Saturday, August 4, 2007

Are you a Doctor?

Two weeks ago I was out on my long Sunday run, planning on running 15-18 miles I started getting some pain in my lower abdomen. So thinking this was a side stitch or something minor I managed to deal with the pain until about mile 13. For the next four days the pain became something that could be best described as mild cramping or tightness in my lower mostly right abdomen. I went through the next few days trying to think of all the typical possibilities one might have like a virus, constipation, heart burn, etc. Over the next 4 days the problem at times got worse. As far as working out that became very difficult, I was very tired and my Heart rate was 15-20 beats higher than it should be. The following day I went to the Doctor, my doc was out on vacation so I saw someone else. He was at a loss and said you might have caught a simple virus or something and I suspect it will clear within a week. So I decide not to do anything but rest. Saturday, after resting for two days, I went out to ride with my normal group and things were even worse, I struggled all day and decided to cut it short at about 55 miles. When I got home I felt like I had been hit by a truck or something. Sunday I got on the computer and started researching all my symptoms again. What I found out was there are about a million things that could be wrong. At this point I was getting emailed from some of my training partners asking... What is the problem? Alisha lions having difficulty with determining a food allergy problem encouraged me to educate myself on everything I could via the Internet and to try and determine the problem by not only talking to the Doctor but cutting out things in my diet that may cause issues. Bottom line collect as much information as you can and try to eliminate as many things as you can. Abdominal pain is one of the toughest things for Doctors to diagnose. Alisha said ... You have to stay on these Doctors and don't let them tell you nothing is wrong. At this point I was down to roughly 4 weeks before my next Ironman race. I was supposed to be hitting everything hard one last time before starting my taper. I was getting very depressed thinking my race may be over unless I can figure this thing out quick. A few more days go by and no improvement, in fact it got worse. I call my regular Doctor and we talk about my blood work etc. nothing there to say anything is wrong either. He gives similar advice... to just rest a couple more days but to call mid week if the problem persist. The next day another good friend tells me not to worry, Nas explained, you already have your fitness, just figure this stomach thing out and you will have 3 weeks left which is a lifetime to do your final prep. She had experienced a similar "life hurdle" last year after being hit by a truck only two months before Lake Placid IM. This helped me regain perspective and I hit the research again. Determined to figure this out, I made another appointment with the Doctor. I wanted to provide him as much info as possible this time around. I decided the best way for me to do this was to force myself to go run. This may sound sort of crazy but when I run I am very in tune with my body and can feel anything that is not right. I can gain just a pound or two and I know it, any little problem I can instantly determine where it is and generally correct it. I pushed myself to run 4 miles at an 8 minute pace, normally that would be a walk in the park. I was spent at the end with my heart rate anaerobic like I was sprinting. I determined exactly where the pain was in my abdomen and proceeded to the doctor that afternoon. Luckily my Doctor is a pretty smart guy and actually "listens" to his patients. He asked me to explain everything from the very beginning, I did and added all the research I had done as well as all the things I had already tried; focusing on the abdomen pain and my elevated heart rate. I told him I thought I had some sort of GI infection. He ask a few more questions, did some examinations to make sure he knew exactly where the pain came from and then diagnosed me with diverticulosis. (Infection in the large intestine) Many people have small pouches in their colons that bulge outward through weak spots, like an inner tube that pokes through weak places in a tire. Each pouch is called a diverticulum. Pouches (plural) are called diverticula. The condition of having diverticula is called diverticulosis. About 10 percent of Americans over the age of 40 have diverticulosis. The condition becomes more common as people age. About half of all people over the age of 60 have diverticulosis. Sometimes these pockets get infected and if not treated can become quite serious. Lucky for me, I caught it early on. My doctor prescribed some antibiotics (Avelox) on Thursday and said I should feel much better on Saturday. He gave me strict instructions to call him on Saturday if I was not getting better. Friday came and I felt twice as bad , so I looked up and found the antibiotics I was taking and found it "can" have some nasty little side effects for some people but nothing too serious, so this was probably the extra bad feeling I was getting now. Saturday came and almost like magic I started feeling much better. Not great, but much better than before. I knew (hoped) at this point the antibiotics were working and the diagnosis was probably correct. I decided it best not to do anything strenuous and just rested all day. I wanted to make sure I got this thing nailed early on without any relapse. Sunday came and I felt even better, so I went out for an easy 25 mile bike ride. All went pretty well, but I felt real weak, like I had been sick :-0. At this point I have 3 weeks before Ironman Louisvlle and my plan is to slowly build my volume and effort through this week hopefully ending the week on Sat/Sun with normal workouts where I feel strong again. Provided that goes well I will then figure out some sort of 2 week taper. I was off sick with no exercise for approx 11 days. Wow did that suck, just another one of those "life hurdles" that you have no control over. I am back training now and started feeling much better, not nearly 100% but hopefully by the end of the week I will be back at 100%. One last thing I noticed when I started feeling better. It was a big change and I only realized then, just how tired and bad I was really feeling. I guess we get used to a certain amount of pain and tired feelings due to our training and thus our thoughts about what is "normal" is much different than non athletes. The next time the Doctor ask me if I am tired, I think I am just going to say YES, because I probably am, but just do not really know I am. Weird!

Lessons learned:

Have a good doctor (I do!) One that listens to you. Research your symptoms on your own via the internet when something like this comes up. As a triathlete you know much more about your body than your doctor does. If you think something is VERY wrong (like I did) it most likely is. Looking back on it, I knew almost instinctively that something was different and wrong. If he is a good Doctor, he will gladly embrace you doing this and recognize your efforts. My doctor said... "Jerry if all my patients did their homework like you did, my job would be pretty easy." Be persistent, but respectful, Doctors are smart and know a lot, but don't be scared to question EVERYTHING they recommend to you. Make them educate you on the diagnoses and how they arrived at this conclusion as well as all the possible options you have for treatment. Again, if they are any good at all, they will appreciate this feedback and the desire for education. Too many Doctors these days are in too much of a hurry and treat people like a number. If you find your doctor doing this, find a new Doctor ASAP, BEFORE you have a problem.

Thanks Alisha and Nas for keeping me focused and headed in the right direction.