Trusting Your Gut: how to deal with the unknown

Most athletes will be familiar with the phrase: “Listen to your body”. With time and experience you become pretty intuitive about when to push and when to pull back, the difference between a stress response and an injury, and even then we still get it wrong sometimes.

However, my experience of Long Covid has totally ripped up the rulebook. My body isn’t just singing from a different hymn sheet: the hymn sheet is upside down.

Since getting Covid in April last year, my attempts to start running again have been short-lived, with even easy 5km runs triggering PEM or ‘post-exertional malaise’, a crash consisting of headaches, sore throat, insomnia, congestion, chest pain, muscle/joint aches, and excessive fatigue, in no particular order. I’m also in line for the Longest Known Runny Nose. The challenge is that these crashes would usually come a day or two after the exertion, so it was hard to identify the trigger. Other times I would crash after a long journey, too many social meetings (for an introvert) or a poor night sleep, or no apparent reason.

Perhaps the best analogy I’ve heard to describe this situation came from Dr Rebecca Robinson, of “being a golf ball stuck in a bunker”.

Even my usual cautious approach wasn’t enough for Long Covid. This was a new beast, demanding a deep clean of stress across all the cupboards of life. Intuitively, it felt wrong to keep doing something and expecting a different result. So, I bit the bullet and took 2 months off running, to try and give my body the rest it needed to crawl out of the bunker for good. Unsurprisingly, this lack of training was going to upset the balance mentally and I’ve struggled with waves of anxiety disorder since. For those who haven’t experienced anxiety, it’s far more than the racing heart, shaky feeling, worrying or the false-alarm heart attacks that send you to the doctors for reassurance. It’s a crippling doubt and paranoia that has shattered my self confidence in all areas of life, often staying at home to avoid seeing anyone I knew.

But, how do we trust our experience if we haven’t been here before?

ACCEPTANCE

In my last blog I spoke about the power of acceptance when feeling overwhelmed.

I’ve been fortunate that I could still work and function, mostly as normal. Even my family and some friends think I’m bluffing when I don’t look ill, and it’s left me questioning my own sanity on regular occasions. But without running or training I’m not myself, or living the life that I want to live either.

Acceptance is a key step to taking ownership of a negative situation and calming the anxiety. Only when we stop fighting it can we start to move forwards. Surrendering to what is beyond our control, is taking control itself.

Fortunately, I haven’t suffered too many close bereavements and don’t want to undermine those who have. But grief isn’t limited to bereavement. It also applies to losing a career, goal, hometown or identity.

With Long Covid, the ability to run isn’t dead and buried (yet) so I can’t properly grieve and move on. Everyone says “you’ll get there”, but there’s no timescale, or solid protocol to follow. So you end up stuck in a grey zone limbo, with less hope than Boris Johnson and an honesty box.

Acceptance is also a key step in the grief process. But acceptance doesn’t mean giving up, or giving in. That sounds terrifyingly terminal. Acceptance is about accepting the situation you’re currently in, but it doesn’t mean we have to STAY in it. We can find another path up the mountain.

DEJA-VU

I’m blessed, perhaps, with experience. Our experience gives us a map, even if Covid had turned mine upside down and dipped it in the dishwater.

After palpitations and erratic heart symptoms, I had a follow-up with a cardiologist recently who gave the all-clear to start building up exercise gradually. But his last comment struck a nerve: “Hopefully with time, you’ll see some improvement…”

“But we can’t guarantee you’ll ever get back to where you were”.

Ouch.

This dragged me back about 10 years to January 2013 like a bad dream. Before Everest I was set back by a running injury – a chronic shin pain – that was never properly diagnosed. Stopping running, cycling and hiking seemed to be the sensible thing to do. When the orthopaedic consultant shrugged his shoulders and said I might not be able to run properly again, it absolutely floored me. For once, the illusion of control and identity that I had formed was suddenly taken away from me.

So, what did I do back then?

I committed. I set the date. In 2014 I was going to climb Everest.

I was 17 at the time. That gave me less than 18 months to raise over £35,000 for the trip by corporate sponsorship, finish my A-Levels and recover. But the act of committing gave me the direction I needed to find a way through. It was a massive gamble. Intuitively, it felt like the right thing to do. Fortunately it paid off and I’ve been grateful for that decision ever since. There’s no guarantee it’ll work again, but it’s reassuring to have at least one option on the table.

BORROW A MAP

For situations we’ve never dealt with, sometimes we have to borrow a map off someone else and find that experience outside of ourselves. Sadly, there’s no shortage of athletes suffering with Long Covid or similar chronic conditions to share their experiences.

By conscious engineering or good fortune, my coach Sophie Mullins has been here before. Suffering with mastocytosis, an auto-immune disease triggered by exercise, she was told by a Doctor that she might ‘go for a little jog in future’… Now Sophie is a GB 100km champion.

We all need role models who have overcome challenges to remind us that it can be done. I soon came across other runners in a similar position, who have since recovered. (Thanks George & Jim). There is hope.

So what could I learn from them?

The science emerging so far suggests that Long Covid could be a neurological condition, linked to issues with the mitochondria and autonomous nervous system. In theory, we could gradually re-train our body to tolerate the stress of exercise, without it going into shutdown.

In addition I’m currently taking more daily supplements than my grandma:

• Anti-histamines (Allevia)
• Di-Ribose (3 x 5mg)
• Multi-vits with Iron
• Niacin
• Magnesium Glycinate with malic acid + Acetyl Carnitine
• Quercetin
• Turmeric capsules
• Chocolate Hobnobs (for stress relief)

I’m obviously not a Doctor so should caveat this isn’t medical advice and it may not be suitable for everyone. The last thing I want is to give false hopes, because I know how they can ruin your day faster than a parcel notification from Evri.

TAKE A CLOSER LOOK

The challenge is that sometimes we don’t have conscious access to our experiences, and old knowledge can pre-condition our actions and behaviours, in the same way that past trauma and failures can stop us from trying something new. Cue the phrase ‘old habits die hard’.

Trusting our gut becomes harder with age and a greater depth of experiences to draw from. At 18 I was comparatively naïve, which made decision making much easier.

One way I approach this is by writing both options down, and an honest stock-take of the pros and cons of each option. I find this process helps to filter out genuine issues from exaggerated hypotheses. From my experience, avoiding an option because of fear won’t feel right either. The gut knows when we’re kidding ourselves.

So, can the same ‘throw yourself in the deep end’ approach work again?

With chronic fatigue and PEM, I’m not sure. But this time it’s been less radical than 2013. Instead of setting the bar high – quite literally, to the highest peak in the world – I’ve started with a ‘Couch to 5k’ approach. This began with 6 x 30s jogs, which feels a little ridiculous for someone used to running marathons at the weekend for training, but it’s the best information I have to go on.

I’ve been ‘running’ up to 4 times a week, with Sophie monitoring my progress, and swimming 30-40 mins or hill-walking on the alternate days. After each session I’m doing short breathwork exercises using an app, to calm the autonomous nervous system, which is also thought to be short-circuiting in Long Covid.

At the time of writing I’m up to 45 minutes of running. I still get symptoms. Sometimes I don’t. There’s still a language barrier with my body. Running free in the hills or doing any kind of intensity still feels a million miles away. My old man even beat me at Parkrun. It’s more about tolerating than improving. But every time I crash, I get a better understanding of these limits. It feels right to keep trying and gradually find the edges of this box.

When there’s no evidence to suggest otherwise, sometimes trusting our gut is the only thing we’ve got, and trusting that it will work out in ways we probably never anticipated.