Ischemic Colitis or Why my body has yet again failed me

I will spare you the gory details and just leave it at this: since November I've had intestinal distress during/after my running.  After ignoring it despite the fact that it disrupted the majority of my runs in the month of December, I was pleased that it went away just as I started run camp in January.  Until last weekend, when it came back with a vengeance in the middle of my 5 mile run on an awful, windy, snowy day.  I had to walk back for almost 2 miles and as a result had issue enough that my mom and Jeff insisted I go to urgent care.  Which I did.  Begrudgingly.  Only to be told that I am in fact not anemic and that I needed a colonoscopy (which I already knew and had scheduled).

Yesterday was the big day.  I was off solids as of noon on Sunday and yesterday had to drink a lovely cocktail of a huge bottle of gatorade mixed with a 2 week supply of Miralax.  The prep wasn't nearly as bad as I was expecting, thank goodness (not at all like the stomach flu I had a couple weeks ago).  I was also quite nervous about the drugs I would be administered during the procedure, but those also weren't bad either - they just make you drift off to sleep and forgot everything that happened.  Although I have this vivid memory of yelling out in pain and the nurse telling me it was almost over.  I don't know if that actually happened, or if I dreamed it happened.  I felt pretty crampy for most of last night, so I wasn't able to eat much, but thankfully today I'm feeling better (and just had a delightful breakfast of french toast and sauteed apples).

But now the bad part: the diagnosis.  Upon talking to the doctor before the procedure, he said he was pretty sure it was Ischemic Colitis, which can affect distance runners.  Sadly, I am not a distance runner, nor will I ever be.  I asked him what could be done about it and he said, "You mean besides stopping running?  I suppose hydration and lots of fiber, but that might not work."  ARGH!!!  These are the notes from the procedure: "Likely ischemic colitis after running.  Await path results.  Will get Doppler ultrasound of mesenteric vessels."  So I have one more non-invasive procedure to confirm, in fact, that my dream of running a half marathon has effectively been put to rest. 

So what is Ischemic Colitis?  "Ischemic colitis is a sudden swelling (inflammation) of part of the large intestine (colon) that occurs when there is a temporary loss of, or reduction in, blood flow to the colon."  There are lots of things that can cause it, including exercise (though it's uncommon).  "Strenuous physical activities, such as long distance running or bicycling, have been reported to lead to colonic ischemia, presumably by physiologic shunting caused by mesenteric vasoconstriction and intravascular volume depletion from dehydration."  As the doctor described it, when you're running, your blood flow is diverted from other parts of your body to your legs, almost as if you're squeezing off your colon to get blood down to your legs, but then when you let go, the blood comes rushing back to your colon and bad things happen. 

I also read this: "This shunting is most likely related to high sympathetic tone induced by strenuous activity. The reduction of mesenteric blood flow appears to be much more dramatic in unconditioned athletes, which may explain why gastrointestinal symptoms often improve with training. In addition to heightened sympathetic tone, other factors such as hypovolemia, hyperthermia, and the accumulation of vasoactive metabolites certainly contribute to intestinal ischemia ."

I think because of reduction in physical activity due to pregnancy, I fall back into the "unconditioned" athlete category, as opposed to the distance runner category.  Come to think of it, back in November, I was starting to push myself to get back up to distance/pace that I used to run and that's when this all started.  I read a study that suggests this can be reversed with some conservative surgical and non-surgical treatments, but other sources suggest, like my doctor said, that there isn't much that will make it go away apart from not running. 

I'm disappointed.  Really disappointed.  For a variety of reasons, including:
1.  I won't be able to achieve my goal.  I hate not achieving my goals.
2.  I've told a boat load of people I'm in training and now I have to tell them the game is off.
3.  I can't run with my friend anymore and I've come to value that time so much for so many reasons.
4.  I realized that part of why I was excited about this training group was that I might be able to make some friends here in Grand Rapids.  I miss having friends who want to/are able to actually do things with me on the weekends.
5.  I spent money on this training program and refunds are not available.  Now I have no money to, say, take a yoga class on Saturday mornings instead.  Damn me and my savings and frugality!
6.  Half of my Christmas gifts this year were running related.  Anyone need any size small running clothes?

This is me trying to find a silver lining:
1.  I get my Saturday mornings back and won't miss yet more time away from Graham.
2.  I'll be able to work on May 12th (ok - not at all a silver lining for me, but it will be for my coworkers).
3.  I can still do yoga (and after a couple months of squirreling away some money, perhaps I can pay for some classes) and maybe I can revisit my goal of doing a headstand sans wall.

Am I glad that I was diagnosed?  I suppose in some ways.  I mean, I don't want these things to happen: Gangrene of the bowel, Hole in the intestine (perforation), Inflammation of the lining of the abdomen (peritonitis), Sepsis.  But ultimately I'm feeling rather defeated. 


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