May 8, 2010
"The good news is that we didn't find anything that would make you sick. The bad news is that we didn't find what was making you sick."
So went the beginning of my most recent doctor's appointment. He went on to say that no tumour was found -- whew! -- and that although I have thickening of my left adrenal gland wall, it is not indicative of a medical condition. Since its been 5 weeks since I've experienced any symptoms associated with the 5 weeks of illness and I've returned to full-on training -- and recovering from hard days very well, better in fact then I was recovering pre-illness -- meant that mentally I had pretty much put the illness in the past. I told him that I was just back to the med induced nausea and all other symptoms had ceased.
Having a diagnosis would have been desirable. Knowing if the potential for a future bout of illness existed would be helpful. But whatever, I just bought travel insurance in case I have to cancel my flight to Cologne for the Gay Games. I tried to make that my summation to close the appointment and got up to leave -- I wanted to ride my bike home before the sun hid behind the office towers and it got colder -- but my doc wanted to chat about the notion of switching my medications to see if it would alleviate the nausea caused by my medications.
I told him my concerns were around cognitive impairment and accelerated brain aging; both found in some HIV+ people taking ARV medications. I am fearful that switching meds would create an opportunity for a new medication to negatively impact my brain function. I've learned to live with and manage the bouts of nausea for years and would much rather continue to deal with them then take a chance on getting stupider. Better to deal with the devil you know, you know?
I had a meeting recently that speaks volumes to the various responses to the medications that suppress (but do not cure, as too many people mistakenly think) HIV. About 2 hours before the meeting I had a bout of nausea and laid down on my office floor for about 20 minutes until it passed and then I was good to go again. The meeting was with a number of people including a man who has been HIV+ for 20+ years and has much experience with various ARV medications. He declared to a recently diagnosed individual that it was "rare" to experience any side effects from the medications. I was so shocked I nearly had to pick my jaw up off the floor -- as did my colleague: he threw up yellow bile every morning for 2 years before switching medications. Different experiences. Different realities.
Speaking of cognitive impairment, last week I forgot to take my medications three mornings in a row. Of course, I don't realize this until I go to take the evening dose and find the morning dose still in my daily pill box. This is not good. HIV, being a sly retrovirus, can quickly become resistant to medication if the levels of those medications are too low in the body. I don't think I've missed 3 doses in a year and to miss 3 mornings in a row is perturbing.
Not perturbing is my training. It has been going pretty well in spite of losing strength and speed during my illness. I've been focusing on building up my endurance, culminating with my longest workout thus far occurring a few days ago: a 60 minute swim and then couple of hours later a 5 hour bike (that included 12 climbs up the Niagara Escarpment) followed immediately by a 60 minute run for a total of 7 hours of training. I could tell during that workout that my fitness had taken another leap forward as the climbs didn't seem nearly as steep as the previous week and I didn't feel nearly as trashed as I usually do after that long an effort.
No doubt when the weather gets warmer my suffering will increase as my blonde / fair skin genetics do not respond well to heat and humidity. As a kid I would get severe heat stroke if I ran around too much on hot sunny days. Vomiting and semi-delirious, I would spend ours on the bathroom floor with a damp cloth on my forehead and eyes until my body recovered. I can distinctly remember how comforting and easing the coolness of the tile floor felt against my hot skin.
I just googled the average temperature of Louisville in August. The odds of the temperature being over 90 degrees Fahrenheit / 32.2 Celsius on race day? One in three. Uh oh. Better remember to pack my sun bonnet.