Give Me A Break!

Handing my blog over to Kel again for the next chapter in her story, take it away Kel...

Give Me A Break! by Kellie Gibson

This is a follow up of the blog I wrote back in April ("Finding Me Again").  I had envisaged by now I would be writing about how I had sorted all of my health issues, was feeling great with an abundance of energy and was enjoying my running again.  Unfortunately the road has been pretty rocky and although I have experienced some valuable steps forward in my journey, I have taken some backwards as well. The positive in all of this is that I am learning so much in the process.

Not long after I wrote the last blog I started seeing a Naturopath, I wrote out a long timeline for her listing all of the symptoms and events dating back to November 2013 when the wheels slowly started to fall off.  Seeing it all written out was a massive reality for me and reinforced how hard it had all hit me. Starting with a DNF in my first Ultra, a sudden break out of cystic acne for the first time in my life at the age of 31 and a host of injuries including foot, ankle and ITB that left me sidelined on and off for over 6 months. The alarm bells now scream to me that these were major signs of hormone imbalance, a topic which is largely unspoken about in the running world (however I found it quite assuring that so many people had contacted me after my last blog that were able to relate to the issue of hormone imbalance). 

As I spoke about in my last blog I had taken antibiotics long term that my Dr had prescribed for the acne (Minocycline and Doxycycline) as well as an Oral Contraceptive Pill (OCP)(Zoely). My performance was really up and down through this period but with the addition of a coach I felt I would build up to running well again which I did for a little while but then around the same time my antibiotic was changed to Doxycycline in November last year my health took a massive turn. Even after taking myself off Doxycycline due to the awful side effects after a month I saw a bit of improvement but not much.

Fatigue started to set in more and more in early 2015, my legs would constantly ache even with a week of rest and cutting my running in half. I was constantly having to ask my coach for extra days off, for extra easy runs to the point where all I could manage was slow easy runs, I could no longer follow a program. My easy pace continued to get slower and slower and my training heart rate was always really high and would often be really erratic shooting up and down. During this same time though my resting heart rate was quite low which to me was a good sign I was fit.  I had well meaning people telling me not to wear my HR monitor because it was probably messing with my head too much and that it may be a good thing just to not worry about it.  My intuition told me otherwise, this had to be a sign that something was wrong particularly as it came with feelings of extreme heavy legs while running, the only way I could describe it was as though someone had filled my legs full of sand or lead, lifting my leg each step I took was a huge effort and my body did not feel like my own. In addition to this I always crashed hard after each run even at easy pace but then again easy pace was just not easy pace anymore, it was hard to even run at that pace! I ended up postponing my coaching until I could sort out what was going on. I think intuition is such an important thing as a runner, no one truly knows your body like you know your own and I felt like no matter how I described it no one got it.  I guess the most frustrating part was that so many tests kept coming back clear and in the normal ranges so I had no answers and just kept battling on hoping it would all pass.

After I received some test results in early April it was revealed that my testosterone level was reduced by 75% from a previous test I had, the issue of hormone imbalance was now becoming very clear.  My Dr assured me that while it was alarming, it was quite normal for testosterone to lower while on the OCP.  This did not sit right with me nor did the fact that I had been told that it was ok that my monthly cycle had been missing for the last 8 months while on this OCP and that it was also normal for women taking that pill, so I took myself off it.  Unbelievably my cycle returned within 3 days after I stopped taking it and it has been regular every month since. I had never had problems with my cycle until I was prescribed Zoely even in the earlier days when I was able to train at a much higher load it was always normal.

The major catalyst for me was finding the e-book “Healing The Grumpy Athlete” by Katee Pedicini.  I was on Facebook one day and it came up in my newsfeed as a suggested post.  I clicked on it immediately as the following words resonated with me:   “If you’ve ever; • Experienced burn out • Suffered adrenal or chronic fatigue • Hormonal imbalance or loss of menstural cycle • Suffer terrible PMS that interferes with your training and life • Lost of love of triathlon due to lack of progress or performance. Even though it was Triathlon focused I knew there would be some valuable information in there for me and there was!

I had toyed with the idea of seeing a Naturopath for some time now but this book really inspired me to do so. Even though progress has been slow I am so glad I did. I felt so positive after my first visit to my Naturopath Jolene, we sat down and looked at the timeline that I had written out and her first response was that she believed that the acne had been a sign of hormone imbalance and that the medication I had been put on had masked those symptoms rather than addressed them and had caused a whole other set of issues for me as well.

It seemed that the antibiotics had caused a range of gut issues.  First of all long term antibiotic use disrupts the balance of good and bad bacteria in the gut and the ‘bad guys’ take over.  In addition to this a gut which has become inflamed becomes very porous and as a result will allow large food proteins, bacteria, metals and toxic substances straight into our blood stream that should not be there rather than allowing them to pass through the digestive tract as they normally would causing widespread inflammation throughout the body. This is the basis of "Leaky Gut Syndrome" and the OCP as well as other medications can also contribute to this.

So I started a program which consisted of basically killing off the bacteria in my gut. And then after my second visit I started the process of rebuilding the good bacteria in my gut and healing the lining of the gut. There is a lot of information out there now about what a massive role out gut health plays in our overall health.  I was also given herbs for adrenal support as my adrenal glands were suffering as a result of the stress placed on my body with everything that was going on with my health.  The problem with stress is that the body doesn’t differentiate different forms of stress so whether it be that you are stressed because you are being chased by a tiger or whether it is digestive stress or any other kind of stress you body reacts in exactly the same manner. To our body, stress is stress and it deals with all of it in exactly the same way. Adrenaline and cortisol are stress hormones released by our adrenal glands and when cortisol is high for a long period of time it can cause our adrenals to become fatigued and our stress hormones do not work like they should resulting in unrelenting fatigue and imbalance of other hormones. Six weeks into my program I was starting to feel fantastic in addressing these issues, I was still struggling with my running performance but I knew that if I kept moving forward it would all start improving and that I just needed to be patient. Part of having leaky gut means that your body also has trouble assimilating nutrients from foods and once I was able to absorb my nutrients more effectively Jolene was sure that my performance would start to pick up.

During a family holiday in July my digestion took a really bad turn, even though I was so conscious about continuing to eat good quality and healing foods while I was away. I was becoming severely bloated throughout the day, not only was it embarrassing but by the end of the day none of the pants I had taken would do up and it was very painful and uncomfortable.  My energy also took another nosedive around that time. I did very little running while I was away and focused on family time and more gentle activity with my boys as I felt I needed some recovery time. When I came back I saw my Naturopath who thought my symptoms sounded very much like SIBO which is when bacteria moves down the digestive tract into the small intestine that causes bloating, this is often secondary to Leaky Gut, can be very hard to treat and can take some time.

After chatting to colleagues about my case Jolene asked me if I had heard of Overtraining Syndrome. This was a term that had recently come up a fair bit in the running networks I was associated with. I could certainly relate to some of the symptoms, but I could never get my head around it as a diagnosis as I really did not feel that the training I had been doing was enough to warrant Overtraining Syndrome.  When we chatted about it Jolene pointed out that the name was probably a little misleading in my case, however with the medication I was taking it had put my body into a very compromised state where trying to keep up my normal training load whilst being so compromised had placed a great deal of stress on my body.  Add to that being a busy mum, running my own business and having very little down time and it could certainly be an answer. I was also told that based on my level of antibiotic use and my set of symptoms that my gut issues would take at least a year to heal.

Taking this into account I decided to keep running to a minimum I have only been running once or twice a week, some weeks I haven’t ran at all because I haven’t felt up to it. One big positive for me has been starting Body Balance classes at Cityfit, my friend Shan dragged me along to one, I was quite resistant in the beginning but I loved it! I have been doing 3 classes a week for the last few months and I am noticing some improvements the more I do. I really enjoy the classes and I feel that they are going to help me get some strength back as I am feeling quite weak at the moment which is most likely due to hormone imbalance.  Its amazing what role hormones play in our bodies, a role which I never appreciated until things started to go wrong. I had no idea I even had hormones when they were working their magic and were in harmony but since they became unbalanced they have really affected my wellbeing.

The last 4 months have been tough, I have spent most days gradually getting more and more bloated and uncomfortable as the day goes on whilst dealing with my digestive issues, I have developed many food intolerances, my blood pressure has been high (150/100 just last month but thankfully normal again for now), running is still hard and my legs still feel like they are full of lead despite cutting it right back and if I push it too hard when I run I break out in hives, unexplained aches and pain, my hair is falling out and has been for over 6 months and fighting the fatigue is still a daily ritual. The hardest part is that it is hard to escape the symptoms it is always there, feeling tired and crappy and being in pain, its really hard to remove myself from it most days and it is hard for others to understand. After going from being someone who was very fit and healthy to this has hit me so hard, it has been 2 years in November since things started to go pear shaped but it feels like eternity. I have been gaining weight even though I have been eating really well and being as active as I can given my situation, it is frustrating as I have been around the same weight for about 10 years now even after having 2 kids, all the things I am used to doing to maintain my weight are not working but I just have to keep doing what I can to get my hormones back on track so my body can function effectively and so I fit back into my clothes (I really hope no one takes this the wrong way or takes any offence to it, it is just something that has happened that is unusual for me, I am still very much within a healthy weight range but have gained 7kg over the last 2 years and my body composition has changed as well, half of it crept on gradually while the other half has gone on much quicker, to put it in perspective that is just over 12% of my previous body weight gained with no real change in my diet, my weight in no way defines me but I have lots of beautiful clothes that I would love to wear again). With all of the above going on it can be really hard not to get caught up the whole cycle of stress. I am finding that my Body Balance classes really help with this, I always look forward to that 10 minutes of meditation/relaxation at the end!

I had an experience of going to a new Doctor a couple of months ago to see if I could have some of my hormone levels and thyroid retested to see where they were at after being off the OCP for 6 months… only to be told off by her and accused of only wanting testosterone tested so that she would prescribe me some! I couldn’t believe it… I basically ran out of there in tears! In the end I went back to my original Doctor as he knew my history, he ordered some of the tests but not others so there were pieces of the puzzle missing. It is hard living in a regional area as we do not have access to a lot of the functional testing I was after and many Doctors are not supportive of it and will not order the tests. My Doctor Requested a scan on my ovaries to rule out Polycystic Ovaries being the cause of my bloating, during the scan I was told by the Ultrasonographer that my ovaries were polycystic, I spent 3 whole days getting my head around this before the report that came back from the specialist revealed that I did not have polycystic ovaries. So much frustration and still no real answers! All of the tests my Doctor ordered all came back in the normal ranges too.  One interesting point was though that my iron and ferritin were in the Doctors normal ranges however when my Naturopath saw the figures she was concerned abut how low my iron and ferritin was for a female my age despite it being in the normal ranges (which are very broad figures) so we have begun the process of trying to boost this. I was a bit surprised about this as my previous values had always been high and so high that they were always just outside the normal range.

A couple of weeks ago I decided to still run the Hounslow 23km SkyRace that I had registered for a long time ago even though I had not really been able to train. I knew it was a tough course and that I would have to hike a lot of it anyway and I knew with everything had been going through I was mentally tough enough to get through it. I got through it and it was tough, I switched between running and walking for the first 8km and after that it became apparent that if I wanted to finish this then I would have to hike it as I didn’t have it in my legs to run. I even had to hike down stairs and on flats that were completely runnable, I just couldn’t run! I managed to finish in 5 hours which is a long day out for 23km.  The course was tough, very rugged with around 2000m elevation gain and loss.  As tough as it was I absolutely loved every minute of it as I love being out on the trails and these were among the most beautiful trails I have seen, I was just so happy to be there! I was really proud to finish this one… BUT I fell into a massive heap the day after, similar to the way I did in the days after I ran the Sky26er at the Buffalo Stampede earlier in the year but worse.  I was a mess more so emotionally than physically (although the physical signs were definitely there too). It left me questioning why am I doing this to myself? It’s a tough thing because I love it but it used to be so much easier!  Someone said to me a couple of days after this race, “good on you, you must be so strong to be able to do that considering what you have been through”. Even though it was intended as a compliment it really got me thinking… Yeah it took a lot of strength both physically and mentally, BUT is strong really a positive thing when it comes to this? Is it worth it to fall into a complete emotional heap for a week all because I chose to do a race that was well beyond my means for where I am at with my health?... NO its not! However, it IS ok not to be strong, it IS ok to miss out on something you love if it is at the sacrifice of your wellbeing. It has come with a massive realisation to me that this kind of thing is placing further stress on my body at the moment as I am trying to heal and it is working against everything I am working so hard for with my health.

Almost there... nearing the end of the big climb to finish the Hounslow Classic 23km SkyRace

The last 2 weeks have bought about some massive revelations for me. Some of my reading has led me to a book by Dr Philip Maffetone called “The Big Book of Endurance Training and Racing” a book which myself and Wes have taken a bit of interest in of late.  Chapter 8 has changed a lot for me just in this last week.  The Chapter titled “Overtraining Syndrome” caught my attention particularly after my Naturopath Jolene’s thoughts.  The points in this chapter that really stood out the most for me and that I could relate to are:

• Training = Work + Rest
• The condition can vary considerably from one athlete to another including its signs, symptoms and onset.
• The big picture is not just the more obvious components.
• The negative consequences are often gradual. The body is quite good at masking the earliest symptoms.
• Early signs can be poor athletic performance, regression, structural injuries particularly foot, ankle and lower back, muscle imbalance, metabolic problems such at fatigue.
• The signs and symptoms go beyond training and competition problems, they can even affect a person’s quality of life, sometimes for many years.
• In the earliest stage the problems are somewhat vague and indistinct. While we think of it as being only sports related, other lifestyle factors may contribute to the cause. Increased work, family or job stress, social obligations, raising children, lack of sleep and other factors can significantly and indirectly contribute to overtraining.
• Pain whether mild or severe may have no positive findings on X-Ray or MRI. Significant fatigue or diminishing performance may exist despite normal values in all blood, urine and other tests. This contributes to serious frustration in the athlete who goes from one health care professional to another looking for a diagnosis
• Interestingly the first stage of overtraining can be accompanied by a short-lived improvement in performance which may convince one that training is progressing well.
• Overreaching is an important part of becoming a better athlete but without backing off, many athletes continue pushing down the road to overtraining.
• Heart Rate Variability reflects autonomic imbalance.
• The first stage of overtraining is usually accompanied by two other functional problems. The first is adrenal dysfunction and aerobic deficiency. Fatigue, physical injury, sleeping irregularities, abnormal hunger or cravings. Some athletes may be unable to lose body fat, get sleepy after meals and have an uncanny craving for caffeine.
• Amenorrhea in women
• Emotional stress
• High cortisol can increase insulin levels which reduce fat burning and increase fat storage. In addition high cortisol lowers testosterone and DHEA which are both important for muscle recovery. Those who frequently wake in the middle of the night and don’t easily fall back to sleep typically have high cortisol levels which is another sign of overtraining.
• Eventually the body becomes exhausted and many hormones are significantly reduced.
• Performance may diminish considerably and many athletes in this state consider themselves sidelined or even retire. They are chronically fatigued and cannot keep up their normal training or race paces.
• Training heart rate is high even though there is an abnormally low resting heart rate.
• Recovery and return to previous optimal levels of performance is a very difficult task.
• Important elements of recovery are to decrease training, immediately cease all anaerobic training and competition. A helpful remedy is walking which can gently stimulate circulation and aerobic muscles and offers mental benefits much like those of meditation as well as redeveloping the aerobic system.
• Athletes will require six months or more and sometimes a year or two before resuming effective competition. 

I was shocked to read this and to be able to relate so strongly to so many symptoms. There is no specific test for Overtraining Syndrome as such but with the amount of light bulb moments I had upon reading this chapter one thing is for sure, whether it is specifically this or not, its time for a big rest! Even though I have already cut back so much my body needs a complete break. I have decided to take the next 3 months off running completely, and more if I feel I need it after that point, with a very gradual return when the time is right. It was a very tough choice to have to make but what I believe is a smart one. In this time I plan to go for walks with my dog Reuben (this will keep him very happy!), continue to do my Body Balance classes and some strength work, exercise is still really important to my recovery and I want to be as strong as possible when I am able to return, but I need to drop the intensity and keep my heart rate down. If I am to be completely true to myself, I know this is what I need. The biggest thing I will probably miss is my Saturday morning run with my friend Shan, who has been an awesome support to me while things have been tough, but being the good friend she is I know she will be waiting for me when I am ready to return.

As much as I love running there is so much more to my life than just running.  First and foremost I am a mum and if I am constantly fatigued and not operating at an optimal level then I can’t possibly keep up with the demands of being the mum that I want to be to my two beautiful boys. I have my own business that I am currently finding it hard to keep up with (in reality I am living the dream here, I work from home with hours that suit me around my families commitments as well as my own and I am doing a job that allows me to be creative and that I love).  I have so many positive things in my life and I need to get back to optimal health so I can enjoy these things more. I want running to be a part of my life and there was a time when I enjoyed it and found it to be an outlet, I saw it as time out… the trouble is our body sees running as a stress and with adequate rest and recovery responds positively but without adequate recovery and additional stress our body never truly gets the chance to recover. I will know when its time to get back into it and I look forward to waking up with energy again, to be able to one day run freely again, to be enjoying it again and to be able have that awesome feeling you get when you get a PB again.

What have I learned from all of this? Listen to your body, symptoms are your body’s way of trying to tell you something, we know our own body better than anyone.  If you don’t get the answers and your intuition tells you otherwise then you need to keep digging! Medication was not the answer for me, it was a band-aid solution and it might have masked the symptoms and appeared to make them go away… but when I ripped the band-aid off the problem was still there, and then some… a tough lesson to learn! But in saying this I have learned that I am ultimately responsible for my health and I do not have to take medication just because my Dr prescribes it, most medications don’t come with warning labels unfortunately and it is up to me to do the research before I put anything into my body. I often wonder what effects medications have on runners and athletes, there is no information out there but I would be very interested to know how it directly affects those with higher volumes of training compared to the average person, I feel in my situation that it did have a huge impact. I hope someone does a study on this one day, I can tell you one thing though… I won’t be putting that horrible stuff back into my body to participate in such a study! Another lesson learned is that in running, recovery is key! I need to give recovery the respect it deserves after running and particularly racing, I always thought I did but now I know I can do so much more… as Maffetone says Training = Work + Rest. Overtraining Syndrome is not as clear cut as the name suggests, I like to look at it as Overcommitment Syndrome as I feel many factors outside training can also have an impact on the whole picture. Our limits vary so much from person to person, one person may be able to do twice as much as another before falling into this trap, I need to know MY limit. The most important thing I have learned is that while running is fun, it is not the be all and end all, my family and my health will always come first. I am super lucky to have an amazing husband who supports me through all of this, he sees the lowest of the lows, he sees so much more than the brave face I have put on for everyone else when its really all been just too overwhelming. The reality is that even with a positive outlook, when things go on for a long time sometimes negativity creeps in, I am making a promise to myself to stay positive and to trust the process. We can’t all be superhuman all of the time and I am OK with that, I don’t really want to be… I just want to be healthy and able to live life and enjoy the people and things I love.