Monday, July 29, 2013

Out for Blood

Beautiful Donner Lake - sight of a killer July 4th training wknd
Really? The year is already half over? I think back to the early months of the year and how excited I was to throw down some solid early season racing.  The opposite happened and instead of torching race courses around the world I felt like my body was on fire. Leading into Ironman South Africa, and thereafter, I was in search of answers. Cortisone shots and I.V. iron treatments were only band aides covering up the real issues that needed to be addressed.
Why was my body breaking down? Why am I feeling sick every day? Why do I take 800 times the daily intake of iron, but year after year find myself chronically anemic? This is one of those posts that I've thought about writing for months, but just haven't sat down to do it. After speaking with 5 girls in the last 2 weeks about battling anemia/low iron I couldn't wait any longer to put this out there.

Iron deficient anemia - if this is something you've struggled with I can relate, and honestly am not sure many people out there have battled this condition longer than I. Severe iron deficiency relates back to my days as a collegiate athlete.  Potential mano was blamed for a few fainting spells, even when I didn't test positive for the virus.  I covered up several signs of severe anemia, all in an effort to never show my coaches a sign of weakness.  After one grueling training session I completely passed out in the parking lot, only to be discovered by the Univ of Michigan athletic director. Not exactly part of his job description! but it sure did grab the attention of our team doc and make him look a little deeper into the issue. Iron levels were wicked low (12 is considered anemic. I believe I was hovering around 3!)
Fast forward 10+ years, and many of the same sensations continued. For instance, I've learned to become accustomed to a tingling arms and legs when I swim.  It wasn't until just before Ironman South Africa when I demanded a doctor order i.v. iron to hopefully get my iron to a non-alarming level.  This meant weekly visits to a blood disorder/cancer clinic to receive iron intravenously.
I sat next to other young females also struggling with the same deficiencies, but week after week became frustrated when they told me how their iron levels (hematocrit, hemoglobin, etc) were sky rocketing while mine were hardly creeping in he upward direction.
I returned from South Africa discouraged, but still determined to press doctors to find a reason. I'm sorry, but it is not normal for someone to digest iron at the quantity I do AND intravenously inject ferrous-sulfate into the body and hardly see any affects. It was if my words were falling on deaf ears.  The i.v. treatments made a small difference and got me on the right track.  Levels were still low for an endurance athlete, especially one pushing their body to compete at the level I do, but there was progress. (PS- if you're considering this your doctor has to show a history of blood work in order for insurance to cover it. Even with insurance paying the bulk of the expense it is not cheap!)

On top of the iron issues I was experiencing severe stomach/digestion discomfort. I gave up dairy about a year ago, but this only marginally solved the issue. Good bye beloved greek yogurt! Then during one of my iron treatments I met someone who could relate to EVERYTHING I was experiencing. For the first time I realized the following symptoms are NOT normal, nor okay:
  • Numb arms and legs while swimming 
  • Seeing stars on a very regular basis- at least 8 times a day
  • Extremely poor night vision while driving
  • Loosing most self awareness and cognoscente wherewithal after 3 hours on the bike
  • Feeling like there were bombs going off in my stomach after most meals
  • Often living in a state of fog. I can't describe it but as things got worse I started feeling like I wasn't really present and there was a sense of daze surrounding me
  • Being asked if I'm pregnant on multiple occasions because of severe stomach bloating (yes the first time this happened I was mortified!)
  • Exhaustion...not the normal kind that we all experience! I know how it feels to work hard, train hard, and attempt to live a life outside of both. This was not the same. I was dying-mentally and physically. 
Meeting this little angel of a girl amidst copper drips going into our veins gave me my first sense of real hope!  She suggested I go see her doc at the Stanford digestive health clinic.  We talked about what I was experiencing (see bullets above). For the first time I was talking to someone who didn't look at me like I had 9 heads when I described these feelings.  Her and her boyfriend gave me a hug, and with it a list of doctors she'd seen.  They both believed a diagnosis of celiacs was likely in my future...didn't sound fun, but finally there was hope! I needed an answer! (I had already seen 4 different gastroenterologist, or digestive medicine doctors-none of which told me that iron absorption could be tied to a gluten intolerance). I can't tell you how frustrated I was! but behind the frustration was a sense of urgency and desperation. I was sick of feeling this way. Off to Palo Alto I went.
Vineman70.3- the first race this season where I went in feeling healthy!
I walked into the office of Dr. Fernandiz-Becker with hope. She rattled off questions about symptoms that no other doctor had ever asked; questions I found myself answering more yes to than no.  Finally someone dedicated to finding the underlining cause, and not just a temporary band aid. I went through a few months of testing for celiacs disease, potential internal bleeding and other potential reasons for my inability to properly absorb iron.
Gluten - I always felt eliminating gluten was somewhat of a joke. If your body can properly digest it why go "g-free." Pure fad! I never thought I had an issue with wheat/gluten, etc but also wasn't well educated on the topic nor all the foods that contain gluten. By the time the test came back for gluten intolerance/pre-celiacs (not really a term, there is a lot of research still needed to determine vitamin/nutrient absorption for those without verified celiacs) I was already on a g-free diet. In fact going back on a 2 week gluten saturated diet before my procedures nearly killed me! By 3pm I couldn't sit in my desk chair any longer, and couldn't imagine having to get in another workout after work. I was lethargic and my intestinal track felt like it was at war with my stomach. Put that damn scope down my throat, take your biopsy's and get this crap out of my body. Gluten had to be 900% eliminated from my diet- STAT!
I already ate very clean and included very limited processed foods in my diet so although the change was tough at first it became easier. Now, 3 months into the g-free eating I can't imagine ever going back. I've been tempted with a few foods here and there, but ultimately I never want to feel the way I did. A slip up at a restaurant and I'm almost instantly on my way home to wallow in bed in complete discomfort.
I'm now getting a full iron panel test every month. July 2013 marked the first time in 10 years that my blood work didn't included a doctors note with the word "anemia" in it. Moral of the story- know your body, find knowledgeable doctors you trust, and fight for your health. The fact that I struggled with anemia for this long but was told time and time again to just "take more iron" is disgusting.  
I believe this gluten intolerance started years ago and may be to blame for my iron absorption issues, but really wasn't a game changer until last year. For a year I laid in bed every night dying to just fall asleep so my stomach wouldn't bother me any more. I thought it was the result of a diet packed with fruits/vegetables.  Wrong! Now that I know the root of the issue I can finally do something about it. G-free living, it isn't just a fad ;-) To those out there who really can't tolerate gluten I feel for you!
Never hurts to have some red blood cells in the body when it
comes time for my weekly Diablo mtn repeats.
This wasn't exactly the most exciting blog post, but if sharing this helps even a few of readers it will be worth it. 
In terms of racing, Vineman70.3 and Lake Stevens70.3 served as great training days for my next Ironman - Ironman Louisville. I've wanted to do this race for a few years and am very excited for this race. I enjoy a glittering of 70.3 races during my season, but Ironman racing is where I thrive.  
Battling a few demons on the LS70.3 run course.
Grateful beyond words to be back racing again...
All the while knowing my best is still ahead
Stay positive, keep believing and push yourself to new heights! No one exemplifies this better than our girl MBK, so I end this one with a huge shout out to Meredith for her back to back 70.3 titles at Vineman and Lake Stevens. A month earlier she lied in a hospital bed after a tough crash on the Eagleman bike course. Nothing is going to hold this girl down! Dreams realized...with more to come for this champ. Congrats my friend!
and so the race season continues....
Early/cold start at for Vineman

 Do What It Takes,