Monday, June 17, 2019

Mohican 100: A Return of the M0jo

My Western States/Badwater double last year was a big ask for my body, especially as a hamstring injury limited any major hill training. But I snagged a silver buckle at States and four weeks later pushed myself hard through the 127 degree temps to cross 135 miles of Death Valley in less than 29 hours. Afterwards, I knew I needed some unstructed run time and some very structured hamstring rehab time. Coupled with kids out of school, family vacations, and nothing on my calendar to train for, I did almost no running over the summer and was very happy to have the time off. But in the fall, when I decided to start back up again, things just didn't seem to click.

Of course, you first tell yourself you are out of shape, but it soon became clear that wasn't it. It wasn't just huffing and puffing. My legs ached when I ran, I was exhausted after even the shortest runs and there was no joy. I took two more weeks off for a full two month's of recovery, but if anything, it was worse two weeks later. I didn't have any desire to run or really do much of anything physical. People kept telling me I sounded depressed. The only thing I felt depressed about was not feeling good, but having no experience in this, I saw a doc and went on anti-depressants. A month later I was still my usual cynical self with no desire to run, so the meds didn't seem to correct my personality flaws or my physical issues. I just needed to get excited about running, I told myself. I needed to switch up my routine. I started doing short fast runs instead of long distance training and I signed up for a bunch of events to "race myself into shape."

So I raced 6 times in six weeks in the fall and the thing was, most of the races went pretty well. I broke my own master's CR at the Autumn Leaves 50k; I set the overall CR at the Silver Falls 50k a week later; I won a trail 30k in Las Vegas outright with a new CR. I got second at a local 5.5 mile trail run but my time was only two second off my time from a couple years prior. I also got third at a local half marathon and was the first person to do the 52 Mile Civil War relay as a solo runner. But the thing was, each event left me exhausted and I did almost no running during the week between the events. And even when the times and results seemed ok, I just felt "off." I had Bandera on my calendar and while I knew a Golden ticket would be a long shot, I thought I would at least get my lottery qualifier.

Race day at Bandera, things went downhill fast. My slowest pace felt so exhausting but I still planned to finish. But by mile 20 I was beyond spent - just absolutely nothing in the tank. I started tripping and falling because I could not find the energy to lift my legs high enough to clear all the rocks. I took three major falls, but so many more stumbles and toe catches. By mile 23 I was sitting on a log under a tree because I needed to rest. It wasn't the usual "gee I'm tired because I am running an ultra"; it was more like "I would like to hibernate in a cave for a week but I don't even have enough energy to move a few steps so I'll just lay on this log." It wasn't an ego thing to DNF; I felt too physically unwell to keep going. I took anther two weeks off to rest, thinking I had over done it on the racing in the fall. The plan was to start back with an easy five miler. But I didn't make it two miles before I once again felt completely drained. I walked back to my car and had to sit there with my eyes closed for ten minutes before I felt like I could safely drive home. Obviously, something was way off. I stopped even trying after that. The worst part of it all was that it was very isolating because runners understand injury, but how do you tell people you just aren't running now because you don't feel good and it isn't fun? People who love running can't register that idea and non-runners have never thought it was fun to run in the first place, so what's the issue? And how do you explain to ultra runners you DNF'd because you were tired? Who doesn't get tired running an ultra?? Also, it made me question who I was as a runner and what I was running for. After nine years with La Sportiva, I wrote what I thought was a very heartfelt letter explaining why I was turning down my contract renewal. While I wasn't expecting them to beg me to stay, I didn't even get a response. It was just one more thing that had me dismayed about running.

My first round of lab testing showed me to be the picture of health - even the things like D3 and ferritin which some people differentiate into "adequate" and "optimum" results were superb. This original panel included a TSH to screen for thyroid problems and mine was right smack in the middle of normal. But being told you are fine when in your mind you are clearly not fine, is actually not reassuring. In fact, it is quite frustrating. I did a lot of doctor "shopping". I saw my asthma doc to see if things had gotten worse; they hadn't. I saw a new allergist to see if he had any different opinions about my asthma; he didn't. Along the way, I ended up getting a full thyroid panel and not just a TSH. And my T3, the active form of thyroid hormone, was practically nonexistent. Both family practice docs I saw dismissed it as T3 being variable throughout the day and not significant unless it affects your TSH (which means your brain now senses that your thyroid level is too low). An endocrinologist friend was also nonplussed. A non medical friend recommended a naturopath; she prescribed T3 replacement within 2 seconds of seeing my results. All of this took time, so it was the last week of March by the time I started Cytomel, a T3 replacement. Three days later, we were in Vegas and it was like a light switch had been flipped. I was rallying the family to go hike or walk the strip. We spent to days in Zion and I once again was leading the charges in our family to get out and do more activities. It was night and day. Despite being an MD myself, I really felt annoyed with the allopathic medical system and feel like they missed the boat on this.

Being inquisitive, I felt like I needed to know more about isolated low T3. I tried read as much REAL literature as I could (no WebMD!!!) and as far as I could come up with, isolated T3 has three main causes: selenium deficiency (because selenium is necessary to convert inactive thyroid hormone to active hormone), gut infections and underlying chronic metabolic conditions like cancer or connective tissue disorders, which I felt fairly confident (hopeful??) that I could exclude. I never got tested for selenium levels because it is a specialty send out test (expensive) and you can get a bottle at the supermarket for under $5 so I just started taking it. But I did get a screen for GI infections and I had protozoan levels 100 times normal. The first two days of a course of Flagyl were awful, but by day 5, I felt amazing. And GI symptoms I didn't even recognize as symptoms (reactions to FODMAP foods, bloating, gas, etc.) went away. And while I was still a bit skeptical of all this "soft" medicine, I felt better than I had in six months. Heck, I didn't care if it was placebo or coincidence, I'd happily take my $5 selenium and generic (so also about $5) thyroid meds. In fact, I added 3 or 4 more "gut health" agents to my morning pill popping routine (probiotic, allium extract, berberine). And then I saw an article Sarah Lavender Smith wrote about Kami Semick and her struggles with low T3 and gut infections. I reached out to Kami and just talking to one other person with a (remarkably) similar experience made me feel like I wasn't crazy, so I guess that's a lot of my motivation for writing all this here: maybe someone else can relate and then doesn't have to feel so isolated or crazy. Or maybe it encourages people to keep fighting for themselves when they just don't feel right. Interestingly (at least me) is that two months later and after the antibiotics, all of my thyroid hormones normalized and I was able to stop taking any meds. I've been off for over a month and still feeling good, so at this point I am a believer in gut health!

All during this time, I only ran 210 miles in 15 weeks or 14 miles a week on average, mostly out of "obligation" and often more walk than jog. But I had a free entry into the Eugene Half Marathon on April 28th and I was feeling good enough that I decided to go. I ran a personal worst by several minutes but I came away quite encouraged. I felt good the whole time, I had fun being out there and I was actually pretty impressed with my time given the circumstances. I decided that was Day 1 of my new training cycle. That was 48 days before the start of the Mohican 100 race. And people pay coaches for six months to get them in shape for 100 miles! Haha. Actually, Mohican was not a part of my plan when I started training again. In fact no 100 miler was, I just knew if I was going  to feel good about taking my spot on the US 24 hour team, I needed to put full effort into my preparation. April 28th was about six months out (see, I plan to train for big events for six moths, too!) and I felt like physically I was ready to put in the work.

But here's the thing, I wasn't just physically ready, I was excited about running again. Soon after resuming training, I was pouring over the list of Western States qualifiers, trying to figure out how to keep the ten finish dream alive. The list of qualifier races is quite restricted. You see, you can run 135 miles across Death Valley in 127 degree heat in 28 hours, but WS does't accept that as good enough. You can run 150+ miles in 24 hours, but Western States doesn't care. Heck, you can have seven finishes and a win at Western States, but the only way to get qualified for the lottery is to run a race every year on the restrictive list of approved races, a decent percentage of which are international. So lining up the calendars of approved races, the two races I already had on my calendar for the fall, kids activities  and our vacations, there were actually only three or four good options and two of the races were already full! Mohican rose to the top of the list despite it's rapidly approaching date. In the weekends that followed, I did a 26 mile run and a 22 mile run, both on roads, the only two runs longer than 15 miles. But I had been doing more mid week "adventures" in the spirit of making running run so I did have some good trail runs of 10-15 miles on my legs. And all I needed was a finish. Feeling good and being in good spirits would be enough to get me to the finish line even if I had to hike all night and I was prepared to do that. In fact, I reasoned if I could get through 40 miles feeling good, I could probably hike my way to something close to 24 hours, and Mohican offers a generous 32.  Neither my cautious running partner nor my pessimistic husband had anything bad to say about this plan. Game on!

The beauty of low expectations and minimal investment is that you can keep everything really simple since you don't have a lot riding on the outcome. I had no pacer, no crew, no split cards and only the most rudimentary knowledge of the course. So little in fact that when the course skipped the protected waterfall area on the second loop, I spent ten miles worrying that I was going to be DQ'd for cutting till I finally broke down and asked someone. It would've been helpful to go over the race day check in and parking areas ahead of time to make sure everything was situated with more than 5 minutes to spare, but that all fell into place, too, and honestly kept me from even thinking about the race until we actually started.

Mohican is a great local race but most people are there for their own personal goals and not for the competition. As such the front pack went out nice and slow and I was very content to just tuck in around 30th place. Most of the course is pretty runnable with frequent short ups and downs rather than prolonged climbs and descents. Still it packs in nearly 13,000 feet of climb and I knew I'd be feeling it at the end so I told myself I had to walk everything on lap 1 that I thought I'd walk on lap 4. Usually my mantra is "check yourself before you wreck yourself" when starting an ultra, but on this day my good friend Bob Hearn's voice was in my head and I must've told myself "Fatigue isn't linear" at least 1,000 times, meaning to me when you start to fatigue you can fall off the cliff pretty fast and that how you feel now doesn't necessarily predict how you will be feeling later on so do everything you can now to keep the fatigue from starting. It wasn't perfect, there were still a few places I probably ran a bit too hard, especially the road sections which are just too tempting to open up, but overall I was feeling remarkably good after the first 53 miles, completing lap 1 in 4:35 and lap 2 in 4:40. The first two laps were listed as 26.8 miles and the final two laps have a short cut that was supposed to cut off almost 4 miles, so I thought it might be reasonable to try to hit a similar split time, but the cut off only took off three miles and it was pretty rough terrain. I also had one episode of puking that I walked for about two miles afterwards to settle my stomach and slowly replenish lost calories since I knew that'd be super important to keep from diving off the fatigue cliff. While I knew I was slowing a bit, I still steadily moved up the field and finishing lap 3 in 4:49. I busted through the aid statin at the start of lap 4 trying to squeeze out the last of the light but I could tell the legs were feeling the miles and the lack of training. Still I was in good spirits, my stomach had settled, and there were no major issues...until the weather gods decided to make some issues!

Somewhere around mile 82 it started to rain. And then rain harder and harder till we hit Biblical level downfall. I'm not kidding: the course to the finish had to be rerouted onto the highway because the pedestrian highway underpass filled with water and a creek bridge was completely under water! The rest of the trails fared no better. Sloped trails turned to rivers. Flat areas were ankle deep water that disguised all the roots and rocks. Everything was either slick or sticky with mud. And the rain and the fog really cut into the effectiveness of headlights. I kept thinking to myself "it has to let up soon" but it would only rain harder. I have seen bouts of hard rain like that in Oregon and Hawaii but for brief spells only. This went on for pretty much my final five hours and a few more for the people who were still out there. I actually felt better on this lap then on the previous one and was ready to push to the finish, but I had to work hard just to do 17 minute miles. I didn't feel like I was in death march mode at all but it would sure seem like it if you just looked at my final split (5:40). Still 19:44 is not too shabby for just wanting to finish (Only the great Connie Gardner has gone faster on this course and I don't think she had to fight a monsoon!)! Plus somewhere along the day I passed all but three guys. But honestly, the time and the win really aren't as meaningful to me as just being able to get out and feel good doing it.

4 comments:

Zandy Mangold said...

Wonderful write up! Thanks for sharing all those deets. Wondering how would I go about getting a gut test? Easy as checking with PCP or is there something specific I should request? Congrats on a super race!! You passed me around mile 30sh looking fresh as can be:)

Pam said...

Zandy- congrats on a strong run! I had a test called GI Map which is PCR for organism DNA on a stool sample. It is through a private laboratory but it has to be ordered by a PCP or other primary health provider. Any PCP could order it but it might take them a few days to get the kit in-house. Then you take it home, do your business and mail the sample back. Lab medicine is my specialty so I did my due diligence and I was actually pretty impressed with the testing and the results.

Anonymous said...

I'm glad I wasn't the only one who thought the rain was insane! I've never seen anything like it.

Rachel said...

What an incredible write-up! So impressed with your race. I wish I were surprised by the hoops you had to jump through to diagnose the underlying medical issues - I know way too many women who've had to fight to get a full thyroid panel. As for the gut issues themselves, any chance they were related to Salem's water quality issues from last summer?