No motivation.

I'm so tired when I get off work.   Anything that happens is an easy excuse not to work out.  I know I feel better when I run, but it's so hard to get started.  

I try "bullshitting' myself by just getting dressed for a walk/ hike.  But then it's really windy, or it snows, and I use that as an easy excuse to not work out.  Can't ride today; it's too windy.  Can't run, it's dark and snowing.   Can't do anything, becuase I'm tired.  And bored.  And hungry.  

PSHFEW.

I need a motivation pill.  Who makes that?

...

My new doctor.

Why did your doctor run that test? Have you had symptoms?

Dr. S sat in front of me, typing my answers into a computer. I don't know why my GP ran that test, I said. I think he does certain tests when you reach a certain age, so maybe that was it. I have had some symptoms, but I thought it was just menopause.

He started going through a list of symptoms.

Had I notice any hair falling out? Well, I didn't think so. I mean, I have LOT of hair. I haven't seen any in the drain, or on my pillow. But then, this past weekend, I turned our vacume over - the little new one we bought for the new house - and I was stunned at how many much blonde hair was wrapped around the beater brush. There was a lot. My hair stylist, meanwhile, had commented that I had "course" hair, which nobody had ever told me before. At the time, I chalked that up to her not having a good chairside manner.

Weight gain? I explained my lifestyle to him. When I got to the point where the only time in the past seven years that I've been in the "normal" range for my height was when I was training for an Ironman, his eyebrows went up, and he typed into the computer.

Family history. "Is your mother still alive?" I told him she died of heart failure at 61, as a complication of cardiomyopathy. His lips tightened, and he typed into the computer.

"Father?"

"Suicide," I said simply. "About 3 years ago. He was the second in his family to do that; there's a lot of depression and alcoholism there."
He continued down a list of symptoms, and asked about fatigue. "The thing is, doc, I do a lot. I work full time, and besides that, I'm usually either doing another part-time gig, or taking classes, or both." But lately, I told him, I'd complained to Sweet Baboo that I just felt old.

"What did you mean by old," he probed.

"I don't know. Just--old. Like time is running out."

He smiled a little, and typed into his computer. He's about 65, I think. Sharp as a tack--he was familiar with the psychopharmacology research that I'm coordinating at my job. But at 65, it must be ironic to hear a 44-year-old marathoner say that she feels like time is running out.

All together, he spent probably about 45 minutes with me, listened to my heart, breathing, explained things to me, answered the questions I could remember (because I forgot my list of questions) and then explained to me why he was going to prescribe what he was going to prescribe.

He told me that generic medications are allowed to deviate from their name-brand counter part by as much as 20%. He also told me that "natural" drugs, like dessicated pig thyroid, are allowed to deviate in potency even more than generics, because they are classified as "natural" and are not subject to the same guidelines by the FDA.

He checked off the "no substitution" box on my prescription. Synthroid, .5 mg

I assured him he didn't need to sell me on that point. "To be honest, doc, snake venom is natural. Spinal meningitis natural. I've also been reading up on all this, and I know that the "natural" thyroid is not bioidentical to human thyroid hormone. I'll take the stuff that's been formulated to exactly duplicate human thyroid hormone, thanks."

It pays to be educated about your condition. When I went to the pharmacy to pick up my new prescription, I glanced at the label. Hesitated. "Is this generic? I'm pretty sure my doctor said no generics."

The pharamcist went to check that the doctor had indeed checked that box, and then called out to me that it would need to be refilled again, if I didn't mind waiting a couple minutes. I went in search of an Oil of Olay product that Oil of Olay makes but nobody seems to carry. That's another story.

When I came back for the right prescriptions, I hesitated again. "How many is in here?"

"Ninetey," I was told. "It's a three-month supply."

I struggled to be my own advocate while still being a good girl. "Gosh, ninety!" I said brightly, giving my biggest Dixie Girl smile. "It sure doesn't look like ninety. These must be tiny pills." The pharmacist looked a bit put out, but then when she took the bottle I handed her, her eyes widened a bit. "I'll be right back," she said.

I finally arrived home with ninety of the right medication, and I started taking it today. "How soon will it start working? What sorts of things might I expect," was one of the questions I remembered to ask. Sweet Baboo wanted to know that, too.

The doctor had smiled, and said, "you know, that's an interesting question. Like you, a lot of people tell me they're only been feeling kind of bad for the past couple months. But then when they get on the medication, and their level is adjusted properly, they realize they've felt crappy for years."

So, I took my new pill for the first time this morning. It has to be taken with water, on an empty stomach, at least an hour before I eat. This morning at 5 am, I took my pill. But I can't help but wonder: I love my life. It's a fantasy life, in my opinion. How much better could it possibly be?

...

Early planning for IM-UTE

So far, nine members of my triathlon team (the New Mexico Outlaws) have signed up for Ironman St. George, aka IM-UTE, on May 1, 2010.  Ones you may know include myself, Sweet Baboo, DreadPirate, Flamin' Mo, MG and his beloved Michi, Stitch, and Paul the Pilot.  Not all these folks have blogs.  

I went out yesterday with Courtney on my new favorite ride down to the Casino and back.  Why is it my new favorite ride?  Well, because it has a bit every everything in 26 miles: a long grind - about 6-7 miles up from the valley into the foothills, short intense climbs, some decent time-trialing stretches, and if you want, you can make it longer and extend the long grindy climb part.  It goes along a wide boulevard with wide, clean shoulders so my paranoia doesn't spike.  But, in case I do, I can always jump over onto a paved bike path.  Lastly, it starts and ends at my favorite place in the world: my house.  

My goals for IM-UTE simple: finish, maybe a little faster than I did before.  According to this calendar, sunrise on that day is 6:40 and sunset is at 8:22.  I'll be finishing in the dark.  I'm not sure what "none" means with respect to moonrise.  Maybe it rises while it's still light out, or something.  

I plan to work at getting better and faster  at this ride, then start doing it twice per ride.  I can also head out from this ride and do another good ride out 313 north to the San Felipe Pueblo.  I finally got my Garmin installed into the laptop that Baboo bought me for my birthday, so here's the profile for the training ride:

All of this is a no-excuses chance to work on my weakness over the next 12 months: cycling.   My goal at IM UTE would be to maybe average 15 mph over the course.  To do this, I'll have to work on climbing, particularly extended climbs.    

For running, I'm going to work on doing one flat pavement run, about a 

10K, once a week, for now.  Here's the profile.  It's the first and last 3 miles of the ride that I do, except that instead of being on the boulevard I'm on a paved running path.  I'll be slowly working my way up to a marathon-length run on pavement.  This route gives me refueling opportunities along the way.  I can get in a marathon distance easily by going out and back.  So, that's my long run.  All my shorter runs will be on dirt paths.  

My midpoint goal is Ironman 70.3 Buffalo Springs Lake, near Lubbuck, Texas.  It's hot and there's some climbs, so I'll be doing one training run after work and one ride after work each week, acclimating myself to riding and running in the heat.  

Tuesday, I go to see the endocrinologist.  I wonder what kind of doctor he'll be - will he say something like, "you need to scale back on your goals, they're too much for you."  Or, will he be the kind to say, "Let's see how we can make sure you get to your goals."?  Although I'm trying to be conservative in my hopes and dreams, I'm just hoping to have enough energy again to tackle the training I'll need to lose some of this weight.  I can lose my own weight; I just need the energy to do it.   

I'm also considering consulting a professional, degreed and certified nutritionist, as well.  I'm now a hypothyroid-vegetarian-perimenopausal-triathlete-endurance runner.  It's getting complicated.  

...

Training, again. And other stuff.

Now that everything seems to be happy and healed (feet, ankles, tibia, IT Band, et cetera) I'm easing back into the training again. 

For now, I'm going to try to ride twice a week, getting used to being in the saddle again, and running 2-3 times a week, getting my legs used to being on pavement for one of those runs. The running is oh, so slow. I did a 10K pavement run on Monday, the longest p

avement since December, walking about 1/4 of it. My average pace was apalling, but it was faster than it's been in a long time.

What's great is that it's so much easier now.  Within a mile of the new house is a paved running path, a boulevard with wide, clean shoulders, and clean,

 dry, dirt running paths. Most of it is hilly, too. As a good friend says, I hate the hills, but love what t

hey do for me. 

My new training ride includes an extended 6 mile climb, and

 I'll be doing that often to get ready for IM-UTE. Here's the profile for that -->

I was planning a ride last night, but put it off because Baboo was gone Tuesday night. Why is that relevant, you ask. Well, I'm still getting used to the new house noises.  So about 11 pm, the cats knocked something over, and I was awake and paranoid and convinced that someone was trying to break in, and spent the rest of the night mostly awake, staring at the bedroom doorway, waiting for the intruder who was certainly in the house to kill me. Every creak and whisper in the house was my murderer, waiting to sneak up on me.

The next day, my normal bike day, I was exhausted all day - I even had that exhausted twitchy eyelid thing going -- so that by 3 pm I was ready to grab 

all my sugarless energy drink mix and pour it straight into my mouth like pixie stix powder. I complained to Baboo, who soon enough was home, as he said, to protect me against cats, plates, and things that go bump.

 I was exhausted and fell into bed which seems more like home with Baboo in it.  So no ride. See, it's all related.

Baboo brought this piece of art back from his trip --> 

(He may be a big tough ironman, but he's sentimental, too. ) 

The picture doesn't really do it justice.  

<-- Here's what it says in the middle, and you'll see why it's such a great piece for a couple of brand-new empty-nesters.  (There's more like it at Storypeople.com)

Here's another writing by the same artist that I thought was also especially appropriate for an endurance sports couple:

You may not remember 

the time you let me go first

Or the time you waited 

at the crossroads for me 

to catch up.

You may not remember 

any of those, but I do

& this is what I have to say to you:

today, no matter what it takes, we ride home together.

5 days to my endocrinologist appointment. I've heard he's nice.  I wonder if he gets hypothyroid patients as hyperactive and random as me.

...

On reference ranges, baselines, and symptoms.

This is kind of a long, rambling post, but I'm hoping it might be useful for someone.
So, yeah. That thyroid thing. I see it everywhere - it's human nature that if you get some sort of condition, you see it everywhere.
I didn't even order this test. It was just part of a routine physical. On my way out the door the nurse said, "he needs to talk to you about this," and I glanced at the paper in her hand: Thyroid Stim Hormone 8.02 (H). What's that? I asked. What the hell is a thyroid? I mean, I know we have one. What does it do? Is it like an appendix? Oh, so many questions.

There are reference ranges for everything in medicine. They are a start, but they aren't the whole story. What is normal for me is probably not normal for you, and that is why annual physicals are so important, because they help establish a baseline for what is "normal" for you, and spot sudden changes.

I've had regular physicals all my life, but changed doctors when I moved and rarely had my medical records fowarded. Why should I--I had your average, run-of-the-mill stuff: Asthma, allergies...the usual. I figued annual physcials were cross-sectional research, and didn't think much about the whole, "baseline functioning" thing.

In my reading, I've found that there are some common symptoms of low thyroid function, regardless of cause...and I've been looking back to see if perhaps I should have been paying more attention. That isn't so much useful to me, but maybe it's useful for someone else out there.

Have you been feeling cold? Well, yes, but who thinks this is a symptom? You put on your robe and your slippers and crank up the thermostat. On the other hand, Baboo and my multisport friends can attest that I've ditched a lot of bike rides because it was too cold. How can you guys ride when it's so freakin' cold out there?

Have you had dry skin and/or hair? I live in the desert, where the average humidity index is about 15%. Everyone's skin is dry here. You buy moisturizer. You deal with it.

Are you having weight problems?
THAT is an interesting question. The answer is, yes and no. In fact my weight has stayed even for the past 9 years. It is documented at my doctor's office; on average, it's hovered between 160 and 170. I even blogged about it.

So let's lay this out: In nine years, my weight has stayed steady. I became a runner, and then a triathlete, then a marathoner, and then an Ironman, and my weight stayed steady. While my eating wasn't always what it should be, it didn't change until early 2005 when the weight had really started piling on. I starting tracking my calories and lowering them to an average of 1800-2000 a day. I lost the weight I'd gained the past year. Then, I took up running but never lost another ounce.
In 2008, I trained for my 2nd ironman: In a week, I biked 60-100 miles, ran 15-20 miles, and swam 2 or so miles, minimum. My weight dropped to about 158, a size 10, which puts me in the "normal" range for my height. In other words, for me to be "normal weight," I had to train for an ironman.
Last year, I ran 7 marathons and an Ironman and several other events, and basically, my weight stayed steady. When my activity level dropped a bit, for me, I gained weight, even though, while injured, I was still more active than the average American. Hmm. I was stunned and disappointed at how quickly I was aging, but worked on accepting it. There wasn't anyone to ask about it; all my female relatives is dead, save one older sister.

Have you felt tired or depressed? There is some debate about this particular symptom - that the tired feeling is really a form of depression. Depression is a sneaky little bastard. There have been times that I haven't written about when I felt like I was near tears even when, arguably, I have the best life a woman could have. I told Baboo, "I don't know what's wrong with me, but it has to be chemical. Everything in my life makes me happy."

As for energy, from my doctor's standpoint, I am an active woman, so my energy level must be okay, right? RIGHT?

But lets look at my baseline functioning. I have always been hyperactive. I was diagnosed with AD/HD, combined type. My mother reported that, as a child, I was up at sunrise and up until nearly midnight throughout most of my childhood. From my elementary teachers straight through to my old college boyfriend, they will all tell you that I am hyper as hell. Between 1990 and 2000, on 6 hours of sleep per night, I worked part-time (20-30 hours a week), raised three kids, and finished my education all the way through a master's degree. This past decade, I have worked full time as a high school teacher, raised two teenagers, finished another master's degree, and trained for an ironman. This is my normal baseline functioning. Normal for me.

But, in the last couple of years, though, I've started complaining to Baboo. I need more sleep. I can't face those teenagers without more sleep. Another part of growing old, I thought. You slow down, right? It's what you do. I figured it was just a woman thing.

My doctor said, You do a lot for a woman your age - I'm surprised you don't need more sleep. I accepted it, and set about trying to get more rest. My friends protested this form of thinking, You're too young to be going through menopause.

Even now, as tired as I "feel," I am working full time, beginning a new season of training, and working on another master's degree. I need 7 or 8 hours of sleep these days, which is NOT normal for me, and I don't feel like working out most of the time. Not normal for me.

Do you have low heartrate?
My resting heart rate is about 57, but I'm a marathoner. There's no way to know if I have a clinically low heart rate or not.

Have you had decreased libido?
I've complained to my doc about it every single year. First I thought it was some medication I used to take. Then I thought it was menopause. It's gotten low for me, but again, what's low for me is low for me, probably not low for most women.

Now, this isn't some dramatic, life threatening condition - it has serious consequences, if left untreated, but I'm curious, so curious about what medication means. It's a quick and easy fix: I take medication, once the proper medication is targeted, and I take it on time, as directed. Maybe levels have to be adjusted from time to time. Blood tests everyone once in a while, which I can do on my lunch hour at the hospital next to where I work.

So, what happens next?

Well, I have an appointment with an endocrinologist on the 31st. ANd I have so many questions. Did I do this to myself? If my current functioning is "normal" for most women my age, what will happen when I take meds? Will I go back to the way I used to be? I said to Baboo the other night, "I don't care about anything else except that maybe I'll have more energy and I can be faster. I can lose my own weight, I just need the energy to do it."

How sick is it that all I care about is getting faster? Oh, I'm a multisport addict. I am, I am, I am.

So, yeah. That thyroid thing. If you feel like you're having menopause symptoms, (other than just the usual hot flashes) and it's very different from what is "normal" for you, and it bothers you but your doctor insists that you're within "normal" reference range, push for the test anyway. It's a simple blood test. The worst that can happen is you wear a purple band-aid for 20 minutes. That's all I'm saying.

...

Irrelevant and unrelated stuff.

1. Window strikes. We have a big picture window in the back of the new house. It faces the foothills. It also reflects the sky, if you happen to be flying toward the house, as one unfortunate bird apparently was:

I allowed myself a laugh the first time because there wasn't a little feathered body lying on the patio; most were just a bit stunned and flew away. Then came the fateful day, a tiny lifeless body on the patio, and I hung wind chimes in front of the window. No more bird dust on the window, no more bodies, I keep my view.

2. Spoiled. I just can't come to this salon any more. It's too casual. It's a 45 minute drive to listen to people people yelling jokes to each other and screaming babies whose mommies weren't willing to put off their hair appointment until they could find a babysitter. The low point came when the owner, who was working on my hair, wanted to have the elderly and severely hyperopic shampoo lady do my color while my stylist did other things. (She's also the owner.) How do I know the shampoo lady is hyperopic? Because she did my pedicure once, and there was nail polish all over my toes. I hyperventilated, and she relented, but now begins the ardous journey of finding a new stylist. One who will devote their time to me fully. I have a bad feeling that devoted $tylist$ are more expen$ive than the other kind.

4. Girls Day Out. Last week, DP, SWTriGal, Cindy, and I went to Santa Fe for a girl's day out. It was close to my 44th birthday and I wanted to celebrate. We spent the morning at 10000 Waves, where we soaked in a hot tub in the snow in the mountains outside Santa Fe. Naked TriChicks in a hot tub! No, there are no naked tri-chick hot-tub pictures. Afterwards, I got my very first facial. I felt like I'd been dipped in valium. Now, of course, I'm thoroughly spoiled.

5. New shoes. I didn't buy these Borns last fall, and I've been thinking about them ever since. I couldn't get them off my mind. But that's not what makes them important.

What makes them important is that I'm wearing heels, with jeans, which I swore I would never do until I was a size 4. I'm not a size 4. I'm a size 12. And I'm wearing heels with jeans. Heel with Jeans. As long as I stay away from mirrors, I can teeter around feeling that I'm a size 4 and lanky.

6. I'm registered for Ironman St. George, 2010. Ulp. The interesting part will be getting iron-distance swims in during the winter.

...

Why did the chicken cross the road?

To get to the finish line.


The one in St. George, Utah.


Um....Yeah.