Been on the move

Wow, its been awhile since I updated this. Why? Cuz I've been TRAINING! Yeeeah! (I've also been working and writing, but that's not as much fun to chat about). Today marks my sixth week since I was released from the hospital. Its almost hard to believe that I only have one kidney. I am feeling on schedule with my training, and ready to rock some longer sessions.

So far my longest training days have been:
Thursday, 6/17, PM - 8 mile run with my teammate Robin (who is a champ. She is a smoking fast runner and she willingly ran a VERY slow 8 with me.)
Friday, 6/18, AM - 37 mile ride, with hills! I did this by myself and didn't actually intend to ride 37, but I got kinda lost :).
Thursday, 6/24, AM - one mile open water swim (I did this after 3 1-mile hill repeats on the bike, so it was more than just a long swim, it was a brick - at 5:45a!!)

I'm now back on somewhat of a schedule. I will be working 16 hours a week as an RN (which I started this week) and I have to stay on schedule with my writing for MIT since we are trying to get a paper submitted by the end of the summer. Plus the course I teach at Tufts (oh, and my spin classes). So I'm hoping that I will be able to sustain my energy levels.

This weekend consists of a rest day tomorrow and a long ride with Greg on Sunday. We are going to go for 40-45. Next weekend I'm heading to Santa Fe, New Mexico. A friend of mine who lives there is trying to help me get a nice road bike for the weekend. Looking forward to riding somewhere new!

Few steps forward.....

And the risk of a few back. I had my doctor's appointment on Friday. The nephrologist is completely stumped as to why I am having such dizziness. The good news is that I am actually showing signs that are consistent with my symptoms. When I was lying down, my BP was 124/78. When I stood up, it plummeted to 84/78 and then normalized after a few moments. She can't see any reason why this is happening, so she consulted with a cardiologist, my anesthesiologist and a neurophysiologist. They all agreed that I should go in for autonomic testing to figure this all out. I REALLY hope there isn't something wrong. I think I'd be happy with a "we have no idea, just be careful". I don't want to go on medication, I am feeling strong when I exercise (relatively strong), so I don't want to have to take any steps back.

The good news - I ran for the first time on Saturday! My pal Miriam and I went into the Fells for an hour and we walked for the first 10 minutes, ran for at least 30 minutes and then walked out for the last 10 minutes. It felt great! A little bit of soreness at the incision, but nothing I couldn't suffer through.

On Sunday, I swam 2000 yards. And then today, I rode for 26.5 miles on a pretty hilly route. It felt great! I'm happy that I have been able to re-introduce some intensity back into my training. I can feel it, though. On efforts that normally may not have been tough, I am sucking wind! Hopefully that means I will peak for Timberman, unlike my normal pattern of training, where by August I am so burnt out that I fall asleep on the side of the course (which I've actually done.....dropped out of a race a few years back and passed out asleep on the side of the course while other racers rode on by.......terrible).

Wanting to run

So on the one hand, things are going great. I rode my furthest steady ride yet last night (25 miles) and kept a decent pace. I have gone swimming a few times and even went stand-up paddleboarding this weekend at my parent's house. I'm staying active, and that makes me happy (and I promise I am not overdoing it).

On the other hand, the dizziness seems to be getting worse. I'm not laying down or sitting around as much, so its happening less frequently, but it is still happening every time I get up. However, certain episodes seems to be getting worse. Today, my arms and legs felt all weak and woozy at one point when I got up and my vision darkened. My pal Janet (she is a nurse practitioner) suggested that it may have something to do with my adrenal gland, which is something I anticipated before the surgery. I even asked my surgeon how careful they are with the adrenal gland when they remove the kidney (I asked because the adrenal gland sits on top of the kidney, so I wondered if they ever got nicked). My surgeon was honest and said that they hit them all the time......grrrr.....so could this be the issue?? And if it is, there really isn't anything that can be done. I am going into the doctor's tomorrow morning since they are concerned that this hasn't gone away yet.

Back to fitness, I am hoping to start running soon. My pal Kelley (who also donated a kidney) started running carefully during his third week. I've been active (gentle activity, with gradual progression) since I got home, so I am not feeling behind yet. I figured one month after the surgery would be a good time to give running a try, so that brings me to June 8 as my first run.

I'm making gradual progress

Its now been two full weeks and one full day since surgery. For the most part, I am feeling fantastic. But there is one small issue I am dealing with....orthostatic hypotension. This is the feeling you get when you are crouched down and you stand up too fast and then get dizzy. Its happened at one point or another to nearly everyone. Since the surgery, its happened to me every time I get up, whether I'm sitting or lying down. The standard advice is to get up slowly, but I am getting up slower than before the surgery because of my incision. And at the very least, I am certainly not getting up any faster. Its so concerning to me that I called my care team. My nurse Nancy brought it up to my nephrologist and they both agreed that it is "weird". My labs are normal. The doc suggested that its possible that I'm not eating enough salt. Hmm. So from now until Tuesday, I have been advised to increase the salt in my diet to see if it makes a difference. Bring on the chips!!

Other than that, I am feeling great. I went for my second bike ride on Tuesday (17.5 straight miles!) and today, I swam 1200 yards. The biggest difference is that after my workouts, I feel wiped. Most normal people feel energized after a workout, but when I finish a workout (and I use that term gently, I'm hardly "working out" at my normal level), I feel super tired. And I did expect that, but its one thing to expect a sensation, and its another thing to actually feel it.

12 days out and I'm back!

I rode 18 miles today :). Not fast, and we planned a mid-point soy chai tea latte break, but I did it. Greg and Johnny were my noble escorts this morning as we left Somerville at a blazing 13.5-14 mph pace and rode out the bike path to the Ride.Studio.Cafe in Lexington, which is 9 miles from home. We sat and had lattes, then I rode a bit up the road to surprise my LUNA teammates who were leading a 37-miler at 10am. It was nice to meet some of the ladies who we are helping train for a century later in the summer. It was great to see them all.

They took off on their ride and Greg and I headed back to Somerville (Johnny went ahead of us). I was feeling good on the road back until about two miles to go. My legs felt pretty tired and flat. But not so flat that I couldn't finish! But it did raise my awareness to just how tired I really am. Three weeks ago, I ran 29 miles.....gah......now I'm pooped riding a slow 18. But I will improve quickly, I just know it.

Beyond the fatigue, the only other challenge was the bumps on the road. OUCH! They are bothersome in general, but with a 12-day old six-inch gash in your gut, they really smart! I stood up for pretty much every bump, which meant I stood up a lot.

I had told myself that I would take two full weeks off before I returned to activity. So I get a big "F" in physical restraint, but my doc said I could get back into gentle cardio "as tolerated". Apparently he doesn't know how much I am willing to tolerate before I throw in the towel :).

Day 10...getting strong!

I had my follow-up appointment with my surgeon yesterday and he said I was doing well and looking strong. Yeah! I've been progressing my walking distance each day and what's better, my time has been going down, so I've been walking further, stopping less and going faster. Mind you, my pace is still pretty slow. To illustrate this point, read about my morning outing: I had to go to the supermarket to pick up soymilk, so I decided to venture out on my own. I grabbed a cart, flopped myself over the handlebars and pushed my way through the grocery store. I was walking down an aisle and I hear "move it!". I turn around and behind me is a cranky 137 year old man in a motorized wheelchair who was pissed that I was walking too slow. What's most ironic about the situation (beyond my age and fitness level) is that my research at MIT has centered around building an empathy suit, which helps younger individuals feel physically older, and helps them to empathize with their challenges (theoretically, of course...) When we calibrated the suit last summer, we found that when folks in their 20's put on the suit, they are as physically mobile as folks in the 70-79 y.o. range, based on standard norms of physical function. While my research is typically well received, here and there the critics will say "well, you really DON'T know what it feels like". YES I DO!

Anyway, the only disconcerting piece of my recovery thus far has been the dizziness. When I get up from the couch, I get uncontrollably dizzy, to the point where I feel like I am going to black out. This has been happening since I got home, and while I am cognizant that its not wise to get up too fast from a lying down position, I don't think I am getting up any faster than before the surgery. I mean, I can't, I've got three holes in my gut, so it hurts to get up fast! They took some labs from me yesterday to see what might be going on. Hopefully its nothing, but it is something I would like to pass.

Its been one week since surgery

And dammit, I got my period last night. The normal misery that a woman experiences once a month is certainly magnified when one is recovering from surgery. But it sucks even more when one is down a kidney. Why? The kidney is involved in red blood cell production. So getting your period reduces your blood count all that much more.

The kidneys produce EPO, which is the hormone that stimulates red blood cell (RBC) growth. (It is also the illegal doping product that many endurance athletes have been caught using in the past....). Since I am in the acute recovery phase, I am producing 1/2 the amount of EPO that I am used to producing. And I can feel the difference! When I walk up and down stairs, I feel like I am living at altitude.....that feeling of "holy shit I am out of shape". My heart races with gentle bits of activity and I get tired pretty easily. I find myself occasionally gasping for air just like I have found myself in the past when I've been at any significant altitude (+9000 ft). The reason for this is because the red blood cells deliver oxygen to the tissues. My oxygen carrying capacity is acutely reduced because for the past week, I've had half the ability to produce RBCs. This is why people who have kidney disease feel so tired all the time....their ability to produce RBCs slowly decreases. Mine is just a result of the transplant.....and this will change. I've been told it takes about six months for my sole kidney to fully take-over responsibility for the functions of my entire body. I'm banking on the fact that I am pretty healthy and strong, so maybe it will be a bit quicker.

And note, this is just my understanding on what is going on, from what I know about kidney function. I am not a kidney expert by any means, I only know what I feel, so I have attempted to tie together what I feel with what I know.......