Monday, March 25, 2013

Diagnosis, decisions, discoveries

For those of you who follow with any interest the running aspects of this blog, you may have noticed that the last few long runs (Boulder Marathon in October, first 42 of JFK in November and NOLA marathon in February) all mentioned that my lungs didn't seem to want to play and that I went (even more) slowly to finish each of them.  Then I had the cold from hell in January and when I was totally out of breath going xc at Rocking Horse (both the E time and the successful, but slow, time), I chalked it up to that.  When I saw my physician for my annual exam a couple days after the NOLA marathon, I mentioned to her that I should probably get a pulmonary consult as my lungs seemed to be getting worse.  She agreed and also scheduled me for a stress echo.  The pre-stress echo got finished up with not a lot of waiting, but then the cardiologist came into the room.  Turned out that things didn't look so good.  Apparently, the radiation for Hodgkins impacted more than my lungs (and my shoulders, but that is a different story) and the echo had detected "moderate" aortic stenosis - maybe:

Classification: Aortic Stenosis Severity
  1. Aortic jet velocity
    1. Normal: <2 li="" m="" sec="">
    2. Mild: 2.5-2.9 m/sec
    3. Moderate: 3-4 m/sec
    4. Severe: >4 m/sec
  2. Mean gradient
    1. Mild: <25 li="" mmhg="" nbsp="">
    2. Moderate: 25-40 mmHg
    3. Severe: >40 mmHg
    4. Critical: >50 mmHg
  3. Aortic valve area
    1. Normal: 3 to 4 cm2
    2. Mild: 1.5 to 2 cm2
    3. Moderate: 1 to 1.5 cm2
    4. Severe: <1 cm2="" li="">
    5. Critical: <0 cm2="<!--0--">
While the area appeared to be around 1.1, the gradient looked much more on the mild side and they were having trouble figuring out the velocity.  Apparently, when you go around running marathons with your heart in this condition, it screws up the standard diagnostic procedure, but there is definitely a diagnosis and an issue (and, of course, the symptoms). Next on the medical front is a discussion with a cardiologist, probably catheterization as it will provide a more accurate picture and is especially recommended when the echo findings aren't consistent or conclusive (true in my case). Then, they will likely still do some sort of functional test to see what the heart does under a workload.

Aside from the medical side of getting figured out exactly where the diagnosis falls, they have said that in the meantime, physical exertion is not a great idea.  After talking with several physician friends (both internists and cardiologists), I decided to continue with the plan to do the 50 miles at the Inagural Prairie Spirit Trail Ultra, but to walk it rather than making any attempt to run.  Looking at a forecast with a low of 30, a high of 40 and a 70% chance of rain/sleet/snow, I had more than a passing thought that I had the perfect excuse to bag it.  But, I'm pretty well trained right now, there is no time limit, I own vast amounts of warm and waterproof clothing and who knows what might happen over the next few weeks/months, so decision made - and remade several times in the days leading up the event.  I had the perfect excuse to not go out in the cold and rain/sleet/snow, but I knew that if I didn't, it wasn't for the good reason of not wanting to harm my heart, but for the feeble reason of being a weather weenie, so the decision didn't change.

I flew into Kansas City on Friday afternoon and the weather was promising.  The drive down to the bed and breakfast was easy, as was check-in, packet pick-up and a pasta dinner.  This time, there were no Friday night nerves, they waited to make an appearance until around 5:00 a.m. Saturday morning.  I didn't need to be awake that early, but I was, so I sorted through gear, prepared my drop bags, had a cup of tea and then headed off to the start.  We hung out in the gym at the Don Woodward Community Center for a bit.  I chatted with some other participants, especially a woman named Amber, who ended up with a great finish in her first 50 miler and started gearing up.  Runners are great.  Ultra Runners (in my limited experience) are even more into supporting each other and offering help and tips.  Then it was time.  At 8:00 a.m., it was full light and in the upper 30s, not bad at all.  I set off at a walk.  My goal pace was 16:00/mile.  I was very near the end of the group and alone most of the time.  I met up with a trio from Oklahoma (Caroline, Roman and Bobby) several times during the run. The first time, when we chatted a bit at the first unmanned aid station at mile 5.25.  I also made a point to eat my Almond trail bar before then and my first packet of Clif Shot blocks before the first manned station (Princeton) at 9.75, knowing my chewing interest wanes as events proceed (one of these days, I'm going to need to embrace gel - maybe - see I forget (or am in total denial) that I may not be able to continue to do this).  Spent about 5 minutes at the aid station, turned down the offer of a taco. Sonny (son of organizer and part of the Brigade) was having a potato taco, which was interesting, but not at all appetizing sounding to me.  On then to Richmond at mile 16.  The trail was lovely in many places.  Woods (which you don't necessarily expect on the prairie), lots of birds, bridges over lovely creeks and rivers, cows in the field, something very, very green (maybe the last of the winter wheat?), and a smooth trail.  Richmond to Garnett went well and I pulled into Garnett at 6:26, 15 minutes ahead of goal.  I used that time and more warming up, changing hand warmers, resting a bit and chatting with Roman and Bobby.  Then, off for the second half.  By this time, it was snowing.  It had started lightly in the last couple of miles to Garnett and was coming down in earnest as I left.  Big soft, but very wet flakes of snow.  It wasn't sticking on the paved part of the path in Garnett yet, but was once back on the trail.  Around mile 27, a stunning big fox crossed the path right in front of me.  That smile lasted at least a couple of miles.  Had it been warmer and drier, I would have taken some pictures (would have missed the fox - he was very fast), particularly of the beautiful blue of the juniper berries on the ground, some of the birds, and more amusingly a "can you identify this scat" series as there was sign of any number of animals all along the trail. Got back to Richmond (mile 34) feeling good, but a little soggy (much thanks to Rob for advice on the Patagonia Houdini - it was working its magic, hence only a little soggy).  I had ramen and hot chocolate, switched out my gloves and added a second pair of handwarmers and put my Arc'teryx jacket in a ziploc and added it to my pack (much thanks to Barry Lewis for suggesting the Ultra Aspire pack - I didn't use the water bladder, but it was amazingly comfortable for carrying stuff and I was able to hook my hand held water bottle super comfortably into the front straps, so I didn't have to carry it), and then headed off to Princeton.  At Princeton, I discovered that my one packing failure was not having a third pair of gloves, but Andrea (another Brigade member) was good enough to work hard at getting the ones I had a bit drier.  I pulled my Arc'teryx on over my pack and added my headlamp (thanks to Andy Glick for the Petzl Myo RXP headlamp for my birthday present), and headed out for the final (not quite) 10 miles.  I think I did cover 10 miles because by now there was pretty significant slow on the ground.  At the road crossings, it was quite deep and slushy in places and so I walked around a bit to avoid the deepest parts, same as I passed into the final three miles and the snow was deep and slushy on the paved path, so I wove around a little.  I still felt quite strong and passed a few people in this final stretch.  I was also passed with somewhere between 2 and 3 miles left by the first finisher of the 100 mile race.  He looked amazingly strong.  I just continued along.  Getting to the finish was a bit of a comedy.  I didn't really understand the cones that were set up and so went to the front door of the center and went in, then was told to go back out and around to the back.  When I did that, I ended up at a locked door.  I pounded on it and waited a little and was about to head back around to the front when someone came to open it (apparently the door stop had failed - oops).  I was able to head in, where they had set up a really neat finish line and had a photographer (I will try to add the photo once they are posted).  I walked in the front door at 10:16 p.m.  Attempting to correct for the longer aid stations stops, I mainted my 16 minute walking pace.  I was not the final finisher and not everyone at the start line crossed the finish line, but everyone of them had a story, all of them in one way or another EPIC.  Thanks for reading mine.  

I'm not sure that a pretty epic March snow was what Eric Steele (the race organizer) had in mind when he was thinking that the event would be epic, but I'm really glad I did it.  It is a nice bucket list item to have participated in an inagural 50 mile event 2 months after my 50th birthday.  I fairly quickly got back to the bed and breakfast, almost cried when I wasn't sure I could manage to turn the key in the lock with my frozen hands, but succeeded and had a short soak in very hot water in the lovely big tub in my room at the Three Sisters Inn. I got up in the morning, got packed up and headed out - into about 10 inches of snow and an unshoveled driveway.  With the incredibly generous help of another guest, I got the car out (after about an hour of shoveling and rocking and pushing and shoveling) and headed to the airport.  Driving was a little slow, but easy enough.  Apparently, despite being in the midwest, MCI airport hasn't quite figured out the logistics of plowing the runways, so it took our plane over an hour to get to the gate, meaning I missed my connection from Cleveland to Philadelphia.  The good news was that missing a flight in the middle of March Madness isn't that sad, because sitting in some sports bar watching basketball would be on my list of preferred activities for a Sunday afternoon anyway.  It was fine that it was at an airport.  Finally got home around 10:00 p.m. and neither yesterday nor today was I particularly sore (the benefit of walking or of being cold acting like icing during the endeavor?).
So, what are the discoveries alluded to in the title?  I don't really remember, I wrote the title on Friday, but I can say I've learned: That the ultra community is a great one and I hope I can stay involved as the diagnosis progresses; that the praririe is lovelier than I expected; that I can overcome being a cold weenie for a good enough reason; that I have amazing people in my life and that life is good (the latter which I knew).
I also need to add some shout outs, to Caitlin Silliman winning the Intermediate at Southern Pines on Remi this weekend, Jenna for texting me those results as they happened, the Blue Hill Crew and Sally Cousins for successful weekends at Poplar, Rob Colenso for his blazing fast Terrapin 50k time, Kaiti and Jen for their messages leading up to and through the weekend, Natalie Hollis for successfully completing the Jungle Cup in weather almost as bad as in Kansas (and more water obstacles involved), and always Henry for setting his worry aside and supporting my crazy endeavors.

Tuesday, March 5, 2013

Running and Riding

No, not a Ride and Tie event, although that seems like it could be great fun, but rather two separate weekend activities.  February 23-24, I spent in New Orleans to run the Rock 'n' Roll marathon.  I was lucky enough to stay at the really lovely home of Bonnie Kibbie's parents in the garden district, close to everything.  I posted a picture of one of the dogs on my facebook, temporarily confusing Bonnie who had forgotten that I was spending the weekend at her parents' place.  Bonnie's dad had headed north to be with his mother and Christina (Bonnie's mom) headed up Sunday morning (after not only totally setting up the guest room for me, but also treating me to a lovely dinner on Saturday night).  Bonnie is a big winner in the parent jackpot (although I suppose there is always some amount of other people fully appreciating your parents more than you ever can).  The race itself went well.  I went slowly, still not a 100% recovered from respiratory remnants of the plague some unknown viral infection, but finished fine and felt quite good.  I did yogilates on Saturday afternoon and yoga on Sunday afternoon (at a studio owned by a woman with whom Bonnie went to high school).  If you are in New Orleans, I can highly recommend  The music component of the marathon was very good.  In the past, I sometimes have been disappointed by the amount/quality of rock and roll at Rock 'n' Roll marathons, but not this time.  Super rock, southern rock, blues, country, even some jazz influenced stuff and all of it good.  It made the miles pass faster.  I walked and chatted with a woman at about mile 22.  She was running her first marathon, 3.5 years after a heart transplant (necessitated by CHF due to treatment for recurrent breast cancer).  Talk about a complete inspiration.  Never say your life is too difficult to achieve your goals.  Sunday night, I had dinner at the Irish House, excellent food, Irish hard cider and the basketball game. The only downside of the weekend was somewhat wet weather (although it held off through the race).  It was great fun meeting Rex, Taiki and Abby and getting to spend some time with the inimitable Fennel.

This past weekend was back to Rocking Horse, this weekend the Rocking Horse Winter III Horse Trials. Keegan and I were making another run at training level.  Our dressage test was right where it has been, despite what I consider the much more difficult (and not very sensible to my brain) Training Level Test B.  I had an error, but without it we would have been right in the same ballpark where we have been.  He did get a 7 on his second canter lengthening.  We've been working hard on that with Hilda's help.  The trot lengthenings are apparent, but not super organized.  He seems to lose track of his legs, but we'll keep working on that.  Free walk less stretchy than usual, but still good for a 7 and stretchy trot good although apparently lacking bend (something that it has never even occurred to me to work on, I love the endless learning opportunities in dressage).  Got off and swapped tack to get right back on for SJ.  Short warm-up and then in.  Hilda was concerned that I would be too brain dead lackadaisical in my approach to the course and pointed out that some of the turns were tough.  Once again, Keegan went in and made the whole thing feel incredibly easy, including handily jumping out of a totally dead distance to the swedish oxer on a bending line.  I apparently somehow managed to execute the turn to the liverpool beyond Hilda's expectations and she was also surprised by how smoothly we performed the inside turn from jump 2 to 3.  I'm going to take him to some jumper shows this summer.  It will be good for me.  My riding is approaching the nearly acceptable level (a couple dead distances aside), but my position is still firmly in the barely trained monkey category.

So there it was 10 am and I was done riding for the day.  Loaded Keegan up in the trailer (he has a slight aversion to the two horse, which is amusing given how good he has been about all other trailers) and Hilda kindly took him back to hang out in his pasture at Ashmore.  I got to spend the afternoon hanging out in control with the fabulous Cyndi Kurth Turk.  It was much colder than it is supposed to be in Florida.  The wind was especially cutting.  There were lots of really lovely rides, but also a couple of tough falls.  Rowdie Adams reported being ok, but grounded and stuck in a neck brace for several weeks.  I didn't hear any follow up report of the other rider that was transported, but it was a long hold.  Marley Stone and Lauren Keiffer get props for coming off the hour plus hold and jumping clean through the rest of the course (only the final fence in Marley's case), both of them ending up in the ribbons.  I got to see Abby the dog (as opposed to last weekend's Abby the cat) and as always enjoyed the close up view of what was happening around the cross country course that being in control provides.  Forrest Nymph and Lauren DeNeve looked great, very cute and good jumping pony there.  A couple of Mike Huber's students were completing their first preliminary or intermediate horse trials and Olivia Cliver recovered from having to chase down her My Mitch  (who escaped while in warm up) to take first place.  There are always a hundred little stories going on at a horse trial.  We finished fairly early and I headed back to do some day job work and wash off the sand that the wind had blown everywhere.

Sunday morning we headed off again (earlier than anticipated due to compressed xc ride times for the training, novice and bn).  We got tacked up and headed out to the cross country warm up.  The event had kindly provided a whole row of actual cross country fences to warm up over.  I think there were at least 6 available even when the bigger ones from the upper levels were removed.  We jumped several of them, working on some turning and keeping a good tempo and then headed out of the start box.  The first four fences were perfect, although Keegan had to help out to 4B, which he did.  Then Keegan found another gear and a bit of willfulness.  Fence 5 (big green bench) went well, the training corner/table at 6 was a non-issue, and although I had been worried about it, the Trakhner didn't warrant a look from him.  He did hit the ground really running though, so in line with my actual plan, I slowed him down significantly before heading to the half coffin (which was a very kind question at this event) and he jumped it very well, then pretty much totally blew me off on landing.  The next table was jumped from a far too flat open stride and had me actually saying to my horse, "D**it, listen to me!  Do you want to get a DR penalty??"  I actually halted him there and then trotted 10 and 11 (which were angled ramps at two strides), no trouble.  We then cantered off to the big picnic table, which jumped beautifully and then to the banks area.  I jumped him over 13 in a direction to land on the flat ground, then brought hime to a trot to make the quite sharp turn to head down the steep slope before jumping up the double banks.  That also cost time, but what we've been noticing is that sometimes if he sees too much, it makes him doubt.  This way, he was able to focus on the single obstacle and then turn and go slowly enough to understand the banks.  We made the turn and picked up speed to the next table and the chevron and then I trotted again as we approached the water combination.  I may not have needed to.  He was very bold over the roll top, down the log drop into the water and out over the (pretty big) chevron - despite my having overslipped my reins and having little steering to that last.  He then took off again, but I got him slowed down and turned to the final two fences, a cabin and a table.  So we finished very slowly, but with no jumping penalties and I felt a great learning experience for both of us.  I also discovered that my rubberized web reins have lost all their rubberization, so new reins before the next event. We ended up last in our division (8th), but I was incredible happy with the weekend and with my rockstar OTTB!  Cyndi said that she was so thrilled for us that she called Keegan, Keebler - twice!  We are eagerly awaiting the eventing debut of Jordan and the menace.