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. 

Another week

I stopped posting my weekly training logs at the end of December, after deciding that they were more demoralizing than motivating, and "training" was probably hurting more than it was helping. I'm still getting out 15+ hours each week, lifting twice a week, and generally doing what I was doing before. And ever since the Fat Pursuit, I've felt progressively better. I still have occasional battles with shallow breathing, and realized that I might be overcompensating by taking it too easy. For the most part, thought, things have been going well.

A long-time blog reader recently contacted me about my "Running on 3 Cylinders" post, and completed the car analogy. I laughed at his observations:

"A car analogy is apt since we humans are a thermodynamic (a heat engine) — funny, we convert our fuel about just as efficiently. Going on with the car theme, a gasoline engine needs three things in the right amount and at the right time for oxidation (combustion) to take place (spark, fuel, and air) since you have plenty of spark (that’s kinda of understatement) and it seems plenty of fuel (Sour Patch Kids comes to mind) your oxygen intake is constricted as you have documented. So I think you're firing on all cylinders but just running low on HP (like a restricter plate in Nascar.) Your torque curve is still awesome (anaerobic muscle contraction.) Your aerobic respiration threshold is probably lower in your power curve for the time being, but training at altitude can increase your VO2 Max."

Anyway, it's been a great week of low-horsepower non-training. On Monday I was still in Fairbanks and trying to catch up on some work, so I went for a lunchtime run. My friends live at 1,500 feet, where the temperature was 5 above zero. I set out wearing a single layer — luckily packing several more — and descended 800 feet into the Goldstream Valley. After about a mile on the lower trail, my legs and shoulders went numb. "Maybe it's not 5 degrees down here," I thought. Actually, it was -15. This photo happened after I put on more layers, than loped along for two more hours. Toward the end of an attempted loop, I failed to find a trail connection and decided to "shortcut" back to the road. Turns out waist-deep snow is no shortcut. It took about twenty minutes of lunging like a seal before I swam to safety. Note to self: This is even more difficult with a bike.

On Wednesday I was back in Boulder and submerged in a weather pattern I'm told is very atypical for the Front Range — as in once-in-a-decade atypical. Heavy inversion with fog and freezing rain, with temps dropping into the teens in the valley and soaring into the 40s above 9,000 feet.

I set out for a mountain bike ride and ended up at 8,000 feet on Sugarloaf Road around 4 p.m., where temperatures were in the low 20s and it was raining. Actually raining. It was a light, misty rain, but it froze to everything it touched, including me. That 3,000-foot descent on black ice was a sphincter-clencher, even with studded tires, and I was so very very cold. I could have brought more layers, but what do you even wear for freezing rain? I just gritted my teeth and bore it.

The freezing fog did make for some beautiful scenery. It was still hanging around on Thursday when Beat and I went running at Walker Ranch. The temperature was about 15 and there was light misting ice in the air. 

I wore Icebug shoes, which have built-in carbide studs on the soles. I learned too late that they weren't going to cut it on hard ice, which covers at least 60 percent of the Walker Ranch trail right now. Despite being careful, I still skidded on a steep descent and fell hard onto my right knee and shoulder. It was incredibly painful, and I writhed on the ground for three or four minutes while calling out Beat's name — although he was too far ahead to hear me. After I pulled myself up, I continued to wobble in place until a deepening chill forced my hand, and I was able to limp out without incident. The knee was swollen, but the brunt of the impact happened below the joint, where a big goose-egg bruise formed. It hurt, but at least I wasn't injured.

By Friday the fog cleared out and temps warmed up substantially. Yes, I was disappointed.

Riding Friday and Saturday on ice, slush, and mud.

On Sunday, Beat and I went snowshoeing on Niwot Ridge. Beat towed his heavy sled and broke trail. As usual, I just tried to keep up.

The wind was incredible — gusting to at least 50 mph on the ridge. It was strong enough to push me backward on the snow crust as I flailed and fought to retain forward motion. Breathing proved difficult — the headwind seemed to rip the breath from my lungs, and I had one episode where I couldn't stop gasping. Then I started crying, because this kind of thing scares me, every time. This was always my fear during the Iditarod last year, because these episodes appear to be self-perpetuating, and strong winds make it hard to control anything.

Later, when I turned my back to the wind and lowered my head to buffer the blast, this particularly strong gust tore the sunglasses right off my face and whisked them into oblivion. #$&! you, West Wind.

Still, it was a useful outing — particularly for Beat, who had an excellent quad workout, and learned that he doesn't like flexible poles. I gained more insight into my breathing episodes with a hope that I'll better learn to control them (avoiding the shallow breathing and hyperventilating.)

It's interesting approaching this year's Iditarod. I have all of the same fears, and more, now that I have a slightly better idea what I might face out there. Still, I can't wait to be out there.

This disappearing world

I've had a bout of writer's block lately. The kind where I stare at a blank screen for twenty minutes before relenting to Twitter browsing, and repeat. The main problem, I think, its that I'm a hopeless news junkie. Lately my morning coffee reading has left me with malaise bordering on despair. What do I do that matters? Nothing. What do any of us do that matters? We're just digging deeper holes. Well, you see where I'm at. It's that existential despair that all of us battle, with varying degrees of optimism and denial and faith. And it's not like this every minute of the day. I'm happy where I'm at and generally excited about the future. But the trepidation remains.

 I was in a rut and I wanted to get away. When my friend Corrine mentioned she had Cache Mountain cabin reserved for the last weekend in January, the wanderlust began churning. Beat and I skipped the Christmas training trip for good reason. Could I justify an admittedly frivolous trip one month later? Still, my Iditarod training hasn't been going particularly well, and my confidence has been similarly smothered. One short trip in similar conditions as the Iditarod — altitude, climate, and terrain — would help me understand my readiness one way or the other. And three days in the wilderness with no electricity or cell phone reception or access to the Internet? It wasn't long enough, but I believed a forced information blackout was necessary.

 On Friday, we set out from the Steese Highway on a "quick" route to the White Mountains. The Whites are a small mountain range, stunning in their own way, about 30 miles north of Fairbanks. The summits climb to 4,000 feet, the hillsides are peppered with spindly spruce trees and alder, and the creeks are flanked with limestone spires. I think the White Mountains are one of Alaska's best-kept secrets — managed by the BLM, the area's restrictions are few, wilderness is expansive, and a relatively well-kept network of winter trails travels to recreational cabins. It's one of my favorite places in the world. Why do I love the White Mountains so much? Sometimes I wonder.

 Corrine skied and I borrowed her bike. Although I wavered on taking the sled and hiking, I decided that biking and bike-pushing would be more appropriate testing/training for the Iditarod. Indeed, the trail was steep with a soft base and wind-drifts. In twenty miles there was more than 3,000 feet of climbing, which is light for a Boulder recreational ride, but pretty steep with a loaded fat bike on snow. The soft base meant I could grind along at a maximum effort and 3 psi in the tires, but it was nearly as fast and a lot less effort to walk. Over the course of the trip I pushed probably 80 percent of the time and 60 percent of the distance, and a moving average of 3.5 mph made a 64-mile, three-day weekend feel like a tough effort. Of course, I loved every second of it.

 Cache Mountain cabin is nestled in the shadow of its namesake mountain, from which flow narrow drainages with cool names like Brachiopod Gulch. This cabin was nicely equipped with a shed full of firewood, many pots for melting snow, an ax, a saw, wooden bunk beds, and a propane lantern for which a previous occupant left a can of propane. We basked in faintly foul-smelling light and slept like logs on the hard wooden bunks (well, I did at least.) I read through the entire cabin log and a book titled "Welcome to the Goddamn Ice Cube," which I didn't love. We ate bland Mountain House meals, talked about adventures and life, and for the most part left politics out of it.

 With two nights at the cabin, we had a free day on Saturday to travel unloaded to Cache Mountain Divide.

 It was a beautiful morning, about 5 degrees above zero, with a patchwork of clouds and subdued sunlight. Having visited Fairbanks in December, March and June — I was surprised by the extent of both daylight and darkness. There's a lot of light compared to just a month earlier, but the night still spreads across 15 hours, opening views of faint Northern Lights behind the patchy clouds.

 The "ride" to Cache Mountain Divide was strange — I stumbled along, taking about five hours to cover 11 miles, and in all that time I didn't acknowledge the passing of time. It was a beautiful sort of mindlessness, putting one foot in front of the other with my shoulders hunched over the handlebars, acknowledging my surroundings and nothing more. The forest was cloaked in a primordial silence that echoed in my impassive mind.

Corrine stayed ahead of me the whole time on her skis. I saw her on the return near the pass, and informed her that I was going to spend as much time as possible on the divide, because I never had a chance to explore while racing the White Mountains 100. I parked the bike on a tripod and attempted to hike toward one of the bald peaks looming overhead. I hoped I'd find a wind crust, but every step off the "trail" — which had only been first broken by two BLM machines, two days prior — sank to my hips in crusty snow. Instead, I walked down the other side of the pass and found a nice place to sit on my backpack, gazing at the peaks until I began to shiver.

 Four to six inches of snow fell overnight, coating the trail with feather-light powder. I didn't think it made the trail any worse, but it did add quad-burning resistance to the parts I could ride.

 Temps started around -5 and rose to 0 by mid-day. This felt toasty at quad-burning pace, and I spent the day gloveless and sometimes hatless with my jacket wrapped around my waist.

 One foot in front of the other.

 The woods near Beaver Creek.

 Corrine skiing out of Beaver Creek.

 That long downhill where I nearly caught up to her. A few snowmachines went through, which really only served to stir up the loose snow and make riding even more difficult and squirrelly.

 Snow-bikers do a lot of complaining about trail conditions. We're finicky to an extreme. Variations that are almost indistinguishable to the eye can make the difference between a 10mph spin and a 3mph grind. That's one thing I don't like about this activity, and I'm guilty of becoming frustrated about uncertainty and lack of control. I daydreamed about my snowshoes and sled, and remembered that I was walking anyway.

 The fresh snow did make for beautiful scenery. Although I mention the typical frustration, it didn't really set in on this trip — I was mindlessly blissful for most of the early miles.

 Of course, as I neared the Steese Highway, reality began to creep back into my thoughts. The world, current events — everything that leaves me staring blankly at a computer screen each day — were still out there.

 And then there were recent observations, in regard to Alaska changing more rapidly than I ever imagined. Recently a friend showed me a current photo of Mendenhall Glacier in Juneau. I compared it to one I took in 2009, and felt shaken by how much ice had disappeared in a time period that I regard as a blip. On the Iditarod, people used to worry about 50 below temperatures and hurricane-force winds. You still have to worry about these things, of course, but now there's rain, snowless tundra, rivers with collapsing ice, open leads that could swallow me whole, never to be seen again. What will Interior Alaska become, once it melts for good? Parched spruce forest and swamp, burning where it's not flooded. The White Mountains would be thirsty, low-lying hills — one of my favorite places in the world, but I'm fairly certain winter is what gives them their magic.

And then I realized I'd slipped into negativity again, and tried to shake it off. The White Mountains were still frozen, it was 0 degrees and alder branches were coated in frost, and I was one of the few humans lucky enough to experience it.

 Near the top of the final climb, I stopped to sit on my backpack and eat one of my last remaining granola bars (I mowed through an enormous amount of food over the weekend. Actually enough to run out of food, which is rare for me on a camping trip of any length.) I looked out over hints of sunset light fading on distant hills, and realized that I felt fantastic, physically. There were no hints of breathing problems, and without those, I don't experience much in the way of fatigue. (My arms were sore. I still lift weights twice a week, but yeah, nothing really trains you for hours of pushing a bike, except for hours of pushing a bike.)

The White Mountains can do amazing things for both body and soul.

Corrine near the end of a five-mile descent, where I finally caught her. She has amazing control on those skinny skis. I envy her. Honestly, I would ski if I thought I could. I gave it a chance for years when I lived in Homer and Juneau, but usually I was either shuffling along, miserably bored, or careening with pale-faced terror down some rather benign hill. Still, I do love snowshoeing and snow hiking. Perhaps it's the mindlessness of this activity — predictable steps through an unpredictable world. And snow biking, in many ways, has qualities of both. The careening, the freedom, the frustration, and the slow grind.

Now I'm rambling again. But it was a wonderful respite, worth every air mile. I loved every predictable and unpredictable step. And, even more, I loved spending three days in the wilderness without outside contact. The news I returned to on Sunday was the most dispiriting yet, and I wanted to run back to Cache Mountain as fast as my legs would carry me.

Instead I headed home to Colorado, where life is still good.