It’s hard to believe that we’re only a week into 2018; it feels like we’ve had hardship enough to fill an average month of winter: a deep freeze, a major snow storm, cancellations and disruptions, not to mention the typical colds and flus. Christmas is a distant memory. February is still a long way off, and when it finally arrives, it will still only be February.
In the face of this year’s seasonal adversity, I find myself wondering whether people are sticking to their resolutions. It must be hard to summon the extra fortitude needed to make meaningful life changes when you’re trying to figure out how to avoid freezing to death every time you venture outside to shovel out the driveway.
As for me, I’m not a big fan of New Year’s resolutions. I say this despite having sympathy for those who yearn for a fresh start on January first. The beginning of a new year inspires hope, and who can look at the new, uncluttered calendar on the wall and resist the urge to box up the mistakes and bad habits from the previous twelve months, seal the box with packing tape, and store it away in one’s mental attic with the tired-looking Christmas decorations, freeing up much-needed space for better choices and happier outcomes in the year ahead.
But I made no new resolutions this year, and not because I’m satisfied with myself or feel any shortage of things to work on. I resisted the temptation to itemize my faults and attach an action plan to each because I knew that I’d fail with that approach. Better, I told myself, to keep plugging away at what I’m already doing in the self-improvement department: maybe make a bigger effort to strengthen a few good habits here and there, or break an especially bad one, but basically stay the course.
In other words, rather than trying to create a “new me,” I’m resigned to making what minor repairs I can on the old one, and this is true for my running, as well as for the rest of my life.
Resolutions aside, as I thought about running in 2018, I did identify several goals – some of them more ambitious than others – but none of them felt like resolutions. To be more specific, as I thought about turning sixty later this month, I realized that I had less interest in actively trying to reinvent myself as a runner according to some youthful ideal, and more interest in adjusting to the REAL new me, the one who has taken up residence in my body without an invitation or any special effort on my part.
Who is this new me, this new runner, and how did he insinuate himself into my life?
Well, first, I should say that the new me shows up ONLY when it’s time to run. All the rest of the time, I’m pretty much the same person I was last year and the year before, slowly accumulating wear and tear that comes with long-term residence on the planet, but not dramatically different from the me of recent memory. Like everyone else, I think I’ve learned to adjust and accommodate the gradual decline.
But as a runner, my experience has been closer to falling off a cliff. What pushed me over the edge wasn’t any kind of external, debilitating injury, although I’ve had my share of those, but an invisible and subtle injury that has been hard to understand, and even harder to accommodate. Let me try to explain it, and apologies to those of you who have heard this explanation before, or some version of it:
For most active people, initiating physical activity – for instance, starting to jog – sets in motion an impressively well-coordinated, body-wide response designed to satisfy the need for more oxygen. Almost immediately after taking those first few jogging steps, one’s heart rate and respiration increase to meet the demand. Almost instantly there is increased blood flow throughout the body, with blood flowing from the right atrium of the heart to the lungs to pick up oxygen, and then flowing back to the heart and out from the left ventricle to the working muscles where aerobic metabolism in the cells supplies the energy for vigorous movement. For most active people, this rapid and effective response all happens without conscious effort. Other than the familiar feeling of babying stiff or sore muscles, there’s no drama or angst about warming up.
For me, this beautifully designed process has developed a bit of a glitch. A malfunction in my body’s plumbing system means that when I initiate exercise, there is a delay in allowing the free flow of blood to my lungs. The resulting lack of oxygen where and when it is needed sets off a cascade of physiological events that, to put it mildly, aren’t encouraging. Soon enough, if I don’t slow down or stop, my body will respond to the crisis by limiting and then shutting down my attempts to continue running at anything like my normal pace. It feels a little like finding myself all of a sudden with a body that is 100 years old, not 60. That’s the new (old) me.
The funny thing is that given a little bit of time to rest and restart, or a more careful and deliberate orchestration of warm-up activities and recoveries, my body will eventually do the right thing; blood vessels will dilate properly, and blood will flow freely. The old me will be back, a reasonably competent runner again, capable of above-average aerobic metabolism.
It’s humbling and disconcerting to experience this rapid decline, and partial recovery, in such a short time. It has certainly made training more challenging, and racing more difficult these last few years. Results from the few races I have attempted at standard distances tell the tale of someone getting way too slow way too fast. It’s shocking to think that a little over two years ago I ran 5:50 pace for a three-mile race. A year later, I could manage only 6:10 pace for 5K. A year after that, 6:30 pace. But that’s not the worst thing. The worst is not being able to run even nine-minute miles at the beginning of a group log run, and having to wait behind while my body figures out how to cope with an activity I’ve been able to perform easily for my entire life. I admit to feelings of jealousy as I watch my buddies trot along with little appreciation for the miracle of healthy hemodynamics.
It has taken me a very long time to understand the new me. I’ve had help in the form of excellent and understanding care from my regular doctor (also a runner) and my cardiologist (also a runner). I’ve taken numerous tests to rule out the really bad, really scary things, and these have given me confidence that running won’t endanger my heart health. Those tests have also shown that deep down, I still have excellent aerobic capacity; it’s just that I can’t access that capacity without an extensive routine of progressive periods of exertion and rest. Oddly, interval workouts on the track are often easier for me to navigate than a continuous run. The design of an interval workout allows for those alternating bouts of work and rest that my body needs to ramp up.
It has taken me even longer to begin accepting the new me, rather than resenting him.
When I first started experiencing my symptoms several years ago, naturally I wanted an explanation. It took a long time to get one that made sense, and that was an important step because it allowed me to worry less that something really bad was happening. But once I had an explanation, I wanted a cure. In other words, I wanted to keep running and racing the way I always had. I didn’t like the runner I had become. For one thing, I really disliked the unpleasantness for the first 10-15 minutes of every run. For another, my symptoms effectively spoiled the social aspect of running for me. I had always liked talking on my runs, and my closest friends were the ones with whom I shared long, discursive Sunday morning conversations as we covered miles of trails. Now, there was no such thing as an easy run for me, and the first few minutes were consumed with the fear that I’d have to stop to let my heart catch up with my muscles need for oxygen. It’s no wonder I wanted to find a solution that would erase my symptoms.
I experimented (and continue to experiment) with various mitigations, and I did figure out ways to diminish the more unpleasant symptoms. But there was no simple way of restoring the old me. Maybe my doctors and I will find something, but I’m not holding my breath – literally or figuratively.
Instead, I’ve begun to realize that learning to live with the new me, the slightly less confident, slightly less smoothly-functioning me, has not been without positive rewards:
- I’ve gained a far deeper appreciation for how signals from the running body are interpreted by the brain and experienced as a variety of symptoms. For example, I now understand in a way I never did before how muscular fatigue can be a symptom of the perception of effort, based on low oxygen saturation in the blood, or high carbon-dioxide concentrations. When balance is restored, the fatigue can disappear like magic. I think this has important implications for training and race preparation.
- I’ve been forced to think about every aspect of warming up, and I think I have a much better understanding of what is most important in a warm-up and how to achieve it. I think this will make me a better coach.
- I’ve learned to appreciate oxygen. That probably sounds funny, but to me it’s quite serious and spectacular. I’m reminded on every run that nothing is possible without oxygen, and not to take it for granted. Oxygen is so much more than fuel: it’s the life vest we use when we explore the world without care or concern, the ticket that lets us enjoy space and time, rather than just occupy it.
- And, I’m reminded every day that regardless of my struggles running, I am alive and healthy. I recently had my annual physical, and it was great — completely boring and uneventful. Many people with my condition are not so lucky. I should never forget how fortunate I am.
- And finally, having recalibrated my expectations around racing, I’ve had to answer the question anew: what the heck are you doing this for? And in trying to answer that question, I’ve discovered another two dozen or so reasons that running is a wonderful thing to do, even when it looks like you’ve slipped badly.
So that’s how it looks to me at the start of this new year. I didn’t ask for the new me; I’m not always wild about the limitations I have with him; and If I find a way to kick him to the curb, I’ll do it without sentiment. But more likely he’s here to stay, and I’d better make the best of it. During these first weeks of the new year, so full of resolutions, self-improvement projects, and people trying actively to bring into being smarter, fitter, thinner, more efficient versions of themselves, I’m beginning to realize I’m actually pretty damn lucky to have this quirky new model, considering the alternatives.
I guess my resolution is, since I can’t create the new me I’d want, to do my best to make the new me I’ve got feel more welcome.
In the unlikely event that anyone else out there is experiencing early exercise pulmonary hypertension and wants to compare notes, I’d be happy to share more thoughts about what I’ve learned, and, of course, would love to hear the same from others. Feel free to leave a comment with a way to contact you.
I wish that there was a magic pill to cure this condition. We need to practice more Rift Valley starts to the group runs.
Thanks, Kevin! I meet with my cardiologist in February, and we’re scheduled to discuss possible (WADA-legal) chemical interventions. I’m looking forward to our experiments!
Thanks for writing this post – it’s really interesting (for a runner insanely curious about how the body works), but would also be so encouraging for someone experiencing something similar. Best wishes for 2018.
Thank you, Marcia, and best wishes to you as well!
Your comment and interest in the mechanisms of this condition made me think of the challenge that runners face when trying to research and understand cardiovascular issues: most of the available research and literature focuses on the population of people facing life-threatening dysfunction. Recently, this is starting to change with studies of heart rhythm disorders in elite athletes, but basic research on pulmonary hypertension in athletes is practically non-existent. I haven’t found a single study or article that looks at my condition from the point of view of PERFORMANCE, and so far, haven’t seen a single description of the conditional nature of the condition in the context of vigorous exercise. In other words, there are countless articles on pulmonary hypertension, but none on my peculiar “early exercise” PH. One of my goals is to convince my doctors that my condition is interesting enough to write about, but I understand that my declining 5K times are of limited general interest!
It is amazing how some topics have been studied ad nauseam while others remain unresolved and research lags on for decades. I do hope you’ll post updates as your journey continues, or forgive me if I ask for a follow-up periodically.
How about a Rift Valley start with a drill or core break 10 minutes in? As long as it’s not arctic blast cold outside why not mix it up.