Saturday, November 22, 2014

When Life Has Plans Of Its Own

When Life Has Plans Of Its Own:
Another Lesson In Endurance

photo by Kathy Vaughan/UltraPedestrian.comBy Kathy Vaughan

     October was beginning and the first Saturday of the month I would be running my 14th ultramarathon, the Baker Lake 50k. Baker Lake was the first ultra I had ever run and my first trail race ever, back in 2011. I was pumped up for the race and ready to run a Personal Best. I had been out on five unsupported ultra distance adventure runs throughout the summer, several of them lasting all night long. I was well trained and feeling awesome.

     With the beginning of October, came the return of some classic pancreatic pain which I have gotten for many years. It comes and goes but had returned 1 ½ years ago with a bout of pancreatitis and a week long hospitalization. Since then, I'd been in the hospital a couple of more times and I did not want to wind up in there again. I was having some cramping in my upper abdominal area that was radiating around to my back. I continued my taper for Baker Lake and went about life as usual.

     Baker Lake went as planned. I saw lots of friends, enjoyed the entire race and took 31 minutes off of my previous year's finishing time. It was also my 6th  Baker Lake finish. I was happy with how the day had gone and feeling excited about my autumn running plans. I still hoped to get out on the Kettle Crest National Scenic Trail before snow would make it impassable and I had lots of other trails in mind to explore throughout October and November. Ras and I had our 3rd annual Highlands Halloween Hundred Trail Un-Run coming up the 3rd week of the month and the first of November, I was planning on running my first 12 hour run, Carkeek in Seattle.

photo by Takao Suzuki/

     Avoidance is a tactic some people use when going at a situation that is too scary to tackle head on. This happens when I feel the beginning of the ache, the sign that I am having issues with my pancreas once again. As an endurance runner, I can ignore pain and push it aside. I can go about my day. I can go on really long runs. The runs make me feel better, mentally and physically. I went about “business as usual” for two weeks, trying to pretend the pain was not really there.

     Finally, I asked Ras to drive me down to the local ER as the pain had become unbearable and was wearing me down. I was very tired and I really wanted some relief. I was starting to feel concerned about why I was having this pain once again. We arrived at the small town hospital and a group of local community folks were gathered in the lobby area which doubles as an espresso stand. It was loud and chaotic as I approached the admitting desk. A young lady came out from a back office and I told her I thought I might be having pancreatitis. She unlocked an office across the hallway, led Ras and I inside, and called for a triage nurse to come into the office. I noticed her nail polish was flaking off and she and the nurse exchanged unprofessional giggles over the phone. I handed the lady my ID and insurance information. She verified my address and the male nurse walked in. He stood at a distance and in an unsympathetic voice asked what was going on. I repeated to him that I thought I was having pancreatitis which I have a history of and that I was in pain. 

     He led me back to the examination area and took my vital signs. I did not like the way things felt. The nurse was standoffish and seemed surprised that I was not running a fever or vomiting, as some pancreatic patients do. Alcoholism is the number one cause of pancreatitis and he asked if I drank alcohol. I have not since my early 20's, and so I told him this. All of this information is in the records held at the hospital on me, as I had just spent 5 days there in March. It did not seem as though he had accessed these records. A doctor came in. He also stood at a distance and never approached the bedside, let alone did he examine me in any way. He asked some questions. I was sure to tell him that I had pancreatic surgery in 2007 and had been fine until these bouts of pancreatic pain had returned recently. He ordered blood work and the nurse hooked me up to an IV. I was given some fluids and one dose of pain medication through the IV. The doctor returned saying my blood work looked great and I could go home. He never looked at my records or contacted the specialist I see at the University of Washington Medical Center. He gave me a prescription for 6 pain killers and told me to go home and stay on liquids until the pain went away. The pain didn't go away. I set appointments with my primary care provider and my specialist. I couldn't get in to see either for over 10 days and by the time I did get in to see my PCP, I had a fever and full blown pancreatitis. 

     I don't like this story. I don't like what I went through or the ignorance of the Emergency Room doctor at the hospital in the town where I live. I ended up spending a week in the hospital and when I saw the specialist last week, she ordered an MRI which showed a 2cm x 2cm cyst in my pancreas, like I've had before and like I thought I might have again.

photo by Ras/

     Now I wait to hear what the doctor says the treatment will be for this cyst. Last time it was surgery, although this time it might be possible to simply drain the cyst through an endoscopic procedure. If the cyst stops causing pain, it might make more sense to take a “wait and see” approach. The doctors are very hesitant to give me a prescription large enough to handle the days of pain. I've been told they don't want me to mask the pain and ignore a serious problem. They don't use consistent reasons or even reasons that make sense.  

     There is one good doctor I've been able to see throughout this process, Dr. Silla. She was the ER doc when I was admitted in March. She is an endurance athlete herself, insightful and intelligent. She was on the phone with my specialist within minutes of me entering the ER. She took it seriously and believed that I was in pain. She was kind, warm and efficient. She was the best doctor I've ever seen in Okanogan County and I wish she could be the doctor that could give me my care during this process. She came in to speak to me once I was hospitalized and apologize for the other doctor's behavior, the one who turned me away, telling me I didn't want to be hospitalized as “There are sick people in there, people with the flu.” At the time, I was arguably as sick as anyone with the flu.

photo by Lisa Eversgerd

      The specialist I see at the University of Washington Medical Center is at least 6 hours away. I like to incorporate a run on the mountain pass any time I am making a trip over. Ras and I had decided to do a run to a place called Stiletto Peak before we left, but as we approached the trail head on the pass, the rain was coming down in sheets and had snow mixed in with it. Clouds hung low and thick fog obscured the surrounding peaks. We decided to continue past the Stiletto Peak trailhead and run along Ruby Creek instead, staying down in the lower elevations. We would certainly get wet on this trail as well, but we would be out of the colder temperatures and the wet snow.

     I love the Ruby Creek trail. The creek itself is loud and roaring. It tumbles over huge boulders and settles into serene pools as it makes it's way toward the confluence with Panther Creek where the trail begins. The trail drops down from the North Cascades Highway through a short series of switchbacks and then crosses the confluence of the two creeks on a strong bridge. After crossing the bridge, the Ruby Creek trail heads off to the east and the East Bank trail along Ross Lake heads off to the west. 

     The rain was falling softly now and the sun was trying to break through the clouds. The brush was very wet alongside the trail and I was immediately sopping. I didn't care though and the fresh damp air smelled good and I welcomed it as it brushed over my face. Huge maple leaves covered the trail in a thick blanket that hid slippery rocks and roots. The trail dipped and climbed along the bank of the creek, sometimes narrow, dropping off to the rushing creek below. I ran along easily, feeling joyful to be out. I felt like I could go forever, even though this run was only a 6.6 mile out n' back. I knew this trail yet it still held mysteries for me. I hadn't captured all of it's best viewpoints yet, or dipped my toes in the icy cold water at the point of the trail where it becomes level with the creek for a stretch. 

     A collapsed cabin, being overtaken by briers and moss, sits almost at the point where the trail meets up with the bridge at the turn around. This bridge leads to another trailhead parking lot and a couple of more cedar cabins, still standing. The trail straight ahead continues towards a steep climb into the high country of Jackita Ridge and the Devil's Dome Loop. I have done this loop several times and it is one I highly recommend. It is tough, but well worth every bit of effort it takes to complete. Last year it was the UltraPedestrian Wilderness Challenge course. I completed it with my adventure buddy Lisa Eversgerd and this is the blog I wrote about our trip.

     Ras and I turned around at the bridge to run the 3.3 mile return trip to the car. It felt so awesome to be out in this lush forest. Huge ferns lined the trail; large cedar, hemlock and fir trees towered overhead;  the musky smell of damp earth filled my nostrils and my mind was clear, relaxed and alert. Again I was filled with the desire to continue this run for hours and hours, knowing that it would soon be cut short. I looked forward to other runs I would do while on this visit to the “wet side” of the mountains. Living at 3,500 feet in a high mountain desert, I thrive on these opportunities to enjoy the coastal and western Cascade forests. Ras and I would be staying at my parent's home in the Anacortes area, just miles from Deception Pass and Ft. Ebey State Park trails. I have run races in both of these parks several times and have some familiarity with the trails. I was planning on getting some miles in these parks over the next few days.

photo by Ras/

     Back at the car, Ras and I changed into dry layers, got out some road trip snacks and continued on our way towards Anacortes. The next morning we would need to be in Seattle for my appointment by 8:45 AM. My parents were out of town, so we would be staying in their home. We wanted to get a few groceries on our way there and possibly purchase a new juicer. During my pancreatic pain, I have to stick to liquids and fresh squeezed juice is a healthy way to be able to do this and still take in some good nutrients. Lisa had lent me her juicer for a couple of weeks and Ras was enjoying using it as well. My favorite juice had been apple, carrot and ginger. Fred Meyer was our one stop shopping trip in Burlington as they have a really nice natural foods section and appliances. We got the less expensive juicer and as soon as we pulled it out in my parent's kitchen, we could see it would be inadequate. This was a bummer, but we would be able to exchange it the following day for the more burly model. 

     The specialist was thorough and easy to talk to. She decided I should have an MRI/MRCP of my pancreas and an ultrasound of my gall bladder to help determine the cause of the recurring pancreatitis. It was easy to get scheduled the very next day for these imagings, which was awesome as we had come so far for the appointment. Taking care of as much as I could while in the area was ideal. I am allergic to the contrast solution used for the MRI, so I had to get some prescriptions filled that would help prevent an allergic reaction from coming on. I had to take strong doses of Prednisone and Benedryl at intervals leading up to the test, as well as a relaxant to help with the claustrophobic feelings of the MRI machine. I had a blood draw at the hospital to check calcium and triglyceride levels as well.  

     Ras had a talk to give later in the evening at Seven Hills Running Shop about his unsupported Washington Pacific Crest Trail OKT. We also had plans to meet our daughter Angela for lunch. She is a senior at the University of Washington and it would be easy enough for her to meet us at the medical center when she was done with her morning class. She met us in the lab area and seemed more than ready to continue on to a more pleasant environment for our lunch date. I was going to have to stick with soup, so we decided on PCC, a market where we could do some shopping and each pick out whatever we wanted for lunch from their deli. This is somewhat of a tradition for our family when we visit Seattle anyway, so it worked out just fine. Our other, more indulgent tradition of vegan pizza from Pizza Pi, would have to wait for a different day. I enjoyed a delicious cup of split pea soup with lemongrass. Angela and I shared a yummy rosemary roll as well. We had lots of time to visit and it was so nice to spend time with my 22 year old college student daughter. She had just finished a math mid term, that she later learned she had gotten 92/100 as her score. I am so proud of her and I love that she is a product of homeschooling from 3rd-9th grade, mostly in an off-grid cabin in the woods along a creek.

     By the end of the next week, I was able to speak with my specialist regarding the cyst. She let me know that the pain was probably from the cyst, but the cyst itself might have been caused by pancreatitis. She didn't know. She wrote me a prescription for more pain meds and pancreatic enzymes. She instructed me to continue on the thickened liquid diet I'd already been on for about six weeks. I started taking the enzymes and within a couple of days, the pain had subsided greatly. I felt more like myself and ready to think about the future again.

photo by Lisa Eversgerd

     I continued with 30 mile weeks during all of the most painful times of this pancreatic bout. I suffered from pain for 6 weeks straight, the only time of relief was during the hospital stay. I began walking the hospital halls as soon as I was able. I continued with my 30 day Squat Challenge, even throwing in two sessions of 60 squats each while I was in the hospital.  I continued training for Baker Lake 100k Fat Ass (the Tofu Trot I would be running with Ras and Lisa) and the 18 mile anniversary run with Ras to celebrate our wedding anniversary. I kept all of these goals in mind. I continued my Fartlek Friday sessions, pushing through strong discomfort and blood sugar fluctuations while doing so.

     I got in a 5 hour run in Whistler Canyon in 20 degree and lower temps with Ras and Lisa, training for our Baker Lake run. This was the day when I noticed a definite turn around in the way I had been feeling. This was the day that I felt like I exited the pain cave. This was the day that I ended the run and had the familiar high feeling of the endorphin rush. I had run well on the final stretch of downhill and I it had felt like I still had my game. It felt amazing.

photo by Ras/

     I spent several other days with Lisa, going on runs in the high country of the Okanogan, followed by several hour sauna sessions in the little cedar structure she made herself. The sauna sits beside a creek and feels like a special spot that only exists in fairy tales. The saunas are always followed up by homemade vegan food that we share with each other and fresh squeezed juice or kombucha. We sip on healing, chilled herbal teas while sweating in the sauna, replacing the fluids lost in the process. Lisa makes herbal soaps with essential oils and the final time in the hot room is spent soaping up and rinsing off with the creek water, warmed just enough on the wood stove. These are the ways I heal from the intensity of a bout of pancreatitis and a five day stint in the hospital. 

photo by Kathy Vaughan/

     There are still big question marks in my life right now. My life has plans of it's own of which I am currently unaware. The house that Ras and I have been caretaking for five years is now on the market and we will have to move out soon. We are already looking for the next opportunity, the possibilities endless yet sometimes not seeming so. We have both been working temporary, seasonal jobs since we returned from thru-hiking the 800 mile Arizona Trail in the spring. It has allowed us to make ends meet, but not to set aside money. We want to return to the trail, to hike and run for 5,000 miles, covering a series of long distance trails in the months of spring, summer and autumn of 2015. This is my dream, the dream that I share with Ras. I must maintain my health in order for this to happen. We must find a place to live and store our belongings when we aren't on the trail. We must find a source of income and a way to fund our trip. Our three cats and two elderly dogs will need a well chosen care situation while we are out wandering. The solutions to these challenges will come with time, energy and effort. I choose to approach my life as if there are zero limits to my dreams and goals.

There are no barriers to my life. The gateways to wisdom and learning are always open, and more and more I am choosing to walk through them. Barriers, blocks, obstacles, and problems are personal teachers giving me the opportunity to move out of the past and into the Totality of Possibilities. I love stretching my mind, thinking of the highest good imaginable. As my mind can conceive of more good, the barriers and blocks dissolve.     Louise L. Hay

Sunday, November 16, 2014

Trail Trot Terror

Trail Trot Terror:

My First 50 Miler, The Runner's Trots,

& The Acoustic Properties Of Port-o-lets

photo by Chihping Fu
by Ras


     In April of 2011 I ran my first 50 mile race, the Mount Si Relay & Ultra Runs. It was another first for me in that it was also the first, and so far only, time that I have suffered any serious sort of gastro-intestinal distress during a race. Enough so that by the end of my tale you may think that the event being named the Mount Si Relay and "Ultra Runs" is not only apropos (apropoo?), but, perhaps, a bit too on the nose.

     Rest assured: I did not accidentally become the Tim Sylvia of ultrarunning. Nor did I suffer a wardrobe/biological malfunction of such memetic magnitude as is pictured below (fictitiously, thanks to Redditor totalitarian_jesus). But I did suffer a widely shared, if not archetypal, experience among endurance runners, commonly referred to as the "runner's trots." Despite the humorous euphemism, this is a genuine biological phenomenon.

graphic by totalitarian_jesus

     In addition to being my first 50 mile race, Mount Si was only my third ultramarathon. And at that point in my life, it would be the farthest I had ever traveled by foot in a single push. I was new and still learning. (Now I'm less new and still learning.) I had not yet begun any of the fueling experiments that I now find so fascinating. In fact, I can't recall exactly what I was eating during ultras at the time. If I had to hazard a guess, I would say this was during my bulk refillable gels, Perpetuem, and Vespa phase. But I really didn't know what I was about when it came to fueling.

     On the morning of the race everything seemed fine. I remember seeing a restroom or two along the course early in and thinking that I didn't need to use one, but it was good to know they were there. Then I didn't see any for a while. Then my intestines started rumbling. Then they started feeling loose. Then I started to worry.

     I had to find a restroom or a Sani-can. I had needs that could not be taken care of behind a tree. And much of this course was suburban gravel trail, not at all conducive to well timed moments of privacy. So I found myself running from one aide station to the next hoping against hope that I would happen upon appropriate facilities before things turned ugly. I was essentially performing a continuous kegel exercise the entire time, as I ran on, clinging to the hope that I would happen upon a Port-o-let in time.

     I passed desperate miles wherein I would occasionally have to stop and walk in order to maintain control of the shituation. Finally, a little more than halfway through the race, I sighted an aide station ahead, with a Honey Bucket front and center. I beelined with a puckered behind, making one last desperate push to quickly cover the ground between me and my Sani-can salvation. A few other runners were just heading out of the station as I darted into the porta-potty, assumed the position, and, to use the Pirate vernacular, I let 'er rip. And this is where the shame began.

     The layout of the aide station was such that you first came up to the drop bags, on the left side of the trail, and the Honey Buckets across from them, off to the right side of the trail. The actual 'aide' part of the aide station was another 50 feet further along the trail. Unfortunately, 50 feet was no where near far enough to give me the privacy I needed, much to my chagrin and that of the poor, beleaguered volunteers. 
     The initial blast emitted by my biological processes produced as much sound as anything else. Equal parts alpenhorn, tuba, and raspberry, the timbre, pitch, and tonal qualities of the noise I emitted were simultaneously concussive and ululating, albeit in a baritone register. I believe it was the low end properties of my performance that reverberated so resoundingly through the plastic walls of the porta-potty. I essentially turned it into the soundbox of an unholy instrument comprised of the eliminatory end of my digestive tract amplified through a six foot tall molded polyethylene elongated cube.

     Although I was inside this aural camera obscura, as it were, I had immediate input from those outside as to how well the sound had carried and how horribly its import had been conveyed. This information took the form of a distraught cry of, "Oh, God!" from one of the aforementioned volunteers innocently manning the aide station some 50 feet away. There was no question; no ambiguity. They knew that whoever was in the Port-o-let had been either the victim or the perpetrator of something horrifically uncouth.

     After I finished taking care of business I felt great. I had done what needed doing, the storm in my innards had passed, and I was ready to get running again, except for a Damoclean sword of shame poised above my head, suspended by a single frail hair of anonymity. I was trapped in Schrodinger's Cat Box. As soon as I was observed I would die of embarrassment. So I waited.

     Although I doubted I could completely avoid being seen exiting the Sani-can,I had two possible means by which I could potentially, if you'll pardon the contextually unappealing visual, muddy the waters. Plan A was to wait until I heard other runners stopping at their drop bags across from me, dart out amongst them, and feign as though I had been with them all along and had no connection to the unseemly events which had played out so recently in yon porta-potty. Plan B was simply to wait so long before making my egress that the volunteers would presume I was an unconnected third party who had come along to make use of the facilities after the fact, and that they had somehow failed to observe the exit of the perpetrator.

     As it turned out, I soon heard runners stop at the drop bags across from me and I made my move. Quick like a bunny, I burst forth explosively from my confines, and was lost among the other runners at their drop bags before the door could slam shut and the volunteers could look up and single me out. I finished at my drop bag and moved up to the aide table along with my new found peer group. I made a solid effort of conveying the sense that I was a serious runner, newly arrived, simply in need of water and a few calories, and in no way associated with the recent unpleasant goings on 50 feet away.

     From the friendly smiles I received and the manner in which the volunteers were unabashedly able to look me in the eye, I concluded my ruse had been successful. They failed to associate the man before them with the cacophony that had assaulted their senses only a few short minutes ago. I counted myself lucky to have made a clean getaway. And if they were just pretending not to know out of politeness, then that is a kindness for which I will forever be grateful.

     To this day, my face reddens in shame any time I call to mind that horrified cry of, "Oh, God!"