Sunday, August 9, 2015

No Leg, No Colon, No Problem

The year was 2010, and I seemed primed for a takeover of the limb-deficient sector of the Paralympic swimming world. Fresh off an American record in the 100-yard freestyle and a first place finish in the 50-meter freestyle at Spring Nationals, I figured to be sitting pretty leading up to the 2012 Paralympics. If I just continued to improve at the same rate, surely I’d be close to the top of the world rankings heading into the Games.

Then disaster struck. I’d been having digestive problems throughout the collegiate swim season, but I’d been so focused on my athletic and scholastic endeavors that I avoided dealing with them as much as possible. Finally, the situation became acute. With my dorm room bed frame actually stained pink from Pepto Bismol, I couldn’t avoid it any longer.

I was diagnosed with ulcerative colitis, an autoimmune disease that causes inflammation of the large intestine and results in frequent, painful trips to the bathroom along with rapid weight loss and other serious complications. My doctors urged me to take time off from swimming in order to regain my health.

My college teammates and I during our final winter training trip to Puerto Rico.
We sure were a fierce-looking bunch.

Knowing that just one day out of the water would mean three to get back to where I'd been, I decided to ignore doctor’s orders. I continued training hard, often multiple sessions per day, but I would never come upon the success that I seemed destined for back in 2010.

Over the following two years leading up to Paralympic Time Trials, I continued to fight, both in and out of the pool. But the disease was ravaging me. At my worst, I was twenty pounds underweight and in the bathroom up to eighteen times a day. Flare-ups always seemed to strike at the most critical times, too, like just a few days before the 2011 Spring Nationals swim meet, for instance. My body had betrayed me.

I finally hung up my Speedo, goggles, and swim cap after Time Trials in 2012, having finished disappointingly out of contention for the U.S. team. I prayed that the reduction in physical and psychological stress would have a positive effect on my health. For a while, it did -- so much so that I opted to go off my medications (once again against doctor’s orders) just to see what would happen.

I was okay for a few months, but then the disease began to progress, and my quality of life deteriorated in kind. I was barely able to leave the house for fear of not making it to a bathroom. So I went back on the meds. I tried holistic remedies. I tried hypnosis. I even followed a strict Paleo diet. Each of these treatments seemed to help at first, but the effects always diminished with time.

Finally, after five years of battling the disease, this past spring I was left with no choice but surgery: a “restorative proctocolectomy,” or the removal of my large intestine and rectum. It was by far the hardest decision I have ever made. Once your colon is gone, you can’t get it back. But according to my doctor, on a ten-point scale of severity, I was an eleven -- at grave risk for colon cancer or a life-threatening bowel perforation.

The surgery went great, the surgeon reported. But that was about where the warm and fuzzies ended. Day two post-op was when things began to take a turn for the worse. As if I hadn’t already been down enough on my luck, I fell victim to just about every post-surgical complication that they don’t bother warning you about beforehand, just shy of requiring TPN (total parenteral nutrition):

  1. An ileus, which is when digestion halts and a nasogastric tube is required. Those were two of the most uncomfortable days of my life.
  2. Oral thrush, which was a wicked sore throat that had me gargling a viscous liquid they called “magic mouthwash” every few hours. 
  3. Severe constipation, which was pretty ironic considering I’d had the exact opposite problem every day for the previous five years. For a week thereafter, all I could eat was pureed food (i.e. baby food), which was actually surprisingly tasty compared to ice chips.
  4. Chest pain and shortness of breath, which turned out to be a pneuomomediastinum, or air bubble in my esophagus, the cause of which was never quite determined. 
  5. Crippling back pain, which was actually a byproduct of malnutrition and severe dehydration.
Gerber: babies (and Fitness Pollenators) are their business.

After a total of three weeks, three hospitalizations, and twenty pounds of weight loss, I finally got onto the right side of what was proving a painstakingly slow road to recovery. In the subsequent weeks, I gradually started needing only one crutch to walk instead of two, then no crutches at all. I gained five pounds, then ten. After being extremely restricted with my diet both pre- and post-op, I started to be able to eat normal food again, like soft pretzels. Lots and lots of soft pretzels.

I gave myself a limit of three soft pretzels per day. Or sometimes four.

I began to be able to leave the house on my own to go for pretzels, then grocery shopping, then to my girlfriend’s house for the weekend. Finally, I was able to return to school (to finish up my biomechanics master’s degree) and to resume my pride and joy: strength training.

I truly believe that what kept me going through my sickness all those years was exercise. Despite acute illness, I actually managed to make decent progress, too. In fact, just the week before surgery I achieved a longtime goal of a double-bodyweight pull-up. I also filmed a short “Feats of Strength” video highlighting many of the skills I’d mastered since transitioning from the pool to the power rack.

Feats of Strength
Watch the Video – 1:31

Following surgery, I was pretty down about all the strength I was losing. After being confined to a hospital bed for three weeks, I was barred from lifting anything heavier than a milk carton for another five weeks after that. Those two months of mandated inactivity felt like an eternity to me. But I tried to look on the bright side. I figured it would be a positive experience for me as a personal trainer to understand what others go through when they resume physical activity after a long layoff.

To my great surprise, however, I reacquired muscle almost instantaneously upon resuming training. Even the last bit of abdominal pain I was still having around the site of the surgical incision subsided once I was finally allowed to start exercising again. Having been so frail, I couldn’t believe my eyes that the lean mass was packing itself back on so quickly. The hardest part for me turned out to be slowing myself down from doing too much!

What do 20 pounds of cold hard muscle look like? A lot like this.

I credit my longtime consistency as the driving force behind the rapid improvement. In fact, this was perhaps my biggest takeaway from the whole experience. It turns out that this phenomenon has some scientific validity to it, too. According to the so-called "myonuclear domain theory," muscle that was previously hypertrophied will hypertrophy far more easily following periods of inactivity. Basically, if you were muscular before, it’s easy to get muscular again -- and quickly.

Sure, the initial gains were mostly “show” (size) and not “go” (strength), but in the following weeks, I also reclaimed the ability to perform bodyweight movements like dips, pull-ups, burpees, and even handstand push-ups. Granted, I’m still not busting out twenty-rep sets of each of these movements like I used to, but then again, most people aren’t. Just the other day I did my first sit-up, which was remarkable considering how weak my abs were after being sliced open and stitched back together.

Back in Action
Watch the Video – :26

Free from disease, I’m better today than I’ve been in years. Gone is the stress of being sick and the toxicity of the medications. I’m eating better, sleeping better, and working better. Sure, I still wish I could have gotten the disease under control without having to go the surgical route. But in the end, what were a few months out of my life now in order to improve my quality of life for decades to come? Plus, since I don’t have a colon anymore, I’ll never have another colonoscopy again!

And who knows? Maybe I’ll even try for the 2020 Paralympic Games. Then again, maybe not, as that would likely require me to cut back on my soft pretzel intake. Hey, even us health conscientious personal trainers have our guilty pleasures.

Now that I’m no longer sick, I can finally enjoy mine.

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