After enduring seven years of baffling health issues, Risa August realized something was amiss.

Hailing from Colorado, the Ironman athlete was accustomed to testing her physical limits while simultaneously managing a wedding and event planning business. Yet, despite her rigorous exercise routine in 2011, she noticed an alarming weight gain.

“Five months after completing an Ironman race, I suddenly gained 40 pounds, even though I adhered to a strict diet,” August recounted. At the time, she was in her mid-30s.

Her challenges didn’t stop there. August experienced a noticeable shift in her jaw alignment, necessitating braces on three occasions within five years, and she developed a mysterious “bony lump” on the side of her head. Over the years, her hands and feet also swelled significantly.

Another perplexing symptom was excessive sweating, requiring frequent outfit changes. “I just assumed it was a part of aging,” August, now 51, admitted.

She was also plagued by severe headaches that occurred uniquely when she sat up at night.

August estimated she made nearly 50 appointments with her primary care doctor, but all of her concerns were repeatedly dismissed. 

‘I knew something was off in my body,’ she recalled. ‘And my doctors kept saying, “Your blood work is fine. We’re not worried. You’re an athlete, you’re successful.” I really think people started to think I was making it up, that I was crazy.

Risa August was an Ironman athlete when she suddenly packed on 40lbs and her hands feet mysteriously ballooned in size

‘I would hear things like, you’re overtraining, you’re not drinking enough water, you’re aging.’

As her body changed, August began to doubt herself and became so desperate for answers that she went to an Overeaters Anonymous meeting after a friend suggested she might be ‘in denial’ about how much she was eating. 

‘I would sit in the circle and I would hear these stories, and I was like, that’s not me. I’m not hiding food,’ she said. 

After falling down a research rabbit hole in 2018, August was convinced something was wrong with her endocrine system, a network of glands that produce and release a cascade of hormones into the bloodstream. 

She demanded an MRI scan, which her doctor at first refused.

When the doctor relented, the scan revealed a golf ball-sized tumor on August’s pituitary gland, a pea-sized area of the brain that secretes hormones responsible for growth, metabolism, reproduction and stress. 

The tumor had caused acromegaly, a one-in-10,000 condition that causes the bones in the hands, feet and face to grow uncontrollably due to excess levels of human growth hormone. It’s the same condition that gave wrestler Andre the Giant his moniker. 

While she was overwhelmed by the news, August was most struck by a sense of relief over finally being believed. 

‘The only thing that mattered in that moment was validation,’ she said. ‘I remember the doctor’s face when she was telling me this. It was kind of this urgency. She said, “This has got to come out.”‘

After 50 doctor appointments, August finally learned she had a golf ball-sized tumor on her pituitary gland, which caused the rare hormonal disorder acromegaly. She is pictured in the hospital after surgery to remove part of the tumor

August still has acromegaly despite surgery and radiation, but removing as much of the tumor was crucial for avoiding lasting complications, her doctors said 

Doctors believe the tumor, which usually has no known cause, had been growing for at least a decade. In addition to uncontrolled growth, acromegaly can also cause a host of potentially deadly health issues, including higher than average sodium levels. 

High sodium causes the body to retain more excess fluids, increasing the volume of blood circulating in the blood vessels, which raises blood pressure. 

That high blood pressure strains the heart and eventually leaves it unable to pump blood to the rest of the body, raising the risk of heart failure, heart attack and stroke. 

Excess growth hormone production also signals the liver to produce more glucose, leaving the body prone to developing type 2 diabetes. Additionally, airways narrow, potentially leading to respiratory failure. 

‘The disease is what will kill you,’ August said the doctor told her. 

August underwent surgery in January 2019 to remove as much of the tumor as possible and spent ten days in the intensive care unit (ICU) recovering.

Part of the tumor couldn’t be removed because it had wrapped around a carotid artery – which is found in the neck and supplies blood directly from the heart to the brain – and was too close to the optic nerve. 

Several months after surgery, August completed a 41-day bike trip from Canada to Mexico, despite intense fatigue and pain

‘I wanted to live bigger and better than before,’ August said about getting back to life after surgery

She had radiation after surgery, but still lives with acromegaly, which can be disabling.

‘About three months post-surgery, I realized I would never be the same person,’ August said. ‘My body physically wouldn’t be the same and cognitively, there was so much that had changed.’

In one instance, she wrote an email only to look up at the screen and see lines of unintelligible numbers and letters. In another, she could barely walk to her mailbox without stumbling. 

‘I felt like a zombie,’ she said. 

Six months after surgery, sitting on the sofa and watching baking shows, August made a decision that changed her life again. ‘I wanted to live bigger and better than before,’ she remembered.

August signed up to cycle 1,800mi from Canada to Mexico. She started preparing by getting up off the sofa and doing less sedentary tasks, like painting, then walking to the mailbox. 

Gradually she worked up to five minutes a day on a bike in her basement. 

‘My mind lives in such an incredible place now. I am so much happier and freer than I was,’ August said. ‘The beauty of the brain tumor was that it cracked me open and helped me step into who I really am’

Training was exceptionally difficult as she was plagued by pain and fatigue, but her illness also forced her to confront the rest of her life, including an unhappy marriage. August left her husband just before leaving for the bike trip. 

‘It was an opportunity for reflection,’ she said. ‘I looked back on 18 years and saw how lonely I was in the marriage.’

Despite the fatigue and needing to have her medication shipped directly to urgent care centers along the route, August completed the 41-day ride in 2021 and still bikes today. 

While she still has acromegaly, she has since written a memoir, delivered a TEDx talk and speaks at medical conferences, advocating for patients who are dismissed or misdiagnosed. 

‘My mind lives in such an incredible place now. I am so much happier and freer than I was,’ August said. ‘The beauty of the brain tumor was that it cracked me open and helped me step into who I really am.’