Running Ruminations

Reintroducing running — and physical activity, in general — about 4 ½ weeks since having the stroke on 2/4 has been excellent. I’ve been taking things really easily and have been abundantly cautious in my approach. At any other time in my life, I wouldn’t bat an eye at running many consecutive days, but for right now, I’d rather not.

It’s not that I’m worried I’m going to injure my brain and cause another stroke — more on that in a second — it’s just that I went from running 50-60 miles per week fairly habitually to ZERO, basically overnight, and stayed at that mark for over a month. There’s something to be said for muscle memory when returning to running, sure, but there’s also something to be said for not building back mileage and intensity like a moron. I will gladly take being conservative here if it means that I can safeguard myself and my body — the latter which feels like it has completely lost every ounce of any muscle I ever developed — and circumvent any potential running-related injury that would crop up from going to 0 to 60 in a heartbeat. I’m all for dreaming big and taking chances, don’t get me wrong, but I’m also into self-preservation these days, too. 

When I said in my previous stroke-related post that I had gotten cleared to run from my neuro NP (on 3/7), I think I mentioned that we were still waiting on the neurologist’s final interpretation of that repeat MR scan I had on 3/3. In what I described was a somewhat shitty chain of events, I saw and read my MR scan results — which were “unremarkable” (yay!), save for some weird cyst thing — but had to wait for nearly another 10 days before the neurologist would interpret them and officially say that I was in the clear.

Rationally, of course I realize that having to wait for results for 10 days would, more likely than not, intimate that that’s great news because if something were more urgent, I’d already be back at the neurologist’s office. Yes, absolutely, but waiting is hard, especially when you feel like your life (and specifically, any control that you think you have, any semblance of normalcy, and any notion of power, volition, or agency that you thought you once possessed) has been dramatically usurped by this insidious THING that just came out of effing nowhere.

Fortunately — and finally — by about mid-day on Thursday (3/15), I heard back from the neurologist.

In so many words:

1. My brain scan was unremarkable (read: boring and normal);
2. They never found any source of the bleed;
3. I’m not at any increased risk for future strokes; and
4. That cyst was a completely incidental (and innocuous) finding.

In other words: I’m fine. My brain is fine. There are no aneurysms lurking anywhere, no congenital or vascular something-or-others they missed, nothing.

My stroke was just a shitty, shitty circumstance.

You cannot begin to understand the weight that I honest to god felt like was lifted off my chest when I finally read my doctor’s (and NP’s) notes and read his interpretation — he, being one of the best in the world, one of the most world renown, so on and so forth expert — and saw that he, personally, had signed off that yes, Erin’s head is fine and no, there’s no need for any further neurological follow-up.

Even though I had gleaned (and hoped for) as much from when I read the findings the previous week, it is a completely different feeling to see for myself, with my own eyes, that determination in writing from not only my physician but who is also, apparently, one of the best physicians in the world for this type of stuff. If you want anyone looking at your brain and interpreting it, it’s this guy. 

I don’t know how or if I will ever be able to find “closure” with this stuff, but for now, reading my doctor’s words is at least putting me on the right path. It’s weird, really, but I think his interpretation has caused a very real and dramatic mentality shift for me in the past week. In fact, I’ve caught myself even thinking about the whole stroke situation differently than I have in the preceding month and a half.

It was as though after reading his words, my mental talk switched from I had a stroke to I survived a stroke, and friends, you don’t need to be an expert in the English language to know that those two verbs have hugely different implications and connotations. Among other things, this shift removed the shitty passivity from the equation — this shitty-ass thing happened to me — and replaced it with action, agency, and power.

There’s no contest between I had versus I survived.

Changing the operative verbs has been instrumental.

With running, one of my all-time biggest pet peeves is when other runners complain that I have to go run 12 miles or I have to go do my speedwork or whatever. Unless you’re a professional runner with a paycheck on the line, you don’t have to do anything; you get to. Simply changing our word choice can greatly affect not only how we approach our workouts but how successful we are in them, too. I have this same conversation with my six year-old about school and other six year-old obligations; she doesn’t have to go to school, she gets to. There are tons of children all over the world, and here in California, who would love to go to school but can’t for whatever reason. The same holds true for running; we can bitch about having to go run (for a hobby, mind you), or we can be grateful and happy that we are healthy enough to go willingly do this stuff for fun in the first place. Words matter, man, more than we sometimes realize. So it goes with this stroke stuff, too.

Tangential soapbox aside, getting the feedback that I was hoping to get from my doctor has been enormously helpful in getting on with my life. I absolutely still think about how this horrible thing happened to me, but I quickly intercept that train running gangbusters off the tracks and remind myself I survived a stroke; I didn’t just have one. There’s a difference, and that semantic difference matters.

I absolutely am still in the mindset that I’m measuring my life by how many weeks I am post-stroke, and I don’t know when any of that will change. I imagine that the further out I get from it, the less omnipresent it will be in my mind (and man, do I ever hope so!). I’m not trying to rush things along — I’m all for allowing myself to “feel my feelings” and roll with all of this as it manifests — so suffice it to say that I’m IN IT, in the THICK of it. Some days are fantastic — most are, actually — and others are rough and suck and are super shitty, and that’s ok, too. It’s part of the process. Every medical professional I’ve talked to has confirmed as much, which is reassuring.

Really, the only thing that my doctor’s final determination didn’t elucidate was why the stroke happened in the first place. He agreed with my Regional doctors’ determination, that it was, more likely than not, due to a weak vein in my head that blew, but a) why that vein was weak and b) why it blew we’ll likely never know. Moreover, when most people have brain bleeds, the bleeding doesn’t stop on its own; as I understand it, the bleed usually is halted or interrupted by some sort of medical intervention. Mine, however, did stop on its own. Again, why that happened we will likely never know. (And as far as I understand it, it’s not only the location of my bleed and the actual amount of blood from my bleed, but also the fact that my bleed stopped on its own accord, that is allowing me to make a full recovery, free of any stroke-related deficits). I cannot say this enough: my utter and profound luck with all of this isn’t lost on me. Everything coalesced perfectly.

I’ll say that one more time because it matters: everything coalesced perfectly.

All of this is really overwhelming. I completely understand how lucky I am, and that’s both really humbling but really pretty terrifying, simply because I know how different an outcome I could have had — but didn’t. Not having a “why” for the stroke is similarly both good — awesome, I should keep doing my life as normal — but also frustrating — shit, if I’m doing everything “right,” then why did this happen to me? I say this in jest, but if I were a raging cokehead and had a stroke, I imagine I’d still feel traumatized at the whole experience, but I’d also have a greater ownership stake in it because I would have done something that heightened my risk. Shit, I had a stroke, but my bad for doing coke! That’s not the case at all though.

When you don’t do anything — when you don’t have any lifestyle factors that could implicate you — and when you don’t have any genetic, racial, or socioeconomic factors that could do you in — not necessarily something you did as much as something you were born into and inherited — it becomes really unsettling. You want to know why, but you’ll likely never have it. That’s hard.

Everyone I talk to genuinely wants to know why this happened. The best thing I can say at this point — and what, I think, my doctors would confirm — is that inexplicable shit happens sometimes. That’s all there is to it. We throw our arms up in the air, and we shrug our shoulders. Weird shit happens every day. It just so happened to me on February 4th. It is what it is.

One last thing: several medical professionals have told me that they attribute my age but also my overall health and fitness to my fast and full recovery. I can recall specifically at least one of my physicians who outrightly said that my being in the shape that I was in — basically, me being a marathon runner — most definitely helped me to not only endure the stress of having a stroke, but to also survive it and come out on the other side unscathed (save for the understandable psychological duress).

I can’t help but wonder, then: did running save my life?

Any runner will tell you that running often tends to have a cascading, causal effect in life:

• you run, so you eat well more often than not.
• You eat well, which then allows you to run pretty well, pretty comfortably, and consistently. (Think of that oft-cited metaphor likening a car, its fuel, and how well it functions to your diet and how well you run).
• You’re running when you’re not doing other stuff in your life (work, family obligations, and the like), so you’re probably sleeping more soundly, more deeply, and likely more hours than the general populace.
• You run, so you’re likely probably not using drugs, smoking, or drinking prolifically.
• And of course, since you run, it’s likely that a lot of your vitals — including but not limited to your cholesterol, blood pressure, resting heart rate, and weight — are probably better than average. (Obviously there are genetic components to all of this that simply being a runner can’t allow you to evade, but surely you catch my drift).

This isn’t to imply that we runners are saints; it’s simply that comparatively speaking, we’re  doing pretty well in the grand scheme of things. Running has begotten a pretty healthy lifestyle for me, one that obviously doesn’t make me invincible, since I am still human, but one that — generally speaking — has set me up for success at the doctor’s office more often than it hasn’t.

While we’ll never know why I had a stroke, as a healthy, active, and risk factor-free 34 year-old, I can’t help but think that my running did, in fact, have at least some role in my recovery. That’s not to say that running will insulate you from a stroke’s shittiest byproducts (because again, we’re all different individuals, and strokes, themselves, vary tremendously), but for me personally — and for my stroke — I cannot help but think that the habitual choices I make more often than not, choices that ultimately help me live not just a healthier and happier life but also that help to make me a better runner (and let’s be honest, a nicer person to be around), helped my case.

If that’s not reason enough to try in earnest to return to what I once knew was normal, then I don’t know what is.

Much love, again, for all the continued outreach and support. xo