It was late June. The last few weeks had been total hell, but as I looked in the mirror, I liked what I saw. My waist was slimmer than it’d been in months, and I felt confident running in just a shorts and sports bra, even though I’d been running that way since May when the weather turned warm. I decided, at the ripe old age of 43, to dress for the weather while training, regardless of how I felt about my body, and this still felt like a radical act even as the pounds that I lost made me more comfortable with how things looked. Never mind that the six to seven pounds disappeared while not eating for five days as I endured some sort of gastric distress related to a flare earlier in the month. My waist was trim and I liked it. 

As the summer wore on and after effects of the acute flare I endured in early June became more apparent, I struggled to maintain the little amount of running I’d been doing. My heat tolerance, which was terrible under the best of circumstances (thank you heat injury in high school softball), was noticeably worse. My mental focus was not much better. My head, which was typically full of hundreds of different thoughts all racing at differing speeds and in different directions, a familiar kind of organized chaos like the airplanes coming and going at O’Hare airport, was suddenly like an LA expressway during rush hour. Lots of thoughts sitting still, baking in the heat. But those that were getting through seemed like they were from someone else’s brain. Can I just say how weird it is to have thoughts you don’t recognize as your own? And I was tired. Oh so tired. Whatever was happening felt familiar, similar to the other flares I’ve endured over the last few years, but in a lot of ways different. It would be the end of July before I’d get to see my doc, as coincidence would have it she abruptly left her old practice and opened a new one the same week as my flare. Because of course. 

When my doc and I finally connected and debriefed about what happened in early June, she saw some lasting effects in my blood work and put the kibosh on what little running I was doing. Just a few weeks out from my family’s annual trip to Cape San Blas, this was particularly devastating, as I’d had “run at the beach” as a goal for the previous 9-10 months. I wasn’t able to run there the year prior due to some persistent and stubborn gut issues, but having done a ton of work on my diet and healing my body, I held running at the beach this year as one of the clearest signs that the past was the past. Not being able to run there again this year, in what happened to be our first year there without my dad, was brutal. With my head still stuck in a foreign fog, I struggled with how I was going to climb out of yet another hole, recover from yet another setback. It seemed pretty fucking hopeless. 

But then I remembered that I didn’t have to do this alone. I messaged with Claire, the dietitian who’s program I’ve participated in since late last September, and brainstormed how best to move forward. I struggled to “get back to” (my god I hate that phrase) the more restrictive diet I followed through the winter and wondered if there was another way forward. We discussed my connecting with the other members of her team – Isabel also a dietitian and Sophie a mental health coach, to see what insight they might have. I recognized this to be a great idea, as if there was ever an all-hands-on-deck situation, this was it. Around this same time, I decide to resume running. Running didn’t have anything to do with the acute flare in June, nor was it making things worse. I’ve been running long enough that I’m comfortable looking after myself and considering that running is how I sort all of the shit in my head, I likely was better off running than not running at this point, even if I did end up paying a bit of a price physically.  

By now it’s late August, and I first connected with Sophie, who made some incredibly astute observations on our phone call that didn’t even last an hour. We talked about what she perceived to be a disconnect between my mind and body, and how that might have contributed to what happened in June. The first half of this year was filled with SO MUCH loss between my dad and our dog Abby (we lost Abby rather unexpectedly in late May). I think I’ve always been a “just plow forward” kind of person and these losses amplified that. She offered some incredible suggestions on how to rebuild a connection with myself, with starting a mediation practice and reading Jon Kabat-Zinn’s Full Catastrophe Living to guide that practice being the most impactful. I’ve experimented with a regular meditation practice off-and-on over the last year or so, but she thought that resuming the practice with the guidance provided in the book would be transformational. And she was so right.

The following week, I talked with Isabel. I rehashed my journey over the last few years, and in particular the progress I made with my health since starting to work with Claire last fall. I shared my current frustration at the difficulty I’m experiencing when trying to resume the more restrictive diet that had been so helpful earlier in the year, and how when it really comes down to it, I hate all of the rules that this approach requires. Isabel encourages me to forget all of the labels (Whole30, AIP, low histamine, paleo, etc) and to ask myself what eating like Kim looks like. I don’t say it aloud, but in my head I think, well she’s most definitely eating sandwiches. We explored what feedback I can glean from my body (beyond body weight) about what foods are working for me and which ones aren’t. She encouraged me to get curious and to feel comfortable experimenting a bit. We talked about how rules can make things easier in some ways, but how many more possibilities lie outside of those rules. Rather than getting off of the call with a recommitment to my low-histamine, AIP diet as I expected, I am instead liberated from the notion of how I “should” eat as someone living with a chronic autoimmune condition, and with a charge to figure out what eating like Kim looks like. Task #1 – find some decent gluten-free bread for making sandwiches. 

Later that first week in September, the same week I talk with Isabel, Full Catastrophe Living arrives, all 600+ pages of it. Because of my work in cardiac rehabilitation early in my career, I’m familiar with the Mindfulness Based Stress Reduction program the book outlines. But while I was familiar with it, I really didn’t know any details. So I dove into the book with a healthy amount of curiosity while at the same time being very overwhelmed by the 600 pages. But then, in the very first section about certain perspectives that must be in place for a mindfulness practice to be fruitful, Kabat-Zinn spends about a page talking about acceptance, one of those needed perspectives. He writes:

“Acceptance means seeing things as they actually are in the present. If you have a headache, accept that you have a headache. If you are overweight, why not accept it as a description of your body at this time? Sooner or later we have to come to terms with things as they are and accept them, …often acceptance is reached only after we have gone through very emotion-filled periods of denial then anger. These stages are a natural progression in the process of coming to terms with what is. They are all part of the healing process. In fact, my working definition of healing is coming to terms with things as they are. (Emphasis by Kabat-Zinn)

…In the course of our daily lives, we often waste a lot of energy denying and resisting what is already fact. When we do that, we are basically trying to force situations to be the way we would like them to be, which only makes for more tension. This actually prevents positive change from occurring. We may be so busy denying and forcing and struggling that we have little energy left for healing and growing, and what little we have may be dissipated by our lack of awareness and intentionality. 

If you are overweight and feel bad about your body, it’s no good to wait until you are the weight you think you should be before you start liking your body and yourself. At a certain point, if you don’t want to remain stuck in a frustrating vicious cycle, you might realize that it’s all right to love yourself at the weight you are now because this is the only time you can love yourself. Remember, now is the only time you have for anything. (Emphasis mine.) You have to accept yourself as you are before you can really change. Your choosing to do so becomes an act of self-compassion and intelligence. 

Acceptance does not mean that you have to like everything or that you have to take a passive attitude toward everything and abandon your principles and values. It does not mean that you are satisfied with things as they are or that you are resigned to tolerating things as they “have to be”. It does not mean that you should stop trying to break free of your self-destructive habits or to give up your desire to change and grow, or that you should tolerate injustice, for instance, or avoid getting involved in changing the world around you because it is the way it is and therefore hopeless. It has nothing to do with passive resignation. Acceptance as we are speaking of it simply means that sooner or later, you have come around to a willingness to see things as they are. This attitude sets the stage for acting appropriately in your life, no matter what is happening. You are much more likely to know what to do and have the inner conviction to act when you have a clear picture of what is happening versus when your vision is clouded by your mind’s self-serving judgments and desires, or its fears and prejudices.”

I read that section no less than five times. And I all could think about was the difference between knowing something and accepting it. I wondered how much I knew about what happened the last few years versus whether I accepted it. By this time, I’d gained back those seven or so pounds I lost in June, with an extra two or three just for good measure. Which I had been very frustrated about. I was frustrated about the flare in June, frustrated about not being able to follow the right diet, frustrated about my body not looking like I wanted it to, frustrated about my brain being a hot mess most of the summer. But in reading that passage on acceptance, it occurred to me that I could choose to not worry about any of it. I could decide that my body is just fine right now, exactly as it is. I could realize that it is really fucked up to prefer the body of an acutely sick self versus a healthier one. I could decide that those food rules that work so well for so many others don’t work for me at all. I could decide that running makes me really, really happy and it helps more than it hurts. I remembered that for 15 years I lived with this autoimmune condition, breaking all of the rules the entire time because I didn’t know they existed. I just took my meds and trusted myself to make the right decisions. And that approach remains a choice I can make. 

So here I sit I early October. I had the best month of running this calendar year in September. October’s training is off to a great start. I’m getting faster, running more miles. I’ve eaten sandwiches nearly every day for lunch the past three weeks and could not be happier about it. I made granola for the first time in years. I made my favorite Bolognese sauce (from Run Fast Eat Slow, you all should try it) that tastes amazing with Banza pasta. I’ve continued to work through Full Catastrophe Living, even trying the impossibly long 45-minute body scan meditation a few times. I check in with myself several times a day to see what I’m feeling. My digestive system is a bit more disrupted than I’d like, telling me that I haven’t found the sweet-spot with my diet yet, but I will. The next blood draw later this fall will provide important feedback, but it’s not the only feedback.  

For as bleak as the summer was, the last six weeks have brought nothing but hope. Hope and joy. So much joy. Joy in a diet that isn’t full of someone else’s rules, joy at running in the midst of a cool fall morning. Joy in embracing my imperfect body, because it’s the only one I’ve got…perhaps I should be a bit gentler towards it? Joy at getting out of my own head long enough to reconnect with the important people in my life, most especially M. I can see now how the last several years have been nothing but a battle. Me battling against my body and with how someone with my condition is “supposed” to conduct herself. (She follows AIP for months, maybe even years, and certainly is not a runner. Running another marathon is not a consideration for her.) Reminding myself that I make the rules, that in reality there are no rules, and that I can trust myself to take care of me has made this rebel’s dark, moody heart so happy. I’m waving the white flag in this war with myself. Even with as tough as the last few years have been, the lessons learned and tools I’ve acquired, most especially these last few months, will help me be more prepared than ever to navigate what life has in store, including the uncertainty that comes with living with chronic disease. Especially a chronic disease like mine that can be heavily impacted by lifestyle choices. I can opt out of the shame and guilt for not doing it the “right” way and just live life, trusting myself to course correct as needed. The difference between knowing and acceptance is living life according to someone else’s rules versus living life guided by my own.

It was early last year (2018). I don’t remember the date exactly, and can’t find it on my calendar, which is really annoying for some reason. It was my regular quarterly appointment with my doc. I’d been stuck in a sort of groundhogs day over the previous year or so, not getting worse but not getting better. I’d recently started to see a *slight* improvement in how I felt, so rather than keep doing what I was doing, I decided to cut back on the amount of meat in my diet.

I’d only been eating meat again for a couple of years, after being vegetarian for well over a decade. Meat got reintroduced not because I decided I couldn’t live without cheeseburgers, but because I started having trouble maintaining iron levels. A dietitian I was working with at the time thought I would see more progress with food and supplementation, rather than just throwing some pills at it. So I gingerly began eating meat again, figuring I’d go back to being vegetarian when things normalized. So when I started feeling better in late 2017, instead of realizing this was likely due to my having left my job at the end of June that year, I decided it was a good time to start cutting back on meat.

Which means that when I walked into my doc’s office that day in early 2018, before I even sat down, she said to me “what’d you do?” And not in a good way. She told me some of my markers were off, worse than three months prior and she wanted to know what I’d changed. I reluctantly told her I’d cut back to having meat once/day, to which she replied “you can’t do that!”. She explained that my body might never tolerate being vegetarian again, and that if it was something that was really important to me, I’d likely be sacrificing some of my recovery. We moved on to other topics, with more conversation about why things weren’t improving, just like every other appointment. It was a reminder to me that food would play an important part in my recovery, but I didn’t yet have any idea of how big of a role it would end up playing.

Right before I started working with Claire (my dietitian) in September, I coincidentally had another quarterly appointment. I didn’t get to see my physician this time as she was on maternity leave, but I met with the nurse practitioner. All of the providers in my doc’s practice go through extensive training in functional medicine, and even though my doc was on leave, she still kept an eye on all of her patients. So the nurse practitioner knew of my story and where I was at in my recovery. I told nurse practitioner that I was embarking upon some significant dietary changes, and she was incredibly supportive. The paleo diet, and a more restrictive version of it called the autoimmune protocol, is best practice for addressing autoimmunity in the functional medicine community. So my working with a Whole30 coach was right in line with recommendations supported by my physician. While we’d discussed diet, my doc hadn’t come right out and said that NEEDED to change my diet. But I’d done enough reading and had enough understanding about where I was in my own journey to know that diet was the next step. It was the only health behavior I hadn’t touched. The best part about the timing is that I’d have blood work from right before I made any changes, and blood work again three months into the program. At this point, I still doubted my ability to follow-through as I’d made countless attempts to change my diet over the last couple of years and got myself nowhere.

I’ve written about my experience through the first two-thirds of Claire’s program, so won’t rehash that here. The last month didn’t bring anything too exciting, beyond the reintroduction of a few foods and several more pounds lost. I learned that I tolerated small amounts of cheese, enjoyed some amazing gluten-free sourdough bread from Bread SRSLY, and successfully reintroduced Picky Bars. Most, but not all, of my digestive issues were resolved, and I lost 13 lbs. The weight loss puts me exactly halfway between my starting point in the program and my former training (running) weight. My former weight isn’t the goal, but it’s a good benchmark of a time when I was much healthier and fit. Other “wins” included: increased self-efficacy in taking care of myself, complete elimination of cravings for foods I shouldn’t be eating, resolution of the brain fog that’s followed me around for the last three+ years, no more colds or stomach bugs which were so prevalent the last few years, and running is much more enjoyable. The big test would come at my doc appointment scheduled for early January, which required a blood draw on Christmas Eve. I was so anxious to see if my dietary overhaul would show up in my blood work, and if we’d finally see some resolution of the persistently high (dangerously high) inflammation levels.

So when I walked into my doc’s office on Wednesday, January 9, I was cautiously optimistic. I told myself that even if my blood work hadn’t improved, that I still had so many wins from the last three months. In addition, I had a very bizarre occurrence of hives in early November that I hoped she could shed light on, as my allergist was no help beyond testing me for an almond allergy (eating a higher-than-normal quantity of almonds seemed to be the trigger, but the allergist determined it was nothing more than a coincidence). And I’d also had some eczema on my face this past spring that I still didn’t know the cause of. I really felt this was all connected somehow. The medical office assistant walked me back to the office, and again before I even sat down my doc exclaims “what did you do?!”, but this time with a smile on her face. I didn’t get a chance to respond before she exclaimed “you look so healthy!”. I just grinned. I sat down and she walked through my lab results. The first thing she pointed to was that inflammation marker. For the first time in several years, it dropped, and dropped significantly. My HS CRP has been routinely in the 8-9 range, way too high, but this quarter it dropped to 2.0. That is still in the moderate category, but a significant step in the right direction, especially considering the improvement in just three months time. The reduction in inflammation is also what allowed me to finally lose weight. Everything else appeared to be normalizing, including my iron levels, which have been slowly climbing since that fateful appointment earlier last year led me to add more meat to my diet.

My doc and I spent quite a bit of time talking about the dietary changes, and she was happy to hear I was working with a coach/dietitian. I mentioned the hives in November, and how I was eating more almonds than usual that week, and she immediately brought up histamine intolerance and mast cell activation. Coincidentally, I read about mast cell activation syndrome recently, so her mentioning that phrase scared me a bit. But as she explained more about histamine intolerance, it made a ton of sense. And totally explained the eczema in the spring, along with the hives in November. We nerded out a bit while she explained the biology behind how all of this stuff is related, and she added a few more supplements to my regimen. While it seems counterintuitive to think that an appointment that ended with more dietary restrictions and more supplements was actually the best appointment I’ve had in three years, that is absolutely the case. My addressing the dietary sources of inflammation allows us to dig deeper and get to the root cause of what’s going on, and it also revealed that diet was a HUGE root case in-and-of itself.

I did some quick research on my own when I got home Wednesday evening, just to see what this low histamine diet was all about. I immediately noticed that many foods I eat regularly are either high in histamine or histamine liberators. The upside to this is that there was the potential for substantial improvement (which includes never again being woken up in the middle of the night by hives, as I was for five nights in a row in November), the downside is that I’d be removing some staples. But the success of the last three months helped me get over any feelings of scarcity pretty quickly. If I feel this good already, how much more of my health and well-being can I recover by taking this next step? Since we’d just returned from vacation on Monday evening, I needed to do some cooking anyway, so this was actually a perfect time to start walking down this road. Armed with this new information, Thursday evening’s grocery list looked a bit different than normal. Gone were the avocados, tomatoes, strawberries, fermented veggies, lemons, bananas, spinach, nuts (which I’d already been avoiding for the most part since November anyway, even though my allergist told me I was fine to eat them), chocolate, collagen peptides, and cheese. Also gone was my beloved sourdough bread. Some of these foods I wasn’t eating much of yet, but others like the collagen peptides in my coffee, avocados, fermented veggies, tomatoes, strawberries, bananas and lemons, I used frequently. And because we’d just returned from vacation, where I enjoyed more than a few treats that aren’t normally part of my diet (which I thoroughly enjoyed without any feelings of guilt or shame – REVOLUTIONARY), I choose recipes from the autoimmune protocol in hopes of more quickly reducing the increased levels of inflammation that I’m certain are present, unrelated to this histamine business.

In just a couple of days, I’ve noticed a significant change in my allergies. I normally take Allegra and Benadryl, even this time of year in the midwest when everything is dead. And even with those medications and a sinus rinse, I still have sinus and nasal congestion all day, every day. Within 24-hours of walking towards a low-histamine diet, I saw substantial improvement in my allergy symptoms. I’ve had bad seasonal allergies since I was a teenager, allergies that have only gotten worse as I’ve gotten older. I never considered improvement in them to be a possibility. I’ve had allergy shots, but because I’m allergic to so many things, they didn’t help much beyond allowing me to be in a room with a cat without wanting to claw my eyes out. So not only will these new dietary modifications likely ensure I won’t ever wake up in the middle of the night with a terrible case of hives, or get eczema on my face after eating a burrito, but they’re already making my day-to-day life more pleasant. It took well over a month this fall for me to see significant improvements in my gut health, three months for me to lose 13 lbs, but these improvements were comparatively immediate, and I haven’t even started the new supplements yet (they’re being shipped), or talked with my dietitian to get her insight on next steps (that happens Monday afternoon). To say I’m encouraged is an understatement.

A few months ago, before working with Claire and doing the hard work of straightening out my head as related to diet and getting out of my own way with regards to my recovery, I think an appointment like Wednesday’s would have left me feeling defeated. As for all of the progress and wonderful improvement in my blood work, I still walked out of there with more supplements to take – not fewer as I hoped, and more dietary restrictions – which came on the heels of the successful reintroduction of some foods I really enjoy. But rather than view this as a set-back, or a recalibration of what I believed to be tremendous progress, I saw it was one more step forward in this journey back to health. More dietary restrictions and more supplements is not a step back, it’s true progress, as we’re uncovering the real issues at the heart of my poor health the last four years. If I don’t do the hard work of the last three months, and cover all of that ground, these remain questions without answers. And there’s a good chance I get woken up with a bad case of hives again. And I continue to test the upper limits of how much Benadryl is safe to take before one spouts a third arm or something. I am so excited to have this information, and to know that there is more I can do to help myself get better. I am drunk with progress.

As I’ve looked back over the last few years, something that’s really bothered me is how long it took me to make these changes to my diet. Everything I read told me it was important, my doc told me it was important. In my over-analyzation of it all, I realized that several factors contributed to my figurative feet-dragging. Initially, I was way, way too hung up on what used to work. I was vegetarian for well over a decade, I was an endurance athlete who trained a lot and raced a lot, and incredibly healthy while doing both. Both of those go against convention in the autoimmune community. I got stubborn about what worked for me in the past, instead of realizing that the paradigm had shifted and that what worked for me previously was no longer relevant. Secondly, it’s really hard to made big lifestyle changes when you feel like shit. Overhauling ones diet takes a ton of mental energy, not to mention the physical labor of preparing food. There was a fair amount of time where I didn’t have the mental or physical resources to dedicate to the change. Which super-sucks, because it turns into a chicken-and-egg situation. The very changes that would help the most are out of reach, but the changes need to be made or recovery won’t happen. I think leaving my job allowed for just enough improvement for me to commit the mental and physical resources to the diet change, which ended up facilitating the big improvements I desired. Lastly, I realized I couldn’t do it on my own and sought out help. I knew that my biggest gaps weren’t in knowledge or information, but in changing habits and behaviors, especially since my health still wasn’t great and making the change was going to take a lot of effort. Having a good understanding of the type of help I needed allowed me to find the right person to partner with, and that was Claire. Her program focused way more on the process of the change as opposed to simply sharing a bunch of information about what a person should be doing. And her program was set-up so that the responsibility of doing the work lied completely with the client, which went a long way towards rebuilding my self-efficacy in doing Hard Things.

While I look back and see a lot of things I could have done differently the last several years, the one single thing I’m most proud of is that I didn’t give up, and that I found a health care provider who didn’t give up on me either. This summer, I started to think I might not recover, that this crap was the new normal. Which honestly was depressing as fuck. Signing up to work with Claire really felt like a last-ditch effort. A hail mary. The crazy thing is, it worked. The same relentlessness and tenacity that served me so well in running, and in my career once upon a time, turned out to be the most important characteristic that I carried into this mess. We just got back from Breckenridge where I skied for the first time in a few years. When I was sick, just putting on all of the gear seemed like SO MUCH WORK, not to mention the actual skiing part. But this year I skied, several days even. On two of those days, I skied for a few hours and then went for a run or a hike. At 10,000ft. A few months ago, none of that would have happened. And I came home from that vacation, not in a fatigue hole like normal, but ready to hop back into regular life, which ended up including a big change to my diet. It’s like my world has been in black-and-white for four years, and someone suddenly flipped the color switch. Everything looks so bright and vibrant. And I have hope, so much hope for the future. I still don’t know what role running will play in this new normal, or if I get to race marathons – including Boston, again. I’ve decided it really doesn’t matter. I still love to run, and running 25-30 miles/week while barely half of my old “normal” mileage, feels like a wonderful miracle. The racing question will answer itself in due time. And I can wait.

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.

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“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