Pumping Iron

Today is iron infusion day! Here's the play by play.

11:50 AM: checked in at the infusion center. Each patient has their own curtained area with a recliner or bed, TV, headphones, even a partial view of Elliott Bay. Settled in to my own big blue vinyl recliner.

12:05 PM: met my nurse, also named Mel. Checked vitals & inserted the IV cannula in my left hand - very painful! Sadly for me, the vein blew and we had to try again at the inside of my elbow. I should have a stellar bruise on the back of my hand by tomorrow. I get a little hot pack to rest my hand on.

12:10 PM: started off with some Benadryl and a steroid (in case of an allergic reaction), then a small test dose of INFeD - iron in a dextrose solution - to see if I'm one of the lucky few who has a severe reaction. Mel asks me to let her know if anything feels weird or odd, but doesn't seem to want to tell me more about what can go wrong. Maybe people get scared or imagine side effects they don't have? Some people do have anaphylaxis from this, but that's not in my plan today.

12:40 PM: no problems with the test dose, so Mel hangs the next bag with the full dose: 1 gram of iron in a 1 liter bag of solution. Now I just chill for the next 3 hours.

1:05 PM: someone's pump is beeping, LOUDLY. Cecil is all done - yay, Cecil! The infusion center is in the oncology/hematology department, so most of the folks here are getting chemo - and I'm here so I can run (better). Well, and not be anemic, but still seems trivial in comparison. 

1:30 - 3:30 PM: read a bit, nap a bit, gotta pee! Unplug the pump & walk the IV pole across the hall to the bathroom. Settle in again in my recliner, repeat: read, nap, pee.

3:42 PM: whoops, pump stopped. Mel resets it & says I have about 20 minutes left. Time enough for another nap, I think.

4:00 PM: nope, read the internet instead. But the infusion is all done and I'm out of here. 

6:45 PM: so afterward, I feel really good - I guess some folks get pretty fatigued after these but so far, so good. Trail runs on deck for Saturday & Sunday, then head to Mazama next week for a running & yoga retreat - really hope the iron starts helping by then!

Two Weekend Runs: A Study in Contrasts

Two completely different workouts this weekend - so different that I felt like two separate runners. Saturday's workout turned out to be the kind of workout I don't like to talk about, or write about, or acknowledge beyond briefly noting the data in my training log and looking away. Even though Saturday's run followed 4 migraine days in the preceding week and started with nausea + lingering head pain, I still intended to attempt the assigned workout: 65 minutes with 30-60 second pickups each 5 minutes starting at 15 minutes in. Perhaps my brain was still addled from the migraines.

Perhaps I'm just stubborn. I set out from Gasworks Park, running clockwise around Lake Union and managed all of two :30 pickups at 15 and 21 minutes before admitting to myself that I really did not feel well at all. By the time I got to Fairview, I was walking, dry-mouthed and stomach churning. I walked all along the south end of the lake, past the park and crowds of charity walkers. Was I done? Was I willing to log just 2.3 miles for the day when I'd already missed 2 workouts due to migraine?

I was not. Once I reached Westlake, I started running again, and made it all the way up the west side of Lake Union before needing to walk again. By this time I think I'd decided to log the damned 65 minutes, however many hours it actually took. (I do not, in fact, know how many hours it took to do this workout - at least two, but I really, really hope not three.)  And that's how it went. Walk along the Ship Canal trail till just before the SPU track. Run to the mini park, turn around, and run back under the Aurora Bridge, up Westlake, across the Fremont Bridge, and down 34th. Cross the street at Stone Way for water at the new Brooks building. Cross back and run to Gasworks - only 58 minutes. Keep going along the trail for another couple of minutes, then walk again. Turn around and run back to Gasworks and, finally, stop. Ugh. 

Sunday morning, though! So very different. Up at 6:00 for coffee, out the door at 7:00 to drive over to Discovery Park, aka The Disco. Cool, a little misty over the meadow, a touch of sunrise on the horizon. Assigned workout: 45-80 minutes of completely relaxed trail running. My goal: three comfortable laps of the Loop Trail.

So off I went on lap one, heading out clockwise on the Loop Trail from the south lot. Steady and relaxed through the meadow, around the sand hill and up to the south bluff, then onward. Very quiet, very peaceful, quite relaxed - easing up the hills and cruising the rest. And just like that, lap one done. Stopped at the car to grab a water bottle and gel, then out on lap two - wash, rinse, repeat. At around 4 miles in, I began to feel noticeably better - not so chilly, legs happy, still cruising the hills. Gel at 45 minutes, then back through the south lot. Knocked a rock out of the sole of one shoe and out again on lap three. 

By this point in the run I began to pay more attention to the other walkers, runners, and dogs out along the trail than to the effort of running, cresting a hill before noticing the extra work. I began to think about why this run was so different - cooler weather, no migraine symptoms, yes - but also the comfort of knowing this trail inside out, in either direction, knowing exactly what comes next, exactly where to relax into the pace and where to push.

The last push on lap three came on the steep uphill just past the turnoff to the Visitor Center, then a cakewalk back to the south lot. Still short of 80 minutes, so why not cruise down the road behind the lot & back to finish out the run? 

This is the kind of run I want more of. This is the kind of running I'm working for, and the kind of runner I strive to be - relaxed, optimistic, joyful. I don't want to be Saturday's runner any more, struggling harder for lower-quality running. The iron infusion scheduled for this Friday should help get my body there - but there's some mind-work to do, too. 

Tomorrow's workout is 40 minutes easy & meditative; I think I'll be meditating some more on Sunday's run.

Not So Iron Mel

The good news is that I'm not anemic. Yet. The bad news is that even though I've been taking iron supplements twice a day for months, my ferritin level has fallen from 6 in June to 4. That's not quite as low as it was in 2009 - the first time I ever had it tested, at 2 whopping ng/ml - when I actually was anemic. As my doctor told me earlier this week, my body seems to be really good at making red blood cells even when my iron is low.

What it seems to be really terrible at is absorbing & storing iron, especially when I'm training, even with supplementation. I don't get much from my diet to begin with, as a vegetarian, and non-heme iron (from plant sources) is poorly absorbed. Fortunately, I don't have the added depletion of monthly bleeding, as do many women with low iron - I can't even imagine how bad my iron status would be if I were bleeding every month.

There's increasing evidence that low iron affects athletic performance, training, and recovery, even when there's no anemia. In my case, running is harder, slower, and more fatiguing when my ferritin is <12 or 13 ng/ml, the bottom of the normal range - though it's never actually been measured any higher than this). So even though I'm enjoying my runs & workouts, they feel far more effortful than they should. Trail running is especially hard right now - steep uphill efforts are simply draining; if I push through the fatigue & keep going up, I get dizzy. Last Saturday's trail run at Cougar Mountain included unscheduled resting-against-a-tree intervals.

On Friday I'll see a hematologist to discuss my absorption & storage issues, and to ask for iron infusions - here's hoping he's receptive to the idea & doesn't want me to wait till I'm anemic again. 

Ironman Lake Stevens 70.3 2012 Race Report

Have I really not raced a triathlon since July, 2012? Wow! Though I'm not sure when or what my next one will be, I do know there will be a next one - they're way too fun to stop doing entirely. And my modest successes in the 35-29 age group were satisfying; I know full well master's racing won't be any easier

Here's a flashback to my one & only half-ironman (so far!):

Goals

Happy with anything under 6:00, figured 5:45 would be comfortable, 5:30 if everything went perfectly.

• Swim: 35–38 min. I’ve been doing 100’s @ 1:40/100 yds; long open-water swim at that pace felt pretty comfortable.

• Bike: 3:10–3:15. Rode the course alone in late May in 3:34, rode it again with the team in 3:10.

• Run: 1:45. Typically run well off the bike, but run pace depends on bike nutrition and weather.

Race Prep

• Laid out gear Saturday morning with piles for pre-race, swim, bike, and run.

• Tried on my kit, made sure gels fit in the pockets. Checked for thigh sausaging.

• Set up transition spot in bedroom and did transition practice between bedroom and living room while dogs supervised. Kept forgetting to grab my race number belt in “T1”.

• Realized putting-on-sock practice is needed, so spent some time perfecting sock roll and placement in running shoes.

• Selected race day earrings (little gold & turquoise birds).

• Executed pre-race mani/pedi: traffic-cone orange polish for toes, neon multi-color camo nail stickers for fingers (pattern includes turquoise to match kit and shoes). Big hit on race day.

Pre-race

• Up at 4:20 for coffee. Make PB&honey sandwich to not eat for breakfast. Grab banana to carry around and not eat before the swim.

• Load bags, boyfriend and one dog into car. Dog sleepy and confused. And farty. SO farty. RT is disgusted and annoyed.

• Find rock-star (FREE) parking one block from transition.

• Set up trademark clean, minimal transition. Silently judge all the how-much-crap-do-you-really-need-don’t-you-know-it’s-a-race transition setups in the vicinity.

• See Ali Vincent (winner of The Biggest Loser) setting up her spot further up in my row. All her gear is pink.

• Take 20 minutes to eat a Clif bar while waiting in the port-a-potty line. Gag several times before remembering to also drink water.

• Head over to swim start. Try not to freak out. Eat a gel and gag some more.

• Warmup swim in silty, smelly water. Gag some more. New goggles are excellent.

Swim

• Line up toward the middle left of the row. Get clear and angle left toward buoy line.

• Suddenly find myself swimming OVER a woman swimming to the right, directly perpendicular to me. Pick up my head and holler “Where the *&#% are you going?”

• Find the buoy line. The buoy line is AWESOME. No need to sight.

• Swim directly over buoy line until I swim under a buoy. Swimming just to the right of the buoy line is AWESOME.

• Start catching the previous wave halfway to the turn.

• Kick to the face #1, just after second turn buoy, and left goggle fills up with water. Consider stopping to fix it. Decide it’s not washing out my contact, so keep swimming.

• Kick to the face #2 (catching swimmers from a few waves up now) gives me a fat lip.

• Elbow to head. But the buoy line is still awesome.

• Swim straight to exit until I touch the yellow muppety exit carpet and run up to transition.

• Glance at my watch & see 7:34 – swim start was @ 6:59, so that means a 35:xx swim! Forgot my watch is 4 minutes fast.

Bike

• Quick transition, remember race number, solid mount. RT shouts encouragement as I ride away.

• Rain for the first two hours. Cold hands and feet.

• Start drinking 15 minutes in and keep sipping all the way through. Decide not to bother taking the 2 gels allocated for the bike.

• See a few riders in the ditch on the way to Granite Falls.

• Eventually realize sunglasses are going to stay wet and fogged up and shove them down my tri top. Amazed that I can see!

• See 6-8 people changing tires. Lots of flats today.

• Wonder if I’ll have to put on wet socks and shoes in transition. Decide wet Smartwool socks will be better than soggy shoes without socks.

• Play leapfrog with a couple of women in my age group. One (with HURLEY on her butt) gets away & stays away. Another, Rebecca, keeps up the leapfrogging for most of the bike leg. Contemplate asking, “But can you run?” but decide if I’m going to talk smack I’d better be able to back it up. Finally drop her with a mile to go.

• Come into T2 just behind [TN teammate] Josh. Clean dismount and quick run to transition. Skip the potties.

• THRILLED to find dry socks & shoes. Manage not to fall over putting on socks.

Run

• Run out on frozen brick feet. Neuroma in left foot is flared up and it’s like stepping on a hot knife. RT and dog run alongside for a few yards.

• Hit first aid station, consider stopping at potties. First potty is occupied. Second potty is occupied, and someone’s waiting. It’s Hurley! One spot made up on the run.

• Mile 1.5, notice someone running hard on my left. It’s Rebecca! She’s working hard, lunging and landing hard. Keep up the quick light shuffle and pull away. Second spot made up on the run.

• Pass the hot corner out and back again – amazing TN team support! It’s like the Wellesley scream tunnel.

• Start second lap – feeling okay but hip starts to hurt. Think I’m still holding about an 8:00 average pace.

• Gels at mile 3 & 8, water from my little handheld bottle. Haven’t taken anything off the course all day.

• Somewhere around mile 9, a woman passes me, says “Looking good.” Let her get a little ahead and look down at her calf. Damn – 35. Make her work for this pass and run on her shoulder for a while but know I’ll lose her by the next aid station. One spot lost.

• By mile 10, realize I’ll finish before 12:30. Still don’t remember watch is fast.

• Try to look good for the hot corner again. Come past for the turn to the finish and muster up some energy for a kick. Sore hip = sad little kick.

Post-race

Please excuse the watermark here. Yes, I'm selfish & evil.

• Collect medal, hat, space blanket, kiss from RT. He starts telling me finish time & splits and I can’t take it in.

• Grab a soda and sit down while RT looks for chocolate milk. Talk to teammates and try not to cry.

• Back and forth to car for clothes, transition for gear, car to load up, finish area for food, team tent to cheer in last racers. So tired. So hard to walk.

Damage

• Fat lip.

• Hot spots on pinkie toe and chest (from sunglasses? Not sure).

• Very sore left hip flexor. Generally sore legs and neck/upper back. Still in better shape than after marathon and some half-marathons.

Results

• Swim 31:40 12/59

• T1 1:40

• Bike 3:06:00 11/59

• T2 2:01

• Run 1:40:04 8/59

• Overall 5:21:25 8/59

The state of sisu

Warning: self-indulgent navel gazing ahead.

I've been thinking about sisu lately - so, apparently, have Forbes and the Toronto Observer - and what it means to live sisu. Sure, I'm stubborn. I keep running, even after more than a year off due to chronic migraines and daily pain. Every day feels like a performance of the ultra-runner's motto "relentless forward progress." My brother the Marine called me Iron Mel in his birthday text last week and said he thought I was tough as nails.

But sisu is more than grim determination or tenacious endurance - it's "a consistent, courageous approach toward challenges which at first seem to exceed our capacities."* Living sisu means more to me than sucking it up every day and waking up the next day to do it again. Living sisu means finding a way to do it better. To keep searching for effective treatments, keep running, keep training.

How? I got some help:

• I found a new headache specialist, and I'm exploring some unconventional treatments.
• I got a coach, who is awesome and fun and has a group of amazing athletes.
• I wrote down some super-secret goals (which I'm not sharing yet because, yeah, super secret). 
• I restarted this blog to keep me focused and honest and looking forward.

And I'm working on framing my ideas and experiences in a way that supports my goals - seeing adversity as experience that builds resilience. That's the state of sisu around here.

*As described by sisu researcher Emilia Lahti in her master's thesis Above and Beyond Perseverance: An Exploration of Sisu.