Monday, December 23, 2013

The Grapefruit Lesson

This is going to be another post about weight loss.  Part of me does not want to be another triathlon blog about weight loss, because I do this crazy sport for so many more reasons than to burn calories.  But this is where I am at right now.  As I've mentioned in many a post before, I've been gaining weight.  I am currently about 10 lbs over my old normal, and 20 lbs over my marathon PR race weight.  My goal is to lose 15 lbs. I've successfully lost weight in the past and have enough knowledge on healthy eating and enough exercise that it shouldn't be a problem.  So why have I been bitching about this for the past year and not done anything but make it worse?

It comes down to wanting an instant result, and I'm not getting it.  On Biggest Loser, they lose 10+ lbs on the first week.  And they aren't triathletes, so why not me?  Ok, I know that is ridiculous and I know there are a zillion reasons why that doesn't work in real life, or at least for people with only 15 lbs to lose.  My logical goal is to lose a pound a week.  That is all I am shooting for.  And yet, if that happens, I feel disappointed.  A pound is so measely, barely beyond my scales fluctuations.  The thought that I have to be disciplined all the time to get a little tiny one pound change gives me the excuse of "well, just this one time, it will only cost you a pound."

I had an epiphany grocery shopping the other day when I picked up a 3 lb bag of grapefruit.  No, this isn't about the health benefits of grapefruit, though they sure are awesome, but rather what I realized when I had 3 lbs in my hand.  You see, I don't have a car and have to carry whatever I buy the 2 blocks home, and then up the 3 flights of stairs.  When I picked up the 3 lb bag, I was dreading it.  Huh, 3 lbs is kind of heavy, isn't it?  If I can just lose 3 lbs, think of how much easier it will be to run.  It will be like I lost this sack of citrus.  And on the flip side, if I pack on 3 more extra pounds, that will be like running carrying this bag of grapefruits.  I don't want to run with grapefruits!

Somehow, this more concrete example stuck.  We've all heard the gains you get in speed for every 5 lbs lost and whatnot, but this was a clear "wow, I don't want to run carrying that" experience.  To make the point even more drastic, I pick up my dog, who ways 20 lbs.  That is what I've gained. It's like the old skinny me is running carrying this dog.  No good.

So it will be a slow process.  I am sure I won't be perfect along the way, but my goal is that in 3 weeks, I will be down a bag of grapefruits.  In a few more, take off a sack of onions.  It comes down to the fact that those 3 lbs seem much more significant now, a baby step that actually will make a difference.  I'm thinking this is the real reason grapefruits are referred to as a health food.   

Tuesday, December 17, 2013

Sick and Complaining

So remember when I vowed to workout hard about a week ago.  Yeah, that worked.  For 2.5 days.  But this time it wasn't weak will, but the cold from hell.  I know, I am a baby to whine and complain about a freaking cold.  If that is my biggest ailment, I will count my blessings.  But it has been absolutely miserable.  Let me give the play-by-play for a moment to justify just how bad I've been feeling...

Wednesday and Thursday I wasn't feeling quite right. Sore throat, tired, achey.  Wednesday I cut my run short, Thursday I rested.  I knew the crud some of my co-workers had and I wanted to avoid it.  Rest is best.  Friday was congestion, sore throat, and headache.  Saturday was much of the same until that evening.  Worst. Heachache. Ever.  Throbbing, accompanied by dizziness with every movement.  I did the sensible thing and called my mom to complain.  She goes "you don't think it's an aneurism, do you?"  Well, not till that moment!  It was one of those things that I was 99.9% sure was not true, but it was a nagging thought in my head as I couldn't sleep that night.  I was also incredibly nauseous, running to the bathroom repeatedly, but never actually throwing up.  Sunday was a bit better, then Monday and today (Tuesday) was full on snot-fest.  Ok, enough whining.  It's a cold.  I will survive.

This has put a wrench in my workout plans.  The logical side of me knows it is not a big deal.  I will work out through a lot, but not this, I could barely function.  Maybe some tough guy out there would, but not me.  I know it is December, a long, long ways from race season.  But, it is suppose to be test week- time to find out what gains I have made in the 7 weeks of the OutSeason so far.  And instead, I feel like I am losing every single gain.

The most frustrating part is that last Monday, when I resolved to workout hard, I felt so in control.  This time was going to be different.  I was going to get it together.  And then this happened.  A stupid little cold, but it knocked me off my tracks.  I will get better, and I won't even remember this come race time, but right now, I just feel liking sitting in a corner and feeling sorry for myself.  And that is exactly what I've been doing... 

Sunday, December 8, 2013

Why Wait Until January 1?

“A year from now, you will wish you had started today.” -Katy Lamb

 On January 1, millions (totally made up number here) will decide to start the year off right, beginning exercise and diet programs, determined to make 2014 the year.  I am typically one of them, as I always look for a good time for that fresh start.  In the short course of this blog, I have been on and off the exercise/health wagon more times than I can count, continuing to state that tomorrow I will...  (give up sugar, run every day, not skip workouts, etc.).  And yet, I continue to be unable to get in a pattern.  While I could list off a zillion (again, accurate number here) excuses, there is really no one to blame but my faulty resolve, and it will be me who regrets it come next season when I am falling short of my dreams and potential.  

So I'm not going to wait until January 1.  From tomorrow until January 1, I am going to see how much work I can get in.  I do not have a specific number in mind, but I am aiming to run, swim, AND bike every single day.  Yoga and core in there too.  I am not expecting to be perfect at this, but to remember that every minute counts.  Maybe I won't have time for a 5 mile run, but I can get in 20 minutes.  No time for a full out core workout, but why not a few crunches or planks.  If I am going to watch tv, it better be on the trainer.  I am hoping this will set me up for 2014 a little fitter, a little lighter, and already in the habit to get it done. 

Saturday, December 7, 2013

Crohn's and Colitis Awareness Week- Why it matters to me!

December 1-7 marks the annual Crohn's and Colitis Awareness Week.  Over 1.4 million Americans suffer from these diseases, together referred to as inflammatory bowel disease (IBD- VERY different than IBS- irritable bowel syndrome).  While we all have different stories, there seem to be some common elements, among them being fear, embarrassment, and isolation in addition to debilitating GI issues. 

To be honest, I've never shared my story before this, ever.  Yes, my doctor's know the medical bit, but not the emotions.  My friends might know the emotions, but I spared them the gory details.  I feel compelled to share now for a few reasons.  First, it is about 10 years since I was diagnosed, and I feel I have enough perspective now (finally) to look back without embarrassment and give my account.  Second, I want to help someone else.  As you'll read, I went about six months of having symptoms before being diagnosed.  Not because I was a medical mystery, but because I was too scared and/or ashamed to ask for help and go to a doctor.  I want someone to read this and see that it does get better, but you need to seek medical attention immediately!  Third, I want everyone who doesn't have Crohn's and colitis to understand what it really means to have it.  The pain, isolation, fear, embarrassment, etc.  We all know cancer is bad.  AIDS is bad.  Diabetes is bad, etc. Well, so is IBD.  No, we won't die of it (not 100% true unfortunately), but most don't really know what life is like with these diseases.  Thus we advocate.  And lastly, advocacy isn't just so others can pity me, or think I'm incredible for overcoming.  It is so that others can be diagnosed faster, receive better support from loved ones, improved medical care, and increase visibility for the need for research into these diseases.

When I was 17, I was independent.  Or I thought I was.  I did what I wanted (though I was a very good kid), didn't ask for help, and didn't need any help.  I was an optimist and prided myself on being the "easy kid".  I was just happy, no matter what happened.  That summer I furthered my independent by going to a college prep summer program at Brown University.  It was there, when I was at the peak of my adolescent independence, that problems started.

I remember the night I first had diarrhea.  To be honest, I didn't think too much of it, mostly just hoping no one could hear my issues from the other side of the bathroom wall.  I chalked it up to eating something that didn't agree with me- after all, with buffet dining, I was eating everything.  But it didn't really get better.  I wasn't having major frequency or urgency, but I was not having any solid bowel movements.  This was probably happening a few times a day.  I knew it wasn't normal, but I didn't really know what to do.  I didn't want to call home, when I felt so proud of myself for being away from home.  I knew if I went to the student health center, that would end in a phone call home as well.  I didn't tell any of my friends there, because a 17 year old doesn't strengthen friendships by talking about diarrhea.  So I hid it.  I figured it would pass.  I was still healthy, right?  Still eating, still doing everything I wanted to.  How bad could it be?

The program ended and I went home.  I kept up the charade.  I think it was slowly getting worse, but as it was a slow decline, it didn't seem too drastic to me.  A few times a day became 5, then 10.  That was my normal for a while.  And I still didn't mention it to anyone.  I had my tricks- run water to block the sound.  I remember once my mom asked me if I was having diarrhea.  I just gave a vague "um, every now and then." Nothing serious of course.

And then it kept getting worse.  I was having to go to the bathroom 20-30 times a day.  I learned episodes usually happened in threes.  Lucky for me, our hall pass system had 3 reasons- locker pass, water pass, bathroom pass.  So in each class I could go three times. I'm really not sure why no one questioned whether I had a drug habit or something, but being a good student lets you skate by without having to give many explanations. 

Obviously at this point I knew something was not right.  It was progressing and not just a fleeting thing.  But I looked for other explanations.  My sister had just self-diagnosed herself with lactose intolerance. Ah, that must be it!  So I cut out dairy products and took those tablets.  But still the diarrhea persisted.  Well, dairy can be hidden in things, it must be that, I'm just not being careful enough.  I also was preoccupied with many other things at the time, it was my senior year after all and college applications weren't going to wait while I sat on the toilet.

I started having fears of having an accident.  Sometimes the cramping would come on so suddenly, followed by extreme urgency.  At the time I was still on my high school gymnastics team, and I was terrified of losing control of my bowels every time I flipped. I started wearing an extra pair of underpants just in case, though I doubt one more layer would've helped.  Thankfully that never happened. 

I was in pain the majority of the day and completely fatigued the rest of the time, but I was determined to be a normal 17 year old, so I just kept pressing on.  However, it definitely wasn't normal, as I was turning down invitations for essentially any outing/social activity since it is hard to hide the constant running to a bathroom.  I was isolating myself when I probably needed the support of others the most. 

My sister had just come home from college for winter break and was out shopping with my mom.  That is the night I first saw blood in the toilet.  It terrified me.  I was scared I was going to bleed out and die.  I was so weak, it was difficult to stand up.  My mom called to check in and I told her, just a very quick before I lost my courage "I had bloody diarrhea."  They immediately came home and my mom called my uncle, who is a pediatrician.  He convinced her I did not need to go to the ER, but I was quickly off to the pediatrician the next morning.

Even to the doctors, I initially downplayed my symptoms.  Blood work showed I was very anemic, likely losing more blood than I was visibly seeing.  It also showed very high markers of inflammation.  Stool cultures didn't show any signs of infections.  Everyone seemed to be suspected ulcerative colitis or Crohn's so I was off to the gastroenterologist. 

Things start to blur together there.  It was a mix of terror and relief.  My secret was finally out and I was going to get better.  The colonoscopy was truly no big deal.  Everyone will say it is the prep that is bad, but for someone wtih chronic diarrhea, the prep was just like any other day.  Finally with a diagnosis, I was started on a mix of Asacol, an anti-inflammatory.  No change.  Then I was introduced to prednisone, my best friend and worst enemy.  I think it was around February, when I had my first solid bowel movement in over six months. 

Unfortunately, the problems didn't end there.  Feeling better was short-lived, and soon I was in the hospital and transferred to the experts at Johns Hopkins.  I was on morphine for pain, along with 60 mg of IV steroids and Cipro, an antibiotic rumored to help IBD patients.  Then were all the medications for the symptoms and side effects of the drugs- something to help me sleep thanks to the prednisone, anti-nausea medication, heartburn, etc. 

The rest of that first year was turbulent.  I was in and out of the hospital with uncontrolled flare-ups.  When you go into the hospital, they typically want to allow your bowels to rest, which means you are NPO- nothing orally.  That includes fluids.  I would go NPO for up to three day periods, which was the max before you needed parenteral nutrition.  Of course I was getting fluid through an IV, but nothing nourishing.  Every morning they would weigh me, and I'd watch my weight drop.  I bottomed out at 97 lbs.  I remember once during an NPO period they decided I needed a barium xray, which required drinking a solution most people would gag on.  I was so hungry that I LOVED it and was hoping the test didn't go well so I'd have to do another one. 

The emotional side of this period was tough.  I was in the hospital or recovering at home more than I was in school.  Johns Hopkins is over an hour from my home, so I rarely had friends visit.  Steroids turned me into a monster- I was irritable and just mean some of the time.  I remember having an "accident" one night and when the nurse asked what happened, I yelled and then cried.  I had also gone from a very independent person to relying on my mom, which was a tough transition.  I found out I was accepted to colleges from my hospital room, and feared what life would be like away from home.  When my friend's parents were buying "Best of... Colleges" my mom bought "Best of...  Hospitals."  I honestly had to consider the proximity of a medical center to my college in my decision process.  I can also remember touring my college and having to drop out of the formal tour because I couldn't keep up due to fatigue.  I looked at my mom and went "why are there so many stairs?"

As the medications began to better control the disease, the other side effects came out.  In that first year I had multiple flares of arthritis in my knees, with is an extra-intestinal symptom.  I had a handful of c-diff bacterial infections that landed me back in the hospital.  I would have weird skin rashes.  I got peripheral neuropathy in my feet from a medication, requiring me to sleep in silk socks because my feet rubbing on sheets was agonizing.  I also had a detached retina, which my doctors debated whether it was due to the disease and/or steroid use.

At 17, I knew a lot about healthcare.  I was taking 36 pills a day and going for routine blood tests every month.  I knew that to keep me healthy I was taking pills that could cause a whole slew of issues, including blood cancers and liver disease.  I knew about health insurance.  This included knowing that I would always have to consider what health insurance policy I would have when looking at future jobs. 

It seemed like such a success to finally get away to college, but just a few days into my orientation, I started having symptoms.  I remember calling my mom in tears.  But I knew I couldn't hide it anymore like I had done for so long, so I ended up in the hospital for a few days.  I was amazed by the support of friends I barely knew, but didn't tell them the whole story of what IBD involved.  You know, stomach issues.  I left out the details.  

While the first year was extremely difficult, it did get better. I still battled fatigue that limited my social life.  I initially had a very limited diet, and can still remember the first time I ate salad in the dining hall after not having raw vegetables since I was diagnosed.  I had to keep tabs on my medications and blood draws and get myself to doctors appointments.  I was hospitalized a couple more times in college, but had a good handle on alerting my physician at the first sign of trouble. 

I have been lucky to be pretty stable lately.  But while I am in remission, I still have a disease.  I still take a lot of medications with scary side effects, and spend time, money, and energy on other medical expenses including blood work and other periodic tests and doctor's appointments.  However, the worst is the fear and not knowing when I could be sick again.  In July of 2010, I was doing my first half-ironman triathlon.  I had trained religiously for 20 weeks, and on the way to the race started to flare up.  I was devastated.  I had felt so healthy, and suddenly I wasn't.  Everything I had worked so hard for was being taken away.  Fortunately, with a hefty dose of steroids and a couple days of pedialyte and white rice, I got myself to the starting line and amazed myself when I crossed the finish line far exceeding my expectations.  That moment is something I will remember forever.  I have a disease but it is not stopping me.  Granted, I know that there may be times it does.  Whenever I book a trip or sign up for a race, there is a voice telling me "but what if you flare..."  Whenever my stomach hurts, or I get "normal person sick" as I call it, I panic.  Is this a flare?  What about school? What about work?  What about life?  Unfortunately, stress can trigger flare ups, so they are most likely when we are least able to afford the time. 

My goal is to be more forthright about my struggles.  No more hiding what is happening.  People think it is just a little upset stomach, or maybe worse, like food poisoning, but don't realize the implications it has on someone's life, relationships, self-confidence, etc.  People need to know that we suffer, even when not having a flare.  We need to demand more research funding for diagnosis, treatments, and a cure.  We need to support fellow patients to help them through.  We need to focus on all that we have to be proud of, instead of hiding in embarrassment.  Crohn's and colitis need to become household names, even though they are as unwelcome as diseases like cancer.  Awareness and advocacy can help make this happen, and help people like me keep on living our lives, prepared to handle any flare that comes our way. 

Monday, December 2, 2013

2013 Turkey Chase 8k

The main thing on my mind lately has been the whole element of mental toughness, and more specifically, my lack of it.  It was evident when I did my bike and run tests, and then reinforced by a recent blog post by Elizabeth Waterstraat.  It is truly mental toughness that separates out the elite- the ability to endure pain, crave pain, push through pain.  It is also what stands in my way of massive improvements.

A turkey trot has been a tradition for me since I was probably about 9 or 10 years old. Back then, just by being the youngest, I could bring home some sort of prize, typically a sweatshirt a few sizes too big.  Anyways, just doesn't seem like Thanksgiving to me without starting the day with a Turkey Trot.  In addition to tradition, I was hoping this year's race could also give me a chance to test that mental toughness, and hopefully bump up my vdot. So with that in mind, off I went to the F^3 Events Turkey Chase 8k

Now of course, I have bad preparation going into this race. Sleeping badly and eating worse than badly is not the way to go.  But to counteract this, I talked myself into skipping workouts both Tuesday and Wednesday (after Monday) had been a rest day) to be most prepared. Yeah, obviously my mental toughness was showing well before race day.

After a bowl of oatmeal with brown sugar, I headed downtown.  And it was cold.  So so cold.  Maybe in January that won't seem as cold, but right now, frigid.  I was going to race in an underarmour mock turtleneck, my running jacket, and tights.  On top of this, I wore my big ol winter coat and sweats to stay warm in transit.  I arrived at the race with plenty of time, probably because I'm use to either 1) having to battle 20,000+ people to use a portapotty, and 2) having to check on my bike, inflate tires, put on wetsuit, etc.  This small town feel of a road race was refreshingly easy!  Eventually I had to part with my extra layers, and that is when I got really cold.

The start was right along the lake.  Wind in your face, just in case the cold hadn't woken you up yet.  I tried to do some warm-up in the grass, but my feet were numb and legs weren't too far behind. They announced that due to the high winds, there would be no start/finish arch or mile markers.  Ok, good, I wasn't making up the winds.  As I stood there getting colder and colder, the mental weakness was seeping in- maybe it is too cold to push it, wouldn't want to get hurt, I'll just take it easy.  Then the good angel was telling me to still go as hard as I can, maybe it won't be my best, but better to try.

The race went off and I was running at a good effort.  My legs definitely felt the effect of the cold weather, and I definitely felt as though that was my limiter at the start.  We were running into the wind for the first half.  Unfortunately, they didn't have the miles marked in any way (my one complaint about the race) and I was not running with my Garmin, so I really had no idea how fast I was actually going.

Quickly the crowds thinned out.  Obviously the leaders were a ways ahead, and I was towards the front of the pack, but mostly alone.  I'd occasionally leap frog with a few different people, but mostly focused on my own pace (which was unknown).  It was definitely getting harder, as the effort was catching up to me.  I knew the wind was against me, so I just kept telling myself that once to the turn around, it would be easier.  There were a couple times on the way out where I let myself slow considerably, to get back from that uncomfortable state to the sort of comfortable one.

I hit the turn around under twenty minutes, and was happy.  I was on track for a sub-40 (sub 8 min miles) which was my modest goal.  Immediately after turning so the wind was at my back, I was getting warm.  I tried to keep my focus but the mental weakness was increasing.  I am sad to report that I stopped not just once, but twice on the way back.  Not just slowing, not just walking a few steps, but stop and stand on the side of the road.  ARGH!  What is irritating is that looking back on it, I can't remember what was so bad that I had to stop.  Was it my legs? My lungs? My brain?  Obviously, stopping was not necessary.  Obviously I could have powered through.  But I didn't.  So as much as this race is a benchmark to my running fitness, it also shows my mental game, and that is a major area to work on.

Ironically, even with an out and back, I had a poor concept of where the finish line was.  I was switching back and forth from thinking it was right ahead to thinking I had a ways to go.  I tried the trick of "you only have 10 minutes, you can do anything for 10 minutes."  Turns out 10 minutes is a long time to be uncomfortable.

I ended up finishing in 39:03.  Pace-wise, I am happy with this.  It bumps up my v-dot, giving me new training paces.  It is closer to where I want to be, though my 8k PR is 35:36 so I have a ways to go to get back up to speed.  However, I am definitely headed in the right direction.

My plan is to get comfortable being uncomfortable.  No more skipping intervals in workouts, no matter what the excuse.  I am also going to sign up for a few more 5k-10k races this winter, as I know they push me more than workouts do.  I am against paying $45 for 5ks on principle, but maybe they can be worth it to get me over this mental hump.  The mental game and type of uncomfortability (is that a word?) is very different in a 5k versus an Ironman, but both require that internal dialogue of SHUT UP LEGS!  I want to run my Ironman (yes, run, not walk!) with memories of when I pushed through no matter what the distance.  Time to train the brain!