Thursday, July 17, 2014

So many good things to share

Despite the setbacks I am having in my running due to my health problems, there are so many things going right at this moment, that I can't possibly be bummed out.


First, I am pleased to announce that I am now representing a fantastic company, Oiselle. This company first caught my eye when they sponsored one of my favorite runners, Lauren Fleshman. They are a group of strong, outspoken women who provide awesome support for female athletes of all levels. I love that they have opened up the team to more runners and are able to support so many athletes despite being such a small company. I saw this as a chance to be part of something that is wonderful.    


Our fun running group last Sunday!
Second, I have partnered with a local studio, P2O Hot Pilates, to help with their running program. I joined this studio on an introductory offer and fell in love with the family atmosphere and the work ethic of the instructors and members. These classes are no joke and are fantastic for developing strength and mobility in runners! I love that they offer a free organized running program that is open to all levels and even non-members. The owners want to encourage running in their community, and I am excited to be a part of that! I am currently leading the runs on Thursday a.m. at 5:30 and Sunday a.m. at 7:00, both from Big Lots at 8700 La Riviera Dr. We head to the bike trail and have a lot of fun. Please feel free to join us for a run!

Third, my businesses are doing really well right now. I am enjoying an amazing explosion in my ecological consulting business. I love the work that I'm doing, all of which is supporting the conservation of biodiversity in California and beyond. I care so much about this work and am grateful I am able to make a living doing what I love. It's also wonderful working for myself. I was pretty freaked out at first about the challenges of starting my own business and all of the hardships that come along with that. I have been pleasantly surprised at how easy and fun it has been. Even with the health issues and medical expenses, I am able to make it work. My coaching business is also thriving, with athletes doing really well all around the country. It is an honor to help them and watch them work hard and reap the rewards of that hard work. That is why I love coaching.        

Finally, it wouldn't be an RAF blog post without a health update. I know it seems weird that I am so public about something that is so personal and really unflattering. This blog has always been about honesty and sharing information and experiences with others in hopes that it will somehow help. The messages I receive from women who are either going through this same thing or know someone who is confirm that my openness is helping others, and that's what it's all about.

This week confirmed that I made the right decision to postpone my marathon until December. My health issues reemerged at an alarming level this week, and I have become even more anemic, yet again. The good news is that I am working on the things that I can: overall strength and running speed. My endurance is not good at all, but I can do speed work without a problem. As always, once the spigot shuts off, I will be able to get my blood levels up and will be back where I left off.

I had a hysteroscopy (scope inside my uterus) last week and confirmed that my big daddy fibroid is in fact occupying my entire uterus and is stuck inside the lining. I have a picture of this guy on my refrigerator. My friends who saw the picture started seeing fibroids in everything: banana muffins, emoticons. I will spare the rest of you that torture. So, the fibroid I have can't be removed surgically without taking everything with it. What they can do, and I go in for a surgical consult tomorrow, is shave away at the fibroid a little at a time. This supposedly will reduce the hemorrhaging. That's the hope, anyway. I may need to go in a few times to get this big guy shaved down, but the recovery time is a matter of hours rather than weeks with this procedure. Totally worth a try. I will look forward to losing a few pounds as well with the removal of this little ball of muscle!

I am proud that I have held my ground and fought the doctors who were ready to yank out my useless uterus, telling me I had no other options. I may be on my 4th OB/GYN, but I now have doctors telling me that I have some great options available and they are actually treating me as if I have a choice. In the end, I may end up having a hysterectomy, but nobody should be pressured into that decision. There are so many other options out there, and we deserve to at least hear about them!!!

So, all good things. Give good stuff to the world, and good stuff will come back to you!  

Wednesday, July 2, 2014

I Got You Babe

I had to make a tough decision this week about my racing schedule. I have been training for the Eugene Marathon now for months and am as fit as I have ever been heading into a marathon. I have conquered some major workouts and have been putting in the highest mileage since last fall. In my last post, I mentioned that my health issues had cropped up again and that I was taking some new medication to try to bring things under control. As luck would have it, the new medication worked for its intended purpose, though I had to up the dosage to get it to work. However, the side effects from the meds were pretty dramatic. Several days last week, I experienced severe GI distress for hours so terrible that I was unable to eat or even stand. I understand this to be a common side effect of the medication, but that doesn't make it any easier to deal with.

As I missed a couple of days of training (and work!) I realized that I just wasn't going to be able to rally from this one. I could feel in my easy running that my blood levels had dropped again (confirmed yesterday with hemoglobin of 11.5 and hematocrit of 35). It feels like I'm running at altitude or through molasses. The easiest efforts feel harder than they should. I've had success at getting my blood levels to recover quickly, but my training suffers until they improve. So, I conferred with friends and coaches and decided that I should let Eugene go.

One of the things that really struck me in my conversations about this was the distinction between just running another marathon and trying to achieve a gigantic goal. I have no doubt that, if my blood levels did rally in the next couple of weeks, I would have a decent race in Eugene. I'm sure I'm in sub-2:50 if not faster shape. I had to ask myself the question: what are you really wanting to do in Eugene? Do you just want to run a decent marathon or do you want to run your fastest marathon? 

We've all read stories of elite runners who overcame years of injury or sickness to come back and have spectacular races or seasons. What I am realizing is that you don't get to play the lead role in that story without making some really smart decisions about your training and racing. You have to decide what is most important and you have to go after that goal with the determination and drive of a predator. It is perfectly fine to race a bunch of races because you love the thrill of competition or racing, but that comes at a cost. You won't maximize your potential with that approach or if you do, you will pay later with a broken down body. I've seen it over and over. The people who achieve the big goals make sacrifices and smart decisions along the way that move them closer to their goals. 

So, I did the calculations. If I ran Eugene and then took the 4 week recovery into account, I wouldn't be ready to start training for another fast marathon until September. I think my best chances for a fast marathon are in my own back yard at the Cal International Marathon. I would need to get started training for that in a few weeks.

So, my body decided not to cooperate this time around. As frustrating as this continues to be, I do know that my day will come and that there is a marathon PR or even an Olympic Trials qualifier in my future. I also know that if I don't work with my body and make smart decisions along the way, I won't reach my potential.

So, I am starting over again, getting back to some speed work and letting my body recover a bit before launching into another marathon training cycle. I feel like Bill Murray in Groundhog Day, waking up to Sonny and Cher over and over and over. But, I'll take that over the alternative any day. 

Keep your dreams alive people!                        

    

Friday, June 20, 2014

The one where I run a 1/2 marathon distance PR

That's right kids. What are the chances that both half marathons I run this spring end up being long, and not just a little long from Garminization, but 3/4 mile long? I feel like I should play the lottery some time soon. Here's a picture of me right after I finished. Do I look pissed?

I think this is right before I exclaimed, "Damn it, Chad!" (a Fleet Feet Event Mgt. employee) as he put my finishers' medal around my neck.
I have put off writing this race report because, quite frankly, it isn't fun to write about failures, and I also needed some time to cool down. I am not going to bash Fleet Feet Event Management, the organization that put on the event. They typically put on really professional races, but they had some bad luck of their own in the days leading up to this one. In short, they were short on volunteers for the event and they weren't able to supply enough course monitors to man the half marathon course. I'm sure they thought they had set up enough barriers and laid down enough chalk to keep everyone straight, but the course was very confusing to even the cyclists with maps who were leading the runners all over Sacramento.

The first problem I had that day was forgetting my Garmin. I have never done that before! I thought I might try to be Zen for this one and just not use a watch, but OMG am I glad I found a loaner! I can't imagine how much more disastrous that race would have been had I not known how long I had been running after I lost the course. And, then having a record of some of my splits for posterity's sake since the recorded time was about 5-6 minutes slow. I saw my friend Erika right before the race and luckily she had a friend, Jacqueline, who was running the half marathon and generously offered me her Garmin. I was so humbled by this gesture! I will pay it forward one day, I promise!

As I saw the pleas for volunteers from Fleet Feet Event Management stream across Facebook in the days leading up to the race, I had a bad feeling that something might go wrong. Given my experience at the Parkway Half and the fact that I had missed a 10k race the month before because of my health issues, I just wanted to run a legit race and test my fitness.

I met the eventual winner at the start line and introduced myself. She runs for the Oiselle Racing Team, and I knew that she would lead the race from the gun since she has a 1:17 half marathon PR. I also found a friend at the start, Kristen, whom I have met at other races and expected her to be right up there in front too. This is an all-women's race, by the way, so the three of us formed the lead pack. Except that we really weren't a pack. From the gun, Alison was in the lead as I expected. She went out hot. I stuck to my race plan which was to run 6:10-6:20 pace for the first couple of miles to get in a groove. I didn't become discouraged as Alison and then Kristen increased their lead on me in those first few miles. I had read a fantastic race report from Ellie Greenwood, the winner of the 2014 Comrades Marathon, the day before where she emphasized the importance of never giving up. You just never know what might happen in a longer race. Especially a hot race. The temperatures would reach 100+ later that day, and I think it was about 80 degrees when I finished, so not exactly cool. I have been heat training so I knew I would race relatively well in those temperatures and that would be an advantage.

Back to the race: Alison had gained a lead on Kristen and me by mile 3 and a cyclist dropped back to help us figure out where to go since we could no longer see the lead runner. Kristen was right with the cyclist and I was a few seconds behind her. We made a couple of turns and then I saw the cyclist stop abruptly while Kristen followed some cones around to make a left turn onto Folsom Blvd. This is one of the most heavily trafficked roads in Sacramento and I was a little surprised that they would shut down traffic for the race. In actuality, I wasn't really thinking. I was racing and following the cyclist and Kristen. As I turned onto Folsom, the cyclist, parked safely on a side street, looked up from his phone and smiled at me. I could see Kristen running in the vehicle lane and, at first, there wasn't any traffic coming toward her. I thought it odd that they wouldn't have coned off the shoulder of the road for the runners, but whatever. Then, the traffic light changed at 65th and Folsom and cars started streaming toward us. I was in the gutter at this point recognizing that something was seriously wrong, but Kristen hadn't caught on yet and cars had to swerve around her as she held her lane. I finally realized we were screwed and yelled at Kristen to turn around, but she was wearing headphones and didn't hear me. Don't wear headphones in races, peeps!!!

I took the first left that I could, which was 65th street and took it to Elvas Ave. I knew that the course hooked up with Elvas at some point, though I didn't know whether it was on the way out or the way back. At this point I had no idea how to get back on course or whether I was cutting it short or running long. I finally found a police officer acting as course monitor and stopped (and didn't stop my watch) to ask where I was. He directed me down an off ramp and I started seeing what looked like course markings. It wasn't until I found an aid station around mile 6 that I found out where I was on course. That's when I knew this was going to be 3/4 mile long. I also found out that the leader had run the correct course, so now she was completely out of reach (as a side note: she ended up slowing a lot in the latter part of the race, which makes me wonder what Kristen or I could have done in the latter stages as we caught up to her). I didn't see Kristen anywhere even though I half expected her to catch up to me as I had lost some motivation at this point. I found out after the race that she was misdirected not once but twice and eventually dropped. Unlike the Parkway Half where everyone ran a long course, I knew that no adjustments would be made to my time for this one since at least the leader had run the correct course. How deflating.

Of course, dropping out crossed my mind A LOT in the second half of the race. Luckily, my friend Christina Applegate was on her bike not only giving me info on what was going down from an effed-up race standpoint, but also keeping me focused on getting my job done. I love that she decided to put these words on this photo she took because they are the same as the title of Ellie's blog post. I did not give up!
Thanks, Apple, for the pic and the support!
The final insult happened when I approached McKinley Park and there was a cop directing traffic at an intersection. He had his back to me (!) and was waving cars to move through the intersection. I made eye contact with the lady in the car who was being directed to cross the lane I was in, but she just kept moving right on through! I kept running thinking she would stop until she eventually nicked me with her bumper as I yelled out in surprise. I wasn't hurt at all, but Jesus Christo that was ridiculous!

I didn't quit the race even though I did slow at the end. Even running to the 13.1 mile point and lapping my borrowed watch was pointless because I had stopped running a few times to figure out how to get back on course without stopping the watch. I am still unsure what I really ran that day, and I guess it doesn't matter. I estimate I was about 5-6 minutes faster than my gun time but who knows?

I ended up coming in second place and found out that a pack of runners behind me also ended up running different configurations of the course., though most ran shorter than me because they figured out the mistake sooner. Eventually, someone figured out the problem and the rest of the runners were directed along the proper course.

I am not going to lie and say that I let this one roll off my back. I didn't. I really felt sorry for myself after this one. I didn't get to run a single legit race in my build up to the Eugene Marathon because I was either anemic or the course was long. That is some bad luck.

The next day, my health issues cropped up in a major way. I had cramps of the same magnitude as the ones that sent me to the ER back in the winter. This time, I had a bottle of Norco to ease the pain, and I knew that it was just my fibroid baby talking to me. But, holy cow, those cramps are debilitating. It took me out for the entire day. Then, I started bleeding like crazy from Tuesday until, well, yesterday. I had my blood levels taken on Monday to just get a sense of where I was and I was only borderline anemic (hemoglobin = 12.3; clinical anemia is < 12). This actually made me happy to think that I could experience as much blood loss as I had the week prior and still not get nearly as low as I was back in March (hemoglobin < 10). Nonetheless, these levels are still low, and I have found anything under 13 has a noticeable impact on performance, particularly my endurance. I ended up having to skip both of my hard workouts last week because of the uncontrollable blood loss, but I am back training as normal again this week.  

I ran a long workout Wednesday (shout out to Jen P. for getting my butt out there!) and attempted the workout as written. I knew I would have to play it by ear given how I had been feeling, but I wanted to give it a try. The workout on my schedule was 16 miles with 5-7 mile warm up and 4 x 2 miles at threshold pace. I was pretty certain my threshold pace was going to be slow but I thought I might be able to do at least 3 of the repeats. It went better than expected with my 2 mile splits at 12:15 for the first 2. I could definitely tell I was working though. I ran one more mile at around 6:08 pace and then the wheels started coming off. The last mile was around 6:15-6:20 pace and I knew it was time to jog it back in. I didn't really jog though. I finished all 16 miles at an average of ~6:50 pace, so that was another surprise. I will say that I felt like hell afterward. However, I rebounded quickly and enough to get in a TRX workout that evening.

I am on a new medication that is supposed to help control the bleeding, but it does have side effects. It is basically a super dose of progestin. It seems to be working to control the bleeding so far (fingers crossed).

So, what does this mean for my Eugene Marathon training? It means that I am going to continue to train as if I didn't have these health issue and just do what I can. I can't push my body harder than it can go, but I am hopeful that these new meds will keep the bleeding to a minimum so I can use the next 5 weeks to create more red blood cells. The good news is, once my hemoglobin levels get close to 14 again, I am going to feel like a freakin' rock star! I have been there and I know that feeling. It may or may not happen before Eugene, and that's okay. There will be other races for me to attempt to run under 2:43.

If I've learned anything from this spate of bad luck and bad health it is to never, ever give up on myself.                            


Saturday, May 31, 2014

Shoes, Supplements and Strength

After months of posts about my health issues, I am happy to move on to much more important things: shoes, supplements and strength training!

First, I should update you on my training. I can't say things have been as great as they were around the time I ran the Parkway Half Marathon. That truly was an exceptional time for me. My blood levels were peaked and I felt awesome. Since then, my blood levels have dropped quite a bit and I had to miss a race because of it. This regression is upsetting, for sure, but I am learning to cope with my new 'normal'. My condition is progressively improving, but that improvement curve is more sinusoidal than linear.

I am learning a lot about patience and attitude. When my blood levels are higher, I have great workouts and when they are lower, my paces slow. BUT, I am doing the work that I need to to become a faster marathoner. I have really had to work on my attitude when my blood levels start to drop. I know it will affect my performance and it is really hard to even motivate myself to go out and run. I know that my goal for each workout is not how fast I run it, but just that I get it done at the right level of effort. As my blood levels rebound I will naturally get faster and paces will feel easier. The work I put in, regardless of how I feel, will pay off in fitness gains.

I make this sound easy, but it's not. I am in the meat of my training for the Eugene Marathon right now and am doing the big Jack Daniels' workouts. I generally have two long runs per week with 10-14 miles of marathon and/or threshold pace mixed in. In the last week, I ran two marathon paced workouts of 10 miles. The first one was run with reasonable (not great) blood levels and the second was a week later with lower levels. The first workout felt absolutely great. I cruised along for 10 miles @ 6:10 - 6:20 pace with ease and felt fantastic. This was a pretty remarkable workout for me given how far out I am from the marathon (8 weeks!).

In contrast, the one I did Thursday of this past week was not so fun. I had experienced the worst bleeding since March and am likely close to anemic again. I knew going into this workout that I was going to suffer. I drug my feet all day about even doing it and finally pushed myself out the door at around 7 pm. It was 85 degrees. This workout was a total of 14 miles with a continuous workout of 6 miles marathon pace + 1 mile threshold (T) + 3 miles marathon. I was mostly dreading that T pace. I started out into a headwind which really pissed me off and I decided to run back and forth on a two-mile stretch of the bike trail to get relief from that for at least half the workout. For some reason, this is easier for me to handle mentally than running out 5 miles and back. I broke the run down into two-mile chunks in my head. I started off around 6:25 pace for the first two miles into the wind. It felt hard. I turned and, with the wind at my back, was able to speed up ever so slightly. 4 miles done. I got some water and turned back into the wind. My pace remained steady around 6:20 through 6 miles. I had already decided to ditch the T pace mile if I was feeling crappy and almost forgot about it until I hit the half mile split in mile 7. I saw that my split was 3:03 and I decided I should try to get under 6:00 (my T pace) for this mile. I actually felt okay running 5:59 for that mile and then slowed for the M pace to complete mile 8. I stopped again for water and then finished up the last two miles under 6:15 pace. So, all in all, this workout was only 1-2 seconds slower per mile than the one I did the week before even though it felt less comfortable. I was mostly proud of that 7th mile.

This entire workout was a HUGE mental battle. I kept feeling sorry for myself and let the worry slip in at every curve. Would I be able to finish the workout? For how many days would my blood levels continue to drop? Will they recover in time for my half marathon next weekend? Would they keep me from running a good marathon in Eugene? When will the madness end? I must have had the most horrible look on my face the entire workout, but I will say I was glad when I finished.

So, my marathon training is actually going well. I am up to around 70 miles per week and I won't go much higher than that this cycle. I am doing major workouts and they are tiring, but they are really giving me confidence in my marathon fitness. I have never run so many long workouts this close to goal pace this far out from a marathon. Fingers crossed that the stars align and I get to the starting line in Eugene fit and healthy! I am defending my title, after all.                                

SHOES

I've been meaning to write about some changes I've made in my running footwear over the past months. Typically, shoe changes lead to injury for me. It normally takes about 3 weeks for me to see the effects, but my last couple of changes have been right before I became pretty majorly injured. I normally wear the Nike Pegasus as a training shoe and the Nike Lunaracers as my racing shoe for all distances including the marathon. One thing that I dislike about the Pegasus is the fact that I wear them down quickly. I get about 200 miles out of them before I start to lose support and need to swap them out. This is about 2 1/2 weeks of training for me, so pretty expensive. So, I began adding shoes into my rotation to break things up a bit and to just see what would happen (I can't leave well enough alone). Here's what I'm wearing.

1. Nike Pegasus 30. I now wear these about 1-2 times per week for easy runs.
Pegasus 30

2. Nike Flyknit Lunar 1. I'm on my third pair of these lightweight trainers and really like them. I like that they have a higher heel drop, good cushioning and are super lightweight. I've been able to get away with wearing them for my long (14-18 mile) workouts. I've been getting about 150 miles out of a pair of these before needing to retire them.
Flyknit Lunar 1

3. Nike Lunaracer 3. These are my racing shoes and I train in them when I'm doing fast and short speed work. I'm not sure I'll ever change these out. They work way too well for me.
Lunaracer 3



4. Hoka Kailua Tarmac. These were a big gamble for me. I wanted to try them because of the extreme cushioning they provide and thought that might be beneficial for recovery days. I also wanted to see if I could get more than 200 miles out of them. The risk was the low heel drop. Each time I've tried to go lower than my Nikes, I have ended up with niggles and injuries. So far, I haven't had a problem with these and I can't quite say why that is. Perhaps it's the rocker bottom that they use, but I don't have achilles or calf soreness from the low drop. Instead, I feel like I get that cushioned ride that I was looking for and can tell the difference running in them. I'm at 200 miles on this pair and I feel like I can wear them longer. My legs feel better recovered after a recovery run. I wear these on my easy days 1-2 times per week.
Hoka Kailua Tarmac

5. Hoka Stinson Trail. I started running on trails a few months back and decided that my road shoes were a hazard. I invested in these right after getting the Kailuas. These are like running on marshmallows, and I really appreciate the cushiony ride on my easy days. I wear these on trails and when I feel like I need a little less impact on tired legs. I also like a heavier shoe for easy days which makes my light shoes feel like slippers.
Hoka Stinson Trail

So, that's my current rotation and it appears to be working well for me.

SUPPLEMENTS              

Right now, I am taking a boat load of (legal) stuff to try to "cure" my health issues and to help my body replace the RBCs I lose. On the sports nutrition side of things, I recently found a couple of products that I am really loving. They are manufactured by BRL sports nutrition. The first is a recovery powder that I also use as a mid afternoon snack. It is called Invigor8. I have tried both flavors and they are both excellent. I typically mix this in my Nutribullet with frozen fruit and either water, almond milk or coconut water. What I love about it is that it has everything in it already so I don't have to add things like probiotics, omegas, digestive enzymes, BCAAs, etc. While I don't ride the 'sugar is evil' bandwagon, this product only has 1 g sugar. I add my own sugar:)

The second product is one that I use more for pre-workout fueling. It's called TriFuel. It is also billed as a recovery drink and I sometimes take it after a workout. It is unusual in the sports drink market in that it has BCAAs, carbs, a load of electrolytes and some stuff that keeps you going and focused during your workout including caffeine. I typically take this within 15 minutes of a long workout and it holds me over for up to 2 hours. I was skeptical about the manufacturer's claims about improved mental focus, but I do notice an improvement in that aspect of my workouts. My recovery has also been very good especially now that I'm adding in a lot of extra stuff (see below).

STRENGTH TRAINING

Every day, I am bombarded with an endless feed of running-related tweets and articles about how important strength training is for runners. I have long been a believer in the importance of strength training for performance and injury prevention. When I was experiencing the worst of the anemia, I lost all interest in doing strength work. It took every ounce of energy I had to work and to run. Doing anything more was not in the cards. When I started to feel better, I still lacked motivation to do my usual extra strength, core and basic maintenance routines.

So, to get myself back into the groove, I decided to start going to group training classes to motivate myself as well as try some new things out. It started with Bikram yoga. I signed up for a new student special at Sacramento Bikram yoga and was shocked back into the torture of this practice. The first day I went, the 105-degree room was filled with the vaporized sweat of about 50 people. It felt like Florida in there. I just about hyperventilated for the first 10 minutes and literally swam in my own sweat when I got down on my mat for the ground poses. I have continued to do bikram 2-3 times per week and have noticed the following changes:

  • Doing yoga in a very hot room hastens heat acclimation due to physiological changes that occur when exercising in the heat (e.g. increased blood volume). My transition to running in the heat (80-90 degree temps) has been very easy so far this spring.
  • I am gaining flexibility in my lower back. It wasn't until I started yoga that I realized that the area with the least amount of functional mobility on my body is my lower back. All of the twists we do in this class are making tiny improvements in this area.   
  • I can sleep on my stomach without pain now. This may not have anything to do with running, but I had to stop sleeping on my stomach about a decade ago because my neck would start to stiffen up and ache after about 10 minutes. It took about 4 weeks for my neck to loosen up but it did and I am happy.
  • My balance is improving all the way from my toes to my head. Several of the poses require balancing on one leg and holding various parts of the body in strange configurations. I wobble and sometimes fall, but each week I can tell I am getting better and believe this will translate to being steadier on my feet while running.
Will bikram yoga make me a faster runner? I don't know. For now, I appreciate the positive changes I am seeing and it is helping to motivate me to get in additional strength work.

I also joined a studio called P2O or Hot Pilates here in Sacramento, of course taking advantage of a 30 days for $30 new member discount. They offer a lot of different classes. So far, I've only tried the TRX class. This class is a butt buster. It challenges your core muscles while also getting the heart rate up with some calisthenics. The thing I like most about it for runners is that it challenges your range of motion, especially in the hips, in a very functional way for running. I'll try their hot pilates class tomorrow after my long run and see how that goes.

Right now, I am doing some form of strength-based training (yoga, weight lifting, pilates, TRX) at least 4-5 days per week. That's a lot more than the zero days per week I was doing a couple of months ago. I feel so much stronger and can actually feel the improvement in my core strength during my runs. I have also been quite pleased with how much more quickly weight has come off over that time period. My weight peaked during the winter when I was dealing with all of my health issues. I was eating a lot of ice cream to make myself feel better and wasn't doing a lot of running. That's a bad combo. I am just a few pounds off of my racing weight now and quite certain I'll get there in the next 8 weeks.

Next weekend, I race another half marathon. I really hope that my blood levels rebound from this last drop in time for the race. I am downing iron shots like they are whiskey three times a day and crossing my fingers. Hopefully, I'll have a race report to share next Sunday!
                 

Tuesday, April 29, 2014

The one where I run my fastest half marathon in almost five years

I am giddy about what has happened over the past four weeks. I have felt progressively better as my body has recovered from the most recent bout with anemia. I found out last week why when I got my blood test results back:

Hemoglobin: 14.0 (11.9 a month ago!)
Hematocrit: 42.6%
Ferritin: 38 (19 a month ago!)

These are numbers I have dreamed about. They are the levels that Jack said he thought I should be striving for. I didn't think it was possible for me since they are higher than I have ever tested! How did I do it? Well, the biggest factor was the lack of blood loss. I have swung in the opposite direction of where I was two months ago. I haven't lost any blood in nearly 30 days! This is unprecedented for me, but I am NOT complaining!

I have also continued to supplement with liquid iron 2-3 times per day. I had been taking other products and was watching my blood levels either stagnate or decline. Once I stopped taking those, I seemed to do a lot better. It is really difficult to determine cause and effect with the supplements. What I know works is: liquid iron supplement + no blood loss.

The challenge with this condition is that you never know when the flood events will hit. I have been walking on egg shells these last couple of weeks just waiting for one to hit. I can't say exactly why I haven't had one, but I suspect the progestin-only BCPS and all of the things I'm doing to reduce my estrogen levels must be contributing. It is also possible that the fibroids are shrinking. I can still feel them, but they do seem smaller. Wishful thinking? Maybe.

I decided a month or so ago that I wanted to plan some races. I had to cancel two of the three races I had planned for the winter/early spring racing season due to this health issue and  was anemic for the one race I ran. So, I wanted to test out my fitness in a low-key half marathon. I chose the American River Parkway Half Marathon. This race course runs along the American River Parkway Trail which is where I do all of my training.

I held off signing up for the race, because my calculations showed the next scheduled flood event would occur somewhere within the week leading up to the race, if I stayed on schedule. As I mentioned above, that didn't materialize but the anticipation was overwhelming. It also meant paying an extra $25 for the race ($75), but I figured that was worth it, especially since some of the funds went to support the Parkway Foundation. I use this trail so much, I was happy to contribute to that cause.

I have been running well in training and doing some hefty workouts again in preparation for the Eugene Marathon in July. My lactate threshold pace is back down around 6:00/mile and my marathon pace has been around 6:20-6:25. I suspected, on a good day, that I could at least hold the same pace that I did for the 10 mile race a few weeks back (6:25 pace). I decided to start out around there and then try to negative split the race.

Race weather was as perfect as you get here in Sacramento in April. It was foggy and cool. I actually wore arm warmers and gloves! The announcer said at the start that he was expecting some really fast times as a result. After the inexperienced and over-exuberant racing chaff separated from the wheat in the first 400m, I found myself pacing with a couple of guys. One was a friend who is faster than me, but he was doing a brick workout so had ridden for 90 minutes before the race. I was happy about that because for me it meant I had a chance of keeping up with him. Even though there was little to no wind, drafting is still a huge advantage in a race. As we clicked off the miles, I saw that our pace was faster than I wanted to go out. However, the advantage of having a group to work with was much more valuable than running my own race. I would try to hang with the boys for as long as I could.

My pack. Isn't this a great photo? Thanks to Randy Wehner!
We were averaging about 6:15 pace for the first 6 miles, and I felt good. We hit the one major turn on the course and headed back toward the finish. When we hit the 7 mile marker, our pack leader proclaimed that they had turned us too far down on the course and we were going to be running long. I looked at my Garmin and the total distance at 7 miles read 7.66. This sucked the air right out of me. I was so irritated that the course was going to be long and that I wouldn't get the chance to see where I was fitness wise.

Normally, I would have shaken this off better. It's only one race, right? Well, consider how difficult it has been for me to get to the starting line of a race for the past 3-4 months. Experienced runners know how rare it is to have the stars align on race day where you are healthy, you feel great, the weather is perfect, you have a pace setter. I mean, this was my day! I cogitated on this for the next mile or so but held on to my pack. Then, I saw the Genius at around the 8 mile mark and blurted out, "the course is long!" Something about vocalizing that made it real and I let one of my pacers go at that point. I slowed to 6:20-6:25 pace for the next few miles. I was feeling sorry for myself and tried to figure out how I could salvage this race given the circumstances. I knew that I was pretty far ahead of any other female runners, so I would at least get the win if I stuck it out. I will never pass up the opportunity to win, no matter how small the race!  

At around mile 11 I decided I could salvage the race by lapping my Garmin at 13.11 miles. I would then at least know what I had run for the distance. That time was 1:22:25. This lifted my spirits. While my PR is just under 1:20 for the half (set in 2009), I haven't run faster than 1:23 since July 2009. It felt really satisfying. I continued on for another kilometer and crossed the finish line as 5th overall and 1st female. I will say that I had little motivation in that extra kilometer to push myself and I didn't. 

Immediately after the race, there was a flurry of Garmin checking and discussion going on about the distance. I had the two lead men run up to me and ask what my Garmin read. They had traveled from Southern California to run this race and were trying for a qualifier for some collegiate event. I felt horrible for them but I told them to talk to the timing company. They would help them however they could to make it right. That afternoon the timing company measured the extra distance we ran and adjusted times accordingly in the results. While I would rather have run the right distance, I was pleased with their quick action and am grateful that my time was adjusted. It was pretty close to what I had split at 13.11 (1:22:35).

I have some really tough training ahead and have my fingers crossed that I will stay healthy for it. My fitness is in a really good place right now given the  times I was running at this point in my marathon training for Twin Cities 2009 (2:46) and Chicago 2010 (2:45). I am right on schedule if not a little fitter. Wishful thinking has me hoping the health nightmare I have experienced this year is completely in the past, but only time will tell. All I know is that running is effortless and fun again and I will cherish the healthy miles I get.        
                

       

Monday, April 7, 2014

Still running a few pints low

And then, it was six weeks later. I'm not sure how time got away from me, but I apologize for not updating my blog sooner.

To recap: Over the last 2-3 months, I have lost a lot of blood and become clinically anemic (low hemoglobin) because I have fibroids in my uterus. There are three of them and one is the size of a 16-week old fetus and the other 2 are about 6 weeks along. In fact, the big one completely fills my entire uterus! I got to see them in ultrasound pictures but decided not to get a printed copy to hang on the fridge. The main, troubling symptom is massive blood loss and the only way to recover from that is to take iron supplements and, well, stop bleeding.

Last time we met, my hemoglobin had tanked to a low of 9.7. Over, the past six weeks, I got it up to a high of 12.4. My goal is to be around 14. My running mileage and intensity increased steadily with my blood levels. I began feeling so much better with each incremental gain in red blood cells. I have also found that this is not necessarily a linear process. Some weeks, my blood levels rose in what appeared to be regular increments while in others, they didn't go up at all, even under the same supplementation regime and without any blood loss. Then, some weeks, like last week, I lost so much blood that I ended up losing ground and became anemic again.

Here is a quick record of my blood levels and corresponding workout milestones:

2/14/14
Hemoglobin: 9.7
Hematocrit: 29.3
Running workouts: Kept all workouts to short speed efforts. Ran about 3-4 days per week, ~20 miles/week. Felt very tired running. Had to stop numerous times to get through an easy run. Had to walk rest breaks when doing speed work.

2/18/14
Hemoglobin: 10.8
Hematocrit: 33.7
Running workouts: Still keeping to short speed efforts. Ran about 3-4 days per week, ~20 miles/week. Still felt very tired running. Still walking in rest breaks when doing speed work.

2/25/14
Hemoglobin: 11.2
Hematocrit: 35.4
Running workouts: Finally starting to feel better. Ran a long run at around 7:30 pace midweek and it was hard. Heart rate averaged 88-90% of max for the whole run (usual pace at that HR range is ~6:10). Did a short speed workout over the weekend and it was the first time I didn't have to walk the recoveries! 48 miles this week. Felt less tired running in general.

3/6/14
Hemoglobin: 11.7
Hematocrit: 35.7
Running workouts: Not much change here. Pretty disappointed that my hemoglobin didn't rise more over the last two weeks despite the iron supplements. I guess recovery from anemia isn't a linear process. I did some running on hilly trails and felt much better than I thought I would. However, I had to cut my first lactate threshold workout into chunks a few days later because I couldn't hold 6:15 pace for more than 800m:(.

3/12/14
Hemoglobin: 12.3
Hematocrit: 38.7
Running workouts: Had my first long workout with 9 miles at alternating marathon and lactate threshold pace. Ran all of it, but boy did I stop a lot. Averaged about 6:25 pace, but I did stop about 6 times during the course of this "continuous" workout.

3/21/14
Hemoglobin: 12.4
Hematocrit: 37.8
Ferritin: 35
Running workouts: Had my blood drawn on my own and decided to get ferritin checked too. Was happy to see that my iron stores are still up there! Ran a couple of lactate threshold workouts and stopped in at least one of the miles to complete at the faster paces (5:58-6:07). I don't recommend this, btw. It's not the way you're supposed to run them, but this is what happens when your brain is disconnected from your anemic body: you think you can run faster than you actually can and then you die during the repeat.

3/28/14
Hemoglobin: 11.9
Hematocrit: 36.8
Ferritin: 19
Running workouts: I had my blood drawn because I had experienced another major episode this week and was very worried about the effect on my blood levels. I had good reason to be concerned. Not only were hemoglobin and hematocrit low, but my ferritin took a nose dive because my body was really needing the stored iron to make new RBCs. I also changed my supplements a little this week from taking the liquid ferrous sulfate 3 times/day to taking it once and adding in a "gentler" product called "blood builder" with non-heme iron, folate, and B vitamins. I won't do that again. That stuff doesn't work for me.

_________________________________________________________________________________

So, that was last week and I had a race yesterday. Maybe you can imagine the deflation I felt when I was making such good progress with my blood levels and then, BAM, I lose nearly a month's worth of progress and turn into anemia girl again. IN TWO DAYS!!! I had hoped I might be close to normal by the time the race rolled around.    

I was a bit conflicted about whether or not to even run the race. I had missed two other races I had signed up for in March because of my health issues. The first race in early March was a 10 miler and I couldn't even run 10 miles at any pace without stopping to catch my breath at that point, so that was kind of a no brainer. Then, there was the hilly but beautiful Race across the Bay in San Francisco where I did so well last year. I was feeling better by then, but wasn't sure I could run without walking the hills. No go.  

With yesterday's Sactown 10-mile race, I knew that the anemia was going to affect me, but I decided I didn't want to miss another race. There is this little thing called ego that tried to get in the way of my decision, but I decided to just suck it up and go for it. I'm really glad I did. I had hoped to run around 6:30 pace for the whole race and try to pick it up a bit if possible in the second half. I stuck to my plan and was at least able to even split the race. I ran 31:59 for the first half and 1:03:57 overall. I was very pleased with this given the fact that 3 weeks ago I couldn't hold that pace for 9 miles. What I have to forget about is that I was running 30 miles/week at less than 6:20 pace two months ago in training.

The good thing about being anemic is that I will feel like a freakin' rockstar once my hemoglobin levels get over 13. I still have a long way to go, but I am hopeful that the meds I'm taking to control the bleeding will eventually kick in. I have been able to keep my mileage up around 60 these past couple of weeks and will be gradually increasing as I get closer to the Eugene Marathon.

So what is the solution to my medical problem? Well, the "easy" answer is to have a hysterectomy. In fact, the two gynecologists I saw prior to seeing a surgeon a few weeks ago, had already written my uterus off. When I walked in to see the surgeon, she said, "so, you're done with your uterus and just want to take it out, huh?" I told her that I never said that and, in fact, had told both of the other doctors that I did not want a hysterectomy. I wanted to see if I could manage the problem with meds before yanking the thing out.

This doctor was very good. She told me I had a few options available before resorting to major surgery. She explained these to me and said that I could totally live with my fibroid babies as long as I could deal with the symptoms. She also confirmed that they were living off a diet of estrogen and that, decreasing that would make them shrink and die. This is why they go away in menopause. I am a few years away from that big change, but it at least gives me a timeframe to work with.

What I have been doing is looking for other alternatives to reduce estrogen levels in my body and to shrink the fibroids. Those of you who've been regular followers will recall that I had my blood estrogen levels tested about 2 years ago (on my own because my docs said it was not useful) and was shocked that they were in the 500+ range which is the ideal level for someone on IVF treatment (very high). The medical doctors I have dealt with think estrogen tests are useless because they change with the monthly cycle, etc., yet they prescribe hormonal pills to increase them in order to remedy problems like I am having.

I am operating on the assumption that my estrogen levels are high (well, I have tests to prove that) and that my progesterone levels are low (taking BCPs for that). I am taking a product called Myomin to reduce my estrogen levels. It takes about 3-6 months to see reduction in fibroids if it's going to work. This is a long-term strategy, obviously. I also believe that I can quash the Occupy Jaymee movement inside my uterus by taking systemic enzymes that help to break down fibrin. This is based on internet research I have done and there is some science behind it, but it is purely a trial. I am assuming it can't hurt me to try.

In making this choice to try these alternative treatments and give my body a chance to kill the little bastards I have chosen a tough option. I won't get quick relief from this route, but I will at least know that I exhausted my non-surgical options. It is so tempting to think about surgery on the days, like the two days last week, where I am bleeding uncontrollably and know that I am becoming anemic yet again.

I am seeing progress. My blood levels aren't dropping as much as they were over a month ago every time I have a period, and I have new ways of coping with the massive bleeding when it comes. Ladies, if you are in the same boat as me and haven't tried the Diva Cup or Lunette, you are missing out on a wonderful world of leak-proof protection! Gross, I know guys, but this little device has literally changed my life. I can do everything I want to do without worrying about the flooding interrupting the party. It is perfect for runners and offers 12 hours of protection (for me that's about 3 hours, but way better than the 5 minutes I get from the other options).

And, I do believe my fibroid babies are shrinking. They are big enough that I can actually feel them in my abdomen (be grateful I spared you the baby bump pictures). They are definitely smaller than they were a month ago. As my symptoms subside, I'll try to get in for another ultrasound in a few months to see how much they have shrunk.        

I am happy to be able to share my story with all of you and add another anecdote to the interwebs about dealing with fibroids--one that is specific to athletes. I got confirmation of the educational benefit of my efforts from a fast guy runner yesterday who confessed that he has been reading my blog despite the warnings I have posted. He said, "I had no idea how much older women have to deal with!" I told him these problems are a lot more common than he could imagine, but most women choose to keep their stories private--and for good reason! I'm glad I didn't.

Sunday, February 16, 2014

Running with Anemia

Things are never so bad that they can't be made worse. ~Humphrey Bogart

I believe I first heard that quote while in the Air Force. It was probably in reference to a bad commander that I couldn't wait to see move on. The military tends to rotate commanders every 2-3 years so we would rejoice when a bad one left. I'm sure some crusty old Chief Master Sergeant saw us rejoicing and threw that quote our way. Inevitably, I learned from experience he was right when the bad commander was followed by someone much worse. I have held that quote in my brain for over 20 years not because I'm a pessimistic person, but because I am a realistic person who likes to be prepared.

I'm going to pick up where we left off because I want to chronicle this adventure for those of you who may find yourselves in a similar situation. I get a great amount of info from others' blog posts and articles I find on the web. What I have found so far is that the issues I am dealing with are estimated to affect up to 80% of women and athletes are not spared. However, there is very little information specific to athletes out there on these topics. I decided I would at least share what I am going through in hopes that others will do the same making more information available to female athletes (and their significant others) everywhere.      

Where we left off: Two weeks ago, I had dropped out of a half marathon race because I had an episode of blood loss the night before. I decided to contact my lady doc since I realized 4 weeks of continuous bleeding was no longer within a normal range of variability for me. She scheduled an ultrasound for me the Thursday of that week and my regular doc scheduled some blood tests for me. I was relieved to get the blood test results showing that I hadn't become anemic since my last blood tests in November.

Just when I thought things were pretty bad, they got much worse. On Friday, I had a meeting scheduled and came prepared in case I had a major flooding episode. Well, the flood gates opened during the meeting and I could not control it. I had to politely excuse myself and drive home. This was flooding of biblical proportion. I had a dinner date with a friend that night at her house and experienced another flooding episode that led to an embarrassing admission on my part and sitting on a towel for the rest of the evening. My friend was, as I of course expected, very gracious.

I went for two runs over that weekend. Seven miles on Saturday and 12 miles on Sunday. I was pleasantly surprised that I was able to pull this off and maintain a decent (7:30) pace. I was definitely tired, but I was never on the verge of passing out or anything extreme.

Last Monday at 2 a.m., I woke to heavy bleeding and decided I needed to take action. I immediately sent a message to my lady doc. It was returned immediately with an out of office message. Damn it! I was luckily able to make an appointment with my former lady doc for that morning.

During that visit, my doc started with my ultrasound results which showed I had fibroids growing somewhere in my uterus. One of them was a big daddy, protruding 7cm into the uterus. The doc explained this was the likely culprit causing my excessive bleeding. However, she said that the IUD I had in place should be spewing out hormones to counteract the bleeding. We decided to have her take a look inside the madness, do an endometrial biopsy to rule out super bad stuff and remove the IUD to see if maybe it was contributing to my problems.

When she started checking under the hood, she got a concerned look on her face. She told me she couldn't find the IUD. She then checked the ultrasound report which would certainly note a foreign object in my uterus had it been present. No notes. She said that she has seen this a couple of times in her long career, and it was always associated with heavy bleeding. So, it appears I am now a human pez dispenser of IUDs. It seems crazy to me that something that big could come shooting out of me and I would not have seen or felt it. She said it is rare, but it happens. When I told my mom about this her response was, "well, I always told you you were special".  

It was a convenient explanation for what was happening. At some point, I lost the IUD and the hormones it was pumping into my system. When that happened, everything went haywire. So, the temporary solution was to put me on a heavy dose of progesterone pills and see what happens. We also went over the options that may be available to me depending on the results of the biopsy. Surgery of some kind looks like a probable next step. She explained that she was happy I had the blood tests done the week before because anemia was the most immediate concern with this issue. Since I wasn't anemic, we had some time to experiment with different treatments.

Not so fast...I got the blood test results back that I had taken after my appointment with the doc on Monday evening. I had become anemic over the weekend. Since this mess started, way back in November, I had wondered how much blood loss I could sustain before becoming anemic. This made me even more impressed with the two runs I had been able to complete over that weekend. This wasn't like low ferritin making me lose a few seconds per mile in my workouts. This was full on anemia. Interestingly, I asked to have my ferritin checked and it was 28, which is the same as it was in December. So, the iron supplements were clearly maintaining my blood iron levels high enough to continue to store iron.  I thought this was particularly germane given my discussion in last week's post about hemoglobin and ferritin. I just didn't expect to become Exhibit A in my own experiment so quickly.  

The progesterone started working within the first two days to reduce the bleeding but then, Wednesday morning, I woke to mind-blowingly painful abdominal cramps. I complained a bit to the Genius before he left for work, but told him I'd be fine. Then, I wasn't fine. I tried to stand and started seeing stars. I became clammy and sweaty. I looked in the mirror and was pale as a ghost. My fingertips were ghostly white. The pain was unbearable and NSAIDs were doing nothing to curb it. I called the Genius and asked him to shuttle me to the ER. He raced me there as fast as he could while I lay moaning in the seat next to him. I pleaded with him to run a red light when we seemed to be stopped there for hours.

As per usual, the ER was an adventure, but not as great as the one I had there that time I left with a full leg, bi-valve cast. I was lucky to have a good ER doc this time who has actually been following up with me via email. He gave me an IV to help hydrate me and a big dose of ibuprofen to help with the cramps. It wasn't until I got the narcotics that the pain finally went away. They also ran more blood tests and the results came back showing I had become more anemic in the last 36 hours with a hemoglobin level of 9.6. The doc discharged me, declaring this heavy menstrual cramps and told me to keep up with the iron supplements. I will admit I felt like a bit of an idiot having gone to the ER for "menstrual cramps". I should return if the bleeding came back full force or if I pass out though he reassured me that I could still lose a lot more blood before it would be dangerous enough for them to transfuse. Comforting.

I had follow up blood work taken on Friday, and it came back showing no improvement over Wednesday's results but at least it wasn't worse. My results for the past few blood tests are shown below for reference:
And that's what a week of blood loss will do to you.
This weekend, the mad scientist came out in me, and I decided this was a great opportunity to see how much the anemia affects my running. I first asked the ER doc if it was safe to exercise and he said that I could exercise to tolerance but to try not to pass out. Doctor Mom did not agree with these  medical instructions and ordered me not to run. Sorry Mom.

I ran Thursday, the day after the ER visit and it was slower than the runs over the weekend, but I didn't pass out. Yesterday I decided to run a workout. It was the workout I was supposed to have done earlier in the week. After deciding to push my next marathon to the summer or fall, Jack put me back on short repetition training similar to what I had been doing last winter.

I must admit that I was a little afraid about how my body might respond to high levels of exertion, so I brought my iPhone with me just in case. I also used the livetrack feature on my new Garmin 620 so that the Genius and my mom could track me during the run. I ran to the practice track at Sac State and had to climb over the fence to gain access. I realized that I must be pretty determined to get this workout done if I was willing to climb the fence to get to the track.

After huffing and puffing through a few strides, I started my workout:

4 x (200m Rep pace/200m jog + 200m Rep pace/200m jog + 400m Rep pace/400m jog)

The first split was 37 and I felt it. I jogged the next 200m and decided I would try to slow the rest of these down. The 400s were tough. I got heavy-legged in the last 100m like I had done 10 or 12 400s before the first one. I walked a bit of the 400m recovery lap and then slowly jogged to the start line to start again. I was shocked at how well this workout went. I ran within a few seconds of my prescribed (non-anemic) paces with the 200s averaging around 39 and with every 400 in exactly 82 seconds. I was tired for sure, but I wasn't passing out. I did notice the anemia during the recovery jogs which became recovery walks for the first few meters between reps. That didn't compromise the workout at all given that the purpose of a repetition workout is to improve running economy by running fast with good form and without strain. This means taking full recovery in between each repeat even if it means taking a little longer to start the next rep.

I jogged back to my car feeling really proud of myself. It wasn't so much about having run a great workout despite my condition. I was happy to have overcome the fear of the unknown. I have felt tired from low iron stores before, but this was serious stuff that had me staring down the barrel of a potential blood transfusion. How would my body respond to the effort? Would I pass out at some point? Would the effort trigger more blood loss? These were the fears I started the workout with and effectively slayed.

I'd like to end with a look back at why my experience is relevant to you, my readers. Many of you will never have to run with full blown anemia, but if you do, at least you'll have my experience to draw from. I will be continuing to post about my progress in recovering from the anemic state I am in and how it affects my activities. There is a ton of information about running with sports anemia (low iron stores) and pseudo anemia (relatively low concentration of red blood cells due to higher blood volume in athletes), but I found zero about running with clinical anemia. If it's out there, I'd love to know about it and post a link.

And, for you lucky ladies heading into your 40s, there is a good chance (maybe as high as 80%) that you either have or will have fibroids. Many women never know they have them and get along fine. For others, they can cause crazy problems like the ones I am experiencing (assuming it's the fibroids doing this to me) but might even present as a sports-related injury like this Aussie triathlete describes in this interview (be sure to click on "show" next to the word "transcript" on the page to read the interview). Her fibroid was pressing on nerves in her spine giving her severe leg pain that wouldn't resolve and made her stop running altogether. It's a great story of courage and the power of pushing back on those in the medical profession.

I will continue to use my body as a laboratory of sorts and post the information. I am most interested in follow up blood work and how my running and racing times and perceived exertion levels change along with my CBC readings. I am of course curious to see how long it takes to dig myself out of this anemic state as well. I have read predictions of 1-2 months all the way up to a year. I imagine this is an individual thing, but I will at least share my experience.                                        

Thanks to everyone who has wished me well through this journey. I wish it were nearing conclusion but I have a feeling it has just begun.

Until later,

Anemia girl, signing off.