Ironman Louisville Race Report: Never Give Up

Pre-race recap:

First Ironman: Wisconsin 2004. Sick heading into the race. Couldn’t consume calories or fluids during. Woke up in the back of an ambulance after I passed out half way through the bike. Later diagnosed with parasitic infection.

Second Ironman: Wisconsin 2005. Very, very rough day but managed to stave off unconsciousness to get to the finish 11 minutes before the midnight cutoff. I am an Ironman.

This Ironman: Missed 5 weeks of training this spring due to undiagnosed illness. Missed another week completely in June plus another couple of weeks of reduced training. Same reason.

Was not racing with a watch. Did not want pressure of time goals. The day was going to be hot, humid, and um, hot. Getting to the finish was job number one.

Not having access to my medicinal cookies to alleviate the side effects of my medications was a concern. It was going to make a challenging day more so. Spelled ‘POZ’ with the reflective tape on the back of my race shirt.

If nothing went wrong – like oppressive heat and humidity – and absolutely everything went right, then I thought 12 hours was possible. But really, getting to the finish line was the primary goal. At all costs.

I was only going to leave the Ironman course across the finish line or by ambulance. Quitting was not an option.

Giddy up, Buttercup.

Swim:

Pretty much according to plan. Just swam easy. Executed my planned mantra for the entire day: ‘Hold back. Relax. Focus on form.’ 

Time trial swim start meant not getting punched in the head even once during the 3.8 k / 2.4 mi swim. Nice.

Bike:

What doesn’t kill you…

Did not push the pace at all. Even though it was not yet 9 am it was hot. And humid. A lot of guys passed me in the first 40 km / 25 miles. I didn’t care. I was going my own ‘easy-does-it’ pace.

Couldn’t consume solid food anymore around mile 65 / 100 km. Only gels would go down. Hmmm…that never happened it training. Must be the heat.

A few athletes walking their bikes up the hills during the second loop. Others are lying on the side of the road. Starting to feel less then stellar myself. Heat really starting to kick in.

The guys that were kind of riding at my pace have disappeared behind me. Fewer guys are passing me. I’m going easy, holding back. Want to make sure I get to the finish line.

Self care is paramount and I’m doing it: calories, water, electrolytes. Cold water in the helmet. Hold back. Relax. Focus on form.

The last 40 km / 25 mi I start feeling a little rougher. I back off the pace a wee bit more just to make sure I’m feeling the love for the run.

Guys stop passing me. I’m starting to catch and pass some people. I ask if they notice that it’s kind of hot.

Oh yeah, it was humid. And hot. Did I mention that?

Run:

Some bad patches. Some ugly patches.

I took my medications, the ones that keep me from certain death, during the second transition. As I swallowed them I thought: ‘Dream as if you will live forever. Live as if you will die today’.

Coming out of transition I did not feel my usual perky self. Running 26.2 miles did not seem appealing.

I thought it was hot when I was biking. Now there was no wind chill factor. Things were going south in a big, big hurry.

The heat was oppressive: 96 F / 35.5 C.  The humidity offensive: well into the 90’s. Making it feel well over 100 F / 37.7 C.

I slowly jogged about 200 metres before walking. I was not feeling well. At all. It crossed my mind that a marathon is a long way to walk.

In what will become a repeating pattern at every aid station, I put ice in a zip lock baggy under my hat. Ice down my shirt. Cold, wet sponges tucked under my shirt on my shoulders and back of neck. Fill my water bottle. More electrolytes. More calories from gels.

I feel a wee bit better and am able to start running. By mile 2 I’m feeling absolutely wonderful. Only 24 miles to go. I’m thinking that I can do this. I’m over that bad patch. Just the same, easy does it. Don’t want to count your chickens.

By mile 4 I’ve lost that lovin’ feeling. By mile 5 I’m walking again. But so is almost every one else at times. I tell myself that I can manage my body by just walking the rest of the way.

By mile 6 I’m lying on the side of the road. Time is distorted. The aid station volunteers keep checking on me: ‘Do I need medical assistance?’

A little voice in my head says ‘Suck it up, Buttercup’. I slowly get up and start walking. And then running. As I go through mile 8 I reach around and give myself a little pat on the back: ‘Good job, Scott’.

I run a few more miles before things deteriorate again. More walking. More athletes lying on the side of the road. ‘That was me’ I think. I run some more.

I stop sweating. I know this is not a good sign. Somewhere around mile 15 I crumple to the grass.

I hear someone say ‘Don’t worry guys, an ambulance is on the way.’ Guys? Plural? I open my eyes to look around and see two other guys lying on the grass.

I’m not done yet. I struggle to my feet. Lazarus rises again. I have to get out of here before the paramedics arrive. I’m scared they’ll want to make me quit.

Some guy asks if I’m sure I should continue. I take a quick glance at the 2 guys lying on the grass and mumble weakly, more to myself then him, ‘never give up’.

Walk. Run. Walk. Run. With the occasional dry heave thrown in for good measure.

I thought of my good friend and training partner, Matt, who died 50 weeks ago after crossing the finish line in a local triathlon. I choke up. I miss him. I took a moment to appreciate being alive. And healthy enough to try to do this crazy shit.

Some uber fit guy, looking dazed and confused, asks me where it all went wrong. I said that I thought it was the heat. Or maybe the humidity.

As I approach mile 24 I decide I’m not going to stop running until I get to the finish line. I’m going to empty the tank. I start digging in to run faster. Sweating returns.

At mile 25 I pick up the pace again. Now I’m really starting to hurt. But I’m passing loads of people and that feeds me emotionally. The mantra has become: Dig in. Ignore the pain. Empty the tank.

I turn the final corner and can see lights illuminating the finish line in the distance. Cheering crowds line the street. There are still a few more people I can catch in the last 400 metres. I dig in again. I am emptying the tank.

200 metres to go and there is one more guy between me and the finish. I dig in one last time and go by him fast.

50 metres to the finish and my sun glasses fall off. I stop, turn around and pick them up. He runs past me. Fuck! I sprint all out, the world starts spinning, and pass him again with 5 metres to go.

I cross the finish line at full speed into the arms of medics. They want to put in a wheel chair. I want to walk. I win, and we walk for a couple of minutes. I think I’m going to be okay.

Then things got ugly.

I recognized the signs of impending unconsciousness and knew I needed to get horizontal. Immediately. A medic told me to keep my eyes open, not pass out. She kept tapping my arm.

They put on a gurney. They are running me through the crowd. Yelling at people to get out of the way. Every bump makes my head ache. Every twist and turn more nauseous. Blackness creeps into my peripheral vision.

We arrive within the air conditioned medical center. I am immediately cold and start shaking uncontrollably. People are pulling off my clothes. I’m being wrapped in blankets and those silver cape things.

A needle is stuck into my arm and I’m hooked up to an intravenous bag of saline. My legs, back and abdomen are cramping. They give me some anti-nausea medication. I continue to shake uncontrollably.

After the second saline bag I start to come around. One of the medics asks if I’m coming back to race again next year. I’ll decide after both my big toe nails fall off in the next few days.

I am an Ironman.

Time splits:

Swim: 1:13:19

Bike: 5:54:50

Run: 5:56:13

Total time: 13:17:05

76^th of 284 men in my 45-49 age group.

To all my friends and strangers that supported me on this journey and sent good vibes my way: thank you, thank you, thank you. You’ve helped more then you know in making it about the process and not the outcome.

And to that guy who bitchily commented on one of my previous blog entry’s that I wouldn’t / couldn’t succeed and finish an Ironman: I’ve got a finisher’s medal you can suck on. Meow.

And because life is too short not to follow one’s passions, and because I want to, I have registered for Ironman Canada 2011.

Til I drop.

Gay Games Race Report

It has been a whirlwind of racing the past few weeks. I had two races in one of the local race series and had a much improved bike segment and finished fourth in my age group in each race so was feeling a little more confident in my chances of getting onto the podium at the Gay Games.

            Making me less confident was finding out that the guy that beat me for the gold medal at the previous Gay Games (2006, Chicago) was returning. My interrupted training and lack of taper added to my doubts about podiuming in my 45-49 age group.

            Due to jet lag, I only had an hour’s sleep before the triathlon. In retrospect I definitely should have done a better job warming up as I felt very sluggish during the swim. The start was a bit rough and after about 100 metres I saw a pair of feet, slightly faster then me, I wanted to follow. Problem was some dude, swimming the same speed as me on my left, was (unintentionally) blocking my attempts to angle toward those feet and yet was not drafting off them himself. Finally I just reached across his back with my right hand to grab his left shoulder and pulled myself forward and across his back toward those feet. All’s fair in love and war. I followed those feet to past the half way point before I decided he was not taking the most direct route to the swim exit and forged my own ‘as the crow flies’ path.

            Always a bit surreal is going from the swim to the bike. During the swim, I am isolated with my own thoughts, unable to verbally communicate, creating my own reality. Popping out of the water and there is the sudden sound of the spectators cheering and clapping. Abruptly I pulled from my internal world to the external. I very quickly strip down my wetsuit to my waist as I’m running as fast as I can – too fast – toward my bike. Perhaps twenty seconds later I’m at my bike and I feel totally sick. I don’t know if it was the sudden change from horizontal to vertical (I’m a delicate flower and very sensitive motion sickness), my lack of medicinal cookie, jet lag and lack of sleep, or just running too freakin hard for 20 seconds, but I felt soooo sick.  

            Nevertheless, onto the bike course for 4 flat loops to make 40 kms. I couldn’t push quite as hard as I would have liked because I was feeling so horrible. I was hoping it would dissipate during the bike, but no such luck. About 6 guys passed me during the bike and I figured at least 2 of them looked to be in my age group. I tried to go with them but they just rode away from me; my body was not responding – it seemed more concerned with making me feel sick. I tried as best I could to mentally block out the nausea, but it was pretty fierce.

            I quickly made my way through the second transition and out onto the run. Nausea still demanding my attention. I could see 3 guys about 15 seconds ahead running together. They became my target. Very slowly I started to gain on them. But pushing my body hard for over 2 hours was not making me feel any better. In truth I was feeling even more sick. My race became very much a mental battle during the run. My body was sending the hugest “lay down!” signals I’ve experienced in quite some time, but I kept telling myself that “bronze is just ahead, keeping digging, Buttercup”. In fact, I had no idea in what position I was, but I needed that potential to exist to keep the hurt on.

One of them dropped of their pace and I caught and passed him at about 2.5 kms. I was in a world of nearly all consuming nausea by that point and forgot to look to see his age. I kept pushing as I slowly gained on the other two. The were running shoulder to shoulder and I caught them just before the half way point. I recognized one of them from the Out Games last year - a young Danish guy (where he caught me on the bike, I didn’t let him get away, and then outran him), however the other guy, a German, looked about my age. I passed them but the German guy did not drop. I could feel my pace dropping off and realized I forgotten to grab my gels for the run. The German guy came back past me – I asked his age – he laughed and said he “wasn’t going to tell” – bugger knew I was hurting and now he was teasing me – but before I could say ‘Bitch!’ he laughed again and said “42” – I said “go get ‘em”.

I made it to the finish line a hurting puppy and re-grouped with friends but I was pretty much a mess and they had to take care of me. Nausea, shaking, goose bumps. Martin, who won the overall race (again!) asked me a couple of times if he should get the paramedics but after about 20 minutes I was feeling much better and another 20 minutes later I would never have known I was sick at all. The body is a strange, perplexing, wondrous thing. At that point I was up to checking out the results board and was tickled to get a bronze medal in my age group. It made all the hurt worthwhile.

But my week of racing had only just begun – the following days I raced the 10k road race (6^th), 800 metre swim (4^th), 5,000 metres on the track (7^th), and 5k road race (bronze!). I then hopped on a flight home to race the following weekend in the Provincial long course triathlon champs where I finished 3^rd and earned a qualifying spot on the Canadian team for the World Long Course triathlon champs in Las Vegas in 2011. Then the following weekend I won my age group at the Toronto Island sprint triathlon.

And now its taper time for Ironman Louisville. Less is more so that I’ll arrive to the start line rested and ready to tackle what is widely considering the most difficult single day athletic challenge. In spite of losing 5 weeks of training in the spring and another week in early June, I’m feeling pretty fit – but not as fit as last year, nor not as fit as I was hoping when I made my goal finish time of 12 hours. For that to happen, everything has to go right for me – the weather cannot be oppressively hot and humid as is probable, I cannot have any mechanical problems, and most importantly I need my body to be having a good day and the side effects from my meds minimal. If all that happens, I can swim 1:20, bike 6:15, and run 4:15 and add 10 minutes for transitions = 12 hours.

But that is not my primary goal. Getting to the finish line before the midnight cutoff is the goal. It has been as much an emotional journey as physical during these months of preparation and I will do whatever it takes, I will never give up and am willing to go deep, deep into an unknown world of pain to accomplish my goal, to cross the finish line. There are only 2 ways to leave an ironman course – across the finish line or by ambulance. Which will it be for me?

You can follow me online on Sunday August 29 at www.ironmanlive.com

I Am A Delicate Flower

“My name is Scott, and I am a delicate flower.”

There, I said it. Admitting it is half the battle, right?

OK, so after I was sick for a few days toward the end of May which necessitated a few days of zero / easy training I jumped back into heavy training. That lasted almost a week and then I was knocked down with more illness. My life came to a complete stop. And I thought to myself, ‘Jeez, Louise, my immune system is like a delicate flower’.

For much of the next two days, every time I stood up the room spun, I was hit with instant and overwhelming nausea, and within 45 seconds I was breaking out in a sweat. For much of the time, being vertical was impossible. Essentially I had a choice: lie down or fall down. Thus, I only got off the couch when absolutely necessary.

Making a slice of toast went like this: Get off the couch and walk to the kitchen holding the walls. Lie down on the floor to recover / alleviate the head spins, nausea, sweats that accompany verticalness. Wait 3 – 4 minutes for above symptoms to weaken. Stand up, remove loaf of bread and peanut butter from fridge. Lie down on the floor for 3 – 4 minutes until symptoms abate somewhat. Stand up, put slice of bread in toaster. Lie down on the floor for – well you get the idea.

Although I slowly got better, I had a full week without any training - or any other life. I then had another week and half before the bouts of nausea and head spins finally tapered off, but I managed to do some very easy workouts just to try to stem the loss of fitness. Having learned my lesson – the one where I’m a delicate flower – I did not throw myself into heavy training. I spent another week easing into hard training days with extra recovery days.

As such, I entered the Welland half ironman not tapered because I had just got back into training so was going to use the race as a training day. I swam hard the entire 2 kms and worked to stay on the toes of faster swimmers. It was hard work and about half way through there were a few moments when I wanted to back off the pace and let the swimmer go, but I heard myself saying, ‘Suck it up, Buttercup’. And then I thought, ‘I’m 15 minutes into a 5-plus hour race – it is far too early to have to start giving yourself pep talks!’ But competitive heads prevailed and I continued swimming hard to hold the draft.

I had a good transition onto the bike and set off on the 90 km flat bike course. Lots of guys in my age group passed me – my lack of fitness was showing but I was content just to be able to race. Then at 70 kms I got a flat tire so had change it which took perhaps 12-15 minutes before I was back in the saddle. That only lasted about 3 kms before it went flat too. But I had no more tubes so could only ride the rest of the way – slowly - on the rim.

By the time I got to the second transition I was near the back of the pack. But I looked forward to trying to catch as many people on the half marathon run as I could to keep it fun. I had to stop twice in the first few kms to try to adjust the insole of my racing flats to no avail: they were pinching my toes and causing me pain. Nevertheless, I kept trotting along, trying to ignore the pain of every step. By the time I got to the finish line I had big muther blisters and swollen toes on each foot. But, I was happy just to be able to race.

The following weekend I did another half-ironman, again without any taper, so I started the race a little bit tired. I had a mediocre swim, a poor bike because my bike fitness really sucks and lots of people passed me, and an acceptable run in which nobody passed me. It was the first day of the heat wave and many people started to struggle during the run. Surprisingly, I tolerated the heat well on that day and actually felt the best I had ever felt after a long race (read: not nauseous and vomiting) so that was encouraging, being a delicate flower and all.

So what have I learned from these repeated illnesses? My muscles, tendons and such can tolerate the heavy training. Likewise, my cardiovascular system can also handle the many hours of swim / bike / run training. Even my brain, which houses motivation, is ready, willing and able to deal with the physical and mental demands of ironman training. My immune system - not so much. Quelle surprise, eh?

American Triple T Race Report: Sick Puppy

For those not in the know, this is 4 races in 3 days and totals just slightly more then the ironman distance. Many folks use it as a training weekend for their ironman race this summer. Some are racing in the team division, but like most, I’m doing the solo version.

It all starts late Friday afternoon with the prologue super sprint: 250 metre swim, 5 mile bike, 1 mile run. Saturday consists of an olympic distance race (1500 metre swim, 40 km bike, 10 km run) in the morning followed by another olympic distance race in mid-afternoon. The twist for this third race is that the bike is first, followed by the swim, and ending with the run. Then Sunday tops it all off with a half-ironman race: 2 km swim, 90 km bike, 21.1 km run. The bike courses are notorious for the hills, hills, and more hills.

Lady luck smiled on me the previous day as I managed to snag a room at the sold out lodge at the race site when a team pulled out of the event at the last moment. Since I had only entered the race a month earlier, the closest hotel I could find was 40 minutes away but I was able to cancel my reservation without penalty. Now I could just ride my bike to each race. Sweet.

I was using the races as a training weekend toward my 2 major goals: Gay Games olympic triathlon in Cologne on August 1^st and Ironman Louisville 4 weeks later. As such, the Triple T races were to finish off a training block and to be followed by some very easy – and well deserved - recovery days. So the day before I drove down I had a hard training day on the hottest day so far this year in my ‘hood: 45 minute swim, 5:45 bike + 30 min run = 7 hours. Waking up at 3 am to drive after that is friggin’ difficult, I tell ya.

Having spent 10 hours driving to the race site in Shawnee State Park in southern Ohio (which included a frantic hour in Columbus locating a triathlon store and buying a wetsuit because 3 hours into the drive I realized I forgot to pack the one I had – duh!) I pulled into a parking spot at the lodge as other athletes milled about.

As I get out of my car I asked the guy in the next parking spot where the front desk was located, as he turned to answer me I recognized him: Alain, my nemesissy from the Outgames last summer in Denmark (where he crushed me in the cycling time trial race in spite of crashing, but I gained revenge by whipping his ass in the triathlon). He was racing in the team division with his buddy Mark and they registered their team name as ‘Canadian Fags’ – so appropo - and ballsy in the homophobic bible belt. Mark would break a toe in race #2 but that didn’t seem to slow him down much – he finished the rest of the tough and challenging weekend.

Then lady luck frowned at me. As I settled into my room and started to prep for the prologue race I started to feel sick. The sick feeling reminded me of when I get too little sleep and since I had 2 nights in a row of short sleep, I figured I just needed a good night’s snooze. By the time the race started I was feeling pretty crappy. My original intention was to make this race as easy as possible – I was going to go slow and not stress my body. I was not ‘racing’ and didn’t care how many people passed me. During the race I actually felt ok but within minutes of finishing the sick feeling returned. After inhaling some food and my meds I was in bed by 7 pm and sleeping shortly thereafter.

I woke up shortly before 6 am feeling worse. I managed to force down a couple of bites of food with my meds but puked most of it all up a few minutes later when I was brushing my teeth. Once in the transition and set up, I laid down beside my bike and debated whether or not I should start the race.

The debate went like this: I drove 10 hours for these races. Yeah, but I was so sick for 5 weeks in the spring I couldn’t train, I don’t want to get that sick again. But this doesn’t feel like the same type of sickness as before, so if I take it real easy during the race I’ll be okay. This is only a training weekend, it doesn’t matter in the larger picture, being healthy 2 months from now is what matters. Go back to your room. But I paid a $250 entry fee, I don’t want to waste it. Nor do I want to pass out and end up in the hospital. This is why I bought travel health insurance. Racing while I’m sick will only make me sicker. Suck it up, Buttercup.

I wandered down to the start line. As competitors lined up on the beach chatting and excited to get started, I lay atop a picnic table as the debate raged on in my head. Finally I dragged my ass down to the beach and pulled a friend aside and asked her if she was cool with me referring paramedics to her should things go from bad to worse for me. I was feeling that rough. But here’s the strange thing: within moments of starting to swim I felt okay. So I continued on very easily, constantly reminding myself to hold back, slow down, stay relaxed.

I felt dizzy when I stood up after the first loop of the swim and again at the finish and bounced off the railing on the way to my bike but otherwise was feeling much better then before I started. The hills on the bike course made keeping my effort low a bit of a challenge but I managed to consume some calories and fluids. The run course was also hilly and there is just no 2 ways about it – running up hills requires effort, but I kept plodding along at what I was calling a jogging pace and finished race #2 feeling pretty good. Once back in my room I laid down for a nap and felt mildly sickish with alternating cold and hot periods. I was definitely fighting some sort of bug but overall was doing better, but not great.

I had another lie down in transition waiting for race #3 to start and gave myself permission to quit if I started to feel worse during the race. But again, as soon as I started I felt better. I took it very easy on the bike – well as much as one could in spite of the hills – and then enjoyed swimming very easily – a number of people had problems with cramping, but I hardly use my legs in the swim so avoided that experience - before heading out onto the tough run course for the second time that day. By the time I got to the turn around on the run, I was feeling good and figured that I must have fought off the bug. While some were walking the hills I just kept trotting along, keeping my effort as low as possible, happy that I was feeling good, that I was over being sick, and looking forward to the next day’s long race.

That feeling didn’t last long. Within 5 minutes of finishing I was feeling sick again and soon worse then before. Damn. I went back to my room and curled up under the bed covers. When Alain and Mark came to fetch me for dinner I said I could only manage to make it the lodge’s restaurant, I was not up to driving 30 minutes to eat in town. Luckily the lodge was serving all you could eat pasta, so we headed down for some spaghetti and fettuccini, but I had to leave abruptly - I was afraid I was gonna puke right there in the restaurant. Not so appetizing for the other diners.

By this time I realized that doing a half ironman on a hilly course the next morning was probably not going to happen. Even the prospect of driving for 10 hours seemed daunting. As I drifted off to sleep I hoped that I would feel good in the morning, but I was not counting on it. I could hear my doctor’s voice from my last appointment echoing in my head, “you know that your heavy training negatively impacts your immune system?”

Come morning I was still feeling sick, so wisely packed my stuff and headed home. Disappointed that I didn’t finish what I started but content that I had made the right decisions along the way. Pleased that I had done 3 of the races in a very controlled fashion. I’m also happy with how my placing improved with each race. Of the almost 400 competitors, I had the 264^th fastest time in the first race, the 206^th fastest in the second race, and the 112^th fastest in the third race. Not bad considering how sick I was and how much I was holding back. 

Special shout out to my gal pal Linnea and her bf Glenn who are racing Ironman Brazil this weekend. Linnea is a major contender for the win in her age group, tough as nails, and very consistent no matter how difficult conditions get. Go get 'em girl!

The Good News Is...

“The good news is that we didn’t find anything that would make you sick. The bad news is that we didn’t find what was making you sick.”

So went the beginning of my most recent doctor’s appointment. He went on to say that no tumour was found – whew! – and that although I have thickening of my left adrenal gland wall, it is not indicative of a medical condition. Since its been 5 weeks since I’ve experienced any symptoms associated with the 5 weeks of illness and I’ve returned to full-on training – and recovering from hard days very well, better in fact then I was recovering pre-illness – meant that mentally I had pretty much put the illness in the past. I told him that I was just back to the med induced nausea and all other symptoms had ceased.

Having a diagnosis would have been desirable. Knowing if the potential for a future bout of illness existed would be helpful. But whatever, I just bought travel insurance in case I have to cancel my flight to Cologne for the Gay Games. I tried to make that my summation to close the appointment and got up to leave – I wanted to ride my bike home before the sun hid behind the office towers and it got colder – but my doc wanted to chat about the notion of switching my medications to see if it would alleviate the nausea caused by my medications.

I told him my concerns were around cognitive impairment and accelerated brain aging; both found in some HIV+ people taking ARV medications. I am fearful that switching meds would create an opportunity for a new medication to negatively impact my brain function. I’ve learned to live with and manage the bouts of nausea for years and would much rather continue to deal with them then take a chance on getting stupider. Better to deal with the devil you know, you know?

I had a meeting recently that speaks volumes to the various responses to the medications that suppress (but do not cure, as too many people mistakenly think) HIV.  About 2 hours before the meeting I had a bout of nausea and laid down on my office floor for about 20 minutes until it passed and then I was good to go again. The meeting was with a number of people including a man who has been HIV+ for 20+ years and has much experience with various ARV medications. He declared to a recently diagnosed individual that it was “rare” to experience any side effects from the medications. I was so shocked I nearly had to pick my jaw up off the floor - as did my colleague: he threw up yellow bile every morning for 2 years before switching medications.  Different experiences. Different realities.

Speaking of cognitive impairment, last week I forgot to take my medications three mornings in a row. Of course, I don’t realize this until I go to take the evening dose and find the morning dose still in my daily pill box. This is not good. HIV, being a sly retrovirus, can quickly become resistant to medication if the levels of those medications are too low in the body. I don’t think I’ve missed 3 doses in a year and to miss 3 mornings in a row is perturbing.

Not perturbing is my training. It has been going pretty well in spite of losing strength and speed during my illness. I’ve been focusing on building up my endurance, culminating with my longest workout thus far occurring a few days ago: a 60 minute swim and then couple of hours later a 5 hour bike (that included 12 climbs up the Niagara Escarpment) followed immediately by a 60 minute run for a total of 7 hours of training. I could tell during that workout that my fitness had taken another leap forward as the climbs didn’t seem nearly as steep as the previous week and I didn’t feel nearly as trashed as I usually do after that long an effort.

No doubt when the weather gets warmer my suffering will increase as my blonde / fair skin genetics do not respond well to heat and humidity. As a kid I would get severe heat stroke if I ran around too much on hot sunny days. Vomiting and semi-delirious, I would spend ours on the bathroom floor with a damp cloth on my forehead and eyes until my body recovered. I can distinctly remember how comforting and easing the coolness of the tile floor felt against my hot skin.

I just googled the average temperature of Louisville in August.  The odds of the temperature being over 90 degrees Fahrenheit / 32.2 Celsius on race day? One in three. Uh oh. Better remember to pack my sun bonnet.

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