Nine

Another week gone by…another gulp in my throat as the race inches closer.  Not so much as nervousness for the race itself but more uneasiness over the things I cannot control.  I need to get over this; I can’t waste energy thinking about things I have little control over.  The things that make me most anxious are the heat I’ll have to contend with after getting comfortable with Chicago fall temperatures and not being able to swim with a wetsuit (which is a great benefit to a swimmer like me).  I can’t do anything about the weather or the rules but I can prepare for heat to some degree by doing some longer indoor workouts as it gets closer to race day and dress in heavier clothes outside than what is appropriate.  As far as the lack of wetsuit goes, this has been a great summer season in Lake Michigan to not swim in a wetsuit as the temps thus far have usually been in the mid to upper 70’s.  My anxiety from the no wetsuit is that quite simply I have not made the gains in my swim time as I had hoped I would by now.

In addition to my fairly regular long workouts, on my race plan is two extra long days. One of those days was yesterday.  It started with a 100 mile bike ride, and then the plan was to run 16 miles with a 2 mile swim at the end.  Because I didn’t get to the beach until noon after my bike and run, the life guards at Ohio Street Beach wouldn’t let me swim with the rip currents.  I got in about 3 minutes of swimming and the life guard yelled at me that I had to get out.  It was no good to argue with her that if I got swept out, I could simply put my feet down as I was literally standing in no more than 3 feet of water, or that I came to the beach to specifically swim in current.  Fortunately rip currents don’t occur before 11am as there has been no one in the past to kick me out of the water when swimming in the turbulent water before then (I hope you can sense the sarcasm).  Sarcasm didn’t help my case with her either.  I did tell her that I understood she was just doing her job.  So at any rate, I wanted to get all three disciplines in on the day because I wanted to take today off completely and didn’t want to prolong the swim so I added on 4 miles to my run and went by my local pool which happened to be open for lap swim & turned into a miserable (but very worthwhile) cool down swim.

Today was a wonderful day to sleep in and recharge with Melissa.  This coming week the emphasis is on a couple days of recovery followed by a few shorter, higher quality workouts.  I haven’t organized my weekend workout yet.  I wanted to see how yesterday went first before looking forward too far. 

10 weeks...

With less than ten weeks until Hawaii, the focus becomes more centered, the training more strict, and the shedding the peripheral things that might keep me from getting better.  Throughout these next weeks, each week is designed with different goals.  With that in mind, I will do my best to put a brief post each week highlighting my focus.  

This past week the goal was rejuvenation.  I've been very complacent the past 2 weeks or so with my workouts.  The tough part of training for an Ironman is the delicate balance of pushing yourself to the brink without overtraining.  I've been overtraining as evident by my lack of enthusiasm in completing my workouts.  That's a very dangerous place to be.  Part of it is sleep, partly work, partly not recovering well enough.  Overtraining does not occur with the same workload for everyone, all the training plans I look at and reading I do to set up my training plan tell me more is better.  And I’ve been pushing myself to do as much as possible in the confines of work schedule and holding back at times to avoid injury. 

Fortunately a part of my work schedule that was busier this week and would inevitably knock out a training weekend with 3 overnight weekend emergency room shifts was this weekend.  Since I would lose out on any high-quality training this weekend anyway, it gave me a good opportunity to let the weekend go from a big training day and just do a few shorter light workouts.

Now this upcoming week will be working on getting a couple good runs in and one of two long day workouts where I go long in all three disciplines.  After the long Saturday workout, I will be giving myself the day off entirely on Sunday, something I set as a goal for myself to do once every three weeks, but really haven’t taken any days fully off.  My off days to this point have been light lifting workouts which to me is pretty much the same as a day off, except perhaps mentally not workout out may have prevented the mental stagnation I’ve had for the past couple weeks. 

PSA

Just a quick reminder to ALWAYS wear your bike helmet, no matter the distance or type of ride. As a doctor I do regularly tell my patients to wear their bike helmets but this was all too often preached more than practiced as I skipped the helmet for the freedom of the wind flowing through my locks when commuting on my mountain bike and saved my helmet for the more serious riding during a workout.  This was until this spring when I regularly got scolded by a friend and colleague (thanks Rob) who would ask if I wore my helmet each day and then a month working in the ER seeing patient after patient come in after getting hit by a car to have gravel picked out of the head or a scalp laceration repaired or sadly, in the case of one, a skull fracture all because they chose not to wear their helmet.  I thought I was impervious to getting hurt while going at the relatively lower speeds and easy maneuverability that my mountain bike has to offer. 

A bike I saw in the ER after a head on collision by two bikers on the Lake Shore Path. Fortunately these guys both had their helmets on..

Just over a week ago I biking to work on one of the really hot days (95ish) and was slowing down to stop at an intersection between a car going straight and the one turning right with ample room between them.  As I approached the stopped cars going no more than 3 mph, I hit a pothole I didn’t see, my sweaty palm slipped off the handlebar and I hit the pavement shoulder first followed by head and knee.  My head was fine (thanks to my helmet) but my shoulder and bike were both slightly injured.  The bike suffered a bent derailleur and my shoulder suffered a 1^st degree AC sprain (not very serious and I hope should get better with time).  Even though I log about 150-200 miles per week on a bike, the fall during such a simple task of approaching a stoplight was a good reminder that an accident can happen at any time.  

The not so glamorous side of Ironman training

Obviously it's been a long while since my last post--as I see now, almost two months.  Thanks to those of you who have been checking and encouraging me to post—sorry for the delay; I really appreciate the support!   

The interruption was the result of a few intertwining forces:  1) June was a busy work month, was scheduled to work 25 days straight, unfortunately didn’t happen (see #4), but I was rewarded at the end of this stretch with an amazing 5 days of rejuvenation back home in South Dakota seeing my family over an extending 4^th of July weekend.  2) in the midst of June and July I’ve been preparing two research project s at work (one on the stages of change in the battle for patients to live a healthier life and the second project is with minimalist running).  It’s a big weight off my shoulders to have them submitted to IRB (the people who decide if the research is ethical to perform).  3) As part of the preparation for the triathlon, I’ve needed to fine-tune my activities in training, spending a little time with Melissa and friends, and resting as much as possible, which has left little time, okay, NO time to actually update the blog.  And 4) much of what I’ve experienced the past 6 weeks has been something I’ve been debating on posting.  But if I’m going to give an accurate depiction of what training for an ironman triathlon entails…which was my original thought behind this blog, then I have to give the unpleasant stuff as well. 

Most of this I imagine is pretty common stuff that just goes with the territory.  A lot of people training for these events have a lot more difficult ailments to contend with, so please don’t take any of this as complaining.  Part of my hesitation with sharing this stuff is, well, kinda uhhm…personal…and certainly far from pretty.  The other part is that it’s a lot of unpleasant stuff that I try my best not to occupy my time worrying about. 

As I wrote in my last post I was out on a long run and felt a minor hamstring strain so I had to do what I could to get home without further aggravation.  That event set into motion a few weeks of cascading misery.  First, I tried to alleviate the hamstring strain with high dose NSAIDs which did help the strain but gave me a likely stomach ulcer.  The ulcer developed over a few days but presented itself when I was on a 12 mile run on a Saturday morning before taking a 25 hour call at work that first weekend of June.  I ignored the initial pains at 2 miles thinking it would go away and was stopped dead in my tracks at mile 5.5.  My stubbornness pushed me to not turn around early but I would later find I’d need every step I could get and this was a poor decision on my part to stick it out.  The next 6.5 miles to get home were nothing short of agony…equal parts crippling abdominal pain, nausea, and dizziness came over me.  The 12 miles that normally takes about an hour and 20 or so minutes took me just over 2 hours to complete.  The only reason I was moving that fast is that I had to get home so I could make it to work on time. 

Once home, I laid down for a few minutes to try to feel better, jumped in a quick shower and was walking for the door when the vomiting started.  I did make it to work and spent the entire day either in the call-room bed or on a sofa in our office.  If not for a seasoned intern working that day, I would not have been able to stay at work as she did all the work without any help from me as I lay on my back for 13 hours until it was time for her to go home.  That meant I was now to see and take care of patients on my own, which I was certainly in no shape to do.  I couldn’t eat or drink anything all day.  Without the two liters of IV fluids I got from a friend who was also working in the hospital that night (thanks Chris), I would have been down about 15 pounds on the day.  I routinely get this dehydrated after my long workouts but that is when I can tolerate fluids and quickly rebound.  This day I couldn’t manage anything.

This led to a horrible bout of constipation with black stools the next morning ending in my discovery of what hemorrhoids actually feel like.  The black stool was a sign of the ulcer in my stomach that was bleeding…fortunately the black stool quickly resolved meaning the bleeding stopped and I was just left with stomach pain for the next few weeks every time I ate because of the acid secretion in my stomach when I ate.  Usually I have no problems with constipation (eating about 5-6 bowls of cereal and drinking 2+ gallons of water per day usually takes care of that) but this one instance did it.  After a few excruciating days, the hemorrhoids were calming down nicely. 

Then came a 25 mile run the weekend I traveled back home to South Dakota.  My flight was delayed out of Chicago and I ended up spending the night in Minneapolis rather than making it all the way home to Aberdeen on Friday night as expected.  I got to my hotel in Minneapolis at about 1:30am and the next morning (had I been in Aberdeen) I had a 25 mile run on the schedule.  My plane out of MSP didn’t take off until 1:30pm but my brother and his family were planning on meeting my aunt, uncle and cousins who live in Minneapolis for breakfast that morning at 8:30am.  I’m just too damn stubborn to not get the workout in so I woke up at 4:30 and got moving.  Besides, I love running in Minneapolis and this would give me an opportunity to do that!  I lived there for a short while and went to school about an hour north of the city at St. John’s a few years back.  My run took me around the beautiful lakes of Minneapolis and through downtown and back to my hotel—about 25 miles total.  It was a very peaceful morning and great to replay old memories as I ran through the city.  I was certain I would cross a few water fountains along the way to hydrate so I didn’t bring any fluids with me.  Then next morning, my punishment for the previous day’s indiscretions of a long run without fluids was the return of the hemorrhoids. 

Next up in my battle of the hemorrhoids was the extremely hot Saturday about 3 weeks ago now where it was 85 to 90 degrees at 5am, which is when I started my long bike ride (120 miles on a mildly hilly route).  Just 40 miles in I knew it was going to be a long morning and by 60 miles I was battling trying to go faster (to get done sooner and keep on pace) vs getting heat illness.  I pushed as much as I could for a while but didn’t want to have to call Melissa to pick me up, or worse an ambulance, so I eventually had to slow down to a snail’s pace in order to make it on my own.  I started the bike ride with about 3 ½ liters of fluid (~1 gallon) on my bike and stopped twice to replenish at a gas station and a park.  Seven hours and 120 miles later I found myself at the wrong end of the hydration spectrum, and once again, with a raging bout of hemorrhoids. 

This summer’s heat has really rattled my confidence for Hawaii since it will be well into fall in Chicago before I go to Hawaii for the October 13^th race and Kona is typically 80-85 degrees, sunny, and humid.  I know our current weather has been hotter than that but I need to figure out how I can best acclimate to that heat when I won’t have those conditions to train in at home.  Still playing with a few ideas but I’m really just hoping for a warm fall.

Fortunately the hemorrhoids are currently under control and don’t really affect the training at all.  While I’m talking about that area, the other problem I had earlier this spring with the increased bike mileage with training in California is pressure sores on my groin that had developed into a seroma (a collection of blood and clear body fluid, like a blister on the inside).  Fortunately they have not developed into abscesses (infectious material) yet.  After draining them myself (I’ll spare you of that pleasant picture), and alternating my bike seat, they did calm down for a few months but most recently I can feel one coming back (time to switch back to my old bike saddle for a few weeks).

So in the midst of juggling work, training schedule, and life, I’ve had a few other medical things thrown my way to keep me in check.  These little issues certainly make me feel grateful for being able to be as active as I am most days without any problems.  They’ve also been an all-too-frequent reminder to slow down once in a while so as not to over-train--a constant see-saw for I think most all triathletes or marathoners.

Less than twelve weeks to go now.   The weeks are just flying by and each week that passes makes me a little more concerned about my training, where I’ve been, and where I’m going.  Confidence is something I’ll talk about in a future post (coming soon).  Thanks for reading.