Three Weeks in a Boot

I fractured my 5th metatarsal and sprained my right ankle three weeks ago with a clumsy misstep in the middle of the night down the stairs.  Today was my three week checkup.

According to my orthopod, this is an improvement from the initial x-ray.  As I'm not having much pain, he's pleased with my progress.  In another three weeks, I will have another check-up and presumably at that time if all is well, I'll be out of the boot.

My mental state through all of this has definitely improved.  I'm swimming, riding a stationary bicycle and doing spin classes, weight training, and even doing a little yoga.  My goal is to maintain my fitness and improve my eating a bit.  Because I thrive on structure, I've asked my coach to continue to give me a "schedule" of activities, like when I'm training.  It's just that the focus of my training is a little different.

At poolside, about to do my first post-injury swim workout.

A week after my injury, I headed back to the pool.  I can't kick, but I can swim with a pull buoy supporting my legs.  I've noticed that a full swim workout with a pull buoy tires me out slightly more than a standard swim workout.  Getting in the water, I have the chance to flex and extend my ankle a bit more, which is good because with the boot I feel like I have less range of motion.  The pull buoy forces me to rotate my torso, something my coach Gerardo has been telling me I need to do more when I swim but I really haven't truly understood until now.  Last week I swam six times.

I can ride a stationary bike, and can even do a spin class.  I just can't stand on the bike, which is fine by me, because I think that standing on a bike in spin class is a little silly because I don't spend much time standing on my bike when I'm riding on roads.

Sometimes selfies are fun.  That's me getting on a stationary bike a little over a week after my foot fracture.  I felt determined to get in a good workout, no matter what my limitations were.  A lot of people who get on the bikes at the gym aren't necessarily pedaling very fast, and often they seem more interested in looking at their smartphone than working out.  I'm not sure if I got more strange looks because I was the only one on a stationary bike pedaling fast, or because of the boot.  Regardless, after that workout, I felt the best I had since my fall.

I'm doing more strength training, some with my personal trainer Corey, some on my own.  Corey comes up with some good workouts, like step-ups on a bench, hopping in sand on one foot, and the usual upper-body challenges like push-ups, pull-ups, and tough core work.  And, when I'm not training with him, I'm doing some strength workout on my own a couple more days a week.  I have decided to challenge myself with exercises like one-legged burpees, which is a tough cardiovascular and strength workout, and as you might imagine yielded a few odd looks.

I've used my injury to my advantage in counseling patients, and perhaps it helps me empathize.  When a patient tells me he or she cannot exercise due to back pain, knee pain, or whatever issue they have, I can point out my own injury (because it's hard to hide a large orthopedic boot) and talk about how I am finding ways to exercise in spite of it, and encourage them to try to do the same.

I miss running more than you can imagine.  But I'm not focusing on that.  Fractures heal.  This is known.  I will be back to running in a few more weeks, maybe 3 weeks, maybe a little longer.  And in the meantime, I'm going to stay fit, and positive.

New Cholesterol Guidelines

Recent updated guidelines have been released regarding treatment of cholesterol.  Specifically, this statement suggests who should and should not be on cholesterol-lowering statin medication.

There has been a lot of controversy regarding this document.  And, as a cardiologist, I don't necessarily agree with its conclusions.

What's new -- new research?  New studies? No.  This is just a group of experts coming together to give their opinion.

The recommendation that patients with known significant arterial disease -- including anyone who has had a heart attack or stroke -- should receive statins is definitely supported by clinical studies.

But, the guidelines also suggest that many patients who do not have disease should receive statins.  They present a new risk calculator, and if the risk of the patient is greater than 7.5% for a cardiovascular event (heart attack or stroke) that the patient should receive statins.  That would mean millions more patients on statins.

The major problem that I see with the guidelines is the suggestion of statins for primary prevention.  But, the literature on that topic does not suggest a strong benefit.  To prevent one heart attack or stroke over the course of five years, one would have to treat about 150 patients with a statin pill every single day.  So, when looking at a huge population, yes you see a reduction in the number of heart attacks and strokes. But, odds are, if you are one of those 150 people being treated with a statin, there is a 149/150 chance that taking a pill every single day for five years will not prevent any type of event.

Further, there have been meta-analyses, which are studies pooling data from several other studies, that demonstrate that amongst the primary prevention population, there is no reduction in mortality.  In other words, a statin won't prolong your life.

There's a great editorial from John Abramson and Rita Redburg in the New York Times on the new guidelines, similarly skeptical of expanding the use of statins.

So, if you feel good, why should you take a statin, which is a pill that has a decent chance of causing muscle aches and is known to slightly increase the risk of diabetes, has a less than 1% chance of preventing a heart attack or stroke in the next 5 years, and won't prolong your life?  It's a good question.  Can you get the same benefit from improving your lifestyle?

YES!  In fact, lifestyle will give you even more benefit than a statin pill!  Daily cardiovascular exercise for at least 30 minutes, but preferably an hour, will help you feel better, lose weight, drop the cholesterol numbers, and reduce your risk of a heart attack or stroke.  Diet is potent too -- and, a whole-food plant-based diet will make you practically heart-attack-proof.

I'm not a big proponent of statins for primary prevention because the data to support them just isn't that strong.  While the guidelines do support lifestyle, I think that we as a profession and society need to do more to encourage people to be more active, eat better, manage stress, and maintain a healthy weight.  And that is how we will prevent heart attacks and strokes, not by feeding everyone a statin.

From athlete to gimp

With one clumsy misstep on the stairs, and the snap of a metatarsal bone, I went from athlete to gimp.

It's been tough.  I am in an orthopedic boot. I can walk short distances in the boot, but anything longer and I use my crutches, because I've found that walking too much leads to quite a bit of pain. I am taking ibuprofen 800 mg three times a day, and an occasional Percocet.  My foot is still swollen, but it's not quite the blue swollen mess with five sausage-like toes as of just a few days ago.

Other than a short weight training session, I have not been exercising. I'd love to do some nonweightbearing exercises with the boot on, but even shaking around the foot with the boot in place gets to be uncomfortable. And I am afraid to get in the pool to swim for fear that my unprotected foot will hit a wall, the lane marker, or even my other foot. Even the slightest touch to the foot can be uncomfortable.

It's been six days. I feel different. I definitely feel more tired. I have a lot more free time. I'm trying to free time to good use by reading. I'm also getting more sleep than I did on my typical two workout days.

Then there's the emotional impact of all of this. I envy my friends and teammates who are racing.  I wish I could be out running swimming and biking with them. I fear what will happen to  my body without exercise.  I worked so hard earlier this year to get into the good shape that I am in and I don't want to lose it.  I am trying so hard to eat less so that I don't gain weight.

I am so fortunate to be surrounded by good friends, family, and an incredibly supportive boyfriend.  From coming over and bringing me dinner to taking out my trash cans, or hanging out and watching a redbox movie or just being a sympathetic ear, I couldn't ask to be surrounded by better people.

It takes only six weeks for this fracture to heal, but it feels like an eternity.  And I am trying to be positive. But it's tough.

When life gives you lemons, make lemonade.

Life has handed me lemons.

My dogs started whining in the middle of the night.  I came downstairs to let them out.  Half asleep, I thought I was stepping my right foot on the floor, when in fact there were a couple more steps.  I landed on the outside of the foot and fell to the floor, fracturing my 5th metatarsal bone.

I am in an orthopedic boot for the next six weeks.  While I am permitted to bear weight on the foot, I am using crutches because bearing weight on the foot is simply too painful.

Needless to say, I cannot run, and I will not be running the Carlsbad Marathon on January 19 as I had planned.

I suppose I could throw myself a little pity party.  And I'll be honest, as I lay in the emergency room this morning while my foot was x-rayed and splinted, I cried.  No honestly I sobbed.  Not from the pain, but rather because my running is being taken away from me.

I choose to be more positive.  I am going to take a few days off from exercising.  Then I can swim.  I can't push off the wall with my right foot, but I can get in a good workout.  I can lift some weights.  I can aqua jog.  And I'm sure my personal trainer Corey will come up with some fun stuff like one-legged burpees to keep me in shape.

As much as I'd love to become the one-legged fitness wonder, Coach Gerardo asked me to take the rest of the week off from training.  That is to keep me from doing more damage.  He suggests that one can take up to 2 weeks off from training and not lose fitness.

This will be a challenge but I will get through it.  Maybe my body could use the rest.  The last time I was in an orthopedic boot and couldn't run was 8 years ago.  It was during that time that I began swimming and riding my bike.  Ultimately, when my foot healed, I put it all together and became.... a triathlete.  Which I am to this day.

I will take on this new challenge of not running.  I will listen to my coach.  I will rest as I should.  And, in the next six weeks, I am going to become an awesome swimmer.

Fitter and Faster

Something you may have noticed.... I'm smaller.

Back in February, in order to change up my routine with the hopes of becoming a better athlete, I hired personal trainer Corey Enman of Fitamorphosis.  Upon signing on with him, I was measured and weighed.  At 5'10", I weighed 159 lbs, with 24% body fat.  While 24% body fat is a normal body size, it's a bit more than what a competitive female athlete should carry.

In about four months, that became 137 pounds and 18% body fat.  Though, in truth, I've gained about 3-4 pounds of that back, and I'm hovering around 140-141 pounds.

On the left, me in December 2011 at 159 lbs.  On the right, a slimmer and faster me.

As you well know, the exercise was already there, with the usual  swimming, biking, and running prescribed by Coach Gerardo of Fortius Racing, and two personal-training weight session per week.  But, with Corey, I've changed that up.  A once weekly session with Corey consists of high-intensity body weight and free weight exercises to burn fat and build muscle.  These may consist of running a mile in a 20-lb weighted vest while carrying two ten-pound dumbbells, burpees on a single leg, frog jumps, pushing a tire across a gym floor, amongst other challenging exercises done back-to-back-to-back.  Then, I'll usually add in one day a week of Barry's Boot Camp.  So that is two days of solid high-intensity strength training in addition to my cardio.

However, I would credit a better diet with my results.  I don't deprive myself.  I eat around 2000 calories per day.  Breakfast is a soy latte, oatmeal with fruit, and usually a smoothie or another piece of fruit later in the morning.  Lunch is typically a salad with tofu or tempha (a brown rice protein) and tons of veggies, and sometimes some quinoa and avocado.  Dinner is usually a stir-fry.  Snacks are fruit, or veggies and hummus, or trail mix.  And I've curtailed my nighttime noshing.

Key to the diet is logging all my food into MyFitnessPal, a free application, to keep me accountable, and to allow Corey to know what I'm eating.

Initially, my smaller body size didn't transform into much speed.  But, in the ensuing months, I am faster.  In fact, in the past three weeks, I have set new personal bests at the half marathon (1:48:34), 5k (23:01), and 10k (49:04).  Hopefully, that means that the Carlsbad Marathon in January will also be a personal best.

Before the Hard Rock Los Angeles 5K on November 2. 

I wouldn't suggest my previous weight was unhealthy -- it was healthy.  But, my lower weight helps me to move faster.

There's no shortcuts to health or speed -- it's hard work.  If you want the support you need to get your fittest and healthiest body, take Corey's FitCamp classes.  Click Here.

Confessions of a New Vegan Coffee Drinker

I've told you that I've started drinking coffee.

It began in Israel in July, where I was competing in the Maccabiah Games.  Our first event was the Bike Time Trial.  This involved a commute from Tel Aviv up to a kibbutz in the Golan Heights, in the north of the country.  For a race start at 7:30 am, this required us to meet up in the lobby of the hotel at 2:30 am to drop off our bikes.  I had miraculously gotten to bed at 8 pm, so I had some rest.  But I was tired.  We discovered that the hotel was kind enough to open up the coffee cart to provide complimentary drinks.

On a whim, I tried a soy latte.  And I was surprised, it tasted quite good.  And there I was, wide awake, probably the only one awake for the entire two hour bus trip up north!  Shortly thereafter, I got on my bike and had an incredible race, or at least good for me, averaging over twenty miles per hour on a hilly time trial course.

So I figured, if I had a good bike time trial on some coffee, why not try it before other workouts?  And so, I had my daily latte for the rest of the trip.  I noticed that my morning runs were faster on coffee.

Then I got home.  Starbucks around the corner from me got to know that "Doctor Heather is on her way to go swimming."  Yes, my soy lattes fueled my morning swims far better than any green smoothie.

So then it made sense -- why give all my money to Starbucks when I can make my own soy lattes at home?  My parents were kind enough to give me a Breville Automatic Espresso Machine as a birthday present.  And now, in five minutes, I can make my own latte, and it's as good as anything I get at Starbucks, but it's not $3.55 (because Starbucks charges extra for soy milk... grrrr!)

A few things I've discovered as a new coffee drinker --
--Non-dairy creamer isn't soy creamer.  It has palm oil and other artificial crap in it... including casein, which is a dairy product.
--Soy milk seems to work just as well as soy creamer in black coffee.  At least for me.
--Why don't more places offer soy creamer or soy milk instead of that "non-dairy creamer" crap?

Oh and one last thing... I'm addicted.  I need my morning coffee.  At least it's a relatively healthy addiction.

Coffee -- Not so bad, actually can be good!

There was a great review article in JACC (Journal of the American College of Cardiology) this week on the health benefits and risks of coffee.  I read it because after 38 years on this earth, I have finally become a coffee drinker.

A lot of patients seem to think that when they hear the bad effects on the heart due to meat, dairy, cigarettes, eggs, added sugar, oil, and salt, that somehow coffee is another substance of harm.

Actually, to the contrary.  Coffee drinkers seem to have a decreased risk of heart attack, stroke, diabetes, and abnormal heart rhythms.  These benefits can be seen in moderate coffee consumption of up to 4 cups of coffee per day.  These benefits may be due to the caffeine in coffee, but there are other chemicals in coffee that may contribute to these health benefits.

The down side, of course, is that some people feel tremulous or anxious with consumption of caffeine.

So, drink up!

Shabbat Shalom!

Last Friday night, I had a vegan potluck Shabbat at my home. Most attendees were not vegans.

I baked a challah from a recipe for Post-Punk Kitchen.

We had lots of options - matzo ball soup (see my passover post from March for links to that recipe). We had a couscous salad, a big kale and tahini salad, lentils, vegan hot dogs, hummus and an Israeli salad. For dessert we had homemade chocolate coconut ice cream, cookies, and plenty of fruit.

Maccabi Triathlon

It's been a week since the race, but what better time than ever to post a race report???

In terms of my own performance, I had a pretty good race.  But in terms of management by the race organizers, this was the most poorly run triathlon I have ever participated in.  I will share my thoughts on that at the end of this post.

Early start
The weather in Tiberias is hot and humid and the temperature is 90° and upward on any given day this week. We arrived at the transition area just before 4:30 AM, ready for a start just before 6 AM.

Swim start
This was a large group that included all Olympic distance triathletes under the age of 39 and those aged 55 and higher.  An interesting combination of swimmers, the elite young and the extreme old, all in one wave.  I started toward the back of the group because I knew there were some spectacular athletes and swimmers who are far faster than I. I think this was probably one of the most violent swim starts that I have ever experienced. I felt like there were people all around me, in front of me, to my side and behind me. I took a few breast strokes just to get my rhythm and let a few people move ahead of me. Then, things were okay.

From what I'm told, there are a number of athletes who cut across the course and did not swim all the way to the buoys for the Olympic course. Instead, they turned at the sprint course buoys. I don't know if this was intentional but to me it was quite clear where we were supposed to swim and I followed the rules. I'm sure several of them had very short swim times recorded.

Unfortunately I ended up off a bit off course. It was difficult to sight some of the buoys.

This is the TrainingPeaks file mapping my swim.  This was an out and back, starting from the green and ending at the red circle.  You can see just how far off course I ended up. 

At the end of the swim, I did more of a crab walk on hands and feet to get out of the water because there were a lot of rocks. The Australian coach, who has become a friend this week, was yelling at me to get up faster, but the last thing I wanted to do was injure my feet.

Transition
There was a long run from the water to transition. I banged through, helmet on, shoes on, sunglasses on, grab a gel and go.

Bike
The bike was an out and back course, repeated twice. The course had been shortened to 36 kilometers. I felt really good here. This is the first time that I have ever done a triathlon and no woman has passed me on the bike course.

Credit is due either to my coach Gerardo who had me working hard on my bike before this race, or to my brand-new Hed disc wheels. Regardless, I had a hell of a bike leg.

Run
The run course was literally out and back four times along the same 1.25 kilometer stretch of road. But this made sense given the hot humid weather. There was an aid station midway along that stretch, so we would pass the aid station eight times. I took a water bottle every time I passed and dumped it on my head and then had a sip or two. I felt very good on the run, didn't start too fast. Garmin was acting up so I don't know exact pace.

The Israeli Triathlon Association like this picture of me enough to feature it on their Facebook page.  It's my game I play with the photogs on the course -- I see what the goofiest gesture is I can make for the camera, without the photog getting mad and putting down the camera.  Here I am pretending I'm an airplane.  And below here I am throwing my hands up like a goofball:

During the run, I passed more people than people who passed me.  The temp was getting hot, from what I hear it was 100 degrees, and in fact at about 3 1/2 hours after the race began, the course was closed and anyone still racing pulled off the course because it was too hot.

My total time:  2 hours 44 minutes.  Oddly enough, my bike was my best ranked of the three splits, followed by the swim, and then the run.  Usually I'm the opposite.  I guess it reflects my hard work on the bike.

I placed fourth out of seven in my age group.  The top three were all Israelis with very fast swim splits, and none of them were entered in the Maccabi Man/Woman competition.  Regardless, I'm happy with my performance.

That said.....
Organization of the Race
Worst organized race ever.  Particularly for something that is an international event as part of the Maccabiah Games, and supposedly an ITU-sanctioned event.  We didn't find out about the opportunity to swim on the course until after the fact at the pre-race meeting, when the race director said, "You all had the chance to swim on the race course from 3-5 pm."  Ummm, no we didn't, at least those of us who weren't Israelis, we didn't have that chance, thank you, giving the Israelis yet another advantage over the rest of us.  Then we were told that we needed to bring our own swim caps.  Several of my team members didn't have swim caps with them, but fortunately there were a few of us who had extras to go around.  We were also told that we needed to body mark OURSELVES -- really?  Very strange.  And at packet pick-up, we were notified that we had to put down a 50 shekel deposit to get our race chip, something we had not been told in advance.  The race course had a guy at the finish turn-off who spoke no English and wasn't paying attention, so several people missed where they were supposed to go to finish.  And, the supposedly "closed" bike course was not closed, with people walking back and forth, and unfortunately one woman stepping off the curb and getting hit by a cyclist who flew over his handlebars, and yet fortunately was not severely injured.

For an international event, this race was an absolute embarrassment.

Regardless, I had fun and had a good race.  But, next time around, they really need to shape up.

I am Maccabi Woman!

I earned a bronze medal!!!  I took third place out of 11 competitors ages 36+!  This was based on total time for four events in eight days, a 26 km bike time trial, a half marathon, an Olympic distance triathlon, and a 5 kilometer swim.  I feel great about my performance at all four events. More later, I just wanted to share my awesome news!!!

Maccabi Man and Woman Half Marathon

This is one of the toughest races. And, as I am participating in a four race competition, with a triathlon less than 60 hours later, I knew I had to run this race smart.

I knew this race would be hot and humid -- at race start it was about 76 degrees and at least 80% humidity.  And there were some hills.  And it started at 9:30 pm, an unusual race time.

The start was absolute chaos.  Not only were there 70 of us doing the maccabi man and woman competition, but there were another 1,300 Israelis in he general public who were running. The running corral was crowded and people were shoving to get to the front.  I really feared I would be trampled.  Those of us with Maccabi were supposed to start at the front with the general public following in 5 minutes behind. Instead, everyone started at once.  As I was at the front and not with the abilities to run with the lead pack, this means a lot of people blew past me. I guess I am lucky I didn't get knocked over.

With all the fast runners around me, it took quite a bit of restraint to hold back. And I knew that holding back would be important. If I went too hard I would risk sacrificing my triathlon on Friday.  I held my heart rate to zones 3 and perhaps a bit of zone 4.

Aid stations had plastic bottles of water, a little different from what I am accustomed to at races in the USA. We were also told that there would be "isotonic" fluids at two aid stations, in other words, an electrolyte solution. I wasn't sure how far out I would have to wait on the course for that, or what "isotonic" fluids in Israel consisted of, so I actually ran with a bottle  of my own usual fluid, Ultima Replenisher.  It's a good thing, because the isotonic solution was not available until 10k and was warm and not very palatable.

So, I had my own fluids to drink. To combat the humidity, I used the water bottles to dump over my head and keep my core temperature cool.

What I loved about the course was the crowds. They yelled "hol ha kavod" which I guess is the equivalent of "great job!"  There were lots of little kids along the way and I high-fived a bunch of them. Around mile 6 I was done with the high fives and focused on my race.

My initial strategy was to run 9:00 per mile. But given the humidity, I knew I would need to adjust my strategy.  I kept my heart rate in my appropriate zones, and whatever my pace was so be it.

I finished in 2:04. That's about 9:25 per mile. The important lesson - be ready to adjust your goal for unexpected conditions. I ran consistently, the second half about the same pace as the first. This was a successful day and I think I have enough energy to do well on Friday. 

Maccabi Update

(I put together a post with pictures.  It will not upload). Sadly I am having issues that I hope will resolve soon. )

Greetings from Israel!

As I told you in previous posts, I am the captain of the USA Masters Triathlon Team and am competing in something called the Maccabi Man and Woman Competition.  This entails four events over the course of eight days -- a bike time trial of 26 kilometers (16.1 miles), a half marathon, an Olympic distance triathlon, and a 5 kilometer swim. 

I am staying in Tel Aviv. The seaside is a beautiful backdrop for a morning run:

 

The Mediterranean Sea and the old city of Jaffa are behind me.

The opening ceremonies were an absolutely amazing experience!  Over 9,000 athletes paraded into Teddy Stadium in Jerusalem. Here I am as I walked with Team USA around the oval:

 

And here I am with triathlon teammates Ryan Landy, Brad Scher, and Howard Sklar:

 

Here I am at the Wingate Pool in Netanya for a practice swim:

 

 Here I am in the park in Tel Aviv for an easy morning taper ride:

 

 

Yesterday was my first event, the bike time trial:

 

 

Coming off the start ramp, we headed down a nice hill.  Racers started a minute apart on this out-and-back course.  and then halfway through we encountered a nice big hill to climb.  The out and back course had us climbing the same hill we coasted down at the start.

I knew I was well-trained for this race. Coach Gerardo has really had me focus on the bike with a lot of workouts with time trial simulation at the end.  And I had a new aero helmet and race wheels.  

And there I am climbing the hill to the finish. 

 

I really felt like I had a great race. I finished the 26 kilometer (16.1 mile) race in 46:57.  As the bike is my weakest of the three sports, I was not planning on winning, but rather giving my best effort. 

This put me in 11th place out of 19 women in my age group. That's pretty solid for this type of international competition. 

 

Today is a rest day since I will be running a half marathon tomorrow. 

 

This is the Carmel open market, with awesome produce.  I bought some bananas, plums, and nectarines, and enjoyed a juice made from fresh beets, carrots, apple, and ginger. Yum!

And then I rested (and blogged!) from the beach.

 

Tomorrow is the half marathon, which starts at 9:30 pm!  The late start is to avoid the hot weather of the day. Since my triathlon is only three days later, this will not be a hard effort. I will start at 8:45-9:00 per mile, and at mile 6 if I feel good I will pick up the pace, though keeping my heart rate in zone 3, or under 168 beats per minute. If the weather is hotter or more humid, I will alter my plan and run a bit slower. 
 

More to come after tomorrow's marathon. 

 

 

Lakeside Employee Newsletter Article about my Upcoming Maccabiah Games

Is your blood pressure being checked properly?

Are you sitting on the edge of an exam table, having just rushed into the exam room, legs dangling, as the medical assistant inflates the blood pressure cuff?  Unfortunately, this is a very common scenario, and is the WRONG way to check a blood pressure.

When blood pressure is checked improperly, the systolic reading can be up to 14 points higher than the true correct reading!!!

Here is how your blood pressure should be checked:

--You are sitting calmly in a chair.  You have been seated in this chair for a couple of minutes.
--Your feet are flat on the floor, your back comfortably supported.
--Your arm is at heart level.  The arm is being supported, either by the arm of the chair, a table, or by the medical assistant who is supporting your arm.  You are NOT holding your arm up for the blood pressure to be taken.

This is how we do blood pressures in our office.  If your blood pressure is checked any other way, speak up.  You want your accurate blood pressure recorded.

Maccabi Training

It's going well.  I've survived my four back-to-back-to-back-to-back race weekends to prove that in a week I can do a 40k bike time trial, a half marathon, an Olympic distance tri, AND a 5k swim. 

Two weekends ago, I completed the Valley Crest Half Marathon, 13.1 miles of running with 1800 or so feet of climbing.  My finishing time was about 2:13.  I'd run a flat marathon quite a bit faster, but this was a good challenge.

Running in the Santa Monica Mountains can be tough, but the scenery is awesome.

This past weekend, I competed at the Big Bear Triathlon.  This was the first Big Bear Tri, and the race director is the cousin of one of my team's coaches.  I had a great time, but someone forgot to measure the course.  The swim was 1.3 miles instead of the pre-stated 0.93 miles.  We were told the bike would be long at 28 miles due to lack of an adequate turn-around point, but it came out to more like 31 miles.  So by the time I got to the run, I thought to myself, I know this is supposed to be 6.2 miles, but I am emotionally ready to run 8 if that's what the course is.

Running at 7000 feet of altitude is tough!!!!  What for me is usually an 8:30-9:00 pace was more like 10-11 minutes per mile, and I was breathing hard!

And that's the finish line.

It's hard to believe, but I leave for Israel in less than four weeks -- on July 16!!!  I'm still training hard.  Today started just before 5 am, with a swim from 6-7 am, a full work day, and then a 90 minute brick in the evening.  Tomorrow I'll be at the ocean at 6:15 am to do it all over again.  Some days are tough, but this is what makes us athletes.

Vegan for Health Reasons???

The vegan diet has caught on.  People have read T. Colin Campbell's The China Study, Caldwell Esselstyn's Prevent and Reverse Heart Disease, and have seen the movie Forks Over Knives.

I'm seeing a lot of patients who have recently gone vegan for health reasons.  Some are getting amazing results, cholesterol plummeting, weight coming off, blood pressure normalizing.  But, others aren't necessarily seeing results -- their blood pressures are still high, cholesterol is no better, and weight won't budge.

Why????

The answer is usually found in the details of their vegan diet.  One patient told me how after his heart attack, he went fully plant-based, and he had great results.  But, after a couple years, the cholesterol numbers started creeping up.  As it turns out, his initial whole-food plant-based diet had slid into a fair amount of processed mock-meats (Morningstar, Boca, Tofurky, etc), oil, and other processed foods.

Another common theme amongst my vegan patients who struggle with weight, blood pressure, and cholesterol -- restaurant food.  It's fun to try out the local vegan and vegetarian restaurants.  But just like most omnivorous restaurants, they're not geared toward a healthy diet.  Your local vegetarian restaurant will add the salt, processed sugar, and oil to your food like any other restaurant.  And vegan baked goodies like cookies and cakes -- forget them!  They're no better for your health than the animal-product-laden versions.

These items may all be vegan, but the vast majority of them are NOT healthy.

The diets that are touted by Esselstyn, Ornish, Furman, and Campbell are not VEGAN diets -- they are whole-food, plant-based diets.  So, get to the basics -- get most of your calories from fruits and vegetables, add whole grains like brown rice and quinoa, and use proteins that are unprocessed like beans, lentils, and edamae, or minimally processed protein like tofu.

Maccabi Man/Woman Competition

This summer, I will be competing at the Maccabi Games in Israel.  The games take place from July 17-30, and I am the captain of the Masters Triathlon Team, consisting of triathletes ages 35 and up.

I will be competing in the triathlon against other women in my age category.  In addition, there is a competition called the "Maccabi Man/Woman".  That involves four events:
July 21-- Bike 40K time trial race
July 23 -- Half marathon (13.1 miles)
July 26 -- Olympic distance triathlon (0.9 mile swim, 24 mile bike, 6.2 mile run)
July 28 -- Open water 5K swim
The athlete in each division with the lowest combined total time for all four events can win a medal as the "Maccabi Man or Woman".

So, that's four events in eight days!!  My initial concern, and still a concern, is that the half marathon could leave me fatigued before a triathlon three days later.  But, if I'm going to Israel to be an athlete, I want to do everything offered, even something as challenging as this.

I discussed with my coach Gerardo, thinking he would try to dissuade me from trying to attempt this.  But, surprisingly, he felt quite positively about it.  So, to train to compete in four events scheduled so closely together, I will racing four weekends of back-to-back-to-back-to-back events.  This should simulate the fatigue of competing in the Maccabi Man/Woman Competition.

Last weekend, on May 26, I ran the Mountains 2 Beach Half Marathon in Ventura:

Mountains 2 Beach Marathon, Mile 1

I had a good race -- I finished in 1:53:00, an 8:39/mile pace, and my fastest half marathon to date.

Today, I raced my first bike time trial, the Piru 40K:

I finished in 1:18:45.  By no means is that a champion time, as I've never been a strong cyclist.  But, I set a goal for myself to finish in 1:20 or less.  I feel like I pushed myself hard, and finished the second half of the race just as fast as the first half, which means I paced myself well.  The medal that I am holding is for second place.... out of the two women who raced today.  It's a medal, I'll take it :)

Next weekend on June 9, I will be racing the Valley Crest Half Marathon, a hilly local trail marathon through the trails of the Santa Monica Mountains.

My final race of the four, the Big Bear Olympic Distance Triathlon, will take place on June 15.

So far, two of the four events have been completed.  I'm trying to recover between events.  I am  focusing on getting enough sleep, and taking in good nutrition to facilitate my recovery.

If I can get through these four weekends of races, then I think I should be able to do Maccabi Man/Woman.

Wildflower Long Course -- A Hot Hot Day!

I raced Wildflower Long Course on Saturday.  I had raced this three times before, but I would have to say, this was one of the toughest races I have ever done, here or anywhere else.

I knew it was going to be a hot day, anticipating something in the low 80s.  In preparation, I made sure I was hydrated well in the days coming up to the race.  On the day before the race, I drank about 40 ounces of sports drink.

This would be my fourth race on this course.  My fastest was two years ago in 7:04, and I figured that with my training I could take a couple minutes off my bike and seven or so minutes off the run time and finish around 6:55.  That would be under ideal weather conditions.  However, that said, I knew to alter my expectations if it would be a tough day.

SWIM
The swim was uneventful.  I swam alongside a few women in my wave who kept about the same pace. I finished in 41 minutes, which is my usualy time for a half-iron distance swim.

In transition, my left ankle timing chip and my wetsuit seemed to get into an argument and not want to separate.  Finally I wrenched the wetsuit off, grabbed the bike and left.

BIKE
It wasn't too hot yet.  The first climb out of the transition area is steep.  There was a topless woman with a sign that read, "My eyes are up here."  That was pretty funny. I had been practicing my long rides by using real food for nutrition, like bananas and a trail mix of cashews, cinnamon sugar almonds, and dried cranberries.  So, that was the majority of my nutrition on the bike and it served me well.  For hydration, I had three 20-oz bottles of Ultima Replenisher.  I use Ultima in my training because it is relatively low-calorie, about 30 calories per bottle -- I would rather eat my calories than drink them.

After the big climb out of transition that lasts a few miles, and takes us out of the park, we get some rollers.  I felt like I was on pace.  I made sure I was drinking enough, which meant at least one bottle per hour.  By the end of the second bottle, I craved water, because the taste of the electrolyte was getting to me. 

Then there were the flats and gentle rolling hills of Jolon Road.  Unfortunately, the road desperately need repair as it gets bumpy.  Now I was really starting to feel the heat, AND some 15+ mph crosswinds.  Wind makes the bike less steady, and contributes to fluid loss.  I would have liked a water bottle to squirt over my head to cool myself off.  BUT, the aid stations from about mile 30 onward ran out of water bottles!  If you wanted water around mile 35, you would have to actually stop, get off your bike, open your bottle and have it filled (typically you fly by on your bike and grab a bottle, no need to stop).  Worse yet, the aid stations after mile 35 didn't even have the luxury of poured water -- there was only Gatorade.   At the end of the aid stations some of the volunteers were offering up bottles of water -- unfortunately most of them were neglecting to mention that these were pre-used bottles that had been discarded by athletes who had already come through the aid station -- gross!

I would have loved to drink some water, but instead I took a bottle of lukewarm Gatorade.  I can't say I loved the taste of it, but it was okay.  I probably didn't drink as much because I was so sick of the artificial sweetness of electrolyte drinks by this point.

Around mile 42 on the bike is a hill called Nasty Grade.  Now, it's not a terribly steep hill, but when you've been on your bike for a few hours in a race, this is not the time you want to be climbing.  According to these stats, the hill is nearly 3 miles long and over 700 feet of climbing.  That's not terrible.  In a normal race, I'm used to seeing one or two people walking their bikes.  In today's race, there were at least a dozen.  And, I was struggling more than I ever recall to get up the hill.  This is when it hit me -- this is a tough day for all of us.  I swore that I would stay on my bike and grind the pedals to the top, which at the painfully slow pace of 3-4 miles per hour, I managed to accomplish.

By mile 50, I looked down at my watch, realized my time was off, and felt somewhat resigned.  But then I had to remind myself -- alter your goals to what the day gives you.  So I knew not to expect a great day, but I couldn't help but mentally beat myself up over the slow time.

As it turns out, my bike split was 3:57:58, less than five minutes slower than the last time I did the race two years ago.  That said, in 2011 there was a bit of wind but the temperatures were cooler.

RUN
A few things I didn't know at this point:  The temperature was up to 93 degrees outside, and many people behind me were struggling on the bike course.  Many people that day would miss the bike cut-off and end up disqualified as a result.

I felt okay starting the run.  Not great.  Mouth was dry.  I felt thirsty.  On my way out of transition, the table had cups and cups of cold water.  I was so grateful for just plain water!  I drank two and poured one over my head.

Even in the first mile, a lot of people were walking,  I was running, more of a jog.  I knew I could have gone faster, but knew I had a long ways to go in a lot of heat.  The aid stations had enthusiastic college kids cheering us on which made a hard day just a bit more pleasant.  They also had hoses.  I would get the attention of the person with the hose and have them spray me.  However, halfway through the run, I realized that the hoses were getting my shoes soaked and heavier, which was somewhat counterproductive.  So by the time my jersey was soaked with water, I stopped asking for the hoses to be aimed at me.

Mile 1 was about 10:30, mile 2 was 11 minutes, and mile 3 was something like that.  I told myself that I would walk when I needed to.  There's a long hill through mile 3 along a paved road through the campground, and I gave myself permission to walk when I got tired.  But I never tired out and was able to shuffle to the top.  Then by mile 4 I started to feel tired and discouraged.  My run/shuffle pace was more like 13-14 minutes per mile.  I walked up a steep hill at mile 5.  Then at the mile 6 marker I knew that the big trail hills were done.  I walked only through aid stations at this point because I knew that if I stopped to walk that it would be hard to run again.

As slow as I may have been shuffling/jogging/running, it was faster than any walk would be.

I had plenty of water, at least two cups at each aid station, a couple orange slices, a half a banana, and a Red Vine.  I was finally hydrated, but my stomach was sloshing as a result.

At mile 7, there were college kids serving bacon and bourbon.  Apparently they had vegan sausage but ran out.  Funny.

Around mile 8, I came upon a group with a beer bong.  Disappointed in my horrible run pace and overall crappy day, I was amused by the beer bong.  Now, I rarely drink alcohol, and I haven't partaken in a beer bong since college.  But, I figured, as awful as this race is, if I hit up the beer bong, at least I'll have a good story.  So, I took about an ounce of beer from the bong (it tasted awful!) and continued my run.

Miles 7-9 are through the campground and there are plenty of people to cheer us on.  That helps more than you would ever know.

Mile 9 is down a paved road.  Mile 10 is up that same hill again.  Most people were walking uphill.  I was jogging, about a 14-minute per mile pace.  Then I knew I was almost done, but it felt like forever.  I developed a side stitch and every step hurt.  I had to remind myself that a side stitch is not a real problem, and forced myself to run through the pain.  The last mile toward the finish was all downhill.  As much as I wanted to walk from the pain in my side, knowing the end was close, I made myself run.

Crossing the finish line, I could not have been more grateful to be done.

Run time: 2:36:38 -- Nearly fifteen minutes slower than my last.

Overall time:  7:27:52.  Not my best, not my worst, but far from what I wanted to do.

I ranked 44 out of 98 women in my age group who started the race.  From the results, it looks like only 72 of us finished, and the other 26 women were unable to finish the race, which is a very high proportion.  That said, I know a number of racers who didn't finish that day, so I think that might be accurate.

WHAT I LEARNED
I shouldn't be too disappointed.  Given the conditions, I had a reasonable finishing time for my relative abilities.  I hydrated reasonably well, though if there was water at the last few aid stations on the bike I probably would have been better hydrated for the run.

Also, this was perhaps an impromptu training for my summer "A" race, the Maccabiah Triathlon in Israel, which will be in the heat of the desert in the end of July.  If I can do a half iron distance tri on one of the hilliest courses there is in desert heat and wind, then I can defiinitely do a triathlon of half that distance in similar conditions.  If nothing else, I have a little more confidence.

Boston

I'm shocked.

Terrorism has directly impacted our sport, running.

I have friends who ran today, and they are fortunately safe.

Boston holds a special place for me.  As a runner, it hosts the ultimate marathon that many of us aspire to run.  But, Boston was home for me for a year, 2006-2007.  My circumstances for going there were less than ideal, having just gone through a divorce.

After dropping my belongings off at my new apartment, my family left.  I remember doing what I do anywhere unfamiliar -- I put on my running shoes.  I ran past the Boston Common, down Newbury Street, up Boylston Street, past the painted finish line of the famous marathon, and back home.  I vowed to make that year memorable, and I certainly did that.  I met some great people (Gideon, Maya, Carey aka Professor Douchebag, SDA who listened to my horrible HHL stories, amongst many others) who made great impressions on my life and I neglect to keep in touch as well with as I should.

I even got a number to run the 2007 Boston Marathon as a charity runner for CJP, Boston's Jewish Federation, but had to bow out due to iliotibial band issues.  On the day of the marathon in 2007, I left work a little early and came out to watch the runners in Brookline.  By the time I got out there, it was mostly the back-of-the-pack charity runners, but if anyone needed encouragement toward the finish line, it was them.

My heart goes out to the city of Boston, my former home, and everyone affected by today's tragedy.

Tomorrow I'll wear one of my race shirts as my show of solidarity for Boston, as many others will be doing.

And, while I've wanted to run Boston, now I want that more than ever.

Fat Vegan

A vegan diet does not guarantee a slender physique.

Nor does a vegan diet guarantee health.

A friend who went vegan nearly six months ago laments that she cannot lose weight.  For the record, my friend isn't fat, though she's probably carrying a few more pounds than what would be ideal for her health.  By following a vegan diet, though, she has seen her cholesterol numbers drop dramatically.

She and I went to dinner at the same Mexican restaurant.  Our experiences were different.

I planned ahead -- I looked at the menu online earlier in the day, decided on a salad, on which I would substitute black beans instead of chicken, eliminate the cheese and tortilla chips, and ask for the dressing on the side.

She pored over the menu looking for something "warm", and chose the vegetable fajitas.  While chatting with our friends, she snacked on chips.  Then she summoned over the waiter to place an order for guacamole.

She shared the guacamole with all of us, and since I had a fairly tough workout earlier in the day, I knew I had a little bit of wiggle room in my calories for the day.  So, I had about two tablespoons of the guacamole and a tortilla.  She had most of the rest of it, with chips.

My salad looked and tasted delicious.  I kept the dressing on the side since there was salsa on the salad which was delicious and gave the salad enough flavor.

When her fajitas came, she also got a plate of rice and beans to go along with them.

Over dinner, she talked about some great vegan finds -- Daiya cheese, and vegan pizza from Whole Foods.

And then, she lamented that as a vegan she hasn't lost any weight.  "It must be my metabolism."

Now, I'm not going to suggest that I'm perfect in my eating.  I'm not.  I struggle with my demons -- late night eating, sweets, the uncertainty of a meal at a restaurant and the lack of impulse control that can come with dining with friends.

My point is this -- just because you are a vegan does not mean that you will be slender.  You need to make wise food choices.  There are lots of calorie-laden, vegan choices -- guacamole, tortilla chips, energy bars that are loaded with sugar, vegan baked goods, restaurant dishes fried in oil, soda, candy bars, and on and on.

Rather than aiming for "vegan", look to whole, unprocessed or minimally-processed foods.  Look to fruits and vegetables to make up most of your diet.  Fill the rest in with whole grains like brown rice, quinoa, and oats, and unprocessed sources of protein like beans and lentils, or minimally processed foods like tofu.

The Annual Passsover Seder Blog Post

I host a seder at my home every year.  I guess at this point I can call it every year because this is the third year in a row.

Passover seder was always a time for family to get together.  Growing up, seder was me, my brother, parents, and all four grandparents, and sometimes family friends or other relatives.  Mom would make food for at least one of the seders, and it was always a big production of amazing food, including her traditional cheesecakes.  Unfortunately, Mom and Dad still live in Michigan, so I took on the tradition of making seder in California.

Two years ago, I thought about having a seder for my family in California, namely my brother, sister-in-law, and my three nieces, and maybe a couple of other random friends who didn't have a seder to go to.  And I thought, a vegan seder is something pretty unique, I'm not sure people will want to do that.  That small seder became twenty people.  Last year, I had twenty-five.  This year, I bought an extra table to accommodate my twenty-eight guests -- I want everyone I know to have a seder to go to.  And, while a few of my guests are vegans like me, most are not, which presents the challenge of showing them a filling seder dinner that doesn't include any eggs or brisket.

We had a good time -- we told the story of Passover.  I'll admit we didn't do the second half, but I'm okay with that.  My niece Samantha read the four questions and helped to demonstrate the plagues.  

I prepared the majority of the food myself.  This year, everything was kitniyot-free.  It is traditional not only to not eat risen bread during Passover, but also not to eat items that in the old days could have been mistaken for bread, such as soy and rice.  (That said, during Passover, I do eat soy, but that's a whole different subject)

Appetizers were a mock chopped liver made from mushrooms, walnuts, and onions, and Sabra eggplant spread.

These are my matzah balls for the soup.  In the past, I've made the Post-Punk Kitchen matzo balls, which are a bit labor intensive, though delicious and fluffy, but also are made with tofu.  This year, I chose a recipe by Nava Atlas, a matzo ball made with quinoa flakes and matzo meal, and a little bit of oil.  Instead of dropping them in hot water, they are baked.  They taste amazing, and while they are not fluffy like your traditional egg-laden matzo ball, they hold up quite well in the soup and do not fall apart.

Spring salad -- most of the veggies in here are from the farmers' market.  Greens, cucumber, tomatoes, carrots, mango, and cinnamon almonds.

Quinoa with cauliflower, pine nuts, and dried cranberries.  I made this last year and people enjoyed it, so I made it again.

Eggplant Casserole by Mayim Bialik.  Amy Farrah Fowler makes a helluva casserole.

Matzo farfel in butternut squash puree.  This is my own creation.  An Italian restaurant made me a pasta in a butternut squash puree. It was amazing, so creamy and yummy, that I assumed they must have slipped in some dairy or butter.  But they insisted, it was just pasta, pureed butternut squash, salt and pepper.  So I tried it at home and it worked with pasta, so I figured it must work with matzo too.  And it did!

The most popular dish, and unfortunately a kind of crappy picture of it.  Carrot apple sweet potato kugel.  The recipe suggests adding sugar.  I don't.  I also cut the margarine down to a third of what is called for in the recipe.

This is what my dinner plate looked like:

Dessert was an apple and date mouse and a chocolate truffle pie from Mayim Bialik's blog.  P.S. Mayim, thanks for the awesome recipes, if you ever read this.

My Summer Adventure!

I will be competing in the Maccabi Games this summer as part of the US Masters Triathlon Team.  In fact, I'm the team captain! 

Please click here and learn how you can support the games and help me reach my fundraising goal. 

Thanks!

Desert International Triathlon

My first triathlon of the season was this past weekend near Palm Desert. 

I didn't have high expectations.  I took two months off -- after my ultramarathon at the beginning of December, which had followed a DNF at the Santa Clarita Marathon, I needed some clarity.  I needed to workout on my own terms -- if I wanted to run, I ran.  If I wanted to ride my bike, I did, but not very often.  And when I decided that the pool and I needed to break up for about six weeks, I did that.

So, official training started on February 1.  Most of that initial training was for the Bandit 30k on February 18, a crazy hilly course with 3,700 feet change in elevation.  And that race went okay, given my lack of training.  But, going into Desert Tri, I had done a total of three brick (combined bike and run) workouts, all crammed into the two weeks before the race.

I did not feel ready at all.  That said, who is really ready for a triathlon at the beginning of March, so early in the season?  Me, apparently.  But, my thought process going into this was that this would be a good practice run, and a great day to compete with other teammates from Team Fortius.

This is what a triathlon looks like seconds before the gun goes off.  A bunch of black neoprene clones in identical caps.  I'm in that picture, if you look closely, and you'll see a sliver of my face.   I lined myself up in the middle, a bit closer to the front.  I'm not the fastest swimmer, but I've done enough triathlons to have the confidence to hold my own and not get scared by the mass of swimmers around me.

Off we went.  To the first buoy, there were a lot of bodies, but I wasn't feeling crowded.  After that turn, the remainder of the swim wasn't too bad.  There were a few aggressive swimmers from the wave start after us who passed, and a number of swimmers from the wave before us who I passed.  The 3/4 mile swim took me 24 minutes.

And that's me running out of the water.  Normally I step out of the wetsuit, but for some reason I actually sat down in the transition area to pull it off.

Reeeally far out shot of me on my bike

Then on to the bike.  Mr. Cervelo (my tri bike) and I just became reacquainted less than 2 weeks ago, so expectations weren't very high.  But I had something new -- race wheels.  I had tried them out at Malibu Tri in the fall, but hadn't noticed much difference, possibly because of the hilly course there.  But Desert Tri was flat -- like a desert!  I looked down at my bike computer -- I was cruising at 20 mph!  For me this is unheard of.  But, I went with it. 

Finally the run.  Normally, I have no probleml putting my bike down and running full force.  But, my legs felt heavy, heavy enough that I didn't even want to know my pace.  As it turns out, I was running 8:35/mile pace, which for me is pretty good, but for some reason, it felt slower because my legs were so uncomfortable.  I was grateful to have a friend out there who was not taking the race too seriously, who ran with me for the first five miles.  I have a strategy when running with someone faster than me -- make them talk.  Ask open-ended questions.  Hear stories.  That way, I can focus my energy on running, not on talking, and listening to them I can forget the discomfort that comes with running hard.

And there I am, racing for the finish.  Total time -- 2:34.  14th out of 36 women in my age group.

I am pleasantly surprised by my performance.  The swim was in a time I would expect, my bike was faster, and my run was about spot on.  This is a good start for my season, which will culminate with the Maccabiah Games at the end of July... more on that later!

And finally, a big thank you to my friend Anthony, who was kind enough to be my sherpa for the day, put air in my tires, and take iPhone pictures.