Taco Dip

I love entertaining, and now that I have my own home I have an opportunity to do it.  It's an opportunity to share delicious vegan food.  Here's one of my favorite recipes:  Taco Dip.

There are four layers, from bottom to top:
Refried beans

Guacamole

Tofutti brand sour cream

Daiya "cheddar" cheese

This dip goes fast, and guests are left wondering if this comfort party food really is vegan.

The Ironman Blues

After all of this training, who would do an Ironman again? 

I did my long workout today, on call.  64 miles on the bike, along the same nine mile loop, so that I'm close enough to my hospital in case I need to tend to a sick patient.  I was exhausted the minute I got on the bike.  Four and a half hours later, I was wiped out, my eyes dry from riding, perhaps a bit woozy from the heat.  Then I put on a pair of running shoes and ran six miles.

Don't get me wrong -- I want to be an Ironman more than anything else.  I love exercise and the way it makes me feel.  But, this is more than I ever care to put my body through again.

One more long workout tomorrow.  Then I taper.

Sixteen more days to Ironman Lake Placid.

The Secrets of Thin People

There is no such thing as naturally thin.

If you are looking to lose weight, watch thinner people -- they have different habits.  Watch at a party what they are eating.  How often do you see them hitting up the buffet table?

A few other secrets of thinner people:

They eat breakfast.

They eat several times a day.

They exercise regularly.

You'll often find them taking the stairs instead of the elevator.

There's no need to obsess over diet and weight, but if you watch closely, you'll see that thinner people have different habits that keep them at a healthy weight.

With a Little Help From My Friends

Finding others to exercise with makes a workout more fun and sometimes challenges us to do more than we might do on our own.

If I tried to do all twenty or so hours a week of Ironman training all by myself, I don't know if I would get through it.

While I do a long run alone at the crack of dawn , and a 1-2 hour bike ride alone one evening per week, I have a number of workouts with others.  I join a coached pool swim, a group ocean drill swim, and I usually find people for my long bike ride.

My weekly e-mail to several women in my tri club who cycle at about my pace goes something like this: 

"I'm doing 112 miles, starting at PCH and Temescal at 7:00 am, meeting up with the PCH 101 ride at 8:30, heading out past the Oxnard fruit stand to Ventura, and then turning around and coming back.


I'd be eager to have someone start with me at Temescal, or start at Zuma and ride out past Oxnard with me, or ride with me at the end, or join me for any amount of time on the ride. Let me know if you're in :)"

There's no one on my exact schedule, but usually I can find people to ride pieces of the ride with me.  Thank goodness for my friend Lee who accompanied me for at least two thirds of my 125-mile ride a few weeks back.  It was fun talking to her as we rode up toward Ventura.  While her strength is riding on flat roads, mine is on hills, and she really pushed me on the flats of the ride.  And, as we got tired out we took turns drafting off one another to give each other a break. 

Similarly, though even if you're not training for an Ironman:  Use the buddy system.  It makes exercise a whole lot more fun.

One Month until Ironman Lake Placid

I look forward to becoming an Ironman.  But, I don't think I need to do another one.

It wasn't until yesterday that I truly got excited about this adventure.  Several of my friends raced Iroman Coeur D'Alene yesterday.  I tracked their progress online and watched the live feed at the finish line.  It is quite fascinating -- the live camera captures everyone after they cross the finish line.  The announcer states the names of the finishers, so that when I cross the finish line (and I will!), he will say, "Heather Shenkman, You are an Ironman!"  People looked tired, but they definitely looked elated to finish.

This weekend, I rode 75 miles on my bike on Saturday.  On Sunday, I swam a total of 2250 yards and ran 16 miles.  Next weekend, I get to ride 112 miles then run 6 miles on Saturday, and on Sunday swim 2 miles and then run 15 miles.

It is interesting how my skills have evolved with my training.  Surprisingly, I've become a faster swimmer.  Through coached swimming and a few pointers, my swim stroke has improved and I am faster than I was at the beginning of the season.  On the other hand, I'm a slower runner.  I haven't done any speed work at the track for months, but then again, that's not necessary when training for an endurance event like an Ironman.  While my long run pace earlier this year may have been 9:30-9:45/mile, I find myself chugging along at 10 minutes per mile or slower, and after a long swim or bike, my pace for 15-16 miles may be closer to 11 minutes per mile.

I've been contemplating my nutrition during the race.  I've found that a Tofurky sandwich on whole wheat with lettuce, tomato, and avocado fuels me well.  I have also found that I can wrap this sandwich in foil and duct tape it to my seat post for consumption later on in my ride.

The event is sponsored by PowerBar, which is a bit of a dilemma for me as a vegan.  Their Ironman Perform electrolyte beverage, which they've sent samples of to all of us since it's not available in stores yet, fuels me well for my long workouts.  But, the PowerBars contain dairy, as do several of the energy gels.  That means I'll have to carry more food on my bike, which shouldn't be a problem.  I'll have one Tofurky sandwich, one PBJ, a PureFit bar, and some Clif Blocks.  I'll also take a banana, which I usually consume in the first hour on the bike.  On the run, I usually go with less solid nutrition, like the blocks and gels.

I've figured out my goal times:  1 hr 30 minutes for the swim, 7 hrs 30 minutes for the bike, and 5 hours for the run.  That should put me well toward my goal of finishing in under 15 hours.

Turmoil in the Water

I like to think that after three years of living as a triathlete in Southern California, having swam in the ocean dozens of times, that I'm an adept ocean swimmer.

Then again, sometimes in multisport training, we have experiences that humble us.  Today was one of those days.

Today was scheduled to be my first two mile open water swim before Ironman Lake Placid.  Now, granted, I've swam nearly two miles in a pool, but an open water swim is a bigger challenge without the walls of a pool to push off of.

I ran into my coach and started chatting with him as the group ambled down the beach to start swimming.  He cut me off, "Not to be rude, but you need to catch up to those people, so start running."  Or something like that.  And I realized, the superstars who planned on swimming two miles were far ahead of me, jogging down the beach.  I took off after them.

I arrived, catching my breath as the two mile group was suiting up.  The group was mostly men, and those who I recognized were definitely what I would consider to be elite athletes.  My friend Gail, who I would say is part fish, was getting ready to do the two miles.  Knowing my relative speed was quite a bit slower than the rest, I asked her to tell me if anyone there might be around my pace, and she introduced me to someone named John, who I asked to keep an eye out for me, though I knew that Gail would look out for me at the end even though she is considerably faster.  For ocean swims, we use the buddy system -- given the possible dangers of the ocean.

The group headed in.  The waves were bigger than usual.  Some of the elite types dove on in and headed out like it was nothing.  Being from the Midwest (or at least that's what I use as my excuse), I tend to get into the ocean a bit slower.  John dashed off.  Gail was quick behind him.  The rest were well ahead.  And there I was -- me and the waves.  Big waves.  One after another.

One thing I've learned is that if you see a big wave coming, go with it.  Put your arms straight out in front, tuck your head, and dive under it.  Do not turn to the side.  Do not cower.  Those are surefire ways to get knocked over, lose goggles, get tossed under, etc.

The waves kept coming.  One after the next.  And they were big.  I'd barely swim one stroke when another wave faced me and I prepared to dive under.  There was absolutely no break.  After five minutes of this, I turned to the shore and realized I'd barely moved forward.  In the distance I saw that several members of the group had taken off.

I was alone, floundering in the ocean, trying to get out past the waves, and I just couldn't do it.  I was tiring out.  After about eight minutes of no progress, hyperventilating, and fatigue, I turned around and swam back to the beach.  I was really upset.  Like as in crying, tears, that kind of upset.  The last time I cried was a year and a half ago when I was unable to finish the Surf City Marathon due to gastrointestinal upset that led to me dehydrating like a raisin.

As I got out of the water, the thoughts in my head were of course disappointment in my abilities to swim through the waves when everyone else in my group seemed to have no problem.  I must have looked quite distressed because one of the lifeguards approached me.  I don't recall exactly what I said, something to the extent of, "I've done this before, I'm not a newbie, I don't know what happened."  He could tell I was pretty shaken up, suggested walking down the beach, catching my breath and getting in at a lifeguard stand closer in.

I walked back toward the start.  I wistfully saw the others who managed to get past the waves, their tiny swim caps bobbing in the ocean as they swam toward the Manhattan Beach pier.  As I came up to the one mile mark, I saw another woman standing in a wetsuit and swim cap, looking shaken up as well.  As it turned out, she was another member of my club who similarly had issues of getting past the waves.

I stood and chatted with her for a few moments.  I felt better.  I suggested that she and I try again, and we could stick together and get a mile swim done.  We saw a few others trying to get into the ocean, and we saw that with the size of the waves that it took them longer than usual.  The waves, while choppy, looked calmer here than they did down at the Hermosa Beach pier, so I felt ready to give it another shot.  My new friend said she would stand by while I tried to swim out.

I was ready.  I swam a few strokes, dove under a few waves, and it felt like deja vu.  But then there was a break in the waves, enough time for me to get out far enough from the shore to a point where the water was calm.  I swam forward, prepared to travel the one mile to the Manhattan Beach Pier.  I did take one break, where I rolled onto my back, looked up at the sky, and as I thought about that day started to hyperventilate again.  From there, I decided I needed to finish, and I could do it.  I would count a hundred strokes and see how much closer I was to the pier.  And then another hundred.  And gradually, I made progress.  At the pier, conditions became choppy and I felt like I was swimming in a washing machine, but with a bit of extra effort I managed to get around, and while almost being hit by some idiot on a wakeboard I did finish the mile swim.

I did see Gail at the end, and she and John had waited for me after getting past the chop -- I just couldn't see them beyond the barrage of waves at Hermosa Pier.

I'm afraid to try the two mile swim from Hermosa Beach to Manhattan Beach again.  But then again, I feel like I won't be complete until I do it.  Next time, I will start early so I don't have to run down the beach.  And, Gail has offered to accompany me next time, and I think I'll take her up on that.

Racing and Training... the beat goes on

My legs hate me.

They're tired.  They're wiped out from yesterday's training ride of 125 miles on PCH from Santa Monica to Ventura and back.  And they were mad that I made them work again today at the Redondo Beach Triathlon.

I wanted to do a race before Ironman Lake Placid.  So, I chose the Redondo Beach Triathlon and I raced it as an Athena, which is the category for women over 150 lbs.  While I'm a normal weight for my height, I'm a tall girl, and just a hair over that weight.  These long legs are no advantage on a bike, so I feel justified in racing that category.

The race was a half mile swim, 6 mile bike, and 2 mile run.  That relatively long swim compared to the bike and run put me at a disadvantage since I'm not a great swimmer.

As we started, I saw one Athena girl take off into the water and I never saw her again.  While she finished the swim five minutes faster than me, overall her time was only 50 seconds faster.  My swim was definitely more tired than usual after yesterday's 125-mile bike adventure. 

The bike portion was an out-and-back two loop course.  My legs were absolutely screaming at me with soreness.  But, I pushed on through.  The mostly flat course of two three-mile loops was crowded initially but then thinned out.

Then there was the run, always my favorite part in a race, because it's where I'm strongest.  And, surprisingly, my legs felt good to run.  Since we Athenas started in the last wave, there were plenty of people ahead.  I passed at least thirty people over the course of two miles and not a single person passed me.

I landed on the podium -- second place Athena!  Had I raced my age group, I would have done well too at seventh out of seventeen.

Horrible picture.  Nonetheless, it's me on the podium, which is pretty cool.

Tomorrow will be a well deserved rest day.  But after this, I have two more Build weeks, a recovery week, and then a Peak week prior to my taper for IM Lake Placid on July 25.

The Doctor's Cholesterol

I just got my own cholesterol numbers back:
Total cholesterol - 160
Triglycerides - 86
HDL - 71
LDL - 72

Thought I'd share what a healthy vegan diet and exercise have done for me. :)

The Paradox of the Hospital Cafeteria

Have you seen the offerings of your local hospital cafeteria?

The hospital is a place of healing.  Many people who are hospitalized have illnesses that are at least partially due to poor diet choices.

So, then, why is it that the cafeteria serves up unhealthy fare?  Fried chicken.  Hamburgers.  Bacon and sausage and biscuits with gravy.  A delicious vegan noodle dish, but with 2200 mg of sodium per serving.  Sure, there is a salad bar and plenty of fruit, but why do we need to serve the junk too?

Why not make the cafeteria a place where the loved ones of patients can learn about healthy food choices?

Eat. Train. Work. Sleep.

That's life training for an Ironman.

Ironman Lake Placid is on July 25.  Two months from now.

I'm in my "build" phase.  That's coach lingo for "arse-whupping".  Last weekend was an 80 mile bike on Saturday, and then on Sunday a 1.5 mile swim followed by a 15 mile run. 

Next weekend's training:  Saturday 100 mile bike followed by a 3-4 mile run.  Sunday is a 1.5 mile swim followed by a 16 mile run.

So far, I'm keeping up....

NiceCream Vegan Ice Cream

This is an incredible concept: A Vegan Ice Cream Parlor!

I met a friend for dinner at Sunpower Natural Foods, then walked over to NiceCream, which opened just over a week ago. They have soft serve, hard-packed ice cream, milkshakes, truffles, and other amazing treats. All are raw.

I tried a scoop of chocolate and a scoop of pistachio.  My friend got some soft serve and I helped myself to some of that too.  Yum!

Nicecream -- 3701 Cahuenga Blvd, Studio City, CA

Appetizers

Healthy appetizers:  Hummus and Spinach Dip with carrots, pita chips, pepper slices, and broccoli.

Cheese for Vegans!!!

No I have not fallen off the Vegan Wagon and gone to the dark side of dairy.

This is a grilled cheese sandwich that I made for dinner with Daiya cheese.

Daiya is the first vegan cheese that I've ever had that melts like dairy cheese.  I've had it on vegan pizza from Whole Foods, on nachos, and in macaroni in cheese.  The texture and the taste are amazing!

Daiya cheese has 90 calories per 1/4 cup serving, with six grams of fat, 2 grams of it being saturated fat, 1 gram fiber, and 1gram protein, with 15% of the daily requirement for calcium.  Interstingly, it is not soy-based like most other vegan cheeses, but its main ingredients are tapioca or arrowroot flours, canola oil, safflower oill, coconut oil, and pea protein.

I enjoyed my grilled cheese sandwich with a spinach salad topped with Follow Your Heart Chick'n Free Chick'n and ground flax seeds. Yum!

Wildflower Race Report

We have good races and bad races, and while it's no fun to not attain our goals, a bad race is something we can learn from.

Two nights before the race, I was busy on call seeing patients in the hospital.  On the day before the race, I had to work, and thanks to Ventura County traffic, I didn't arrive at the campground until well after 10 pm, and was chugging Coke Zero wtih caffeine to stay awake for the drive.  Thank goodness for terrific friends who brought my tent up with them and pitched it during the day so that I didn't have to wrangle with it at night.  But, as I'm not one who enjoys camping, even though I was tired, I didn't sleep very well on the night before the race.

My day just started out bizarre.  Just before our wave of women 35-39 started (I'm 34, but because I turn 35 this year, my "triathlon age" is 35.  Depressing), we had the chance to get in the water to warm up.  I jumped in, swam a few strokes, and noticed that my timing chip felt loose around my ankle.  So, I tightened the velcro.  Apparently, adjusting wet velcro is a bad idea, because as the gun fired at the start of the swim portion, I felt the chip come loose again.  I had to stop in front of a bunch of women running into the water to readjust it.  Then as I swam through a crowd of bodies, getting kicked once in the face, the chip was lost and gone!

Now, athletes do not get to finish a race without a timing chip.  I panicked as I thought of what I would do.  I'd try to find a race official upon getting out of the water.  Or maybe I'd borrow my friend Jessica's chip, since she was registered but wasn't racing and might have it with her.  Nonetheless, I was quite distracted as I swam, trying to figure out what to do without a timing chip.

Meanwhile, as I swam in the lake, overhead on the microphone to the thousands of spectators and athletes:  "Heather Shenkman, we have your timing chip.  Please come and get it."  That did me no good since obviously I couldn't hear.

I got out of the water, panicked.  My time was 44 minutes.  Same as last year.  I looked for a race official to tell that I didn't have my timing chip.  I couldn't find one.

When I got back to my transition area, I looked down and right on top of my bike shoes, there was my timing chip!!!  What a relief.  I fastened it tightly around my ankle and took off with my bike.

That's me taking my bike out of the transition area to start the 56 mile bike portion of the race.

As always, Lynch Hill is the first hill we encounter as we ride out of the transition area. It's steep. It's tough. Then came some rolling hills, and about 25 miles of mostly flat road. Then there was Nasty Grade, this monster of a hill that's a couple miles long, around mile 42. And I got up it. The ball of my left foot was burning, along with my toes, but around mile 53, the pain was pretty bad. To try to ease it, I stopped pedaling with my left and pedaled strictly with my right foot for about a minute. The brief rest helped somewhat.

I felt a little slow on the bike. And, as it turns out, I was slow on the bike. Over four hours. Last year, the 56 mile ride took me 3 hours and 50 minutes.

As I transitioned from bike to run, I knew I wasn't moving very fast. I knew my goal of breaking 7 hours was gone. Maybe I could break last year's time of 7:11?

The first mile of the run was 11 minutes. The second was about 12. My left foot was in excruciating pain, especially trying to run any hills. I walked about half of mile 3, as I winced and thought, can I really finish this? Will this pain ever go away. Luckily it did. I ran/walk through mile 5, through more tough hills that I should have been able to run. Those five miles took me over an hour! I couldn't believe how slow I was!

Negative thoughts kept creeping into my mind.  If this race is going this poorly, can you really do IM Lake Placid?  Are you really as good an athlete as you think you are?  I am tough on myself, no question.  To quash those thoughts, I tried to remember what I had said to other athletes who were disappointed after a disappointing race -- "You're a good athlete who is having a bad day."  Right?  I wasn't sure.

Then, even on the flats, my run pace was 11-12 minutes per mile though I felt like I was moving faster. Clearly I was not. But, unlike many athletes out there, I was still running. Just one foot in front of the other. I was going to finish.

The half marathon run took me two hours and 40 minutes. My most recent half marathon before this was 1:58. Yikes.

My finish time: 7 hours 39 minutes. That's 28 minutes slower than last year.
That evening, LA Tri Club had an amazing dinner, and it was just a lot of fun to hang out at camp and relax after the race.

I put in the training for this event.  I just wasn't rested, and that darn plantar fasciitis (I think that's what was going on with my left foot) flared up.  I know I shouldn't beat myself up over this.  It wasn't my "A" race -- Ironman Lake Placid is, and I have just under three months to get ready.
 
I'm staying positive.  I've learned from Wildflower, and I will be as rested as can be when it's time to race Ironman Lake Placid.

I Hate Exercise

This is exactly what one patient said to me this week.  He had exercised in the past, but it became such a chore that he absolutely abhorred it.

I probably have several other patients who clandestinely feel the same way.  Some grit their teeth, do everything they can to get out the door and do their walk, the same walk every day, because they know they need to do it for their health.  Others with those feelings may choose not to exercise at all.

I can understand that.  If I did the same workout every day, day in day out, month after month, I'd get bored.  I'd probably quit.

My mother gets on the treadmill for an hour five days a week.  She walks at 3.5 miles per hour, or a little faster, with maybe a 2% incline while watching TV.  That's her workout.  She rarely walks outdoors.  Somehow she sticks with it, but I think that after nearly two years it's getting a little monotonous for her.

I think exercise needs to be interesting in some way.  Whether it be choosing from a few different treadmill workouts, perhaps one with an incline or another with intervals, or doing different exercises, like golf one day, bicycling another, dancing the next, and so forth, mix it up!

That's what I love about triathlon.  There are three different sports to master -- swimming, bicycling, and running.  No two days in the row have the same exercise.

What I told my exercise loathing patient:  Just get up a couple times a day and go for a short walk, even if just for a few minutes -- it'll make you feel better.  I didn't use the word "exercise", because if I did he would likely tune me out completely.  And he even agreed, he could use the stress relief of a brief walk in the middle of the day.

Exercise needs not be a chore -- make it interesting and fun and it will be easier to keep the habit.

Sugar and Cholesterol Levels

We know that our cholesterol levels are impacted adversely by consuming cholesterol, saturated fats, and trans fats.

An article from JAMA (Journal of the American Medical Association) on April 21 2010 finds that the higher the intake of added sugar, the lower the HDL "good" cholesterol, and the higher the LDL cholesterol and triglycerides.

It is likely that this is due to fructose, which leads to increased production of lipids by the liver and decreasing removal of lipids from the blood stream.

So, as part of a healthy diet, here is yet another reason to stay away from foods with added sugar.

Found My Nemesis

It's a bike climb in Brentwood called "The Three Bitches".  Three successive hills.  Relatively short, but extremely steep.

On this morning's ride, a group of us split off to climb "The Three Bitches".  I climbed the first, standing on my bike the entire time, huffing and puffing.  At the top, I looked to my right to see an even steeper hill, the second of the three "Bitches".

I'm always up for a challenge.  However, I'm racing Wildflower Long Course next weekend and am supposed to be tapering, or cutting back on my exercise so that I am well-rested for the race.  Now is not the time to do insane things.

But, I do promise:  I will be back.  (as I say that, ironically, I do believe that the Guvernator, Arnold Schwarzneggar, did drive by us during our ride.  No joke.)

Two Weeks to Wildflower

I am racing Wildflower Long Course again this year.  It is one of the toughest half-Ironman-distance races -- 1.2 mile swim, a very hilly 56 mile bike, and a similarly challenging 13.1 mile hilly run.

For the most part, my training has been going well. Today's workout was a 3000 yard swim in the pool, my longest swim workout yet, followed by a 5 mile run at just under a 9:00/mile pace. I did have a lousy workout yesterday -- I was supposed to ride for two hours and then run for 45 minutes. I was not in the mood to ride, though my legs felt okay. I just wasn't feeling it, and with the lack of mind to override the body, so to speak, I ended up with a side stitch and quit at an hour and twenty minutes of riding.

We all have good days, and we all have bad days. Yesterday was a lousy day, and today was pretty great.

I've been riding and running lots of hills lately.  I have found some killer hills in my new neighborhood -- for those of you familiar with the San Fernando Valley, I run a route that includes a nearly two mile climb from Ventura Boulevard due south to Mulholland.  It's tough, but it's helped make me a strong hill runner.  My bike rides have taken me up several of the canyons from PCH up through the Santa Monica Mountains.

Last year's Wildflower was a pretty good race for me. But this year I want to do better. Last year I finished in 7:11; this year I want to break seven hours. I am more experienced and I think I'm more fit.  Coach Jamie of Triathlon Training Series, my coach for over two years, who has really helped me to grow as an athlete, continues to put together my workouts.  There have been changes, though.  Since January, I have a new personal trainer who pushes me very hard. Also, I also think my nutrition is better, incorporating more protein and less sugar and processed foods.

I have two more weeks to train.  This week will be challenging, and the following week will be a taper so that I am well rested for the race.

Plavix Controversies

Several patients have had questions about Plavix (clopidogrel) lately.

Before you read on, if you are on Plavix, DO NOT STOP TAKING IT!  You are likely on it for good reason, and depending on your clinical situation, stopping it may be extremely dangerous.  Talk to your doctor if you have any concerns.

I am not going to get into the scientific nitty-gritty here, just simply an overview.

Combination with a proton pump inhibitor (PPI), such as omeprazole, Protonix, Nexium:
There has been concern that taking Plavix and a PPI together reduces the effectiveness of Plavix.  Small studies on healthy volunteers demonstrated decreased platelet inhibition when Plavix was taken with a PPI.  However, a larger randomized trial, the COGENT trial, which enrolled thousands of patients showed that outcomes were no worse when Plavix and a PPI were combined, and in fact the combination of the two medications reduced risk of gastrointestinal bleeding complications.
Bottom line:  If you are on both Plavix and a PPI, it is likely safe to continue to take both medications.

Resistance to Plavix:
Recently, the FDA published a warning that people with certain genetic mutations may have resistance to Plavix, and these patients tend to have worse outcomes.  This statement certainly sent a flurry of phone calls and questions to cardiologists nationwide.  The problem with this warning is that it is true that these patients do less well, but there is no evidence at this point of exactly what we should do for patients who are resistant to Plavix -- should they receive a double dose of Plavix, or be switched to a different medication such as Effient (prasugrel)?
Bottom line:  Don't stop your Plavix.  Talk to your doctor.

So You Want to Tri?

I am really excited to hear that a few people close to me want to do their first triathlon.  As I love this sport, I encourage them wholeheartedly!!!

This is me finishing my first triathlon nearly five years ago, the Finger Lakes Triathlon, in September 2005.

I had a blast and after that race, I got hooked by the sport.

Why I still "Tri":  To stay healthy, feel good, stay in shape, handle the stress of life, and to set a good example for my patients.

Triathlon is a great sport to get into.  If you can swim, bike, and run, you can do a triathlon!  Pick a sprint (short) distance race, and start training!  Of course, see your doctor first to make sure that you are healthy enough to train.

If you are in Los Angeles, look into joining the LA Tri Club.  They have lots of great workouts for beginners all the way to seasoned athletes.  And, find a race to set as your goal -- I love the Hansen Dam Triathlon, which is a friendly sprint-distance triathlon in August, and you can read my race report from the 2008 race.

LA Marathon 2010

My training has been disjointed -- for various reasons, my runs have been broken up. Iliotibial band pain caused a 20-mile run to be run as a 9 mile run one day and an 11 mile run the following day. Another 12-mile run was interrupted by a patient emergency.  So I can't say I had done a complete run longer than 15 miles before the marathon.

I was so excited to run the LA Marathon with the new Stadium to the Sea course, starting at Dodger Stadium and ending in Santa Monica.

Organization was definitely lacking, and in particular, traffic. We were lucky that we arrived two hours early, and even then, we were in a long line or cars to get in. I hear that people were jumping out of the shuttle buses on the 110 freeway because they thought they'd miss the start. Nonetheless, the start was delayed by 25 minutes and we were stuck crammed in the start corral.

Shortly before 8 am, we were on our way. The route began with a loop around Dodger Stadium, then into downtown LA. There were a few small hills. It was crowded.  Someone tripped me and I nearly landed on my face at mile 3.  Then at mile 4, we hit a big hill, the hill heading up to Disney Concert Hall. I saw a guy taking a picture of himself, so I told him to pass me his camera and I took a pic of him. He shot one of me also and gave me his email address. So here's the pic of me that he took climbing that hill. You can tell that it was early on because I was still smiling.

Why run a race if it's not going to be fun?  And this was just a friendly course.  There were people cheering us on along the entire course.  So many fans set up their own hydration stations or handed out cut up fruit and candies and Red Vines.  It's like a buffet, but we definitely have to work for it!  The enthusiasm of the spectators is what pushed me through the second half and to the finish line.

I started too fast.  I thought I could go at a 9:45 pace.  But, I may have been a little faster for the first few miles, thinking I felt really good.  But, around mile 11, my legs began to feel way too heavy.  My mile times were getting slower.  The bottoms of my feet hurt.  In Beverly Hills at mile 16, when I saw one of my mile splits was 10:30, I decided I was done watching my pace and I just wanted to be done.  By mile 20, running through the VA, I wasn't sure I would make it.

I love beer during a long run.  At mile 22, there were a couple spectators passing out beer.  I eagerly swigged down the small cup of beer -- it tasted so good!  I have drank beer during three of my eight marathons, including my personal best time in Long Beach in October.

San Vicente is a downhill through Brentwood and then into Santa Monica.  I sure didn't feel like it was downhill!  But, I was so happy to see people I knew, friends, tri-club members, and friends from the track, on the sidelines cheering me on.  On the last mile, I saw Coach Jamie, and I think I stuck my tongue out at him to let him know I felt like crap.  Not very nice of me.

My final time:  4:28.  Not my best (Long Beach 2009 -- 4:12).  Not my worst (Chicago 2000 -- 5:37).  But decent for the training that I had.  And fun in spite of the pain.

Success!

I'm thrilled to hear when people I know are able to improve their health through lifestyle change.  Here's a few recent success stories:

* A young physician with high cholesterol adopts a vegan diet.  As a result, her LDL cholesterol drops by more than half, down to a normal level, while her HDL (good cholesterol) remains stable.

* A woman in her early 50's with high blood pressure and a history of other complications after surgery a few years ago initially comes in with chest pain.  She was an avid swimmer, having recently joined a master swim group.  I put her through a stress test, during which she was able to walk and run on the treadmill and the test was negative for ischemia (in other words, no evidence of significant coronary disease).  She is free of chest pain, has her blood pressure under control, and now swims competitively and has completed two triathlons and is training for her third.

* A man in his early 40's who is significantly overweight and with elevated triglycerides starts working out with a personal trainer and adopts a vegan diet.  His personal trainer tells me that so far he has lost more than 5 percent of his body fat and is getting fit.  While I have not seen his repeat lipid panel since his lifestyle changes, I am sure that he will have great improvements.

My Fuel

We all have those products that we rely on for performance. Here are mine:

PureFit Bars

These bars are amazing!  They have anywhere from 200-240 calories, 18 grams of protein, and less than two grams of saturated fat per bar.  They are perfect fuel in the middle of my afternoon.  Today I ate one to refuel as I was losing steam on a tough hill climb on my bike -- it worked!!!  PureFit bars are vegan, kosher certified, and gluten-free.  I just ordered six boxes online -- http://www.purefit.com/

Vega Sport Performance Protein

This stuff is fabulous for refueling after a tough workout.  One scoop has 110 calories and 20 grams of protein, including branch chain amino acids.  The instructions on the package say to mix one scoop with a cup of water.  I prefer to mix it with water and a splash of orange juice, or better yet with a soy yogurt.

Clif Shot Bloks

On a long run or bike ride, it's critical to take in fuel and electrolytes.  Clif Bloks are easy to ingest.  Three blocks contains 100 calories, 70 mg sodium, 20 mg potassium, and 24 grams of carbohydrates.  I love the fact that the blocks are not messy like gels.  And, they're tasty, kind of like gummi bears!

Firecracker 10k

Up until this weekend, I hadn't raced in about six weeks.  But, there were two great races this weekend, the Race on the Base triathlon (see post below), and the Firecracker 10k today. 

The Firecracker 10k was held in Chinatown.  It's the hilliest race I've ever run.  The first 3/4 of a mile is a gradual incline.  Then until mile 3 it's a climb, and some of it is quite steep.  The scenery in Elysian Park was beautiful, followed by the course winding along Dodger Stadium, and ending downtown. 

I finished in 54:52, a time that I'm quite proud of given the hills on the course.  The last standalone 10k (as in not part of a triathlon) that I ran was eight years ago back in Detroit, and my time was twelve minutes slower on a flat course.  It's good to know that even though I am getting older I'm still faster :)

Race on the Base

Today was my first triathlon of the season.  It was also my first reverse tri -- run-bike-swim, instead of the traditional swim-bike-run. 

I had a rude awakening -- even though I am 34, I am no longer a 30-34 year old, I'm now a 35-39 year old!!  Since I turn 35 this year, I aged up to the older group.

I realized this was not a hard-core race.  I saw a lot of mountain bikes and even a beach cruiser!  I like these kinds of races, where many participants get their first taste of what a triathlon is like.

The weather was not the most agreeable.  We started our run in rain, and as the race progressed, the rain only poured down harder and the wind blew hard.  I put my head down and ran as hard as I could.

My run was good -- I kept a pace of about 7:50 per mile for the three mile run.  That's about my usual 5k pace.  I was worried that I might not have the steam for the bike and swim. 

Coming into transition at the end of the run, I saw a full rack of bikes -- this is a good sign, meaning that I'm ahead of most of my age group.  I pulled off my wet shoes and socks, which took a few extra seconds of transition time, put on my bike shoes, grabbed my bike and headed out.  The flat bike course, which consisted of three loops of the runway, had plenty of puddles, so my bike and I got soaked. 

Since I knew I had a good run, I didn't want to give up my lead, which I knew was quite possible since running is my best event and I am not a strong cyclist.  Only two women passed me on the bike, and neither was in my age group.

Running to the pool was interesting.  As I ran, I tried to put on my swim cap, which was quite awkward.  The swim consisted of four lengths of a 50-meter pool.  The pool was crowded, and swimming after a run and bike is more challenging than swimming at the beginning of the race.  At the end of the swim, there were lifeguards to help lift us out of the water and the finish mat was just a couple feet away.

The medal was pretty cool -- a dog tag:

For me, it was a great race.  I was fourth place in my age group out of 56 women.  That was less than a minute and a half behind the third place winner, in other words thirty seconds off my first transition time and a minute off my bike.  But I'm still really happy with my performance.  It's a great start for my season!

Is Soy Dangerous?

Many myths exist about soy not being safe -- that it can increase risk of breast cancer, cause hypothyroidism, and increase sterility in men.

Neal Barnard, M.D. wrote an editorial for The Huffington Post that dispels these myths.

Image from gobblegreen.com

There are many benefits of soy, including reducing risk of cancer, decreasing LDL cholesterol, reducing the risk of uterine fibroids, and lessening the risk of fractures.

Read on here.

Recovery Hike

The view from my morning recovery hike to the Hollywood Reservoir, taken by my cell phone camera.
After running 20 miles this weekend, today is a rest day.

Forks Over Knives

Many diseases, including coronary artery disease, hypertension, diabetes, and obesity can be treated and prevented by a plant-based diet.  This is a belief that I am passionate about and have seen in my daily work as a cardiologist.

The movie Forks Over Knives, which is coming out this summer, is based on the premise of diet as a treatment for disease.  It traces the lives of two important pioneers, T. Colin Campbell PhD of Cornell University and Caldwell Esselstyn MD of The Cleveland Clinic.  Both come from animal farming backgrounds, and yet both are strong proponents of plant-based diets.

View the trailer here

For Foodies

I love eating, and I loooove trying new restaurants!

One of my favorite blogs is quarrygirl.com.  When I think I've tried out just about every veg-friendly restaurant in LA, I go to her site and see all the neat places that I have yet to check out.

This is a great site if you want to eat vegetarian but aren't sure where to go. 

I love LA -- it's a great place to be a vegan!!!

Vinh Loi Tofu

There's a lot of Asian vegan food in Los Angeles.  But, Vinh Loi Tofu is unique -- the tofu and mock meats are made fresh on the premises every day.  In addition, owner Kevin Tran is a runner, training to run the LA Marathon next month, and will be doing his first triathlon later this year at Malibu.

Here are some of my favorite dishes:

Ham Spring Rolls -- my sister-in-law says they actually taste like ham.  I don't know about that because I've never eaten ham in my life, but they are delicious.

Curry Udon with Chicken

House Soup -- big enough for a small meal by itself, or great to share:

Tucked away in a strip mall in Reseda, you'd never expect to find a place like this -- but, as it's become well known, there's always a crowd. 

Vinh Loi Tofu
18625 Sherman Way, Reseda
818-996-9779

Lifestyle Change Works!

A study from the February 1, 2010 issue of the American Journal of Cardiology demonstrates the benefits of making lifestyle changes with diet and exercise.

A group of patients with heart disease or risk factors for heart disease were asked to follow a vegetarian diet with less than ten percent of their calories from fat, get at least three hours of exercise per week, and practice stress management for one hour per day.  Another group received the usual standard care.

The patients who followed the vegetarian diet, exercised, and meditated had improved endothelial function or function of the lining of their arteries.  They also decreased their C-reactive protein and interleukin-6 levels, which are markers of inflammation which have been shown to be linked to heart disease.

Source:  Dod HS, Bhardwaj R, Sajja V, et al. Effect of intensive lifestyle changes on endothelia function on inflammatory markers of atherosclerosis. Am J Cardiol. 2010;105:362-367.

Farmers Market Lunch

Sweet potato, whole wheat pita with black bean hummus and garlic hummus, and a salad with Korean tempeh.

Morning Run Misadventures

I woke up early to get in a run, thinking it would be about 4 or 5 miles, mostly flat.

Just after 5:30 am, I headed out the door, with my Garmin GPS on my wrist and my IPod on my arm.  I felt slow, but that was okay -- it was my first run in about a week as I was resting from a shin splint injury -- but I felt good.  I ran up the hill to the Hollywood Reservoir to run the flat, scenic roads around the reservoir.  Unfortunately, the gate was locked, possibly due to the rain, or possibly because the sun was not up yet.

I turned around and ran back down the hill, not sure where I would go.  I ended up taking a few twists and turns up and down some small hills, then ended up on the main street.  I felt energized -- instead of my short loop up and down the hill, I 'd do my longer loop.

But, I had never done my longer loop backwards, which is what I would be attempting to do.  It was still dark out, and I was just over two miles into my run.  I started up one of the canyon hills, on the sidewalk, when I tripped on a piece of uneven sidewalk, scraped one of my knees and both of my hands.  I rested for a moment, hoping I didn't tear my favorite running pants, got up and continued up the hill on the road instead of the sidewalk.

Running uphill felt good.  And I kept going, and going, and missed my turnoff.  I realized that I was not where I should be when I looked down on what I thought would be the canyon and saw a beautiful sunrise over downtown Los Angeles.

I kept running, now five miles in.  I didn't know exactly where I was, but if I kept running in the direction that I was running, I would eventually hit a street that I knew.  And I did. 

But then I took another wrong turn, which led me to Mullholland Highway, which I had never knew how to get to.  Somehow, I managed to trip AGAIN!  I scraped both my knees and hands and hit my left shoulder.  This one hurt even more than the first fall.  Now, keep in mind, I maybe trip on a run once a year, and now I've tripped twice in a single run! 

As I get up, my knees are sore and blood is dripping from both hands.  But I keep going -- I have to get home so that I can get to work in a reasonable amount of time, and somehow in spite of the pain I still feel good!  I don't know quite where I'm running, but I find another road that I've never run on, with a sign that reads "Scenic Road 1/4 mile".  I looked down, and wow, what an amazing view across the canyon!  And just above me is the Hollywood sign.  It was just amazing.

Nonetheless, it was a wrong turn, and after I again figured out where I was, my bloodied and bruised self was home.  Instead of my flat 4-5 mile run, I had run nearly eight miles of hills!

As it was far later than I had anticipated, I very rapidly showered, rinsed off my bloodied palms and kneecaps, and headed to work as quickly as possible.

I still feel great -- a good long run, and some new sights to see!
Image from visitingdc.com

Sports Nutrition

Just because I'm the VeganHeartDoc doesn't mean I have it all figured out when it comes to my own nutrition.

I'm not perfect in my own eating habits, but I think I do better than most.  I get my fruits and veggies. I eat whole grains instead of refined grains.  I don't eat a lot of junk, and though that big chocolate chip cookie from Follow Your Heart after lunch was delicious, it certainly wasn't necessary.  I'm also not perfect with portion control either, and I do love to snack throughout the day.

I've been thinking hard about my own nutrition and what changes I need to make.  Perhaps part of it is the extra five pounds of padding that I've acquired in the off-season.  But, more importantly, I'm about to take on the most daunting physical challenge that I've ever encountered:  The Ironman.  2.4 miles of swimming, 112 miles of bicycling, and 26.2 miles of running, all in the same day.  My training weeks will consist of anywhere between 10 and 18 hours of cardiovascular exercise in a week.

I've recently talked to a nutritionist, and I've discussed nutrition with my new personal trainer.  The consensus is that I need more protein in my diet.  Now, the average person needs no more than ten percent of their calories from protein, and when left to my own devices, that's about how much protein I consume.  But, as an endurance athlete, my requirements are higher so that I don't catabolize too much muscle.  From what I've read, I need about 1.3 to 1.5 grams per kilogram body weight of protein per day, which for me is about 90-100 grams of protein per day.

I've been thinking of ways to get that protein -- veggie chili, soy yogurt, Chicken-Free Chicken, Luna bars, tofu, Kashi Go Lean (which is my favorite cereal already), and protein smoothies.

My personal trainer did bring up a good point -- I would benefit from a rapidly digestable protein.  Whey protein is digested rapidly, but as a vegan, I do not consume dairy.  I am looking into a good source of rapidly digestable vegan protein.  So far, I have come up empty.  If anyone has thoughts on this, feel free to share!

Back to Training

I like having a goal.  And I like structure.  And competition.

That's why I'm a triathlete.

I've enjoyed the past three months of working out for the sake of working out, with no schedule and no coach to report to.  But, I'm ready to start training again.  I'm even ready to start swimming again.

Ironman Lake Placid training starts February 1.

Southern California Half Marathon

It is still my off-season, but I've been keeping up with my running, staying at 20-30 miles per week, much of it hills because I'm really beginning to love running in my neighborhood.

A friend wanted to do a half marathon this weekend, and I agreed to join her.

The weather today was perfect for a race -- at the 8 am start time, it was in the low 60's, and warmed up slightly during the race.

As I haven't been specifically training for a half marathon, I hadn't thought too much about pacing myself.  I have wanted to run a half marathon in under two hours.  Toward that goal, I decided that I should aim for 9:00-9:15 per mile, and if I felt good at the halfway mark to pick up the pace.

The start was crowded.  With thousands of us lined up, and no indication of where walkers, slower runners, and faster runners should start within the crowd, the first mile was crowded.  I probably spent too much time and energy dashing between people.  My first mile was 9:09. 

I had a little bit of an ache in my left ankle, which I've ignored this week thinking it was a big nothing, but during the race, it did nothing more than just ache.  I was more bothered by a blister in my left arch.  After the race, that was a different story, as I sit here typing with a bag of frozen corn on my right ankle.

Back to the race:  The course was on major roads and along canal paths, and it was mostly flat.  I had consistent mile splits, averaging about 9:10 per mile, so by mile seven, as I high-fived a guy announcing the race and wandering the course with a microphone, I decided to pick up the pace a bit, and the last half was done at an average pace of 9:00 per mile.

There were lots of enthusiastic volunteers on the course directing us, which I loved!  But, the fluid stations were horribly understaffed.  I couldn't get anything to drink at several stations because there weren't enough volunteers, the volunteers were not spread out and were too clustered together, leading to too much crowding to effectively grab fluids.  One station had only one volunteer with Powerade and about a dozen other volunteers holding water.  Another station ran out of Powerade by the time I got there; that shouldn't have been the case -- I was definitely in the faster half of runners so there was no reason to run out.  I think that the race could have done well with fewer volunteers with direction signs and more volunteers at the aid stations.

I wasn't sure that going sub-2 hours for the race was doable, since my training has been pretty free-form -- I run when I want and as far as I want.  But, when I hit the ten-mile marker and saw that my time was 1:30, I realized I could do it.  As long as I kept sub-10 minute miles, I knew I could do it.

So, I pushed the last few miles, and coming around the corner to the finish line, I knew I had it.  My finishing time was 1:58:58, my best half marathon time by four minutes.  24 out of 126 women in my age group.  202 out of over 1700 women.  896 out of over 3800 runners.

Cravings

Think about the foods you crave.  What are they?  Pizza?  Nachos?  Candy?  Or maybe fruit?  Salad?

Fruit?!?!?!?

I was thinking about this while talking to one of my patients today.  She is someone who has made some major changes -- she now follows a low-fat, mostly vegetarian diet.  She also now exercises regularly.  Her cholesterol numbers, as a result, look fabulous -- her total cholesterol dropped from 239 to 139, and her LDL (the so-called bad cholesterol) plummeted from 168 to 71.

She tells me that she feels better eating lighter, and she doesn't crave a lot of the heavier foods that she used to eat.  She was surprised to find herself craving healthier items.

I can understand that from my own experience.  While I once craved fast food, I now crave things like apples, strawberries, carrots with hummus, oatmeal, and even salad.  Granted, I still enjoy a little bit of chocolate or ice cream occasionally.  But those aren't regular staples of my diet.

If you are thinking about making changes to your diet, keep this in mind:  As you make positive changes to your diet, you will feel good, and your body will crave the healthy foods that make you feel good.

Pumpkin Pudding

So I'll be honest -- the only reason I have a can of pumpkin in my kitchen cabinet is because I was afraid I might mess up the pumpkin pie that I made for Thanksgiving.  I came up with this recipe, and I'm proud of the results.

Ingredients:
One can of pumpkin, 15 oz
Silken tofu, seven ounces
Agaven nectar, three tablespoons
One half teaspoon of nutmeg
One half teaspoon of allspice

Put all ingredients in a blender and puree until well mixed and smooth.  Refrigerate in individual dishes.

Makes four servings.

Nutritional information per serving:
120 calories
1.5 grams of fat
5 grams of protein

Dinner for my parents

In honor of my parents' visit to Southern California, I cooked for them:

Squash, carrots, and sweet onion stir-fried in a tiny amount of oil and teriyaki sauce.

Whole wheat pasta spirals

Mashed cauliflower, mixed with a little soy milk and pepper.

Field Roast -- a great source of protein, but high in sodium.  If you want a low-sodium option, grill some tofu steaks.

Staying Fit on Vacation

I just returned from a relaxing trip to the Bahamas.

A lot of people see vacation as a time to throw caution to the wind, become sedentary, and eat obscene quantities of food.  I see things differently.

To me, vacation is a time to unwind.  But, because exercise makes me feel good, I keep it up.  I tone down my routine, but I still exercise in some way on most days of a vacation. 

I do a lot of running on a vacation.  I find that running is a great way to explore the local sights.  Another favorite workout is running barefoot on wet sand.  I go barefoot, and I run along the beach just where the waves touch the sand.  It's a little more challenging than running on trails and works different muscles.

I found another triathlete physician, and he put me through the paces of his own workout.  It was fun for me, because I always love a challenge.  We did intervals of ten minutes alternating on the bike and on the treadmill, and did a total of six intervals, followed by a brief swim (yes, me, voluntarily swimming in the off-season) in the ocean.

On vacation, the bottom line to exercising is to keep it fun.

Happy New Year!

2009 was a good year.

Professionally, I joined Valley Cardiovascular Specialists and moved into my office in West Hills.  I've been fortunate to work with wonderful people, including Ashley, my receptionist, and Keely, my medical assistant.  I have had the opportunity to get to know and take care of some terrific patients.

Athletically, it was a challenging year, and yet one of great accomplishments.  I DNF'ed a marathon and came back to complete a marathon two weeks later to prove I could do it.  I learned what it was like to be a cardiac patient with my arrhythmia and ablation.  I completed two half Ironman-distance triathlons, one of which was a personal record for me, and the other is considred the second-hardest triathlon course in North America.  I even learned to not take myself so seriously by running a marathon in costume.

My most proud athletic accomplishment of this year: taking forty-five minutes off of my marathon time from 2008, getting down to 4 hours and 12 minutes for a marathon.

I'm looking forward to the upcoming year of challenges, of meeting and caring for new patients.  I'm excited to finally be able to call myself an Ironman (or Ironwoman, which is it?) once I complete Ironman Lake Placid in July.

Happy New Year... and may your 2010 be filled with health and accomplishment!

Losing a Patient

I take care of patients with complicated medical illnesses.  Unfortunately, that means that occasionally my patients pass away.

One of my patients died a few mornings ago.

I met him in February.  He was an engineer and inventor, one of the brightest people I've ever met.  He had right heart failure, and was one of the few patients who knew why I look so closely at a patient's neck.

"How's my angle of Louis?" he would often ask as I looked at his neck veins to assess his right heart pressure.

He was one of my more talkative patients.  He would talk about science, research, often things that were a bit over my head.  He was dutifully compliant with his medications and kept meticulous records, though he occasionally indulged in foods higher in salt, which led to occasional decompensation of his heart failure.

He read my blog, because he'd ask me about my races and comment on my posts.  In particular, I remember him being very curious about my experience with supraventricular tachycardia and my ablation earlier this year.  I think he even posted an anonymous comment about my "ablative cardioversion".

I was also fortunate to have the connection of my medical school advisor being one of his closest friends.  He invited me to his home for lunch, which gave me the opportunity to reunite with my former advisor.  Seeing his home gave me more insight into who he was as a person and as an inventor.

But, it was ultimately other health issues that took their toll.  A compression fracture caused terrible back pain.  Cognitively, I could see him declining as he became less intellectual and less talkative at his more recent visits.  Most recently, swallowing became difficult for him and he was hospitalized due to aspiration into his lungs.

He was discharged home and passed away two days later.

He's a unique man who definitely left an impression.

Athlete Cookies

My friend Gail competed as part of a relay team for the San Diego Triathlon, to benefit the Challenged Athletes Foundation. She offered to make cookies for anyone who sponsored her $100. I took her up on the offer, and challenged her to make vegan cookies. Here they are, and they are very funny!!

From left to right, these are in honor of my best 5K race, my best marathon, and my most recent marathon which I ran in costume.

Clockwise from the top, these commemorate Santa Barbara Long Course triathlon with its chilly ocean swim, California International Marathon, and the New Moon Century ride.

These cookies are for Wildflower Long Course triathlon and Vineman 70.3, the two half-ironman distance races that I completed this year.

Running as Supergirl

I thought seriously about whether to post my marathon pictures on the blog. As a cardiologist, I have a certain image to maintain.

But, the more I thought about it, the more I thought that being Supergirl for a race was something I wanted to share. Fitness has to be fun, and I think that this experience reflects that. If exercise was always serious and always hard-core, we would burn out, a lesson that I've learned over the past few months of training.

So here are a few pictures from my race. Through the wind and cold, I had much more fun running as a superhero than I would have otherwise.

CIM Marathon

Today was the CIM Marathon in Sacramento.  I've been doing more cross training and a lot less running, and I wasn't sure what to expect from my legs or how long it would take me to finish.

I chose to run with the 4 hour and 15 minute goal time group.  My last marathon seven weeks ago, that I was far better trained for, was a 4:12 finishing time.

But, for the first time ever, I ran the marathon in costume, as Supergirl.  Complete with a cape.  The day was cold and windy, so the long sleeves of the costume and the cape worked well to keep me warm.

Self-portrait with my camera.  Better picture coming soon, hopefully.

At the start of the race, it was 29 degrees and maybe by the end the temperature was in the mid-40's. I started with the 4:15 pace group. Our leaders, Lisa and Mike, definitely made the running eperience unique. They had us shaking out our arms and fingers every couple of miles. It seemed silly, but they kept saying, "You'll thank us at mile 20", and yes they were right, it kept our upper body loose. They instructed us to take the tight turns on the course so that we limited the distance that we were running.

I felt good at mile 4, so I broke away from the group and went ahead. A few miles later, I stopped to use the restroom and the group caught up with me around mile 8.

The winds were strong and made running far more challenging. Our pace leaders told us to "tuck in" and run closer together to try to shield the wind. It helped a bit, but the cold and the wind definitely took their toll. With wind, there is more fluid loss, so I was mindful to drink as much as possible.

I pulled ahead of the pace group again at mile 12, and they caught me at mile 14. Lisa, one of the pace leaders said, "We caught up with Supergirl!" Part of me thought she was taunting me for thinking I could pull ahead.

I stayed with the group through mile 21 I needed that group support, positive energy, and shielding from the wind. It took everything in my being to keep up with them and not drop off.

At the water stop at mile 21, I choked on my cup of water, and as I choked, the group ran by. I tried to keep them in sight, but they kept getting farther and farther away.

Dressing as Supergirl definitely has its advantage in crowd support. Lots of people yelled, "Go Superwoman!" "Go Supergirl!" It really helped push me forward. But, my mile splits dropped below ten minutes. I felt tired. But I kept going. Three miles left. Two miles left. One mile. And then a strong finish. Even the announcer yelled for Supergirl!

My finish time:  4 hours, 16 minutes, thirty seconds.  That's about three and a half minutes slower than my time seven weeks ago at Long Beach, when I was training harder.  I'm proud of my time, and I had fun along the way.

Does work count as exercise?

I ask all my patients if they exercise.  It's an important question since exercise is so important for cardiovascular health.

A common answer:  "I exercise at work."

Unless you are a bicycle delivery person who covers large distances or a valet car attendant who spends most of your shift running to retrieve cars, it doesn't count.  Construction and manual labor don't really count either, since those jobs involve short bursts of lifting or exertion as opposed to a sustained effort.

Granted, a job that has you moving on your feet is far better than a desk job in terms of promoting heart health.  However, for true cardiovascular benefit, you should be doing something outside of your daily work that involves a sustained effort, preferably for at least thirty minutes on most days of the week.

Tofu Pumpkin Pie

I baked this from a recipe from Vegweb.  It's a whole wheat crust, which I bought from the store, and a filling made from pumpkin puree, maple syrup, cornstarch, silken tofu, nutmeg, and cinnamon.  I'll be serving it up with Soyatoo whipped cream.

Happy Thanksgiving!!!

Teriyaki Bake

This is a similar, easy recipe to the one from a week earlier.

Chop up some veggies and extra-firm tofu.  The veggies in here are eggplant, carrots, squash, sweet potato, and onions.  Add teriyaki sauce.  Mix it up, cover with foil, and bake for 40 minutes at 400 degrees.

Cranberry Sauce

A less sugary, lower-calorie, easy version of a Thanksgiving favorite.  I concocted this on my own to make sure it tasted good before subjecting my family to my cooking.

1 bag of cranberries, 1/2 cup of orange juice, 1 large sliced apple, and 1 1/2 tablespoons of agave nectar.  Heat it in a saucepan for about thirty minutes, until the cranberries all burst.

Where I'm At

I've been coach-less for three weeks and doing mostly what I want for exercise.

Needless to say, I didn't qualify for Boston.  However, I am proud to say that in the course of eighteen months that I cut my marathon time down from 4:57 to 4:12.  I'm proud to say that through much effort and good coaching that I'm a better runner.  One day I'll qualify for Boston, it just won't be this year, or likely next year since I'll be shifting my focus to Ironman training.

However, I decided to run the CIM Marathon after all.  I'm already signed up and I love doing long training runs, so I'm going to just do it.

I have only been running three days a week.  Last week, I ran 4 miles on Monday, six miles of hills on Friday morning, then twenty miles on Saturday morning.  Perhaps the six miles of hills on Friday made Saturday's run more painful than it needed to be.  Nonetheless, I finished the long run.

Another thing I've noticed with less exercise is that I can't get away with eating quite as much.  In peak training for my 70.3 (half-Ironman distance) races, I could easily maintain my weight on 2700-2800 calories per day.  Now, doing only about an hour of cardio 5-6 days per week and two days of weights, it's more like 2400 calories per day.

I feel great.  Relaxed.  Eager to start Ironman base training in January.

Dr. Shenkman Goes to Washington

I spent a few days in Washington DC last week.  As you can see, it was quite rainy and cold, not at all resembling the weather that we are accustomed to here in Los Angeles.

I traveled with a Young Leadership group from the Jewish Federation of Los Angeles.  We went to the White House, Capitol, Supreme Court, State Department, Holocaust Museum, and US Treasury Department.

We also had the opportunity to meet with representatives of our members of Congress to discuss a couple of important issues:  hunger in Los Angeles and Iran.

In Los Angeles, one in eight people face hunger every day.  That's a very sad statistic for a wealthy country like ours.  As I discussed in an earlier post, this is the role of the Jewish Federation's Fed Up With Hunger campaign -- to bring attention to hunger locally and to raise funds to combat it.

As a cardiologist, I had the opportunity to give my perspective on hunger:  Those who face hunger are poor and as a result eat unhealthy foods that are high in calories, fat, and sugar, and hence obesity is becoming more and more prevalent, especially amongst the poor.  Obesity leads to high blood pressure, diabetes, abnormal cholesterol, and as a result to heart disease.

Diseases like hypertension and dyslipidemia that once were thought to occur in middle age are being seen in younger and younger people.  I took care of a 25 year-old man with a heart attack and have a handful of patients who are younger than me who have suffered heart attacks.  I see teenagers with high blood pressure, diabetes, and dyslipidemia.

To help to combat obesity, we need to fight hunger by providing healthy options to cheap junk food.

Veggie and Tempeh Bake

I chopped up some yellow squash, sweet potatoes, a green pepper, red onion, and coconut-flavored tempeh mixed it with some Liquid Bragg's and a little agave nectar and sprinkled with pepper.  I baked this at 400 degrees for about 35 minutes and served it over whole wheat pasta.

Low Carb Diets Won't Make You Happy

A study in this week's Archives in Internal Medicine (Nov 9, 2009, Vol 169, No 20) looked at the effect on mood and cognition of a low-fat versus a low-carb diet.  Patients on both diets lost the same amount of weight, 14 kilograms.  However, those on the low-fat diet had greater improvements in mood compared to those following a low-carb high-fat diet.

Interestingly, the "low fat" group got 30% of its calories from fat.  I'd call that more of a moderate fat diet, but clearly that diet has less protein and fat than the "low carb" diet.

Why the difference in mood?  Serotonin may be suppressed by a low carbohydrate diet, while it may be upregulated by a lower fat diet.

Thee bottom line:  It doesn't matter what you eat to lose weight.  But, what you do eat in your weight loss obviously has an impact on how you feel.