The Good, The Bad, and the Unknown

The Good: MRI came back negative.  No changes compared to last April's scan (re: lesions), though I have not seen the full MRI report with my own eyes, as yet.  Not MS.

The Bad: An inner ear issue seems most likely with issuance of an Ear Nose Throat (ENT) specialist referral.  No appointment has yet been made due to the holidays, but I hope to have more knowledge of what might be going on in my head as soon as I can.  In the meantime, symptoms have improved some, but worsened in others.  Concentration appears to be a large catalyst - the harder I concentrate, the worse things get.  If I didn't know any better, I'd suspect my wife gave me a concussion in my sleep for snoring too loudly (not that I'd blame her based on how loud I've heard my son snore!).  In the meantime, I have more time to scour my text books and the internet for more information on the vestibular system and the inner ear.  Surely that's what my ENT will want to hear.  "So I read on the internet that..."   Ha!

The Unknown: The result, in the meantime, is more unknown.  Those facing the potential MS ("You might have something called Multiple Sclerosis"), often go through a lengthy period of time until that diagnosis materializes into reality ("You have MS").  As strange as it may sound, relief sometimes becomes the descriptor people atribute to the day they become diagnosed.  What they will face for the rest of their lives, however unclear that future may be, now at least has a name.  Some portion of their future has become Known.  And with that knowledge comes a little peace.  Certainly that was the case for me.  No matter what the future would bring, I could better steel myself for it once that Unknown ("might") became Known ("have").  

This confrontation with yet another Unknown has spun me into one of Dr Seuss' eloquently named Slumps.  And as he notes in Oh the Places You'll Go, "Unslumping yourself is not easily done."

Enter my coach, Karen Smyers.  I basically described where I was with relation to training, including a general inability to mentally get my head around where I needed to be in preparation for Ironman Lanzarote.  She has an amazing knack for saying the right words at the right time.  That's one of the big reasons I've worked with her for over a decade now.  In her words: 

"The unknown in all of this has to be draining and take a toll on you physically as well as psychologically.  So recognize that this will happen and it is OK to have down periods once in a while."

Until I had read that, I never realized how much it had taken a toll on me - I briefly burst into tears after someone had given me permission to self-acknowledge the source of my Slump: this focus on the Unknown.  For optimal fitness raining, you train at the level you are at.  That enables you to make advances in fitness and get to where you want to be.  Training where you want to be, on the other hand, tends to get you hurt or burnt out.  Be where you're at.  I had taken this mentality with my disease and (mostly) with my exercise: "control the controllables." My fitness, my balance, my diet, my sleep (mostly), my mental aptitude - great chess game today, Dad!  Maybe I'll get you next time.

But that's all one can do.  As I get more information (from my ENT visit, for example), I may find that I have more specific things to focus on to optimize where I'm at.  But in the meantime, focus on the Unknown only leads to the Slump.  Focus on the Known gets you out of the Slump.

Go on:  Unslump yourself.  I triple-dog-dare you.  (Yes it's the Holidays).

Happy Holidays.  Mine are getting a lot better, even if my symptoms aren't.  Thanks, Coach.

The Things We Take for Granted

Holiday time has arrived.  It never fails to sneak up on me, despite Christmas items finding their way onto store shelves shortly after Labor Day (?!?), Christmas music hitting the airwaves November 1st, and Thanksgiving rolling around before one finishes thinking "November started?" 

Yes, Holiday time has arrived, and with it comes the realization that family really does mean a lot.  Sometimes I need reminders, but this year, much of my family and my wife's family made the journey to the Pacific Northwest, where the Portland Ramsey's hosted Thanksgiving.  It was a hectic, but wonderful, week.  

But shortly before the holiday, I had started having some vertigo issues.  Being a PT, I self diagnosed myself with BPPV (Benign Paroxysmal Positional Vertigo), a generally self-limiting cause of the room spinning.  Some self-treatment (it's good to be a PT, if I haven't mentioned that before) and some time later, and I was feeling much better.  

Feeling pretty good even, until I woke last Friday.  Something had changed overnight.  The room no longer spun, but dizziness pervaded my existence.  Not BPPV.  Driving took an enourmous amount of concentration to keep things in focus - literally.  My vision continually wanted to go out of focus - as if I'd had a bit too much to drink (and while it certainly was after noon somewhere on the planet, I had not been nipping at the flask).  I suppose fortunately, it had snowed here in Portland - something of a rarity, and Portlanders have no clue how to drive in the snow, so traffic crawled along.  My normal commute of 45' (leave home, drop Mattias at school, and get to work) took me 90' instead.  All of 20 miles.

This issue continued through the day.  I arranged a visit with a optometrist, which was long-overdue anyway, for the following Monday, and hoped I had a detached retina.  Yes, this sounds strange, and not simply because such a diagnosis wouldn't account for the dizziness.  But I want it to not be MS.  Anything but the MS.  

I went for a run later in the day, and strained a calf.  A long-planned Guy's Night (first since sometime last spring) was put off due to a combination of unexpected travel and the weather.

A trifecta of Crappy Things to Happen on a Friday struck, and I found myself in the immature reaction of deciding it was, afterall, after noon where I stood, and proceeded to crawl into - and through - a bottle of wine.  Not a good decision, but the one that decided upon.

I now sit here typing a few days later, after having a normal eye exam with my optometrist, but  an abnormal neurology exam today with an MRI of the brain scheduled for Friday.  My 8th since 2008.  If it's MS, that's probably the end of it for now - wait and see what happens.  If it's not MS, then something has simply "gone wrong" with my vestibular system, and we will deal with that at that point, starting with an Ear / Nose /  Throat (ENT) specialist assessment, and while vestibular system is not my area of specialty, I do know the long-term prognoses are "improved" rather than "cured".  

Today, I have had a(nother) Sobering Moment.  I have spent a lot of time under the impression that I, really, have no idea how long I have left to function "optimally."  And while I know that I am not optimal anymore, I also realize that I really have no complaints about it, either.  I have had a realtively benign course of MS.  Sitting here now, my eyes tired from the strain of maintaining focus on a computer screen for this duration, I have realized that something as simple as a vestibular attack may take so much away.  I do not feel comfortable getting on a bike outside right now.  I am forced to be much more conscious about my driving.  I am much more conscious about chopping vegetables.  I enjoyed racing my boy up to bed, and then regretted doing so from the queasy stomach that followed.   I have needed 10-15hrs of sleep per day for the last week.  I have another damn MRI on Friday.  I am unsure of whether to hope for an MS attack or vestibular dysfunction.  No-win scenarios suck.  

Mostly it occurred to me that MS is a disease that doesn't need to completely debilitate you to take away your ability to enjoy life.  It just has to hit one or two key systems.  You take away my balance, and you take away my sport - and potentnially all aspects of each individual sport within triathlon.   It just has to take away something I take for granted: knowing which way is up.

And so I appreciate those who bear this disease with me - my family - all the more.  I wish for more time and energy to figure out how to show them, but it may need to wait for another time.  MS, or whatever this is, might win this round.  But with their unending support (and I love them dearly for it), some determination, and some grit, I'll make it to the bell, take a rest, and attack in the next round.

That's just all I can do:  Keep on Keepin' On. Hug your family, hug your spouse, hug your children, hug your parents.  Hug those who help you.  They make it bearable.  Even when we sometimes forget.   Hang some mistletoe.

Thank you to all of my family, but most especially to Micha and Mattias.  You bear the brunt of this with me.  I do not envy you.

And that's my new sign-off:

Keep on keepin' on