Ups and Downs

I was warned. Friends who have also had chronic fatigue told me that as I recovered there would be a general upwards path but I would have some downs on the way. That is exactly what has happened.

I competed in the OMM (Original Mountain Marathon – formally known as the KIMM) at the end of October, where I was dragged round the elite class by Neil Talbott. 13 hours of hard running through some of the UK toughest terrain, was tough and considering my lack of training I was very happy that we finished 5^th. I felt physically tired afterwards but the symptoms of my chronic fatigue did not reappear. Within a few days I was back running again. Throughout November I started to feel better and better. I was running longer distances and did about 8 hour training a week for 3 weeks. I did some orienteering events and although my navigation was rubbish my running speed was gradually improving. My mind was also finally clear, I could sit at my desk at 9am ready for work. I was really productive and able to multi-task for the first time in 18 months. Basically at the end of November I felt completely back to normal.

Then it hit me again. The ‘brain fog’ reappeared. I am not sure what the trigger was.  I had done a couple of long, hard runs during the week before (I was enjoying the beautiful snowy weather).  I also had a stressful event a couple of days before where I got quite annoyed. Then I competed in an orienteering event, followed by going round a shorter course with one of my children and collecting controls in quickly (all without any food). I thought the ‘brain fog’ would last only a few days but a month later I still do not feel right (this is despite only a very small amount of alcohol over the Christmas period). I am struggling to concentrate and after running for about 40 minutes I start to feel light headed. But the great thing about doing a blog is I can look back and see how much I have progressed over the last 12 months. What 2017 will bring with regards to my fatigue is impossible to say but if I can go out running or walking regularly in the fells then I will be happy. 

I hope anyone who reads this has a great 2017. 

Picking up Litter

Here is a link to an article I have written for Berghaus about how I have started collecting litter when out for a walk or a run. It is a real shame that I and others need to.

http://community.berghaus.com/knowledge-advice/hands-up-and-say-i-have-occasionally-dropped-little-bits-steves-confession/

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 9^th 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.

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/

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.

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.