Wednesday, 28 September 2016

Back to racing – but is it too soon?



I am lying in a bed in a hospital ward at the Cumberland Infirmary in Carlisle with the world’s loudest snorer on one side of me and a guy with pneumonia on the other. I thought I was recovering from my fatigue so why am I lying here?

For the last year I have occasionally been suffering from strange heartbeats. When it happened I had lots of short beats instead of my usual steady slow heartbeat. They were fairly common (every week or so) when I was at my worst at the start of the year but I had not had any episodes for the last couple of months. They were always fine the next day but I was concerned about them, was it possible I might be about to have a massive heart attack?  At the end of June I was out for my normal steady 40 minutes run, the only unusual thing was that it was hot and really humid so I was sweating loads. I ran up the one short hill on the route and I knew immediately that my heart felt funny. I took my pulse and it was really inconsistent and racing away at around 150-160 beats per minute, although hard to count due to its inconsistency. After resting for a minute or two there was no change. So I jogged home very slowly and it was still as bad. I decided that I should really get it checked out while it was bad, so I went to Keswick hospital and was given an ECG. The nurse looked concerned and called the on-duty GP who told me the problem was atrial fibrillation (AF) (not life threatening but needing to be checked out) and sent me to Carlisle hospital. It was strange that they seemed so concerned and worried as I felt fine and was happy it would be OK the next morning. I was not allowed to take the bus so my wife, Emma, had to drive me, which was a real pain for her and the children. After lots more ECGs it was finally back to normal the next morning and I was allowed to leave. It was good to know what the problem was but really annoying having to spend the night in a ward not sleeping. A night without sleep certainly did not help my fatigue.

Lying in the ward, completely bored and unable to sleep got me thinking. The question was: were the AF and the chronic fatigue related? They started around the same time. The doctors in the hospital thought the AF was causing my chronic fatigue but did not understand that I am obsessed by taking my pulse so I know for certain how occasionally it happens and that there had not been an episode for over two months. So it did not make sense that the AF was causing the fatigue. But it made me think that it was possible there was something else causing both problems. Magnesium deficiency is associated with both AF and chronic fatigue. Could this be my problem? I have had lots of blood tests but none have measured my magnesium (it seems that  in general GPs only test magnesium concentrations in old people). Even if I had a magnesium blood test it might not pick up a problem as only a small fraction of magnesium in the body is found in the blood. It is also strange that good sources of magnesium are vegetables and nuts and as a vegetarian I eat lots of these sorts of foods. But Magnesium is sweated out and I have always sweated loads and thought my problems were a deficiency in something as a consequence of this. I have found this article interesting (http://www.drmyhill.co.uk/wiki/magnesium_-_treating_a_deficiency)

So as well as being even more careful in eating lots of green vegetables and nuts I have started to take magnesium citrate supplements up to the recommended daily allowance ( If you take much more than the recommended daily allowance of Magnesium it causes diarrhoea). I have also cut right back on my tea drinking as that might affect the magnesium absorption into the body. I have also tried having baths in Epsom salts (Magnesium sulphate) to see if that helps. [I know sometimes when you are not right you will try anything to get better and taking Magnesium supplements might be a complete ‘red herring’. So if there is anyone reading this with knowledge of any of this I would be very interested in hearing from you]
The other major thing I have tried is a course of Acupuncture, which a number of people have recommended for chronic fatigue.

Whether it was the magnesium, acupuncture or just time I suddenly started to feel loads better within a month of my stay in hospital. I ran up Snowdon on holiday and found it quite easy and felt no tiredness the next day. Other two hour runs were similarly good. My concentration was improving and almost back to normal in the morning (when my concentration is worst)
  
I decided to test my body out with a race. I did the Rab Mini Mountain Marathon event from Braithwaite in the Lake District. A four hour score event over the Coledale fells. This seemed like a good start as I was not running directly against anyone and if I felt tired I could just give up and jog back to the finish. I felt OK for the first 3 hours and although I slowed right down I managed to keep jogging to the finish. I was very happy to have finished and to be the second highest scorer – although partly because I chose a good rote and did not make any navigation mistakes. The next day I felt tired but not completely wiped out.

Two weeks later I then did the Lake District Mountain Trail. Again I struggled after about 3 hours and this time I got really bad. I felt really dizzy and very nearly gave up – I lay down for a minute at one point wondering why I was doing this race. But I had to get back to the finish somehow so I carried on and eventually, after five hours, picked up again to finish in 5 hours 37 minutes in 9th place. My legs felt fine the next day but I started having hot flushes where the whole of my chest (front and back) and sometimes my arms felt really warm and a bit tingly. They are not particular uncomfortable more just a bit concerning that I know I still do not feel right. These have carried on for the last couple of weeks.  So now I am not sure where I have got to in my recovery. I am loads better than six months ago but I still do not feel 100%. Maybe I just tried to get back to racing to soon in my recovery. I still not to be patient and in time I will fully recover.

Thursday, 30 June 2016

Mountain Marathon Tips

Here is a link to article I have written for Berghaus on Tips to succeed at a Mountain Marathon. A lot of them based on mistakes I have made. They are probably mostly fairly obvious but hopefully people will find them useful.

http://community.berghaus.com/athletes/13-5-tips-on-how-to-succeed-at-a-mountain-marathon/

Monday, 13 June 2016

Patience



I have never been patient; I really hate waiting for things. But now I have to learn to be patient. My Chronic Fatigue is gradually improving but my full recovery will take a long time. I now hardly ever feel dizzy and my heart beat seems to be back to steady and normal. I still struggle mentally in the mornings but compared to where I was even a few months ago it has improved. But I am impatient to get back to doing long runs and a couple of times I have done too much (an hour’s run with some hills at a faster pace rather than my normal flattish jog) and then I have suddenly felt really dizzy and exhausted for the next few days. Even if I do slightly too much in the garden I can feel the dizziness starting to come back so I have to stop.

The other thing that affects my Chronic Fatigue is stress. Even a small amount of stress can bring along hot flushes in my chest and tingly arms. It can also affect my sleep and ability to concentrate. A couple of week ago I wrote an article for Berghaus about the difference between fell running and trail running (http://community.berghaus.com/athletes/athlete-blogs2/the-difference-between-fell-running-and-trail-running-why-i-will-never-be-a-trail-runner-steve-birkinshaw/). I wrote passionately about why I prefer fell running and there was a large response, mainly positive but some negative. Unfortunately, to some people it read like I was being snobbish and saying than fell running is superior to trail running. I do not think fell running is any better it is just different and I personally prefer fell running. I think trail running is great; it has got loads of people out running that would otherwise be sitting on the couch. There are good reasons why some people prefer trail running (rather than fell running). They want a set route without worrying about which way to go; they prefer a good trail; they think the atmosphere is much better and they like a goody bag and want a medal for their achievement of having finished. I do not like sayings but it is very much “horses for courses” or “each to their own”. I should also have pointed out that I appreciate it is equally hard to run a fast road race, trail race or fell race – just differently hard! The consequences of writing this article are that I have unintentionally offended some people. In my current delicate state I have found this stressful and the hot flushes and tingly arms have returned.

So I now know it is really important to avoid any mental or physical stresses to my body and be patient. I need to think positively and remember how lucky I am to live in a beautiful place and also that I can go out for a 40 minute jog every day.

Again, thanks for all the comments I have received. I really do appreciate them. Many of the suggestions on how to recover I have taken on-board and they seem to have helped.

Monday, 22 February 2016

Am I starting to Recover?



This is the question I keep asking myself. Is my tiredness getting better or worse? Strangely I do not know the answer. I have some good days and some bad days. Sometimes I am really optimistic and then the next day my optimism vanishes.  

Some symptoms are better than a couple of months ago and some worse. Looking at the good side first. My “brain fog” in the morning seems less bad. My mind seems a bit slow but at least I am capable of writing an email and doing some work. My resting pulse is a little lower than it was (but still higher than normal) and when I go for a gentle jog (I call it a jog not a run as it really is slow and my heart rate never gets above 120 beats a minute) it is easier than it was a couple of months ago. I am also sleeping better and have fewer headaches. Another good sign is that I sometimes feel anger again. For months if something was going wrong I would just get really sad and upset, now I sometimes get cross. I used to have a lot of anger, which I needed to keep a check on by going running and so to have it again is definitely a positive sign of returning to my old self.

 The main symptom that is worse is that I quite often feel dizzy, really light-headed, sometimes as if I am about to faint. Another really nasty symptom is that sometimes my heartbeat is really erratic. It can have three or four little beats really close together followed by a normal beat.  I also get these hot flushes, particularly when out jogging. This heat suddenly starts flowing through my body particularly my chest but sometimes my legs. 

The change of lifestyle I am finding to be reasonably easy. It is over two months since I had any alcohol, the long hard runs stopped a while ago. I am avoiding taking on any new things that will cause me stress and I feel much more on top of everything at work so much more relaxed. 

Overall, I knew it was going to take a long time to recover properly and I guess I just need to be patient but optimistic that I will fully recover.

The doctors are taking my problem seriously, which is good. My blood pressure and resting pulse are higher than normal so they know something is wrong but lots of test have shown no reasons for my fatigue and tiredness. It seems once they have ruled out everything else they are left with the only other thing matching my symptoms which is a mild form of Cronic Fatigue Syndrome (CFS). Mild, because I can still function reasonably normally, including going for gentle jogs. It is nice to have a diagnosis (or will be when all the tests are finished) but it is not one I particularly like. It seems to me that the current state of medical knowledge is saying that we know there is something seriously wrong and there are other people with similar problems but at the moment we are not really sure what is causing it. This is why in my previous blog I liked the adrenal fatigue diagnosis (even if it is not a medically recognised condition). 

Thanks for all the comments from my previous blog and personal messages I have received. I really appreciate all of them and I am taking on-board everyone’s suggestions. It is great to hear from other people who have had similar tiredness and hear how they have recovered. 

To finish here are a couple of pictures when I have been out and enjoyed the occasional nice day we have had recently.


 

Sunday, 20 December 2015

Tiredness Update

This blog is an update in how I am feeling. I have not written it as I feel sorry for myself; I have written it for two reasons. Firstly, I hope it is useful or interesting for other people who have been through or will go through similar experiences. Secondly, a selfish reason, which is that it is great to have a blog written down as to how I am feeling and my thoughts at the time. I can then look back at any point and see my recovery (or lack of it). I really enjoy reading reports from inspirational runners who have just won a race but many people are suffering from various injuries and illnesses and it is really important that all this information is out there for people to read.

My symptoms seemed to have settled down, instead of just complaining about feeling tired I feel I can now catalogue them.
1)    Persistent exhaustion that has now been going on for 6 months. But there were also signs ever since I completed my Wainwrights run. So even 12 months ago after a long hard race it would take me two weeks to recover and feel up to running again.
2)    ‘Brain fog’. I cannot think straight or concentrate and my short-term memory is absolutely awful. This normally clears around midday and by the evening I feel back to normal. But on a good day it might clear at 10am, on a bad day it might never clear. When the ‘brain fog’ is bad I find it impossible to write a simple email or even remember a simple instruction.
3)    The persistent wish to go to sleep even when I have just had an 8-9 hour sleep.
4)    Disturbed sleep. If I am in a bad phase, I wake up in the middle of the night and cannot get back to sleep
5)    Regular headaches.

 I also now know three things that make it worse:
1)    A long fast fell run (90 minutes or more). Particular bad is a long hard run before breakfast. After this I can feel shattered for a week or more.
2)    A big drinking session. I have just had my works Christmas ‘do’. For three days after it I was exhausted and I found thinking and concentrating nearly impossible. All I wanted to do was lie in bed.
3)    A stressful situation, such as having to give a talk in front of a group of people. On the next day I will again by really tired and find even a slow run impossible.
What does not seem to cause any problems is a run (or jog) up to an hour, as long as I keep my heart rate down below 130 beats per minute. In fact being outside relaxing my mind seems to help.


As I mentioned in my last blog the doctors have given me a blood test and have found nothing wrong. So what is the problem? The symptoms are those that are found in either Chronic Fatigue Syndrome (CFS) or Over Training Syndrome. There are various theories about these illnesses and one of these concerns hormones, which brings me onto another possibility which is adrenal fatigue (where the adrenal gland is above the kidney and it is responsible for producing hormones particularly adrenaline and cortisol). This is still not a medically recognised condition and as such there is still a considerable amount of controversy about it, but the symptoms again correspond with what I am suffering from. At the moment I also like this diagnosis because there seems to be a scientific explanation of why the stresses I have put my body under for the last 18 months would have caused me to feel as I do.

Vicky Ware has produced an article for cyclists about adrenal fatigue here: http://www.cyclingweekly.co.uk/news/latest-news/is-your-adrenal-system-making-you-tired-198720 
Here are a couple more:
https://liveto110.com/epidemic-adrenal-fatigue/
http://elinorfish.com/i-think-i-have-adrenal-fatigue-should-i-stop-running/

I am not a biochemist and with my ‘brain fog’ as it currently is, I still cannot work out the full details of all this, but it does make sense to me. For example, in general the hormone cortisol is highest in the morning, whereas if you have adrenal fatigue this is not the case. This would therefore explain the reason why I feel so lousy in the morning. Also loads of cortisol is released during a long hard run, so for the next several days all the stores are exhausted and I feel absolutely shattered.

As for the future, I feel confident I will return to running at a top level. My mind-set has finally changed. As an ultra-runner I need to ignore my body when it is telling me to stop. I have to carry on pushing it and pushing it, accepting it hurts but ignoring the pain. Finally my body has caught up with me. So instead of fighting my body I now need to be very gentle and work with it (which is basically the treatment for any of the possible diagnoses). I can now happily accept that I am not going to run hard again until I have fully recovered and then wait a while afterwards. I am also going to avoid alcohol. Avoiding stresses in my life is harder but I know I can do it. I have no more talks planned in the near future and the work will become easier once I can think straight again. The human body has an amazing ability to recover if you look after it and that is what I need to do.




Here are a couple of pictures to finish the blog. These are when I did get to the top of a fell (Threlkeld Knotts) in November.



Saturday, 7 November 2015

Joss Naylor 60 at 60 Pictures





In 1997 aged 60 the legendary Joss Naylor ‘Iron Joss’ ran 60 peaks in 36 hours. To celebrate this amazing achievement Phillip Allder painted a picture of Joss and 500 limited edition prints were produced and sold to raise money for MS. My family now has the remaining copies of these prints and we are selling them to raise money for an MS charity called the Samson Centre (http://www.samsoncentre.org.uk/).

When I completed the Wainwrights last year (beating Joss Naylor’s record) I was raising money for two MS charities one of which was the Samson Centre. But the reason we have the prints is not because of that. During the summer my older sister, Karen Parker, completed the Joss Naylor Challenge http://jossnaylor.blogspot.co.uk (I supported her on the 2nd half), with Joss, as usual when someone finishes it, coming out and offering his congratulations. My younger sister, Hilary, who has MS and gets treated at the Samson Centre (she can walk a short distance with a stick but mostly needs a wheelchair to get around), was there helping Karen with roadside support and she got talking to Joss who said we could have all the remaining 60 at 60 prints if we sold them to raise money for an MS charity of our choosing.

So now we have the honour and privilege of selling these last 100 prints. The print is 36cm x 55cm. The piece of paper is 45cm x64cm and includes some text at the bottom and Joss’  hand-written signature (individually signed on each print). The difficult question is how much to sell these prints for. We have decided that a minimum charity donation of £20 to the Samson Centre is reasonable, plus another £4 for p&p.  My Mum, Sue, has kindly decided to sort out the payments and send out the pictures. She can be contacted on  sue@josspicture.myzen.co.uk
The prints are available on a first come first served basis. Knowing how popular Joss is I think they might go quickly.


Thursday, 24 September 2015

More resting needed?


In June I was struggling to run fast, feeling really tired and decided I needed a rest. This is a bit of an update on my progress since then.


I took a couple of weeks completely off running and felt fine again. So I started running doing short and gentle runs at first and then slightly harder and longer runs (up to about an hour). I thought I was over whatever the problem was. So in the middle of August I completed the Sedburgh Hills Fell Race. I took just over 2 and a half hours, which was about 10 minutes longer than normal. I was happy with that (considering I had not done a large amount of training) and felt no ill effects afterwards. I also competed in the short Round Latrigg Race again I was a bit slower than normal but happy that I felt OK after. 

However, three days later I did an hour long training run and felt absolutely shattered afterwards. I felt half asleep the whole time, a bit feverish and dizzy. I was definitely too tired for running. I started to feel a little better but was worried about trying to support my sister over the second half of the Joss Naylor challenge (my section was about 8 hours over the fells with lots of climbing). As I had promised to help I thought I would try and see how I felt. To start with I was really tired, but I picked up through the day and felt quite strong by the end and was happy to have helped her complete it. 

For the next week I felt OK and was running regularly but then suddenly one morning my run took more effort to run slower. Again I felt shattered for the next week. I had entered the Lake District Mountain Trail and the day before I felt just about good enough to start. I thought I would jog round if I felt OK and maybe make it to the finish. Surprisingly as soon as I started I felt good and was moving quite well. I was astonished to finish second. 

So what is going on? I wish I knew. Sometimes I feel OK and sometimes really tired. I managed to get a blood test from the doctors but it found nothing unusual. It seems most likely that I have a virus that I have never completely recovered from (is my body still not completely recovered from my Wainwrights run last year?). But if anyone reading this has any better idea then please let me know.

What I probably need to do is take it easy for a while. I think I should make sure all the runs I do are short and steady (the problem is that at my age is if you stop completely it is very hard to start again) and then once I know I am completely recovered then build it up again slowly. The problem is that I love running and I enjoy going to races and racing hard, but I need to think about next year and future years and not do myself any long term damage.