Rant: The prescribing and adherence to low doses of cortisol

People who are diagnosed with adrenal insufficiency should be taking the lowest possible dose of hydrocortisone (HC) possible.  Fact.  What is the lowest possible dose?  It all depends upon your physiology, your diagnosed and undiagnosed comorbid conditions and the amounts of other hormones you are on.

How does your doctor determine how much HC you should be on?  Pathetically enough, he basically pulls a number out of his ass with no regard for your quality of life or clinical symptoms.  He likes to err on the side of a lower dose and very poor quality of life.  The generally recommended guidelines in medical literature are about 15-25 mg of HC per day without any regard to activity level, binding globulins, other hormones you are taking that affect cortisol metabolism or the other diseases you have.  

I know of very, very few people who can function well on 15 mg of hydrocortisone a day.  I know of only a few.  Some have decent quality of life.  Some do not but prefer to suffer from all of the symptoms of under replacment:  bronzing, nausea, vomiting, low bp, fatigue, hypoglycemia.  In addition, cortisol is needed for bone growth.  Not enough cortisol INCREASES your risk of osteoporosis so if you think you're doing yourself favors by suffering through the symptoms of under replacement to make your doctor happy, you are actually a martyr and a little suicidal.  

The average replacement dose is about 20 mg of HC per day.  The recommendation is based on nearly nothing.  There is no monitor for cortisol that's widely available to the public.  There are no guidelines for cortisol numbers based on the dose, patient's metabolism, comorbid conditions and time of the last dose.  The 20 mg of HC number was collected in a hospital setting on people who sat around all day getting blood drawn.  When's the last time you sat around all day, chatting, reading magazines and waiting to have blood drawn?  Most of us don't have that sedate or stress free of a life and need more cortisol to mow the lawn, take care of kids, work full time, fight with our spouses and exercise. 

If you find that you need more than 20 mg of HC per day to function well, don't let your doctor tell you you will be over replaced with cortisol if you take more.  Some of us have active lifestyles, stressful lifestyles and/or thyroid (GH too) replaced at too high of a dose for someone who only has a fixed amount of cortisol in her system.  Know the symptoms of over replacement.  Tell your doctor what they are and which ones you don't have from deviating from his recommendations.

It is far more dangerous for you to be under replaced than properly replaced.  You are unable to store glycogen in your liver if you do not have enough hydrocortisone.  If you do not have glycogen stored in your liver, you will more easily become hypoglycemic.  Hypoglycemia is when you don't have much sugar in your blood.  The sugar in your blood feeds your brain and muscles.  You can die from severe hypoglycemia.  

If your doctor is only prescribing the bare minimum of hydrocortisone, how do you keep a small stash in your wallet, gym bag, desk or purse?  What do you do if you vomit and need to triple your HC dose?  How do you increase your HC for exercise?  Heaven forbid you get a fever and need to double or triple for days in a row?  If you're willing to share your strategies on this, I'd love to hear them.

I'm back bitches!!!!!!! Mutual Mine 50k

It was a crazy Saturday and Sunday.  Good thing I rested up for a few months!  Mutual Mine is a fat ass group run that takes place in the Withlacoochee State Forest near Inverness, Florida.  On the way to camping out the night before the run, I hit IKEA, the Cooter Festival (sounds much more exciting than it was) and then Ron, Scott (fellow Vol Staters) and I went to dinner with Heather and Dave.  I got to meet birthday girl Mama Joan who is turning 90 soon!

It was COLD Sunday morning.  43 degrees. About 65 of us showed up for the run, some of whom had run a 50k the day before.  I've been slowly easing back into running (without falling) for about six weeks now.  I couldn't have chosen a better run to start off the running season!  I saw familiar faces, new faces and good friends.  The course was all trail and stunning.  The weather was perfect.  At one point, some yahoos removed signage and about fifteen of us went MILES in the wrong direction.  As the super fast guys blazed past to get back on course, I nabbed one of them so we could figure out how to get back on track.  Richard and I had a great time wandering around, getting back on track, staying on track and chatting up a storm.  I'm always amazed at how much we ultrarunners can have in common and be able to talk and hang out all day long when we've never met before.  I was lucky to hang out with so many people that I felt this way about:  Yogi, Scott K, Ron, Richard, Scott M, Jan (fellow VSer and pacer from L2O) and Marilyn (my pacer from Route 40).  Any how, I digress, Richard and I stuck together and stayed on track after the wrong turn to the end.  Eddie caught up with us and fell behind like a yoyo for a while and then went ahead at the very end so that I could have the DFL position.  At the last mile and a half turn, there were Jan W and Amy, Richard's wife and fellow tutu wearer!  The last time I saw Jan was when she picked me up in the Meat Wagon at Vol State.  Once again, she was a welcome, cheerful sight!  The four of us headed for the finish and Richard took off at a run and so did I.  After my last place finish, I did the lamest one armed cartwheel.  I ran more than I should have but it was worth it.

As far as the Addison's goes, I took 10 mg/ hour of hydrocortisone on the hour most of the hours.  For some stupid reason, I've taken to only bringing enough HC to last me the length of the race.  I'm not sure why.  When I went a couple hours out of the way, I panicked and thought I didn't have enough HC so I alternated 10/5/10/5 for a while.  It worked out fine.  I had enough energy to drive home and shower.

Thank you to everyone who made this weekend what it was.  Paul for taking care of the animals (we've added a fish to the family in addition to the birds and dog) and holding down the fort, Heather, Dave and Mama Joan for meeting us for dinner after a very long day of driving, Ron and Scott for camping with me, Terri for gathering all of us together, Richard for keeping my mind off of my lack of training and making me laugh, Yogi and Jan for being there at the end, Jim for the encouragement and whomever else I forgot.  Thank you.  For the first time since June 20th, I feel like myself again (even if I can't lift my arm yet or do a proper cartwheel).  I've got my motivation back and I'm ready to do a sub 24 hour Ancient Oaks in December.  I'm back Bitches!

Yep, that's a Cooter between my legs.  Cooter Festival, Inverness, Florida 

Lovely Terri telling us about the course.  Only none of us knew what she was talking about and fifteen of us followed the wrong yellow blazes

Vol State crazies line up at Mutual Mine.  Scott and Ron, did you match on purpose?



Yogi is training super hard and did a 50k the day before this race.  She looks good, doesn't she?!

Magic in the Withlacoochee

Scott M, Vol State crazy and RD of LOST and R40R

I don't know who this guy is but he embodies the joy I was feeling yesterday.  I love this picture

Ahhhhh, trail!

Giant Orb Weaver.  They like to have their stomachs stroked, really.

 

Richard and Eddie

Gotta love the low key ultra running sigange!

Jan drove over to Mutual Mine on her way to Panama City for her first Iron Man and Yogi stuck around until I finished.  Gotta love these girls!!

My husband made me shower before I got in bed last night.  I don't know why...

Meds and shit Lake to Ocean 100k

This post will probably be of interest to only a few people and to me at some distant time in the future.  I'm just chronicling my Addison's meds and what I could have done different and better or keep the same.  My race report is in the post below this one.

Lake to Ocean 100k was a training run for Vol State.  It didn't follow the "train specifically" principal BUT it was a long run that I did finish.  It did last a long time, 18 hours 29 minutes.  Vol State is 314 miles on Tennessee roads in the heat of July that has to be finished at your pace in under ten days.  So: heat, check!  thirst, check!  an unrelentingly long day, check!  Road, ok, not so much.  med adjustments, check!

MEDS:

• Woke up at 4:45 am and took the regular stuff (10 mg HC, .05 florinef, DLPA, 6.25 T3, probiotics, testo, progesterone).
• 6:15 am 10 mg HC
• Every hour on the hour 10 mg HC
• When I felt tired or lagging or too nauseous, another 5 - 10 HC.  I guestimate that my total HC intake for the day was about 200 mg.  Mind boggling to me but felt right.  I had no trouble sleeping.
• 200 mg sodium every hour until I started getting nauseous and cramping then two and hour and one every half hour.
• I drank about four gallons of liquids and peed three times.  I cramped spectacularly.  I sweated so much, it was unbelievable and disgusting.  Short story.  I met a really nice police man as I was going under a gate of awkward size.  Hanging under the gate with the policeman watching, my hamstrings and calves cramped up so much that I couldn't stand up.  I didn't want to drop into the dirt and mingle dirt with sweat.  I just hung there under the fence waiting for the cramps to subside.  They didn't subside quickly enough, I had to drop into the dirt.  It was a sign that I needed some salt!!

MISTAKES:

• I think I needed more florinef in a second dose on race days.  I felt unable to hold on to sodium or water.  I may be needing a little bit more overall on a daily basis.
• I think I needed more sodium for the above reasons.
• Only eating one Oreo all day.

GOOD:

• I don't think my nausea was any worse than anyone else's.  It was never debilitating and was not super comfortable.  
• I kept drinking water.
• My energy was pretty appropriate the entire time.

AFTERMATH:

• Napped twice on Sunday and still slept
• I was achingly sore on Sunday, slightly more than I usually am.  I also tried harder than I usually do so perhaps this was appropriate.  Perhaps I was sorer than usual because of all the cramping?
• Still cleaned cages on Monday!!
• My Tuesday streaking mile was...painful and whine inducing
• I pulled something in my right leg, hamstring, muscle across the back of the knee joint and, most worryingly, my right calf
• I might have curtailed my HC consumption too soon
• Got a migraine on Wednesday
• Friday and Saturday no longer sore (except right leg) but having big trouble with edema in legs, feet, arms and hands.  Oh yea, my lungs have felt a little smaller for about three days as well.  I took some extra Florinef and some sodium, viola!  Peed off over a pound of fluid.  BINGO.  I hope this keeps getting rid of the fluid because I've gained 10 pounds in six days.  NOT COOL.

Third time's a charm! Route 40 Romp 116 miles complete

Photo credit:  Lauren Hadley  Finishing the R40R in the Atlantic Ocean

As usual, this race report will be entirely too long and have too many pictures.  Quite unusually, I am writing this a few days post event.  Stuff will be bolded so you can skip the stuff that doesn't interest you.  If I forget to mention your name or thank you, I apologize!  I had an incredible, overwhelming weekend, met new faces and saw some old ones.  

Overview:  Route 40 Romp was thought up by Marv Skagerberg who did it quite a while ago.  I want to say in the 80's.  Marv and I did Vol State together last summer.  He's old school ultra.  Sitting and talking with him over the hotel breakfast was enlightening!  Scott Maxwell decided to create an actual event this year that he called the Route 40 Romp from Yankeetown, Florida to Ormond Beach, Florida.  116 miles of road.  To run this race, a crew was a good idea.  I was going to run with a stroller to hold my stuff but ended up with Marilyn as my crew.  For that, I'm grateful.

Marilyn:  Kathleen Wheeler who did the race had Marilyn contact me.  Marilyn offered to crew me.  We had met briefly the year before at Ancient Oaks.  Marilyn was an excellent crew.  What does a crew do?  Crew drives ahead and anticipates all of your needs before you do.  Crew treats you like a baby when you need it and kicks you in the ass when you need that.  Crew feeds you and gives you coffee and reminds you about your meds.  If I'm ever fortunate enough to have a crew at a race again, they have big shoes to fill!  I couldn't have done this race without Marilyn.  She was amazing and selfless.  She was always in a good mood.

Meds and health:    In the past, I've done complicated things with my meds.  A bazillion small ziplock containers with different pill concoctions in them for different times.  This time, Keep It Simple Stupid was my motto.  I took 10 mg of HC and 200 mg of sodium every hour on the hour.  If I couldn't remember if I took it or not, I took more.  I skipped all of my other meds.  In retrospect, I probably should have taken florinef Sunday morning but didn't think of it until now (Wednesday afternoon).  I came into this slightly hyperthyroid.  As a result, I had some difficulty with heat.

Race:

0-20 miles:  Casual start at the boat ramp.  I ran quite a bit and entirely too fast but it was nice.  I spent a little time chatting with Stephanie Miller who would eventually win.  Ran well, took meds and drank water.  Slowed down around 15.  Saw some interesting sights.  It's like Duck Dynasty up there.

Touching the Atlantic wearing my Orange Hat, very unflattering photo.  In my defense, the ramp was slanted

Sunrise over the Withlachoochee River

Ole' Yeller

WTF?  On Pocahantas Parkway

Really big bug

20-40 miles:  It got hot.  I started overheating.  Enjoyed spending time with my Vol State friends.  They are funny guys and make me laugh.  I was slowing down quickly and losing my appetite.  The heat really got to me and I kept hiding in the bushes to cool down and lay in the shade.  Jeff, Jeffy and Tim flew past me.

Photo credit:  Sue Anger

Wow, I'm actually running in this picture.  I think I look a lot cooler when I run than I actually do.

Ocala:  Ocala extended for many more miles than I had expected.  It was full of leering men from the eastern to western outskirts of all colors and sizes..  If you ever need to be hit on, go to Ocala and someone will hit on you.  Lucky me, I was told by a teen age boy that, "I would do you".  GROSS.

40-50 miles:  Marilyn and I got concerned.  I couldn't eat and I was really red in the face.  I wasn't drinking much either.  I was getting nervous that I would have to quit and called my husband.  He and Marilyn had ESP.  Paul told me to rest and have Marilyn make me soup and not leave until I could eat.  Marilyn had soup waiting for me at 50 miles.  I changed clothes, rested and ate.  Things started looking up, I felt better.  Finished 50 miles in 12 hours which was a goal of mine.

Sorry Jesus, this is the cheesiest painting I've ever seen. 

50-100 miles:  Marilyn fed me soup, coffee and water.  She was sweet and kind and even tempered no matter the hour, no matter her discomfort with being alone in rural Florida.  I was running hot and half naked running down Route 40.  For me, I did a lot of running.  It felt good.  I love zoning out in the night and just going.  Hated wearing the required "Rape Me" vest that told every motorist that a woman was running alone and half naked down the road.  I usually run under the radar, no lights and defensively.  Drunks don't swerve at you nearly as much if they can't see you.  I slept for 10 minutes on a picnic table on the side of the road.  That was all I slept during the race.  I was a little bummed to seem  to only have about 9 songs on 3 different music devices.  Scott Krouse was unexpectedly at the 99 mile aid station.  What a nice surprise!

I hit 100 miles with a one hour PR on my last PR.  That made me smile as, apparently, does jumping up on a statue and taking a picture with stallion balls in the middle of the night (see picture below).

Horse statue balls, I found this highly amusing

At Marie's Home Cookin', they have "FAMILEY" feasts.

There was a weird place with lots of statues.  I picked the Grizz and took my own picture with it. Marilyn was making me Jiffy Pop at the time.

 100 to 116 miles:    The wheels started coming off.  Sun came out, I was tired, nauseous, feet starting to ache and I didn't want to do it any more.  I tried to take Jim Sullivan's advice and use the time to think over what a great run it had been and what a wonderful experience it was but that didn't work.  I was having trouble eating but drinking was good.  Marilyn and I cheered every time I announced that I had peed.  At about mile 112, Sueper Star Anger (Sue Anger) offered me someone to walk with AND Marilyn gave me a Slurpee.  I got a cute British boy for four miles and I perked up a lot.

Marilyn taking care of me and encouraging me.  Steven probably couldn't believe how slowly I was walking.  Yes, Marilyn picked out my bandannas so that they matched my outfit!

Cartwheeling over the finish in my Wonder Woman costume.  116 miles in the books
9 solo starters, 4 solo finishers, 3 of the 4 finishers were the three women starters!  Well done  Stephanie, George and Kathleen!

Happiness and appreciation

Aftermath:  Monday and Tuesday were tough.  Tuesday night I had a little bit of a breakdown.  Today is Wednesday and I feel ok.  Muscles were achy on Monday but not noticeably so on Tuesday.  My feet ached when I took my sneakers off to go in the ocean but they were perfect, no blistering or bruising.   I have been taking enough HC to make me comfortable but probably not quite enough.  

Unlike other long races I've done, I've had no swelling post race, no weight gain and very little appetite.  I would imagine that taking enough HC has made all the difference in the world.

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 18^th (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!!

Rant: Quite literally, your mileage may vary

Shifting gears here from my medical and adrenal insufficiency related rants, I'm on to an exercise rant.

I've had people say to me, quite apologetically, "I'm not running yet but I'm going to or used to or insert excuse here."  Here's the truth.  I DON'T CARE IF YOU RUN OR NOT.  The more important question is, "Are you moving daily?"  Do you walk your dog every day?  Squats and push ups during commercials?

Let's get real.  I'm big time into walking.  I LOVE me lots of walking.  Running makes it hard to find money, take pictures, play with snakes and mud puppies on the side of the road and generally screw around.  Half the fun of my "running" is screwing around and finding treasures.  I'm not a serious runner.  Don't apologize or make excuses to me, the Screw Around.  Find out what YOUR thing is and DO IT.

Often people start out with lofty goals, don't write them down and plan out a reasonable schedule or any schedule at all and then they get injured or fail.  It's disgusting.  Don't get up off the couch and do five miles if you've been sick for three years.  For hell's sake, go to halhigdon.com and find a nice, reasonable WALKING plan that you can stick to for six or eight weeks. Find someone who will hold you accountable.  Report back to them daily Be nice to your body and don't damage it right out of the gate.  Exercise shouldn't hurt mentally or physically.  Find something you love.

You can do anything I can do.  Chances are, you can do it much, much better than I can.  I'm a hack.  Find what you love and get a reasonable program to get you there.  It doesn't matter how you get your miles in.  Biking, swimming, running, martial arts, walking, hiking, rock climbing, gym ratting, CrossFiting, WHATEVER!  Commit to something, set your goals high, progress reasonably and move your ass each and every day.  You can and you will feel so much better for it!

Don't compare yourselves to others.  Compare yourself to you last week.  After a month of moving, compare yourself to the you of a month ago.  After six months, set your goals higher and be proud of where you've come from.  Do more, be more, shoot for the stars.  Start today.

50K RUN IN CHICAGO, TAMPA OR VIRTUALLY FOR LANDAU-KLEFFNER SYNDROME - CHICAGO ROUTE UPDATE

To those of you who are interested: 

The route has been changed to the Chicago Lakefront - we'll now be running 31.1 miles along beautiful Lake Michigan on the Lakeshore Drive Bike Path but we're still planning on ending at Buckingham Fountain.  http://runkeeper.com/user/MollyMcForsythe/route/2090812

Start time will be at 6am just south of Buckingham Fountain, heading north towards Rogers Park and then looping back south towards 57th street (Museum of Science & Industry).  Then back north to the fountain.  Parking is free near Montrose Beach as well as the Southside Cultural Center along the lake.  OR if you're a city dweller you can hop on your bike, walk or run over to meet us.  If you are interested in joining us feel free to email me or just pop over to the bike trail and we'll be in pink t.shirts running our hearts out!!

On May 11th Darcy Lawler (Braden's Aunt), Amanda Collins, Dusty Hardman (running from her hoe state of FL), Terri Preast (running from her home state of TN), Courtney Anderson and I are running for Landau-Kleffner Syndrome and we're going to run our hearts out!

DONATIONS ARE STILL BEING TAKEN IN HONOR OF BRADEN PEIFFER AND LKS:

https://www.rarediseases.org/about/support/donate/fg_base_view_p3

https://globalgenes.org/give/

http://ireport.cnn.com/docs/DOC-930698

http://lksrun50k.blogspot.com

https://www.facebook.com/molly.m.forsythe?ref=tn_tnmn

Rant: Run before you walk? Impossible!

I am not sure if this is just human nature or if we are a very entitled society.  Why would anyone want to run before they walk.   It's exhausting to see people constantly undermining themselves by wanting to run full throttle at the very beginning of an exercise program.  In the end, people who want to run before they walk get sicker or injured and then complain, complain, complain!!!!!!

Tell me why people think they can be couch bound for a year and then think they should get up and run five miles?  Why?  What can they expect to gain?  What's so great about going far and fast and running the whole way?  I really want to know.  It's not a very good idea and NEVER has positive benefits.

WHAT HAPPENS WHEN YOU RUN BEFORE YOU WALK

• You have an under trained body that's not used to the old, physical stresses.   Muscles, bones and tendons are weak.  The endocrine system is not used to being pushed.  You are probably fat which makes the above problems worse.
• You set your mind to the glory of doing what you "used to do a decade ago".  Woohooo for you, you ran a 10k ten years ago.  Since then you've been ill, put on 20 pounds and had a kid or two.
• You are ready, you go out and RUN.  It feels great at first.  You start to feel ill but push through to five miles.  You drag your sorry ass home.
• You are unable to get off the couch for two days because you are so sore.  You complain that running is not fun.
• Perhaps you persist in this regime for two weeks?
• You end up with a stress fracture in your foot and a pulled hamstring.
• You determine exercise didn't work for you.  You complain more.

REALITY

• Too much, too far, too fast will ONLY get you hurt.  Look at David Goggins.  Even excellent athletes that do too much, too far, too fast will get hurt.
• You will get depressed that your exercise "didn't work".
• You will whine and complain that you get hurt from exercising.
• Even if you are determined to exercise again, you will have to take a break so that you can heal and whine about that too.
• Most likely you will go back to your couch life and affair with Pop-Tarts and the TV and get fatter.
• YOU HAVE GONE ABOUT GETTING EXERCISE ALL WRONG.

A WAY TO ACHIEVE YOUR GOALS

• Consult your doctor to see i f you are healthy enough to exercise.
• If your doctor says no, pin him/her down as to what WOULD make you healthy enough to exercise. Set health goals and reach them.  Go back and get the go ahead.
• If your doctor says no and you don't agree, find a new doctor who will support your goals.
• Hire a trainer who knows his ass from his elbow and can help you come up with a consistent, slow build program.  If you want someone who is currently uncertified but has half a brain, contact me, I can help you build a reasonable strength training and walking program and set goals for a fee.

• START OUT BY HAVING A GOOD WALKING ROUTINE.  WALKING IS GOOD, WALKING CAN BE HARD, WALKING STRENGTHENS BONES AND MUSCLES.  WALKING WILL BURN CALORIES.  (Why do people think walking is so uncool?  I don't get it.) IF YOU ARE GOOD AT WALKING, YOU CAN WALK FASTER AND FARTHER THAN PEOPLE RUN, THINK ABOUT IT.  READ THIS IF YOU WANT TO THINK WALKING IS COOL OR EVEN IF YOU DON'T.  This guy can kick your ass and he's in his mid 60s.
  Ultra Walking With The Master – Ulli Kamm

• Set long term goals, medium term goals and short term goals and don't be married to them.
• Be consistent.
• Be proud of your accomplishments no matter how large or small.
• Be more consistent. Be consistent, be consistent.
• Keep a detailed journal of your medications, exercise and how you feel.  You will see patterns on paper.  You will make up patterns if you try to remember things.
• Be more consistent. Be consistent, be consistent.
• Adjust medications as you progress or as needed.
• Know that you can achieve any goals you set.
• Be more consistent. Be consistent, be consistent.
• BE INSPIRED

That's it, rant over.  A rant along the same lines about Adrenal Insufficiency meds will follow...eventually.

314 miles in 9 days and the meds that made it possible

When a person has adrenal insufficiency, they are unable to produce:  cortisol, aldosterone, DHEA, testosterone (women), progesterone (some women).  If you can't maintain a good blood sugar, blood pressure and muscle mass, you can't do much.  Sometimes, people die from lack of cortisol and aldosterone.

I replace all of these hormones and thyroid hormones.  Replacing hormones while on a long run is challenging.  Knowing how to replace them takes study of medical journals, understanding of human physiology and listening to other's experiences.  Next, there's a LOT of trial and error.  Years of it.

Most of my pills are round and white.  Quite annoying because they all look the same after they've been in a back pack for a week and have been jiggled around for 250+ miles.  Good thing I can tell some apart by taste or I'd be pretty screwed taking DHEA instead of hydrocortisone.

The first three days, I did what I've done in training runs:

• 10 mg HC, .1 mcg florinef (I usually take .075 but splitting the pills that little was too much work), 12.5 mcg T3, 12.5 DHEA and probiotics
• One hour into running, I took 5 mg HC and 2 salt supplements/hour, T3 at regular times (11 am and 2:30 pm),  6.25 DHEA at 11 am also
• The last dose of T3 and DHEA were questionable because the pills crumbled up and I couldn't tell what they were for certain.
• On the really rainy day, I only took one sodium supplement/hour
• 100 mcg of T4

On the third day, I started having trouble with nausea, crying and inappropriate muscle soreness.  The third night a light bulb went off in my head, I was under replaced!  The fourth through ninth day, I took 10 mg of HC/hour for a total of 100 - 150 mg/day.  I needed it.  I did have some trouble sleeping but I do whenever I get a lot of exercise and also did on the first three nights when I was taking 50-75 mg of HC so I don't think it was the HC.

When I had my breakdowns on the road, it was almost always due to needing to eat and needing more HC.

I was very careful to stay hydrated.  On the hot days, I drank about two gallons of water.  No Gatorade.  I didn't want to drink hot Gatorade, it was just not appealing to me.  I had a few Icees.  One root beer and one gingerale.  Ice water was a treat.

If I had to do this all over again, I'd start out my adventure with 10 mg/hour of HC.  For any race under two days in duration, I'd stick to 5 mg/hour.

I was also careful to eat when I was hungry during and after the race.  When I finished my other multiday run, which was half the distance, I returned home feeling very hypothyroid.  After doing some research, I discovered that the body needs food post race to stay out of the hypothyroid state.  During my international travels immediately post race, I didn't eat much because I was too dumb to convert my money into Euros so I had no money to eat.  I bought a huge bar of chocolate and that's all I had for about 24 hours.  Gross.  I suffered when I returned home.  I took the eating thing to heart and have not felt hypo.  

If you've got any questions, please ask.  

Wow! Barkley exceeded my expectations!

Geoffrey Baker took what I would consider the best picture of me EVER.   www.geoffreybakerphotography.com
Here's his Ultrarunning gallery:  http://www.geoffreybakerphotography.com/?gallery_page=slideshow&pp_gallery_id=1321285315 He took before and after pictures of us.  He's really talented and I'm excited to see how they turn out!  The picture above is after being on the trail for 12+ hours.  I was so happy to have done what I did.  Hiram is to the left.  We're getting our pages out to have them counted.

As usual, I have to start out with thanks to my husband for putting up with me and my nonsense.  For making me go out and train, for just rolling his eyes when I apply to a race in the middle of the night, for dropping me off and picking me up in various places so I can run and for understanding (?) my obsession with Barkley over the last 3.5 years.  Thanks also to Lora for being wonderful Lora and starting me down this path.  Thanks to the Veterans of the Barkley who have been so kind and welcoming to me over the years (Rich and John) and recent months (Oak Ridge boys).

I just don't know where to start.  This race was HARD.  I knew it would be hard and I set my expectations and training miles low to accommodate my expectations of me.  I was hoping to finish one lap.  I made that clear to the RD, laz, too.

I arrived at Frozen Head on Thursday and stayed at the "Limacher Hilton".  I woke up Friday with a blazing headache and a lot of fear.  Friday, laz arrived, set up camp and put out the map.  There was a new section added to the race called "Hiram's Gambit" if you were going down and Checkmate Hill when you went up.

I slept well Friday night.  Saturday morning, I felt pretty good actually despite the raging headache the day before.  The conch didn't sound until 8:11 am meaning the cigarette that starts the race wasn't going to be lit until 9:11 am.  When the race started, I stayed in the back of the pack as usual.  I was given some good advice to catch up with Hiram (of Hiram's Gambit).  I met Hiram a few weeks before during some training in the park. Once I caught up with Hiram, I held on and didn't let go!!!!!  His navigational skills are amazing and he's calm and peaceful.  Because Hiram is so good at navigating, I tried to take in directions and navigation and just enjoy the race.  The hills were amazingly steep both up and down.  I bonked a little going up Rat Jaw and thought I would lose my guys but they took a break at the Fire Tower and I caught up, nearly crying with happiness.  There was no way I could navigate the next section without them.  The prison section was incredible.  We walked through a tunnel under Brushy Mountain State Prison and had to climb out of a ventilation shoot.  The final section, where you're not allowed to train and can only see on race day, is incredibly steep uphill.  I can't even describe how steep it is.  I think someone said 40% grade?  Hiram and I finished our loop in 12:11.  Kerry gave us some of Leslie's chili and Hiram gave me a Coke.  I changed clothes and Hiram, Will and I went out on loop 2!!!  Hiram and I only did book 1 & 2 of loop 2 and then came back to camp with Marco.  I ran my mile for the day on the way down and arrived at the gate slightly before the guys.  laz played taps for me (very badly!).  I have to say it was one of my proudest moments ever.  If anyone got a picture of me, I'm grinning like a goon.  I did not expect to do as well as I did.  We did 25ish miles with 14,500ish vertical elevation gain.  For once, I was AWAKE at night, even at 3 am when I was showering.

Health wise, I FELT FANTASTIC!  I was the only person in my group that didn't get nauseous!!!!!  I'm not sure what I did differently.  Perhaps I have trouble with altitude and this lower altitude is easier on me?  Maybe heat really agrees with me.  Meds were as follows:  10 mg HC, 12.5 mcg T3, 12.5 DHEA and .075 florinef upon waking. 5 mg HC every hour.  I took 2 salt stick/hour.  It was badly needed.  I was getting cramps in my feet that reminded me to take more salt.

I want to go back next year if laz will let me. I KNOW I can do better and go farther.  I think three loops is within my grasp.  More intense training is what I need.  Mentally, I have what it takes.  Physically, if I could feel that good every time I raced, damn, I'd be out of control.  I've never felt so good during a race.  I'm so thankful for feeling good.  It doesn't happen often nor does feeling awake that late at night.

It was such a privilege to toe the line with Brett Maune, Jared Campbell, John Fe... the 3 people who completed the race.  Beverley Abbs finished the Fun Run.  It was also a privilege to be in the race with Frozen Ed, Stu Gleman and the rest of the amazing veterans.  What an eclectic bunch of people, a 75 year old man, many Europeans, world class runners...and me.  Wow!

Pictures from the race

Everglades Ultras!

I hate to do this to you all.  This is going to be long.  I'll try to keep my boring writing concise.  Skip the reading if it's too long or boring.  Look at the pictures!!

Saturday, January 21st was the first inaugural Everglades Ultras put on by Ultra Sports, LLC with Bob Becker as the race director.  I have to say, this was a special race.  The terrain was breathtaking, fast and easy as well as slow and challenging (see the video of mile 44).  I finished with minimal whining and no crying.  I did cartwheel at the end too.  I came in third overall out of the women and won a beautiful, hand carved walking stick!!!!!!!!!  Ok, there were only three women who finished but who cares?

H, another Addisonian, was there.  She volunteered but would have rather been running.  She was recovering from an injury.  We camped out the night before the race and she showed me nebulae through the telescope!!!  She was also at an aid station at the beginning of the race.  Fun to have Addisonian talk and support!

All of the volunteers were wonderful and enthusiastic.  The were so appreciated.  The ladies at mile 33.5 were especially wonderful.  One really babied me and gave me energy.  Thanks volunteers.

Bob Becker organized the race extremely well for a first race.  Well done Bob!!!!!!!!!

The State Park Rangers were all incredible and had big smiles for me when they went past.  They were so laid back and seemed to be having fun.  Nice to see such laid back law enforcement!

Biggest threats, poison ivy and mosquitoes.  I successfully covered up as much of my body as possible to avoid poison ivy.  I'm a mass of itchy mosquito bites though.  Man, they can bite the hell out of you through clothes.  Saw a small gator on the trail and a black racer back snake.  I saw some of the cutest, tinyist deer tracs and a spider.

As far as the race went, I was very happy with my performance.  I didn't cry.  I only sat on the side of the trail once.  I ran a lot despite very few, ok scratch that, NO LONG RUNS since Ancient Oaks in the beginning of December.  I actually took very little extra HC.  Maybe 30 mg on top of my 25 usual dose.  It was a good amount for the day.  The following two days I took 10 extra.  Seems about right.  I took two Zofran, one prerace morning and one when I thought I was going to hurl.  I finished 50+ miles in 13.5 hours.  I was happy with my performance.  More than anything I felt so thankful that I had the opportunity to see places that very few people ever see.  I got to meet new wonderful people and hang out with old wonderful people.  It was an amazing weekend.  Thanks Bob Becker!

Shit, sorry this is so long.

Video of mile 44.  I'd have this at the end but I can't caption it nor can I center it so, here it is.

Big Cypress Boardwalk the day before the race

Gator mama and baby at the Big Cypress Boardwalk the day before the race

Some type of fig plant that is parasitic and becomes terrestrial.  I really liked it because I took 100 pictures of it.

 

Friday, January 20, 2011 - look short sleeves at the prerace meeting!!!!!!!!!!  Bob Becker, race director, in bright yellow on the left.  I love Florida's warmth!  Zane was snowed in Idaho!

Steaming swamps in the early morning on West Main.

Sun is rising, birds are chirping beautiful.

East Main tram, swamp on either side of the road.

Sun coming through the trees on East Main

My shoes were like this from about mile 8 on.  Well, they got washed off in the unexpected creek crossing where I was convinced I was going to take on parasites or be eaten by piranhas.

Paparazzi!!!!  Kidding.  This helicopter flew over my head several times and parked close to where I was.  I had flash backs to Morocco.  I kept waving like an idiot at the helicopter, they eventually waved back probably because they felt sorry for me because I looked mental.

Can't remember where this little beauty was.

Right after the most wonderful aid station at mile 33.5.  Strangely out of place.

Back into the swamps on a tram.  This one was very over grown and kept snagging my tiara.  THE NERVE!

Out into the grasslands.  Hot and beautiful.

It got so hot out there and I wasn't handling it well (stomach wasn't).  I decided to take a rest.  It worked wonders and I felt well enough to continue.

Mile 44.  There was a lot of this at mile 44.  Finished up with muddy, wet shoes and a big fat smile on my face.

A well deserved breakfast on Sunday morning.