Time really flies!

I have no idea where the month of December went. But I certainly didn't spend much of it blogging!

The holidays are of course a busy time. For me, they are also a big time of transition since I will be joining a new cardiology practice in January. It's a good decision for what I want in my career, but I will miss my patients and the staff at my hospital and my office. I have posted my new office phone number in the right hand column.

I am still running and doing my best to eat healthfully at this time of the year when yummy high-calorie treats abound. This month, I ran my fastest half marathon ever in 2:06:41 and my fastest 5K ever in 25:51. To get to my goal of running faster and qualifying for the 2010 Boston Marathon, I'm running about 35-40 miles per week. That means some very early mornings sometimes -- as early as 4:30 am. To motivate myself, I think forward -- all this hard work will be well worth it when I achieve my goal of running Boston.

Have a great holiday season, and more sometime soon....

Chicken Free Chicken Stir Fry

This is tonight's stir fry: Follow Your Heart's Chicken-Free Chicken with Annie Chun's Chinese Stir Fry sauce and a bunch of frozen veggies -- carrots, okra, spinach, broccoli, and cauliflower.

I recently discovered Chicken-Free Chicken. It has great flavor and texture, has 80 calories, 2 grams of fat, and 11 grams of protein for a two-ounce serving. It is made by Follow Your Heart and is sold at their store in Canoga Park, but can also be purchased at Whole Foods Market.

Buy These Shoes!

Choosing leather-free shoes is an ethical choice for both the environment and for animals.

Do-Ni footwear is not only beautiful and vegan, but they donate all of their profits to non-profit organizations.

I just bought a pair of their shoes online and can't wait to try them out.

Smoothies

In my quest to eat better, I've discovered smoothies.

Since moving to LA, I've loved Jamba Juice smoothies. My favorite is the Mega Mango. I always felt somehow guilty, that they taste so good, and even if there is fruit in them, it can't be good for me! Surprisingly, the 16-ounce all-fruit and juice smoothies at Jamba Juice are 220 calories. And, if you add a scoop of vegan soy protein powder, it brings the grand total to 250 calories! Not bad?

I've started making my own smoothies at home. My recipe is 4 oz soy milk, 3 oz siklen tofu, 1 cup of berries or mangoes or any other fruit, and 1 tablespoon of crushed flax seeds which are full of omega-3's. I use frozen fruit for the smoothies, and put it in the microwave for about 45 seconds. Then I pour all the ingredients into my blender and set to "Puree". The total calorie count on this creation is 200 calories, and provides me lots of energy for an early morning run.

In my three weeks of eating better, I've lost 6 pounds. This puts me at a healthy body mass index of 22.4. My running has also gotten faster. I would have never thought I could run 6 miles in under an hour, let alon the 56:14 time that I posted on the treadmill on Thursday.

One Week of Eating Healthier

This is tonight's dinner: Two vegan chicken cutlets, brown rice, spinach sauteed with cannelini beans (and no oil... who needs oil when you have good spices?), and some sweet potato.

Working with a nutritionist has been an eye-opening experience. I've been on this meal plan for one week. I have eaten more veggies, more protein, less carbs, learned to not eat and eat and eat when sitting at home at night, and to just walk away from a tub of Laffy Taffy, one of my favorite candies in this whole world.

I've learned that I need to eat frequent meals, but not TOO frequent. My habit is to eat, and then nosh something an hour later, then something a half hour later... I need to limit my eating to about six times a day.

After one week, I have lost two pounds.

More meals to come....

Diet Overhaul

I'm in the best shape of my life and the slimmest I've been as an adult. I'd consider myself a healthy weight.

But, my diet hasn't been great. I've just about given up cooking, so I've relied a lot on processed foods to microwave, along with the occasional big bowl of cereal for dinner with a pound of frozen mango.

To achieve my big goal of qualifying for the Boston Marathon, I not only need to fuel myself better, but need to slim down a bit to run faster. I don't need to lose a lot of weight, perhaps ten pounds. I would still be within a normal weight range for my height, just as I am now.

I have consulted with a nutritionist. She is the wife of a physician that I work with, is a PA and also has several fitness certifications, so she knows what she's talking about. Also, from talking to her previously, I knew that she would not be critical of a vegan diet.

I met with her, bringing along my food diary. She cringed at my "4 oz of coke", "6 french fries", "gyoza dumplings", "bag of mangoes", the high amount of carbs that I consume, and the lack of vegetables. She came up with a food plan that is higher in protein and lower in carbs.

Two days into the new eating plan, and things are going well. Here is tonight's dinner: 1 cup of whole-wheat pasta, 1/4 cup marinara sauce, and a tofu scramble with 4 oz tofu, 1 cup of carrots, and 1 cup of spinach, sauteed in olive oil, garlic, salt, pepper, and turmeric.


What surprises me is that I'm not ridiculously hungry! During the day, I feel more full than I used to before this eating plan.

So far, I feel great, and I hope this eating plan helps get me to my goals.

Racing for Something More Important

Most races have some sort of cause that it benefits, and often I don't think much about that when I race.

Today's Eco-Fest 5K Run had a more important meaning.

Lawrence Fong is the LA Tri Club's membership director. Not only that, but he's a great friend and athlete, and one of the first friendly faces I encountered as a newcomer to Los Angeles and to the LA Tri Club.

On Wednesday evening, he had a brain bleed, and was found on the ground. He was immediately taken to the hospital, where he underwent emergent surgery to his brain to relieve the pressure. Since then, he is starting to recover and respond to commands, but he has a long recovery ahead of him.

One of Lawrence's passions is racing. He was planning to work as staff for the Eco-Fest 5K. All proceeds raised from this race go to Lawrence and his family.

It was a terrific race. Many club members, including Wayne Fong, Lawrence's 76 year-old father, raced. It was a cross-country course, up and down and zigzagging across a hill, and was pretty challenging.

I had a great race too -- I placed second in my age group and won a cowbell, some socks, sunscreen, a water bottle, and Clif Shot Blox.

For more information about Lawrence Fong and how you can help, click here.

Soma Half Ironman -- last race of the season

I really don't understand what would possess anyone to live in a desert like Arizona. Or somewhere with snow. Or rain all the time. Perhaps I've simply become a weather brat now that I've lived in Southern California for a year and a half.

Nonetheless, this past weekend I raced Soma Half Ironman, in Tempe, Arizona. My goal was to beat 6 hours and 30 minutes. My previous half ironman time, Vineman 70.3, was 6:48, and with my new fabulous Cervelo P2C bike and a flat course, I thought I had that in the bag. The swim wouldn't have to be spectacular, and the run, since I found out it would be a high of 93 degrees, would be something that I would simply trudge through at a consistent pace so that I wouldn't become a wilted prune.

The swim was in Tempe Town Lake. It's pretty nasty. Other than for triathlon races, they do not allow people to swim here. It was chlorinated and shocked for our benefit. Fortunately I didn't know about the dead bird that was seen in the lake on race day until I'd finished the race.

The swim start was a crowded mess as usual. Lots of limbs. Someone behind me trying unsuccessfully and annoyingly trying to swim up my back. A girl next to me who even as I moved away from her kept following way too closely to my right hand side. It was all a bit too much, and I hyperventilated after just a minute into the course. But I switched to breaststroke for about thirty seconds, got the breathing under control, and trudged on through the zero-visibility water.

I was completely baffled by a woman whom I shall refer to as Backstroke Girl. I kept seeing her to my left. She was doing the entire swim with the backstroke. She'd zigzag with her bizarre backstroke, going way off course, bumping into me a few times, and then would stop dead in her tracks, vertical in the water, look up, look two ways, and go back to her silly backstroke. And what really made me mad -- I couldn't pass her! How could this woman, swimming backstroke, be at the same pace or faster than me doing my race day freestyle stroke? I was hoping to figure out who Backstroke Girl was, and why anyone in their right mind would backstroke through an entire 1.2 mile leg of a half ironman.

Finally, we get to the end of the swim, which is good because I hate swimming. Especially at the end of the season. There were stairs out of the lake and people lifting us out of the water and onto the stairs. And, for the first time, I encountered the concept of the "Wetsuit Stripper".

A wetsuit stripper pulls your wetsuit off of you. It's pretty cool. I watched the pros do it -- you unzip the wetsuit, pull it to your waist, then drop to the ground and lie down while two or three people pull the wetsuit off. I decided to try it, hoping that I wouldn't be the aberrant person whose tri shorts would be pulled off with the wetsuit. It was very efficient, and afterward I got off the ground, wetsuit in hand, still fortunately wearing my tri shorts, and dashed to the transition area.

Bike shoes on (fortunately the wetsuit was off, because I have this bad habit of trying to put the bike shoes on before the wetsuit comes off), helmet on, glasses on, race belt on, bike off rack and .... oh wait am I forgetting anything? No really, am I? After a brief hesitation, off I go.

The bike course was relatively flat, but had this bizarre configuration of multiple 180-degree turns, with a lot of speed up and then suddenly slow down to make a sudden turn. On one of those turns I had a very close call where I nearly launched myself off my bike. We had to do three loops on this course. Nonetheless, this was my chance to see how fast my sexy new Cervelo P2C would move. Apparently it moves significantly faster than my previous bike did, but some of your grandmothers can still probably whoop my arse on the bike.

I amuse myself in my own way along the bike course. I met a terrific club member named Teresa (I hope that is your name... hard to hear on the bike sometimes!). We kept passing each other and I think she overtook me once and for all in the second lap. We both have coaches with Triathletix, and I suggested that once we get back to LA that we ride together since after all we're about the same pace. When passing people who had their bibs on with their names, I'd say "Way to go, Jared!" or whatever their names were. It got me some strange looks and some laughs. In the stagnant traffic next to the course, I found a guy in a really neat looking convertible. I complimented his car, then he suggested that we race, but clearly as he was stuck in traffic I won. At the next (argh!) 180 degree turnaround, I saw him again and waved as he waved back.

And finally, I encountered the Sportswoman of the Year. She approached me to pass, as most cyclists with any speed do, and yelled, "On your left, ON YOUR LEFT ON YOUR LEFT!" It was all quite obnoxious since I had gotten over quite far enough for her to pass. I looked at her as she passed and said, "I heard you!" to which she replied, "You're lying!" As some choice words were about to fly out my mouth I reminded myself that I'm here to have a good time and not to worry myself with such nastiness.

Throughout the bike ride, I drank. A lot. Even Gatorade, which I think tastes nasty, because I knew I would need all the electrolytes for the run.

So with the bike behind me, and leaving my beautiful Cervelo behind in transition, I headed out to run. I knew there would be no heroes today on this run course, and as a Californian not accustomed to the desert that I was at a distinct disadvantage. While it is a flat two lap course around Tempe Town Lake, it is also above ninety degrees, and I knew that I would have to keep a consistent, even slow, pace. I knew that if I could finish the run in under 2:30 that I would beat my goal time of 6:30. Coach Jamie's advice was to at each aid station drink one cup of water and dump another over my head. This served me well. I shuffled/ran the course conservatively, walking about 30 seconds at each aid station.

The run was interesting. I found a woman who I went to med school with... in Albany, New York. Go figure?! I cheered on some LA Tri Clubbers. I high-fived my buddy from Arizona, who looked a little too comfortable running through the desert. I high-fived two LA Tri Clubbers on the side of the course and nearly entered the finish chute one lap too early. As I started the second lap, some woman yelled, "Great job! You're almost done!" I laughed at her. I had six more miles of hell to run through. But, I stayed consistent, keeping my heart rate of 160-170 and a pace of about 11:30 per mile.

The race advertises that it is the only course with a Slip-n-Slide at the finish. You can simply run through the finish line, or you can jump on the Slip-n-Slide and finish in style. I chose the Slip-n-Slide and jumped right on. Given my mid-to-back-of-the-pack status, the thing was half-deflated by now, and I landed square on my rear end and moved nowhere. The water pool at the end of the slide looked even nastier than Tempe Town Lake, so I chose to scoot to the end of the slide, and with my very small remaining amount of energy, climb off that slide and avoid the nasty liquid at the end.

All in all, a great, fun race that was very well organized. I finished in 6 hours and 26 minutes, achieving my goal of beating 6:30. A great way to end the season.

Food is Love

When our loved ones are ill, we want to comfort them. Food is often the way we try to heal others.

But, it is often this food that is killing them.

I find congestive heart failure patients whose families bring them soup. Soup is loaded with sodium and as a result worsens heart failure. Diabetics have sugary fruit juices on their bedside tables. And patients who just had heart attacks have fattening pastries.

One of the worst foods that I've found in patients' rooms is a Middle Eastern yogurt drink. I forget the brand name. A small twelve-ounce bottle contains 220 calories, 20 grams of fat, 12 grams of saturated fat, and 1200 mg of sodium. In one of those patients' rooms, I left a note for the family: "Please bring this drink home. It is bad for his heart and he should not drink it. Yours Truly, Dr. Shenkman"

I talk to my patients about nutrition. When they are in the hospital, I will often request a dietitian consultation. But it is often very difficult to overcome the cultural belief that comfort foods will heal when in fact they can harm the patient.
Image from www.isrealli.org

Running Progress

On Sunday, I ran the GLA-ALA Justice Jog 5K in 26:03. This is a personal best by over two minutes for a 5K distance and I placed first in my age division.

I'm getting faster!

Destination: Boston 2010

I want to run the Boston Marathon. And I don't just want to run it -- I could get a charity spot to raise funds and go that way. I want to qualify for the 2010 Boston Marathon.

I've got a long way to go. My fastest marathon time is 4:57 one year ago, but I have gotten significantly faster as a runner since then. I have to be able to run a marathon in 3:40 in order to qualify.

I talked this over with my coach. Given that it's a year and a half away, I have time. It's going to be a lot of training, speed work, and tempo runs. But I'm also going to have to drop a couple of pounds, maybe ten or so. It's not that I have some sort of body image problem, but in order to be able to run the speed that I would need to run, I need to weigh less.

I lived in Boston for a year. It was an amazing year, a transition time in my life. I absolutely love the city. I miss running on the Charles and living just blocks from the Boston Common, the Theater District, great restaurants and nightlife, and many different T stations that would take me just about anywhere I want to go in the city in just minutes.

I had a charity spot to run the marathon back in 2007, when I lived in Boston. Unfortunately, due to a nagging iliotibial band injury, I had to give up the spot. On that Marathon Monday, though, I went out to Coolidge Corner in Brookline, about Mile 22, and I cheered on lots of runners, runners who were struggling toward the finish line but still going strong. It was such a great atmosphere.

So this is my big goal. With a coach to guide me, and with a lot of hard work, I think I can do it.

Photos from flickr.com and hulbei.net

Great Workout at the Track

Tonight I did a track workout with the Los Feliz Flyers. For me, it was a great workout, showing that my splits are getting better even in this ridiculous heat and humidity.

I feel fabulous -- another reason I participate in triathlons is that I have a bit of a competitive streak. Mostly competitive with myself, to see if I can do better and push myself harder. However, I will admit that I did gloat a little bit about beating JLo at Malibu by over 15 minutes.

I do have a new goal in mind. It's a bit of a long term goal for my running. I'm not ready to share it until I discuss with Coach Jamie and determine that I'm not completely out of my mind to think that I can achieve this goal. But, if I can achieve this goal.... then wow.... More later on that topic, maybe.

Image from workoutmommy.com

Every so often I bake

The occasion was my brother's 30th birthday party. I made a vanilla cake with vanilla frosting.

Seriously, though, my lack of time in the kitchen has become quite sad. I used to love cooking. Now it just doesn't thrill me. I'm busy with work and tri training and when I get home, exhausted and hungry, all I want to do is eat something quick and easy. Honestly, it's not always something incredibly healthy. For example, microwaved frozen gyoza dumplings and microwaved soup-in-a-box make for a yummy dinner, are somewhat nutritious but a little generous with the sodium.

I've decided to order food from a delivery service. I am trying Vegin' Out. They deliver a week's worth of dinners. For a week's worth of food for a single person and delivery, the cost is $110. To me, that's well worth it if it cuts down my grocery shopping and time in the kitchen.

Malibu Classic Triathlon

0.5 mile swim, 18 mile bike, 4 mile run. Several celebrities, though I can't say I saw and identified a single one. Lots of cameras and paparazzi.

I have nothing exciting to tell about this race, other than that I just felt good doing it. The course was all familiar territory to me. I've ridden that bike course on every other Saturday since March, and I've swam and run at Zuma Beach a few times. So I felt like I had an advantage.

My next two races are Pumpkinman Sprint Triathlon on October 18 and Soma Half Ironman on October 26. I could use a break from racing, but I know that over the next few weeks my training is really going to ramp up. I look forward to the challenge.

Los Angeles Triathlon

This was a tough one. I finished in 3 hours and 23 minutes. This is ten minutes faster than last year and on a tougher bike course.

Usually, I show up alone, and maybe see one or two people that I know on the course, and will cheer on anyone with an LA Tri Club jersey. This time, though, I got to race with a friend, which was nice. Not only that, now that I have lived in Los Angeles for over a year, I knew a few people who were racing and on the sidelines. Without those friendly faces, this would have been a much tougher race.

The swim was at Venice Beach. All 200 women doing the olympic distance course started at the same time. There were lots of limbs and elbows, especially at the first buoy. I seemed to drift to the outside on the swim, which maybe was good because that means I didn't have as many limbs to deal with.

Out of the water onto the bike. We rode from Venice Beach to Downtown LA. Venice Blvd to Fairfax to Wilshire to Highland to 6th Street to Alvarado (with a couple BIG hills) to Sunset (more hills!), turning around on Sunset just after Kaiser Permanente Hospital, and then into Downtown.

Then on to the run! I got my shoes on, stopped in the port-o-potty for about twenty seconds and headed for my 10K. The run was an out-and-back couse that we had to run twice. There was a HUGE hill, heading up toward the Disney Concert Hall. I couldn't run it, and even power-walking the hill my heart rate was 179! I saw my buddy near the top of the hill, which inspired me to run the last little portion of it. Then I ran down, which felt good, then headed for the turnaround to do it all over again.

I headed back up the hill for the second time, and was just absolutely beat! At the top, someone starts running toward me yelling my name -- it was Hans my spinning instructor! What on earth....? He started running with me! It was great to have his encouragement because I was tired out. I think I ran faster with him. Then we got to the water station, where there was no water. No water?!?! Luckily, Hans had an extra bottle of water which he handed to me. I was so incredibly grateful.

It was a tough race, and great to see that I've gotten faster over the past year.

Yes I Still Can Cook!

I used to cook a lot, and you can see that in my earlier blog posts. But, living alone, working more than full time, and training for triathlons, I'm just not inspired to cook nearly as often.

Here's a simple creation: A teriyaki stir fry with broccoli, baby portobella mushrooms and Trader Joe's Chik'n Strips made from soy protein, on a bed of jasmine rice.

Hot Dogs and Cancer?

Eating processed meats significantly increases the risk of cancer. This is fact.

I was very excited to hear about The Cancer Project's new commercial, which dramatically makes the public aware of this link.

And I'm fascinated by the public outcry over it. It seems as if people don't want to hear the truth, as if it is heresy to let people know that a traditional American food causes harm.

Not only does processed meat, in the quantities that the average American consumes it, increase risk of cancers, it also increases the risk of obesity, raises cholesterol levels, raises blood pressure, and as a result increases the risk of coronary disease, heart attack, and stroke.

Yes it's alarming, but people need to hear this message loud and clear.

Watch the commercial here.

Image from hankblog.wordpress.com

I'm Racing Against J-Lo!!!!!

Jennifer "J-Lo" Lopez will be racing the Nautica Malibu Triathlon on September 14. While I am disgusted by her love of wearing fur, it is neat to see a celebrity drawing attention to our sport.

Photo from justjared.com

Hansen Dam Sprint Triathlon

After my foray this past year into olympic distances and a half ironman, I decided to take a step back and do a sprint triathlon.

The swim: 500 meters. Small inland lake. Water felt like bath water. Because of the temperature and the short distance, I chose to go without a wetsuit, a decision I do not regret. The start was crowded -- for some reason, all women 39 and under started at once, and the older women, 40-49 and 50+ each got their own waves to start in. I'm a little jealous, but I guess age should come with some privileges. I swam a bit off course and had to swim back around a buoy, maybe losing 10 seconds. My time out of the water was about 13 minutes.

Transition 1: I've been really focusing on getting my transitions better, trying to take a few extra steps out. I removed the strap on my sunglasses in advance. So, run to bike, put on bike shoes, put on bike helmet, put on sunglasses, wish good luck to guy I know in transition, and run out with bike. Bam bam bam.

The bike: 11 miles, relatively flat. Coach Jamie said go hard because it's a short race, don't save energy for the run. So I pushed myself. I passed a lot of people on mountain bikes and a few on road bikes. A lot of people passed me too. But hey, the bike is not my forte. There was one sharp turn where the woman next to me nearly took out my bike. My pace ended up being about 17-18 mph. For me, that's good.

Transition 2: Another area I've been working on. Before dismounting the bike, I un-velcroed my shoes and pulled my feet out. So once I dismounted, I could run faster with bare feet than with my clumsy bike shoes. Helmet off, right sock on, right shoe on, left sock on, left shoe on, and this time with thinner socks that are easier to pull on than my usual thick socks. Grab visor and run. But, boy did I have to pee! So I made a quick pit stop at the port-o-potty. It took me 20 seconds to do my business. As I dashed out, someone yelled to me, "Quickest transition port-o-potty stop ever!" Funny.

Run: The phrase that I always repeat to myself during the run is "Mind Over Matter". I really think the run on any triathlon is as much mental as it is physical. It's the point of the race where our bodies are tired from swimming and biking, and we have to find it in us to efficiently use all the energy that's left in us to finish those last few miles. The trail run was for the most part flat, though there were a couple of slight hills. At the end was a rather short, steep hill. My heart rate shot up to 194. Mind over matter, keep going. And I just pushed to the finish. Average run time: about 9:15/mile.

Overall time: 1 hour, 19 minutes.
Average heart rate: 164/min

These are my measurements. Official times have yet to be posted to the internet. But I'm really happy with how I did. Probably my best sprint tri ever.

Another Reason Why Meat is Unhealthy

The salmonella bacteria that infected crops of tomatoes was derived from contaminated meat. Somehow, this fact gets missed in the mainstream media cover of the salmonella outbreak that caused over forty thousand people to become ill.
Photo courtesy of Physicians Committee for Responsible Medicine, PCRM.com

Flip Turns

As a triathlete, I race in open water. However, I practice at the pool once a week. I proudly wear my LA Tri Club swim cap to proclaim to my master swim group that yes I swim slowly, but I run AND bike too!

Nonetheless, I've gotten the urge to learn to do a flip turn. My grab-the-wall-and-push-off technique is pretty well streamlined, but real swimmers do flip turns.

The way the flip turn should go is, flip over, push off with feet onto back, turn onto stomach, and swim.

Mine goes something like this:

One stroke to go before hitting wall. Look up and hesitate fearfully. Take deep breath.

Flip over. Realize, I'm flipped over, don't inhale.

Panic and inhale, getting water up nose.

Search for wall with feet.

Push off. Be surprised by random direction in which I am pushing off. Sometimes launching to bottom of pool. Other times diagonally toward oncoming swimmer.

Panic again with water up nose. Eventually hit surface. Cough.

Proceed with stroke.

I need a *lot* of practice with flip turns. For now, though, the grab-the-wall-and-push technique is working well enough.
Image from blogs.phillyburbs.com

Zapped

I've never experienced anything like this.

Coach Jamie told me to take it easy this week to recover from Vineman 70.3.

Now, I've done marathons, and I'm sore for three days, but after that I'm up and roaring, back to my usual workouts.

Not this time.

I raced on Sunday for almost seven hours of swimming, biking, and running. Then, on Tuesday I went to my usualy bike/run workout. I got on the bike, and whoa, I definitely did not have my usual strength.

Then I thought I'd be fine by Wednesday, the day I do speed work at the track. Not so much. I was more tired and far slower than my typical speedwork pace. So instead of the usual workout, I mostly ran/walked around the track on my own.

I asked my coach how long -- he said to give myself a week and a half. I've taken today off completely from working out, and I'll swim tomorrow.

Maybe by then I'll be back to my usual self.

My First Half Ironman -- Vineman 70.3 -- Done!!!

Initially, my goal for Vineman 70.3 was 7 hours and 30 minutes. Then my coach suggested 7:10. And as I thought about it, I figured I can do the swim in 45 minutes, the bike in 3:45, and then run even if I completely fall apart can be done in 2:30. So my goal was seven hours.

And I had to remember, this is my "A race". I'm only competing against myself to do the best that I can, but this is *the* race that I've been training for. And, I need to focus. Often in races I find myself daydreaming and acting like it's just a training swim/bike/run, but this time, this is the real deal.

The day started chilly. My wave, the 30-34 year-old women headed to the water for a start. I hadn't been too nervous until just then.

"Ten....nine....eight...."

"I think I'm going to throw up." Not sure where that came from. But as the gun went off, any nausea dissipated and I started swimming up the river. Aggressively to start, per Coach Jamie, trying to draft off of someone. The outward portion of the swim seemed to last forever and I settled into a good pace. Shortly after the turnaround, my arm hit the ground and I stood up in the water which must have been only three feet deep. I glanced at my stopwatch, regained my concentration, and dove back in.

I finished the swim in 41 minutes. In transition, I tried to put on my bike shoes without removing my wetsuit. Whoops. That ate up a couple seconds. To the person who keeps mocking me that my transitions take too long, no I did not put on makeup or cook tofu in transition.

Off on the bike. I used disposable water bottles, which did not want to stay in the bottle cages. My Gatorade flew off the bike as I rounded the first turn. Whoops! So I had only one bottle of water, and no electrolyte solution, for the first nineteen miles of the bike. I bent my front bottle cage so that the water would not fly out. That took me a couple extra seconds.

The first five miles of the bike were flat. Then miles five to fifteen were rolling hills, and a bit challenging. Then around mile 25 was the first "hill". I pounded up it, and at the top wondered, "Was that a hill?"

Something hit my face around mile 40, then fell on my leg, and then there was a stinging sensation on my right thigh. I looked down, and there on my leg was a bee!!!! I was stung, through my bike shorts, by a bee!!!! It stung like crazy, and thanks to adrenaline I was able to for the most part ignore the pain for the duration of the race. But on the way home in the car that evening, I definitely felt the bee sting.

Then there was yet another, far longer and a bit steeper hill at mile 45. Not too bad. I was surprisingly faster than I anticipated on the bike. My average pace was 16.2 mph, faster than my goal pace of 15 mph, and in total the bike took 3 hours 36 minutes.

Then, off on the run, which was really hilly. I reminded myself that I had 2 hours and 40 minutes to finish the run -- even if I completely fall apart on the run, I will break seven hours for the course. The first four miles seemed to be all uphill, but as I ran them the opposite way on the way back, they sure didn't seem like they were downhill at all. My legs felt like they weighed fifty pounds apiece. My stomach started getting upset at mile eight. I'd start to walk a bit, but then I couldn't get myself to run again. We ran through the La Crema Winery, which was really the only pleasant part of this run, as the rest was just hills and more hills.

I felt awful during the last 5k of the run. I was exhausted, and my legs were heavy. My left calf started to cramp up in the last mile, and I tried to ignore it. I pushed myself for the final stretch. The announcer called out my name, then asked, "We've been waiting for you all day. Where have you been?" Kind of a bizarre question. Nonetheless, it got me some applause as I finished.

My finishing time: 6 hours, 48 minutes. I'm pleased.

Tapering and Chilling Out

There are four days until Vineman 70.3. I'm supposed to taper -- in other words, significantly decrease the amount of time spent exercising. It feels so weird. I went to the pool today, instructed to swim 500 meters, as opposed to my usual 2000 or so. I rebelled and swam 600 meters.

Coach Jamie says to do lots of stretching. Take "me time" -- when is that? When I'm busy blogging about how I have no time to take "me time"? I'm supposed to lie down for five minutes in a quiet room every so often and just relax. That's called sleep and it happens for five, maybe six, hours a night.

I don't relax. I'm pretty high-energy, high-strung. But, I'm trying to get more sleep, do less, and just chill out this week. But work is busy, and that's just not happening. Nonetheless, I'm trying to limit my outside committments to get myself ready.

Tomorrow I'll wake up and run my easy 1-2 miles, which will just feel downright bizzarely short.

Possibilities

Various statements I've made througout the years:

"I like to run... but I could never do a marathon. That's just too far."
(Since then, I've run three marathons)

"Yes I'm a vegetarian... but being vegan would be impossible! How could I live without cookies?"
(Vegan for three and a half years... and still enjoying a cookie every now and again)

"I do sprint triathlons, and maybe one day I'll do an olympic distance. But I don't ever need to do a half ironman. That's crazy!"
(I'm doing Vineman 70.3 this weekend)

"I think I can die without having ever done a full Ironman."
(I haven't done one yet... but I would love to be able to say that I'm an IronWOMAN!)

With this in mind, I'll contemplate whether I want to do an Ironman this November, or wait until next year to take one on. I'm just not sure I want to do it yet.

Breath of Life Triathlon Race Report

For me it was a good race. And a race where I finally have a picture of myself running where I don't look like I'm about to die. Excellent.

If you look at the race stats, I'm number 15 out of 17 in my age category, which is a bit depressing on first glance. BUT, this is only my fourth olympic distance race ever, and I've only been doing this sport for less than three years, and my times are getting better. My overall time, 3 hours and 9 minutes, is 17 minutes faster than my previous fastest time. And, my 10k run was in 59 minutes. I've never run a 10k in under an hour, let alone having swam, biked, and then run a 10k!

Swim: Cold ocean water, a bit choppy, but a favorable current.

Transition: Ran way too far on sand to get to my bike. I was a little tired out.

Bike: 25 miles almost perfectly flat. I cruised at 16.7 mph. For me that's fast. Your grandma could probably pass me on the bike.

Transition 2: How did it take me over three minutes to get out of my bike shoes and put on my running shoes? I'm still not sure, but that could use some improvement. Maybe I was thrilled to hear my name on the loudspeaker: "Heather Shenkman is racking her bike and is looking strong and about to go out and run 10k!" It was some guy from my tri club who had the microphone. It was cool.

Run: Whooooo hoo! I just had fun with the run. Cheered for people from my tri club,mostly people I don't know, because when you're in a club with 1500 people, you simply can't know everyone. Told some 70 year-old man who was racing that he's my hero and that when I get to be his age I just want to be able to crawl across the finish line. No, really. He's my hero.

Finish: Heard my name on the loudspeaker again as I ran toward the finish line. Felt great. Ate a post-race Boca Burger, which I swear was the tastiest burger I've ever eaten in my life. The man serving the burger asked me, "How come all the early finishers eat meat and you're getting a veggie burger?" My response, "How do you know I wasn't just chilling out for an hour?" I wasn't, but I'm not going to let him think I'm weak because I don't eat meat.

So that's the race. Two weeks until Vineman 70.3, where I'll try to dawdle less in the transition areas.

Still alive and Tri'ing

I haven't posted much. There are just over two weeks until my Vineman 70.3, my first half ironman, and I'm in the middle of a move to a new place. But I did the Breath of Life olympic distance triathlon this past Sunday, with a time of 3:09, my best olympic distance triathlon by 16 minutes. I'm still slow, but I'm getting faster. More on that, and a better picture, soon.

More on Tim Russert's Death

This is the best article that I've found to assimilate the medical facts and fictions with respect to Tim Russert's death.

Tim Russert

Tim Russert's death at age 58 has drawn a lot of attention to coronary artery disease, particularly because of his young age.

There has been so much speculation about what occurred. What we do know is that he had coronary artery disease, he was overweight, and he was a diabetic. He had "passed" (whatever that means) a stress test recently.

In all of the scare over coronary disease and sudden cardiac death, there is one thing to keep in mind: the vast majority of them do not occur out of thin air. Most people who have cardiac events had at least one risk factor, whether that be diabetes, high blood pressure, abnormal cholesterol, a history of smoking, or a strong family history of coronary disease. I can think of only very few cases where there was no significant traditional cardiac risk factor.

The bottom line remains the same: Know and manage your risk factors. If you do not know your blood pressure or have not had your blood drawn recently to determine your cholesterol and electrolytes, then it's time to see a doctor for a check-up. And if you do have risk factors, they need to be managed with appropriate medications, diet, and exercise.

But, most important here is how we take care of our bodies. By eating well and exercising, the risk of hypertension, diabetes, and hyperlipidemia is significantly reduced; and as a result the risk of coronary artery disease is far less.

Bonelli Olympic Distance Triathlon

On the day before this race, I rode 47 miles, rounded on 19 cardiac patients, drank a Corona.... and still I had my fastest Olympic triathlon yet!

That said, this was not my "A" race. It's a concept that I'm getting used to. My "A" race will be Vineman 70.3, my first half ironman distance triathlon, which is in *gasp* six weeks.

Swim -- Don't ever put on sunscreen and then use the same sunscreen covered fingers to wipe out your goggle lenses. Baaaad idea. After a lot of rubbing, the lenses were clear. This was a small race, so maybe only 50 or 60 women, I think. The good thing is that there were fewer thrashing limbs to contend with in the water. However, on the flip side, I'm used to following a pack of swimmers, so I had to use a little more effort to make sure I was swimming in the correct direction.

Bike -- Three loops. I think the women were the last olympic distance wave. So, men who were on lap 2 or 3 on the course whizzed by. On my third lap, the quantity of cyclists on the course had thinned out, and a police officer directing traffic asked me, "Are there many more behind you?" "Yes there are," I responded, in deluding myself that perhaps many others at my pace or slower were still out there. How would I know how many people were behind me anyway? My bike wouldn't go into the small chain ring, which would have been helpful on a couple of hills, but wasn't a huge problem.

Run -- Due to a last minute course change, someone told me that the run was only 5.3 miles, not 6.2. Ack, ruin my celebration of beating my best olympic tri time!!!! Whatever. The run went better than my last run, but due to the small size of the race and the fact that I was in the last wave, I ran mostly alone. However, I did chat up an Australian guy who will be doing Vineman 70.3 next month also.

The End -- Never good being the last group to finish. I had to yell at some guy to get out of my way as he was meandering across the finish chute as I was sprinting in. And they ran out of Boca Burgers. Lately places are running out of veggie burgers -- are vegetarians taking over the world?

Pictures may be coming soon.

Making Change

A blogger friend asked me how to get her father-in-law who is undergoing cardiac bypass surgery to make lifestyle changes.

It's not easy. I struggle every day with motivating my patients to change their lives.

If many of my patients with high blood pressure stopped smoking, started exercising, ate better, cut out excess salt, and lost weight, they would be on fewer blood pressure medicines. And, in the long run they would have fewer health problems and live longer.

How do we get people to do these things? To someone who has lived a sedentary lifestyle eating whatever they want, making all these changes at once must be overwhelming.

The best time to get people to make changes is at a life-changing moment, such as when hospitalized with a first heart attack or when needing coronary bypass surgery. People are scared, and as a result they are receptive.

So, to my blogger friend who asked how to get her father-in-law how to live more healthfully, use the resources at your hospital while he's recovering. Ask for someone from the hospital's cardiac rehabilitation program to talk to him. Get the nutritionist to sit down with him and explain what he should and should not be eating. Encourage your father's nurse to educate him also. And, you personally may live a healthy lifestyle, but it's hard to hear these things from a family member. There's too much emotional attachment. It really has to come from someone else, not just you, so try not to sound preachy.

Think back if you've made lifestyle changes. Did you do it overnight? I certainly didn't. In college, I was a vegetarian who ate way too much sugar and dairy and barely exercised. During my sophomore year of college, I decided I should start running -- on that first day, I got halfway around the block before my friends drove by and picked me up.

Be patient, and be supportive, and best of luck.

A Needed Break

The Blog has been slow. Life has been busy in balancing work, triathlon, family, and friends.

I just got back from a very needed vacation in Ixtapa, Mexico. Four days to just relax in the sun. I didn't completely slack -- I did take a couple of 30-minute runs barefoot on the sand. I brought my goggles and swam a few laps, Perhaps I could have done more, but I didn't.

More to come to the blog soon.
Photo taken from http://wwp.greenwichmeantime.com/time-zone/usa/images/vacation-travel.jpg

Building Up

Here's an action shot from Wildflower, the triathlon that I did last weekend:

My training is being turned up a notch. I'm in what my coach calls the "Build Phase", which is supposed to get me ready for my half ironman race in two months. On Saturday, I rode 32 miles, and today I swam a mile in the ocean and ran four miles along the Santa Monica and Venice boardwalks.

One of the perks of having this blog is that every so often someone will send cool stuff. I was selected to sample some of ProBar's new flavors. This is the Sesame Goji bar. I was a little daunted when I read that the bar had 400 calories, but as I thought about it, that's the perfet number of calories for a bike ride of almost two and a half hours. The bar was delicious and gave me the energy I needed for my ride. I don't think I'd use it as a meal replacement, as it would leave me feeling quite hungry, but for a long ride or run it'll work.

Wildflower Race Report

First off... camping was successful. I assembled a tent all by myself and slept in it for two nights. I consider this an accomplishment.


This is the toughest race that I've ever done. It's a hilly course, particularly the bike. The run is pretty hilly too. Because the bike has been my weakness, I've been training hard for the bike with a long ride on the hilly Pacific Coast Highway on weekends and two spin classes each week. And, while I felt ready for the bike portion of this course, I should have run more hills. I also should have hydrated myself better while on the bike.


The swim went well. My goggles kept fogging up, so I lost a few seconds in the water trying to sight the correct direction to swim in.


Next on to the bike. The first mile and a half of the course is uphill, and it is one heck of a hill! I was absolutely sucking wind getting up that hill. In past races, I've been passed left and right, but this time around that wasn't the case. I was definitely stronger on the bike.

The run did not go well at all. At the beginning of the run, I checked my heart rate -- 180. That's way too high. So I walked. And I could barely get my heart rate under 170. On top of that, the hills were awful. I ended up power walking much of the 10k, with a time of 1 hour 10 minutes, surprisingly faster than what I thought I had done, but definitely slower than what I wanted to do.

Even after the race, my heart rate was still high. I was standing waiting for the shuttle a half hour after finishing, and my heart rate was still 145!!! I sat down, chugged some water, and it came down to 120, and finally when I got back to my car where I had some extra water bottles, I drank more and it came down after about an hour and a half.

It was a challenging race. I'm so glad I did it, and I feel like this race will definitely help me prepare for Vineman 70.3, my half ironman race in July.

Thoughts before the First Tri of the Season

My first triathlon of this season is on Sunday -- the Wildflower Olympic Course. I'm not nervous about the course; never mind that it's the toughest course that I've ever raced -- I'm well trained and I'm ready to race. What I am fretting over is the preparations and travel to get there. And the camping.

Wildflower is taking place about four hours from LA. It is known as the Woodstock of Triathlons. People camp out at the race site. Thousands of them.

I don't camp. I haven't camped since I was 19 years old, and for good reason. I like a bed and plumbing and indoor amenities and protection from the elements. Houses and apartments are really not that bad of inventions.

In fact, when I registered for this race over a month ago, I booked a hotel room about 30 minutes away. Then I thought I'd sleep in my car. And then I had the courage to do the unthinkable.... I bought a tent. I looked over the instructions thoroughly last night and I think I can put this thing together. Heck, I do angioplasties to unclog coronary arteries; I think I can handle assembling a tent.

And finally, there's the packing. I had no idea that so many things had to be thought about before traveling to a triathlon. Here's my tri club's packing list. Amazing.

I'm a little overwhelmed, but I think I can do this.

Another Vegan Passover

I was far more inspired to cook last Passover, but this time around I made my veggie loaf, which came out far better this year:

This is my vegan Passover dinner. Accompanied by the Passover Frog, my niece Samantha's new toy, starting from upper left and going clockwise: Vegan kishke, veggie loaf, pasta with mushrooms (unleavened pasta of course), sweet potatoes in brown sugar, sauteed broccoli and asparagus.

Shark Attack Kills Triathlete

Dave Martin, a member of the Triathlon Club of San Diego, was killed on Friday while swimming at Solano Beach near San Diego. He was out for a training swim with eight other tri club members. Apparently, sharks can mistake a person in a wet suit for a seal.

The last shark attack in San Diego was in 1994, and the last one in the Los Angeles area was near Malibu in 1995.

It all gives me pause before I head to Manhattan Beach tomorrow morning to swim.

Training Progress

I'm feeling pretty good about my first race, the Wildflower Olympic Course on May 4.

I've been biking longer, consistently doing a weekend long ride up to 35 miles and two spin classes during the week. Today we climbed one of the canyons on our bike ride. Now, the last time I climbed with a triathlon club group, I was dead last up the hill. Totally different story today. I was toward the front of our group on our twenty minute climb!

One month ago, I ran hard for one mile and finished in 8 minutes 38 seconds. This week, I completed the distance in 8:21

Master Swim Experience

I've done Master Swim, an organized swim program for adults, in many places. I'm always one of the slower swimmers, but in my current Master Swim, these folks absolutely blow me out of the water (ok, perhaps not literally).

Amongst triathletes, I'm an okay swimmer. I'm somewhere in the middle of the pack. And of the three sports, it's the one that I place best in at any triathlon that I've done. But in Master Swim, I'm in the slow lane.... oh no, I stand corrected, it's the "development lane". And I'm the slowest person in that lane!

The workouts are written for elite swimmers. For an hour workout, we may have 700 m to warm up, then 6 x 150, then 10 x 50's and then something else, oh I don't know, maybe 4x10000m. I lose track after a while, so it doesn't really matter to me, because were I to complete all that we are supposed to do for that workout, I'd be in the pool until midnight. I get through maybe two thirds of the warm-up and then we move on. The 150's are supposed to be on 2:45. Are you kidding me? My 100's are on 2:30!!! And if we're doing this in the big 50 meter pool, then you can bet I'm missing that nice wall that I expect to find at 25 meters across so that I can jet myself to the other side.

They expect us to do backstroke and butterfly. While attempting to do the backstroke, you can call me Crash. I'm weaving back and forth in the lane just trying to propel myself forward. And as for the butterfly, I think I can flail my arms up and down once or twice to look like I'm attempting the stroke.

Now I do understand, I'm one of those triathletes who "crawls out of the woodwork" sometime in March or April to get back into the pool. I was a little bit busy training for a marathon during the winter, and I'll admit, I don't love to swim. I like it, but give me a chance to go run an hour, I'd take that any day over swimming laps in the pool.

The coaches are welcoming and encouraging and give some good tips on technique. But a part of me feels out of place amongst these swimming all-stars.

Photo courtesy of http://www.ci.san-marcos.tx.us

Balancing Act

Being a cardiologist and a triathlete don't always go together so well.

My job is unpredictable, because my first priority is always an ill patient. When I'm on call, which is about every three days, I have to answer my pager when it rings. That means that my pager is in a plastic ziplock bag at the edge of a pool when I'm swimming laps. Or it's sitting on my shoulder while I'm in a spinning class because the music is so loud that I wouldn't hear it otherwise. Or, it's on my fuel belt, along with my cell phone, when I'm out for a long run.

On occasion, I actually have to rush to the hospital to take care of an acutely ill patient, and that can mean dropping a workout completely at the spur of a moment. If a patient is having an acute heart attack I need to be at the hospital within thirty minutes. I've adapted my workouts during times when that is an issue. I have a run that I call the "MI Shuffle" -- MI for myocardial infarction, or heart attack. I start the run at my apartment, and I run the 2 miles to my hospital and back. From any point on that run, I can either sprint to the hospital or back home to get my car to drive to the hospital. If I have a bike ride to do, then I ride laps around the local park, because from any point in the park I can ride to the hospital in a timely manner.

And then there's the issue of time. My average work week is about 60 hours, which for a physician isn't that horribly busy. I know busier doctors. And I do about 10 hours of training each week right now. I wake up every weekday between 4:15 and 5:15 am to get to the gym, the pool, or onto the streets for a run. Mornings are the most reliable part of the day with the fewest disruptions and hence the best time to work out.

Weekends aren't always open either. For triathletes, the long workouts are done on the weekends, and those are the core of training for those of us gearing up for a half ironman. But, I'm rounding at the hospital every third weekend, which can mean up to 16 hours of running around the hospital seeing up to thirty patients in a day. So, if I'm on call on the weekend, I'll move my weekend workouts to the middle of the week so that in case I get very busy I don't miss out on too much.

As I advance from base training and put in even more hours of training, it's going to be very interesting.

Base Training

I'm a few weeks into the base phase of Half Ironman training. I've also chosen my first triathlon of the season -- Wildflower Olympic distance on May 4. It's a challenging, hilly course. Further, it's known as the "Woodstock of Triathlons" since most people camp near the course the weekend of the event. Now, I've never been one to camp as I have a great appreciation for mattresses and indoor plumbing, but for a good event, I'll suck it up for one weekend and sleep in a tent.

I've started swimming again, and I think I'm going to join up with a master swim group soon.

And finally, because the bike is my achilles heel, I'm going to set up a private session with my coach to help out with my bike form. I know I'm very inefficient on my bike, and with fixing those problems, hopefully I'll move faster than my usual 14-15 mph on long rides.

Tomorrow I run hills. On Saturday I bike hills. My life is going to be full of hills for the next several weeks.

What have I gotten myself into?

I am now in the base training phase for the Vineman 70.3 half ironman in July. So far it's not so bad. As long as I'm not on call, I can reliably get in my workouts. It's a goal I'm excited about.

But, I'm not as excited about the Ironman that I signed up for in November. Why? The marathon was tough enough. Do I really want to run that far after swimming 2.4 miles and cycling 112 miles. Do I really want to cycle 112 miles? Right now, a 24 mile bike ride is a long ride to me.

And, do I want to be out in the sun exercising for what will likely be more than sixteen hours straight?

What about the training? Can I train for it AND do my job, AND have a life?

I signed up with a friend. If I decide not to do it, will I let her down?

I think I am going to focus on my next big race, Vineman 70.3. After that race, I'll see how I feel, if I really want to do the Ironman. Because, if my heart isn't into it, I won't do it.

Not Quite Common Sense

A conversation after I perform a coronary angiogram:

Me: You have a blockage in your artery.
Patient: So you put in a stent?
Me: No.
Patient: You didn't open the blockage?
Me: No. You will do better with medicine.
Patient: The blockage is still there?
Me: Yes. But it was a complicated blockage, and putting a stent in it just wouldn't be the right thing to do. Medication is a better way to treat this.
Patient: Medicine? For a blockage?

It seems intuitive -- Find blockage, open blockage, patient all better. It doesn't quite work that way. In fact, there's a trial published last year called the COURAGE trial that found that many patients with stable coronary disease do better with medicines than with angioplasty. There are definitely situations where angioplasty is the right thing to do, but there are others where medicines or surgery are better options.

Further, any time we place wires, balloons, and stents in a coronary artery, there is a risk. We could tear the artery. We could puncture a hole in the artery, causing blood to accumulate in the pericardium, the sac around the heart. And the dye that we use can cause injury to the kidneys. These are just some of the many possible life-threatening complications.

I'm sure there may be a few unscrupulous cardiologists out there who would be willing to put a stent in just about anything. The patient knows the blockage is open and does well, perhaps just as well as if no stent had been deployed, and yet an unnecessary risk has been taken.

Maybe it's a hard sell to say that there's a blockage and it's better not to open it. But, often it's the best thing to do.

Photo from www.endovasc.com

Pictures from The Marathon

Before the race, on Ventura Blvd.

Somewhere in the middle of the marathon, chugging along.

The last mile, downtown. In pain.

Crossing the finish line!!!

The cheezy finisher's photo.

More on The Marathon

Not everything goes as planned. I couldn't find my pace group, so I prepared to run alone, aiming for 11 minute miles with one minute walks through the water stations at each mile marker. I had my trusty Garmin GPS to pace me and measure my heart rate. I'm a scientist -- I like numbers.

I wanted to make sure I didn't start too fast, and I was partially successful at that. The first mile was all uphill and the next four were all downhill. It was tempting to run full gear down the hill, but I remembered the advice from Coach Mary: In the first few miles, two types of people will pass you: People who are faster than you, and people who will be walking at mile 22. Seven years ago, at my last marathon, I was the girl walking at mile 22, and I didn't want that to happen.

The first 10K split had me at 1:08:19, a 10:59 per mile pace. And I kept going, felt good, a little aching in my knees but otherwise fine. Half marathon (13.1) split was 2:26:44, 11:11 per mile pace, a little slower, but I felt good. I felt fabulous through mile 18 or 19, not too much aching, able to run more than the people around me who were too often slowing to a walk. My 30K split was 3:27:41, a 11:08 per mile average.

Hit the wall? Is there a wall? I don't see it.

And there it was at Mile 22. The bottoms of my feet ached, but mostly, I just felt tired out. There was a hill, and I took an extra minute and a half walk break to get up the hill rather than run it. And I started running again, slowly, like a 12 minute mile pace. I changed my rhythm to five minutes running, one minute walking. Those five minutes were the longest five minutes ever.

At mile 24, there was a photographer, and I was the only runner in his view. I put on my best smile to hide how miserable I felt. I wonder how that came out.

And then at mile 25, I found some steam. The end was in sight. In fifteen minutes, or sooner, I'd be done, so now was the time to give it everything. We headed through downtown, past mile 26, turned right on Flower Street, and through the finish.

My time: 4 hours, 57 minutes, 35 seconds. An average of 11:21 per mile.

I wanted to run faster, to finish in 4:45. But I'm still proud of myself. This was 18 minutes faster than my marathon seven years ago, and a more consistent running effort. To put it into perspective, my place was:

5,767 out of 17,011 finishers

1,390 out of 6,520 women

217 out of 778 women in my age group.

All in all, not too bad.

Photo courtesy of www.answers.com

4:57

Not as fast as I wanted, but my fastest marathon yet, and a fairly consistent pace. Hit the wall at mile 22.

Tlred, sore. More tomorrrow.

Race Day Strategery

I'm ready. But a few things I'm not sure of:

Who do I run with? My run group has a 4:30 pace group and a 5:00 pace group. I don't know that I can keep up with a 4:30 group for the entire race, and I think 5:00 would be too slow for me. Should I suck it up and go with the 4:30's and drop back if they're too fast for me, or go it alone and time myself doing 11 minute miles, and if I feel good at the halfway point, picking up the pace? Or, maybe I'll find a 4:45 group from another running club and join them.

Do I wear a hat? It will keep me cool, but will it feel funny since I haven't run with one recently? Will I look good for pictures in a hat? :)

And how about the fuel belt? Do I run with my trusty two 10-ounce bottles of PowerBar Endurance Fruit Punch drink and two 10-ounce bottles of water, or will I run faster with eight fewer pounds around my waist? And then where do I put my Clif Shots and Gu? Maybe I'll safety pin them to my body.

I am leaning toward the following:
-Joining onto a 4:45 group and if there is none then going it alone.
-No hat. Headband and sunglasses, with pony tail.
-No fuel belt to weigh me down. Drink at all water/Gatorade stations. Safety pinning Clif Shots and Gu to my shorts.

Regardless of these little details, I've made it this far without any significant injuries. I am ready!!!

Getting Psyched for the Marathon!

"Go Heather!" will appear on the front of my shirt.

The elephant's rear will be on the back.

I think this will help me get some crowd support. I'll definitely need it.

Shirt courtesy of Running Banana.

Burnout

I'm finding it hard to stick to my workout schedule. First off, I'm still getting over this upper respiratory infection, which while I'm feeling better, is sapping me of my energy. And I just don't feel like working out.

It will be a relief for the marathon to be over. I'm ready to change up my routine. It's been two days weights, five days running, and three days cycling for weeks on end. I haven't been in a pool for months!

One big change is that I'm changing my coach. Mary, my current coach, is fabulous, but she is in Rochester, NY -- if I still lived there, I'd definitely stick with her. But, I need to be better connected to the local tri community. More than just being a member of the LA Tri Club, I need to know which of the many workouts in a week are suited to my goals.

I've chosen to work with Triathletix, a local triathlete coaching company. Tonight I had the opportunity to speak to Jamie, my new coach, and I'm confident that he's going to put together a great program for me.

Sick :(

I hate slowing down. It makes me feel like I'm lazy.

I've come down with a sore throat and feel exhausted. Maybe I'm a little better this evening. I haven't exercised in two days, which feels really strange.

Many people around me have been sick with a similar illness, and I took pride in the fact that I haven't been ill in over a year. Maybe I brag about it a bit -- I attribute it to a healthy vegan diet and being a triathlete.

The marathon is in sixteen days. Tomorrow is supposed to be a ten mile run. I really want to do it. I am not terribly close to anyone in the group, but I just like running with other people. Right now I don't feel up to it. Maybe I will in the morning? I hope I do. Maybe I'll run with the 11:30's instead of the 10:30 per mile pace group that I usually run with.

Or maybe I should just skip it. That's going to feel really weird. I'm going to see what I feel like when I wake up tomorrow morning.

Update, Saturday February 16: I did not run. Instead I walked a couple miles, to and from Trader Joe's. Getting outside, I realized that running just wasn't a good idea today.

Image from www.luckyoliver.com

I'm a cardiologist, not a pastry chef!

In honor of my parents' visit, I made carrot cake. Normally it's a two-tiered cake, and normally, the frosting goes on nice and smoothly. However, I covered it shortly after baking, and it absorbed a lot of water, making it a bit flat and far too moist, which made frosting the cake a challenge. But it does taste good, even if it looks a little funny.


The recipe is from Dr. Pete's Eating For a Healthy Heart. He's a cardiology fellow at U of Washington. He's a vegan, a fabulous cook, and wrote this cookbook while in medical school.

One slice has 375 calories, 8 grams of fat, and 3 grams of protein.

My Valentine

This valentine is from my two and a half year-old niece, and is the first piece of mail that I've received addressed to "Aunt Heather". If this is the only valentine I get this year, that's all I need.

The Twenty Miler

In marathon training, our training peaks at a certain mileage. The group that I run with chooses to run twenty-six. However, at the urging of my trainer, and with a little bit of common sense, I ran twenty miles, as those extra six miles run during training can lead to injuries. And, bottom line, if you can run twenty miles, you can definitely run twenty-six on race day.

My run was good, with the exception of this nagging pain in my left foot. It starts at the base of my big toe and runs about halfway down my arch, mostly a dull pain. It was much better with running on dirt as opposed to pavement. And, after running, it doesn't even hurt. I'm not sure what it is.

During the run I felt like I could definitely run faster. And, at the end of the twenty miles, I felt like I could have run another six, were it not for my aching foot.

I think I've conquered my upset stomach issues. Whenever I do a distance event, triathlon, or run longer than ten miles, I'm sick to my stomach toward the end and for the rest of the day. I've found that for me, I need to keep drinking, even if I'm not thirsty, not just water but also an electrolyte fluid. I need solid food for carbs on my run too. Oreo cookies work very well -- it's not like I eat them any other time of the week. And yes, they are vegan.

I think I'm ready for the marathon. From here, I will be tapering my running distances to get ready for marathon day on March 2.

The Suit Experiment

I'm a young woman and I don't look like the stereotypical cardiologist. So, I've become accustomed to the confused stares that I get when I introduce myself as a cardiologist. Often I suspect that my young looks give me less credibility than if I was a man and had some grey hair.

Normally, I wear pants and a shirt or sweater or a dress under my lab coat. I've never been one to wear a suit to work. But today, I put on my black pant suit and blue button down shirt, without the lab coat, to see if there's a difference.

One of my colleagues who noticed said, "I'll vote for you!" suggesting that I look like a candidate for office. Others complimented me on how nice I looked today. And I had a few questions of what the special occasion is.

There definitely is a difference in how patients react. Today, I felt like I got fewer of those looks of astonishment from new patients. And, patients seemed to take what I had to say more at face value.

Maybe I should wear a suit more often.

Image from www.designerexposure.com

The Zetia Scandal

Schering-Plough, the company that makes Zetia and Vytorin (simvastatin combined with Zetia), released the results of the ENHANCE trial. The trial looked at simvastatin 80 mg versus simvastatin 80 mg plus Zetia 10 mg and the effects on carotid intima medial thickening, in other words, the lining of the carotid artery. The addition of Zetia had no beneficial effect.

I think that the intent of Schering-Plough was to demonstrate that not only is Zetia good at lowering LDL cholesterol, but that it also has a beneficial effect on the lining of the arteries, and therefore can protect against cardiovascular events. Clearly, the study fell short.

I've gotten phone calls and e-mails from patients on Zetia asking, should I stop taking Zetia? Does it matter if my cholesterol is lowered?

The bottom line is this: There is great data for statins, particularly simvastatin (Zocor) and atorvastatin (Lipitor) for lowering cholesterol and reducing event rates. With these medications, we know that lower cholesterol is better, with an optimal LDL goal of 60-70. And, I think that this new study lends credibility to the theory that it does matter what class of drugs are used to lower cholesterol, that it's not just the cholesterol lowering effect of the statins that make them so effective, it's also the effect on the arteries' lining.

However, some people cannot tolerate statin medications due to muscle aches or liver function problems. For these patients, Zetia might be an appropriate alternative.

If you're taking Zetia or Vytorin, please do not stop your medicine. Talk to your doctor. If you are on Zetia alone, you may ask if you should be on a statin instead. There may be good reason why you are on Zetia.

The Training

My week's schedule for training looks like this:

Monday -- 1 hour weight training and 30 minutes running
Tuesday -- 1 hour spinning (indoor cycling)
Wednesday -- 1 hour weight training and 40 minutes speed work
Thursday -- 50 minutes running
Friday -- 1 hour spinning
Saturday -- Long run. 20 miles.
Sunday -- 1 hour spinning and 30 minutes running.

Spirit of the Marathon

I went with several members of my running club to a screening of the movie Spirit of the Marathon. It detailed the training and obstacles faced by a few first time marathoners and two world-class runners, and the reason why they choose to run a marathon. It was really well done.

The timing of the movie was great. For me, I'm running my first marathon in almost seven years. It got me thinking about why I train to race in endurance events.

I run to prove that I am strong, that I am capable of finishing a marathon, and hopefully by the end of the year, a half and full ironman. I run to destress from life. And, I run to set an example for my patients.

If you can, see this movie. It is absolutely inspiring.

Image from www.marathonmovie.com

Lentil Pilaf with Bulgur

This recipe is from one of my practice's office managers. She is an amazing cook, brings in home-cooked food for us all the time, and when she brought this in, it was so amazing I *had* to have the recipe. And finally I got around to making it.

Put lentils in pot, cover with water, and boil. Then add bulgur and a cup of water, and simmer until water evaporates. Meanwhile, saute some chopped onion in olive oil. Then mix it all together.

With a salad and some sweet potato soup from Trader Joe's, this was a filling dinner.