“In that case, I have one more question for you” a fellow Rifle climber posed to me after I accepted his offer to give me beta for a route. He was lounging comfortably in a lawn chair at the Bauhaus wall on a sultry July afternoon, a spliff in one hand and a laser-pointer in the other.
“Would you like beta given via conversation or via laser?”
I received a piece of advice recently, from a surprising source.
“Do what it is you need to do”
For days, the words tumbled in my mind like a pebble stuck in my shoe, persistently yet softly reminding me of their presence.
Each word is simple, common and monosyllabic. Yet, they are arranged in such a way to express an idea that is worth enough to be profoundly unclear upon first reflection; to understand it, I had to sit with it.
But, as I considered the simple beauty in that, most of my attention was focused elsewhere.
Life here shows itself in far-gone gestures and traces, always one step ahead of me. I have never seen the mountain lion I decided was male and affectionately named Igor, but often find his fresh tracks. In the evening, what I believe must be a dignified owl – its hoot so deep and melancholic – makes itself known, but never seen. The bounding antelope undulate and meld with the distant heat-waves. Even the fighter-jet pilots frequently fly over this area are visibly untraceable as they send a shivering whistle that can be heard for miles.
The presence of field mice, though, has been confirmed, as they unfortunately found a way into my van. I dubbed them (all four of them) Henry, after the affable husband of the protagonist in one of my favorite books, Olive Kitteridge, who dies. I have been reading a lot, lately.
After briefly considering them as pets, I ultimately provided four suppers for the local owl. His hoot seemed to liven up a bit and I felt better about Henry the third, who set the trap but did not actually die. I found him next to it, hyperventilating and only slowly responsive.
I took him outside and laid him like bait on the gravel. My heart filled with lead and sank as he looked up at me, perhaps confused as to why it was suddenly so much colder. I closed the door of my van and went to bed.
Startled, having just set foot in a doctor’s office for a check-up required by work, my mind went to humor.
“So, you mean like the weight of a house cat?,” I replied.
“Gain some fat, get a cat” became an inside joke between my coworkers and me, a rallying cry preceding many large dinners as we worked in California’s High Sierra.
That wasn’t the first time I heard such advice. In 2016, I was becoming interested in climbing performance and body composition and got a DXA (dual x-ray absorption) scan, a test that measures amounts of fat, muscle tissue, and bone density. For female athletes, body fat between 14-22% is considered healthy. Bone density is measured in “T-scores”, standard deviations from normal bone density, which is represented as 0. A score between +1 and -1 is considered healthy.
At 5’4’’ and 110 lbs, I clocked in at 15% body fat with a bone density score of -1.1, meaning I had low levels of both. The technician asked if I was having regular periods, an indicator of healthy levels of hormones like estrogen that influence bone density.
When I first noticed the disappearance of my period in 2012, I was under tremendous stress due to a debilitating and complex injury. When I regained my health and my periods were still only infrequent, I transferred the excuse from “stress” to “birth control,” as missing periods are a side effect of the pill.
My dismissal of adverse health indicators and my ability to write off the experience as a joke reveals my attitude toward the issue – I didn’t see it as a problem. I’ve always been naturally thin, a voracious eater and often buzzed with an energy that bordered on hyperactive. I ran and eventually climbed to outlet this energy. In college, I earned the endearing nickname “the vulture” because I would always pick off people’s unfinished plates.
In fact, gaining fat has always been difficult for me, with excess calories manifesting as muscle. The doctor’s declaration that I gain weight sounded like an echo of remarks I’d heard from family, boyfriends and friends. Sometimes it seemed well-intentioned, but it also felt patronizing, debasing and pointless – like they were telling me to just “grow taller.”
As I pursued climbing, I was told anything from “you look great and toned” to “be careful, you are starting to look too muscular for a woman,” as if the purpose of my body wasn’t to enable me to perform, but rather to look a certain way for others. Praised and criticized for my natural physiology, I felt pulled in opposing directions, the result being that I stood still where I was. I became hyper-aware of my appearance as mixed messages swirled like violent eddies in my mind. Perhaps my body, lean and potentially beneficial for climbing, and the stereotypical female body I was told was desirable and attractive, were mutually exclusive.
These competing thoughts were white noise against the background of my drive to climb well. Instead of considering the comments that grew from genuine concern, I developed a chip on my shoulder. I felt energetic, was eating well and was doing what made me happy – why would I change for anyone else?
In 2017 I saw a gynecologist to discuss IUDs, a type of birth control. She took one glance at my medical history, four years of infrequent periods, and ordered another DXA to evaluate my bone density. Since the first scan, I had gained weight, so I assumed the problem was resolved. “This is great comparative data!” I thought. The results arrived quickly.
“Significant osteopenia is noted at the spine and hips; there is currently an increased risk of fracture “
In my spine, my bone density was 86% of normal, 87% in my hips and 81% in my neck. I had early-onset osteopenia, a reduction in bone mass preceding osteoporosis, a severe condition in which bones become brittle and fracture easily. I was 26.
A fear dropped in me swiftly and hard. A once distant threat, some imperceptible sensation I could barely recognize, suddenly brandished itself in irrefutable numbers, grasping me by the shoulders and screaming for attention. I felt cheated; my body was silently crumbling away and it didn’t even warn me – except that it had.
It seemed like an irrevocable and destructive force was moving through me. It was painful to even begin to consider the reality that it was I who let it in.
It’s referred to as the female athlete triad,” my gynecologist told me on my follow-up visit.
The “triad” refers to a syndrome that manifests due to three interrelated conditions. Intense exercise and under-fueling, intentionally or unintentionally, can reduce energy availability to a threshold below that needed to maintain normal menstrual cycles.1 As periods become irregular or absent, levels of estrogen and progesterone, hormones crucial in bone formation, drop. In 2014, the International Olympic Committee coined RED-S (relative energy deficiency in sport)2 to replace the female athlete triad, emphasizing that men are also affected by energy deficiency.
My low bone density and irregular periods were two signs of a third inevitability — I had inadequate nutrition to meet my metabolic needs. My body was stopping basic processes and I felt fine, with enough energy to excel in graduate school, socialize, train, and progress in climbing. My mind felt slippery, ricocheting between my perception of my health and the reality unfurling before me.
Professional rock-climber Mina Leslie-Wujastyk touched upon her experience with RED-S in this excellent piece. While Mina noticed low energy levels yet maintained healthy bone density, I had the opposite presentation. However, we both had a normal BMI, abnormally low estrogen levels, lost our periods, and hadn’t noticed due to hormonal birth control.
The consequences of RED-S are severe. If left untreated or diagnosed too late, a patient is left susceptible to osteoporosis and potential cardiovascular issues related to poor hormonal health. I wasn’t only gambling with my athletic ambitions, but with my long-term health.
Fortunately, since I was still young enough to put down bone, I could reverse the osteopenia.
I was referred to a nutritionist. A vegan for four years due to environmental reasons, I had a restrictive diet. I couldn’t avoid the question — did veganism cause my RED-S?
According to the nutritionist, the answer was probably not. I wasn’t a vegan when my periods first disappeared and I was eating well. I increased my caloric intake and took calcium and vitamin D supplements. Eventually, I decided to eat meat, eggs and some dairy products, though transitioned away from veganism slowly. To increase intake, I had to eat when I wasn’t hungry, behavior which I had always viewed as inadvisable. My weight stayed the same as my body funneled the calories to returning to physiological normalcy, rather than to adding weight.
Changing ingrained habits or opinions is always daunting. As I paid precise attention to what I ate, I realized I was probably not objective about my diet. Though I always felt I had a good relationship with food, obviously something was not right. It took me a long time to admit this to myself.
Changing my eating habits forced me to consider the consequences for climbing.
A climber’s performance is affected by his or her strength to weight ratio. Easier and quicker than increasing strength, weight loss is a popular tactic climbers employ. Though I never tried to cut weight, I, like most, considered it a viable and normal strategy. Now, it felt like a playing card had been taken from my hand. In the context of greater concerns for my health, the strength of this frustration felt out of place and immature.
I briefly went off the pill to monitor my period. However, a month after it returned, I got a hormonal IUD. While the IUD masks my period it is also remarkably beneficial in my life. Choosing between sexual freedom, a basic right that is very important to me, or receiving cues that tell me I am healthy is a rather irritating conflict that I have given much consideration.
To decrease my susceptibility to chronic stress, another major cause of energy deficiency and an insidious tendency of mine, I tried to calm my mind via guided meditation and also socialized more. I was advised to exercise less, a catch-22 since climbing and running have always been a form of therapy for me. I compromised by stopping my habit of cycling everywhere. Otherwise, I did not reduce my exercise and climbed some of my hardest routes in the middle of treatment. However, I did become more regimented in my gym climbing; by making plans ahead of time, I sometimes avoided staying there for hours and using the gym as an emotional outlet.
After two years, I received another scan. My bone density increased; I was at 91% of normal for the spine and hips, yet at 85% for the femoral neck, meaning I still have minor osteopenia in my neck, and, as I near my 30’s, I likely always will.
I had wanted to try an IUD for a year prior to my doctor’s visit, but I put it off due to a busy schedule and lack of health insurance. Had circumstances unfolded differently, I might have walked into the gynecologist’s office in my late twenties, when reversing osteopenia is potentially impossible. While only a frightful hypothetical situation for me, finding out about RED-S too late is likely a reality for many young athletes.
Today, I always consider RED-S when I plan my diet or training. This requires discipline, as my major symptom is a silent one and my birth control effectively removes my ability to monitor my hormonal health. It can be easy to fall into cycles of stress or of believing uncomfortable notions that I am eating “too much.”
So, months after the diagnosis, I printed the initial report and put it in my climbing notebook. That paper can turn the hollow pain I felt on the first day — fearing I made a mistake I couldn’t recover from — into a physical presence I can carry within me.
Sometimes, it is roused when I stress over jobs, climbing or relationships. It reminds me that health is fragile, though easy to ignore in pursuit of other goals, even something as trivial as a climbing grade.
On good days, I realize that what is on the line is often far greater than what I might lose, or, more simply, what I might not achieve.
This article was originally written for Gnarly Nutrition. The post can be found here.
1 Nazem, Taraneh Gharib, and Kathryn E. Ackerman. “The female athlete triad.” Sports Health 4.4 (2012): 302-311.
2 Mountjoy, Margo, et al. “The IOC consensus statement: beyond the female athlete triad—Relative Energy Deficiency in Sport (RED-S).” Br J Sports Med 48.7 (2014): 491-497.
The first time I heard someone wobble I was dropping down into L’Espadelles, one of the most popular crags in one of the most legendary sport-climbing areas in the world.
The cries were shrill and prolonged, laced with expletives. It went on long enough that I was able to pinpoint the source — a recognizeable professional climber, fists pounding in the air. The image of him sinking into his harness as his anger seemingly turned to sorrow stuck with me. His sense of overwhelming defeat was palpable, as if hanging off the end of the rope —not having to deal with his own weight against gravity—was all he could do.
I thought it was embarrassing and immature. I didn’t understand why someone would have such an emotional reaction over a random piece of rock in which success was indicated by two adjacent bolts. It was spring 2013 and I was a foreign exchange student living in Barcelona for a year. A 5.11 climber, I was just beginning to get comfortable taking lead falls and certainly hadn’t tried a route more than once or twice.
I was absolutely ga-ga over this new sport, and, naively, couldn’t understand how someone could derive so much anger from it.
Seven years later, I’m a different kind of climber.
My eyelids fluttered closed as I put the van in park. Still, the glowing lights of the highway pulsed in the darkness. Though I had just driven for fifteen hours straight, I did not feel tired. The smell of the night’s rain lingered gently, weaving its way through my window. For a minute, though I was alone, I felt the warmth of intimacy curling up into my spine. Sleep came quickly and I awoke slowly, the hum of traffic on Rainier reminding me where I was. I lit the stove and soon the sound of cars was broken with the welcome slow gurgle of a finished pot of coffee. Today, I noticed the shape of the mug, its heat emanating into my hands.
The only time in which I find total clarity is when I am running. It’s often very brief, a few minutes here and there, but it is distinctive and real. I suppose the simplicity of the action is freeing, it’s almost like breathing- you just do it.
In October and November, I had been running on the Yosemite Valley loop trail. Every time, I ran the same length of trail which passed directly underneath a classic, steep and short route called Cosmic Debris. You can see the short angled crack jut between the pines, daring you to come try it . I had been working on the route for several days. Normally, when I’m projecting a route, I tend to find myself visualizing it when I run.
In fact, for Cosmic Debris, I’d always deliberately look at the route when I ran, to try to force my mind onto it. Because this time, and for many runs prior to and after this one, I was elsewhere, I was somewhere I really didn’t want to think about. My feet were touching ground with Yosemite Valley, but in my head I was in a vivid fantasy, performing the eight moves of the finishing crux to a route I had worked on over the summer. I could feel the left smear under my left foot, could almost see the Californian sun get a little dimmer as I found myself in a dark, wet, small cave in northwestern Washington. Physically, I was in a climbing mecca, a gorgeous spot many people vie to be in, even if only for a few days. It honestly feels embarrassing to admit this, like I am pining for some long lost lover.
That’s why you’re good”. “The best , they always try to push through the pain. They have to.”
My right hand was warm, covered in clear ultrasound gel. A probe was pressed against the base of my right ring finger, the same place that had been achy for two weeks. A computer monitor to my right displayed a coarse black and white image. In the center was a thick line made up of different shades of gray. It reminded me of a river. Below the line was a large black gap, and then a bright white base. The gray river was my tendon. Normally, it sits flush against the white line, the bone. My tendon was held well above the bone- 40cm at minimal resistance- because I had torn the ligament, the pulley, that holds it there.
For one last moment, the place we’d left that evening materialized in front of me. Evanescent, like a thin dawn haze you’re not sure exists, and yet so solid that you’ve spent months here. It is secret and mysterious, radiantly verdant and bursting out of the forest, daring and breathtaking.
When climbing clicks it’s as good as any buzz out there. It is fierce and lithe- a cheetah taut, tight, and then leaping at full stretch. It’s as precise and right as an iris flower, beautifully optimized to perform. It is momentous and captivating, the beginning score of a flawlessly tuned orchestra rising suddenly from silence, deep, full and roaring inside of you. You’ll go through a million bad days for those minutes of absolute perfection.
That feeling brushed by me last weekend, like a soft wind soothed by the mountains. A mere thirteen body movements at the cusp of my limit, executed perfectly. I chased it down the rest of the day, but as quickly as it came it was gone.
More often than not, the big cat is turned nervous and edgy. The flower opens too soon, a jagged out of tune note thunders out of harmony, the volume turned up full blast. It’s a thin line to walk- achieving the most meaningful flow requires a no-guarantee investment of many, many bad days.
Climbing near my limit forces me to prove it to myself. Can’t be weak and try voodoo. Can’t be unfocused and try voodoo. Maybe I can’t love you and try voodoo. Can’t give anything less than a furious, firey, ball of energy. A calculated, controlled explosion of emotion, power, fight, strength, and humility.