Tiny Particles

5 days ago I woke up with worse than normal nasal congestion and a sore throat. I typically wake up with sniffles that resolve by 10am. I figured it was some kind of allergy, but wasn't going to see an allergist. Quoth the pig-headed surgeon,"Why see an allergist? What have they to offer me after a battery of horrible tests that involved needles under my skin? Antihistamines or shots...I don't want shots; and I didn't need to go to medical school to figure out how to take antihistamines!"

This summer the morning sniffles became an all day nose blowing fest sponsored by Kleenex and a few nights of complete nasal congestion had me running to Afrin for relief (and I HATE sticking anything up my nose). A few of my Wound Clinic patients have stopped asking me if I was sick and comment weekly,"Will you EVER stop having a runny nose, doctor? Maybe you should see an allergist..."

Long story getting longer: those symptoms 5 days ago have increased in a 1000-fold magnitude. I'd never been so congested in my life. The mouth breathing/ suffocating goldfish routine was relieved by just one thing: Afrin. I did the BIG NO-NO and used 4 doses in a row---now I had it: Rhinitis medicamentosa. Rebound nasal swelling from overuse of intranasal vasoconstrictive medications. I was a stinking Afrin addict. I'd seen patients with it during medical school and remember thinking, "How could you get addicted to something that required sticking it up your nose?! EEUUW!" Let me tell you how: When you feel like your head is going to explode from all the edema in your nasal passages, when you want to drive to the ER and call ahead for a tracheostomy tray, when you're contemplating being sedated and intubated until it all passes over...and the only thing that allows you to get enough oxygen so you can stop thinking those thoughts is that nasty little bottle of magical nasal mucosa shrinking elixir---that's how you become addicted.

For the last 3 days, I've ingested, inhaled, and snorted every antihistamine known to medical science. I broke down and used ONE drop of Afrin in only ONE nostril last night just so I could breathe enough to sleep. I'm planning on riding for one hour today. Kevin doesn't think I should ride outside because I've been so dopey on these drugs. My dad tells me to not operate or make ANY clinical decisions while on these drugs. Lovely.

It's maddening that some tiny particles: allergens? viruses? have completely shelled me. So what does this have to do with triathlon beside being a long-winded excuse for not training for the last 5 days? It has to do with being humble enough to be honest with oneself.

Growing up with a pediatrician dad and a pharmacist mom, I didn't take many sick days from school. First all, faking it was nearly impossible. Secondly, if I did take a sick day and stay at home, Mom would make me do housework (so it was actually better to just suck it up and go to school sick). Being sick and God forbid! taking a sick day meant being frail, weak, and bordering on lazy. As a surgery residents, we'd all get i.v. fluids when we were "sick" just so we could keep working. A sick day was "a sign of weakness"--that horrible wickedness no surgeon wanted to have.

So if I'd just faced the reality that I have seasonal allergies that require some consistent dosing of antihistamines or steroid inhalants, I may not have had to dig myself out of an Afrin addiction. Where's the weakness in taking a Claritin once a day? I hate taking pills and hate even more being sick (which means having to take pills). My body's reaction to the tiny particles is an immunological hiccup, not a character flaw or a moral depravity for crying out loud! So I have allergies...some people have cancer. Neither affliction is a sign of weakness. Get over yourself, Boon!

My dad assures me that in time my immune system will become desensitized to whatever allergen is giving me these symptoms. Good! Now I can skip that visit to the allergist!

My Inner Bitch

Many people say that an Ironman or any endurance race will show you what you're made of and/or who you really are. Today, I ran the Rochester Half Marathon and unroofed a part of myself I was surprised to find.

I signed up for the race mostly because I was sick of doing my long runs with a Fuel Belt loaded down with Gatorade Endurance and water and carrying gels in my sports bra. I figured the $50 entry fee was worth paying just for the aid stations. Besides, I had not run an open 1/2M in 6 years and wondered how I'd do on relatively fresh legs. The plan was to take it easy for the first 15 minutes then try to keep M-pace for the rest of the run.

I showed up at the Start Line carrying only my car keys. I made the wrong assumption (and you know what happens when you assume!) that each aid station would be the sumptuous buffet present at all the Mdot races' aids stations. The first 5 aids stations had only water. The only aid station with gels was the one at Mile 6. The rest of them had only water and what tasted like diluted Powerade. Can you see I'm setting you up for a tale of calorie and more importantly, salt intake woes?

By the 2nd aid station (right around the time when I'd like to take a gel), I'm getting the idea that this may be a race free of nutritional support. I do the Richard Strauss OODA loop thing (Orient oneself to the problem, Observe, Decide, Act). I am to be an emotionless decision making machine. So I figure the run is just a couple of hours; I had a big breakfast and a gel before the start--I should be just fine. How's that for OODA? Maybe the D is for Denial in my case today.

Just as I start to increase to M-pace, a female runner in a blue shirt runs right behind my left shoulder. A quick glance over to her and I notice that she's wearing make-up. The emotionless decision making running machine immediately thinks,"I'm not gonna let some bimbo wearing make-up pass me in this race." So I pick up the pace and lose her on a slight uphill (the course was quite flat). At that moment, I decided I'd set a time goal of breaking 2 hours. "Yeah, that'll show that make-up wearing girl what's up!" I thought.

Now, I'm not sure why I found make-up at a 1/2 marathon so unconscionable. Maybe it's my deep-seated resentment of the stuck-up popular girls in high school--who invariably always wore make-up (even at a 1/2 marathon?). Who knows? It was completely illogical, but that painted woman would show up hovering around my left shoulder for the rest of the race pushing me to pay attention to maintaining my pace.

By mile 10, my plans to kick into tempo pace--"NO!" said my ego, "Your balls out 5K pace!"--had seized up like my left calf and muscles on the bottom of my left foot. I really needed some salt and the "A" of OODA was kicking my own Ass for not bringing salt tablets. The day turned out to be warm and humid. I sweat like Shaquille O'Neal in volume and like a salt lick in sodium content. Every left footfall brought on excruciating pain. I had slowed to my E-pace though I had plenty of cardiovascular reserve to run at least tempo pace.

About 500 yards from the finish line, a female runner passes me that I recognize. It's Kitty Cantwell! I've met her in and outside of work at least 8 times in the last 5 years, but everytime she sees me she acts like she has no idea who I am. In fact, she's just sometimes downright unfriendly. I say to myself, "I don't care if you cripple yourself. You are NOT going to let f@*king Kitty Cantwell beat you!" So I pick up the pace and run by her. The pain in my left leg, foot, and now my right hamstring is blinding. But I beat her. HAHA.

Aside from learning that I should bring my own salt tablets on a hot and humid run. I also learned that I've got a mean-spirited, catty side. It's not that I've considered myself utterly sweet and always thinking of others with compassion and love in a Dalai Lama sort of way. I just don't get to look at that side of myself in a full frontal way very often.

After the race, Make-up girl came up to me and congratulated me on finishing. She told me that this was her first 1/2 marathon and that having me run along side her really helped push her along. She was so nice---I felt bad for thinking unkind thoughts about her. Maybe she just wanted to look nice for her first 1/2 mary. Maybe Kitty Cantwell just has a memory block with asian female surgeons. I'm still glad I beat her though. MEOW!

A Swimming Milestone

I dragged my sorry carcass to Masters last night with legs completely hosed. Wednesday night I had run my little tush off for my fastest run test to date. The next day consisted of a work day that ended later than anticipated, a hurried endurance ride on stiff quads, and eating dinner (a Kashi bar) in the car on the way to swimming.

My new habit for swimming is to not look at the entire workout before getting in pool, but go from one line of each set to the next. When I preview any workout, there's the inevitable "*Sigh* Pull sets, again!" or "Aw, man! Not IM. Ugh..." or "Pffftt! I'm not swimming more than 100 yards in a row."

I guess the only pool workout that wouldn't elicit that kind of reaction from me would go like this:

Warm-up: Cannonball of the 1m diving board x3, rest 2 min in between while eating a cupcake

Main set: 15 min game of Marco Polo

Underwater handstand x 5 in deep end, rest 2 min with cupcake

Doggy paddle 25 x 4, concentrate on emulating family canine pet

Cool down: 100 easy with foam noodle thingy

Splash water at Kevin liberally

Last night's workout looked nothing like the above. It went more like: drill, pull, kick, swim, swim hard, pull, kick, drill, repeat x 10,000. The finale was a timed 200 IM. By then, I was hungry enough to chew off my arm and figured the sooner I got this done the sooner I could start snacking on my fingers. Now to all you fishies out there, 200 IM may be a mere sneeze. However, to me, it's an anaerobic flail-n-looks-like-she's-drowning effort. In fact, until last night I'd never completed a 200 IM without having to stop either after aspirating half of the pool's water during backstroke or moving backwards doing the breaststroke or making the life guard nervous with my butterfly. I can't say I felt great when I finally made it to the freestyle part but I wasn't completely seized up with lactic acid in my usual fashion. I had done it: 200 IM without stopping or dying of hypoxia.

I was so proud of myself I added a couple of underwater flips to my warm down.

My Bestest Friend has come out to PLAY!

My dearest pal and bestest buddy is coming to play with me in Penticton next August. That's right, the Wev is officially registered for Ironman Canada 08 and British Columbia bound. Since I was going to be near a computer (actually several of throughout the hospital), I had registration duty. Starting at 12:57, I kept hitting the refresh button for the website every 20 seconds. At 12:58:30, the active.com link came up--Score! I click on it...another page to confirm that it was indeed the Subaru Ironman Canada in Penticton, B.C. that I wanted...click "register now" and...
"Due to the high volume, you may experience a delay..." DELAY?! No F@*KING WAY! It was one thing to register for myself--I'm feeling some extra weight of responsibility to register for someone else. I go back to the IMC website, click the active.com link again, try a different register now link, try opening my own active.com account, new guest accounts...repeat, repeat, repeat. I'm opening more and more windows with the same stupid delay message. I will NOT be thwarted by some bitch-ass server moving at glacial speed. Finally, I get onto the registration page. Now calm and controlled typing of Kevin's info and...ahhh...he's officially registered at 10:04 PDT. It is a triumph of my manic compulsive behaviour!
I am so happy that he shall be joining me for this adventure. I feel like it has already started: the house has been swept clean of empty calories, training plans are being hatched, the hunt for lodging continues (Nathalie has been an ACE at it!), race nutrition is getting tweaked, and the overall excitement is barely containable.
This race will be our first Ironman done together. Team Kevtima goes to B.C. (of course, the Kev part will cross the finish line hours before the other half claws her way across). I can't imagine a more wonderful race with my dear friend and training pal, Nathalie and the Kevster. It's like we all made the same kick ball team...now it's time to play!

My Former Life

My extended family lives in Thailand. My family was part of a large Thai community that was my surrogate extended family when we lived in Brooklyn and Long Island. When we moved from NY, we were still part of that family, but geographically separated. So I've always wanted to belong to a big family and have sisters (I have one brother). I figured in my former life I was probably a Madagascar fruit bat. They live in large family groups where the females are all related. They spend most of the day hanging out together in the family tree and eating fruit. I've always wanted to fly and I love tropical fruit. I'm hoping that in my next life I'll get to be a Malagasi fruit bat again. It's an obvious fit.
On a recent trainer ride, I watched my "Life of Mammals" DVD (yeah, big geek alert--I love those BBC/David Atenborough nature shows!). The featured mammal was an elephant shrew in east Africa. It's a small rodent that makes trails through the grasslands in order to have a pathway to hunt for insects. It's also incredibly fastidious about keeping those trails clean of debris as it must run very fast on those trails to escape from hawks and eagles. To demonstrate this extreme neatness, David Attenborough puts a camera right next to the trail and sprinkles some dried leaves in the middle of the trail. Within 45 minutes, the elephant shrew shows up. She sees the mess on her trail. If rodents can look pissed-off, this one surely did. In one swift fling with its tiny forefeet, it pitched the flotsam from its trail. Kevin says,"You were definitely an elephant shrew in your former life."

Okay, so I am a bit of a neatnik, but I don't run very fast nor do I like to eat bugs. Which brings me to the point of this rambling: While we can have very clear ideas about what we want, we shouldn't lose sight of what we are.

I've been thinking about this point recently as I review how this triathlon season went and start making plans for next year. I had some specific time goals with my HIM season this year. None of them were met--not because of an unexpected injury or because the goals themselves were unrealistic for my abilities. What I didn't factor was just how much energy I would expend in stress over going to court for my first malpractice suit. I grossly underestimated how much life the whole process would suck from my soul. I just figured I'd train through it and still be able to peak for Eagleman 48 hours after the jury deliberated. Wrong! I really didn't take into account the other part of my life--the surgeon part, the part that takes up alot more time than the triathlon part. So my goal for Longhorn is not so much for redemption of those lost goals, but for a revisit to myself (the surgeon, the fiance, the elephant shrew that can't be excised from the triathlete) and ultimately a revision of those goals that fit all of it.

In 3 weeks, I shall have a great change in my career (that I chose). It will take some time to adjust to the changes, positive and negative. I won't set any goals for Penticton until I see how I adjust to those changes. For now, I'm just so dammed happy to be going that I haven't even thought about any of the splits. I just want to show up at the Start Line healthy and uninjured. Maybe that's enough of a goal...

Oh for crying out load! Who am I kidding? I was OCD statistician in the life before I was an elephant shrew. There'll be exact numbers for watts, pace, and splits.

*big sigh* I can only hope that in my next life that my small, fruit-fed bat brain can't count past 2.

Race Report:My First Xterra

Recent news of Barbara Warren's bike accident reactivated my lingering fear of disability by bike accident. I'm not afraid to die while riding (in fact, that's how I'd like to go--clipped in, doing one of my favorite things). I just don't want to be mangled to the point where I couldn't ride at all. Having nabbed a spot at Penticton, I didn't want to break any bones or tear any ligaments that would prevent me from training and racing next year. Remembering how pro mountain biker, Tara Llanes, is a paraplegic from a mtb accident, I had some reservations about doing my first Xterra.

The race site is at a boys scout camp in the Catskills. The half-paved, half-dirt, free of paint to mark the shoulder (there were none) road to the camp reminded me of roads in Tanzania. Kevin and I arrived at the race site on Saturday afternoon for packet pick-up and to ride one loop of the bike course.

The course started with a steady climb on a gravel Jeep road before turning into the woods. The single-track portion (which was at least 50% of the course) is on a loamy surface--like riding on a 8 inch carpet of peat moss--with rock gardens. The other parts of the course is rutted Jeep roads with loose rocks the size of apples to shoeboxes. It had rained that day; and the trails were muddy, the rocks were slick. The last 2 big spills I took on my mtb were on wet logs. So what was supposed to be a casual recon ride turned out to be an anxiety-ridden, white-knuckle expedition for me. I thought,"I just got into Penticton. I don't want to break my leg or tear up ligaments!" Over an especially robust rock garden section I decided that I would NOT do this race tomorrow. I figured it wasn't worth risking the injury--not before Longhorn, not before Penticton. This course was a little bit beyond my mtb skills and way above my confidence in those skills.

When I tell Kevin, he's obviously disappointed. In an effort to be sympathetic, he says, "Poor Bunny, can't race tomorrow."

Wah?! Can't race? Of course, I CAN race. My legs haven't fallen off! I tell myself to get over it and that the only thing that's holding me back is fear. I would not be a pussy and wimp out on this one. I'm back in it.

So the entire night before I hatched a plan and perseverated over it instead of getting some sleep. There are some races you race, while others you simply tour. I would be a mere tourist for this one. No heroics on dirt--just get through without having to consult an orthopaedic surgeon after the race.

The swim was a 2 loops in a shallow, murky lake. Lake grass brushed my fingers with every pull for most of the swim. I felt strong and swam with moderately low effort, catching a draft for at least half of the time.

I cashed in alot of good triathlon karma because the bike course really dried out. Still some sections of mud that felt like riding through peanut butter, but no slick rocks at all! I rode alot more confident and relaxed. Many incredible mountain bike riders (who obviously swam worse than me) zipped by, passing me on the singletrack portions. Everyone was incredibly polite and had a positive word to say on that ride. I made it through the first loop shiny side up and utterly inspired by the skill of my fellow competitors on mtb.

The second loop was all about small victories. Every section of downhill or rock garden that I unclipped for the first loop, I muscled, pedaled, and bounced by way through on the second loop. I let out a gleeful,"Yay!" after each victory with only the woods to hear it. On the first loop climbs that I had to unclip because I felt unsteady on the loose rocks or just ran out of anaerobic capacity, I made it up just a little farther the second time around. I MUST learn to do a track stand. I must learn to keep myself upright on a bike with balance and not just speed. I could have really used that skill on those climbs just so I could catch my breath and not clip out.

The last downhill of each loop is a long straight descent with round wooden poles that crossed the trail, creating drop-offs 1-2 feet tall. Between the drop-offs are the ever-present rock gardens. For my last time down that hill, I stayed clipped in except for the biggest drop-off (around 3 feet). I finished that bike course a downright happy camper.

The run was a combination of scrabbling over boulders and logs with 2 steep climbs, one really steep descent onto a waterfall crossing that was littered with boulders. There was one log that blocked the trail that was so big and high that I had to stop, throw my leg over it, then straddled it like a horse with my feet dangling in the air. I definitely took the tourist approach for the run and went very slow so as to not twist my ankles.

I managed to place 3rd in my age group (mostly by just showing up). The race was well organized. The atmosphere was relaxed (the race started at 11am!), friendly, and collegial. Every bike in transition was caked in dirt and well-ridden. Every triathlete at the finish line was caked in dirt and happy. There was a Gatorade chugging contest before the awards ceremony.

Overall, the race was the most fun race this year. I'm so happy that I decided to do it. I was definitely out of my comfort zone for the bike portion, but made some great gains in my mtb skill and confidence. I wiped out only once on the bike, going over roots to avoid some rocks. I didn't carry enough speed/momentum through the loam (which is like riding on sponges) to skip over my obstacles. Falling on the trail was not like landing on sponges, however. So there's a moderate sized bruise and scrape over my right ass cheek. No problemo. Small price to pay for the amazing experience of my first (and definitely not last!) Xterra.