A letter to Abbie on long-distance running with a J-Pouch...

Hi Abbie, I stumbled across your blog while looking up J-Pouch marathoners... and am wondering just how far you've gotten with your running since you wrote this piece.  I'm a J-Poucher since just after 9/11 when I had my rectum removed at Mount Sinai Medical Center on the Upper East Side.  16 months later, I moved to Mexico and am living here almost 12 years now.  I've run off and on since college in the early to mid 90s... I probably would have been a much more serious runner had I not injured my ileal-tibial band in college in 1993.  My uncle Henry (Dr. Carl Henry Nacht) was a top NYC Marathon runner until he was killed on the Hudson River bike path or the Riverside Park bike path (I don't know what it is actually called) by a drunken NYPD tow truck driver riding home with his wife after dinner in Chelsea... His death appeared in all of the NYC papers.  You can look him up as "The Bicycle Doctor"...  My younger sister Beth Rosenberg (also a marathoner) was invited to run with his # in his memory in the following addition of the Marathon that same year (2006).  Beth, an incredible marathoner and mother of 2 girls, was diagnosed with rectal cancer this past March and had immediate J-Pouch surgery that same month...  She's planning upon running marathons again.  But, there are significant question marks surrounding the endeavor.  

That said, I miss Central Park and especially Prospect Park.  Mexico's cities lack parks of their magnitude, especially for running.  Although I've made due...  I live in Guadalajara and began running seriously again this passed May.  During the process, I've encountered issues of "rectal" bleeding after surpassing the 30 minute mark.  Inquiring into the possible causes, I've come to believe somewhat greatly that it has something to do with ischemic "bowel"... although it could have something to do with pouchitis...  I belong to the J-Pouch.org and most of the J-pouch runners who experience the same bleeding and visit with their doctors, have mentioned that there is no visible change in their J-Pouch for explaining the bleeding... no pouchitis.  I stumbled across Ischemic Colitis on the Runners World website.  All this said, with all of my research on diet not directly related to running or the J-Pouch or my sister and my F.A.P./Gardners Syndrome I stumbled across Prickly Pear Cactus (Nopal) and mucilage as a cure for colitis or ulcers or chronic inflamation and started cooking with the Nopal Cactus.  Low and behold, the bleeding during the runs stopped.  Since May, I've changed from the cactus "Nopales" to ground flax seeds (to increase my HDL cholesterol etc) and they and their mucilage have worked even better than the cactus leaves...  (During a hiatus from the Nopales, I started bleeding again after 30 minutes and that bleeding stopped with the ground flax seeds)...  For the first time in 21 years since increasing my runs from 5.2 miles per day to 7.3 miles in one week when I injured my ileal-tibial band in 1993 I found myself running 6 miles, 5-6 days per week (a slow 63 minutes) without pain or injuries and without bleeding.  I just read "Born to Run: A Hidden Tribe, Superathletes, and the Greatest Race the World Has Never Seen" by Christopher McDougall that takes place just north of Guadalajara in Copper Canyon, Chihuahua and found myself incredibly inspired, moved...  

I'm 45-years-old and in a very personal movement to finally encounter true health (against all odds with my FAP/Gardners that seems like a horrible ticking bomb) through a lot of research and reading and wishing I had had better conversations with my uncle long before he died to truly know how he experienced his running...  At the age of 27 while in medical school, he decided to run marathons, going from running his first mile to running his first marathon in 13 months to finishing his NYC Marathons and Boston Marathons in the top 100 (when the New York Marathon had 16,000 starters).  His best time was 2:38...  We would wait for him to pass (around the 22 mile marker) behind the Metropolitan Museum of Art... 20 + minutes after Bill Rodgers had passed... He would appear so relaxed, as if he was out on a 5 mile Central Park Loop warm-up; My aunt Mary Beth (also a Marathon Runner before she started having problems with a pinched nerve) would greet him with a hug and a kiss and run with him for a stint and then we would wait for him to appear at their apartment on West 83rd Street and then West 103rd/Riverside for the wonderful Marathon Party Mary Beth would organize for this incredible man... 

When I run, questions appear in my mind directed towards Henry... or Uncle Henry or Dr. Demento (great sense of humor for entertaining his little neices and nephews we once were) or Dr. Carl Henry Nacht... or now known as "the Bicycle Doctor"...  I wish I could ask him, now that maybe we share two distinct interests that didn't really interest me when he was alive: extreme running (he regularly ran the 50 mile Central Park Ultramarathon: 10 times around) and health.  Its kind of a one-sided series of questions... a silent and slightly sad conversation not really worth having with just anyone, since he wasn't just anyone, but someone who incredibly appreciated how his body worked and moved... For him, it seems that running was beyond personal, but spiritual.  The only way you can truly understand how it works for you is by connecting at a very deep spiritual level where somehow you should find the best answers.  If you don't have that friend or that family member or if you aren't that journalist like Christopher McDougall, you have only yourself for truly understanding how and where you are running.  And, I'm not sure if that always is enough... and why I'm curious how your running experience with the J-Pouch has evolved over the past 2 years, since now you've been given a challenge that I imagine no marathon runner has before they become a marathon runner.  In ways, it was a miracle for me to reach the 10km mark with absolutely no stress... seemingly no effort.  And now I'm thinking of reaching 21 kms (the un-thought-of half marathon).  But, reading "Born to Run..." more interesting than a marathon (that never interested me in my life), are the ultramarathons.  Why?  Because ultramarathons do not have an actual limit on distance or time-frame.  It's not so much about winning or about finishing a certain distance, but about being able to run seemingly forever.  To be able to cross states on foot (not as slow as walking) instead of on wheels; being closer to the country you are crossing...  more connected...  In a very strange way, the closest we can appear to flying... Riding a bike is not you flying, but the bike moving you, although you are peddling...  The plane motor is flying you from JFK to LAX, not you.  But, running an ultramarathon would be the equivalent of getting you there on the wings of your feet... Sounds crazy coming from someone who has never run more than 7.2 miles, let alone a half marathon or a marathon... especially a 45-year-old J-Poucher...  J-Pouching does not bode well for running over 4 hours straight with all the digestive and bathroom issues etc... let alone running over 1 hour... But, running well over 4 hours?  And what would happen to the J-Pouch if there was an issue of Ischemia?  What if you needed a bathroom urgently at any given moment of the run?  How would a J-Poucher eat for the run?  How would you plan your bathrooms and diet and sleep the night before?  What would you carry with you for eating during the run?  What about the hightened risk of dehydration for J-Pouchers?  And, I say in a strange and probably not understandable way at this point in my running, "who cares?"  

Why who cares?  Because in order to barrel past all of the extreme obstacles that make us so extremely different than all the rest of the people and these dreams seemingly unobtainable, in order to begin, you've really gotta say, "who eff'n cares?"  Because, truthfully, you are the only one who truly cares and truly understands what it all signifies for you... And, there must be a point where you must stop caring and you've just gotta give a shot...  Like living in Mexico without a colon and without a rectum and with a J-Pouch that makes such difficult living just that much more difficult.  And, truthfully, "who cares?  Let's just do it and see where we end up..:"  and that's why I'm intrigued by your experience...  

Ross