It’s All A Matter of Perspective

I saw my pulmonologist today and left feeling happy and excited.

I’ve been struggling with my running.  To the point of there isn’t much running happening.  I’ve been working on my running for over a year now, and as of today, I can barely run 1.5 minutes.  And it’s not because I’m taking it too fast.  I’m doing this at 4.3 mph.  Last fall I’d was up to running for 5 minutes.  Running 3 minutes felt standard.

Then the decline started, as there always does, in the fall.  It started the week of the Army Ten Miler.  By November I was on IV antibiotics for 6 weeks.  In December when I came off the antibiotics my lung functions were back to “my normal” and my x-ray was unchanged.  Yet my ability to run for even a minute was drastically changed.

I was frustrated that despite my continued efforts to follow a running program I couldn’t progress to running even 2 minutes.  If everything else was looking the same, then what’s the problem?  I wanted an answer.

And today I got one.  Not that it the answer hadn’t been there all along, it was my new understanding of my lung functions that made the difference.

There are 2 numbers that are listed first on the pulmonary function test (PFT):

FVC – This stands for “forced vital capacity”.  It measures the total volume of air exhaled after a full inspiration.

FEV1 – This stands for “forced expiratory volume in 1 second”.  This is the volume of air exhaled in the first second during maximal expiratory effort.

I was under the assumption that the FVC was the main number used in determining how the lungs are functioning.  My FVC is 68% of predicted.  This means based on women of similar age, weight and ethnicity my total volume exhaled after taking in a deep breath is 68% of “normal”.

It turns out though that the FEV1 is the important measure.  Mine (as of today) is 38% of predicted.  This means in that first second of exhaling after taking in a deep breath I am 38% of “normal”.  To put this into perspective, in order to be considered for a lung transplant one needs an FEV1 of less than 25%.

Why was I happy and excited about this news?  It explains why my running has struggled.  It explains why back in 2001, when my FEV1 was 61% was able to run for several miles.  My lung capacity has dropped 48% in that 14 year period.

I feel like I can be more understanding with myself after a round of antibiotics.  Of course my lungs aren’t able to rebound after a week or two.  It’s going to take a little more time.

Now my FEV1 does fluctuate somewhat.  In December it was 42%.  At least I’m currently considered stable, which means it is staying in the same range for a prolonged period of time.

Then, this evening, a little reality crept in.  Does this mean I’ll never be able to run a mile non-stop with these lungs?  Does this mean I have little hope of achieving a 13 minute mile pace or less (and am I being optimistic about even getting to a 14 minute pace)?  Which of course means giving up hope of finishing a race in the top of my age group (unless I can keep at it into my 70’s or 80 ‘s when hopefully there won’t be anyone else in my age group).

There are a lot of unknowns involved.  What I do know is this:

  • I won’t stop trying to increase my running distance.
  • I won’t stop trying to increase my running speed.
  • I won’t stop signing up for races and completing them as fast as I can.
  • I won’t stop seeing myself as a runner.
  • I won’t stop believing anything is possible.
  • I won’t stop working to make a difference in the world.
  • I won’t stop.

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