A year ago, inspired by my daughter skiing the 57-kilometer American Birkebeiner race, I set a goal for myself to ski the 30-kilometer Korteloppet in Hayward, Wisconsin. The American Birkebeiner Foundation is celebrating its 50th year this month. Each year for the last five decades thousands of skiers have braved a grueling racecourse and capricious weather to ski the famed race. This is the first time I’ve attempted to ski the Korteloppet since contracting MCAS.
Mast Cell Activation Syndrome (MCAS) is a chronic condition that affects all organ systems. MCAS is serious and disabling and people with MCAS often experience significant and debilitating symptoms daily, including anaphylaxis, which can be fatal.
MCAS is often found in combination with other chronic conditions such as Ehlers-Danlos Syndrome (EDS) and Postural Orthostatic Tachycardia Syndrome (POTS).
Healthcare providers frequently do not know about MCAS, and the tests for MCAS are problematic because they are not uniformly reliable. MCAS can be difficult to manage. Treatments include blocking mast cell mediators with anti-histamines and mast cell stabilizers, as well as avoiding triggers.
Check out this post on how to manage MCAS.
Cross-country skiing, or Nordic skiing is a form of skiing that takes place on relatively gentler terrain, as opposed to downhill skiing. It involves propelling oneself across snow-covered trails using skis and poles. This type of skiing can be pursued for both recreation and as a competitive sport, with participants utilizing different techniques such as classic skiing (where the skis move parallel to each other in pre-made tracks) and skate skiing (where the skis move in a skating motion). This activity provides an excellent full-body workout and is popular in regions with snowy winters.
I prefer the classic technique, perhaps because it’s the form I learned first. Classic skiing requires that you wax your skis both for kick (to give you grip to climb hills), and gilde (for speeding downhills).
The Korteloppet is roughly half the length of the Birkebeiner, which is patterned after the annual ski race held in Norway commemorating the legendary rescue of the infant prince Haaken. During the Norweigan Civil War centuries ago one faction was looking to kill the young heir to the Norwegian throne. To keep the prince safe a small group of Birkebeiners brought Prince Haakon and his mother, Inga, north in 1206. The two best skiers carried the child over a strenuous mountain journey and brought the young prince safely to Trondheim. The prince grew to become the king who united Norway, after 1000 years of civil war, and led the country into its golden age. In 1932, 147 men completed the first Norweigan Birkebeiner race on a 59 km long trail in honor of the historical event, and the race has been held annually since then. Participants in the Norweigan Birkebeiner must ski wearing a backpack symbolizing the weight of the baby prince.
The last time I skied the Korteloppet was in 1987 when my hair was permed and they gave out powdered sugar donuts at the aid stations. A lot has changed in the last 37 years: I had three kids, developed a chronic illness, and sports nutrition evolved. This year, there is barely enough snow to create the racecourse, so race producers scaled the Korteloppet back to a 20k event. Instead of donuts, they are giving out maple syrup shots. And, rather than driving six hours round trip to battle the crowds of thousands of skiers on the course, I opted to do a virtual Korteloppet at the local ski area near my home.
My ski today started at 8:30 a.m. when the temperature outside was around 30 degrees Fahrenheit. At the end of my ski, the temperature had risen to 46 degrees, and the tracks were turning to slush. I could feel the sun warming my body in an unaccustomed way. I can only imagine how hard it would have been to start the event at 11 a.m. with the sun beating down on the 1000 participants in my wave, all of us churning the snow to mush with our skis.
My ski today is an achievement, and I’m basking in proud feelings, sore muscles, and chapped cheeks. A year ago, the Korteloppet seemed like an impossible goal. The farthest I had skied at one time in decades was about 10 kilometers. I honestly doubted that I could finish the event.
I’ve chronicled my Mast Cell Activation Syndrome (MCAS) journey on this blog, and at my lowest point, I could not walk a block without severe pain. But I began training over the last twelve months, gradually starting with biking, and then adding running a few times a week to my routine. By mid-summer, I was running up to six miles, but I still had to walk every uphill. I battled tachycardia, flushing, and inflammation daily, and could only exercise on alternate days so that I had a day of rest between workouts.
I was sick with the global pandemic virus in November and was sidelined for six weeks with a bad cough and severe fatigue. But surprisingly, I recovered from that illness and felt energized to continue training for the Korteloppet.
It hasn’t been a good year for snow sports in Minnesota. We received the bare minimum amount of snow in December for ski trails to open, and during weeks of cold temperatures, ski areas made supplemental snow with snow guns. Then we experienced weeks of spring-like weather that melted the snow, followed by sub-zero temperatures that hardened the snowmelt into rock. Somehow local ski areas accumulated enough artificial snow that Minnesota could host the World Cup races last week. But as the week of Birkebeiner events approached, the 20k Korteloppet and 30k Birkebeiner races were scaled back to be held on multiple 10k loops.
With the lack of cold temperatures, sporadic opportunities to train, and the threat that the Birkebeiner week festivities might be canceled altogether, I lowered my expectations. As late as yesterday I planned to drive to Hayward to ski on the artificial snow loop, stopping after 10k. But I decided I needed access to my rescue medications and the comfort of familiar trails, and it didn’t feel worth it to drive six hours to be the potential victim of other skiers losing control, crashing on the ski trails, breaking equipment, or worse.
Nordic skiing is my favorite form of exercise. Maybe it is because of my Norse heritage, but when I’m gliding down the ski track I feel like my body is moving in the way it was built to move.
Today’s ski was an unforeseen delight, a triumph over MCAS, and a compromise. The sun was out, and the day was clear. I used the Strava app to track my progress, but I accidentally paused it around 16k. My best guess is that I skied about 24 kilometers total today. I brought my own maple syrup shots and was pleasantly surprised that they tasted good and I didn’t react to them immediately, though my gloves were pretty sticky by the end. I carried my hydration backpack and consumed plenty of water. In the final six kilometers, my muscles began to cramp and my right foot became numb. But I successfully keep going. I didn’t fall, I didn’t get injured, and I enjoyed a beautiful day outside.
Reflecting back, I hardly recognize the Korteloppet skier I was in 1987 when I could easily dodge fallen skiers around me, push past anaerobic thresholds, and haul my ass up steep hills. Having MCAS has challenged me in so many ways, and my expectations of myself as an athlete needed to be rebuilt from ground zero when I could not tolerate exercise of any kind.
After vomiting at every competition I took part in during high school and college I realized that I hated competing. Now I have a newfound appreciation for the joy of recreational skiing. And though I surprised myself today by kicking up hills that I had to walk earlier in the season, and my mindset is now freer of those limitations, I’m still held back by the limits of my aging body.
Gradually over the last three years, I’ve surprisingly found that I have more capacity for exercise than I thought. I’ve learned what distances I can tolerate, how to make adjustments when I’m reacting to mast cell triggers, and when I need to stop. I’ve skied two to three times per week this winter, and I’ve fought the frustration inherent when the weather didn’t cooperate. While last year I could not ski more than one day consecutively, this winter I found that I could tolerate up to three days in a row.
I’m grateful that I realized I have MCAS and that I’ve learned how to work within the limits MCAS puts on my body.
I’m grateful that I live in a country free of civil war, and I hope that wars around the globe will soon end for all people.
Since my daughters took up Nordic skiing last year I sincerely hope that we will continue to enjoy snow sports despite the alarming trend of climate change.
And I’m grateful for you, my readers!
I feel so full of gratitude that I had the privilege to complete the virtual Korteloppet today. I’m grateful to the ski areas and grooming teams that worked around the clock for months to build the snow base needed for training and to make my virtual ski event possible. I’m grateful my dad supported my competitive ski career, waxed my skis, and drove me all over the Midwest to competitions as a youth skier. And I treasure the friendships I made while training and racing.
One of the best ways I’ve found to manage MCAS, especially when I’m exercising, is to track my symptoms. Knowing your symptom progression in a symptom flare is the key to developing your rescue plan. In a previous post, I discuss how to determine your symptom progression. Once you know what typically happens in your symptom progression you can design a rescue plan to address those symptoms.
Exercise is a symptom trigger for many people with MCAS. So when I exercise I pay special attention to what is happening with my symptoms. In this case, I noticed I was developing extra inflammation in the evening, so I took three rescue medications a couple of hours before bed.
Another thing to be careful about is adding a new food to your diet. It’s best to test a new food, such as the maple syrup shots I used during my ski, on a day when you are not already stressing your body. I didn’t follow my own advice on this, and unfortunately, I realized too late that my skyrocketing inflammation was probably caused by the sugars in maple syrup. I can tolerate a little maple syrup in baked goods, but I hadn’t tried it as an endurance fuel before. I took two Untapped maple syrup shots, and each contained 1 ounce of maple syrup. That’s a total of 40 grams of sugar, and though maple sugar is my best-tolerated sweetener, it was too much sugar for me.
Finally, I’ve found that trying something new, like doing an endurance ski, is best done as early in the day as possible. That way you give your body more time to come down from the stressor before bed. Insomnia is my worst MCAS symptom, and for this reason, I started my ski early in the morning and was finished by 11 a.m.
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The preceding material does not constitute medical advice. This information is for information purposes only and is not intended to be a substitute for professional medical advice, diagnosis, cure or treatment. Always seek advice from your medical doctor.
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