Hike: Siphon Draw, including Flatiron

What I thought began as a great hike on a wonderful route Saturday, turned out quite badly for me. It leaves me still today with more questions than answers to my future in endurance or perhaps athletics at all.

A very brief synopsis of the route. From the Lost Dutchman State Park (LDSP) its a pleasant hike to a Wilderness Gate and then a rocky uphill to a seasonal waterfall called Siphon Draw. It is then an increasingly steep scramble towards the top of the Superstition Mountains with occasional areas of vertical bouldering. The route is on the right side of mountain in the header above this blog.

This should have been easy for me. And in fact the trip to the dry waterfall was uneventful. The storm the night before left the temperatures much lower but the humidity much higher. Knowing this I brought 180 oz of water in my pack, its only contents other than my survival kit and some calories.

I began to fatigue about 3/4 of the way up. I sometimes used rest steps, which is not unusual for me. I rested five minutes of every thirty, but again I build in rests because I tend to miss whats around me if I don't. At the top I rested and enjoyed myself for 45 minutes. I felt good. I also considered something that I noticed with most other people on the mountain, I had significantly more water than anyone else, that I could see. Many people bringing just one or two liters with them. I drank 3 liters (100 oz) just getting to the top.

One of my outdoor idols is mountaineer Ed Viesturs, he is famous for living the phrase, "Getting to the top is optional, getting down is mandatory."

The decent began innocently enough. Then I began to cramp in my quadricep. Hard. Those that do endurance races like marathons and Ironmans understand the sudden onset of rigored spasms that leave a person in what can only be described as an agonized state of tazer, knowing that there is still hours of movement to go.

The cramping came and went, as it often does, and I dealt with it like many of us do, I pushed through it. But for once I considered my age, which is a new weakness for me. I may have been the oldest person I saw on the route the whole day. My knees ached and I was sweating like a colander holds water. I felt old, or perhaps something else.

At some point with 1.5 miles to go, I really started to fall apart. Mentally and physically. I replayed the Ironman that nearly cost me my life a year and a half ago and all the things I have done since to avoid this very moment. All the promises I was breaking to my family, my friends, being in this state of collapse. It only sped my decline.

The heat, humidity and physical defections continued to compound. My training took me back to accomplishing simple goals; get to the next curve, walk to the next rock. I could not simply sit down in the unshaded desert and expect relief. Looking at my GPS I realized on the way up I had plugged in a way point for a campground shower area just off trail. I was a half mile away from that and my car a half mile again past. My goal became to reach this peice of civilation and cool myself under a shower and rest inside before going further. I could not get more wet than I was from sweat.

As I approached the campground my face began to tingle like a low voltage current passing through it. A sure sign of heat injury, as if I needed more evidence.

I sat in a shower stall for several minutes before I reached for the knob to turn it on. It didn't work. Nor did the other. I went to the sink basin and poured water over my head and torso with a water bottle but realized the enclosed room was not cooling me down as much as the wind would outside, so I slung my now empty pack over my shoulder and went to my car letting the wind cool the water on me. The hike really was beatiful and I know that any other day I would have greatly appreciated the wonder of nature around me. But my quad was feeling tazed with more regularity as I reached my car.

Unfortunately I knew what was coming when I stopped at my car which filed me more with dread than delight. You see when your in a state of cramping, your body gets accustomed to working a certain way and when you change that motion, by say sitting or crossing your leg, aggressive cramping attacks other areas of the body. In my case this day, the calf below my already cramping quad. Not usual. And half the toes of my opposite foot.

Now some people reading this can say they have had excruiating toe cramps, though I have heard of such things after ironman swims or cycling, I could not lay claim to this anomaly until today and oh my god I couldn't believe that the pain I felt along 18 inches of thigh for the last 90 minutes could be focused in three small toes all at once.

Now I suppose I am aggrandizing my suffering without really prescribing the right amount of stupidity I should have felt. Nothing made me feel worse the entire day than calling my wife and describing my condition. I went to place I promised I would never go again.

The rest of the day was spent in bed, dealing with cramp aftershocks, drinking cold beverages like Gatorade and apple juice and eating salty foods. The next morning I seemed to be most recovered except for the inital quad cramp that continues to frustrate me.

A recap of 14 months

I was at a birthday party for a true friend and tri-buddy, Hardcore Mike, this weekend. A lot of the team is suffering from some sort of endurance injury; swim shoulder, runners knee, ITB, etc. Of course they're all still training regardless of slings and boots and braces. Compared to them I looked pretty damn healthy.

Some new people to the team were there and having recently trained with the walking wounded and now seeing me they wondered why I'd been slacking considering some of more crazy stories about my training and racing. So my exploits begged the question from these new members, "So why arn't you doing (insert race here) with everyone else this year?" And after some goodhearted ribbing, some yelling over to the wife to ask when I could train hardcore again followed by some cursing and strong admonishments from several others I would relate this story:

"Fourteen months ago, Ironman Arizona, 40 miles into the bike course, my body told my mind to stop racing. Something was terribly wrong with it. My mind said, No. My body decided to cramp up its legs until it felt like I had tasers in each quad and calf and I couldn't stand up without falling. My mind said No. My body said I will shut down your kidneys and liver. My mind said, No. Friends and medical professionals along the course pleaded with me to stop. My mind said, No. My body finally decided to seize up my heart and my lungs, pleading with my mind, PLEASE STOP. My mind said, No, there is still time on the clock and I will not stop moving.



My mind forced my body to go more than 60 miles past exhaustion. I was taken off the course 8 miles from the transition area and all I wanted to do was get off my bike and run a marathon. Even with my race over, my mind would not let my wife take me to the hospital, it was just a bad day. Several hours later an ER Doctor told my wife, Be prepared, he may not make it to sunrise. My mind said, I will never give up.



And here I am, fourteen months later. Alive. My body still recovering from its physical defections, doing the right thing against a mind that would not listen to reason. I am told by all mainstream doctors and experts to never train or race again, it will most likely kill me. I am slowing coming back but today my body is still too damaged and weak to fight my mind on a race course. Maybe in 2010 my body will be strong enough to fight my mind, but until then I have a lot of healing and listening to do."

Rest, Recovery and Peace of mind.

Exactly one week ago I was given the yellow light for training. Today my morning HR is +8 beats over baseline requiring me to take a mandatory rest day from training. This is expected and a part of my recovery system. I am sure after a day of no exercise and full sleep I can get back to it tomorrow.

This blog is not just about my training. It's as much a life journal as a training journal. Some other issues I am dealing with this week and probably contributed to some elevated HR stress--

No one had heard from a training partner since New Years. This is someone who has no family here and was proactive in communicating with us. I finally drove by his house at 11pm last night and found him home, fine. Admonishments ensued but glad he is okay. I really thought I'd find him face down in the tub.

My grandmother will most likely pass this week. She has had a long life and the last few years have been marred with health issues. My mom is back east to help her family as best she can. She is super strong, I think stronger than I could be if I was in her place. This will be the second family member to pass in as many months.

Mo had a trip to the cardiologist today at Phoenix Childrens hospital. His two other doctors recommended it after seeing some high numbers in recent results. Everything went very well. He is doing great. It was concluded that his genetics and medical condition contributed to the numbers and by looking at a bigger picture he is in good shape with no follow ups needed. At the end of the month he will have his annual sigmoidoscopy to review his colitis. It has worsened over the last year, however the issues of his low immune symptoms (pneumonia, bronchitis, asthma, and the itinerant steroids and antibiotics) has dropped dramatically so we are blessed in that regard.

My dilemma

Let me explain my dilemma. I feel as if my four years of Ironman training gave me a base fitness that allowed me to coast along with some semblance of fitness appearance long after my kidney failure. In December, nine months after all the misery I put myself through at Ironman, I felt like that coasting had finally played out. For the last month I have felt for lack of a better term, normal.

I no longer feel fluid enough to swim 2 miles in open water, nor have the legs to ride 80 miles before my day even starts, or have the constitution to run 15 miles at a moments notice. For any of those workouts, sometimes two in one day, I only needed a phone call and a meet time.

I felt determined and I had every intention yesterday of working out, I felt as if my sanity demanded it. I chose my exercises carefully so I wouldn't muck up my blood and activate the Rhado. It would be a glorious re-introduction to some sort of program and I could take back a part of my life that has been missing like an amputated limb.

Then I thought about my kidneys being screwed up on Saturday. And then my partner started in on me asking if that was really the best thing I should be doing. And then we got into a conversation about how screwed up I was a couple months ago, that my doctors want me to wait till Spring to start up again. That if I screwed anything up I could end up spending a night in the hospital hooked up to an IV and waiting for my kidney numbers to drop.

Instead of working out, I walked out. I needed fresh air. I was, I am frustrated. I talk to the doctors this week this week. I am hoping there is something positive to go over.

Business Fitness

I suppose most people are finally getting back into work today after what seemed to be a blessedly long holiday vacation period. In fact I woke up on Sunday before my usual waking time, went downstairs and started going through my groggy routines for ten minutes before realizing, "Ah crap, it's Sunday" and then heading back upstairs for another two hours of sleep.

On Saturday I went to the grand opening of one of my company's new locations. Man ,talk about energy and enthusiasm and lots of business. The community completely opened up to us.

It also kicked off a two part contest for employees. The first part is a 60 day body morph challenge. On Saturday each was measured, had their body fat taken and a 'before photo'. In sixty days we will do it all over again and the one with the most dramatic change wins a cash prize. I actually won this contest the first year we did it, I dropped 77 pounds and 2/3 of my body fat and was part of an ad campaign.

The other part is a physical fitness contest that for the sake of brevity I will include in a future blog post.

I am not involved in either contest as a competitor. Obviously I still haven't been released for exercise, let alone doing one or both extreme body transformations. In full disclosure to my friends, being at the grand opening and being excited about the two contests jacked my adrenaline up and turned my urine tea colored. Needless to say I spent the rest of the day drinking lots of water and resting. Very similar to THIS experience.

Whatever your goals are this year commit to be great at it. Don't do anything half-hearted. Talk to your support system, tell your co-workers and friends. Dare to be your best at every opportunity. And you may surprise yourself at your results.

There's treasure everywhere.

Its an everyday correction

Someone who means a great deal to me is Nancy Toby. We have blogged together for many years. She and I were part of the first tri-blogger get together which was Ironman Florida in 2006. She and I could not be more different in so many areas of our lives yet I have a huge heart and deep respect her.

Nancy and I are not afraid to mince words. Dare I say we have 'robust dialogue' in our emails which are sometimes eight or nine exchanges in length, that go on for days. Maybe only she would understand that I consider her the Jefferson to my Adams.

One of the reasons my thoughts turn to Nancy every day is because every day I am forced to confront myself and the consequence of Ironman Arizona. Weeks before Ironman we had a typical exchange of emails. As always she challenged me, this time to answer what criteria I would use to determine if I should continue racing or DNF if physically I got into trouble as I had in the past. She gave me some advice on mental acuity tests and a stern admonishment that no race was more important that my health as a husband and father. Part of my response below became a bit too prophetic. Its an answer that I reread in my mind everyday when I wonder how I can ultimately change who I am. (For a bit of clarification 'Charlie Mike 'is an Army term for Continuing the Mission.)

Charlie Mike or DNF?

Tough question to talk about honestly because my primal decisions countermands rational thought. I know inside me is a dark place that I go to when faced with a mission/challenge/race. Its a switch that shuts off pain and emotion. Its raw and base. There is snot and blood and action. Its the last 'R' of the Ranger creed which says "Readily will I display the intestinal fortitude required to fight on to the Ranger objective and complete the mission though I be the lone survivor." In other terms, Don't Quit, Do You Have The Heart?, Ever Forward, Charlie Mike, and other quips I have used to Just Keep Moving Forward and finish what I started.

I don't know if I can stop in a race, I don't like to even sit down exhausted during a run. I know I should have stopped at every aid station along the bike course last year and called it a day. I did not intend to stop at T2, however what came out of my mouth to the volunteer was not, "Take me to my gear bag" and she immediately rushed me to the med tent. But what was constantly being repeated in my head for the last 56 miles was not negative thoughts like, "Your slowing down", "Your butt and whole body hurt", "Give Up." It was one word: "Options". Quitting is not an option, its a solution akin to death. As long as I was on the race course I could decide what to do, I had decisions to make to keep me alive. Once I quit, the step between solution and acceptance would last much longer than the pain I would be in while out there.

I will Charlie Mike till the end, I don't know how to quit. They will have to pull me off the course. I do think I have learned through my experience last year that if I do pull out of a race for whatever reason, I will not be ostracized by my friends. That was a concern of mine, letting people down, but really I just don't want to let myself down. I can come up will all sorts of alibis to not workout or cut a practice short, procrastinate a task, justify one thing over another. But in the end, deep down, I will know if I quit early on what is important and after all the effort and money and sacrifice I have put into this race, its important today. I will know, if I still had something in me to give. That I had not exhausted every option. That for me, is harder than living with a DNF. Should my line between doing whats right and pushing the edge be a little bit closer, probably, but in me its pretty far apart. Whatever I can do for short term for results I can deal with long term later.

Everyday I replay this statement in my mind, looking for answers. Trying to decipher my internal language and rewrite the code that is inside me. The code that may very well kill me if I don't learn how to control it. And I don't want to die. For now, while I recover I have plenty of time to figure myself out and I am glad that I have Nancy to ask me the tough questions.

Pushing fire through a straw

This thought popped into my mind as I was meditating yesterday. Its a pretty apt statement of my mindset. I have a tremendous fire inside me to compete and go full throttle through life. It consumes me like a fever. Yet because of those very impulses I am a battered shell today.

Its used to be that I could push my fire through...well there was no governor. The fire came out of me, burned through me, through everything. It engulfed my soul and gave me the extra percentage of effort I needed when I needed it most. I can go to a deep dark place in my mind that shuts out pain and thought and purifies action. "MOVE. DO ONE MORE. DO ONE MORE. DON'T STOP. COMPLETE THE MISSION. NEVER QUIT. I WILL. MOVE. ATTACK. ATTACK. ATTACK. FASTER. FASTER. FASTER. C'MON. C'MON. C'MON." This is what dominates my thought in a competition, specifically races. And racing has dominated my thoughts for the last week because I can't do it. Its something I want to be able to train for let alone do just one more time. All out.

The fire is still there inside me. Uncontrolled. Wild. Burning. Like all fires, it wants to be unleashed. It wants to CONSUME. I want to give in. I want the fire to wash over me as it has so many times before and blaze with the white hot intensity of a man focused on the single thought of crossing the finish line.

To my detriment I have never cared how I finished, only to get there. First place, last, place, pulled muscles, broken leg, road rash, dehydration, vomiting, even multiple organ failures. I am ashamed now to say I will literally kill myself to cross a finish line. I am the embodiment of the cliche bantered about by the fearful and boastful who almost always are the first to give up when the pain creeps over them. The only thing that matters is looking back at the challenge of the race course as I crossed the finish line and yelling, "I kicked your ass." I want to leave nothing on the course but blood, tears and puke. People who have raced and trained with me have seen this far to often.

It takes considerable effort to control the fire inside me. I know that I have abused the fire. I let it burn too hot and consume too much of me. I get lost in the euphoria. I am trying so hard to find a way to tap the fire so it will work for me and not for itself. Right now if I let it, the fire will take me outside and extract revenge on my body for holding it back for so long. Letting loose, running fast and hard and pushing my heart rate to the extreme; destroying muscle tissue and flooding my bloodstream with impurity's my kidneys cannot clear and in the end burn me up. Maybe kill me. Most likely put me on dialysis. My whole life has been about giving into the fire because it has allowed me to do so much I am proud of. It has forged a man of iron will.

When you look at me now, you see me walk a bit slower and check my pulse several times a day. A body that used to be surrounded by fire is now tempered by a constantly checked mental barrier that calms and cools my body, holding the fire back as I get the rest I desperately need. The only physical manifestation of the great internal fire is a straw sticking out of my mouth that ecks out heat for workouts that not long ago wouldn't even reach the level of Active Rest.

But look into my eyes and you see the fire is not gone. The fire waits. The fire will come.

Reminders

My life seems a constant reminder of things to not do. I have affirmations and prayers that I use to create a vision for my life the way I want it to be, but the rest of the day seems to be a liteny of thoughts telling myself, "too fast, be patient, your not cleared yet" and so forth.

I am heading out right how and going to push my HR a little bit on a short 30 minute run and perhaps a bit on a mountain bike later in the day. Nothing extreme, like say, oh 165 bmp. But nevertheless.

When I have thoughts like this I think, "Just push it a little. Don't get emotional about it and start charging up hills, its a treat to run in the woods at sunrise, not a punishment."

I had no clue that one year after not finishing Arizona that I would not finish again. I certainly had no clue what was going on with my body to that extreme, what I had been doing to it. But it showed me that, its always still there inside of me. It can lie mostly dormant for a year or years and then when I need it the least, a race, my system shuts down and I need a gallon of IV fluid.

But I apprecaite the object lesson. The whole year between those races I trained without a clue to the damage inside me. Blaming it on a virus and not realizing that I was burning my kidneys up from the inside, not only with my training but with my nutrition.

So with every workout that leads to my recovery I remind myself that I have to stay in control of every workout. I have to be adult, or mature, or wise about the choices I make when I see a short climb or pancake flat with with some prize at the end. And with that, the trees await.

A view afield

This trip to Seattle I am not renting a car, I will be using public transportation to and from the airport and a combination of taxi/buses/feet around town. Part of this decision is financial, this medical visit is expensive. Also, I booked a hotel about a mile and half away and can walk to and from the clinic gathering my thoughts and enjoying cooler weather. Lastly, I would not mind trying something new. I do not have a history of using public transportation and this is sort of a trial run on how I can adapt to traveling abroad, ya know in case I get on Amazing Race, in a familiar city.

BTW, the Phoenix public transportation blows. Hard.

I am looking forward to hoofing it. It simplifies my decision making. Mistress has come to terms with me ignoring all our friends on this trip but has given me two mandates. First, I must go to the REI flagship store and second I must enjoy a nice seafood dinner. I love fresh seafood.

BTW, the Phoenix seafood scene blows. Hard.

I am sure I will have plenty of time this evening to post some thoughts from the days events.

Going Deep

On Wednesday I fly to Seattle for my clinic visit. I have never had a trip like this before. I fly up and go straight there and into three days of testing and consultation and fly straight back when I am done.

I have been told to bring lots of patience, "Yesterday was sunny, today its raining." I guess that's some zen quote meant to roll with the punches and be even keeled about life. As most of you read in my posts and the readers comments back in April and May, I was very uneven and in denial.

Its taken me three months but I am finally in a better place about this. They are telling me already there is no doubt that based on the information I have sentthey are seeing real damage to my kidneys. To what level is part of what this trip is about.

I like that these doctors are real about my prospects but optimistic. They want my life to have balance and know that fitness is important to me. They hope the results of all this allows me to have fitness in my life, if that the direction it takes. They want me to keep my definition of myself open, again some zen type meaning how life is in constant change. My prospects to a full recovery are zero but the opportunity to return to some regimen of swimming, biking, running and weight lifting is there.

Right now thats all I ask. I don't need to finish any more races, just let me practice with my friends and really, deep down, complete a missing part of my life. Exercise is as much a part of me as the love I have for my wife. Without it, I feel lost and unfocused.

A ton of bricks

I did a quick little workout yesterday. 15 minutes in the gym. I also did handyman work around the house. I woke up this morning feeling like I got my ass kicked in bar fight. Crap this is hard to cope with. Over the weekend, my ten minute jog and 20 minute OW swim and some work around the house, caused me to sleep for 11 hours Saturday night, completely sleeping through the bike ride I was going to do with the team on Sunday. Oh well, I needed the rest. Have I mentioned that I am going on 80 days since IMAZ and I still haven't pee'd clear. That is getting frustrating. I drink over a gallon of water a day right now.

I did a blood test yesterday and sending in a hair test tomorrow to the labs. I got an email from the clinic in Seattle asking me to schedule a trip there this month for 2-3 days. I have a feeling I am going to get what I wished for and I am going to have to make a LOT of changes to my training and nutrition.

I mentioned handyman work. I am the absolute worst handyman in the world. All I wanted to do was fix a sink pop up and rewire three light switches that all work the same light (4-way switch). In all things creation, be it food or fixing, multiply the standard time to do things by four and that's my speed. After spending time under the sink and at Home Depot, I got the wrong size pop up (but it was 'universal') and then the next day at Lowes, I got the right length but the wrong width (again a 'universal' unit). Arggh.

When Mistress came to see how I was doing on the light switches, two up stairs and one downstairs, maybe the fifty times I ran up and down added to my body being hammered today, I was proud to say that after two hours I got everything working they way they were before I started but had not solved the problem of closing the circuit so all the light switches worked and not just two of the three. Oh, and I didn't shock myself this time. I am here to tell you that the fear of being shocked by an outlet is worse than the hard tingle you get when actually zapped.

Russian Roulette

Well three of my team mates, two of which are my primary training partners, Jeff and Hardcore, pulled the trigger on the 2009 Ironman CdA. None of them would have considered it had I not been talking about this event due to all the bloggers there last weekend and my overwhelming guilt for not being there myself to sherpa and fellowship.

I of course wanted to bite the bullet for next year. I logged into Active.com and stared at that screen. Each frenzied call asking me to go over the times for enrollment, what is the webpage address, I got in. It only made me happier for my friends and more melancholy for myself. Then realized if I completed the entry form it wouldn't be a hypothetical gun in my mouth but literally biting down on a cold hard barrel and blowing my brains out.

I knew this day was coming, when IM life would finally leave me behind kicking and screaming. I told myself that knowledge is power and in my condition it's not my place to debate the obvious stupidity of doing something like an Ironman that is well beyond the exertional stress my kidneys and liver can handle for the next several years if ever.

To hammer the point home, I have a test kit I am mailing out today. I don't think I would survive till morning if I came home telling Mistress, "Hey babe, I mailed off my metabolic test. By the way, signed up for another Ironman today." I can already smell the April Fresh fabric softener on the pillow case that would be smothering me in bed.

There is more to life than Ironman. I'm over it. My hang up is not that I can't do the race, its that I want to be there in training for my friends and supporting them every stroke, pedal and stride like we have done for each other for almost four years. I still want to be relevant. I've heard its hard to be that when your dead.

Revoked

Training privileges have been revoked.

There are multiple layers to contend with here but a big sway on the part of the doctors was the temperature outside. The last five days have all been over 110* with single digit humidity (8% as I write this) so regardless if inside/outside, day/night, every body fights dehydration now. Even with our a/c set to 79* inside, sleeping under a fan and with humidifiers going, hydration is a battle I am losing.

I think I have mentioned earlier that I am having a hard time with clearing my urine despite copious amounts of hydration. Well breaking down my body by exercise is not going to improve that condition. Add heat. Add physical, intellectual and emotional stress. Add already damaged kidneys and liver. The sum total is I am already and still behind the eight ball.

In reviewing what training I have done since they told me I could, the doctors also factored in that I was too aggressive from their point of view. They released me to do activities that kept exertions low and promoted general health, NOT specific training for triathlons and CrossFit programs which is what I have been doing. My bad. hehe.

So its back the trinity of civilian live often mentioned by my first Platoon leader many years ago, "You'd rather be home eating bon bons, drinking Schlitz, and fingering (pervert) your remote control."

Fortune Favors the Bold.

Sitting is Active Recovery?

When you watch the local news tonight take a gander at the southwest and you'll see its now pretty hot. Not officially hot, that happens when the ten day forecast is nothing but 110+ degree highs and 90 degree lows. On the flip side I did hear that Aspen's Ski Lodge will be open this weekend for Fathers Day. Last chance to hit the snow!

I have been a good boy, if not a bit lazy. Last Saturday I went to a triathlon and volunteered. Just doing my part and it was enough to wipe me out the rest of the day. It made me a little worried about training.

Since Ironman and the whole liver & kidney failure thing, I drink about a gallon of water a day, if not more. Since Saturday, no matter how much I drink I can't get my urine to clear out. It goes from tea to yellow but as of yet it hasn't been close to clear. So to be honest I have been giving myself a forced rest. I may try to do a little something today just to test the color of my next #1 but nothing to hard. In the meantime I have been trying not to exert myself too much and drink as much fluids as I can. Sittings enough right?

I figure its going to cost about eight grand out of pocket to cover the hospitals, doctors, tests and travel I will have to do this year to get my Rhabdo under control. That's a tough pill to swallow, but we have to believe that in the end, I will have all the answers I need to live a healthy and productive life. Its an investment in my future.

I have received two of three tests from the Seattle clinic that I can do at home. I have to follow some routines for a couple weeks before I can complete them and send them in. A third test will be coming soon. Then it looks like a trip up there.

I really hope all of you in the midwest are okay and sorta dry. My thoughts are will all of you.

A Systems Go

Productive phone call Tuesday with the Seattle doctors. I have been given a Green Light for all things fun, or in this case exercise. And I have an action plan for the next few months from them. To begin with I can swim and use weights. I can bike and I can run. I have to self-monitor (uh-oh) and gradually build back up. Nothing long yet. I can go to altitude.

I am being sent a couple of test kits. I need to see some other doctors down here for specific exams. They want me to eventually come up and while there do a lactate threshold and resting metabolic test with a power to weight ratio thrown in. I said I can do that here no problem.

We talked about training volume and nutrition and different scenarios I can look into down here to help me out.

I asked if there was any conditions I need to place on my training and he was pretty straightforward, nothing to hard. He has a client on the Slipstream cycling team that has a similar condition to me and is now doing very well but it was a process.

I am ready for my next big adventure...I just gotta find my running shoes.

Ear to Ear

I have a pretty good disposition. I am a hopeful person. I am also pretty sarcastic and I know it doesn't translate very well through a keyboard. I would rather talk face to face than anything else. So for those that I don't correspond with very much, please read my posts with a little bit of incredulity, a sense of the wry and bit of a smirk. Even with the stuff that is not so pleasant.

I realize all my writings of being banned from exercise or exertion, my descriptions of odd pains and medical results showing failed organs is pretty grim. If I didn't believe that I could rise above, then I would probably have never risen above any of the life changing, or life threating, obstacles that I have faced in my past. Oh trust me, I have some serious issues with being to optimistic, Mistress knows that all to well, but overall HOPE is a powerful thing for me.

Last Friday I had another set of labs done and today I got my results. My liver and kidney functions looked normal. YEAH. I am still dealing with some personal issues from those complications a month ago but according to the labs, blood is clean and organs working.

After the episodes Saturday and Sunday with the pain, Mistress sent me to the doc's this morning. My doctor, rolled her eyes when I mentioned yard work and effort over the weekend and after another haranguing, she ordered up a set of labs to check my CPK and renal functions. The area I described is right around my liver and she wants to see if the Rhabdo came back. It could be a lot of things. Like lifting some damn heavy and awkward concrete pieces in a deconditioned state. (I know, I know, preaching to a choir with your admonishments)

So good news. Kidney, liver and blood work on Friday looked normal. If the results from today come back good, I'd like to think I have stabilized and after a another week or so my doctors will move to Phase Two of this life plan. I doubt Phase Two will include much exercise either.

I have no idea how many phases this may take or if they are even phases at all, but when I ran missions in the Army, phase lines were imaginary lines on a map between where you started and where your objective was along the avenue of advance. The unit would reach a pre-named phase line and call the Brass with their status, "Hey You, this is Me, at Tango (phase line), Charlie Mike (continuing mission), Out." If they needed you to slow down, hurry up, or do something else, then you would get at call back, otherwise...

...Charlie Mike.

Technically...

...I didn't work out and was supervised.

I had several months of tree/shrub overgrowth to deal with from my neighbor, plus assorted containers of house material that all needed to go to the dumps. In an effort to not tax myself, I worked all last week in the evening, for a about 45 minutes each time cutting back growth and bagging yard waste. On Saturday it would only be loading a truck and unloading at the dumps.

I decided that morning to first load up an unused water fall fountain that no longer fit in our backyard scheme. It stood only a few feet tall. I didn't realize it was made of painted concrete and each of the three main pieces weighed between eighty and one hundred pounds by estimate. I should have realized this as the first piece blew the tire on the wheelbarrow.

Mighty Mo in his infinite ability of word recall, yelled "Mush Daddy!" as I walked 75 yards, dragging each piece of the foundation on a tarp and using a climbing rope as a harness around my waist. Then I only had to lift each piece up onto the tailgate. That was not easy either.

Mistress made sure I took breaks and drank water and helped tie down and unload at the dumps. She even made me go lie down upstairs with movie to recover. Good woman.

While relaxing I realized I was rubbing my rib cage under my right chest. It hurt, similar to the cramping I experienced at Ironman in all the muscles around my lungs and rib cage, though this was nowhere near as extreme or prevasive. I told Mistress and it went away a few hours later.

Sunday night as I was laying in bed the pain came back in roughly the same spot. A bit wider area but same pain. I woke Mistress up and she asked if any other place hurt and it didn't. I stretched out, rolled over, massaged the area for a couple hours before the pain went away enough to doze off. In the morning the only discomfort was from my rubbing a bit too hard on the area.

I fired off a message to my consultant for his feedback. That plus my new blood work results should be in Tuesday and will know if my liver is finally back to normal.

I am trying to do right. I had no intention of over exerting and it was probably stupid to move a several hundred pound fountain in its five pieces. But I spent the next two days resting as much as I could indoors. I am sure I will be blasted in comments and by Dr. Chu but I deserve it I suppose.

Mush!

Days like these

There are times in the day when I am struck with incredulity. How can it be that a man who has defined his professional and personal life by fitness suddenly is unable to do it? Then I consider myself very lucky to have all my body parts, for the most part all my mental faculties and despite my currently failing liver a decent level of health. The trade off to potentially not being able to train like I did for so long is that I can still be a whole father and husband.

My future is still incredibly bright and regardless of any physical defections I may have I will not slide into sloth or obesity. I am not stunted in my outlook. Like I have preached many a time, "Ever Forward. Charlie Mike." For all the trouble those mantra's have caused they have been the foundation for me to do great things. And will continue to do so.

Sunny disposition

I realize that sometimes that in my own personal writings, like yesterday, the tone can seem less than sunny. Be that as it may, I am a very hopeful person. I believe that while bad things happen to good people, almost any storm can be weathered with the right attitude.

Of course as I know all too well, to much of the 'right attitude' leads straight to the emergency room. I'm learning that you can't ignore the storm completely like I did at Ironman, and the Ironman before that, and then the day I got the heat stroke and all subsequent heat injuries since, and so on.

The doctor I am consulting with, Dr. Chu, he warned me in our first call that any physical activity I did would be harmful because of the intensity I would put into it when my blood was still screwing up my body. His exact words were, "You can't go do a race for fun. You'll get passed by someone, feel a tailwind, eventually a bell will go off in your head, you'll disengage any biofeedback and go full on." I disagreed until Mo said a single word, "Mush", to me in a parking lot and I began sprinting, pushing him on a costco sled. It wasn't even a race. It was just me, playing with my son, and 30 yards later I understood. Completely.

I had no clue. I just snapped. Like Pavlov's dog. And the sickest part is that each time that bell went off that ended up with me having an IV or hospital visit or being hang-dog in bed dehydrated, has done irreparable harm to my body.

There are a lot of reasons why I can be upset or frustrated at these tests and if they portend less than perfect outcomes for my health. Each of those days that ended with an IV drip and odd blood labs started with a great adventure and ultimately became a great story. But I am a hopeful person, and I know that I will have more great adventures and do more great things at the threshold my body can handle....

...I may rev it up a bit, though albeit with a governor on me. It is after all, hard to change our nature.

Mush.

Lazy Bones

When the liver results came back worse last week, I realized that this will be a long term process to resolve. In order for me to have the fastest recovery possible I have to let my body do its thing and its going to take time. Yet I have to continue to explain why I can't be the physical person people expect me to be. I don't have a cast, I don't have bandages, I don't even have a cut. Its my insides that are all screwed up.

That being said, I had a completely lazy weekend. Is this how the Common Man lives? Kids birthday party, the home depot, little yard work, hit the mega grocery store, the video store, book store, got the car washed, sat in the jacuzzi at least twice each day. Watched superhero movies with Mighty Mo.

I have another blood test tomorrow and hope things come out better. I'd really like to go to Mexico this weekend with the ability to at least have a couple of cocktails. Even though I am not racing at Rocky Point, the whole family is going for a bit of a getaway surrounded by good friends.

I put Mistress through a lot of camping the first several years of our marriage; now staying in a 6,000 square foot penthouse at a Mexican resort overlooking the ocean is about as close to camping as she will get. Vegas being a close second, (better room service).

The Good and The Bad

Good news.
I did not play paintball with my company. My hands were shaking and I was full of adrenaline but I didn't do it. I used to be a tourney player and would have just dominated with my own marker (gun) and gear; every game someone would ask me to be on their team. Oh well. I knew the owner of the indoor field from my time playing back then and it was good to catch up. He let me put on a shirt and ref. I took it slow out there.

SIDENOTE: In the following information, I am telling you this as I learn it. I think that we as individuals are more concerned about our health than any doctor who deals with dozens or hundreds of people on a daily basis and work on a reactive rather than preventative or active care plan. I have firmly believed that if a patient is not; hot, broken, red or swollen, a doctor has as much a guess as you do, except they see and hear the trends in their region and can order tests. As such the internet is a great way to inform yourself on test results and symptoms but I do not think that it can be used to self-diagnose.

I got my latest labs back and my blood looks normal. The one area of concern is my eGFR which is simply listed below normal. This is a test to determine kidney damage.

Bad News.
Out of nowhere my liver test came back horrible. In the hospital I did have acute kidney (renal) failure and liver failure but the doctors were much more concerned about the kidney issue. On the results I just got back for my liver it shows two high liver markers, ALT and AST, in my blood. Someone hand wrote discharged numbers next to the current ones.

The limits for AST are 0-45, I was discharged at 87 and one week later I am 86.

The limits for ALT are 0-55, I was discharged at 41 but one week later I am 275.

I have clipped the following (from HERE) for explanation

ALT and AST are enzymes made in the liver. They are also known as transaminases. The liver uses these enzymes to metabolize amino acids and to make proteins. When liver cells are damaged or dying, ALT and AST leak into the bloodstream. Many different things can cause liver enzymes to rise above normal levels, including:

• Viral hepatitis
• Excessive alcohol intake/Alcoholic liver disease
• Liver inflammation from medications and certain herbs,
• Auto-immune hepatitis - a condition where a person's immune system mistakes the liver for an invader and attacks it,
• Fatty liver- fat build -up in liver cells, called steatohepatitis when the fatty liver is inflamed
• Inherited liver diseases
• Liver tumors
• Heart failure

ALT (also called alanine aminotransferase or SGPT) is found in the liver only. High levels of ALT in the bloodstream mean that there may be liver inflammation and/or damage. This test cannot predict liver damage or disease progression. It is simply a direct measurement of the amount of ALT in the person's bloodstream at the time of the test. The normal range of ALT levels is between 5 IU/L to 60 IU/L (International Units per Liter). ALT levels in people with HCV often rise and fall over time, so additional testing such as HCV RNA, HCV genotyping and a liver biopsy may be needed to help determine the cause and extent of liver damage.

AST (also called aspartate aminotransferase or SGOT) is found in other organs besides the liver. High AST levels in the bloodstream can be a sign of liver trouble. AST testing measures the level of AST in a person's bloodstream at a given time. The normal range for AST levels in the bloodstream are 5 IU/L to 43 IU/L. Like ALT levels, AST levels in people with HCV often vary over time and can't be used to forecast disease progression or specifically measure liver damage.

I am directed to give another blood sample next week. They are also going to screen me for hepatitis. Words like that one and dialysis are common words that I read and see all the time but until this month couldn't tell you the how, or why, or what about them. I'm learning as you do.


Adding a Terrible Ugly

I just got off the phone with Big John while writing this post. His brother Dan, multiple IM finisher, including IMAZ this month, lives in San Diego and trains with the SD Tri team. He bailed on his team OW workout this morning due to some drinking last night. His normal OW swim partner, Dave, decided to pair up with a first time OW team mate when he was attacked and killed by a Great White shark a few hours ago. Everyones head is spinning over this, especially the woman he was assisting who was right next to him. When you hear it on the news, know that he was a triathlete who was helping a team mate overcome a fear.

delayed

No news today. Will be called tomorrow. On the positive side, it looks strong that I will be going to the Bay area this summer for some very specific testing

Quick Post

I should find out my latest blood test results sometime today and will post on the outcome when it I get it.

Been sleeping a lot. Eight hours a night. Drinking loads of water and eating well. Only working out has been getting in and out of my jacuzzi after Mo hits the sack.

"Have you read this..."

I have a rather...odd relationship with my doctor, "Ann". I saw her today for a post-hospital check up and blood test. Here are some random comments from our meeting.

Ann: "Good Lord, Comm. Rhabdo? You know this can kill you right?"
Comm: "Yes Ann."

A: "You're too young for this. I have patients twice your age with less indicators. And you did this to yourself didn't you. How many times now?"
C: "Ironman.And its about 8 times we think since 1993."

A: "Oh for crying out loud Comm. Bring me these after a traumatic accident or massive heart attack not because you did it to yourself in an Ironman. Didn't you feel your body going over the deep end?"
C: "Yes Ann. I couldn't quit if I tried. I had to just keep moving forward."
A: "Do I need to refer you to a doctor to have your head examined?"
C: "No Ann."

A: "You looked at these ER reports right?"
C: "Yes."
A: "Did it read like your obituary? It sure does to me."

A: "So when do you go back to work?"
C: (Long pause) "I went back to work the day after I got out."
A: "WHAT ARE YOU? HIGH!!! Comm....Comm, what kind of work are you doing in the office."
C: "Answering emails, pushing reports. No lifting, no weights, no exercise."
A: "Absolutely no working out...
C: "Absolutely no working out, promise, nothing."

A: "Wait...you had liver failure and acute renal failure? This is just amazing. You are so stubborn. I've never met any patient who purposefully put them self into this condition through exercise and you continue to do it to yourself."
C: "I know. Ann...when can I workout again?"
A: "Um never. I am not touching this one Comm. You need to work with your specialist. Just reviewing this file is horrifying to me. I can only imagine what your thinking."
C: "I'm thinking I'd like to workout."
A: "I'm thinking I'm calling your wife."

On the plus side the blood draw went really well.

Floating Suspended

Hindsite being what it always is, I should have stayed in the hospital one more day. I did not do much exertion Thursday or Friday but I was winded and taxed each day. Almost as if the effort of Ironman waited to give me the 'day after' feeling once I got out.

My phone consult went really well Friday night. A close friend of my father's, a world famous endurance doctor whose written numerous books on fitness, pioneered research on performance, and is a current Olympic and collegiate coach, has offered to help me. He will have his own sport performance business and his contacts at Standford university help me find a way to manage this condition. Forgive the dramatics, but it will be several months of blood tests, exercise analysis and nutritional consulting before I am back to a fitness program at any intensity I'd consider vigorous. Most people are told to hang it up at this point, when even the exertion of too many push ups could put me on dialysis. It will be interesting to see what comes of this as he told me that not only is this fatal if I don't respect the situation but some professional athletes that develop Rhabdomyolysis never completely recover, period.

This is supposed to be 'float' time when an athlete is in recovery from tremendous effort such as an Ironman or marathon but feels pretty good physically. Usually an athlete can test them self, go on a short ride or quick run. I can't. In fact I had a whole weekend just realizing I have to think of a different plan. While my friends are gearing up for races, the rest of my year is testing the waters. How fast? How far? How long? What intensity? The missing question is, How soon? My body is definitely telling me that answer is, Not now.

On Saturday, Mistress, Mighty Mo and I went to the Wildlife World Zoo. We are members of the Phoenix zoo and go several times a year so the hour drive west did not make much since but Mo really wanted to see the white tigers and well I wasn't going to be gone all day training. While walking around a pretty blond woman walked up and asked, "Are you Commodore?" It was Fumo Santos significant other; Fumo walked over and we talked about the race and the whole week in between. Bloggers are everywhere I tell you.

The whole week has just left me drained and the zoo was the cherry on top. I pretty much spent the rest of the weekend in bed.

Changing seasons.

Feeling better today. Met the team last night to talk about our successes and failures last weekend. It was a good time for all of us, but especially me. I don't feel bad about not finishing. In hind site I feel bad I put my family in the spot I did. But they and I knew I would anyway. I have to find a way to stop self-abusing myself and jeopardizing my life.

Today, my first Friday of no training in months, I am going to see the new Jackie Chan/ Jet Li movie with dad. This weekend the zoo with the family. I will be the model Common Man. Mow the lawn, clean the garage. I promise. Nothing strenuous.

Tonight I am having a phone consult with a world class Olympic physician/coach to work with me on a game plan. A friend of the family.

Monday starts Comm's 2.0 or 3.0 or whatever version of this I am. Probably without the exercise right away. On the race course and in training I have a mantra, one of many, "Today is the day the Lord has made, rejoice and be glad in it." I will still use it but its been replaced with new one:

"Today is the new me."

Let the healing begin

Don't expect puppy dogs and butterflies from me. I am in my office today, yes, less than three days after being diagnosed with kidney and liver failure. Bolder couldn't stop from laughing as I called on the way in but I did promise just sitting at my desk and answering emails and deadlines.

I was told I have a medical condition called Rhabdomyolysis caused by excessive exercise exertion. It rapidly releases protein enzymes from my muscles into my bloodstream and this is what causes my kidneys and liver to stop functioning. Based on my medical history this most likely began from my heat stroke I had in the early 90's, which I have mentioned before, and perpetuated by each case of heat injury and high fever I have had since then that has put a strain on my kidneys.

The damage is done and my body can not recover from the stress placed on it when competing, right now, at Ironman distance. Much like with skin cancer, it never goes away you just manage your protection from the sun, because its easier to get the more you subject yourself to it. In my situation I have to find a place that my body can handle the volume and load of of triathlon training and keep my kidneys working. I think for the next year that level will not exceed Olympic / half marathon distance though I am hoping to eventually train hard for half ironman level.

There definitely needs to be some changes in my training, the more I strain my kidneys the worse they will get (gee might as well substitute concussions for kidneys). I have put together weekends with 80 mile rides and 15 mile runs without fail during my IM build ups but something doesn't click during the actual race. One theory I heard is that my pre-race adrenaline the week of an IM race already expresses this enzyme into my bloodstream, thereby lowering the tolerance level I enjoy during a typical training week.

I already have a plan in motion. First I need to get a post hospital check up next week and then find a metabolist to work with on the actual condition and a plan of attack for future training levels. I have a sprint in two weeks, need to be ready ;)

FREEEEEEDOM

Under my honest promise to rest and hydrate, and a sincere cross-my-heart to not exert myself this week, I am outta here.

hospital update

Just got turned over for my every eight hour shot, in the gut of heperin, a anti-clot. He, nurse, had my latest blood test and all indicators are normal now except CPK. That dropped to 3000 from 3500 but nowhere near the norm of 250. I am going to pray and argue hard with the dr. that controls my release that its enough to go home, otherwise logic dictates I'd be here another five or six days to reach normal level.

Mistress and Mo came to see me last night and we were all hungry so we went to the cafeteria. I was looking forward going down there all day but when I was looking at my optons was kicked out. "Patients not allowed." I think the glare in my eyes was enough to step the cook back but when I told him I was being held here against my will and would gladly pull the IV out of my arm for a cheeseburger he found something to do away from me. I made a hasty retreat to the exit to wait for family.

I slept very little last night, about two hours split up. I started becoming very negative and bitter about feeling so normal at that time but still in hospital. But I knew at 1am last night that 72 hours ago had I not come here...the reality is its the closest to death, medically, I've ever come. And I've been close before.

I wrote long drafts that I hope are saved for me to parse on a proper pc. I sought wisdom from mentors in calls and text.

I am not ashamed to admit I "worked" out yesterday. I measured off the distance around the nurses station, 22 laps = 1 mile and walked 1.5 miles dragging my IV tower with me.

Bottom line, I am bored and a bit guilty because of it. So much pain around me and no longer any in me. The 100's of messages have been truly my only salvation. thank you.

I'll post again after the doc tells me yes or no about going home.

some good news

The Dr. just came by. My kidneys are working now, good news. But...my CPK (a muscle/heart enzyme)(?) is too high. Normal is 250 and I am 3500. Yesterday I was over 4000. So it looks like I'm here tonight too as I probably won't get another blood draw till around 3am. I feel fine though.

Mistress brought the portable dvd player and I'm watching Eurotrip, again today. I so love this movie. This 2nd time is with the 'drinking game' commentary on disc. I am using water of course.

I also have 300 but Im saving it for a special occasion, like two o'clock, yeah that sounds like a special occasion to me.

Ironman: the next day

well...

I am using my blacberry from the hospital. Mistress said I went to ER. I'd lost 13 lbs on the course and another 2 at home vomiting. I hadn't stopped throwing up for six hours and the neighbor down the street heard them all. The blood test came back with my kidneys and liver non-functioing. so they admitted me.

I've had cat scans, x-rays, ultra sounds, too many blood draws. I am here overnight hoping that the IV and stuff they put in me get kidney function back or i go on dialysis.
I've had a history of kidney problems from increased core temperature since my heat stroke 15 years ago. Two seperate doctors today have expressed its an actual medical condition that does get worse. Each strain on the kidneys wear them down, sort like my concussions. The term dialysis has never come up, but its never taken my system this long to reset.

Once again I eschewed all rational thought to Charlie Mike. At mile 40 the cramping started. By 50 it felt like someone was tazzing my legs. One the third loop I meet Mistress and several friends at the base of the 11 mile hill called B-Line. I laid on the ground in intense pain unable to breath because the muscles around my lungs cramped up. Unable to bend my legs from cramps. I had to push started.

At the top of the hill at the turn, I stopped to sit and ended up laying down again. Some medics came by to treat me but I refused to get in the ambulance. They strongly advised not continuing. A race official came by telling me the course was closed. I told her I made the turn in time and I would Charlie Mike until I couldn't make the cut off. Regardless that the last two aid stations were out of water and so was I. Regardless that the next 18 miles was unsupported.

Mistress waited for me at the bottom with no chance of making the last ten miles in ten minutes. So I packed in in. I would have finished the last ten but between not able to breath fully, a police escort, my wife, absolutely zero energy in me and a race officail telling me I was the last rider off the course, the overwhelming evidence suggested finally to stop moving forward.

I was Ironman's cautionary tale yesterday. and I'm paying for it today.

what!!!!

I can not believe that man sneaked over her and blogged after I put him in bed vomiting yesterday. I just caught that little note there. He really is crazy.
Mistress

The last Ironman for Commodore

Good morning all. I hope every one that did the AZ Ironman is in decent shape and that you hit your finish goals. This was Commodores last Ironman as I put it to him last night in the ER if he wishes to continue to come home he will do sprints only. Love the man dearly but enough is enough he does not have a distance stamina. He is also a stubborn ass and I had to literally drag him in to the ER with our son at midnight. He was in pretty rough shape as he continued vomiting non stop until about 1:15 am. He tried all of his rx's for nausea and vomiting but no luck. By the time I said enough get your ass in the car he agreed, but the past 6 hours had taken their toll he will be in the Banner Baywood Medical Center in Mesa for at Least another 24 hours. He pushed this one too far refusing to go in. He is getting kidney and liver tests and some cat scans for the abdominal pain and to double check that precarious noggin of his. Have no fears he will be fine but he will be tied down to the hospital bed for days not hours. If I have to actually tie him down I will! Because he has had sever dehydration several other times (why he does not learn from the past not even a spouse will ever know) He has some odd blood tests. Nothing to panic about but needs double checking. He does have his cell phone with him but not up to answering calls yet. If you have his cell number feel free to text, I will retrieve his cell later this morning and return calls to any one wishing more info on him. His test result will not be in until noon but I will go see him after I stop in at work. One of us must show up to work thats the draw back of working for the same company somebody has to go in to work. Thanks every one and I hope all of your other Ironmen are doing great this morning.
Mistress.

0-2 @ IMAZ

felt great in swim, whole body started cramping on bike. could not pedal without leg cramps, still no breath from muscles around lungs cramping. sgarp pain with deep breath. Rough shape again.