On the running front, it's been a rough year. Despite all my best efforts, I just seemed to be circling closer and closer to the drain. One bad race after another where I just seemed completely spent, overly winded and lifeless in the legs. Sadly, training wasn't much better. Even slow paces had me huffing and puffing and my legs didn't seem to work right. Worse yet, they just ached and ached and ached sometimes so badly that I woke up in the middle of the night.
Something was very wrong - I just knew it. Running wasn't fun at all anymore and I was upset and frustrated. I tried to explain all this to my primary care doctor (a marathoner herself) last April and ended up in tears in her office. Crying, muscle aches, trouble sleeping, a feeling of doom, lack of energy, loss of enthusiasm for previously joyous activities...Well, she put it all together and diagnosed me with "moderate depression" (I skipped right over mild!) and she put me on Cymbalta, which along with treating depression is approved for muscle aches. But she did refer me to a neurologist because I kept telling her my legs just weren't working right.
The neurologist practically laughed at me because I had no trouble with any of his tests. As to my complaint of weakness, he told me I was stronger than any other patient he had seen all week. He assured me that I did not have a neurologic problem. And then he changed my anti-depressant prescription.
I was willing enough to give the anti-depression meds a try, but I don't think I ever bought into it. I don't have hang-ups about mental illness or feel ashamed by it, but it just didn't seem to fit. I stopped the meds two weeks before Western States; I didn't feel like they were giving me any benefit and I didn't want to be on any unnecessary drugs for such a physically demanding event.
I knew I wasn't trained as well as I wanted for WS, but I still expected better than I did. By Forest Hill, I was spent. I had been working way harder than I should have been and once again my legs felt so weak. What did I expect?? I had done less than half the mileage I had done for WS the three years prior. I tried to put on a happy face- hey, it was still a silver buckle as Western States; how bad could it be? But inside, I was even more worried.
That was right around the time all the articles came out on over-training and they just seemed to confirm my worst fears: I was just another one of the washed up over trained ultra-runners with flash-in-the-pan success before running themselves completely into the ground. Several periods of rest would make me feel marginally better, but I would be back in the toilet after any moderately hard run. I was obviously in the deepest stages of overtraining. The clincher was trying to pace Liza Howard at Leadville. I had felt miserable for the ten days prior while we were in Colorado, and I kept warning her that I wouldn't be able to keep up with her, but even I was aghast when I got dropped after three miles. Three fucking miles! Yeah, Liza is super speedy, but I'd like to think if I am fresh and she has 50 miles on her legs, I'd have the advantage! As soon as we were climbing Hope Pass, I just could not get enough air, my legs were so weak and I kept getting so dizzy. Altitude sickness, everyone assured me, but I knew it wasn't right, and when I got back to Oregon and good old sea level, I was still wasted. Though it practically killed me, I resigned from the US 100km team; I was in no shape to run 62 miles three weeks later.
I sought out a new primary care doctor, this one an experienced triathlete with an ultra marathon on his resume to boot. He agreed I was probably overtrained noting that I had put my body through a lot the last few years and I started back on anti-depressants. He sent me to a cardiologists just to make sure, you know, since I am over 40 and all now. My heart rate soared on a stress echo - it escalated way faster than it should have and I was breathing so hard. My legs ached, but I had no problem completing the test. The cardiologist said that it was odd but I had the max heart rate of a 28 year old and my ejection fraction (heart strength) was way above normal, so from a cardiac standpoint, I was fit as a fiddle. The primary care doc said I was just "deconditioned."
All during this time, I had lots of labs and they all came back perfectly normal - hormones, electrolytes, and nutrition all totally awesome. The new doc recommended three months off with nothing but yoga. Oh, and double the dose of Cymbalta for depression.
I stopped the meds all together two days later and started looking for a new doctor. Thankfully, doctor #5 was a godsend! Dr. Yates is a multi-time Kona Ironman finisher and one time Masters Ironman world record holder who served as the Portland Winter Hawks (minor league hockey) team doctor for 23 years. His special interest is in medicine for endurance athletes and he is right here in Salem! He listened to me for about 20 minutes and adamantly told me "This is not depression!" and "Of course your heart is fine! You have asthma - this is classic!" I have a history of asthma and have had a few bad attacks, but I was still skeptical; this didn't feel like an attack. "But I don't wheeze and my chest isn't tight," I countered. Though he couldn't entirely explain why, he told me leg pain and weakness are common symptoms of asthma in endurance athletes. Is my HR too high? Do I breathe really hard? Do I cough after workouts? Do colds always end up in my chest? Do I feel like I am not getting enough air even at rest? Is it worse climbing hills or at altitude (places the body needs more oxygen efficiency)? Do I start out feeling ok and then just fall apart? Yes, yes, YES! Well, holy shit, why didn't somebody tell me this 18 months ago and why the hell did I take so much anti-depressant medication?? Plus, he told me three times that I am only 41! Best doctor ever!
Unfortunately, that's not the end of the story. It turns out I also have gastric reflux. Well, how did I get so lucky? Apparently asthma and reflux have a tight correlation: 75% of asthma patients also have reflux. I did not know this and I am a doctor for gads sake! One more thing I didn't know: distance running increases the risk for reflux- all that pounding and increased pressure in the abdomen can weaken the lower esophageal sphincter. And all those crunches and ab workouts...well, they don't help either. So there's your excuse to skip core workouts! It is thought that either refluxing acid gets into the throat and irritates the lungs or that the acid irritation in the esophagus causes nerve irritation that in turn constricts the airways. I am not sure why all this started, but it seems like once it did, things just kept snowballing until they were out of control.
The good news is that I now have an idea of what has been going on and why I have felt so bad for so long. And I am not overtrained! (OMG - I am so woefully undertrained!). I can't say that having a bunch of chronic illnesses makes me happy, but they should be treatable and after just three weeks I see a HUGE difference. Heck, I even won a race last weekend. Ok, it was a small time 5.2 miler but it had 1000 feet of gain and at no point did my legs feel weak. Actually, I felt totally awesome at the end of the race with that post run euphoria that I had been missing for so long. I don't know that I'll ever get back to my 2013 top form, but I don't know that I really need to to be happy. More than anything I have been missing just feeling smooth and easy and finishing a workout thinking "Man, I love to run!" I am building back very slowly with only easy runs and no speedwork yet, but even so these past three weeks I have started to feel "fit" again and I can honestly say, "Man, I love to run!"
|Yes! This is what I love! (ph:Nine22 Photography)