Going up, just 'cause

I think the thing I would miss most about big scary goal races is the training, and by "training" I mean "long solo efforts in somewhat arduous to very arduous conditions." See, as a mostly rational adult person, it is not practical to seek out these situations — not quite enjoyable, not quite purposeful — "just 'cause." When I discovered endurance racing by accident, what I really discovered was justification — "You're going to head outside after sunset to push a bike through deep snow during a December storm in Alaska? What's wrong with you? Do we need to stage an intervention? Oh, I see, you're training for the Susitna 100. This makes so much sense! Carry on!" 

Oh sure, I wanted to finish a difficult race ... it seemed like a good accomplishment to add to the life story. But what I really wanted to do was go out after work and wrestle with my bike in a snowstorm for a few hours. Why did it need to have a purpose? I still don't know — I suppose our search for meaning is the base of most human behavior. 

Right now, when I'm not physically fit enough for training or healthy enough to plan for big race goals, can I still justify spending a whole day alone, moving aimlessly through the world? I dragged my feet all weekend, doing little chores and working on writing projects. My health has actually been on an upswing for the past two weeks, which has improved both my creative efforts and outlook. Still, without justification I do lose motivation, and I've been beleaguered by inertia. Finally on Sunday night, I told Beat I wanted to go hiking on Monday. 

Originally I wanted to head out for a long hike to see if I could muster the capabilities to potentially pace Beat at the Ouray 100. When he decided he wouldn't start that race due to a minor hip injury and prioritization of his European races at the end of the month, even my pacing dreams no longer had purpose. However, I'd already figured that even a short section of the Ouray 100 at Beat's pace wouldn't be realistic. My problem is that I am laboriously slow right now. I genuinely can't change this. When I'm walking my 20- and 25-minute miles in the mountains, my heart is pounding and my breathing is taxed as though I'm running a brisk tempo pace. It seems most of my body believes I'm running. But my legs know better. They're convinced they are the most bored legs in the wide world of legs. The legs — along with my brain and the emotional personification of my heart — yearn for hard efforts despite the cardiovascular limitations. "What do you think about a 26-mile walk over a couple of mountains?" I asked my legs. "Would that make you feel better?"

I set out not-so-early on Monday morning. Despite the reasonable hour, my car was the only vehicle in an expansive Sourdough Trailhead parking lot. I actually chose this trailhead to avoid crowds — it generally sees fewer people because the region is filled with prettier options that don't begin on loose, rocky jeep roads that steeply climb to a fence-lined research area. But Niwot Ridge has become a winter favorite of ours, and I looked forward to heading up there when 60-mph winds and ground blizzards weren't ripping down the Continental Divide. The day's forecast did call for a high chance of afternoon rain, which is something we saw at home every day this week. So I figured rain was inevitable, and packed nearly enough clothing and safety gear for a winter trip, in case I needed to hunker down beside a boulder. I've been on the Divide in a storm; it becomes amazingly cold, even at the end of July.

From Niwot, I stumbled along overland for a while and found a trail that dropped down to the Brainard Lakes area, where I began to encounter crowds. Really it was just a dozen or so people, mostly older folks in canvas pants and leather boots, ambling around Long Lake on a Monday morning. One guy with tiny terrier on a leash pointed out a bull moose in the brush. We stood and watched for a few minutes as his dog nibbled lightly at my ankles.

I continued up the ridge toward Pawnee Pass, slowing considerably. I like to believe that since I live at 7,000 feet, most Colorado altitudes shouldn't bother me. But every time I climb above 10,000 feet, it feels as though the Earth's gravitational pull multiplies. By 12,000 feet, I'm pretty much a slug oozing along rock piles. My non-scientific theory is that my blood already isn't circulating enough oxygen at friendly paces and altitudes, and I can't work with less. This is why I wouldn't be able to pace Beat in Ouray — he wouldn't be able to finish the race with too many of these 45-minute-miles.

I oozed my way up to Pawnee Peak, just below 13,000 feet. It felt good to sit on a windless summit and snack on crackers for lunch. The sky was so bright I couldn't see the screen on my Delorme InReach to send Beat a text. It was here I remembered that it was July 31, the date we celebrate as our anniversary — the day we met in Montana in 2010. Seven years. Time does fly. I felt a bit guilty for spending the day hiking all by myself. It was indulgent, but satisfying.

I was stoked about the weather, which remained warm and dry into the afternoon. There were a few dark clouds and thunder booms to both the north and south, but my mountain was spared by a perfectly pleasant weather window.

While up there, I scoped out ridgelines for potential future traverses — maybe someday, if I gain my fitness back enough to not become dizzy and unstable at these altitudes, and can cover miles fast enough to achieve the necessary distances. And if I don't, well ... a future without big, purposeful, physical goals — a future of being excessively gentle with my heart and ignoring bored legs — is something I need to consider. Still, so what? I will find different ways, different excuses to spend entire Mondays in the mountains.

I nearly stepped on this ptarmigan while stumbling down Pawnee Peak. It's amazing how well-camouflaged these birds can be, and how resolutely they refuse to move (I've nearly stepped on them in the winter as well, when their feathers have turned white and they're huddled in snow drifts.)

I didn't fare that well as I descended to Long Lake — catching my toes on the boulders, rolling my ankle badly, wincing at the subsequent and persistent shooting pains, and stumbling frequently. My heart rate had been a little too high for too long, and I was dizzy and slightly air-drunk. I'd moved about as slowly as possible, and it was still unsustainable. Why can't I be like ptarmigan and rest quietly on the rocks? Ptarmigan only flies when he needs to, and probably is stronger for it.

The day grew late as I followed a ski trail toward Lefthand Reservoir. It seemed like this trail was mostly a winter trail. It was swampy and strewn with more obstacles and punchy climbs than I expected. I'd hoped to start doing more 18-minute-miles and maybe even run most of the Sourdough Trail back, but this wasn't to be. Instead I gazed through the trees for occasional views of the hazy plains far below, and tried to enjoy it for what it was — a beautiful stroll, harder than it needed to be, but easier than sitting still. 

Taking my medicine

Last week I dove far too deep down the rabbit hole of Internet health content — synopses of scientific studies, anecdotal evidence, dubious recommendations and subsequent debunking. Combine all of this with a hearty dose of world news, and I emerged feeling hopeless — which is nearly always my reaction to the (non-adventure-focused) Internet. I don't even know why I spend any time in that place. 

Despite this disheartening spiral that ultimately re-enforced skepticism, and despite Beat's well-reasoned argument that trying too many things at once will only yield inconclusive results, I still ended up at Rite Aid with $100 of the most anecdotally recommended nutritional supplements. I contemplated the tedious realities of adopting a restrictive diet (I dislike food prep so much. If they made a Soylent-type product for the autoimmune protocol, I would be all over it.) Finally, my endocrinologist sent the okay to up my medication dose in a way that requires cutting pills in half. Do you know how much I hate that I've become a 37-year-old who contemplates special diets, needs a pill cutter, uses multiple daily prescriptions, and has a cabinet full of dubious supplements? I'm turning into Collette Reardon from the classic Saturday Night Live skits. 

That part of me thinks I should just chuck it all and feel the way I feel. But in this physical state, life loses some of its shine. My mind becomes a dull, unfocused place, overrun with unjustified anxiety. My body becomes strangely detached — both over-tired and over-stimulated, in a way that I believe I've previously compared to an underpowered car, my old 1996 Geo Prism. I imagine that car when I am sputtering up a hill, gas pedal pressed all the way to the floor. That thing would groan and rumble, but it did make it all the way to Alaska and back. And despite hard use, the motor was still running well when I finally let it go with 200,000 miles, expecting it to be sold for parts, and then catching a glimpse of it on the Interstate over a year later. Can I really glean hope from the performance of an old car? No, probably not. 

But performance is secondary. Right now, I'd rather rebalance my mind. If I thought I could do that by laying in bed all day, I probably would. But after a two-hour nap on Saturday, I felt more detached than ever. Beat is wrapping up his training for the Ouray 100, and wanted one more long day in the mountains. I was admittedly dreading this outing, because I don't feel so great in the high country. I feel underpowered, dizzy, and a little bit desperate, in a way I've described as oxygen-deprivation, although chemically it's probably more complicated than that. It's sad to spend a Colorado summer fearful of mountains, so I'm trying to overcome the aversion.

Beat planned to push hard to the top of James Peak while I meandered part-way up the mountain. He completed the seven miles with 4,000 feet of climbing in just over two hours, which is impressive. I was surprised to see him at the saddle — even moving as slowly as I had been, I expected to make it a little farther up the mountain before we met. But it all worked out well; I didn't exhaust my circulatory system trying to keep up, and thus felt a lot better than I would have expected to feel at 12,000 feet.

A nasty-looking storm followed Beat off James Peak. We both made efforts to pick up speed as we climbed onto an off-trail segment along the Continental Divide. I expected the storm to catch up to us, but it never did.

Moving toward sunny skies. The wooden posts signify the Continental Divide Trail.

This is a wonderful ridge walk, skimming the lip of dramatic cliffs above turquoise lakes.

I just can't feel bad in this place. When I'm back at my computer, like right now, I remember the sputtering and desperation. Yet all of that can so effortlessly fade in the moment. Maybe the excess hormones finally burn off, and I'm freed of my weird anxieties even as thunderstorms bear down and objective dangers rise. I don't know. I suppose my body has always been this way. It feels like happiness, and chemically it's probably not more complicated than that.

As is often the case with these longer outings, I felt better as I went. We swung around the ridge onto the loose gravel of Rollins Pass Road, and started running. And even though for me it was little more than a shuffle, I was still chuffed to manage simultaneous running and calm breathing at 12,000 feet. It was enough running that toward the end my right IT band began to hurt, which was so satisfying. I'm sure it's difficult to justify, but I genuinely begin to miss regular aches and pains. In many of my recent efforts, aches are either eclipsed by breathing difficulties, or I just can't go hard enough to experience them.

The collapsed tunnel on Rollins Pass Road. Spooky. I always want to climb inside, but then I see the huge boulders suspended in broken wire netting, and think better of it.

Working our way down to one of the Forest Lakes to eat a snack, filter water, and collect a few mosquito bites. This seven-hour outing was re-affirming — that I remain capable of motion where it counts, that I remain capable of soaring feelings of joy, and that summer in Colorado — despite my current physical state — is pretty fantastic. I probably just need to spend more time in mountains, as far away from the Internet as possible. 

Thyroid update 3

Note: I write these update posts for my own records. I don't expect anyone else to find them interesting. So here's the TL;DR: I'm back to feeling not super great, and I want to spend a few paragraphs venting about it. 

The past five months of Graves Disease treatment have felt like a rollercoaster of good weeks and bad, but there's been an overall arc that seems to be heading in the wrong direction again. My lab numbers would bear this out — the emoticons on these graphs illustrate my general state at the time:

T3 is the metabolically active thyroid hormone, and thus the one with the most influence on body functions. Symptoms of high T3 ("thyrotoxicosis") that I seem to experience are heat intolerance (always fun in the summertime), tremors, irritability, brain fog, elevated heart rate, muscle weakness, shortness of breath, and exercise intolerance. Currently my treatment includes a drug that blocks thyroid hormone production, along with some admittedly half-hearted efforts to avoid stressors and foods that are high in iodine or possibly inflammatory.

T4 is produced in the thyroid gland in much larger amounts than T3, then converted to T3 in the body. T4 tests are generally used to determine whether a patient has hyperthyoridism, and T3 tests determine the severity. My Free T4 has been been in normal range since April, but my general sense of well-being correlates better with the T3 chart. Still, these numbers would convince a doctor that I'm doing well. And I am ... only I've definitely been feeling that upswing. What felt pretty good in April doesn't feel as good in July — my perspective has shifted to yearn for those "good weeks," back when I could run the 25-mile Quadrock with ease and feel like I was breathing fire, not fumes.

My doctor reduced my anti-thyroid medication dose from 30mg to 20mg after May 12. I've requested re-upping that dose twice, and my doctor doesn't agree. Personally I would like to go back to where I was on May 12, and fear I will continue to head in the wrong direction.

Thyroid Stimulating Hormone is the test most often used to measure thyroid function, because it's easy to obtain. However, TSH doesn't affect any other organ besides the thyroid. This pituitary hormone has been likened to a thermostat — if your thyroid hormones are low, TSH tells your thyroid to turn up the heat. It will continue cranking up if your thyroid doesn't respond, which is why hypothyroid patients have high TSH. If the thyroid is already overproducing, TSH shuts off. In Grave's Disease, autoimmune disease antibodies inhibit TSH response, so unless I go into remission (this is the goal), my TSH will remain low. The fact that my body produced any TSH at all was a great sign — it meant I was responding well to treatment and my antibodies were diminishing. I'm also frustrated that this already tiny number is on its way back down.

Yes, it's possible that the physical and emotional stress of participating in the Bryce 100 on June 16 contributed to this downswing in health. However, my numbers were already changing before then. Summer contains other stressors — my allergy season, although thanks to ongoing allergy shots, I believe I'm feeling less impact from pollen this year. Sunshine, to which I'm also mildly allergic, and even ample amounts of SPF 50 or covering most of my skin doesn't always prevent breakouts of small blisters on my arms and legs. Heat, to which I'm particularly sensitive these days. Undue malaise, which has dogged me for mostly inexplicable reasons during summer since I was a small child, with the exception of the years I was in Alaska.

My experiences of "brain fog" also cause stress. This is usually noticed when I try to read something on a screen and continually lose my place, or attempt to write something and zone out, then catch myself staring blankly and feeling confused after unknown seconds or minutes. Once I dip into this foggy-headed zone-out pattern, it's difficult to be all that productive for the rest of the day. These were common occurrences during the winter, and they've started to happen again.

My most prominent symptom is still shortness of breath while exercising, and sometimes while doing simple things like walking around a store or climbing stairs. My heart rate also is affected by thyroid hormone swings. My resting heart rate dropped into the low 60s in May, but has climbed back into the 70s and 80s more recently. (Note: I usually check this in the afternoon. I need to get in the habit of checking first thing in the morning.)

When exercising, my heart occasionally begins to race at relatively low efforts — I've seen the 180s while jogging a 12-minute-mile, which is just ridiculous. It usually drops quickly, but afterward I continue to feel short of breath. When I compare heart rate stats to similar workouts from three or four years ago, my averages are notably higher now. (Earning me high suffer scores on Strava, and not much else.)

Efforts to take it easy from the start still leave me short of breath at moderate heart rates; it just takes more time to feel winded. The physical effects have taken much of the motivation and some of the joy out of activity. I go to the gym to lift weights even though I suspect my muscles are deteriorating again due to high T3 — if anything, I hope that weightlifting will prevent that to some degree. And I go on long rides because I still love scenic tours and the meditative rhythm of movement. I'm no good at rest either. If I'm sedentary for too long, the jitteriness builds and my tremors, irritability and brain fog become worse. Long, slow distance at lower heart rates is still good medicine. The length of a workout doesn't seem to affect my well-being. Intensity does. When it's 90 degrees outside, I also overheat quickly, so I struggle with that as well.

I have several reasons to believe that intense exercise is bad for my health right now, so I'm not inclined to do much more than these twice- or thrice-weekly long rides or hikes. I don't feel I'm overdoing it with these alone. But I sure do miss those brief May days of being in shape again, of "breathing fire."

Things certainly aren't as bad as they were last winter, but I'm still discouraged. I realize my doctor has a long view that I don't possess, and also that there are probably other steps I can take to improve my health besides popping pills. I've already experienced how much difference those pills can make, so despite discouragement I'm hopeful.

Until then, I'm reading up on leaky gut and inflammation, and dreaming up other methods I can leverage for placebo effect. Road trip? Weekend backpacking trip? Last year I was nicely "cured" of breathing difficulties by our annual trip to Europe, so I'm looking forward to fresh air in the Alps. Good things will come. They always do.