RETURN OF ARTHRITIS (IT'S 2020 AFTER ALL)

Figure I should finally update this blog, it has been a while! Shortly after my last post I had my liver function test (LFT) come back significantly elevated. They had been slightly elevated a time or two over the last few years, but nothing like the spike on this particular test. Unfortunately, this is a somewhat common side effect of the leflunomide. As a result, I had to stop taking it and have everything checked out to make sure it was really the drug causing the increase in LFTs.

So I stopped taking it and braced for the worst. It's been six weeks off the drug now, and the psoriatic arthritis is definitely creeping back in. It took maybe two or three weeks before I started getting definite symptoms and then it has slowly gotten worse ever since. It is still only like 25% of what it was back in the day when I was trying to figure things out, but give it another few months untreated and I'm sure I'd be right back there. It's tempting while you're on the medication to think about stopping it and it just not coming back... but yeah, it's there. Shit isn't going away!

I ended up taking a bunch of tests, including an ultrasound of my liver. They all came back completely normal, which was a relief. You start reading about what else it could be, especially something like autoimmune hepatitis, which would fit my health profile, and you start getting very antsy for those results. Luckily everything came back completely normal, other than the elevated LFTs. So, still just the one chronic illness, thank you very much. The elevated LFTs should creep back down to normal over the next few months. They spike up way quicker than they go down.

As a result of all this, I have to start a new drug. Unfortunately, I've ran through the first line treatments of methotrexate and leflunomide, and the one other drug they use in that class tends to have even worse liver results, so it is onto the next class of drugs, the TNF blockers. So I get to start on the #1 revenue drug in America, Humira! I'm not thrilled with this, but I don't really have a choice other than not treating it and limping around. Without insurance it would cost $96,000 a year. My insurance has negotiated treatment at $60,000 a year. I pay $5 per month. USA #1?

Anyways, I should be starting that some point this week. It's another injectable medication which doesn't bother me, I injected the methotrexate for eight months or whatever it was. I did a bunch of research on it and the nastiest side effects tend to appear in people that do not match my age, disease, or "drug cocktail" profile. So hopefully it'll work and I'll take it without incident. I'll update the blog here once the treatment is rolling and hopefully I can get back to where leflunomide had me... in complete remission.

In regards to running... I am still doing it, but any speed or distance I had built up is completely gone. The silver lining of all this happening in 2020 though is that I don't have a marathon to worry about. If I had to do New York at the beginning of November I'd be completely fucked. As it is, I can stumble four miles and call it a day. Maybe I'll leave the "running with arthritis" post for another day. It is a quite interesting experience. 

WEIGHT LOSS 2020

Thought I should post something other than a monthly recap, so let's talk about my recent weight loss. Unlike my eleven pound mission in 2015, I did not document this one on the blog from week to week (obviously). Apparently I also made an effort to drop some weight from August to October 2017. I have no memory of that, but I have a bunch of weigh in and food logs in My Fitness Pal so I guess that was a thing. Basically the pattern is every two or three years I have to make an effort to get back to goal weight by losing about ten pounds.

Day to day I do not count calories in any formal way. Many days I just roughly track them in my head, ballparking stuff, and that is pretty successful. I think I did the math at one point, and let's say I need to eat 2200 calories a day to maintain my weight. If I gain ten pounds over two and a half years, that means I'm eating something like 2235 calories a day on average. Which is pretty dang good when you think about it! Basically, the weight slowly creeps on, which makes it really hard to notice. I don't regularly weigh myself or anything, so usually the first alarm bell is my pants being noticeably tighter. I'll ignore it for a month or two, then one day I'll step on the scale and that usually sets something into motion.

Tracking with MFP.

This time when I stepped on the scale my weight was 180.4. Anything over 180 for me is definitely "red alert" time. I had stepped on the scale every so often over the years and my weight usually was no more than 176. I'd like to be at 170, but when I'm only six pounds over I'm not ready to "buckle" down. Most of my pants still fit fine at this weight. Once I'm more like 178... then the pants get tight. Anyways, I knew weight had slowly crept on, I could see it in the mirror,  and now faced with the scale reporting over 180... I went into immediate action.

My goal weight is 170. When I lost weight back in 2015, I set it at 165. If you go back to the final week or two of that series, you'll see that I figured out 165 is too low. Anything under 168 and my pants start falling off my body and my face gets all angular and I don't like the way I looked. I could buy skinnier pants, but naw, I like how 170 looks and my entire wardrobe is based around that. So 170 it was! That meant I needed to lose 10.4 pounds. Easy enough.

Like all the times previous, I simply counted calories. This worked for my initial weight loss back in 2011 and each time since. I set my goal to lose the weight in six weeks, so I had to lose between 1.5 and 2.0 pounds per week. This put my daily caloric intake at 1700ish. The first few days I was starving. All the memories of weight loss were flowing back. However, I was determined to stick it through. I knew if I did it, it would work, and I would be done in six weeks. So onward I pressed. After the first few days, I was no longer ravenously hungry.

Honestly, it was pretty uneventful. Maybe even easier this time around with the pandemic, I was stuck at my house all the time and didn't go out to eat much or anything. So it was very easy to control my meals and stay on track. By two weeks in or so, the 1700 calories actually felt satisfying. The results were matching the calories in/calories out math almost exactly too. Funny how that works. Anyways, I ended up hitting my goal in six weeks, just like I had set out to do.

I will say that the last week or two, when I was a pound or two away from 170... those were hard. For whatever reason my mental game let up and I started to crave gorging on food and all of a sudden I wasn't satisfied with 1700 anymore. So they kinda sucked. However, I was determined to stick with it. Over the Fourth of July weekend my family did some socially distant camping, so I knew I was going to pig out and live it up then. So that "reward" kept me on track to hit my goal.

Anyways, it is now a month later and I am still right at goal weight. I have continued to track in My Fitness Pal to maintain. I don't know how long that will last, but it has definitely helped me stop snacking a couple of times. Previously, I could house 400 or 500 calories of Ritz and cheese at night as a snack. Now, I'll look at my tracker and have a popsicle instead. Little things like that can really help that slow weight creep from happening. I'm sure it'll eventually happen again, but maybe I can last a little bit longer this time around.

MID-SUMMER UPDATE

Things are ticking along. I've been good about getting out for two runs during the week and the long run on the weekend. One difference this summer is that if I'm out of town on the weekend, I'm not doing my long run that weekend. I'm not training for anything, so there's no reason for me to to scramble to get those done. Normally I'd do twelve miles on a Monday night or something to make up for it, but not this year. So I've missed two weekends because of that. Otherwise, perfect attendance. I've even thrown in a half marathon distance run in addition to my usual 10 miles.

Ten miles in the heat last weekend.

My body is definitely back to one hundred percent. So that is nice! Heart rate is back to where to used to be and my legs are officially back to normal. FINALLY. For a while they were like 95% of the way there, but on some long runs they would ache and bitch dramatically toward the end. Kind of felt like the end of a twenty mile run or something. However, in the last month or so, that has gone away too. Ten mile runs now feel like the ten mile runs I am used to. I honestly feel back to normal other than the fact I am slower than I used to be. That is definitely a thing. However, I have time to work on that. Hopefully by marathon training time next year I'll back back to my 2019 shape.

It has been HOT recently. The other day it hit 100 degrees for the first time in two years. I almost wanted to go out and run just for fun while it was triple digits. However, a three block walk left me sweating like a pig, so I decided it probably wasn't the best idea. The day before that it hit 99 degrees. This also happened to be long run day. Fun! I meant to get up and out the door earlier... but you know how it is. When I left at 11am it was 80 outside already, and by the time I finished nearly two hours later it was 90. Phew! It was manageable though. I just ran slower and tried to stay in the shade as much as possible. I also had a pit stop at home for water at mile six. I just combined my six mile loop and my four mile loop to keep things simple.

WELL, GUESS I'M NOT DOING A MARATHON

Not a whole ton new to report. I'm continuing to tick along and see marginal improvements here and there. Nothing major, but my true "easy" pace is slowly dropping, my speedwork is going well, my heart rate has come back to where it should be... all good things! I recently even worked my long run up to twelve miles without issue. Compared to where I was just three months ago, this is huge progress!

The New York Marathon was unsurprisingly cancelled this week. I had been expecting that and neglected to start officially training in mid-June like I normally would have done. I could see it coming miles away. I'm glad they cancelled it now though and didn't string us along. I won't seek a replacement, because, frankly, there won't be any. I also don't want to do a virtual marathon. Big "hell no" to that. Long story short, I will have no marathon in 2020. I'm cool with that.

So much winning. USA #1!

The New York Marathon will be giving us the option to defer our entry to 2021, 2022, or 2023. Which is great! The lottery odds are not good, so I'm glad I don't have to wait until I "win" it again. I plan to defer to 2021 and do it next year, assuming it happens. This year was supposed to be the 50th anniversary and they confirmed they'll be celebrating that next year instead. So hopefully it happens, I can do it, and I come back with some sweet 50th anniversary swag.

Other than those options, it is just the same old, same old over here. Definitely getting sick of the whole pandemic thing and a little angry that the United States has handled it so very poorly. I've been a very "good boy," but a lot of my fellow countrymen have not. So now we are all going to get punished because apparently some people thought everything was a hoax or plot by Bill Gates or something. So that's cool.

NOTICEABLE PROGRESS HAS BEEN MADE

Recent speed workout, 8x400m intervals on the roads.

Greetings, fair reader! I'm pleased to report progress is being made. While it has been slower than I would have liked, I am getting into better shape and runs that should be easy are starting to get easier. Yesterday I was able to run four miles at a 10:30 pace with a heart rate of 158. That's not great - BUT that is much better than a month ago. A run at that pace would have spiked my heart rate into the high 160s/low 170s. I no longer feel breathless on "easy" runs. And while I still have on and off days, the average fitness i am seeing is definitely going up!

Also, my long runs have moved back to the normal ten miles. The first time I ran ten it was pretty tough! Miles 8 and 9 were definitely a slog and pushing myself. My legs ached. The next weekend, only mile nine sucked. The legs felt a little better. This last week? Ten was basically no big deal. Legs were a little tired but not bad at all. Each time I go and do it, it gets easier. So that's all very encouraging. Again, I am slower and my heart rate is a little higher than I would like, but all the trends are in the right direction.

Mostly, I am just running by feel. It is too easy to be discouraged and not enjoy the actual run if I am eagle eyeing my watch for pace and heart rate, so I've turned it to the time of day many times and just ran by feel. Then, most the time when I am done, I look at the stats and I am right where I wanted to be anyways. So much better than fussing about it the whole run! Sometimes, less is truly more. It's also kind of funny how consistent I can be even without the watch... they don't call me The Metronome for nothing!

Lastly, I have been doing one speed workout at week. First, it was a two mile tempo bookended by mile long warm up and cool downs. Then I bumped it to three miles with half mile bookends. Last week I did 8x400 "street intervals," alternating jogging and sprinting every quarter mile. At some point soon I'll do a full four mile tempo run. These runs are hard but feel good once they are over. It is the kind of hard work I need to put in if I want to get faster and try to claw my way back to something resembling my fitness last year.

APRIL 2020 UPDATE

Oh hai! Well, it's been nearly a month now since I've been back. How are things going? Pretty well!

First off, I am out of shape. Other than when I didn't run for about a year due to the arthritis, I have never been this out of shape. Which is weird, because I only took two weeks off! But I guess the month of running on broken legs didn't help. Unfortunately my fitness has not snapped back quite like I was hoping for. At times it has been frustrating because what should be an easy pace (10:30-10:45) is often spiking my heart rate into zone 5 (above 168 bpm). So some runs have been an exercise in frustration.

However, things are getting better. My legs themselves feel fine and there has been improvement in my cardio and heart rate over the last month. I ran 11:00 on the nose the other day and my heart rate was in the 150s. I'm just going to have to claw my way back again. I've done it before and I can do it again. Before, ignorance would have been bliss in regards to my heart rate. In that sense, I miss my old watch. It didn't tell me I was working too hard and get into my head. I would just go out and run. Despite the frustration sometimes, it is nice to see my progress, however slow it may be.

I've felt confident enough in my steps forward to introduce some speedwork the last two weeks. Nothing crazy, one mile warm up, two tempo, and then a mile cool down. However, it felt really good to run fast. To just YOLO it and not care about my heart rate. It's SUPPOSED to be high during tempo work. And while my tempo pace is now low to mid 8's, it still feels good to be out there kicking it. My legs have responded well to the speed work too. Hopefully I can get some gains there and it will make my true easy pace slide back to 10:00 or so like it was last year.

Anyways, that's the update! The plan moving forward is to just keep slowly going at it. My long run is up to 8 miles now, I hope to get that back to 10 in the next few weeks. Otherwise, I will stick to two four mile runs during the actual week, one with speedwork. Luckily, assuming it is not cancelled, my fall marathon is late this fall (early November for NYC) so my marathon training doesn't have to start in earnest until mid-June or so. Until then, I'll just keep trying to improve and then assess my goals at that point.

Recent two mile tempo interval bookended by a mile warm up and cool down.