Sunday, June 16, 2013

Running with Cytomegalovirus

The obsessive side of my personality construct is something I consider a strength.  When I want something or feel like I need something I work towards getting it.  It doesn’t matter much what it is, if I want it badly enough generally I’ll do whatever I can within my power to make it happen.  Work, work, work.  That’s usually all it takes.  For me, putting in the work is not a problem.  Often the fallout for my obsessive, workaholic tendencies comes in the form of getting less sleep or missing out on social events with family or friends, but such is life.  We all choose to make sacrifices in one form or another.  My Mom, one who is no stranger to keeping herself busy, says she will sleep when she is dead.  As her progeny, I’ve mostly adopted this motto as my own, for better or worse.
Something else I consider a strength which dovetails with my restless nature and seeming inability to relax- a definite weakness- is the bottomless energy well from which I draw to complete tasks.  Go, go, go.  That’s what I do.  I like it that way.  I don’t know where this energy comes from, it’s just there.  It always has been.  Now, at 36 years of age I’m wondering how much in reserves my energy well contains and for how many more years from it I will be able to make liberal withdrawals.  Decades I hope.  What actually got me thinking of this is my recent bout with injury.  I have Cytomegalovirus (CMV).  For some having CMV might be a condition.  For me CMV is an injury because it has kept me on the sideline.
Last winter there were many wonderful things going on in the Gorman household.  Our son, Trail, the most wonderful, who is a beam of light shinning upon my life in an area that I never realized before was shrouded in complete darkness, had yet to begin sleeping through the night on his own.  During the winter months is when Gaby and I began “sleep training” him.  For the uninitiated, sleep training is what new parents attempt by coaching their little ones to sleep through the night, on their own, without Mommy nearby and usually unswaddled.  The process can often be tough on parents, possibly even tougher on the parents than on the little ones, as the sleep training parent(s) is awake much of the nights.  Sleep training Trail this past winter was my job.  Gaby did enough.  During the training, which in reality didn’t take that long, when Trail was up so was I but even when he wasn’t up I often was anyway.  I’m not a nap taker either.  I couldn’t take a nap if I tried.  The cumulative nights of lacking in sleep added up.
Santa was good to me in December also and over the winter I began sleeping in a Hypoxico altitude tent.  When sleeping in an altitude tent it is better to up the altitude bit by bit over a few weeks or months because the quality in one’s sleep is lacking during the initial stages.  However, each night, late, I crawled into our tent set straight away at 6,000 feet.  Looking back, that probably wasn’t the smartest thing to do.  At least for me.  Compound the sleep training and altitude tent with the myriad house projects I tasked myself with, a busy work schedule and about 60 to 75 mile base building weekly miles I was running at the time- sometimes at night- and a perfect storm developed where my immune system became severely compromised.  Only I didn’t realize it at the time.
All I knew is that some time towards the end of January and very beginning of February my energy levels began to fall off.  It was tough getting out of bed in the morning.  My motivation was way off.  I was tired during the day.  At times I experienced “brain fog” where my memory failed.  And my runs were so very spotty.  At first week to week I felt good, then bad, then good again while running.  Then it became run to run where I felt good during one run then bad on another.  Then my symptoms became much more acute where during the first 10 minutes of my runs I felt awful, the second 10 minutes felt good, then five minutes felt awful again, then 10 minutes would feel good, until finally the remainder of the run would feel terrible.  This went on for about two months.  Other than complaining to Gaby and threatening to seek blood testing I kept these issues to myself because I was scared to tell anyone and admit that there was something wrong with me.  I knew there was something wrong but I had no idea what it could be.  Over training?  I didn’t think so- in fact, I knew so- because I hadn’t been training that much and I took a full month off completely after Pinhoti in November.  What then?
Anxiety crept in.  Prior to every run I worried whether I should even go out because I would probably either feel terrible, that I might be hurting myself, or that I might actually have a good run and give myself false hope to continue on.  Western States, Hardrock, UTMB loomed on the horizon after all.  An epic summer if there ever was one.  I faked my way through TWOT in February.  I bailed on trying to bang out a hard half-marathon effort in DC in March.  I had zero desire to sign up for additional races leading up to Western States.  By the time Terrapin rolled around, the only other race I was registered for, I was at a very low point.  Moments before the start at Terrapin I confessed to Dave Hryvniak, eventual race winner, that I felt only half there.  A few days prior to Terrapin I confessed to my friend Drew that I had never felt so underprepared for a race.  That should have been a huge red flag and I should have come clean then and there but I was in denial and did not want my Terrapin registration funds to go to waste.  Seems silly to think about now.  From the gun I suffered at Terrapin.  At mile 20 at an aid station I ran up to Horton’s truck, grimacing “DNF”, and before I could even muster the words and ask for a ride Horty said with a smile “No rides.  No rides.”  Ugh.  I continued on to the finish.  Terrapin was a sufferfest.  At that point I decided to schedule an appointment with Dr. Robert Wilder, distinguished sports med and rehab doctor at the University of Virginia, hoping to get to the bottom of my issues.  This was on March 23rd.  Fast forward to April 12th, with three more weeks of mostly questionable running under my belt, two appointments with Dr. Wilder and two rounds of blood tests, the diagnosis was in.  I had CMV.  No running for three weeks.  No cross training.  Complete rest is what my body required.  “Wait…Cytomega-what?” is all I could think of.  I had never even heard of it.
What I now know of CMV is that it is a respiratory virus claiming between 50 to 80 percent of American adults by 40 years of age.  Says many medical publications I’ve read, most people don’t even realize they have CMV.  CMV is opportunistic and its symptoms might only surface when a host’s immune system becomes severely compromised, like mine was.
Three dreadful weeks crept by where I didn’t run a step or do much else other than work, eat, play with Trail and purposefully try to sleep a lot.  This was hard on me.  Sure, knowing I had CMV and coming to grips with the fact that my summer running dreams were becoming less likely with each passing day was no walk in the park but for an obsessive, over-energized guy like myself, who always follows doctors orders, to be prescribed complete rest was hell.  After the third week I ran a few times before my follow appointment with Dr. Wilder.  Additional blood analysis revealed my liver function levels had come down 50 percent but they were still elevated; a signal that I still had CMV.  Dr. Wilder prescribed two more weeks of zero activity.  This was on May 8th.  He also said to forget about running Western States and Hardrock.  Attempting to race 100 mountainous miles at altitude, back to back, soon after recovering from CMV was too risky.  Calling Craig and Dale to withdraw from the events was a regretful experience.  Like most individuals in their positions, both of these race directors care deeply about their events and the athletes who participate in them and the least I could do was call and pay my respects, rather than write to them an impersonal withdrawal (DNS) email.
For the past four weeks I’ve been getting back to running nice and slow.  For four days for 15 minutes per day during the first week that I ran I felt strong and light on my feet.  Five days for 20 minutes per day during the second week I ran and I continued to feel good but I also began to realize how out of shape my body felt.  Six days for 30 minutes per day last week is what I was prescribed to run but I cut out two of the days because I was worried that I might be relapsing with CMV.  My breathing felt labored.  I no longer think that is the case, I am not relapsing, and anxiety and my body simply reacting to being out of shape is more likely what I felt.  Today I finished a complete week by running for 40 minutes every day.  Plus, I’ve been busting my ass with work over the past several weeks, working long hours, and working in the yard quite a bit, getting flower beds ready for several trees I would like to plant soon.  Despite having experienced a few off days last week I’m feeling good overall and confident that I am getting back to normal.  Energy wise, I feel like my old self.  My motivation is back.  My confidence is coming back too and my body no longer feels like it needs sleep constantly like it did while I was in the throes of having CMV.  Mornings now I can’t wait to get out of bed.  On June 25th I have another appointment with Wilder and I suspect he will want to perform another round of blood work to determine for sure if my CMV (and elevated liver functions) has abated.  Hopefully I will get good news and the green light to begin ramping things up.  It will be interesting to train with a mind towards peaking in the fall.  For the past several years my goal races have taken place in the spring and summer.  There are  so many good events to choose from in the fall.
This summer my primary goal is to return to full health and get back to enjoying carefree running with no worries or anxiety.  I have also decided that whatever comes this summer weather wise- heat, humidity, derechos or whatever- I will use as the block to hone my training edge and just enjoy it for what it is.  More than anything, healthy running is a state of mind; a free place in one’s head and in one’s heart that does not feel pain, or pressure, or anxiety brought on by outside circumstances.  This is the place where I want to be.  Therefore, even small stuff, like not complaining about the heat is how I want to roll.  As soon as I get a clean bill of health on my CMV issues I intend to ramp up smartly and make the most of summer.  Moving forward I will be more mindful of protecting the health and strength of my immune system which of course starts by getting proper rest because once an individual has CMV it stays with them for life and I want my fight with CMV to go only one round.

9 comments:

  1. Wow, Neal- sorry to hear about your CMV, but good to hear you're on the mend. Hope your recovery continues and you're able to get back to doing everything you want to do. It's really true- if you don't have your health, not much else matters.

    ReplyDelete
  2. Sorry to hear this Neal. I hope you get 100% well very soon. Take care.

    ReplyDelete
  3. Hope you get back to good health soon!

    ReplyDelete
  4. You got this M10. 10+ weeks to UTMB. Health first, build slow. Trust the base. Big peak in August and short taper. Boom- back on top! Rooting for you this year. Hope to see you on the trails stronger than ever.
    Jer

    ReplyDelete
  5. Neal, get well soon and we'll all miss you at Western States but get strong again and I'll see you on the trails soon, I hope.

    ReplyDelete
  6. Neal, hope you beat this thing quickly...the few times we have met I can see what a class act you are...such high integrity and very modest. Enjoy life and your family. Best regards, James

    ReplyDelete
  7. Neal, I can only imagine how difficult this must be for you. Your good attitude toward what has come to pass can only help. In the meantime, I hope you savor that extra time with your son and wonderful wife.
    Here's to the Fall and new races to run!

    Kirstin

    ReplyDelete
  8. Neal! This is the 1st I've heard of your CMV! Sorry to hear this. Didn't know this affected such a large percentage of people. Very glad you got checked out & are doing what you can to get better. Every single one of us in this world has something or other, rest assured of that. Always good to heed the body's signals. I have docs in my contact list, so I feel ya bro! :-) XO Love Donna M.

    ReplyDelete
  9. Same for me :( though I didnt take time off.. well I took one week. and 3 weeks later one more week. can't do any long runs as my breathing is too labored instead running 3-5k's. I've used an "astma inhaler" to help me finish those... CMV is positive (acute) still and it's been 2 months. so I guess it's time for some real time off.

    ReplyDelete