Three months ago, there I lay: the fluorescent lights burning my eyes and the sound of tissue crumpling beneath me. I couldn’t help it. I was so tired that I fell asleep on the table in the urgent care examination room while I waited for the doctor. I’m not one to make much of being sick, but at 41, I’m also reticent to take good health for granted. I’ll admit it; I was a little scared. I had never felt sick like this before, so sick I no longer cared about the fact that I was missing many runs of the marathon training plan I started three weeks earlier. Twenty-four hours later, I’d learn that I was one of the rare adults over 40 to contract mono.
Yep, that mono: the mono that prevents many a college student from partying hard, that gives high school students an excuse to miss first period, that was threatening my marathon training plan and my entire summer.
What is mono?
Mono, short for mononucleosis, is an infectious disease caused by the Epstein-Barre virus.
The symptoms may include:
- sore throat
- swollen lymph nodes/sore head and neck
- swollen tonsils
- sensitivity to light
Most people who contract mono are teenagers or young adults. As I said, it’s very rare for a person over 40 to get it, with studies showing 95% of people contract it at some time in their life before the age of 40. The disease is spread through saliva, which is how it came by the nickname, the “kissing disease.” However, like other viruses, it is also spread through coughing and sneezing. In general, the symptoms of mono are more intense the older you are when you contract it. In fact, children who have not gone through puberty who get it often show nothing more than cold symptoms and a slight fever. My doctor thinks my sick three-year-old probably had it too, and that we contracted it from the same source (read: probably from one of the other kids).
Interestingly, it’s hard to identify where one contracts mono, because the incubation period, the time it takes for symptoms to appear after contracting the virus, is four to six weeks. So sometime in April, I caught the Epstein-Barre virus. Some people experience mild fatigue or cold-like symptoms during the incubation period, but I did not.
Typical progression of mono is something like this:
- Incubation period: 4-6 weeks before onset of symptoms.
- Prodromal period: The 3-5 days where you feel like you have a cold, before the serious symptoms occur.
- Acute stage: 7-20 days when you feel sick. This is when you are so tired, you can’t think or move or even think of moving and experience the most severe symptoms.
- Convalescent stage: 2-24 weeks. This is when you don’t feel sick per se, but weak and tired.
My Experience with the Prodromal Period of Mono (Complicated by Strep Throat)
My story starts with the prodromal period. Monday, May 16, two days before my 41st birthday, and the first day of the second week of my shiny new marathon training plan, I woke up with a sore throat and what felt like the beginning of a cold. I wasn’t that sick, so I did my planned six miles while my feverish toddler napped, and hoped for the best. The next day, I struggled to do anything, plagued by a fever and an incredibly sore throat. My littlest was still sick too, so we cuddled in bed most of the day. The fever was still there on Wednesday, but I managed to come out of bed for my children’s “Happy Birthday” serenade and to relatively enjoy a cupcake from my mother.
By Thursday, my fever broke and I managed a very weird-feeling four-mile run, my husband had all the symptoms of strep throat, and the children were beginning to complain of them too. I realized that, while quite a bit more severe than past bouts, my symptoms mirrored the familiar pattern of strep. So on Friday, May 20, after squeezing in another weird-feeling six-mile run, we packed the family into the car and headed to urgent care where all five of us tested positive.
Because of the strep throat, it’s difficult for me to know exactly when the prodromal period ended and the acute stage began. I’d say I felt pretty good on the Thursday after my fever abated and on Friday when we went to urgent care, but I started feeling progressively worse beginning Saturday morning, five days after my symptoms appeared.
My Experience in the Acute Stage of Mono
I tried to muscle through the tiredness and ran another 6.5 miles on Sunday, May 22. And another six miles on Monday, May 23, but I felt even more tired and the weird almost dizzy feeling was worse. After the run, I started to feel sicker … and sicker and sicker. While the rest of the family was on the mend, I was on a downward spiral. I felt increasingly dizzy, exhausted, and the lymph nodes in my neck felt like they were growing by the second.
I went back to urgent care on Wednesday, May 25, which was also the last day of school for my big kids. I fell asleep on the table waiting for the doctor, who was convinced I had some horrible bacterial infection. On a lark, and on the advice of Poppy who had a friend recently diagnosed with mono, I asked the doctor if that could be the problem. He was very skeptical, but pricked my finger and sent the test to the lab. He sent me off with a prescription for a scary sounding heavy duty antibiotic, which I never bothered to pick up.
The next evening, another doctor from the clinic called. The result? I was one of the rare adults over the age of 40 to contract mono.
The days immediately after my diagnosis were a blur. Looking back, I think my acute stage started around five days after the initial onset of sickness, so around May 21. After my diagnosis on May 25, I became sicker and sicker by the minute. My face hurt down to my teeth. I could barely move my neck. I definitely couldn’t get out of bed save to pee or shuffle for some ice cream, the only thing I could swallow or stomach. Scooping it was an aerobic workout. My mom picked up the kids and bags full of their belongings. I played Candy Crush and listened to NPR to distract myself from discomfort and to make the time pass. My brain was too tired to read.
I hit bottom on Saturday, May 28. That was the sickest day of my life. I almost went to the ER because the pain was unbearable. My head hurt more than anything I have ever experienced, and I’ve experienced an unmedicated birth. I am fortunate to have an aunt that I am close with who is a primary care physician. I talked to her about it, and she convinced me that going to the hospital would be more painful and uncomfortable than riding it out at home (lumbar puncture to test for meningitis: no thanks!). I had some pain killers from dental surgery I had years ago stuck in the back of my medicine cabinet, which I never took because I hate how they feel, but I took them and was so grateful for them. While their effects didn’t last long, they supplemented the ibuprofen and Tylenol that wore off incredibly quickly, and allowed me to sleep here and there.
Sunday, May 29 was slightly better. Monday, two weeks after the onset of symptoms, was slightly better than that. We signed our big kids up for day camp and my little one stayed with friends and family. While I was improving, I was still unable to care for my children and barely myself. Overall, I’d say my acute stage lasted for about twelve days.
My Experience with the Convalescent Stage of Mono
After being sick for seventeen days (five days in the prodromal period and 12 in the acute stage), I finally felt well enough to have my youngest home with me on June 4. By Saturday, June 5, I was up cleaning my basement. On Sunday, June 6, I was back in bed. And so went the next couple of weeks. I’d start feeling a little better, have a little more energy, I’d use it and BAM! Back in bed.
I was petrified of a relapse, so I didn’t dare even try to run for the first couple of weeks. Making lunches, folding laundry, and shuttling kids felt like a workout. I was so weak. My muscles seemingly disappeared before my eyes. Somehow, I managed to only gain three pounds despite my sloth.
Almost five weeks after I became sick, on June 14, I thought I could try running again. I ran about two miles. The next day I was so sore. My whole body hurt. I tried again the next day (I feel stupid admitting it), but within two minutes I thought better of it and gave up. So many people were warning me about relapses and setting myself back. Despite a few temporary moments of weakness, I was terrified of sabotaging my recovery by giving into my impatience to get running back in my life sooner.
I took the rest of the week off of exercise, save for some very very light strength training. I did a lunge matrix with four reps of each exercise. I did ten clamshells on each side. I did a 15-second plank or two. When I say I was weak, I’m not joking. This was challenging.
At the six week mark, on Monday, June 20, I went to see my doctor. We discussed everything and she, who has been not so very understanding of the whole running thing in the past, was very supportive of me running again. She assured me that a reasonable return to running might actually help me recover faster and feel better. I think I skipped out of the office!
On Tuesday, June 21, I did a two mile walk-run, more walking than running. I did another the next day, with slightly more running. By the weekend, I ran four miles straight, albeit very, very slowly. This return to running felt as rough, if not rougher, than returning after having a baby. I have not felt this physically weak, perhaps ever.
Since returning to running and over the course of the entire convalescent stage of mono, I’ve experienced strings of good days followed by progressively shorter and less severe strings of bad days. On the good days, often, I feel completely normal! I have normal energy levels and forget I’m sick. But then seemingly out of the blue, I’ll wake up and feel sick again: fatigued, like I’m wearing a weighted body suit, and, the weirdest thing, an intolerance to sunlight. I know I’m having a mono “flare-up” when my eyes hurt outside and I feel a crushing heaviness over my entire body. It’s very strange. But just as soon as a flare-up pops up, it will disappear and I’ll feel fine! Now, three months after the onset of symptoms, I haven’t had a flare-up in about a month! So, I feel somewhat safe to say the convalescent phase for me lasted about eight weeks. That means my mono ran its course from the first symptom to the last in about 11 weeks, which all-in-all is pretty good.
My Return to Running after Mono
My return from mono, eight weeks after the onset of symptoms, five weeks off (except for the one ill-advised two-miler):
Week 1: 17.75 miles all easy and including some walking breaks. (5 days running.)
Week 2: 24.5 miles all very easy. (5 days running.)
Week 3: 30.5 all very easy. (5 days running.)
Week 4: 35 miles all very easy. (5 days running.)
Week 5: 40 miles with one fartlek (1, 2, 3, 3, 2, 1). (6 days running.)
Week 6: 25 with a fartlek (6 x 2:00/2:00). I’ll take it dealing with a stomach bug Friday through Sunday, which made me miss two runs, including a long run. (4 days of running.)
Week 7: 33 miles with a fartlek (3 x 3:00/3:00, 2:00/2:00) and managed not to have a mono relapse while dealing with a stomach bug going through the family and vacation! (4 days of running.)
Week 8: 38 with a fartlek (3 x 3:00/3:00, 3 x 2:00/2:00, 3 x 1:00/1:00) I would have liked to run six days, but with back-to-school and dealing with some elderly in-law health issues, this was a solid week. I’ll take it! (5 days running.)
It’s been 8 weeks now and my easy pace is almost to where it was before mono, but still not quite there. When I’m running I feel about the same as I did before I was sick, so that’s a step in the right direction.
I’ll be back soon with Part II, where I will talk to other adult runners who have experienced mono. We’ll compare their experiences to mine and share some tips for identifying if you have it, how to get through it, and best practices for returning to running.
Have you had mono? What was your experience, and how did you handle running/your return to running while going through it?