A lofty title for today's post indeed. There seems to be precious little information on the web for endurance athletes (or those who want to compete in endurance sports) with autoimmune disease. I can't provide much general insight, but I can share my experience.
My own slice of autoimmune joy is uveitis. My eyes have an inflammation in the middle eye, which causes swelling on the retina. This leads to severely compromised central vision when the swelling is not controlled. Mine is controlled by slow-release implants of corticosteroids that get injected into my eyeballs every 4 months (ish). In an effort to beat the disease into remission I'm also on a regimen of immuno-suppressants (currently CellCept, usually used for transplant recipients).
Right now I'm training for my first big race of the season: Ironman 70.3 St. George. It's a race consisting of a 1.2 mile swim, 56 mile bike, 13.1 mile run. As you might imagine, this sort of distance requires a fair bit of training. Just to give a little better idea of how much training someone might do for this type of event (and I am trying to get closer to the front of the field in this sport), here's how much training I've done so far in 2013 (and I'm currently starting to build my training volume).
Bike: Approximately 30 hours. Largely spent on my indoor trainer due to weather. A good fraction of this has been high intensity training.
Run: Assuming I run as planned later today, about 14 hours. This has been split about 9 hours trail running (mostly in snow), 4 hours road running and 1 hour on the treadmill. My running is lagging a little behind my plan.
Swim: Well, least said soonest mended. I just started swimming again after my Ironman triathlon last year.
How does autoimmune disease affect my training?
- Most of the time my vision doesn't interfere substantially with training or racing.
- When I have injections in the eye I can't swim for 3 days afterwards. Last year I also had 2 eye surgeries that kept me from training for longer.
- Immunosuppressants have the biggest impact on my training. Methotrexate (which I no longer take) gave me nausea that made quality training impossible for 1-2 days per week. It feels like I'm tolerating the CellCept better, but it occasionally messes with my GI tract. This means that I have days where long training sessions are impossible, and I also find it hard to eat sufficient calories to sustain my workouts. Yesterday I had to stop a 1.75 hour ride on the trainer early, after taking two breaks.
- Immune suppression, well, suppresses the immune system. So does intense exercise. This makes me susceptible to catching whatever is floating around out there. Thanks to a good diet and some healthy paranoia I've been able to stay healthy for the last couple of years with only one real dose of man-flu.
- Alcohol. This isn't highly recommended for folks taking immunosuppressants. I got out of the drinking habit when I started on methotrexate and I'm typically having one drink a month these days. It's brilliant. No hangovers. More of my calories are nutrionally valuable. I just feel better. I can train better. My mind feels generally sharper. In this respect starting systemic medication has been awesome for my training.
- Muscle growth and recovery from workouts... these are made more difficult by my medication. Sometimes I just don't have the strength that I know my muscles can provide. I don't feel weak, per se, I just can't hit my potential some days. Recovering, like healing from wounds, takes longer than it used to. It still happens, but I'm still getting used to just how slow it can be at times.
- Blood monitoring. I actually have a doctor watching the state of my health closely, and I get blood tests done every month or two. I know what my body is doing, long term, and I have a doctor watching it all. This is surprisingly useful, if you take a little time to understand what all the tests mean.
- Mental health. This is a biggie. When I see my vision slipping away in one eye as my condition flares up, it makes staying positive about everything harder. It makes work harder, since I need my vision to work, and that raises stress levels. When I'm coping with side-effects from medication, same story. Mental toughness and the ability to stay focused and positive under extreme conditions are vital for endurance athletes. I just get more opportunities to develop that toughness than average.
In short, dealing with autoimmune disease often includes "performance-reducing" measures. By accepting that changes will have to be made to get the best out of your body it's totally possible to participate in, and be competitive at, endurance sports. Listening to your body is key, and training has to be smart. At the moment my body doesn't respond as quickly as it used to to training, so I have to think more about how to manage the physical stress I place on my body to get the training I need. There are no shortcuts, and I'm still learning just what I can get away with.
There are some real inspirations out there too... folks dealing with autoimmune diseases that are competitive sportspeople with great attitudes.
Some well-known sportspeople with auto-immune diseases:
Sanya Richards-Ross, sprinter; Venus Williams, tennis player; Phil Mickelson, golfer; Novac Djokovic, tennis player
Triathlete Angela Durazo also keeps a great blog about racing with rheumatoid arthritis. Check it out.
