I am in science experiment mode again. After experiencing what I initially perceived to be a minor infection (as in "maybe I'm getting a cold") and sensing I could swim faster if I could just get more O2 to my muscles, 2 weeks ago I contacted my doctor to get a refill on an albuterol inhaler. I'd had one laying around from a prior cold/flu incident that wasn't used up, and had been self-administering just a little as I felt necessary since beginning of October. I wasn't full dosing it, as I thought I only needed a little bit.
As winter arrived, and finally really cold weather, I noticed this slight shortness of breath wasn't going away, and I was running out of inhaler. It was also time for me to schedule my annual (that I will attempt to begin doing quarterly) blood work roundup consisting of CBC, liver enzymes, thyroid, cholesterol, fasting glucose, etc. I scheduled the blood work, asked for the inhaler, and my doctor said I needed to come in for whatever I thought I needed the inhaler for. Smart move on her part!
So last week, I went in, to get both the blood draw and the evaluation. First thing I got was, "Who ordered your blood work?" Um...me? Then they said it needed to be authorized, and I was like, OK so I'm seeing doctor make her do it. That was taken care of.
Now, in addition to the breathing thing, I had really felt like I'd put on just a few pounds that shouldn't be happening as I've increased training and am pretty good about matching my calorie intake to my outgo.
During the appointment, this was first time I was tested on a spirometer. My readings were "normal," and I told the nurse practitioner (PAC whatever that means) that I should be off the chart given my aerobic capacity. She listened to my lungs, and of course, said they sounded normal. I said they aren't. I listed a whole pile of observations I'd made as to what's been going on as I've noticed this issue with my lungs:
- Increased my training load
- Moved most of my training indoors
- Cold weather
- Tightness in chest
Now, there are other things at play here that wouldn't make sense to anyone except another athlete:
- Changed my swim stroke. So there is some left pec soreness/tightness still lingering. I know this because I tested myself. When I shovel snow right-handed (which is my natural), it hurts a bit, but not when I move to left-handed shoveling. Therefore, my left pec is still getting used to the new swim stroke.
- This is first fall/winter in my house since I've had it air sealed. It's great, because the house is no longer losing all the warm air, but bad, because it's trapping in a million things that I'm allergic to.
I failed to mention the air sealing and allergy thing at the appointment. I spaced out! When I was in college, I became quite sick once and was put into the infirmary. My lungs were messed up. I had a history of recurring bronchitis as a child, so once I was well enough to be discharged, they sent me for allergy testing. Turns out I'm at least mildly allergic to almost everything except foods--so pollen, mold, dust, pet dander, air... It's just enough that if I catch a virus, I can be severely impacted. So I went on allergy meds that at the time were like speed! They were great--you put speed on top of my normal high energy level, and I was basically bouncing off the walls constantly. Until they took that drug off the market, LOL! A few years after college, I was switched onto Claritin (which was prescription at the time) or Allegra, and I also took desensitization shots, as I had a cat, and the cat was a major allergen. Not as bad as some people who can't even be around them, but just enough to be a bit wheezy.
I kept taking allergy meds until I no longer had cats, in 2005. I love cats, but my last pair went psycho and had sprayed all around my house, and I just have not wanted to get more, plus the care and feeding. But I adore cats. Someday...
Anyway, once I no longer had cats, I tried going without the allergy meds, and seemed to do OK. Until this year. It didn't dawn on me until after my doctor appointment.
Back to the appointment: the PAC gave me a 5-day prescription for prednisone (sadly, the last day was yesterday), and sent me to get a chest X-ray. I started on the prednisone right away, and went and got the X-ray. The radiologist said my lungs look fine (no spots or anything odd), but that my diaphragms are "flat." This can be indicative of COPD. So that's what the PAC told me. I was, of course, like, FUCK! But I'm lucky to have a close friend who is a nurse and said just wait it out. The PAC said I should go see pulmonologist.
So after this little wakeup, I remember about my allergies and that I've not been being treated for them, and when I think about it, this is exactly how I felt when I failed to take them. I also think I may have exercise-induced asthma. COPD? It's possible due to my history of bronchitis, but I am hoping that is off the table.
The interesting thing is that through these last 3 months, I've become faster at Swim/Bike/Run and stronger in the weight room. So yay for me overcoming whatever the fuck is wrong!
So...well let's just say I love prednisone. Me on steroids is pretty entertaining. I felt no pain, although I don't think I actually over-extended myself. I just knew I should be
way more tired at the end of each day than I was. But I wasn't. No wonder people become addicted to the things! I will surely crash today, though. I had these nice rosy cheeks, smiling all the time, and was
very chatty. Also a little more "
don't fuck with me," but I was able to keep that at bay.
I have the pulmonologist appointment set up. I asked my doctor for Advair, as the albuterol isn't cutting it now, and even if I
do have COPD or allergies or asthma, they'd probably put me on that, so yay for me asking for it, and I have it without another doctor appointment.
Now onto the blood work. My cholesterol is awesome (HDL 72 / LDL 110 / triglycerides 59). CBC looks good, although I will need to compare to my last results. What is fucked up? TSH. I learned from 2013 that when I am feeling great and nearly hyper (even without steroids!), that it can mean my thyroid is underperforming, or more accurately, I don't have enough to meet the metabolic demand I am putting on myself. And I was right!
Now, my suspicion is that my body can only produce so much thyroid hormone, so when I start ramping up training, I tend to go more hypothyroid, as my body plus existing meds can't keep up with what my body needs in order to do the training. This I will share with my doctor. I had thought she said they wouldn't give me more Synthroid, but she is giving me more, and then I will need to be tested again in 6 weeks to see where I stand. Ugh...this is the part I
hate. The waiting to see if the dose works, etc. It is so ridiculous that a test hasn't been invented yet for measuring thyroid function that you can do at home with a prick of your finger, like you can to check your blood glucose. I would do it daily.
So...in conclusion, I have some lung shit to get sorted, and I'm back on the thyroid testing/dosage adjustment train again. Which means I
still haven't been through a full Ironman training cycle with my thyroid properly regulated.
EVER. Not in a single one I've done, since I know that I've been hypothyroid way before I ever started all this--it's just that the acceptable ranges have changed, and if you're even a little off doing what I'm doing, it's a huge impact. I have a feeling that what I will need to do is modify my dosing based on my training cycle, so I will talk to my doctor about how we can best manage this. I think at a minimum, I need to be tested every 3 months to see where it's at. But in a way, I'm happy this is all happening to me, and glad I'm doing this
now. Because I think I have time to get myself better adjusted and functioning properly again!
How exciting will it be for me to have my 100% lung power
plus having all the thyroid hormone I need? I am optimistic that my athletic performance will finally rise to the level of training that I do. It's not been poor, by any means, but I know I can do better. I will also once again offer my doctor the opportunity to write me up as a case study. She should welcome the offer, but you never know. If she wanted to run blood work on me monthly, I'd do it.
So yay for me for demanding the blood work now, even though technically some of these things didn't need to be tested until April. But it was time, I had the feeling my TSH might be off, and that is something I have to attend to. The difference in how I feel at various levels can be subtle, but now it makes perfect sense to me and I'm learning to interpret how
my body feels at different levels. Last time I'd been tested was in April, 2014, and TSH was fine, but I was hardly training at the time. So this correlates to my theory of how much hormone I can manufacture, and that when I'm not training much, it's enough, but dump on more training, and it's not.
My pharmacy fucked up my Synthroid prescription, though. They gave me generic. Luckily I caught this last night and called them. It was their mistake, not my doctor's. I can't take generic--I went through that fucking shit in 2013 of being on a rollercoaster because my body is sensitive to the drug purity. So glad I didn't take that. I will pick up the correct Synthroid this morning, and off we go! Recall that for Ironman Cozumel, I was still on generic levothyroxine, and I wasn't being given enough of it, and so I had a craptastic performance in the race. I am very excited to see how I will feel when we synch up the brand drug Synthroid at proper dose with my training!
Based on all this, I highly recommend to anyone doing Ironman training to get their blood work done at least twice a year, quarterly if feasible. The training puts such a high demand on your body that it's imperative to ensure it's in perfect working order, and as happened to me, the high training load can reveal issues you have that you might not otherwise find out about until years later. And things will change throughout the training cycle, so just because you were fine 3 months prior doesn't mean you should just live with the status quo.
Happy training and science experiments!
