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

PAST FAILURES
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!!!

STEROID GUILT
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.

BIG SCREW UP MAKES ME SEE THE LIGHT
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.

ENDURANCE EXERCISE AND HC DOSING
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.

WHAT I STARTED DOING DIFFERENTLY AND WILL DO AT R 40 R
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!


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

Friday, March 21, 2014

So much to do, so little time

I've been thinking about writing a blog post for a long time.  I sat down last November and wrote two months worth.  I haven't written any since.  This is going to be long.  Sorry.  It's a self indulgent post so that I can remember things when I look back.  Skip what's boring.  I've broken this out into Summary, Addison's Stuff, Running and Upcoming Race.

I think I'm on a kick so there might be weeks of pictures on this blog to follow if I can get my butt in gear and make some blog posts today.

Summary:  I've been doing a lot of bird stuff because I love it and I'm the Treasurer on the Board of Parrot Outreach Society  ("like" us on Facebook!).

Look at this sweet baby, she's not actually a baby, she's 18. CC is a Moluccan Cockatoo who needs a home.

I've been running as much as possible.  Usually running to the Parrot Outreach Center so that I can combine commute time with my run.  Efficiency and all that shit. For someone who has no job, I am always busy doing something.  Too much time with the birds, perhaps?  Well, that's okay because I love those homeless birds, even the mean ones.

We are moving to Vero Beach, Florida in the fall or early winter.  We are building a house there.  

Paul is working hard and bringing home the bacon.  He's running, doing crossfit and dreaming daily about our new home in Vero.  Dolly, the miniature schnauzer, and Keiko, the Senegal parrot, are doing well.  Dolly is running my mile with me three or so days a week and walking .5 the other days.  Dolly is 12 so she's doing awesome and staying active!  Keiko has been with us for a year now.  I adore him and he adores me.  He makes me smile every day.  I am doing well.  Feeling mostly good.

Addison's stuff:  I went for my yearly check up and got blood work.  Turns out some things are off.  I am, once again, over range with my Free T4 for someone with adrenal insufficiency.  This would explain some things that are going on that I won't discuss in this company.  My FT4 has been high before and I felt totally different but I was also 1) drinking alcohol very regularly 2) not taking enough hydrocortisone.  I haven't had a drink in eight months and I am taking hydrocortisone liberally so I am actually feeling the effects of being hyper (with adrenal insufficiency, if you are hyperthyroid and not taking enough cortisol [hydrocortisone] you will feel both hyper and hypothyroid at the same time).  Anyway, I'm working on that and hope it doesn't affect my run this weekend.

Running:  The running has been good.  I got two new pairs of shoes for Christmas (thank you Paul and Mom and Duane!).  My old ones were worn through to the insole and hurt my feet and legs.  I know you minimalist people think shoes with no cushion are the bomb, I think they don't work for me.  I like a tiny bit of tread too.  Shoes with tread and a little bit of padding make all the difference in my running comfort.  The training has been going well for the most part.   Weight lifting has been sporadic at best and my running always suffers for two weeks post event but I've been getting out regularly.  My mile a day running streak is still in tact after two years and  at least walking one mile a day, four years.
Old, ouch! Sorry for the bird food and poo stuck in them.

NEW! Pretty and comfy.
In December, I did Ancient Oaks again and completed the 100 miles in 27:48 (?) and felt great!  In February, I used the same training, eating and med tactics and completed about 60 miles at Lake Okeechobee Scenic Trail as part of a relay team with Scott K. from Vol State.  In both cases, I felt great, ate and drank and had the same med strategy.  In both cases, I stayed up almost all night!!!!!!  I slept on and off through labor with my son when I was twenty years younger so staying up all night was a huge accomplishment.  The days following both, I was not terribly sore either.  Another accomplishment.  I will apply the same strategies in my upcoming race, the Route 40 Romp (R 40 R).  

Upcoming Race:  The Route 40 Romp (R 40 R) goes from Yankeetown, on the Pacific side of Florida, to Ormond Beach, on the Atlantic side of Florida mostly via Route 40.  It is 116 miles.  I will have a "crew" named Marilyn.  Marilyn and I met at Ancient Oaks in 2012.  She generously and selflessly offered to crew me at this race when Kathleen T told her I was going to push a baby stroller to hold my supplies.  This race has long stretches without water so a crew is necessary to keep you from dehydrating.  I am overjoyed and overwhelmed by Marilyn's enthusiasm and generosity.  I'm stunned that an acquaintance would give up her weekend to take care of me in such a self-serving, self-centered endeavor.   I am thankful and humbled.  My husband has paced me before but I've never been crewed.  This will be a new experience for me.  

The race is tomorrow, Saturday, March 22 at 7:30 am.  I have a med plan in place that is similar to the ones I've used in the last two races.  Food and clothing is ready.  I am nervous as hell.  I've been awake before 5 am three days this week because of the hyperthyroid and the anxiety over this race.  It's one thing to go 100 miles, to me it's quite another to tack on another 16 miles.  I need to trust that I can do it.  

This is getting too long.  I will put my med plan into a different post.  

A quick thank you to my husband who allows me to work with the birds, keep the house clean, take care of the pets and run.  Thank you to all of my wonderful friends who support me in so many ways.  Thank you to Marilyn for offering to take care of me for the weekend.

XXXOOO to all