Risa August's Unsolved Medical Mystery: A Former Ironman's Struggle with Unexplained Symptoms

Risa August, a former Ironman athlete from Colorado, spent years battling a mystery that no doctor could solve. In 2011, she gained 40 pounds in just five months despite maintaining a strict diet and rigorous training regimen. Her body began changing in ways she couldn't ignore: her jaw shifted, requiring three rounds of braces within five years. A "bony lump" appeared on the side of her head, and her hands and feet ballooned to sizes that defied explanation. She sweated so profusely that changing clothes became a daily necessity. "I thought it was just aging," she said. But the real issue was far more insidious.

Her symptoms worsened over time, culminating in debilitating headaches that struck only when she sat up at night. August estimates she visited her primary care doctor nearly 50 times, but each time, her concerns were dismissed. "They kept saying, 'Your blood work is fine. You're an athlete, you're successful,'" she recalled. "People started to think I was making it up." The frustration was compounded by well-meaning but dismissive comments like, "You're overtraining" or "You're not drinking enough water." The emotional toll was immense. "I began doubting myself," she admitted. "I even went to an Overeaters Anonymous meeting after a friend suggested I might be in denial about my eating habits."

The turning point came in 2018 when August, fueled by desperation, dove into medical research. She became convinced her endocrine system was malfunctioning. Her doctor initially refused to order an MRI scan, but after persistent advocacy, the test was finally performed. The results were staggering: a golf ball-sized tumor on her pituitary gland, a pea-shaped structure in the brain that regulates hormones controlling growth, metabolism, and stress. The tumor had caused acromegaly, a rare condition affecting about 1 in 10,000 people. This disorder, linked to excess human growth hormone, explains the uncontrolled bone growth in her hands, feet, and face—similar to the condition that gave wrestler Andre the Giant his iconic stature.

The diagnosis brought both relief and fear. "The only thing that mattered in that moment was validation," August said. Her doctor's urgency was palpable: "This has got to come out." Surgery was scheduled for January 2019 to remove as much of the tumor as possible. The procedure was grueling, and August spent 10 days in the intensive care unit recovering. While the surgery and subsequent radiation therapy have not completely cured her acromegaly, removing the tumor was critical in preventing life-threatening complications.

Acromegaly is a silent killer. The excess growth hormone can lead to heart failure, diabetes, and respiratory issues. High sodium levels from the condition cause fluid retention, elevating blood pressure and straining the heart. Excess glucose production by the liver increases diabetes risk, while narrowed airways can lead to respiratory failure. "The disease is what will kill you," August's doctor warned. Today, she lives with the condition but credits her persistence for survival. Her story underscores a sobering truth: when symptoms defy explanation, trust in your instincts—and demand answers.

A tumor clung dangerously close to a carotid artery in August's neck, entwining itself around the vital blood vessel that feeds the brain. Surgeons could not remove it entirely because it was too near the optic nerve, leaving fragments behind that would later reshape her life. Despite the risks, she faced the aftermath with relentless resolve.

Months after surgery, August embarked on a 41-day bike ride from Canada to Mexico, pushing through exhaustion and pain that left her questioning her own limits. "I wanted to live bigger and better than before," she said, her voice steady with conviction. The journey was not just physical—it was a declaration of defiance against the disease that had altered her body and mind.

Radiation followed the surgery, but acromegaly lingered, a condition that can cripple with its relentless symptoms. Three months post-operation, August stared at a screen and saw only a jumble of numbers and letters in an email she had written. Another day, she stumbled while walking to her mailbox, her legs betraying her. "I felt like a zombie," she admitted, the words raw with the weight of her struggle.

Six months later, she sat on a sofa, watching baking shows, and made a decision that would redefine her life. She signed up for the 1,800-mile journey, a choice born from a desire to reclaim her identity. Training was brutal—pain gnawed at her, fatigue dragged her down—but she persisted. Each step, each pedal stroke, was a battle against the remnants of the tumor that had cracked her open.

The trip forced her to confront more than her health. It exposed the cracks in her marriage, a relationship that had grown hollow over 18 years. She left her husband just before the journey, seeing the loneliness she had ignored for decades. "It was an opportunity for reflection," she said, her tone quiet but resolute.

Despite needing medication shipped to urgent care centers along the route, August completed the ride in 2021. Today, she still bikes, her body and mind transformed by the experience. She has written a memoir, delivered a TEDx talk, and speaks at medical conferences, advocating for patients who feel unseen. "The beauty of the brain tumor was that it cracked me open and helped me step into who I really am," she said, her words echoing with the weight of a life reborn.