Friday, April 21, 2017


...and I'm BACK! Severe adrenal fatigue is no joke. My last post was back in August - crazy! There has been a lot of rest, rejuvenation and regrowth since then. Now that I have a clear(er) path forward I thought I'd provide a quick update.

I followed the doctors orders and took 3+ months completely off (with zero expectation of heavy training or racing for at least 6 months). This may seem impossible to conceive, but the truth is when you feel as beat up as I did you have little energy or interest in resistance.  Waking up before 9am was harsh (but clearly something I had to do for work). The reality was that morning workouts were no longer an option for my body, mind or spirit. My stage of adrenal fatigue was so severe that my cortisol levels were in turmoil. I was tired ALL day, but come 7:30pm I was jumping up and down in search of the next house project to tackle. Not ideal!
To add insult to injury (literally), during the initial weeks of rest I noticed that my knee pain was not subsiding. I finally got an MRI, and the images left me questioning how I ever ran an Ironman (let along 2) on this knee. Both the tibia and femur had large stress reactions and areas of severe edema (bone bruising). The cartilage showed substantial wear, leading to a diagnosis of arthritis. Yup, this isn't reversible folks. As the doctor rattled through the MRI results all I really heard was:"you may never run again." Say what??!!? "You may never run again."
     Caroline - Process the words that are coming out of his mouth...then respond.
     "Never run again, well that isn't an option. When this tri thing is done my next chapter will be    ultra running. So how do I get through this."
My amazing doctors and PT came up with a plan to slowly regain strength and mobility while allowing rest to potentially take care of the bone damage.  I waived my white flag of surrender with veracity.
Reunited with the Alter-G
I'd be lying if I said I didn't feel defeated, but I choose to look at this as an opportunity. I haven't taken this kind of break from training and racing since I was in law school (2006). This was an opportunity to truly rest, and rebuild in a way that was unobtainable while racing 4 Ironmans per season. I received a cortisone shot in my knee to assist with the pain and allow me to regain full range of motion. My PT started me on the simplest of exercises to prove convince me that the road ahead was long. The muscles around my knee had completely atrophied.
Name of the game: Rebuild.
Mindset: Opportunity!

While strengthening my knee with simple PT, and sitting on my butt to reset the adrenal's I had another round of blood work and a second MRI in December. Both proved promising and the second phase of recovery was initiated.  Time to start moving again. Before you can run, you must walk.

Love the Hydro-Worx. This has been my #1
tool if returning to full weight bearing, and
then adding mileage. 
I started by just trying to fit in one workout a day - imagine that! The reality is that triathletes have a sick sense of normalcy when it comes to training volume and frequency. Thankfully I have a (kick ass) job that took every ounce of energy, so the indulgence to train was still lingering on the horizon. My focus was/is on rebuilding from the ground up: form and strength over volume and intensity. For a few months all of my running was on the alter-g and hydro-worx (deep water) treadmills (pictured).  I promise this made me hungry for the days when I could run for hours on the trails. It took time, but when I finally made it over the 10 mile mark I was gleaming!

I've truly learned to embrace this opportunity. I approach each workout with sheer gratitude. I saw the light at the end of this pro racing tunnel.  I realized I've never given much thought to how my post pro racing days will look. I have a new found appreciation for elite athletes who have stepped away! I am thankful that the mental, physical and emotional difficulties that come with this life altering change are now more openly discussed.  I now know that when it comes for me to exit stage left, I'll be more equips to deal with the challenges it brings. That time will come (sooner rather than later), BUT I have a chance to make one last push towards the summit....and I will EMBRACE every moment of it!  

Plans for 2017

Race plans are still up in the air, but I am aiming for a late season Ironman as my first for 2017.  I hope to race a few local half ironman distance events, and maybe even some shorter distance events for shits & giggles. I'm taking things in stride and not pushing anything right now. For a girl that use to race 2 Ironmans before the end of May this is shockingly refreshing. I'll pick a race and likely put all my eggs in that one basket. Along the way I look forward to getting back to the social aspects this sport once provided me. I don't want to chase my heart rate on every single workout -I'd rather chase my fast friends!

Finally, I'm excited to announce another addition to this year's adventures: 
Coach Caroline?!

I have been debating stepping firmly into the coaching arena for quite some time. I've been coaching friends on and off over the years, and find great pleasure and passion in that journey. My life is hectic, but I know it's time to share my passion and vision with other like minded athletes. I am excited to take on a few athletes to coach this year. In the future I certainly hope to increase my roster of athletes, but for now I want to dedicate my (precious) time to a select few. I would rather give more of my heart to a few athletes then spread myself thin.  I sincerely feel I can offer guidance, support and a clear vision to athletes facing similar time restraints as I have. My journey to prove I could win at both sport and career has been fulfilling beyond my wildest dreams. I look forward to helping other career focused individuals the tools to excel at sport in a way that launches their career and makes them a more productive team player within the work place.
My methodology for coaching revolves around proper (two-way) communication! so it's important that I work with athletes who are willing to give to the process as much as I will invest in their success. It's all about the journey, and I can't wait to shape and inspire the triathlon journey of others. If interested feel free to reach out to me via email:

Thanks for checking in, and sticking with me during the highs and lows...It's all about the journey!


Time off afforded me the opportunity to travel (without my bike box for the first time in 5 years!).
Top to bottom: Maui excursion (to celebrate the ability to train again), visiting my BFF Kristin in Madison Wisconsin, trip to the Caymen Isands to give back to the triathlon community there and jump into Mercury Man race with Kim and Alyssa, Quality time in San Diego including a visit with Simone-one of the people who encouraged me most to start racing professionally, Christmas in Bend Oregon with the family, working hard to help our Nike athletes break the 2 hour marathon (which is now only 2 weeks away)!, football Saturday in Eugene with my favorite little duck, beaches of San Diego with Bekah, and returning to Ann Arbor for our 20th reunion of UofM Rowing as a varsity sport = I'm old! 

Monday, August 29, 2016

Roth & Ruckus

Life has indeed been full speed ahead since I returning from racing in Roth, Germany. The trip itself was a bit of a whirlwind, but there isn't a single piece of me that regrets going. I wanted to post a few pictures and thoughts from my European extravaganza, as well as an update on my plans for the rest of 2016.
I left for Germany on Thursday, had 1.5 days to prepare for the race, raced Sunday and flew back to the states 15 hours after crossing the finish line. Roth was a bucket list race, and I refused to let the opportunity slip away. I was lucky to have Molina coaching me through the preparations, and reminding me how special this event is (he never raced it, but I'm happy that next year he'll finally check this one off his bucket-list as well).

Preparation leading into Roth was less than ideal.  Training volume dwindled once I started my new job, and my body wasn't responding well to any of the high intensity workouts. Other professional athletes who have raced Roth in the past convinced me that I needed to embrace the experience and opportunity to race Roth. Truthfully, a million things went wrong leading into the race, but being honest with my race expectations allowed me to shrug them off, put on a smile, and be grateful for the opportunity.  I usually go into races with podium goals, but for the first time in years I simply went into race day with a "roll with the punches, embrace the experience" mindset.  If that was my only rubric for measuring my success at Roth I'd give myself an A++.
Roth displays amazing energy in the days that lead up to Sunday's race. Fireworks, live music, and Bavarian dress up parties to name a few.

Race Day: The excitement race morning was electric.  Unfortunately they started the pro women at the same time as the pro men, and to make matters worse they also included age groupers who predicted to finish under 9 hours (or those with huge ego's). The swim was brutal.

I was whacked, kicked, punched and dunked more times than I could count. Again I reminded myself "smile and enjoy the matter how high or low this roller coaster takes you." At no point during the swim did I have any clue where any of the pro women were, but to my amazement I exited the water with the first chase pack (Daniela was already well on her way to crushing us all!).

In terms of the course and spectator support the bike ride was spectacular. You ride from one little town to the next, with each offering their own form of cheering entertainment. I usually race with my eyes either fixated on my Garmin or half closed out of agony. This time I stared right into the face of each cheering spectator and embraced their spirit. While I wanted to grimace (out of frustration for my power numbers) all I could do is smile. This couldn't be more true then when it came time to climb Solar Hill. The crowd was deafening!
THIS is what you go to Roth for!
(Huge thanks to Thorsten Radde for snapping this one!)
In terms of my performance, the 138.2 miles that followed the swim were simply abysmal. I had nothing in the tank and every time I asked more of myself I came up empty handed.  Come hell or high water I was going to finish, but over the last 8 miles of the race things got ugly. I knew my lead up was sub-par: closing on a house, new job, moving, trying to find my way amongst new training grounds, living out of bags for months.... but I'm beyond proud of the focus I put on perspective around this race. I couldn't end my racing career without competing at Roth!

Run Course! Can't beat this surface!
Post Race Updates:
I returned home and shortly after closed on my house in Portland. Work is demanding, but I am loving the challenges. Problem is, I always felt I was running on an empty tank. I was feeling pretty run down, but attributed it to my hectic life and post Ironman decompression. Inevitably, I took a few weeks off from training and then slowly started to get back to running and swimming. Best case, I wanted to do a late season Ironman, and worse case I thought I'd train for a few trail races and possibly a fall marathon. I embraced the Portland/Nike running community and enjoyed the opportunity to be social with my training again. It quickly became apparent that my body wasn't cooperating with my upcoming race vision. I was struggling to get out of bed after 10 hours of sleep, and dragging myself to even the easiest of workouts.

During my lead up to Roth I blamed my inability to recover, nail hard workouts, or hit race weight on "old age." I never envisioned that this would be my last year of professional racing, but maybe my body was deciding things for me. I didn't want to go out with the performance I had in Roth, but I found myself questioning whether I just had to throw in the towel and accept that my time in the sport was up.  Was it time to give everything to one career, instead of two?  This is an emotional decision, and one that I think only those who have left professional athletics can comprehend.  It wasn't until I backed off my training, and felt more settled in my house/job that I believed something simply wasn't right. Thankfully I connected with an amazing sports med doctor in Portland. We ran a full gamut of blood tests, and sure enough I had my answer: extreme adrenal fatigue, and iron deficient anemia (again). It was as if alarms started going off while the blood work was analyzed. The doctor I've partnered with treats countless professional and elite athletes, and his methodology, approach and analysis directly correlates with treating athletes as athletes and not just the common folk. I am beyond thankful to have been introduced to him, as this is EXTREMELY hard to come by within the medical community! I certainly had reason to pause when he told me that "these results are far worse than any I've ever seen." Okay then, if that isn't a nice whack over the head I don't know what is.
Closing day on my house!

While extremely frustrated to hear this, I can't say I am surprised. The past year has been incredibly stressful, and on top of that I keep asking my body to get faster and find more endurance. This wasn't the answer I wanted, but at least now I know I was right in thinking that something is indeed wrong. This means that I'm not on a forever downward spiral, that I can get healthy/faster/stronger again. Only my body will know how long this will take.  It's time to start listening and stop pushing. Yes, running 7:30 pace shouldn't feel like a sprint, and it isn't laziness (or happiness to be in my own bed again) that has me unable to get out of bed every morning.

So... all racing has been put on hold. I was suppose to run Hood To Coast with one of the Nike teams, but thankfully they found a worthy replacement. It's time to really rest and recover. I know in the end my desire for athletic endeavors will come back, but for now my body simply won't have anything to do with this frame of thought. We've put in motion a few changes in my diet (up'ing protein to 130+ grams a day- so I'll definitely be relying on Designer Protein to fill the gaps. Use coupon code: Caroline20 to save 20% on your next order). The upcoming weeks/months will offer a new set of challenges, but in the end I am confident that great things will come from this time out.

It turns out we aren't super human, and living life full speed ahead can eventually bite you in the ass. OUCH!
Huge thanks to my amazing sponsors who support and encourage me through both the highs and lows! Together we'll fight our way out of this!
Photo credit: Thorsten Radde

Saturday, June 25, 2016

"After the final no, comes a YES!"

Time for a little update on my training, racing (or actually my decision to hold off on starting the 2016 season), and my continued pursuit for greater success in my (non-triathlon) career. I'd say the quote used in my title perfectly sums up the past 6 months. After months of trials and tribulations, practicing my P's (patience and perseverance), and committing myself to a specific destiny, I found my YES.

Every year I come up with a word or phrase embodying my athletic drive and goals. The short mantra always encompasses great personal meaning, and offers substantial motivation when the going gets tough. 2014 was the year to "DWIT." The complete visionary goal, "Do What It Takes" to win an Ironman, shaped my entire methodology for how I lived each day.  In 2015 things were shortened to one word: "Believe." Much of this steamed from the unfinished business from 2014. Although I fell short of my ultimate goal I feel confident that I set myself up for success. Outside of my unwillingness to give up my job, I did what it takes. I gave up an awful lot in pursuit of this goal! (Many argued walking away from full time work was the final ingredient - including coaches - but I held onto my long term vision for life and never entertained this foolish discussion). Here in 2016 my motivational mantra shifts a bit to include not only my athletic drive, but also my career aspirations. PASSION. My recent pursuit of passion hasn't been easy, and came with great risk. Oh but how sweet the reward is....

Many have asked why I haven't raced yet in 2016. My answer lacked certainty and commitment. I've been focused entirely on making a major pivot in my career.  "Where there is great risk, lies great reward." Right?!?! Normally by this point in the year I've raced 1 or 2 Ironmans and a few 70.3 events.  Neither injury nor illness has kept me out of the game. However, I'm here to tell you that  emotional stress is equally as debilitating. Finishing every Ironman takes extreme tenacity, commitment, and mental fortitude. One must go deep into the well, suffer mentally and physically, and rise above. This holds true on a daily basis...especially for those of us juggling sport with work, family, etc. etc. Physically training was going well, but the past few months left me emotionally drained. I simply haven't possessed the mental nor emotional fortitude to toe the line.

Often we hear career advice along the lines of: "if you're passionate about what you do for work good things will come, and you will find long term success." I am pretty sure this is Oprah's soap box speech.  Sadly many are severely misguided by this often endless pursuit. I'm not saying that someone can't find success when following their passion, but instead argue that proper thought should be given as to whether this passion offers financial feasibility.  Tony Robbins talks about this very point in his recent TED talk.  He discusses the tremendous work that passionate people put into their passion, and also mentions the need to question whether your passion offers a potential payout.  This resonates with me and made me think of so many friends trying to make a living from their athletic talents. Yes, we all have the passion for the sport, but the financial support within triathlon is not going to change simply by us exuding more passion. While we can stride for change, we must accept the reality (or at least I must).

From the second I got my pro card I believed that only a handful of triathletes have the luxury and comfort of calling themselves a "professional." Professional to me means the ability to make enough money to support oneself (and family) now AND into the future. By future I mean retirement. If there is one thing I know from my years of professional racing, it's that every single solitary professional athlete toeing the line does so with great passion! No one has enough talent to mask the passion needed to reach professional ranks of triathlon. Few are able to take that passion and turn it into (my definition of) a profession. THIS is why I've never given up my career to focus 110% on triathlon success. I enjoy testing myself physically and mentally, and believe working full time is the right decision for me. I am thankful that my sponsors understand, support and applaud this decision. fewer words: my long term career means a great deal to me, and falling victim to lay off's in 2015 left me gutted! Immediately I looked for jobs within the software space.  After months of working with a company to define and strategically lay out my job roll things feel through. Family and friends tried to reassure me that one door closing meant another would swing wide open. I honestly didn't want to hear it!  Let me set the picture for what I mean when I say that things feel through last minute. My entire house was packed into boxes, and the movers were schedule to come the following day.  As if God hadn't been hearing from me often enough, my prayers turned into sob fests- complete with panic attacks and insomnia. In the blink of an eye I was no longer moving across the San Francisco bay.  God's plan left me in a state of turmoil, however deep inside I finally accepted that the software industry wasn't the industry to bring out my passion. It was time to search deep inside my soul. It was time to regroup, refocus, and ultimately embrace risk.

I left everything behind, and committed every fiber of my being to pursuing a passion I've had for quite some time: to take my eclectic skill set to the athletic footwear and apparel industry. There was only one place to go; I loaded up my car and drove straight to Portland, Oregon. Go big, or go home. I wanted to play with the big dogs (or should I say "Shoe Dogs"). It was time to pursue a chosen career in an arena that enabled me an opportunity to combine my experience in business, law and athletics. Time to fight for my passion.

I began networking with all the major athletic apparel companies. It wasn't long before my career goal took shape and my desire became defined: Nike was it! I spent months, networking, job searching, and learning. I began researching the global giant and trying to figure out the complex Nike matrix structure. I couldn't believe how willing Nike employees were to meet with me and help me figure out which internal team would be the best fit. I filled notebook after notebook with valuable insight from daily networking meetings. In the end I met with 30+ equally passionate and driven individuals. I was on campus at least 3 days a week meeting with people who graciously shared their Nike career path. I sincerely could write a book about this entire experience! Tenacity with a capital "T." I read memoir's about the early days of Nike and channeled the founders visionary drive as I continued my fight through the coveted Nike doors.

Is it crazy that while cleaning out the drawers in my bedroom at my parents place
I had one newspaper from my days at UofM...and this was the front page?!?! Foresight?

With my triathlon racing days winding down I know a great void is inevitable. I've raced 20 Ironmans, and know my body doesn't have another 20 to give. With each networking meeting I gained substantial confidence that this void could be filled through my (paying) profession.  I am ecstatic to report that I landed an amazing job on Nike's Innovation team.  I follow this sentiment with the fact that I never would have landed this role if I had walked away from my legal profession back when I started professional racing. I needed to travel each and every road (through career and sport) in order to land myself here.

The past month has been chaotic! After 13 years in California it was surprisingly easy to say goodbye. This next chapter shows great promise. Ultimately a resounding "YES" landed me on the perfect team within Nike's organization.  I've found a position that perfectly aligns my experience in business development, law and professional athletics. While I am far from settled in Portland, I am happy to be in a great mental space so I can test my fitness at Challenge Roth.  This bucket-list race is the perfect place to exude my passion for the sport and praise for answered prayers.  I questioned God's plan so many times the past year- but He delivered in a miraculous way. I have my yes and won't let it go to waste. It's time to JUST DO IT!
My whiteboard desk on my first day at work. 

Wednesday, February 3, 2016

Spirit and Smile

Melia Resort- an amazing home for race week!
After a rough go-around at Ironman Chattanooga I was extremely excited to close out my 2015 season enjoying every second of race day.  Everyone raves about the atmosphere in Cozumel, so I decided that was the perfect choice for one last shot at my beloved hot & humid combo (something Chattanooga did not live up to).  From the moment I arrived in Cozumel I was greeted with smiles, welcomes and adornment. As I travel the globe, from race to race, I am continually captivated by the communities' embrace of our sport.

  My smile says it all! Racing is what makes me feel alive, and in the days leading up to Ironman #4 of the year I felt a mix of contentment and jubilation. I just wanted to get out there and have fun every....single....step of the way.  2015 was a challenging year in many ways, but triathlon provided me the outlet I needed to keep persevering. Through the ups (seeing new areas of the world) and downs (bike crash, digestive health issues, injury 3 days prior to race day, work loss) I kept my head up and fought to win every everything I tackled from the moment my feet hit the floor. For me, triathlon offers far more than race results and finishers medals. These experiences truly will live a lifetime, and for that I have the utmost gratitude for the sport and those that share this passion with me.

Race morning, as I stood at the waters edge, I had zero doubt that I'd make it to this finish line.  A young 5 year old boy and his amazing family have inspired me all season long. Chad (Tough) Carr lost his battle with DIPG (terminal form of childhood brain cancer) a few days before I left for Cozumel. I carried this precious boy in my heart, and committed myself to help spread knowledge and awareness for this awful disease.

My swim volume coming into this race was far less than I'd like. This has been a large point of "contention" between my coach and I the past two years. I know what I am capable of, and exiting the water 3 minutess down from the leaders (in 10th) simply was not it. Although, if you are going to swim solo, this isn't a bad place to do it. One large group ahead of me, and another behind. Majestic scenery for 2.4 miles!

Last few strokes before exiting the water
I rode the full course in the days prior to the race, and knew to expect wicked winds on the back side of the course. The conditions were tough, but consistency was the name of the game for 112 miles. While I wasn't overjoyed with my power output, my splits through each section of the course were consistent from mile 1 to 112. During the 3rd lap, as my legs and knee began to throb, I reminded myself that it was time to have a little fun. I planted a smile on my face and held on until reaching T2. While I race as a professional, I still do so out of love and enjoyment for the sport.
The run course is also three loops. I felt absolutely amazing over the opening miles. I made a conscious (and very wrong) decision to hold back and remain conservative through the first 1/3 of the marathon. As I started the second loop I began to build momentum and pace. I was moving through the field, and sincerely felt confident that I could put together a sub 3:10 marathon. Silly me- this course is deceivingly difficult and the final 10k chewed me up and spit me out! I knew I had moved up 5 positions since getting off the bike, but had no idea what place I was running in.  I estimated that I was 8th, but upon crossing the line was told I finished 10th.  This was one of the most competitive fields I've raced on the Ironman circuit, on one of the most difficult courses I've raced. Flat is not easy folks! Especially when you add in heat and unrelenting wind. Ultimately my goal was top 10 and I just squeaked in for a paycheck. 
When I look back at my triathlon career I am reminded of times when I failed to stand tall and be proud of the days when I gave it my all and accomplished more than I ever thought I might (i.e.: Ironman Louisville 2013).  I made a conscious decision to applaud the fact that I gave everything I had time and time again this season. I've dedicated a tremendous amount of guts, tears, sweat, time and sacrifice to this sport. They say we're our own worst critic...always wanting more...never satisfied.  While I didn't take home the champions crown, I was indeed satisfied! I spent the following few days basking in the sun embracing and enjoying THIS phase of THIS journey.
Celebrating with (from right to left) 10th, 11th, 12th. Cheers
 Huge thanks to the Melia Cozumel resort for taking such great care of all of the athletes who stayed with them! Service with a smile is a complete understatement when it comes to their hospitality. I can't wait to see you again in 2016. Cheers to Ironman #20 and another season in the books.
Enjoy the journey!!!

Sunday, October 18, 2015

From the Inside Out

Where to start! I'm worried this could be a long one, but I'm laying it all out there. My main audience for this post are those dealing with gut discomfort or digestive issues.  I hope through telling my (long/painful) journey that I can hopefully help others find their own answers. It is my sincerest hope that others do not have to experience 3, 4 or 5 years of discomfort before finally finding answers.  I can never get the past three seasons of professional racing back and I'd do anything to have discovered answers at the onset of symptoms! Well, time to dive in.

It was over three years ago when symptoms first started to impact my everyday life.  Looking back the symptoms started even earlier, but things were manageable.  With each passing year my symptoms worsened, and eventually hit a point, earlier this year, where I took matters into my own hands and demanded answers.  I'd been given many "answers" from doctors, nutritionists, and coaches, but in the end none of them made any sense. I knew something wasn't right deep inside.
This is simply my story and the research I discovered in my search for answers. I'm certainly not an expert in gut health, but I am most definitely an expert in my body and how my degrading gut health impacted everyday living and my athletic pursuits.  Here we go...

Onset of Symptoms & Gluten Testing: 

The first symptoms I experienced were bloating and gas. I decided to cut dairy from my diet (goodbye beloved greek yogurt) and noticed a significant improvement. Little did I know this was only the beginning...

Approximately one year thereafter I struggled with severe anemia (again), stomach discomfort, gas, bloating and other symptoms stemming to common vitamin deficiencies. After several visits to doctors and GI specialists I got a physician to prescribe i.v. iron treatment to help restore iron levels. While sitting through one of my weekly i.v. treatments I met another girl suffering from similar symptoms. We started talking and within 10 minutes we were both in tears. Not only did we sympathize with each other, but for the first time we felt we were talking to someone who completely understood and believed how the other was feeling. It had been two years since I first visited a GI specialist, but it wasn't until this moment that I believed I wasn't crazy and there might be real answers to my inability to properly digest foods.   She was a few steps ahead of me, and had been working with physicians at Stanford Health who discovered she had severe celiac disease.  I couldn't believe the similarities in our symptoms and immediately made an appointment to see the same physician.  By this point I'd already started the process of cutting gluten from my diet. This doctor studied at Harvard and is a leading researcher in gluten intolerance and celiac.  She had to have the answers!

Besides dealing with gut discomfort, extreme bloating and gas I also suffered from extreme malaise during training and racing. I remember racing Ironman South Africa and literally running past the turn towards the finish. I was in a complete daze and had to be directed towards the finish line. I had similar feelings on bike rides where I'd be only a few miles from my house and found myself turning to riders next to me asking where we were. It was as if I was training from high atop a cloud.  I also had leg and arm tingling during most of my swim workouts.

These symptoms started effecting my work day. Around 2pm every day I started feeling severe gut discomfort and wanted to run home and plant myself on the couch. The final straw was repeatedly being asked if I was pregnant (clearly it isn't universal knowledge that you never ask someone this unless it's very obvious. Wait, maybe the bloating was really that dramatic?!?!).  When I went into Stanford the physician was shocked to learn of my struggles with iron absorption and discomfort after eating. She asked me a long list of questions to determine what symptoms I was suffering from. It wasn't until that moment when I realized all of the above listed symptoms could be connected to my digestive track.  She convinced me to undergo an endoscopy to test for celiac, and assured me we'd get to the bottom of things through various biopsy screenings.

The test for celiac disease came back negative, but due to my symptoms I was instructed to keep gluten from my diet. I didn't need to be told twice. What people (who haven' dealt with severe gluten issues) don't realize is that the symptoms for celiac and gluten intolerance can be equal in severity. It is just that celiac disease is connected to the autoimmune system.  (I could go on and on about celiac and gluten sensitivity, but I'll stop there).
Prior to the endoscopy it's imperative that you consume a substantial amount of gluten.  For three weeks I ate yummy bread and gluten packed meals every night. Within five minutes of eating gluten gas bubbles started building in my stomach and soon after agony set in as they began exploding.  I couldn't wait to get these foods out of my diet. Even a drop of soy sauce would set my gut afire. My doctors at Stanford indicated that it was possible that if I continued to eat gluten I could later develop celiac. This is an area where much medicine research remains, but again I didn't care. I knew how I felt when I ate gluten and that was all I needed to cut it 100% from my diet.


All seemed to resolve itself and I went on with my training, racing, and daily grind. While I still had digestive issues with some fruits, vegetables and beans I chalked this up to normal dietary distress caused from these foods. Slowly symptoms worsened and I found myself cutting more and more from my diet.  Things came to a haunting point earlier this year when I realized that symptoms not only worsened, but were present after almost every meal.  I started keeping a food diary to determine what foods gave me issue. I spoke with my coach and dietitian who chalked things up to irritable bowel symptom (IBS) (clearly IBS is a serious issue affecting millions of people. I just knew this wasn't the answer and for me something more was going on).  While gas, bloating, diarrhea are all marquee symptoms of IBS I knew this wasn't my answer.  Our (QT2) core diet nutritionist suggested I follow the  FODMAP diet.

FODMAP stands for:  fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. These are poorly absorbed sugars that pass through the small intestine and enter the colon, where they are fermented by bacteria, releasing gas, which stretches the sensitive bowel causing bloating, gas and pain.  It was helpful to read about the ingredients within FODMAP that cause distress, however when I realized that 99% of the food items on the list gave me issues.  With that I threw my hands in the area and said "enough is enough."  IBS is a diagnosis made on symptoms, with no test to confirm this diagnosis. (The most common symptoms of IBS are: abdominal distention, constipation/diarrhea, abdominal discomfort). To me this was a catch all, scape goat diagnosis. Did people really think it was normal/acceptable to not be able to eat all of these healthy and natural foods!?! Honestly, I found it laughable.  To say I was frustrated would be a huge understatement.
*note: FODMAP is not a "diet" per se in that it is not meant to be followed for a long duration of time. Instead it's meant to be used short term (4-6 weeks) followed by reintroducing items one at a time to determine which items cause a reaction.

So...let's paint a picture of what I was eliminating from my diet at this point. Onset of symptoms came from: all dairy, honey, several fruits (grapes, all dried fruit, mango, apples, watermelon, cherry's, pears, dates (or any dried fruit)....), a ton of vegetables (various forms of lettuce, sugar snap peas, asparagus, brussels sprouts, cucumber, cabbage, broccoli, onion, peppers... to name a few), soy (tragic when my favorite Clif Bar product are the Luna Protein bars which use soy protein), and most beans (chic peas, black beans, white beans, lentils...).  Furthermore, I was no longer able to properly digest sports drinks and many sports nutrition products due to the glucose levels.  (Thankfully Clif Bar offers a whole host of options, and by rotating through gels, blocs, organic energy food, and bars I was able to properly feed the machine).
Eating any of these items caused severe stomach distention (yup, once again I was being asked if I was pregnant), gas, and fatigue. I was struggling to get back down to race weight, or even to drop a single pound. I sat at a 300 calorie deficit and couldn't drop an ounce. We took things down to a 500 calorie deficit and even still I sat firm at 10lbs over my normal/comfortable weight. I could get over the number if I had to, but I couldn't get over how I felt.  It was time to become my own advocate, to self educate. I started reading and listening to a lot of podcasts on gut health. Knowledge is power. Just call me Ms. WebMd.

My initial readings lead me to believe I was suffering from small intestinal bacteria overgrowth (SIBO).  SIBO is a condition in which colonic-type bacteria (resembling bacteria normally found in the colon) proliferate into the small intestine.  Common symptoms of SIBO are sensitivities to supplements, fatigue, brain fog, abdominal distention, abdominal discomfort, extreme gas and diarrhea or constipation. I had the first 6 symptoms, so this must be my issue, right? I reached out to my friends in the medical field to determine which the best tests for SIBO.  All recommended the at home SIBO breath test by Commonwealth Lab.  There's nothing fun about this test that includes 24hrs of a limited diet and fast, but I swore this would get me the answers.  The lab turned the test results around in just a few days, and responded to let me know there was a negative finding for SIBO. I was shocked.  (We're actually now rerunning the SIBO test to confirm there wasn't a false positive, however as you'll see I eventually found the culprit). 
-  Here is a great article by Chris Kresser on SIBO and why diet alone will not cure SIBO.  (It is important to do a lactulose test and not glucose, as lactulose is more accurate. A negative glucose test can not completely rule out SIBO as it doesn't test the full length of the intestine where overgrowth occurs). 
The search for answers continues...

Bacteria/H.Pylori Screening:

H. Pylori is a bacteria that affects over 50% of the human population. Shocking statistic considering it took years before I learned about H. pylori and got tested for it.  H. pylori is a bacteria that is picked up just like the flu or common cold. It can come from another human or from food/water.  Sadly not one physician ordered this very common test.  While the presence of h. pylori bacteria is not necessarily dangerous, it can lead to stomach ulcers and is thought to be the cause of some forms of stomach cancer if left untreated.  I am still in conversations with Stanford Health because this is something that is routinely checked for in endoscopy procedures. However my results make no mention of such test.

I worked closely with BioHealth Labs to make sure all the necessary tests were properly ordered (all require a physician's order).  They ran a complete GI pathogen screen, functional adrenal stress profile, salivary hormone test, and metabolic assessment profile.  All of these tests can be conducted at home and mailed directly into the lab.

The combined results from each of these tests allowed me to see the full picture of what was going on within my digestive track. The results came in, and it looked like I finally had my answer.  The GI pathogen screen showed a positive finding of h. pylori, as well as yeast overgrowth (candida). H pylori isn't something to mess around with and definitely requires treatment. By this point I didn't even care what was going on inside me, as long as I had an answer and a plan to dealing with it.  Tests also showed my hormone levels were effected.  I can now say with strong certainty that the presence of h. pyoli, as well as my affected hormone levels, were the root cause for my inability to lose weight. (I knew this wasn't a simple equation of calories in and calories out, and that starving myself wasn't the answer!)

I did my research and learned that the bacteria can be attacked either through herbal means or by antibiotics.  I am not a fan of antibiotics and haven't taken them (or any prescription drug for that matter) in 15+ years. I'll always go the natural route...but not this time. I weighted my options and opted for the antibiotic route for two reasons: 1) the success rate at killing the bacteria (for good) is 80% with antibiotics and homeopathic measures showed a much lower kill rate; 2) the antibiotic regimen takes 14 days while the homeopathic track takes 2+ months. Unfortunately the timing of trying to kill the bacteria and yeast overgrowth landed right at the beginning of my final push for IM Chattanooga.

I set off for our QT2 pro camp in Texas with drugs in hand (a PPI, and 2 different antibiotics taken in a very high does twice a day).  I'd love to say that it wasn't a big deal to be downing all of these drugs, but it was a rough few weeks. I literally felt like I was going to fall over and die during my workouts. Even an easy swim sent my heart rate sky rocketing. My body was working so hard to kill off the bad bacteria and here I was asking it to perform at crazy camp volume/intensity.  I remember rolling out for one of our first rides, praying it would be short and sweet.  (Now remember, I am one who lives for long training days! So to feel the way I did after 40miles was bothersome). I turned to Jesse to ask "is it time to turn around yet," only to hear "come on Caroline, this isn't your first rodeo."  From that moment on I buried my head and sat firmly in the hurt tank....workout after workout, day after day. Coach Tim was amazing at keeping me on track and pushing me through.   Things didn't improve until about three days after finishing the medications.  As bad as it was, there was no way I was delaying taking these drugs and killing the bacteria. I wanted to feel healthy and normal far more than I wanted to have a great race.

I noticed a pretty significant turn around after finishing the antibiotics regimen. I was able to tolerate (high doses of) sports nutrition once again and finally started to drop weight. In fact I dropped 7 lbs, in 2.5 weeks without even trying. Things turned around just in time for me to race Ironman Chattanooga. I felt confident and left for Tennessee with a renewed excitement.  We all know how that turned out- but to have figured things out and be on the mend felt like the biggest win of all.

I just sent in another round of testing to confirm the antibiotics did their job and completely killed the bad bacteria. Results confirmed what I had suspected: all bad bacteria was dead and gone! I did a happy dance. This was indeed a huge victory.

Rebuilding Healthy Gut Flora

Once the bacteria has successfully been killed off, and  hormone levels return to normal, it's time to rebuild a health gut flora.  There are many products out there that contend to help stimulate this process, but I've chosen to try to gain results through my diet.  I learned about homemade kefir milk while in Australia earlier this year. It is easy to make and contains more healthy strands of bacteria and vitamins than store bought options. Kombucha and sauerkraut/fermented vegetables are also great options for rebuilding healthy bacteria in the gut.  (making homemade fermented vegetables is next on my list).  I am also working with the founders of Sound Probiotics to learn how pre and probiotics can restore gut health and have added their probiotics into my daily routine. Their product includes a prebiotic which will help restore healthy bacteria in the gut.  (Chris Kresser Podcast on ways to build healthy gut flora if you're unable to process probiotics and fermented foods. Listening to this made me realize others have it way worse than I).

It's been quite the journey to get to the final stage of not only finding answers, but treating the root cause of my symptoms.  If you relate to any of this story my first bit of advice is to be your own advocate. I challenge you to get to the bottom of the root cause of your symptoms, and to remember you know your body better than any physician, dietitian, homeopathic guru, etc.   I can certainly relate to the day to day obsession of trying to overcome diet restrictions while pursing sport at the highest level. Eating was a stress in my life and simply a means to feeding the machine.  While it's important to slowly reintroduce food into my diet I have certainly tested the waters. My body tolerates small amounts of dairy again, every vegetable I've tried as well as fruit and dried fruit.  I'm also feeling a difference in my body's ability to digest red meat which is crucial due to my history with anemia. I tested a small quantity of (gluten filled) bread and to my amazement didn't experience any stomach pain as a result.  I'm still waiting for a huge training day to sit down and indulge on real pizza to give the system a real test. (Although after three years of being 100% gluten free I can't even imagine being able to add this back into my diet. This one is still TBD).

Rebuilding healthy gut flora takes considerable time.  I'm patiently optimistic things won't relapse and I can remain in the clear. For now I seriously feel like a new person. To those who I've consulted with along the way I thank you for openly sharing your knowledge with me. It's been a long road, but I am thankful and appreciative to have forged ahead instead of living complacent with cutting out so many foods from my diet.

I plan to follow up with a twitter chat/Q&A with Sound Probiotics. We'll announce a date/time on twitter once solidified.

Take Away's:
Here are my over arching pieces of advice to anyone dealing with gut health concerns.

  • Use IBS as the catch-all only after all other digestive diagnosis are ruled out. This isn't to say that IBS isn't an actual syndrome, but it's better to be safe and rule out any other issues which can become worse if left untreated. If your symptoms are as drastic as mine then I can only imagine your reaction to an IBS "diagnosis" will be to laugh it off. 
  • Use FODMAP foods as a marker to determine how many of these foods give you issue. If cutting all FODMAP foods makes you feel better then it's time to dig into what's going on in your gut. Please don't just assume you should permanently cut all these healthy foods from your diet. 
  • Always remember you know your body best. If you feel like something is not right then trust your gut ;-) don't stop until you find a practitioner who can access what testing you might need.
  • Most importantly- if frozen yogurt starts causing digestive discomfort you MUST seek medical attention immediately! 
There you have it. Sorry for the long post, but I do hope this can shed some light on issues others might be facing. Please feel free to leave a comment or reach out to me with any questions. Again, I'm no expert but I do know finding answers is well worth the investment. health and happiness!