Blog changes

Thanks to everyone who followed Training Because I Can! over the last nine years. This blog started with Addison's Disease, hypothyroidism and a crazy idea of doing an Ironman distance triathlon. My life has changed and so has this blog. I am using this blog strictly for Addison's Support topics from here on out. I hope to continue providing people with hints for living life well with adrenal insufficiency.

Saturday, March 22, 2014

Route 40 Romp "Strategy"

This post is silly long.  Sorry.  Probably of most interest to people with adrenal insufficiency who exercise.

Again bolded at the start of topics so you can skip what you want.  Here's what I wrote about Past Failures, Steroid Guilt, Big Screw up, Endurance Exercise and HC Dosing, What I Started Doing Differently and Summary

By the time this post is published, I will have started running the Route 40 Romp.  My ultra "career" has been plagued with multiple attempts at long distances that were thwarted by a lot of exhaustion, fatigue, nausea and vomiting.  It took me six years and many 100 mile DNFs to come to the conclusion that I was entirely responsible for my failures but in a different way than I had thought.

I thought I was not training hard enough, I was not training right, I was not genetically predisposed to running (probably true) and screwing up the race in the week prior by doing too much.  Well, yes, the fault was entirely mine but, in retrospect, I do not believe neither training nor genetic disposition were the problem.

Let me list my problems at about mile 60:

  • Fatigue
  • Nausea
  • Vomiting
  • Exhaustion
  • Inability to stay awake
  • Low blood pressure
What does this sound like to you people with Addison's?  Yes, poorly managed adrenal insufficiency!!!

My biggest problem was that I was suffering from steroid guilt and didn't want to take too much hydrocortisone.  As much as I preach, take enough HC to make you comfortable, I didn't practice it.

At Vol State in 2013, I made a terrible error with my meds.  Long story short, I took 1/4 of the HC I needed by accident.  I suffered badly and even think my calf pull was due in part to not having enough cortisol in my system.  At Barkley in 2012, I did take enough HC and I performed surprisingly well for me.  Fast forward to Ancient Oaks 100 in December of 2013 and LOST in February of 2014.  I made the conscious decision, based on VS and Barkley, to change up my race strategy entirely.  By strategy, I do not mean what most people who run mean.  I am not coming up with some huge master plan of how I can win.  My "strategy" is how to manipulate my hormones manually to mimic what other's bodies do naturally.  What a pain in the ass.

With adrenal insufficiency, we are told over an over by doctor after uneducated doctor, that we should take as little hydrocortisone as possible.  We should not need much extra for exercise.  In reality, there are NO STUDIES of endurance athletes with adrenal insufficiency.  The studies I've seen about cortisol production and "endurance" exercise are of middle aged men on bikes for 45 minutes, 6 days a week.  Um, yeah.  Somehow that doesn't seem to correlate even to the pathetic endurance training that I do.  How can any judgments about cortisol production correlate???  The answer is:  they cant.  If I had taken a realistic look at my symptoms during the middle of the race, I would have seen that I was under replaced and possibly doing harm to myself.  Following my own advice of taking enough HC to alleviate negative symptoms, I would have performed better for the last six years.

Here is an (edited) email that I sent to my friend H after Ancient Oaks that sums everything up quite well:

I felt SO GOOD the ENTIRE race.  The only time I cried was with happiness for about 30 seconds.  My feet never swelled or hurt, they did get uncomfortable but not painful.  I was able to stay up all night except for one hour.  I was hydrated the whole time.  I ran right up to the end.  I didn't run every step but I certainly ran a lot.  My splits were, for me, extremely consistent.  I wasn't trying (to be consistent) either.  Someone mentioned it and I checked it out after.  Do you know how many 100s I've started and failed?  So many.  I usually ended up swollen, nauseous, dry heaving and so tired that I literally laid down on the side of the trail (not a good idea at sunset in the Winds of Wyoming).  Hmmmmmmm let's think about what those symptoms sound like, LOW CORTISOL.  Why did I accept those symptoms as "normal"?  Because I thought people who run long distances have these problems. It was normal.  What did I do differently this time???
·         Quit drinking on July 18th (I was drinking a lot)
·         Quitting drinking helped me train better and more consistently
·         Lost weight, 14 lbs since the beginning of 2013
·         I was SO motivated after Vol State AND once the VS med debacle became clear, I took enough HC post event to heal properly
·         During the race
o   Took 10 mg of HC each and every hour without fail (was taking 5 mg every hour or two)
o   Ate every hour
o   Drank fluids consistently
o   Drank 1.25 L of COKE (more than I’ve had in 5 years combined)
o   Wore Wonder Woman socks with capes
o   Had my mug from Bonnie in the car [mug says: crying won't help]
o   Had an awesome pacer through the night for 22 miles

For all of the other 100s I’ve attempted, I was ruined after the race even when incomplete.  After the Bear (completed in 35:45!!), I was ruined too.  Taking double or triple in the days following helped my healing.  Within 72 hours, I was no longer sore.  In 48 hours, I was cleaning cages with no problem.  Recovery was so swift with added HC, good training, lower weight and no alcohol in my system.  I can’t freaking believe I stayed up most of the night.  This was monumental for me!

In summary, my strategy will be to take 10 mg of HC/hour, eat, drink, not cry and appreciate having Marilyn as a crew!!


Unknown said...

I've read it before, but I read it all again. :) You probably won't see this comment until you've finished your run, eaten chili at my house, and gotten a good night's sleep. But know that I'm cheering you on right now!
Run, Dusty, Run!

Unknown said...

I live in Central Florida and have suffered from exercise and physical training since my Addison's diagnoses in 1996. I seem to go into mini crisis mode when I train too hard. I also have hypothyroid as well. On a 40mg HC, .2mg Florinef, and Levoxyl for my maintenance doses. I only train 45 minutes to 120 minutes depending on the task of weight lifting or endurance training. I see your new stragedy for your competitions. What about training?
Have you found any exceptional information to help you? Any exceptional doctors?
Thanks for sharing your journey. Best wishes on this race and your journey!

Unknown said...

Heather thank you for your amazing hospitality! Chili was delicious and I loved my presents and my medal!

Unknown said...

Dusty, this is amazing and thank you. I am quickly learning how much I have been under-dosing myself because of that dreaded "steroid guilt."

That is stupid. I am done doing that.

I know the signs of cortisol overdose. I am done listening to those that preach "take as little as possible." They aren't long distance runners. They don't live an active crazy life-style.

I am going to take the dose that allows me to live my life as a functional human being.

Unknown said...


Thank you for leaving this comment. You made my day! I look forward to hearing about your progress and I'm thrilled that I could be a part of it!