Back in the Saddle Again

I was hoping to give this blog entry a title with a super positive spin, something like – “If you’re happy and you know it, clap your hands” – because I hadn’t had any ‘anxiety’ attack episodes for an entire week, only bouts of nausea – and they seemed to be lessening as the days passed - and mild abdominal pain that failed to recur mid-week. Sunny skies.

Alas, I had another episode late Saturday for 30 minutes, so my mini theory that the episodes had occurred over 10 days with their intensity peaking in the middle – such that if graphed it would reveal a bell curve distribution - is doubtful. Unless I attribute the most recent episode as an ‘outlier’.

I saw an internal medicine doc this week and he said that my primary doc was already doing all the rights things – “very thorough” - to check for heart trouble or that rare tumour. He also suggested that I could be having anxiety attacks without the anxiety and I told him I was totally cool and perfectly happy with that theory.

Lots of people seem to live with anxiety attacks – and with the fear/flight symptoms, which must really suck – so I’m fine with that diagnosis and clean urine and CT scan results will support it.

But my own personal unscientific theory goes like this: whatever was making me ill initially – and from which I’m slowly, but decidedly, recovering - infected or affected my adrenal gland(s) and now they are easily aroused and periodically release adrenaline for a while. I figure as I continue to recover – I still seem to need 10+ hours of sleep at night – they will fade away.

Also inspiring a lot of hope that I was getting over it all, was the return of my energy and ability to start training again to no ill effect. In the last 7 days I’ve managed to ease back into training:

3 swims - 30, 40, then 50 minutes, total 2 hours – continuous, very easy pace

3 bikes - 60, 70, then 80 minutes, total 3.5 hours – continuous, very easy pace

3 runs – 30, 40, then 50 minutes, total 2 hours – continuous, very easy pace

3 weights / core workouts

Compared to my pre-illness week:

4 swims – total 3:35 hours – continuous, easy pace

5 bikes – total 6:45 hours – hard days would include intensity

4 runs – total 5:45 hours – hard days would include hills

3 weights / core workouts

I’m aiming to test my body a little with a ‘real’ training day on the last day of March: a 60 minute swim in the a.m., then later a brick workout of a 2.5 hour bike with a 30 minute run. It will mark my first hard training day in exactly 6 weeks. It also means that Ironman Louisville is just over 21 weeks away. And as long as nothing major goes wrong between now and then – like I get too eager and over train and suffer a health setback or injury - I should be able to get enough fitness to get to the start line. Emotion will get me to the finish line.
Giddy up!

Ambulance ride and the Grim Reaper

Well, it has been an up and down week – physically and emotionally.

When all this started 5+ weeks ago, the most severe symptoms were profound fatigue and feeling very crappy all the time (much to my chagrin, I don’t have a better word then crappy). But not nauseous, as I never felt like I was going to vomit and the crappy feeling didn’t seem to emanate from my stomach. As the fatigue and crappy feeling started to lift in the last couple of weeks, I was able to be more functional.

Things have changed in the last week or so. I now have 1 or 2 bouts of nausea each day that last about an hour – but no longer experience the crappy feeling and instead of being very fatigued, I am merely low on energy most of the time. I also have sporadic abdominal pain, mostly on my left side. And some of the anxiety attack-like episodes – I say ‘like’ because I don’t experience the psychological fear/flee symptom - have become more intense and longer in duration. During a recent episode people asked me if I was okay to drive because I was shaking so vigorously. As I shook in the check out line of the grocery store, the cashier asked me if I was cold as she glanced outside at our sunniest, warmest day yet this year.

The night after my last blog post I had a severe episode of racing heart, rapid breathing, sweaty palms, and shaking. Even though the symptoms were more intense then any other previous episode, I assumed it would also pass in less then 10 minutes. Instead, it became worse – my abdominal and thigh muscles also started shaking – pretty much my whole body just trembled uncontrollably – and after about another 10 minutes without abatement I decided it was time to call an ambulance. Even though paramedics arrived in just a few minutes, the rush of adrenaline had ceased and I was left feeling only mildly (comparatively!) trembley and with slightly elevated blood pressure, which, 5 minutes later, was in the normal range. Once in the emergency room they ran blood tests and did a chest x-ray – the same things my own doc had already done – but no clues were evident. However, I now have an appointment this week with an Internist at an internal medicine clinic – which my doc is happy about.

I also went for a chest/heart CT scan and stress test this week – they said they would call me directly within 48 hours if anything was amiss and they didn’t so I’m assuming my heart is not the problem. Next up is a CT scan of my abdomen and should show any adrenal gland tumours. I am also about to start a 24 hour urine collection for analysis which is the third piece of the puzzle in determining if I have this very rare tumour.

Since it is very rare to have a pheochromocytoma tumour and they are difficult to diagnose, I asked my doc what his second best guess was and he said anxiety attacks even though I don’t have the psychological symptoms. Anxiety attacks without the anxiety. Just attacks. Lovely.

Actually, I really like that theory much better and have been trying to justify it – some of the onset of these episodes have been in social situations (albeit non-stressful) and the episode I had at 4:30am yesterday woke me out of a dream about my running buddy Brian who died totally unexpectedly 2 days earlier at only age 49. Seems like a strong anxiety link to me. And much less daunting then a tumour. But doesn’t really explain my earlier symptoms and only sort of explains abdominal pain and bouts of nausea.

Saturday, after the early morning episode and a brief one mid-morning, I felt better as the day went on and I noticed that my appetite came back – also, no sweaty palms or other symptoms – I even rode my bike to meet friends for lunch – and by the time I went to bed that night I was feeling quite good and started to think again about easing back into training. I even dared to think that maybe I could still make it to the start line of Ironman Louisville.

Alas, another bout of nausea yesterday morning followed by abdominal pain when I tried to ride my bike has derailed those thoughts – hopefully the Internist I see this week will get me back on that exercise train. Derailed, train – get it? Crack me up.

Losing another friend suddenly and unexpectedly really drives home the need – again - to enjoy each day, each moment. Before the inevitable visit from the grim reaper that we all will eventually receive.

Rolling with the punches,

Scott

From Saddle Sores to Bed Sores: Felled by the Flu?

Well, not really – I was never on the bike enough to get saddle sores, nor immobile long enough to get bed sores, but I have been battling something that I was attributing to the flu.  And if I don’t get better soon, getting to the start line of Ironman Louisville is in serious jeopardy.

So that’s why I haven’t updated in so long – 4 weeks ago today I woke up feeling crappy, not nauseous, just very crappy without energy and spent the next several days on the couch. Kind of pissed that I got the flu again – I just had the (self-diagnosed) flu 3 weeks earlier, but ultimately I was glad I had gotten those H1N1 and seasonal shots before the holidays.

So after spending another 4 days sick I was able to resume training / work and then BAM! - 2 days later I feel very crappy and quite fatigued, with periodic shivering and chills, and with a sore throat. Since this latter symptom was new, I thought that I must have contracted yet another flu bug – grrr.

After another 2 days on the couch – I think the Olympics started at this point – then I had a good day and did a very easy bike, just spinning. I was being very careful not to stress my body since – I figured – it had just fought off 2 flu bugs.

Felt ok the next morning so went for a very easy swim in the morning, but toward the end of my easy evening run I started to feel crappy. I spent the next 8 days on the couch – profoundly fatigued, feeling very crappy, with periodic shivering/chills and dozing while the Olympics played on the tv. I went to my doc and got blood work but only my amylase was elevated.

Since then I’ve had an increasing number of good days – when I can get stuff done, and have walked for an hour and felt ok – and fewer bad days when I’m forced to the couch wondering what’s happening with my body.

Yesterday I went to see my doc again and was telling him about my symptoms including an increased awareness of ringing in my ears. I had forgotten about the shivering/chills – when I suddenly started to tremble like I do when I get cold, so that reminded me to tell him while I put my coat back on to alleviate what I thought was shivering.

Then my heart rate started to race, my chest felt tight, my breathing became rapid and I felt physically anxious, but not emotionally. And that’s what I told the doc, so we went into his exam room and he took my blood pressure and heart rate while I continued to shake, my palms sweated, and my breathing was rapid.

He said that I was exhibiting symptoms of an anxiety attack and I said – between rapid breaths - that I thought that that was accompanied by psychological symptoms as well. He continued monitoring me and after perhaps a total of 7 minutes the symptoms started to abate and a few minutes later I was feeling mostly normal except a little trembley.

The doc then asked me if I had felt like I had to flee the room during the symptoms and I told him no. He said something is going on – could be my adrenal glands and mentioned that there was a very rare form of tumour that can grow on them – or it could be my heart since highly trained athletes may experience heart problems and symptoms differently then most folks. 

So the upshot is that one day next week I spend 5-6 hours for an abdominal CT scan and a stress test. Today, so far, I’ve been feeling not too bad, so this afternoon I did an easy 45 minutes spin on the bike and so far, so good - although I can tell that my body is not running smoothly – something is definitely amiss and hopefully we can get it sorted out so I can get back to training.

I figure that with my lost fitness and the fact that I’m going to have to very gently ease my way back into training once I get on a recovery plan, that the latest I can earnestly start training again and still be able to finish the Ironman – the 12 hour time goal is becoming a distant dream – is sometime in April. Otherwise I will have to try to push too much training into too little time and risk injury – or more likely – illness. Safety first!

Stay tuned - now that I'm more functional I'll get more regular with the blog and let you know how the medical testing goes - I know I'll be happier when a diagnosis is made and we can get a plan of action happening.

Yours, with sweaty palms.