It was Thursday evening, November 15th. I was tired. REALLY tired. As in, I can’t get myself off the couch or even read a book tired. Again. M had been gone for nearly three weeks, at training for a new airplane. And despite having the best week of training since at least April the week prior, I hadn’t ran a step in a five days and counting. But I wasn’t frustrated, mad, or disappointed. Of course I was tired.

It’s been three years since the flare of Hashimoto’s thyroiditis really ramped up and laid me flat for the first time. Four years since it started percolating in the background. During that time, it’s only been in the last 17 months that I’ve fully committed to regaining health and wellbeing. The first few years consisted of a heavy dose of denial with a side of stubbornness and a shot of insolence. Because I lived with Hashi’s for so long without any of the “normal” complications (I was initially diagnosed in 2000 at the age of 25), I assumed I was different, special even. I trained harder and at a higher volume than medical professionals said I could, I didn’t follow a paleo diet or the more restrictive Autoimmune Protocol. In fact, I was vegetarian for nearly fifteen years, which flew in the face of known best practice (in my defense, none of this I knew for the first ten years). I held stressful a job, and trained hard even while giving plenty of attention to my career. It wasn’t unusual for me to get up at 4-4:30am and run 10-12 miles before work. I didn’t consider the pace I kept to be remarkable or unusual, most of my runner-friends did the same, many raising a family on top of it. M and I traveled, going on vacations where we hiked or skied the days away. I thoroughly enjoyed my life and how I spent my time.

When I first started to get sick, I didn’t realize what was happening. I thought if I just waited it out, it would resolve itself on its own. Initially, signs of the flare only showed up in training. My exercise tolerance was down, my weight started to creep up despite few changes to diet or training volume. I thought I was just getting “old” as this was about the time I turned 40. And recognizing that I’ve been running since I was 11, I expected my performances to plateau sooner than some of my friends who didn’t begin training until later in life. I could explain it all away. My job was stressful, but I didn’t consider this to be the source of the problem, even though intellectually  I knew the dangers of chronic stress. After six months, I went to see a Naturopath in Fort Collins who worked with athletes. My local endocrinologist was terrible and I knew she’d be no help. He uncovered some nutritional deficiencies and saw some warning signs in regards to the Hashi’s, but being a Naturopath couldn’t do anything about it. Looking back, this is the moment, in late 2014, when I should have found a functional medicine MD. I don’t know how much of what followed could have been prevented, but with the right medical care I’m guessing a fair amount of it. I worked with a dietitian to address the nutritional deficiencies, which included adding meat back into my diet (something I still haven’t fully reconciled, four years later), and talked to my endocrinologist back home in Illinois about the Hashi’s. He didn’t see anything that concerned him, he assured me I was fine. I trusted him.

Throughout 2015, things got much worse. I’d run my last marathon in April of that year, which coincidentally was also my last Boston. I ran well through the summer, but my dad getting diagnosed that August coupled with an even more stressful new job seemed to be my undoing. By October of that year, my weight was as high as it’d ever been and I was barely running. My endocrinologist continued to insist I was fine – the 20-25 lb weight gain was not a red flag to him, neither was my nearly complete intolerance to exercise. Late 2015 is when I finally found a few doc. I’d researched Hashi’s extensively by now, and knew what I needed. Using the website for the Institute of Functional Medicine, I found Dr. Sarah Zielsdorf. I saw her for the first time in January 2016. We talked about chronic stress and diet, but I still underestimated the work I needed to do to get well. I didn’t make meaningful change to my diet, still riding the wave of cockiness born from 15 years of doing what I wanted while living with this condition. I worked part-time from Oct. 2015-Oct 2016 – this was my “sacrifice” – and in seeing some recovery, assumed I was out of the woods. My weight was still high, my training still a third of what it used to be. Turns out, I was still standing in the middle of the forest, not remotely close to finding my way out. I took a full-time job at the local health department in Nov. 2016 that kicked off the final march to rock bottom.

In the eight months I worked at the health department, I came down with five colds, had the stomach flu for the first time in over a decade, had more asthma flares than the entirety of my previous 41 years on the planet, and gained an additional five pounds, just for good measure. My training came to a complete halt that spring. I’d applied to Wilder a week into my new job, while still riding the wave of progress I made in 2016. I learned I’d been accepted before Christmas that year, and by the time I arrived at Caldera in late May 2017, I was a sick as I’d ever been. While I would give about anything to go back and attend that retreat healthy and fit, meeting those women for that weekend in the woods at precisely the moment I did gave me the courage to make the radical sacrifices needed to get well. In them, I could see how sick I was. How I could barely complete the workouts, how much I missed being able to use my body in sport. I’d go home from the retreat and give notice at my job, committing to myself to take as much time as needed to get well.

It would take another year and the onset of some fairly disruptive digestive issues for me to finally tackle my diet, but in doing so, I’ve found what I believe the last piece of the puzzle. I’m still frustrated with myself, that it took this long for me to finally address my diet, but stubbornness is a hard drug to quit. My weight fluctuated over the last year, consistently hovering 15-25 lbs above my former training weight, with another high point coming this past September. Since I’ve been addressing nutrition, I’ve lost about 10 lbs and started training again. By early November progress was coming quick, quicker than it has in some time, before fatigue forced some time off mid-month.

Addressing the digestive issues brought forth an unexpected benefit, a full reconciling of how life has changed with this flare. Somehow in recognizing that my body won’t tolerate certain foods as it has in the past, it allowed me to make peace with other things that were altered by this flare. I acknowledge that my body will likely never tolerate the stress levels it did before, which dramatically shifted how I think about my career, and role it plays in my life. In October, I took a part-time job as the education coordinator at the local arts center, working with a friend I made through rotary when we lived here the first time. The flexible schedule and reduced hours (~20 hrs/week compared to 40+) fit perfectly with where I’m at right now, as does my lack of responsibility when compared to my previous work. I’m still considering going back to school, having been accepted to an online Masters program that starts in January. Working part-time and with less stress leaves physical and mental energy for me to devote to other areas of my life such as training and traveling. During the flare, work got most of my focus. It was a choice I made, but not consciously. It took taking a break from my career to really sort through how I wanted to divvy up my much smaller pie. We’re going to Breckenridge in January, and I expect to have the energy to ski for the first time in a few years.

Lastly, I acknowledge that getting over-tired is part of my life now. I can’t just power through being over-scheduled as I did pre-flare. I can’t train through fatigue as I did pre-flare. De-programming YEARS of “just endure and persevere” mentality, which running and training only reinforced, has been very, very hard. But I’ve done it. Which is how I found myself couch-bound last week, without much disappointment or animosity. Of course I was tired. We traveled to see three concerts in October. M was gone for three weeks in a row, highly unusual for him outside of deployments, leaving me to get up with our early-rising pup while I was already short on sleep. I started a new job. Lots of good stuff, but lots of good stuff that made me tired. So I took a week off of running. A week off, immediately following the week where I had a breakthrough with training. A recognition that it would be a big set back, as I don’t have enough training under my belt to just jump back in after a week away. But by eating a nutritious, anti-inflammatory diet, and resting as much as I could, I knew that I was doing what I needed to do to ensure the fatigue resolved itself as quickly as it could. And that I’d be ready to resume training when it passed.

I still don’t know what all of this means for racing, if I’ll ever be able to train for and race marathons again. I don’t know if I’ll be able to work full-time in the future, at a job with a nice office and fancy title again. I don’t know if I care. My pie might have permanently shrunk itself during all of this. If it did, I can live with that. I have a lot of pride for what I accomplished professionally and through running while I was healthy. I never thought I’d be fast enough to run Boston five years in a row, or that I’d be a dean. But those accomplishments don’t carry as much weight as they used to. They didn’t make me a better person, or more valuable to society. I’m certain I over-valued them at the time. I appreciate the perspective I’ve gained while being sick, the clarity it fostered. The recalibration of priorities. I’ve been forced to make hard choices about how I spend my time, as doing it all is literally not an option anymore. I’m young enough that I hopefully still have quite a bit of time on this earth. It’s safe to say that the next 20 years will look radically different than the previous 20. And while I wouldn’t have chosen any of this, and I occasionally do get very angry about it all, I’m curious and invigorated by this knowing.

“Illness is the night side of life, a more onerous citizenship. Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick. Although we all prefer to use the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place.” ~ Susan Sontag