent of the American population, but who often experience no symptoms until they go to high altitudes, to which they'll never adapt), as well as lung scarring and other obstructions that can't be detected by an X-Ray (although my lung function is good.)

So ... there is hope! I recognize that I am quantifiably healthy and can't complain too much about this condition. Right now I am optimistic about medication, still looking into allergy shots, and also moving toward acceptance of working with whatever fitness I have if these treatments don't help. I also remain optimistic that mostly what I need is for summer to go away, and I'll quickly build strength the way I did last fall and winter (with relapses into asthma symptoms that I believe were directly related to respiratory illness.) There's still time to launch into "training season."

The plan is to get back on the bike tomorrow. Honestly I'm a bit scared of my bike right now — not only because of the weak arm/steering issue, but because you can't hide from more intense efforts on a bike. Running, you can always slow to a plodding walk if you need to, but keeping a bike upright on a steep hill requires a minimum of effort, even with a granny gear. It seems this minimum of effort puts me in the hypoxia cave. But yes, back on a bike tomorrow and most likely a long run into the high country this weekend.

I'm excited! Even if I am starting to think of summer the way other people view winter — an uncomfortable time to be endured until friendlier weather returns.

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.