Running, being and artery disease

Running was a big part of my life.  I ran for the usual reason like fitness & weight control, but I mostly ran for what I can only call spiritual reasons.  Running was how I felt in touch with myself and the world.  The rhythm of my breathing & the sounds of my footfalls, especially on gravel, combined with the more acute consciousness of my surroundings enhanced by the exercise made the whole thing a kind of meditation in motion.

Running away or running to

I started to run earnestly in the late 1970s.  There were reasons in my personal life.  I broke up with a long-term girlfriend.  I was becoming disenchanted with grad-school.  It was just a time of uncertainty and running seemed to fill in.  I cannot discount societal factors, however.  Running was in style. Whole books were written about it.  But maybe the biggest factor was the invention of good running shoes. Nike came out with their “waffle trainers.”  Until that time, running was too destructive on your knees and feet to be practical for anybody over the age of twenty-five.  There was a kind of folk wisdom, “the legs go first,” and it was true.

The 30+ years run

For the next thirty-some years, I ran regularly.  I started on the lake trails in Madison and Milwaukee, along Mendota and Michigan respectively.  I started to push longer and longer, eventually joyfully going on twelve-mile runs.  When I got the job in the FS, I took my running international.  I don’t like eucalyptus plantations because they support little wildlife because nothing much eats the leaves, even bugs, but eucalyptus plantations in Brazil were wonderful places to run because precisely because there are not many bugs.  My favorite trail in Norway went through the King’s farm, open to all but with perfectly maintained gravel trails and ideal Nordic farm scenery.  They said that old King Olaf sometimes walked around those trails, but I never saw him.  Krakow featured trails through a beautiful beech forest culminating at a big mound dedicated to national hero Josef Pilsudski.  But probably my favorite trail was closer to home. I used to call it my “Mr. Smith Goes to Washington” run.  A long run could encompass the Capitol, Jefferson & Lincoln Memorials, and the various wonders of the Smithsonian. Besides the area around Capitol Hill, it was mostly flat and over well-maintained gravel paths.  I much prefer to run on gravel over concrete or asphalt.  I could list dozens of other favorite trails, but I am likely already being tedious.

A really debilitating injury

I found a nice running trail in Brasília along Lake Paranoá, and it was there that my decades-long running adventure ended abruptly.  It was on February 2, 2012 – Groundhog Day.  I was accustomed to pulls and pains associated with running.  I usually could just ignore them, maybe limp a little, but no injury stopped me from running for more than a few days.

A new kind of pain 

This time was different.  I thought it was just a shin splint.  I stopped running and in a very short time the pain stopped. That was easy.  I started running again and the pain came right back.  It was feeling different from any I felt before.  It was not so much a pain as an extreme fatigue.  I decided to give up the run for the day and walk home. But walking was not less painful.  I could go only about 100 yards before the pain got acute. But it went away almost immediately when I stopped, only to come right back when I moved.  It took me a long time to get home.

Walking hurt so much that I started riding my bike even the short distances to the restaurants and grocery stores nearby.  It hurt to ride the bike too, but not nearly as much. It was bearable.

This injury scared me.  Aspirin had no effect on the pain. Not being able to run was bad.  Not being able to walk was terrible.  But I still figured it was some kind of pull or tear.  It gradually got better, but I did not try to run again for fear of repeating.

Happened again

Then it happened in the other leg.  I was not running this time.  In fact, I notice it while driving. I was headed to Georgia for a conference on longleaf pine.  I was looking forward to exploring Savannah on foot.  This was less enjoyable with the pain.  I had trouble on the field trips.  I felt embarrassed as people older and apparently more infirm were easily able to do what I had trouble. I limped along.

This time, I figured I should see a doctor

Turns out that I had an aneurysm knee behind my knee.  They did some ultrasound and found I had peripheral artery disease (PAD).  This seemed very unfair to me, not that nature is fair.  This is the kind of thing common in people who do not exercise much, often those who smoke or have high blood pressure.  I had none of the usual markers.  The doctor gave me a long explanation, which boiled down to a simple, “shit happens.”   I don’t think he believed me when I told him that I exercised all the time.

There were two options.  You can get surgery to bypass the problem and put in stents.  In time, this would restore much of the mobility and it would relieve the pain almost immediately.  The other option was to exercise enough to mitigate the condition.   My explanation is simplistic and no doubt wrong in detail, but as I understand it the exercise creates new channels for the blood, expanding arteries.

Surgery or not

The doctors told me that the choice was mine, although they seemed to favor the surgical option, since it would relieve the immediate pain.  I don’t think they had confidence that I would exercise enough to fix the problem.  I chose the non-surgical option.  They gave me some blood thinning medication and told me to come right back if the acute pain returned, warning me that ignoring the condition was very dumb.  The condition could result in amputation or death if left untreated. I had been twice lucky, but maybe three strikes and I would be out.  They also wanted to do another ultrasound in six months.

Painful progress

Progress was painful, as the doctors warned.  I developed a kind of a system. I would walk as far as I could tolerate and then rest for 30 seconds.  I timed it.  It was remarkable how much it hurt and how fast the pain stopped when I stopped.  The muscle was starved for oxygen. That is why it hurt.  The pipeline was just too narrow.  When it got a chance to catch up, the pain was done.

I walked every day using this system.  I am not sure exactly when it got better.  One day I just noticed that I was not stopping for those “blood breaks.”   My legs still were not as good as before, but they were functional.

The hiking challenge

Alex wanted to go hiking in Utah, but the friend he had planned to accompany him dropped out. I was second choice.  I was happy to go, but still afraid of my legs not working well enough. I had the hiking poles, so I figured that I would be okay.  Even if my legs had been perfect, I cannot keep up with Alex. Age does that.  With that caveat, I went.  I did not always feel great, but I did manage all the hikes, albeit not so fast.

Next time I went in for the ultra-sound, they told me that my legs were better, not great but better.   They said that I could go to a year between appointments.  Last year (2018), I was lucky enough to get a WAE assignment to São Paulo.  I walked every day to and from the Consulate. It took about an hour each way and sometimes I would have to let my legs rest, but generally it got better and better.

When I came back, I felt that there was a quantum change.  My now annual ultra-sound confirmed it. The doctors were surprised.  It was as good as surgery would have done, maybe better.  I just got a letter from the doctor asking me to make an appointment for this year’s tests.

Back to old habits

Returning to running, I am going to try to return to running.  October 15-November 15 is the best running season in Virginia, so I am resolved to restart my running program next Tuesday.  I don’t think I will take my watch, so as not to be too discouraged by the slow time.  I will never get back to what I was, but even absent the PAD problem my 64-year-old self would not be as fast as my 56-year-old self.  At least now I have an excuse.

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