Become a Creator today!Start creating today - Share your story with the world!
Start for free
00:00:00
00:00:01
Episode 73: Carolyn McNamara - Acromegaly
14 Plays8 days ago
Acromegaly is a rare condition caused by a pituitary tumour that leads to excess growth hormone. In this episode, Carolyn shares candidly how her symptoms, which developed slowly and over a long period of time, were mistaken for menopause or normal aging, until a series of unusual infections led to her diagnosis.
She reflects on the shock of being told she had a brain tumour, the challenges of undergoing major surgery, and the ongoing reality of living with residual tumour and long-term treatment. We also talk about the importance of listening to your body, and the progressive journey to recovery and feeling your own self again. Carolyn’s story is one of resilience and hope: she has run marathons, completed triathlons, and learned to manage her energy carefully while still embracing life fully.
The song that Carolyn chose is Unwritten by Natasha Bedingfield.
Recommended
Transcript
Introduction to 'On One Condition'
00:00:00
Speaker
Hi, I'm Sylvain Bertelot and you're listening to On One Condition, podcast to raise awareness about health conditions by listening to people who live them every day. My guest today is Caroline McNamara and we're going to talk about acromegaly.
00:00:16
Speaker
Hi Caroline, thank you for joining me. How are you? Hi, Sylvain. Thank you for having me on the podcast today. I'm good, thank you.
Caroline's Inspirational Song Choice
00:00:24
Speaker
Great. Before we talk about Acromagaly, I love starting with a song. So which song did you choose and why?
00:00:34
Speaker
So I chose Natasha Beddingfield's Unwritten. Basically, that the gist of the song is like an uplifting song. And it's kind of saying that no matter what has gone before, every day is a new day that you can start fresh.
00:00:50
Speaker
I'm very much someone who doesn't kind of, you know, colour within the lines and I, you know, I call things out. And, you know, it's all about just making the most of your life the way it is and also starting each new day with with a blank page, a fresh approach.
00:01:09
Speaker
And I have like a glass half full mentality. I'm quite upbeat. And that song, you know, when you heard hear the first few bars and how kind of upbeat the song is, it just kind of resonates and the words in it resonate as well. So, yeah, it was a perfect choice.
00:01:24
Speaker
Okay, nice. And I love what you said about not being the one who colour between the lines. I like that. She says that in the song. Yeah, absolutely.
Understanding Acromegaly
00:01:34
Speaker
Let's start with acromegalia. I have no idea what it means. So could you share with us what it means and what the symptoms are? please Yeah, absolutely. So I'm a little bit of a linguist as well. So the actual word means large organs, believe it or not, acromegaly. I think it's from Greek in origin.
00:01:56
Speaker
But what it is, it's basically an excess of growth factor, IGF-1, in the body that is usually caused by pituitary tumour.
00:02:09
Speaker
on the pituitary gland, which is, pituitary gland, for those that don't know, it's kind of located behind your nose in the middle of your head. The pituitary gland is known as the master gland and it controls all of the hormones in your body.
00:02:22
Speaker
So when you have a tumour on your pituitary gland, It causes excess growth hormone throughout your whole body and some pituitary tumours affect other hormones in your body.
00:02:33
Speaker
Specifically, acromegaly is related to excess growth hormone, excess IGF-1 caused by a pituitary tumour. and Okay. Wow, so already a lot of details that make me want to ask so many questions.
Caroline's Diagnosis Journey
00:02:47
Speaker
Growth hormone like has a lot of impact in the body, but is that something that affected you as you were growing up, or is it something that happened later in life?
00:02:59
Speaker
Yeah, so when when when people hear the word acromegaly, they have heard of it at all, they think of Andre the Giant, they think of extremely tall people. And certainly if you are diagnosed before the end of puberty, then often you will grow in height.
00:03:19
Speaker
and If you're diagnosed after puberty, and I was in my 40s, just 40 when I was diagnosed, when I had my tumour, Your growth plates are fused by then, so your limbs don't grow, but everything that can grow does.
00:03:34
Speaker
So before I was diagnosed, I had odd symptoms, but my hands grew wider. In the years before I had, because pituitary tumours very slow growing, in the year before I had carpal tunnel surgery on my hand, because the yeah the that's what one of the...
00:03:56
Speaker
complications that people have with acromegaly due to the growth in the in the wrist my cheekbones grew larger i had general swelling in my whole body my whole face had very different to how I look now my whole face was swollen you get frontal bossing so the area above your eyebrows starts to protrude and which I had as well your feet grow I also had oddly.
00:04:23
Speaker
So my tongue grew. So I was biting my tongue. And for anybody that has bitten their tongue before, it's absolute agony, you know, down the sides because my tongue was basically too big for my mouth. It sounds very odd. and it was very odd. But yeah, I was constantly biting my tongue and I couldn't figure out why on earth I was biting my tongue.
00:04:41
Speaker
It also affects things like menstruation. So when I had my symptoms, because of my age specifically, I thought I was going into like an early menopause. And I just thought, you know, this is me now, you know, with this kind of crazy looking face and, you know, these odd large hands and had excess skin on my feet. So all of these very, very odd symptoms. I can see that you're frowning. Yeah. Yeah, exactly. I mean, who would have thought excess skin on your feet would be down to a pituitary tumour. But, you know, it's quite funny because after my surgery, I literally shed so much skin off my feet.
00:05:22
Speaker
I couldn't even make it up. It was unbelievable. and Okay, well. Yeah, yeah.
Diagnosis Process and Treatment
00:05:27
Speaker
So how were you diagnosed then? Because I can imagine that it's not necessarily straightforward. no not at all.
00:05:36
Speaker
Often patients have seven to ten different symptoms that all don't seem related, you know, so it's very difficult to diagnose. For me, what happened was in 2014, I had particularly bad bike crash, a push bike. So i was I'm a cyclist and I was doing triathlons. and I was training for a triathlon when my accident happened.
00:05:56
Speaker
And I was very fit at the time. And I could, you know, do a sub two hour half marathon, just turn up and, you know. was super fit, basically. So I had this accident and broke many bones and punctured my lung. And, you know, that's by the by. But when I was trying to recover from that accident, I found that my recovery wasn't going well at all. And I kept getting these odd infections.
00:06:19
Speaker
I had sinus infections. But normally, if you have something like a sinus infection, you recover from it very rapidly. You know, go to your GP or maybe you taken off the shelf, remedy and you're back up to up and running within, you know, week or so.
00:06:34
Speaker
but these infections were kind of flooring me and I was on the sofa and barely able to make it to the kettle. I had such a ah lack of energy and that happened a couple of times and then i had had an odd impetigo infection on my face. So these great, you know, huge boils.
00:06:50
Speaker
never had anything like that before. And then I had an issue with an eye, had a corneal infection. all these very, very odd things. I went back to my GP and I said, something's going on. No, I'm not quite right. i keep getting all of these crazy things happening with me.
00:07:04
Speaker
you know, is there something wrong with my immune system or, you know, could we do some bloods? So of did they did standard bloods and they came back all fine. And I said, well, ah okay, they're fine. So we're going to need to do some some different tests then or so or something because I'm just not well.
00:07:20
Speaker
So I did some IgE tests, but IgG, IgM, IgA, one of them came back high. I was referred to an immunologist, I'd been to my GP obviously lots of times, with all these different things going on. Of course, the GPs, they can only address one thing at a time.
00:07:37
Speaker
So I had the opportunity to sit down and say, I've got, you know, something on my feet, something on my face and I'm biting my tongue and my throat feels swollen, but there's no pain. I never had the opportunity to go through all my symptoms.
00:07:51
Speaker
So I was referred to an immunologist and went to see the immunologist. The first thing he said was, OK, so you're here, you're sat in front of me. Tell me about you. don't know if said you're married, but you're not wearing your wedding ring. I said, yeah, I can't get my can't get my ring on anymore. My fingers are too swollen.
00:08:08
Speaker
He said, oh, OK. And then slowly but surely, he kind of unraveled with all of the things and, you know, asked me lots of ah very targeted questions. And at the end of that meeting, he said, he said, I don't think you've got anything wrong with your immune system.
00:08:23
Speaker
What I do think is that you may have a pituitary adenoma that is causing excess growth in your body. He said, so send you for a brain um MRI and we're going to do an IGF-1 blood test and we'll see what comes back.
00:08:36
Speaker
And what came back was growth hormone, three times the level what it should be, and a large tumour on my pituitary gland. Okay. That must be scary.
00:08:49
Speaker
Well, you know, like a lot of people, ah love Dr. Google. And I've been Googling my heart out after this appointment, you know, and I'd come up with all sorts of things, but I had not come up with acromegaly. So I didn't, but at the time when I was diagnosed, I was on my own in the in the room, you know, at this consultation because i thought I was just going for, you know, something to do with my immune system that was going to be very benign and, you know, just very general.
00:09:13
Speaker
yeah And just sat in the car and I thought, I've got to go back and tell my husband that I've got a brain tumour. I just couldn't, I couldn't, couldn't, couldn't compute it in my head. was like, as that is that why he's just told me in very nice words, you know?
00:09:27
Speaker
And it's like, wow. so yeah, it was, it was a shock. It was a shock. But you have to kind of push through these things and get on with it, basically. I mean, I wasn't feeling very well. So I wanted, i was, I was happy to know what it was actually. yeah And to have an explanation for it so that I could start to get better and start to feel better.
00:09:48
Speaker
How long did it take for you to get this appointment with the, was it an immunologist? Yeah. So I'm very fortunate in that I've got private healthcare. care And at that point I'd waited quite a long time and been quite ill for some time.
00:10:04
Speaker
So I did see a private immunologist and he then refer referred me back to the NHS, to a neurologist who would then do my surgery.
Surgery and Recovery Challenges
00:10:14
Speaker
Yeah.
00:10:15
Speaker
So I had transphonoidal surgery. So that's where they go up through your nose into your head, basically, yeah to the pituitary area. And then they remove excess bone and tissue to be able to get to the tumour. And then they remove it back out through your nose.
00:10:34
Speaker
And that was that was at the famous St. George's Hospital in South London, Tutankhamen, where I had that surgery. Were you asleep or awake?
00:10:45
Speaker
Oh, no, asleep. Yeah, absolutely. Yeah, yeah. yeah So they have like a knee nose and throat specialist as well as a neurosurgeon that do the surgery. It's quite an involved surgery.
00:10:56
Speaker
So I had the appointment with the immunologist and I think it was around the September of 2016. And then my surgery was the following. It was June 2017. Okay. okay Wow.
00:11:08
Speaker
That's a long time knowing that you have a brain tumour. Mm-hmm. How was it from a and mental health point of view? How did you deal with the waiting?
00:11:23
Speaker
Just by keeping busy with other things, really. Taking my mind off it and just trying to kind of get myself into the best shape physically and mentally that I could be to deal with something like that, you know, to have to get through something like that.
00:11:39
Speaker
There's not that much crap that you can do beforehand, really. I mean... I didn't have any medication beforehand because the idea is that if they can take all the tumour out, you'll be pretty much cured, shall we say, to a degree.
00:11:53
Speaker
Unfortunately, if you've got an excessive growth hormone in your body for any period of time, it already does damage. So even if you have the tumour out, you still have problems afterwards, unfortunately, particularly with your joints.
00:12:07
Speaker
It causes that growth in the joints. And so you can have early onset osteoarthritis and things like that, even if the tumour is removed. So... it's You know, you've got to kind of come to terms with the fact that you might not, they might not get all the tumour out. And even if they do, you might have lifelong things that you're going to have to deal with afterwards.
00:12:27
Speaker
Yeah. Did they manage to take it all out for you? No. No? No. So before I went so into surgery, the the neurosurgeon said to me that it would be like, almost like peeling an orange and that hopefully you'd get all of the skin off the orange and the tumor would be gone. You know, so it was attached basically. They said that if the tumor had started growing through, so say the peel had gone through the orange as such, which it obviously it never does, but you know you know, that kind of concept.
00:12:57
Speaker
If it started moving through those barriers and affecting things like speech and vision, then they would, you know, they'd just take as much tumour as they could and they'd leave as little as possible behind, but not affect deficits, not cause deficits, basically, in function in the patient.
00:13:16
Speaker
So my mine had started to grow through the the the barriers. So they literally had to kind of shave off what they could and leave residual tumour behind. And did you have any other impact apart from the growth hormone?
00:13:30
Speaker
I have also have ah raised prolactin levels as well. So my tumour also does that in terms of my hormonal effects, if you like.
00:13:41
Speaker
m Okay. So some people have what's called a prolactinoma, which only affects their prolactin production. Okay. Well, so the impact on your body and your symptoms, did it happen more or less all
Acromegaly's Progression and Symptoms
00:13:56
Speaker
at once or is was it something progressive?
00:14:00
Speaker
No, that the pituitary tumours are slow growing. And I think the fact that the symptoms come on quite slowly means that yeah even yourself and the people around you don't really notice it.
00:14:13
Speaker
But if you look, so so when I had my second appointment with the immunologist, he said, look back through some photos. after like the last 10 years and bring them with you and see if you can see changes.
00:14:26
Speaker
And i mean, my face was so swollen at that point. It was quite clear that there were ah my face had actually changed massively because of the excess growth hormone causes your tissues to swell, basically.
00:14:37
Speaker
So I had excess growth hormone. and Well, it's it's in your whole body, isn't it? That it's secreting it. So like my throat tissue was swollen. My face was swollen.
00:14:48
Speaker
My body was swollen. My feet were swollen. Everything was swollen. I should have said before as well that one of the unfortunate symptoms of acromegaly as well is that, don't know if you'd call it symptom or not, but you have a raised risk of colon cancer.
00:15:06
Speaker
Oh, okay. So patients that have acromegaly are regularly offered colon screening, basically, to catch that early. It's two to four times the risk of colon cancer in somebody with acromegaly.
00:15:20
Speaker
Oh, okay. And I've had that procedure several times. I've had precancerous polyps removed. So it's something that someone with the disease has to be very aware of.
00:15:32
Speaker
Okay. and I went vegetarian a couple of years ago to try and kind of maybe have an impact on that. Interesting. Do you think it has had an impact?
00:15:43
Speaker
Well, my last colonoscopy was clear. So I think yes. Wow. What do doctors say when you mentioned that you've gone vegetarian and it seems to help?
00:15:54
Speaker
ah Yeah. So i I'm reviewed annually now by endocrinologist that I see. Yeah. So I told her that, yeah, I've gone vegetarian and that my last one was clear and she was, you know, super pleased to hear it.
00:16:07
Speaker
Hopefully she'll spread the word. Yeah. And I'm spreading the word now. Absolutely. Yeah. And it's not the first time I hear like of a change in diet that has a positive impact on the body.
00:16:22
Speaker
that's so That's a different conversation, I think. Absolutely. absolutely Going back to the slow progression of your symptoms, it seems like it's taken time for you to actually get to see an immunologist because of like the GP only focusing on on one symptom at a time.
00:16:42
Speaker
But at the same time for you, I imagine that there's a point where you look back and you're thinking, well, no, that's sort a lot of things together. Was there a period of time where you you didn't really realize and you just dismissed yourself some of the symptoms because it wasn't that obvious?
00:17:00
Speaker
I seriously thought it was menopause. Yeah. I seriously thought I was just getting old listen and getting older and I was aging. And the you know that i think the fact that my period stopped as well just made me think it was menopause.
00:17:18
Speaker
I had no reason to think it was anything else. I wasn't having headaches at that point, yeah you know, that made me think, oh, it must be something. I'd never heard of the disease, you know. chi to it' so It's a rare disease. I'd never heard of it.
00:17:31
Speaker
And there was no reason. There's no family history of anything like that. So there's no reason for me to think that that was what it was. You know, when I hear about tumors or tumors in people's heads, I think – I associate it
Ongoing Treatment and Symptom Management
00:17:44
Speaker
with things like dizziness and headaches and vomiting and things like that, you know, and I never had any of that.
00:17:50
Speaker
So I just totally didn't join the dots at all. Even when I had, even afterwards looking at it and seeing that, you know, the carpal tunnel and the facial swelling and all of that, that it's all symptoms. I never, ever put it all together, ever.
00:18:04
Speaker
Okay. so now, obviously, you've already mentioned that you've shed skin on your feet, for example, that your face looks different to what it was when you were diagnosed.
00:18:20
Speaker
Do you know how it goes back to normal? And does it actually go back to normal? Yeah. So basically, when your growth hormone normalises, everything shrinks back that can.
00:18:32
Speaker
Bony changes stay the same, but the tissue swelling, for example, goes down. so So those things are resolved. Periods come back. you know So things things then start to go back to normal.
00:18:44
Speaker
What I found was that whilst all of my symptoms reduced, so after the surgery, it was like, OK, so we'll do an MRI in, I don't know, 12 weeks, see how you're going, whatever.
00:18:57
Speaker
And I didn't, thankfully, didn't need any long term medications coming out of hospital. But what I found was in the months that followed was that whilst my symptoms were greatly reduced, they were all still there.
00:19:10
Speaker
So I was still slightly swollen. I was still having headaches and I was still feeling pretty rough, still getting sick, just still feeling unwell.
00:19:21
Speaker
Do you know what it's related to, the feeling unwell? Yeah. So at this point, I was seeing an endocrinologist in a general hospital. They were doing an IGF-1 test when I would go along to the hospital.
00:19:34
Speaker
And the IGF-1 test was coming back normal because an IGF-1 test is just your growth hormone at that specific point in the day. It's not looking at your growth hormone over a day, let's say.
00:19:46
Speaker
So that result was coming back normal. And that endocrinologist was just saying, oh, you know, you're fine. Your your results are normal. And there were some other things that that happened with that endocrinologist that I wasn't happy about, like prescribing aspirin, which I was then taking with no stomach protector because that hadn't been prescribed, which can cause gastric cancer, which I only found out when I saw my gastroenterologist for a colonoscopy and he was like why are you taking aspirin with no stomach protector I said I didn't know didn't know I was supposed to have that said yeah you should not be taking aspirin on a bare stomach you really shouldn't anyway so cut a long story short I went back to my GP and I said I want to go somewhere else for my pituitary care I want to go somewhere that specializes in pituitary disorders
00:20:34
Speaker
That's when I was referred to St. Bart's Hospital in London, where they have a pituitary centre. And, you know, massive shout out to them because they've been absolutely fantastic the last site five or so years.
00:20:46
Speaker
So I went to them and saw an endocrinologist there and they did what's called a growth hormone day curve test. So you go to the hospital in the morning at eight o'clock and they take blood periodically through the day, every three or three hours, approximately until like the last ones are like seven o'clock at night.
00:21:05
Speaker
They get a view of what your growth hormone is doing across a day rather than an IGF-1 test, which is just a very immediate result. And what it found was that my growth hormone was still too high.
00:21:17
Speaker
The residual tumour was still producing growth hormone, which was still causing all of my symptoms. So I started a drug called Lanreotide.
00:21:28
Speaker
It reduces your growth hormone levels. Okay. So over a period of a couple of years, I started on the lowest dose and then went back to my endocrinologist. They'd do another day curve, up the dose, do another day curve, up the dose, do another. Yeah. So that went on for several years. And I'm now on max dose lantarotide to keep my growth hormone in check.
00:21:52
Speaker
Is that something that you think will carry on? the life. yes Yeah. Does it have any side effect for you?
00:22:03
Speaker
Yeah, it does. and Many people find that they have gastric issues with it. Oh, okay. Okay. So it's something that you do every four weeks. ah It can also cause gallbladder problems as well, long-term. Okay. And gallstones. That's what certainly what my my research has has told me, that um that is an unfortunate long-term side effect, is issues with gallstones and gallbladder.
00:22:29
Speaker
And yeah, I have yeah gastric issues normally you know for a couple of days after the injection, which I ah do that every four weeks. And I do that myself. Okay.
Adapting Lifestyle and Fitness Post-Diagnosis
00:22:38
Speaker
And in terms of your fitness level, is it back to normal now? You know, it's quite funny because literally just last night, my husband was saying that he was going to sign me up for a half Ironman next year.
00:22:52
Speaker
it was like kind of coming full circle from having my crash, which I was training for a half Ironman, which I did that. which i never I never did the half Ironman. I'd never got back to it. But I did ah for the first time in eight years, I did a mini triathlon two weeks ago.
00:23:07
Speaker
And massively enjoyed it. I mean, since being better, I've done two marathons. I've done London marathon twice wow ah and enjoyed it twice. I've swum. I've done some serpentine, which is like a two mile swim in the serpentine in Hyde Park.
00:23:25
Speaker
I've done ride London, you know, the hundred mile. bike ride around London so I've kept fit but I've never kind of joined them all together and done the triathlon you know a long distance triathlon so we'll see but I'm certainly in better fitness than I was but what i do now is manage my energy levels otherwise I get fatigue So what I do is I kind of work out hard, if you like. So do a run one day, but then the next day I won't do anything energetic. I'll do like a walk or some yoga.
00:23:55
Speaker
And then the next day I'll do something more energetic, like a bike ride, rather than trying to do everything day after day, because that would be too much. If I were to do that, I'd end up like having to take a week off or week on the sofa or something, and I wouldn't be able to do any exercise.
00:24:11
Speaker
So I'm very much in tune with my body and what my body will let me do, if you like. So I'm very aware of like my energy levels and not letting those dip because fatigue and energy levels was something that I really struggled with when I was being diagnosed and in like the throes of it. you know i was really That was a real ah real symptom for me that had to deal with.
00:24:37
Speaker
Yeah. And is that something that you discovered the hard way? Because what I imagine is that I would go back to try to like regain my my fitness level, but then suddenly you realize that you you crash and and you need adapt. Yeah.
00:24:55
Speaker
Absolutely. And it's funny because it was so bad. I remember and I tell this story to people. There's two stories actually that I tell to people. One of them is that so work were very understanding at the time and I would with the fatigue and, you know, i was starting to get headaches and things before my surgery. And I did what I could when I could. But I remember one day I went to work I started work at eight o'clock in the morning, relatively short car journey there. I got there at eight o'clock.
00:25:21
Speaker
and at 8 10 in the morning i said I've got to go I'm too tired I'm going to go home got to go home and I just had to go home and sleep because this pressure would build in my head and I just you just have to sleep and another another weird thing that happens when I get that is that my eyeballs it hurts to move my eyeballs it's it's such an odd such an odd feeling it's very unpleasant and Yeah. And then the other one that i tell people is that don't know if you've ever heard of this thing called spoon theory. And you give yourself a certain the amount of spoons a day. But yeah, I did some of that. So what I would do, what i realized was that I could only do like one thing in a day. So normally you get up, don't you? You go shopping and or you maybe you go to work or you come home, do some housework and you make dinner and, you know, go maybe go for a swim or, you know, you do all those things, don't you, in a day, possibly, you know, lots of things.
00:26:13
Speaker
I could only do one of those. I could shop or I could make dinner, but couldn't do both. And I remember one specific day, my husband drove me to the supermarket, and which was probably about a five or 10 minute walk. But i said, no, you've got to drive me because I can't.
00:26:29
Speaker
And so we went to the supermarket and we're walking around and we got halfway around and I said, I've i've got to go. We've got to leave. We've got to leave. got to leave And we had to drive the five minutes home, ditch the shopping instance and leave, you know, i just couldn't do it.
00:26:45
Speaker
Yeah. Yeah. So I'm not like that anymore. It's incredible that you've got back to being able to run marathons. Yeah. Yeah. Yeah. It's amazing, isn't it Yeah. I mean, if I think about it, I can't really believe it myself either.
00:26:59
Speaker
Yeah. It's yeah, it's crazy.
Proactive Health Screenings and Relaxation Retreats
00:27:02
Speaker
So now do you still have to go and get like colonoscopies regularly or do you need to do any more and MRIs in the future?
00:27:13
Speaker
So I see my endocrinologist on an annual basis now. Okay. and the month before I see her, I get a battery of tests done at St. Bart's Hospital.
00:27:24
Speaker
And then she goes over the results with me. So she talks to me about my symptoms, asks me how I'm feeling. And then based on my symptoms, she decides, you know, if I need an MRI or not.
00:27:35
Speaker
I haven't had an MRI in a long time because the tumour is quite slow growing. None of my symptoms are indicative of it growing again. So I don't i don't need an um MRI. I do have to keep up with the colonoscopy screening.
00:27:48
Speaker
I have had breast cancer as well since then, 2018, early breast cancer. So I was paranoid about my health by this point and had a very small pimple.
00:27:59
Speaker
That was actually nothing, the pimple, but they compared it with old imaging and realized I had calcifications in the breast tissue, which is call it stage zero breast cancer.
00:28:10
Speaker
So, yeah, I had lumpectomy and radiotherapy for that in 2018. So, yeah, had to also recover from that. So, yeah, have screening for that as well. So I am, you know, literally constantly monitoring my body now. Yeah, that's a good thing to do. Yeah, absolutely.
00:28:27
Speaker
yeah Wow. What a journey. I have one last question for you. Okay. Which I'm asking everyone. What's your happy place? The place where you feel at peace?
00:28:39
Speaker
I'm very lucky to have a house in France. Oh, okay. Near Carcassonne. And i think that's probably my happy place. When I go there, I cycle, switch off, chill out.
00:28:51
Speaker
Just me and my family. Beautiful surroundings. And yeah, just relax. That's my that's my happy place. Just kind of forget everything for a few weeks. And enjoy the cuisine from southern France.
00:29:05
Speaker
Yeah, to a degree. Maybe not Castellet. Well, no. Yeah, no, especially if you're vegetarian now. Yeah. What strikes me when I read my notes is how difficult it must have been to actually sit down and one day and and think, well, no, that's too much. There's too many things going on because it it feels like it's something that for some time was hidden in in plain sight.
00:29:31
Speaker
think it probably was. Yeah. Yeah. It was all the but all the infections that just didn't add up. That was what made me question Okay. okay You know, just just those nonstop infections. Otherwise, if I hadn't have had those, I just don't know where it would have ended, you know, what would have been the trigger that made me go down that road.
00:29:50
Speaker
Yeah. Well, thankfully, you don't need to worry about that anymore to some degree. from Yeah. Well, thanks a lot for your time. i absolutely loved talking to you.
00:30:02
Speaker
And I hope you do do your half Ironman. I want to hear about that. Yeah, yeah. Fingers crossed. ah Thank you so much.