This post isn’t about hiking. It’s a general update about what’s going in with me.

I had COVID-19 (for the second time) in July 2023. I tested positive my last week of working at the Attorney General’s Office. The timing is important, because the job change meant a lot of stuff was going on in my head, and that made it difficult to sort out what was going on with my body.

Since that bout with COVID, I’ve had lingering fatigue. Even with the commute to Yakima three or more times a week, I was running regularly. I had an hour-long lunch break on that job, and the office is next to a non-motorized path. It was easy to get my runs in. Since coming back to work for Franklin County, I’ve struggled with consistency. Even on days I’d decided I was going to run, I had a lot of trouble actually doing it. It was extremely frustrating because this isn’t like me. I’m lazy, but I’m also pretty damned stubborn: it’s not normal for me to decide to do something and then completely avoid doing it. (Usually, it’s hard to talk myself into quitting or calling off something when it’s appropriate. Once, on a hike when I was struggling, I asked God for a sign if I should quit. Not long after, it hailed. I still didn’t quit. It took my stove malfunctioning – flames shooting out where the stove is secured to the fuel bottle – for me to quit. See? Stubborn.)

The most puzzling thing about this is that I missed running. I’d see a stretch of dirt and desperately want to be running. There were days I brought my running gear with me to work, only to feel too wiped out at the end of the day to go running. Or I’d plan to run, and then not be able to force myself out the door.

I figured coming back to this employer was causing a fair amount of emotional turmoil (that I largely try to ignore because it’s more convenient than dealing with it). I chalked it up to the exhausting emotional chaos of the last five years, and with my personal disappointment that I just couldn’t hack it at the AG’s Office. (I love the agency, and I loved the office I worked in. I just struggled too much trying to learn the job, and I didn’t want to spend the rest of my career worrying about screwing things up.) I know from personal experience that emotional distress takes it toll on physical energy. Stress is cumulative; your body doesn’t care if it’s stress from working out, stress from work, stress from not getting enough sleep, stress from being ill. It adds up, and if you don’t give yourself time to recover you’ll rapidly deplete your energy stores.

I finally decided that I needed to discuss the fatigue with my doctor. I was delighted to find my old doctor again. I knew he left the practice I used to use, but when I did a web search for his name I couldn’t find it. I figured he retired. (I found out later that the practice he’d been at was telling people he retired – how crappy of them!) My office changed insurance providers, and our new insurance has its own clinics. Their mission statement indicates they’re doing things differently, like giving doctors more time for each visit and integrating mental & emotional health practitioners into their offices. I went to the website for the clinic nearest me and saw that *my* doctor practices there. I cannot tell you how happy I was to find him!

What I love about this doctor is that in all the time he’d treated me before he mentioned my weight once. And that one time was simply “if you lost even just ten pounds, I bet you’d see a significant change in your blood pressure.” He never questioned my self-reported training schedule. (Back then, I was regularly training for half marathons & occasionally training for an ultramarathon.) His answer to any complaint wasn’t “you should lose weight.” As a fat woman, it’s a rare treat to find a doctor – especially one in good physical condition – who treats your complaints instead of chalking everything up to your being fat. So yeah, I was delighted to find him again. I knew he’d listen to me – really listen.

My first appointment with him was back in May. Shortly before that appointment, a friend suggested I get tested for anemia. I’m glad she did because it reminded me I hadn’t been taking the iron supplements I’m supposed to take. On the day of the appointment, I’d been taking them for about three weeks. I told my doctor my brain fog seemed a little bit less, and I felt a little better. My blood test results showed that my iron was a little low, so perhaps that was part of the problem.

I had a follow up appointment at the end of August. A couple of weeks before that, I’d hiked the PCT from Walupt Lake to White Pass. It was dreadful. I started at Walupt Lake at about 4 p.m. on Sunday, and got to Sheep Lake just before sunset. The next day I managed four & a half miles. The third day, I made it nine & a half. The fourth day I hiked until after dark to make it to White Pass. This hike was 29 miles, and I expected it to finish on Tuesday rather than late Wednesday. It was demoralizing. So when the nurse asked me, “So how are things going with the fatigue?” I said “awful.” While she was out of the room, I took a look at the elevation profile. 29 miles with 7350’/2240m of elevation gain & loss, and all but four miles of the trail is above 5000’/1525m. In contrast, Section J of the PCT (Snoqualmie Pass to Stevens Pass) is about 70 miles with 16000’/4875m of elevation gain & loss, and almost all of it is below 5000′. I live at about 400′ above sea level, and I’ve not been doing much hiking over the past few years. It’s completely unsurprising that hiking through the Goat Lakes Wilderness kicked my butt.

Even so, I am still struggling with fatigue and executive dysfunction. When I mentioned this to my doctor, he said “hold that thought — I have a possible solution.” We then started talking about me weight. Given that he’s never done that before, I knew this wasn’t just “you’re tired because you’re fat & lazy.” He pointed out that I’m thirty pounds heavier than I was eight years ago, and that’s concerning. He’s prescribed a drug that’s FDA approved for weight loss. It’s an appetite suppressant, but it was originally developed as a treatment for ADHD. (Again, how awesome is it that my doctor actually listened to me instead of just blowing off my concerns about the scatterbrainedness?) He said he’s back-door diagnosed patients with ADHD after they were prescribed this drug because they’ve reported that they’re much more focused & productive at work. (The downside is that the drug’s effectiveness in treating ADHD is short-lived in most patients — that’s why it didn’t work as an ADHD drug.)

So I’m on this drug now, and I’ve been taking it for a couple of weeks. I’ve never thought an appetite suppressant would work for me because my overeating doesn’t stem from always feeling hungry. But it has worked. I think that in addition to suppressing my appetite it’s bolstered my impulse control. Some of the time, it seems to improve my executive functioning, but I’m still pretty scatterbrained. I’m hoping that improves.

One side effect I’m getting is that my lips feel like they’re sunburned. I suspect this may be a very mild allergic reaction to the drug. It’s not fun, but I’m sticking with the drug for now because it does seem to be helping. The drug also seems to have potential mental health side effects in some patients. I have been feeling a bit depressed, and I’m not sure how much of that is a side effect caused by the medication. I miss food, and that’s a bit depressing on its own.

I started a new training plan, and so far I’ve done the scheduled runs. I’ve ignored the strength training part of it, but that’s pretty typical for me. I need to be more diligent about strength training because I need to get ready to hike 500+ miles next August/September, and the strength training will help me avoid overuse injuries that could derail that trip. I went for a hike yesterday. I’d planned to do an overnight, but decided to turn around & do a day hike. That was the right choice. My legs started feeling weary on the return to the trailhead.

My next follow up appointment is in November. If the feeling in my lips doesn’t improve, I may talk to my doctor about it before then. I’m cautiously optimistic about being able to improve my overall health & physical condition. My weight is down a bit – the lowest it’s been in a year – and I’m trying to focus on nutrient-dense foods since I can’t eat as much as I normally would. It’s late in the season but I’m hopeful to be able to get in a few more hikes before the snow makes trails impassible. I’m focused on my big hike next August.

Epilogue: At the November appointment, my doctor agreed that the thing with my lips is most likely a mild allergic reaction as it’s not among the listed potential side effects. He wants to keep me on the appetite suppressant for another three months. When I stop taking it, he wants me to monitor how the impulse control & other ADHD/ADD tells are. I’ve already noticed that I’m struggling with impulse eating again — I’ve gone well beyond my daily calorie budge a couple of times in the past week. (The reason this drug didn’t make it as an ADHD treatment is that it stops being effective. I suspect that’s what’s happened … just in time for Thanksgiving’s gluttony.)

I maintained a workout schedule for the first three weeks, but I haven’t been able to workout since. I’ve been sick, and I’ve had fatigue issues off & on for weeks. I’m at the tail end of a bad rhinovirus – still sniffling – and my resting heartrate is back up as if I was in the midst of a really bad cold. (It’s usually 52-53 bpm; today, it’s 60. Just walking around sends my heart rate up to 100. Something’s out of whack.)

I’m hopeful that I will start back on a regular workout schedule after Thanksgiving. Given that my current *big goal* is hiking, I plan to just walk or hike. And as usual, I need to add in regular strength training. Here’s hoping I can stick with it.