View Full Version : Meds Can Make You Fail

The Weasel
11-13-2003, 14:07
In the last three months, I have found out why, at least in large part, I failed to get past Mt Rogers in '00 on my thruhike. Since it is an object lesson in how medications can affect performance, I'll do my usual thingy of over-explanation:

In 1998 I received a triple bypass due to severe coronary arterial blockages in three arteries. After my bypass operation in '98 (yeah, great surgeon: 20 months later I was doing Springer) I was placed on cholesterol-reducing meds, initially Lipitor, which was later changed to Zocor. As I trained, I felt aching in my calves, and attributed it (duh!) to the training process. And as I did the Trail, I'd ache (surprise! surprise!) and feel, especially in Trail towns, incredible weariness (surprise! surprise!). I sloughed this off as the inevitable feeling that one gets from long trail hiking. I finally stopped my thruhike as I approached Mt Rogers, with a sense of total fatigue and, despite moving well - I was by then averaging 20 miles a day - continued full body aching. I just assumed that was how it felt to thru hike, and couldn't countenance it any longer. To steal a phrase from Madelaine Kahn in Blazing Saddles, "I'm so tired!"

It was not for almost two years that I found that the source of this was NOT the Trail, but an adverse reaction to the class of anti-cholesterol drugs known as "statins" (Lipitor, Zocor, etc.) which, in up to 2% of users, causes generalized myalgia - full body pain - particularly centered in the calves, and significant tiredness and even lethargy. Several months ago, my cardiologist tinkered with my meds, taking me off the statins entirely for a while to verify (along with blood tests, which confirmed it) that this was the cause, and has since given me alternatives to the statin drug regime. Since then, muscle pain is gone, and my energy level is incredibly high.

There are a couple of lessons I pass along from this: First of all, for those in my age group who are taking one of these specific meds (statins - Lipitor, Zocor, Pravachol), do NOT dismiss these symptoms as "training pains" or the like. Raise them IMMEDIATELY to your doctor. While rare, in the extreme they can lead to liver failure or even death, both of which can really screw up a thru hike.

More generally, however, check ALL of the possible adverse reactions to any meds (INCLUDING "OVER THE COUNTER" DRUGS), and ask your pharmacist for possible interactions (again, include the OTC drugs in this). For example, if you're taking a "daily dose" aspirin (and if you're 40 or over, you'd better!) AND taking a blood thinner (almost guaranteed if you're seeing a cardiologist), you do NOT want to use ibuproen ("Advil") since it too has anti-clottiung properties. I learned this little gem as I bled all over the floor of the Blueberry Patch from a small scab I picked....the combo of all 3 - aspirin, blood thinner and Advil kept me from clotting for 15 minutes. NOT good.

And there are other adverse reactions, even if you don't take anything, and it helps to just be aware of what they are. Believe it or not, there can be adverse reactions even to vitamins; taking too much of some can be toxic, and in other cases some vitamins can interfere with absorption/effectiveness of prescription drugs and vice versa. I've taken the time with my pharmacist to inventory what I take regularly and symptomatically (e.g., I only use acetominophen/Tylenol now for pain relief) to minimize these situations or at least know what causes them.

This is probably good advice anytime, but when you gear up physically and mentally for a thru hike, it's very uncool to find that trying to keep yourself healthy actually resulted in being UNhealthy enough that you dropped out without even realizing why. Frankly, had I stopped the statins, I would have been restored then (as now) and be able to put "->ME" after my name here, which would be nice.

The Weasel

So yeah, I was doomed.

11-13-2003, 14:22
Some good info here Weasel. Thanks a lot. Now the question is. Now that you know the cause are you going to attempt another thru-hiker or pick up where you left off?

11-13-2003, 15:17
yea , yea , yea The Weasel...let me tell ya bout meds....but what would ya do with out'em :sun

I also take Lipitor for elevated triglycerides....my legs ache at night no matter if I hiked or not...I have a little creatine elevation...along with a few other abnormalities...

HAhaha..I know what you just thought...and your probably right :D

quit eating that red meat ..esp that over cooked dried out hamburger you carry

there is one really good "med" out there to help with the muscle aches and other side effects....it available now in the civilized country of canada,,,,you live close to there..run for the border :banana

11-13-2003, 15:23
The Weasel

So yeah, I was doomed.

yea ..me too....but


by the way ..I just finished my 10th traverse of the AT inside the GSMNP....starting at hot springs south to our fav...rainbow springs...

The Weasel
11-13-2003, 16:24
quit eating that red meat ..esp that over cooked dried out hamburger you carry

Steve --- Like most people, you can handle some drugs better than others, including me. Are you referring to tobacco? Did you know that Ontario produces a lot of it? And that the largest cash crop in North Carolina ain't tobacco? :-?

As for meat...I think my recipe for VERY good dried soy substitute (indistinguishable from hamburger in trail meals and keeps for up to a year) is posted here somewhere. The kid don't do meat anymore.

And as for restarting, I'm already training. 3 weeks ago did the delightful Manistee Trail in Michigan, which links with the NCT in a nice round of mid-Virginia style PUDS for 20 miles.

See second post re "prediabetes".

The Weasel

The Weasel
11-13-2003, 16:29
Short note on the other aspect of 'tiredness'.

Being overweight, my doctor also diagnosed me recently as having modestly high blood sugar, which is clinically recognized now with the name "pre-diabetes." Left unchecked, it can and often does lead to Adult Onset Diabetes. As my weight lowers, I'll need less medication that I've recently started for it, and possibly go off it entirely.

However, high blood sugar also causes significant lethargy, which probably contributed to my other problems. Significantly, it comes from very high carbohydrate intake which, of course, is typical of trail meals. It is minimized by significant exercise (20 mile days! woohoo!) but is noticable immediately after mealtimes, which makes breakfast a 'challenge meal'.

The rest of you dudes and dudettes over 40 like me, esp. if you're packing extra pounds at the beginning, should test for this before starting, too.

The Weasel

11-13-2003, 17:10
As for meat.... The kid don't do meat anymore.


The Weasel

Yea, The WEASEL, now get into the organic whole grains dude, they affect your glycemic index less...I gotta good line on some whole grain organic veggie noodles ....

ontario grows that burley leaf ..don't they ?????

NC..gotta make some cash somehow...

man just wait until your Lactic acid counts creep up ..you'll love that..talk about muscle aches.....

The Weasel..it's really true ..the miracle of modern meds comes with great price..and it just ain't Big pharma profits,,,hangin there :banana

Sand Crab
11-13-2003, 19:10
Hey Weasel, good post. I had bypass surgery last year and also take Zocor daily along with a couple of other drugs. I don't believe that I have myalgia (I think I'm just naturally lazy), but I do get cramps on my daily walk in the calf my surgeon stripped for replacement veins. I think the cramps are just due to decreased blood flow, but wish I had this information last week when I went for my follow-up visit so I could have mentioned it to my cardiologist. I may give him a call to discuss it. What type of alternative drugs did your cardiologist recommend for you?

The Weasel
11-13-2003, 19:58
man just wait until your Lactic acid counts creep up ..you'll love that..talk about muscle aches.....

Steve, why don't you give the Lactic acid speech. I don't do much dairy crap when I'm trekking, and that's why. You take the soapbox.

The Weasel

11-13-2003, 21:28
Steve, why don't you give the Lactic acid speech. I don't do much dairy crap when I'm trekking, and that's why. You take the soapbox.

The Weasel

the weasel,,I see why you are a attorney do you think we could have acase agin phizer ..i think is the company who manufactors.... lipitor for side effects hurting our hiking...maybe some pain and suffering and emotional damages...

lactic acid is the by product from the crebs cycle that your muscles use making sugar into energy..has to do with aerobic and anaerobic reactions...doesn't have anything to do with dairy.....in this instance...
but a byproduct of metabolism.
that burn you get in your legs after running hard and you start breathing harder and your muscle go to anaerboic energy production ..that's lactic acid...most folks system reconverts but sometimes mitochondrial damage caused from medications keeps us from processing this byproduct and we get a build -up...try co-enzyme Q10...a great mitochondria "food" keeps those little rascals working....get plenty of rest breaks and drink extra fluids...

now for some real muscle pain(screaming)...try rabdomyolisis..that was fun....it's the next step if you really push it....caused when the muscle cell walls start bursting and releasing proteins into the blood stream...potenially rapidly FATAL...

Tx lots of fluids...preferably by IV at the Bryson City hospital if your in the smokies :D

so the weasel do ya think we gotta case????...R am I jist crazy as is the usual assumption :jump

11-26-2003, 01:56
I too am now part of the Lipitor generation and one only needs to read the fine print fact sheet that comes with all prescriptions for all of the potential side effects. Even though I am not arthritic my doctor gave me free samples of Bextra (valdecoxib 10 mg p/dose) to take on my last five week hike and one of these took the place of 4 or 5 200 mg Advils with no side effects. This worked for me, BUT, common sense dictates check with your MD and on top of that it can't hurt to read up on medications from the PDR as on one occasion I found a rare side effect from another medication I was on in the past which the MD overlooked. Self medicating even with over the counter stuff can screw you up.
While on the subject of health I had good luck checking with an experienced podiatrist for foot and ankle symptoms. I know it sucks spending the bucks on MDs, but in the long run it can prevent unnecesssary pain in the future, both physical and $$$$.

11-26-2003, 15:11
Consulting with your Dr is a great idea and should be part of the equation. However, I recommend getting to know a good pharmacist and consulting with him/her about drug interactions. Also, using the same pharmacy is a good idea, because their computer can sometimes warn the pharmacist about problem interactions. There are so many drugs out there that Drs have a hard time keeping up with all the interactions and such.

My father-in-law has almost died (been killed) twice by drug interaction problems because the Dr or team of Drs was not paying attention to drug interactions.

My good friend and hiking partner is a clinical pharmacist and I usually call him when I have a drug question. He knows stuff off the top of his head that my Dr would have to look up.

11-26-2003, 16:13
time for a new doc???????/