18663 Ventura Blvd, Suite 202, Tarzana CA 91356

Friday, December 14, 2012

Apps For Heart Health

I have finally joined the twenty-first century, by ditching my old Blackberry and acquiring an Iphone.

Here are a couple of my favorite fitness and heart-health related apps.  And they're all free.

MyFitnessPal --

Free application that allows you to track your weight, food intake, and exercise.  You can input your current weight, your goal weight, and you will see how many calories you can consume during the day to meet that goal.  The food database is extensive -- for example, the Bolani specialty products that I buy from the farmers' market every week are in there.  You can also scan a bar code for a packaged food, and the program will automatically pull up nutritional information.  In addition, you can add your own recipes, such as my usual green smoothie, so that I don't have to manually add almond milk, maca powder, half a banana, a cup of spinach, frozen mango, carrots, and celery every time I make the smoothie.

You can even have "friends" on MyFitnessPal, and can see their progress and encourage them in their efforts.

Striiv --

A free pedometer for your Iphone!   I like it more for curiousity than to force me to exercise, because I'm pretty self-motivated when it comes to that.  The app gives you various walking challenges to encourage you to walk more.

There are other great apps, I'm sure, but these are the two that I use for now.  I have a patient who uses his Iphone to monitor his pulse, but I'm not sure which app he uses.  Any recommendations?

Sunday, December 02, 2012

My First (and probably last) Ultramarathon

I ran the Ridgecrest 50K race today.

This wasn't the race I planned to run, as I was signed up for North Face 50K.  But, hearing about the experiences that people had at North Face yesterday, sliding in the mud, no matter how okay people felt about pouring rain, I felt validated in my decision to run a different race.

This was a smaller race.  The kind of race that doesn't accept on-line registration, let alone have a chip that you wear to electronically register your time.  I'd say there were about 350 people there to race the 50k and 30k races.

The course was less hilly, with close to 2,700 feet of elevation gain throughout the race.  That said, the biggest challenge of the day was wind, with reportedly gusts up to 40 miles per hour.

I didn't really have a race strategy.  I knew I had the training to finish 31 miles, and I can't say I had an expectation of how fast I would run them.  I knew there would be some walking.  I may have started a bit fast, because in miles 3-7 I was being passed a lot.

There were aid stations positioned every 3-4 miles, starting at mile 5.  These consisted of a table full of orange slices, bananas, jelly beans, potato chips, boiled and salted potatoes, pretzels, energy gels, Pepsi, Gatorade, water, and at a few stations, Guinness beer.  The stations were well-stocked, but I would recommend perhaps some sanitary measures, like spoons or small containers for the jelly beans so that people didn't stick their germy hands all over them.

Another suggestion that I have for the race:  port-o-potties.  There wasn't a single one on the course.  And this was a desert race.  So there weren't exactly many places where one could discreetly urinate, or god forbid, defecate if one had the "runners trots".  Most people aren't going to finish 31 miles of running without having to do their business, so to speak.

FINALLY, around mile 8.3, I saw a nice big rock suitable for squatting behind.  I discreetly ran behind the rock to see a man finishing up his business.  I said, because it was a bit awkward to encounter him there and not say anything, "I guess I'm not the only one thinking of this," at which point, this man stopped and wanted to engage me in conversation!  I said, "Please, just go, go, okay?"  He got the hint.  Were it a ladies room, with stalls, and he were a lady, perhaps we could have chatted.  But here... NO.

Onward I ran.  Felt good.  It was windy.  I was climbing from miles 7-10, but not a steep climb.  Ran most, walked a bit too.  And, for posterity, recorded some of the experience.  It's a little hard to hear because of the wind but here it is:

The wind only became more troublesome.  I continued to feel good for a little downhill through mile twelve.  My right hip was a bit sore, and I regretted not rolling on my foam roller a bit more over the past few weeks.

Then around mile 13, we had a steady uphill, with a very strong headwind.  Now, this wasn't a terribly steep climb.  But, when wind is blowing at you with this force, there's no point in trying to run.  So I power-walked uphill, with mile splits of 15-17 minutes apiece.  That said, just about everyone else around me was walking.

With the wind, one loses more sweat.  I have a bad habit of not drinking enough when I run.  So, as the wind pounded me, I drank as much water as I could.

I have to say, this really is one of the friendliest races even!  The volunteers were super nice, and helpful.  When my Camelbak ran out of water, a volunteer would take it and fill it for me while I stuffed my face with jelly beans and other fare at the aid station.

Miles 17-20 seemed to level off, with a steady climb from miles 20-23.  The wind continued to pound us.  And I decided I needed another video:

Around mile 25, the aid station had beer!  Now, I'm not a big beer drinker, but during a race, beer tastes good.  And, two of my best races, Long Beach Marathon 2009 and LA Marathon 2011, included drinking beer.  So for good luck, I had about an ounce of Guinness.

The rest of the course was downhill, fortunately.  My feet ached, I had the expected fatigue from being on my feet for hours, but overall I felt okay.   My miles were about 11-12 minutes apiece from here.

My friend and teammate Jason took this video at the end:

Done!  6 hours and 19 minutes.

Now, I had fun.  I can call myself an ultra-marathonner (I think I said "ultraman" in the second video clip, but the brain does funny things when you're running and talking, so I misspoke).  I'll put it in the header of my blog, because I am an ultra-marathonner, just like I'm an Ironman.  One and done.  Don't necessarily plan to do another.  But, if I did, I just might come back to Ridgecrest.  A small town race with a very friendly vibe.  Hopefully, the wind won't return for next year's racers.

Friday, November 30, 2012

Ultra Time!!

Weather has not seemed to want to cooperate with my race schedule.  First, Hurricane Sandy led to the eventual cancellation of the New York City Marathon.  Now, days of heavy rain are causing havoc on the North Face Endurance Challenge course, leading to last minute course changes and muddy trails.

I registered for the North Face Endurance Challenge months ago.  I planned to do the 50K race, about 31 miles of trails with 6800 feet or so of climbing, tomorrow.

Then I saw the weather forecast:
Now, I've run in rain.  I finished the 2011 Los Angeles Marathon, during which there were torrential downpours from just after the start, intensifying throughout the race to what could be considered monsoon conditions.  In spite of the weather, I had a pretty good race.  Two weeks ago, I ran four hours in the Santa Monica Mountains, slip-sliding in mud at times, covering nearly 19 miles.

This will be my first ultramarathon.  I will be out on the trails for over six hours.  I don't want to be miserable, cold, and wet.  And, I don't want to risk my safety and health running on a muddy and presumably slippery course.

So, I'm out -- I'm not running North Face.  Several of my teammates will be there, and I hope they have a good and safe race.

BUT, there's another ultramarathon this weekend!!!!  Ridgecrest 50k.  It seems like a low-key race. It's known as the friendliest ultramarathon.  I'm not sure what that means.  There are aid stations about every three miles.   The high will be 66 degrees with a 30% chance of rain.  And, while North Face 50k has about 6800 feet of climbing (though they are being forced to change their course due to the weather so it will be less), this race has less than half that amount, about 2,664 feet.
Yup!  I'm running this!

I'm looking forward to my first ultramarathon on Sunday, hopefully in sunny weather!

Friday, November 23, 2012

Can Endurance Sports Hurt Your Health?

Exercise is good for you.  But is there such a thing as too much exercise?

-At the end of marathons, runners have been shown to have elevated troponin levels, a markers of heart muscle damage.  They may also have elevated CPK levels, representing skeletal muscle damage.  The consequences of these abnormalities are not known.

-One study found that there was MRI evidence of dysfunction of the right ventricle of the heart.  This was a transient finding, and, again, the long-term consequences aren't known.

-Arrhythmias, such as atrial fibrillation, are more common in endurance athletes.

-Athletes have died during Ironman distance triathlons.  That said, athletes have died during marathons, half marathons, and shorter distance triathlons, and the incidence of sudden deaths during the Ironman is no greater than any other distance race.

-Long-term marathon running increases the amount of calcium in the coronary arteries, which is a marker of coronary plaque.

-Blood markers of inflammation are higher during intense training.
Me -- on my way to becoming an IronMan!

So what about me?

I'm a triathlete, who has completed 13 marathons, an Ironman triathlon (Ironman Lake Placid 2010), countless other road and trail races and triathlons of other distances, and next weekend I will be running my first ultramarathon, a 50-k (31 mile) race.

I've had an arrhythmia -- AV nodal re-entrant tachycardia, a form of SVT (supraventricular tachycardia).  I underwent a successful ablation procedure in April 2009, and have had minimal palpitations since.  To my knowledge, AV nodal re-entrant tachycardia is not an arrhythmia that is encountered any more frequently in athletes than in non-athletes.

During my Ironman Lake Placid training, I did some blood work.  My cholesterol numbers rocked, my hemoglobin was well within the normal range, and electrolytes were good, but my high-sensitivity c-reactive protein level, a marker of inflammation, was quite elevated at 7.4, with normal being levels less than 2.

As I trained for Ironman Lake Placid, I was tired all the time.  I didn't feel good.  My run times dropped, and I slogged along on my long 15 to 20 mile practice runs at an 11 to 12 minute per mile pace.  I couldn't wait for my 6+ hour long bike rides on Pacific Coast Highway to be done.  And the swimming... I've never been a fan of long swims, so the day I had to swim two miles, thankfully my friend Ray was there to entertain us with the occasional group hug or joke, as we then doused our faces in the water and stroked on to the finish.

I finished Ironman Lake Placid in 14 hours and 45 minutes.  I see my friends and teammates who have done multiple Ironman races.  I contemplate how on a flat course and the right training I could finish in under 13 hours.  Because I could achieve that.  I even thought about signing up for Ironman Arizona 2013.  Fortunately, when the race went on sale last Monday morning at 11 AM, I was busy with patients and wasn't bored at my computer to repeatedly hit the "refresh" button.

But, if I were honest with myself, I don't want to do another Ironman.  I will do an ultramarathon for the same reason I became an Ironman -- to say I've achieved that distance.

I'm not going to be an endurance athlete forever.  I'll always be physically active, and I hope that during the length of my "career" as an endurance athlete that I can take away the health benefits and not be left with the possible consequences.

Tuesday, November 13, 2012

Over It

I DNF'ed a marathon.  It's not the end of the world.

I'll chalk it up to burnout and mental distraction, and starting the race too fast, not accounting for the 80 degree weather expected later in the day.  As I prepared for NYC, my sole focus was breaking four hours.  That was my goal, and I should have been more flexible.

On my only other DNF ever, which was the Surf City Marathon in 2009, I scrambled to find another marathon to redeem myself.  And I did.  I posted my best time ever at the time, in my fourth marathon.  That said, I was a nervous wreck, having put so much pressure on myself to finish well so soon after a bad race.

In the first couple days after my most recent DNF, I was a bit sad.  But honestly, I think I'm over it.  I've run 13 marathons.  So what if my attempt at number 14 is a bust?

I've had to refocus -- I've had some great races this season.  Yet, I seem to perseverate on where I've failed, when I've actually had some awesome successes -- I took fourteen minutes off of my Santa Barbara Long Course race at the end of August, had a great day at Age Group Nationals, and qualified for Age Group Nationals for the second year in a row by placing in the top ten percent of my age group at the Malibu Classic race in September.

I didn't blog about those accomplishments.  Yet I am not hesitant to overanalyze where I've screwed up.

Next up is the North Face 50K on December 1.  That will be my first ultramarathon, at just over 31 miles. 

 Me and teammates Evan, Ray, and Alex, at Westridge Trail on Sunday morning

Yes it's more running.  But, trails are so different from roads.  I ran 27 miles of trails this weekend, and I'm not sore.  If' I'd done that on roads, I'd feel quite differently.  And, an ultramarathon, while longer than a marathon, has less pressure.  Or at least I put less pressure on myself.  My goal is to finish so I can call myself an ultramarathoner.

After North Face, I am taking a much-needed hiatus.  It might be a month, it might be longer.  While I do not plan on sinking into my couch and scarfing down vegan bon-bons, I will exercise when I feel like it, without a schedule, without a coach to report to, for the first time in about two years.

And, after my hiatus, I'll come back and figure out what I want to accomplish as an athlete next year.

Sunday, November 04, 2012

DNF at Santa Clarita

I was supposed to run the NYC Marathon.  You know that if you've read my last 2 posts.  Instead, I signed up to run the local Santa Clarita Marathon.

I started at a good pace, 9:10-9:15 per mile.  My heart rate was a little high, but I felt okay.  I kept that up, give or take a couple minutes, through mile 13.  Then it all fell apart.  I can't say there was anything that specifically hurt.  I felt tired.  I just couldn't keep up the pace.  It was a bit hot out too.  Any attempt to run had my heart rate around 180.  Around mile 14 I starter walking some intervals.  Then I found myself walking more.

Just after Mile 18, I was at Magic Mountain Parkway, and knew the finish line geographically was only a mile away.  I took off my race bib and walked to the finish area, grabbed my gear, and left.

Sure, I could have finished.  I would have walked and run, and I would have finished in 5 hours or maybe a little longer.  But I didn't come to just *finish* a marathon.  I came to finish a marathon well.  And if I had schlepped another 8 miles to the finish line, I would be sore and fatigued for several more days.  By cutting my losses at mile 18, I know I'll be recovered sooner.

Training was spot-on.  I did all my workouts.  I even did my yoga.  I think this is all mental.  It's been a stressful week in all manners, particularly trying to decided whether to go to NYC, and then of course personal issue.

I'm not sure what to do next.  My next race is December 1, the North Face 50k.  I want to complete an ultramarathon, but I'm not excited about a terrible marathon performance hanging over my head.  There's the CIM Marathon in Sacramento and the Rock N Roll Las Vegas Marathon, both on December 2.  I could run either of those, and the Las Vegas race is even offering a 20% discount to those of us who were registered to run NYC this year.

All I know is today was not my day.

Friday, November 02, 2012

My Day On Radio and TV

It's been an interesting couple of days, in deciding whether or not to run the New York City Marathon, which ultimately was cancelled as of today.

On Wednesday, I was revved up and ready to go, come hell or high water.  My friend, a reporter at local NPR affiliate KPCC interviewed me for a piece she was doing on the race.  Then, the following day, before her story aired on the radio, I decided not to do the race.  Nonetheless, I'm still featured in the story and she made it work.

Click here to hear the interview, which aired on the radio this morning.  The audio link is on the left side of the page.

Then, later in the morning, I was contacted by a reporter from our local CBS affiliate, and I was featured on the evening news, along with teammate Dolores Schutzman.

Tomorrow, I will be waking up early to get to the Santa Clarita Marathon race expo and sign up, just in case I'm not the only person who was shut out of the NYC Marathon who will want to race at the last minute.

Finally -- I've donated to the Red Cross to help support recovery efforts from Sandy.

Thursday, November 01, 2012

NYC Marathon -- I'm OUT!

I've been training for the NYC Marathon.  I've been so excited to run through all 5 boroughs and be cheered on by the loud crowds of spectators.

Then came Sandy the Superstorm.

Initially, I thought, it'll be cleaned up by Sunday.  New Yorkers are resilient.  My flight is still on.  My hotel hasn't cancelled my reservation.  It's going to be a sunny day according to the weather.

Then reality set in:  My hotel has no electricity, heat, or hot water, nor do many other hotels in NYC.  Many businesses are closed.  Public transportation isn't fully functional.  Where would I stay?  How would I get to the start line?  How would I get to the Javitz Center to pick up my race packet?  And what about the course?  Will there be changes to our route?

It was a tough decision.  Coach Gerardo gave me some clarity and made the decision much easier:  I take this stuff seriously.  My reason for running this race is primarily to have a sub-4 hour marathon.  I love visiting NYC, but that is secondary.  If I go to NY, I'm not going to have my best race given the conditions of the city and the race.  So, I shouldn't race.
Someone posted this on my Facebook wall.  The deadline to defer to next year has been postponed to Saturday at midnight, the night before the race.  While we won't get our money back, we do get a guaranteed spot in the 2013 marathon.

JetBlue was kind enough to refund my airline ticket, and fortunately the hotel that I booked at didn't require a deposit, so I lost no money there either.

THIS is my race on Sunday:
Fortunately, there is a local marathon on Sunday to take the place of the NYC Marathon for me.  Ironically, it's the marathon that I was supposed to run last year that I skipped because I was sick.

Sandy was a terrible natural disaster.  I'll run NYC next year.  Right now, the east coast's recovery is more important than my silly little marathon.

Tuesday, October 16, 2012

I Don't Love Yoga...

....but I've come to accept its role in my training.

Many yoga classes have made me feel self-conscious about my lack of balance and coordination.  I'm the one who tries to get into Tree Pose and then falls over.  And, while once in my life I was the girl on the high school cheerleading squad who could jump into the splits, I lack that flexibility as an adult triathlete.

Coach Gerardo typically puts yoga on my training schedule once a week.  At the studio that I attend, Black Dog Yoga, I've found three yoga classes that I can appreciate:

Restorative Yoga -- I like to think of this class as "Glorified Nap Time".  This is an hour and a half of chill music and poses held for several minutes at a time while supported by bolsters and blocks.  It's incredibly relaxing, and is great stretching after a weekend of long, challenging workouts.  The only down-side of the class is the jazz-skat version of "Smoke on the Water" that makes me want to slit my wrists.  But, at the end of this class, I feel refreshed, relaxed, and less sore than I did walking in.

Deep Stretch Yoga -- Various stretches, often uncomfortable, especially after a long week of training.  The Friday evening class definitely helps recovery.  I'm always in awe and amused to see the instructor twist herself into a pretzel while I'm definitely struggling doing just a quarter of the given stretch.

Basic Flow -- A beginner class that caters to all levels.  Monday evening tends to be a good time to recover from the weekend's workouts.  I like the spin that the instructor takes on the poses, her stories, and the level of comfort that she provides to those of us who aren't yogis.  I never feel self conscious here.

But yoga does something else cool.  It can take me out of my head.  Now, I don't mean this in some sort of crazy supernatural sense.  I'm rather type A (cardiologist, triathlete, vegan... no, really?).  I have my lists.  I have plenty of internal chatter in my head, things to do, issues to solve.  Sometimes, yoga helps turn that chatter off.  And, with that peace, every so often, something that was previously burdening me becomes clear.

That happened to me yesterday evening in my Basic Flow class.  Even while on call, with my cell phone clandestinely in silent mode poking out from under my mat, I felt a certain clarity.  That clarity helped me make a decision today, and with that I am relieved of a stressor that was burdening my mind.

I will never be a yogi.  I will never love yoga.  But, I've come to recognize what it can do for me as an athlete.

Monday, October 15, 2012

Hazards of the Sport

All sports have risks.

I've had a few mishaps in the past couple years.  I've been bitten by a dog while running.  I've done my share of tripping and falling on trails, and I have the scars on my knees to prove it.  And I've been nailed by some serious waves in the ocean that have slammed me to the ocean floor and sprained my shoulder, leaving me with ears full of sand and a new fear and respect for the ocean.

But, a recent incident has made me think pretty hard about the dangers that triathlon training poses.

On Saturday, a 36 year-old woman was killed while riding her bike on PCH in Malibu.  The full story is here.

She was reportedly out for a training ride on Saturday afternoon on PCH at Puerco Canyon Road, which is near Pepperdine University.  She was passed by some trucks, caught her handlebar on a parked car, which led her to veer into a bus.  She was then dragged under the bus.

Now, this wasn't a particularly treacherous stretch of PCH.  It's a piece of PCH that I have ridden dozens of times, never feeling particularly unsafe.

What to do..... do we stop riding completely and resort to a life of spin classes and sitting on the bike trainer?  Stick with riding on PCH to the west of Trancas Road, where there is far less traffic?  Or just recognize there are hazards and do our best to be cautious?

I don't know.  Even though I didn't know her, the triathlon community is small enough that one of my teammates was a friend of hers.  This definitely hits home and I know this easily could have been me.


Friday, September 28, 2012

White Coat Hypertension Tip

White Coat Hypertension is the phenomenon by which some people have an elevated blood pressure when visiting their physician.  These patients do not need treatment for hypertension, whereas people who have elevated blood pressure whether they are in or out of the doctors office need to be treated to lower their blood pressure to normal levels in order to reduce risk of heart attack and stroke.

The instructor of the Restorative Yoga class that I attend gave an interesting tip.  She has white coat hypertension.  She comes to her doctors' appointments early and will meditate in the waiting room.  This way, by the time she is called back to see the doctor, she is relaxed, and when she does this she typically will have a normal blood pressure.

When she told the story initially, she relayed it as if a doctor wouldn't like that she does this.  I think it's a terrific idea, and so I'm sharing it!

Monday, September 03, 2012

Conquering Mount Baldy

I didn't have any race plans for this weekend, until Coach Gerardo suggested the Mount Baldy Run to the Top race.  Five of us from Fortius Racing Team took on the challenge.

At 10,068 feet, Mount Baldy is the tallest point in Los Angeles County.  During the winter, while the ground may be clear in the valley and the city, you can see snow-capped Mount Baldy from far away.
I climbed this today.  Picture from

We started from about 6,000 feet, climbing all the way to just over 10,000 feet, over the course of 7 miles of trails.

I hadn't planned to enter this race.  So my approach was conservative.  I thought I'd walk/run it.  I ran the first half mile downhill, but held back because I had an idea of what was ahead.  Then I ran the next half of a mile.  Then, as the hill became steeper, running just wasn't a possibility, so I was briskly walking, with an occasional very short jog.
Photo courtesy of Gerardo Barrios
Then around mile 4, it got steeper.  Then around mile 5 we were on single track.  And it got steeper.  My brisk walk became more of a mountain climb.  My calves ached.  My hamstrings were sore.  And with a mile to go, at nearly 10,000 feet of elevation, I felt stuporous at best, lightheaded and just trying to get one foot in front of the other.

I made it to the top in 2 hours and 14 minutes.  That must be the slowest 7 miles ever, but one of the most challenging feats I've ever accomplished.

After all that climbing, we had to descend 3.5 miles to get to the ski lift to get back to the bottom of the mountain.  Coming down may have been just as tough as climbing, because it was a challenge just to maintain our footing and not slip on all the rocks!

This was a tough challenge, and I'm glad I took this on.  However, I know tomorrow I'm going to be very sore.

Wednesday, August 15, 2012

It's been an interesting trip.....

I posted this photo on Facebook, of me doing my first triathlon, the Finger Lakes Sprint Triathlon in September 2005.  It's gotten some interesting reactions, maybe because I look different now.  I am a much better athlete, and have had many new life experiences, compared to when this picture was taken.

I'm racing at the USA Triathlon Age Group Nationals on Saturday in Burlington, Vermont.  If you'd asked me nearly seven years ago, I don't think I would have ever thought this would be possible.

It's been an interesting road since that first race.  After a foot injury had derailed me from running for nearly a year and a half, I took up cycling.  I pulled my decrepit Toys R Us mountain bike out of the back of the garage, walked into the bike shop in upstate New York hoping not to get laughed at.  They were kind enough to get this clunker into riding shape.  I rode with the local womens' cycling group, hauling ass just to keep up with these women, most older than me, but on much nicer road bikes.

Then I started swimming on my own, and then with a local masters' group.  I swam in the slow lane, forced to learn to breathe on both sides.

Eventually, after months in and out of an orthopedic boot, and finally in a pair of orthotics, my injured foot healed and I started to run again.  I ran a local 5k in about 32 minutes.
That's me at the end of the 5k.  I was excited to be running again.  But I knew that running with no cross-training was a problem and would lead me to become injured again.

Shortly thereafter, in Mary Eggers' spin class, I asked her -- "Can you coach me to a triathlon?"  She was a local triathlete and coach of Team Train-This! .

I spent that entire summer training for my first triathlon, the Finger Lakes Sprint Triathlon.  I followed her program, which had me training about 7-8 hours per week.  I found it tough to fit in the workouts, but I got most of them done.

And there I am, finishing Finger Lakes Tri.  I wasn't last, but I was far from first.

I had so much fun racing that day that I wanted to do even more triathlons!  But I decided I wanted to do them well.  Circumstances in my life were difficult around that time.  A few months after that first triathlon, I went through a divorce.  It was about as amicable as something like that can be, but when you lose someone that important in your life, it leaves a hole.

I filled that emptiness by striving to be a stronger athlete.  During the winter in icy Rochester, NY, I would get on my treadmill in my bedroom and do "Soccer Workouts".  To this day, I don't know why that is their name, but they are mile repeats at progressively faster paces.  When I finally broke a ten minute mile, I rejoyced!  I continued to swim, bike, and run, planning on races that spring in Rochester and then for the upcoming summer and fall as I plotted my uncertain future alone in Boston, where I would be moving for my interventional cardiology fellowship.

I achieved a long-time goal that spring, to run a 5k faster than 29 minutes.

I moved to Los Angeles a year later to begin my career as an interventional cardiologist.  Triathlon has continued to be a big part of my life -- it's been my hobby, a way to meet great friends, and a terrific outlet for stress.  Through hard work and excellent coaches, currently Gerardo Barrios of Fortius Racing Team, I've continued to become a stronger athlete.

In the meantime, I've achieved and surpassed several goals that I've set for myself -- finished an Ironman, gotten my marathon time down to 4:05, ran several 5k's in under 25 minutes, and many others. 

This weekend's race is much the culmination of all of that.  While I won't be winning any medals this weekend, or qualifying for Team USA for the ITU Worlds race, I can celebrate all my hard work, and I'll be happy and honored to be able to race amongst such talented athletes.

Monday, July 23, 2012

My "C" Race

We're supposed to prioritize our races.

"A" races are the ones we really train for, that we want to do well at.

"B" races are ones we want to do well at, but know that these aren't our top priority.

"C" races are the ones where we know we're not going to do great, and we race for the experience.

I raced at the He Tried She Tried olympic distance triathlon.  It's a neat concept -- you are paired up with another person to race, and based on your combined ages and race times, this determines your award for the race.

Did I mention this race is in Michigan?  I thought it would be fun to do a race while visiting my parents.  And I was so grateful to have my parents cheering me on.  They hadn't been at any of my races since Ironman Lake Placid in 2010, where my Dad was convinced that every passing ambulance had me in the back of it.

I was jetlagged, having arrived in Michigan from California at 3 am just two days earlier.  I never quite got onto Michigan time and only had 4 hours of sleep the night before the race.  Since I didn't travel with my bike, I borrowed a bike.  It was a tri bike and the right size frame, and I am so grateful for being able to use it, but it is a lot heavier than Mr. Cervelo, my trusty grey speedy machine.

I think the swim went okay.  We swam in a nice warm inland lake that was 82 degrees, so no wetsuit was needed.  I practiced drafting and found a guy whose hip I drafted off of for the first quarter of the race.  It's a skill that my team has been working on in our open-water simulated practices.  An olympic distance race swim is supposed to be 0.9 miles -- this one was significantly longer, well over a mile, but that's ok.

I anticipated a really bad bike ride.  And, it was a tougher ride, with a heavier bike, that wasn't fit to me.  But somehow I averaged 17.5 miles per hour, which is only a mile per hour slower than I usually ride.

Unfortunately, on the run, I could feel my very tired legs.  The run had a lot of hills and some trails at the end. My 10k time was an hour and two minutes.  WHAT?!?!?!  Keep in mind I did the 10k run at San Diego ITU just a few months earlier in just over 51 minutes.  My legs were so heavy, and no matter how hard I tried, I just couldn't get them to go faster.

My finishing time was terrible.
Cool looking finishers medal.

Interestingly, though, my partner, who I met on race day, and I managed to place first out of three female teams with combined ages of 80-89.  I guess that's a cool accomplishment.

I think there's something to be learned even from the worst races.   I don't travel this far to most races, and now I know for USAT Age Group Nationals in Burlington, Vermont next month that I need to get my rest and get used to the time zone.  I'm also glad that I decided to have my own bike transported to Vermont and not try to ride someone else's bike.

On another note, I really think Epic Races did an amazing job with this race.  It was so organized at registration, the course was incredibly well marked with volunteers at all of the important points, and aid stations on the run were well stocked with water, electrolyte solution (even though I think Heed tastes horrible), and Hammer gels.  And, at the end of the race, the selection of food was fabulous -- bagels, hummus (mmm I love hummus!), watermelon, pineapple, oranges, and cookies.  The finishing medal was pretty cool too.

Sunday, July 15, 2012

Super fast dinner

This dinner took me less than ten minutes to put together.

Below is a squash salad, with zucchini and yellow squash grown in my garden, red pepper, tofu, and sweet and sour carrot sauce from Bolani that I bought at the farmers market today.

Then I made a lentil soup.  In the blender, I added veggie broth, lentils, a few leaves of kale, two tomatoes, and a couple leaves of basil.  I pressed the "Hot Soup" button, let the Vitamix work for about three minutes, and then I had soup!


I had a half of a sweet potato with this, and a peach for dessert, both from the farmers market.

Tuesday, July 03, 2012

Where I'm at... and it isn't blogging!

I've slacked terribly in updating this blog lately.....

But, life as a multisport athlete has been exciting.  I just found out that I made the US Womens Masters Triathlon Team for the Maccabiah Games in Israel in 2013.  It's one of those things I would not have imagined happening when I did my first triathlon seven years ago.

I have two races this month, a sprint and then an olympic distance race.  But, my big races are in August -- USAT Age Group Nationals in Burlington, Vermont, followed by Bulldog 50K, my first ultra-marathon.

My next blog post will be of substance, I promise.  Here's a few topics I'm mulling:
-Is endurance sport training bad for the heart?  Oooh there's lots of good stuff here...
-I signed up for a 50 mile trail run.  Am I out of my mind?
-Or, what do you want to hear about?

Thursday, June 07, 2012

Ojai 2 Ocean Marathon

The concept behind this marathon was cool:  Fast, downhill course, beautiful scenery, small race limited to 1000 participants.

In practice, there were a few things that could be tweaked to make the race better.

I came into this race in a rut.  My last half dozen marathons have all been between 4:11-4:18.  My LA Marathon in March was 4:11, but I felt like I had the training to do better.  Today was the day to prove it.

Race started at the awful early hour of 6 am.  I took a 4:15 am shuttle to the start line, where we sat in pitch darkness, while a couple of pickup trucks parked with their lights on to set up the start line.  It was quite eerie at that hour sitting by the side of the road, as there was no indoor shelter for us, and it was a chilly morning.

I must say, I was amused by the placement of the port-o-potties.  With my small bladder, I'm always observant of where they are set up.  Just off to the side of the start line was a row of five port-o-potties.  So, as racers lined up for the race, there were lines of port-o-potty users intersecting with the race start.  It was very interesting trying to discern who was in line for the port-o-potty and who was trying to gun it to the front of the starting pack.

Gun went off a little after 6 am.  The first three miles were downhill.  Then the next three were back uphill to the start, as we did a short six mile loop.  As always, a lot of people passed me at the beginning -- and I remember, they're either faster than me, or I'll pass them during the second half of the race.

In my LA Marathon race report, I talk about all the friends I had on the course.  Here at Ojai, there were only a couple people on the course from Fortius or LA Tri, and none of them were around my pace, and there were no familiar spectators, so I was solo.

Around Mile 4, I found a woman who was about my pace.  We started talking, and she and I ran together for the next 12 miles.  Stephanie, as it turns out, is my age, has run a few more marathons than I have, and is aiming for a similar goal pace.  So, we stick together and chat about everything from work and dating to silly things people do and wear in races, like a racer with his running number on his back, or a woman wearing a running skirt so low-cut that her butt crack was showing.

We also encountered another runner named Tim, who apparently eats Cup O Noodles before every marathon.  He seemed to have boundless energy, joking around with people, dashing ahead, falling back, and just having a good time.  For some reason, I decided that every time I encountered him during the race I would refer to him as "Ramen" (noodles, right?).  He cheered us on and kept us smiling.

Aid stations were spread out, probably about 3 miles apart from one another.  The first few aid stations had only water and no electrolyte solution (ie Gatorade).  I do all my long runs with some sort of electrolyte, so I was concerned, but kept going.

Mile 11 -- port-o-potty stop.  Quickest pit stop ever, fortunately before one of the steepest downhills, so got out of the port-o-potty and made up time within a couple of minutes.

Mile 13 -- 1:58 split for the halfway point..  Making good time, feeling good, heart rate where it should be in the high 160's.

Mile 15 -- the worst smell of my life.  I think we were running through a sewage treatment plant.  The scenery along this path was horrible.  Oil wells.  Factories.  Yuck.

Mile 16 -- still keeping about a 9:15/mile pace.  Other than a mild aching in my feet, feeling good.

Mile 20 -- surprised that I was still keeping a 9:15 pace!  A little tired out perhaps, as we turn on to the beach path.

Mile 21 -- I see the finish line.  But we have to keep running all the way down the beach and loop back around to the finish line.  Dammit!!!

Mile 22.5 -- Side stitch!  The pain was terrible.  I slowed to a walk.  While I ran a bit ahead of Stephanie a couple of miles earlier, she caught up with me, and I forced myself to run.... briefly.  That didn't last, and I was again walking, doubled over in pain.

Mile 23 -- Aid station.  I figured my side stitch may have to do with being electrolyte depleted or dehydrated.  I grabbed two cups of Fluid (the electrolyte solution) and a cup of water.  I started trotting, jogging slowly, and within a minute I felt better.

Mile 24-26 -- through neighborhood and then along the beach.  Getting it done.  Pace a little slower, about 9:45/mile, but not terrible.

Mile 26.2 -- Finally!!!  4 hours, 5 minutes, 17 seconds.  A personal best by 6 minutes, accomplishing my goal for the day.  Were it not for my side stitch issues, I think I could have finished a couple minutes faster, but I'm still pleased.

Suggestions for Race Organizers:
--I love the Ojai 2 Ocean concept.  But how about a more scenic course?  I understand the convenience of a bike path, but Ojai is so much more beautiful than what we ran, I think.

--Better positioning of port-o-potties.  Not next to the start line.  Not good to mix up your start line and your port-o-potty line.

--Shelter at the start.  It was very cold at 4:30 am sitting on the road by the high school.  How about a couple tents?  Or let us into the high school gym to wait?

--Electrolyte solution at the first few aid stations, please!!!  Water only until mile 11 was not cool.

--I do love the green concept of the race.  Love the recycled steel medals that apparently double as beer bottle openers, and I do love the fact that I didn't get a plastic bag full of paper coupons that would have landed in my recycling bin.  Thanks for keeping it eco-friendly.

Tuesday, May 29, 2012

Soft- versus Hard-Sell

We know the facts -- a plant-based diet is so beneficial -- it's kinder and healthier.

So why isn't everyone a vegan?

When someone reluctantly admits he eats meat, we may think, he needs the facts.... NOW!  Tell him about how meat clogs the arteries, and plant-based diets reverse coronary artery disease.  Show him pictures of chickens crammed in wire cages, pigs in gestation crates, and cows hanging at the slaughter. And get him to a screening of Forks Over Knives..... STAT!!!

But, that approach can seem overzealous.  Overwhelming people with facts will not lead them to change.

I'm more in favor of the "soft sell" approach.

In my daily life as a cardiologist, I advocate a plant-based diet as a way to prevent and reverse cardiovascular disease in all of its forms -- to lower blood pressure, lower cholesterol, stabilize or reverse coronary plaque, reduce risk of diabetes, and so forth.  However, I recognize that not every patient who walks in my office is going to walk out a vegan.  In fact, most won't.

When I start talking to patients about diet, a reaction I often get is, "I'll never become a vegetarian."  And expecting a person who eats meat, butter, and cheese for three meals a day to give it all up isn't realistic.  But, I believe we can meet somewhere in the middle.

We can agree that this patient's diet and lifestyle habits have gotten him to the point where he is with his health, that years of animal products, fast food, junk food, lack of exercise, and smoking led him to his present disease.  We can also agree that in order to do better that some of those habits need to change.

Eat more fruits and vegetables.  Eat less meat and dairy.  Walk for a few minutes every day.  True, a plant-based diet is ideal, but let's start somewhere with attainable goals.  Maybe at the next visit we'll talk about taking it one step further.

I'm not going to say I haven't had patients go full-on plant-based at the drop of a hat.  Because I've seen it happen and I've seen the great results that come with it.  But most patients aren't going to do that, and we need to start somewhere.

Thursday, May 17, 2012

San Diego ITU Worlds

I raced this weekend at San Diego ITU Worlds in the Olympic distance race -- 0.9 mile swim, 24 mile bike, 6.2 mile run.

The week leading up to the race was less than ideal -- the race was on Saturday morning, and at 2 am on Thursday morning, I was doing emergency angioplasty.  So, needless to say, I wasn't well rested before the race.  Then again, patient care always comes first.

This race was the triathlon club national race.  So, this wasn't a small race, and a lot of tough athletes showed up to compete.

My group, women 35-39, were the third to last wave of competitors.  Behind us were two waves of men in their 30's.  In other words, men to clobber us on the swim, so I was anticipating having rather aggressive men trying to get around me on the swim.

I started near the back of the pack on the swim.  I should have started toward the middle, but since I waited until the absolute last minute to warm up in the water, I was one of the last women in my wave start to gather, and I didn't want to push people to get toward the front.  So, as the gun went off, I ran past a few women into the water and swam around several of them until I got to the right position.

The swim was a bit choppy, and there were some currents, and with the men starting just a few minutes after us, I constantly felt like people were swimming very close to me and past me.

Swim time:  34 minutes.  Slower than my usual time which is closer to 30 minutes.  I blame the currents.

Coming out of the water....

Toughest bike course of any sprint or olympic distance race.  The road conditions were less than ideal with plenty of potholes and cracks in the road.  We rode two loops up Mount Soledad (I think that's what it's called)!  It's a long hill with some really steep points.  I saw one woman climbing the hill on her bike topple over as she hit one of the cones on the side of the road.  I heard of a couple other bike accidents on the course also.

Most of my pictures on the bike were of me sitting upright, not on my aerobars, because I wouldn't want to topple over from hitting a pothole the wrong way.

Here, I think I saw the cameras, so I got onto my aerobars intentionally for the picture :)
Bike time:  1 hour 31 minutes.  Not so great.  Reflects the hilly course, and my general lack of focus on cycling this season.

My favorite part of a short race.  There were a few women in my age group who I was going back and forth with on the bike.  And on the run, I passed them for good within the first 2 miles.

This is my running game face.  It doesn't look very convincing.

And this is the fun picture:

I was working hard on the run, but I had a good time.  The run course was around Mission Bay.  We saw the residents in their beachfront homes drinking mimosas as we ran by.  I ran by one woman I knew, but didn't recognize until she yelled, "Shenkman stop looking at your watch and run!" and left me laughing for the next couple of minutes.  A crew of my team members were on the course near the finish line cheering us on, which is always awesome too.

Run time:  51:38 -- my fastest 10k EVER!

Overall time:  3 hours, 11 minutes.
30th place out of 66 in my age group.

The race reflected my relative efforts over the past several months.  Excellent run, decent swim, and not-so-fabulous bike.  Great race, tough competitors, and beautiful scenery.

Saturday, May 05, 2012

What Next?

Having been a multisport athlete for a few years, I feel like I am still evolving.  I used to love treadmill runs.  Then I found myself enjoying road running.  This past year, I've been introduced to trail running.

Trail running and I haven't necessarily gotten along so well.  I've scraped up my knees and scuffed up my hands from a few falls.  On one trail run that I had intended to be out and back, I ended up completely lost, and were it not for the GPS on my phone, there would have been a search and rescue party looking for me.

But there are some real benefits of trail running.  The views are awesome.  The terrain is gentler on the joints.  And there's a certain sense of adventure to getting on trails.

I did my first trail race in January of this year, the Boney Mountain Half Marathon.  Then last weekend I completed the Malibu Creek Challenge 22K race, 14 miles with nearly 3000 feet of climbing.

Having completed both of those events, I have decided on my next challenge -- an ultramarathon.

I am now signed up for Bulldog 50K on August 25.  It's about 31 miles, basically two loops of the Malibu Creek Challenge, in August, in what could be 100 degree heat.  This is one of the tougher races, but I figure, go big or go home, right?

Sunday, April 08, 2012

My Epic Vegan Seder Dinner

I hosted my second annual seder at my home for 25 of my friends.  Growing up, Passover was always a holiday to share with my family.  Living in Los Angeles, I know that there are others like me who don't have their entire family here and want a seder to attend.

A vegan seder isn't the most common occurrence either.  One vegan Jewish guest told me that she hadn't been to a seder in years because as a vegan she always found it uncomfortable.

That said, my guests were a mix of Jewish and non-Jewish, vegan and omnivores.

This is my seder plate -- painted by my 6 year-old niece Samantha.  Instead of a shankbone, I use a beet.  The shankbone represents the Passover sacrifice, or the tenth plague of the slaying of the first born, and a beet in its bright red color resembles blood.  Instead of the egg, I use a flower, which like an egg can represent birth and spring.

I had plenty of appetizers before we had our meal.

This is a "Mock Chopped Liver" from Debra Wasserman's The Lowfat Jewish Cookbook.

 Eggplant Caviar from The Lowfat Jewish Cookbook.

What seder dinner would be complete without Matzah Ball Soup?  This is my one blatant use of kitniyot, or beans, as the matzah balls do have tofu in them.  This recipe came from The Post-Punk Kitchen.  I've tried other vegan matzah ball recipes, and the matza balls fall apart.  If you have a good vegan matzah ball recipe that doesn't require soy, let me know.

 Dinner is served!!!!  With 25 people, we did things buffet-style.  The tray in the middle is Passover Apple Carrot Sweet Potato Kugel, which was the dish that by far got the best reviews.  Originally from family friend Roseanne, I prepare this every year and the recipe is here.  After grating up sweet potatoes, carrots, and apples, which can be done easily in a Vitamix, this is a very simple recipe.  I did not add sugar and I used about half of the recommended amount of margarine.

 Quinoa with Cauliflower, Cranberries and Nuts.  Quinoa is okay to eat on Passover, even for Ashkenazi Jews! 
 Mashed potatoes and cauliflower, courtesy of guests Warren and Michelle.  I thought I was eating mashed potatoes -- the cauliflower makes this a healthier dish with more fiber and nutrients.

 My dinner plate, with salad, Vegetable and Matzoh Casserole from Roberta Kalechofsky's The Vegan Pesach Cookbook, kugel, quinoa, mashed potatoes, and veggies.

Dessert!  No Bake Chocolate Matzoh Roll from The Vegan Pesach Cookbook.  

Chocolate brownies brought by my friend Debbie.  Basically, a chocolate brownie box mix prepared using flax seeds instead of eggs.

A successful evening!  I look forward to hosting another seder next year.

Friday, March 30, 2012

Passover is Coming!!!

I will be making my second annual vegan Passover seder this Friday.  So far, there will be 25 guests at the seder table.  I'll post pictures and tell you all about it once it's done, but in the meantime, here are some previous Passover meals and celebrations:





Eggplant and Matzo Meal Pancakes

And... why a vegan Pesach isn't that hard.

I went to and entered the phrase "vegan passover".  Five of the first 21 pictures that came up were from my blog.  Wow, I think that almost makes me an authority on vegan Pesach!!!

Sunday, March 18, 2012

LA Marathon -- With a Little Help From My Friends

Today was my twelfth marathon.

My athletic bucket list has just about everything checked off.  5K in under 28 minutes -- check.  Half Ironman -- check.  Olympic tri in under 3 hours -- check.  Half marathon in under two hours -- check.  Podium finish in a local race -- check.  Ironman finisher -- check!!

But one item remains on the list -- Qualifying for the Boston Marathon.  So, I take my running seriously.  I've been dutifully doing my runs as prescribed by my coach.  I go to track once a week and push hard.  I even do my yoga, which I don't entirely love, but know will make me a stronger runner.  But that BQ time (Boston Qualifier) remains elusive.

While my training was on track, my sleep last night was poor.  Before my next race, I will remember to turn my phone off before I go to bed.
 My Race Bib

Having good friends made this race the success it was for me.  My friend Kiki was kind enough to drive me to the start line at Dodger Stadium at 5 am.  Since she would be spectating in Westwood around mile 18, I gave her a bag of Gu Chomps (fast-acting carbohydrate) to hand off to me if she saw me during the race.

The weather for today was projected to be terrible, similar to last year's race.  I was layered up, with gloves, arm-warmers, hat, and tights.  But, just before the race started, the sun came out.  No one expected sun today!!!

In the first mile, which initially was a shuffle as we all piled onto the race course, I saw a sign that read, "Go Vegans!"  Obviously, that got my attention.  Holding that sign was my friend Lawrence Ziese:
I'm not sure where the nickname "Sensational" came from, but I'll take it.

Miles 1-3 were more downhill than uphill.  Miles 4-5 were the biggest hills on the course.  Miles 6-8 took us up Sunset, onto Hollywood Blvd.  Around Mile 8, I saw my friend Trey, gave him a high-five and kept going.  I was on pace at this point and felt good.

Still feeling good, at mile 11 I saw teammate David Wachtel.  He was kind enough to take my gloves and arm warmers.  He was also filming with his IPhone.  He asked me if I had anything else I wanted to say, and for some reason my response was "Booyah!"  Endorphins clearly do not make for intelligent speech.

Onward.  Miles 11-14 took us through Hollywood, past Grauman's Chinese Theater, down the Sunset Strip..  The wind was pretty tough at times.  Then we turned onto San Vicente, a nice downhill, and then right on Santa Monica Blvd in West Hollywood, with great entertainment, including cheerleaders in drag.  Mile 16 took us through Beverly Hills, and Mile 17 was down Rodeo Drive.  Again, I saw Lawrence and his "Go Vegans!" poster.

Shortly thereafter, I saw LA Tri Club friend Byron Lea. Last year, coincidentally I was running with him for about four miles -- he was out doing a training run, and I was running the race.  I ran into him last weekend and jokingly suggested that he should be on the course so he can pace me for a few miles.  He asked where would be ideal and I suggested that the second half of the race would be good.  Now I didn't expect him to actually take me up on this.  But there he was, in his shorts and running shoes, waiting for me!

So I had Byron with me for miles 18-22, through the rest of Beverly Hills, Westwood, and through the VA.  I let him do most of the talking since I was tired.  He reminded me what was coming ahead, to shake things out, be ready for a hill, and so forth.  Having someone with me kept my mind off the pain.

At mile 18, at Santa Monica and Westwood, as expected, there was Kiki with my bag of Gu Chomps screaming some words of encouragement.  The Chomps definitely hit the spot.

Miles 20-21 traveled through the VA Medical Center, my least favorite part of the course.  It's boring and it's uphill and at that point I just can't see that I am going to finish this race off.  My pace dropped off here.  Big time.

Byron left me at mile 22 as I turned onto San Vicente in Brentwood.  Running alone again, this may be where I "hit the wall".  Nothing in particular was bugging me, but I was just tired out.  I struggled just to keep a 9:45-10:00 pace.  I ran up the short hill, and then "everything was downhill", or so they say, because when you've run 23 miles and have three more to go,*nothing* feels like it is downhill.

The next few miles, we were battered by strong winds.  Mile 23 was my friend Carol with a bag of frozen grapes that absolutely hit the spot.  Miles 24-25 had a few other LA Tri Club friends to cheer me on.  Then at mile 25 was the turn onto Ocean Blvd for the final stretch.  I gave everything I had left of my tired legs.  My calves were starting to cramp up, an issue I've never had before in a race.  At Mile 25.5, Fortius team members Kelly, Cynthie, and Bodie were cheering loudly for me, but at that point, I was so spent that I think I tried to smile but nothing happened, and yet I was so grateful for their encouragement right then.  At mile 26, I saw Fortius teammate Hans, yelling for me as I headed toward the finish.

Finish time:  4:11:36.

And finally, a huge thank you to Lisa, my ride home, who surprised me with coconut water, blueberries, and a granola bar.  A perfect post-race snack!

This was my personal best by a minute and 17 seconds.  But, I am disappointed in how my pace dropped off.  Next marathon, the phone will be turned off at 8 pm, and I will be better rested.  In the meantime, I will train like hell, drop the 5 pounds that I need to lose to make me faster, and next time, at the Ojai 2 Ocean Marathon in June, I will kill it!

Friday, March 16, 2012

Red Meat Increases Mortality

There's been a lot of buzz lately about a study that came out this week demonstrating increased mortality associated with eating red meat.  The more servings of red meat consumed, the shorter your life span.

The article was published in this week's Archives of Internal Medicine.  The study evaluated over 37,000 men and over 83,000 women who were enrolled in the Health Professionals Follow-up Study (HPFS) or the Nurses' Health Study (NHS), with up to 28 years of follow-up.  Subjects were asked about their consumption of processed and unprocessed red meat, fish, poultry, nuts, legumes, dairy, and fruits and vegetables.

One serving per day of red meat, processed or unprocessed, was associated with a significant increase in mortality, including all-casue mortality, death from cardiac casues, and death from cancer.  The risk increased with increasing consumption of red meat.

Image from

The researchers suggest that 9.3% of deaths in men and 7.6% of deaths in women could be prevented  if everyone consumed less than half of a serving of red meat per day.

Is this surprising news?  No.  But it is one of the largest studies demonstrating increased mortality with meat consumption.

Dean Ornish wrote an excellent commentary.  He discusses the consequences of decreasing our consumption of meat -- not just improved health, but also more grain resources to feed the hungry, and less impact on our environment.

I also enjoyed Kathy Freston's commentary on the Huffington Post, "Meat is the New Tobacco."  It's an interesting perspective.  We now universally recognize that tobacco leads to illness and death.  Now we have strong data demonstrating that meat consumption has the same effect.

This is great motivation to encourage people toward a plant-based diet.  But, in the words of Dean Ornish, "We have a spectrum of choices; it's not all or nothing."  When you exclude some meat and animal products and include more whole-food plant-based foods like fruits, vegetables, beans, nuts, and whole-grains, your health will improve.

Pan A, Sun Q, Bernstein AM; et al. Red meat consumption and mortality: results from 2 prospective cohort studies [published online March 12, 2012]. Arch Intern Med. doi:10.1001/archinternmed.2011.2287.

Thursday, March 08, 2012

Irony and Dog Bites

Earlier this week I posted about the joys of running with dogs.  Which makes today's adventure an odd turn of events.

This morning, I went running.  When my dogs see me put on running shoes, they get excited, wag their tails, jump and chase me around the house.  So, for my tempo runs, I'll take the dogs with me for my 10-20 minute warm-up, then put them in the house and finish my workout on my own.  And that's what I did this morning.

I started my tempo portion of my run, heading down the sidewalk along Ventura Boulevard.  I turned onto a side street and ran toward a man and his dog on a leash. I was at least three feet away, when the dog lunged toward me and bit my leg.

I stopped, stunned.  The older man holding the leash fell silent.  I looked down at my left leg, a couple inches below the knee, and saw the puncture wound of the dog's tooth.  It was a bit less than a centimeter wide, but there was some depth to the wound because I could see a couple granules of fat tissue.  Blood was flowing down my leg, and I used my black crop pants to try to blot the bleeding.

The man remained silent.  His dog stood still, perhaps even shaking a bit.

I said, "Do you see what your dog just did?  Do you see this?"

He finally said, "I'm sorry." 

My first thought was that I'd look odd finishing up my run with blood dripping down my leg, since ideally I would have had about another 30 minutes to go.  Then reality hit:  I should not be running with a dog bite, I need to get this wound looked at.

I didn't have my phone with me, which I often do since I do a lot of my running when I'm on call.  But, fortunately I have a good memory, and fortunately this was an honest man who gave me his real name and his real address, which I was able to confirm later on the internet.  In retrospect, it would have been good to have the dog's license number as well.  The information that I did obtain was useful for the report that I filed later that day to the Los Angeles Department of Public Health.

I ran home, quickly showered, washed off the wound a bit, covered it in a band aid, and went to Urgent Care.  There, the wound was cleaned up well after some local anesthesia.

Since the Los Angeles Marathon is only 10 days away, I was worried that I might not be able to participate.  But, the physician recommended a few days off my feet for the wound to heal.

I worry about tripping and falling, twisting an ankle, or straining my IT band as the events that can derail my running.  I never thought a dog would get in the way.

Monday, March 05, 2012

Running With Dogs

I've never loved "recovery runs".  They're usually on days when I'm tired out from doing a long run the day before.

I've turned them into an opportunity -- to exercise my dogs.

I have two retired racing greyhounds.  This is Gold.  He is 8 years old.  Once upon a time, he chased a stuffed rabbit around a track.  Now he chases me as I shuffle through the neighborhood.

And this is Curves.  She is 6 years old.  She is a greyhound, but at her petite size of 51 pounds, she was never a racer.
These guys are 45 mile per hour sprinters who can catch a squirrel in my backyard (yes that's pretty gross cleaning up the mess).  But when it comes to distance running, I am a little faster than they are.  We're happy doing a 11-12 minute per mile pace.

We stop a lot.  We sniff and pee and poop on things (well, I don't do those things, but my dogs do).  We say hello to other dogs in the neighborhood.  And overall, we have a good time.

The dogs are great companions.  They get my mind off of worrying about my pace.  They remind me of why I run -- to escape, to feel good, to free my mind of stress and obligations.

And when they are exercised, they are happier.

 Here we are.  One big happy family of runners.

Saturday, February 25, 2012

Electronic Medical Record

I have a new friend to carry around with  me at work -- my laptop computer.

For about the past month, I have been on the electronic medical record.  Rather than dictate my notes to a bank of transcriptionists in India, I type them.  Actually, it's more of a point-and-click system, but for many aspects of the note, I prefer to type.

On the first day using the electronic medical record, I wanted to crawl under my desk and hide.  My orientation had been at least four months earlier, and the technical support person on site was clueless -- I'd ask him a question, he'd stare blankly at the computer and tell me that he's "not familiar with this template"

The first few weeks of EMR (electronic medical record) were beyond painful.  At first, it took me far longer to complete a patient visit.  But, now I think it's faster than the previous paper charting.  I don't have to write prescriptions because if the patient's pharmacy is in my computer, I can fax a prescription right from the exam room.  As a patient talks, while I used to write down notes, I can type my notes, which don't need to be subsequently dictated because they are being typed directly into the EMR system.  And, rather than have a pile of charts waiting for me to dictate them at the end of clinic, it's easy enough to finish off a patient note at the end of the encounter with a patient.

While I enjoy the technology, I don't want to take anything away from the personal interaction with my patients.  I try to set up my computer so that it is not directly in the line of eye contact between me and my patient, and so I angle myself toward my patient, and slightly away from my computer.  I have had to learn how to balance the entry of data with making eye contact with my patients, and try to minimize the number of moments of awkward silence while I try to find the right place to point and click.

So, if you have an appointment with me, and you see me in the room with the laptop computer, please know that even though I may be typing, and pointing and clicking, I am listening.  Really.

Tuesday, February 21, 2012

Pasadena Rock N Roll Half Marathon

I've been suffering from a lack of confidence in my running lately..

Of my last three running events, two were terrible.  Long Beach Half Marathon was run as I was recovering from a stomach bug and I had the opportunity to meet the medical staff as I nearly passed out after the race.  Then, my performance at the Santa Barbara Marathon was dismal after having to skip the marathon that I had wanted to run the week before (Santa Clarita) due to a sinus infection.  I rarely get sick, so to get derailed from two races back to back was unexpected and disheartening.  Boney Mountain Half Marathon was a good race for me, but as I had never done a trail race before, I had nothing to compare it to.

So, heading into Pasadena Rock N Roll Half-Marathon this weekend, I was a bit apprehensive.  Having decided to dedicate the coming year to becoming a stronger runner, I wanted to prove that in a race I really have gotten better.  In order to run faster, I have been following Coach Gerardo's running plan, got back to my track workouts with the Los Feliz Flyers on Wednesday evenings, and have accelerated my usual winter weight loss of excess pounds that I tend to gain in the Fall "off-season".

So, better trained and leaner, I approached the start line.  I started with my friend Tom, who I've done several long runs with.  But, knowing he's a faster runner, I let him go at the beginning.

One of the runners in front of me had a shirt with a picture of a pork sandwich and the words "Runs on Bacon".  At that point, I had two thoughts:  1) It's a shame I don't carry business cards with me when I run because this is a man who just might need me in the future, and 2) I cannot let a man who gloats about his love of bacon to beat me.  So I passed him.  :)

Coach Gerardo gave me a plan of what paces to keep, to gradually get faster throughout the race.  This was going to be tough to stick to since there are so many hills in Pasadena.  However, it became a moot point when somewhere in the first mile my watch broke and for my pace displayed "3:00" per mile.  I was a bit panicked by this, but I thought back to my track workout this past Wednesday, where as a pre-race workout I ran three 8:30 miles with a short rest in between, to give me an idea of how I would feel on race day.

Miles 1-2 had some significant uphills.  I started feeling good around mile 3, which is where I spotted my Dad on the course.  It's rare that someone comes out to a race just to support me, so it felt good to see a familiar face.  Miles 4-6 were a little too fast, averaging 8:30 per mile, but I felt good.  I slowed a bit during miles 7-9, maybe to 9:00/mile.  Then I picked it up a bit, and as we ran the last loop around the Rose Bowl and the golf course, I charged it into full gear, huffing and puffing.

Ten more minutes of pain for the confidence gained from a well-run race.

Finishing time:  1:55:18.  My best half marathon time ever.  And on a hilly, challenging course.  Average mile splits -- 8:48 per mile.

What is coolest is that this race put into perspective for me how far I've come.  When I first came to LA almost 5 years ago, I remember posting to LA Tri Club's web page my big goal, to "Finish a 5k at a pace faster than 9 minutes per mile."  I have just finished a half marathon at a pace faster than 9 minutes per mile.  Wow!!!

This is exactly what I needed to give me confidence heading into the LA Marathon next month.

Me and Tom Ackerman, friend and long-run training partner.

Sunday, January 22, 2012

Really, Paula Deen?

One of the most decadent chefs of the Food Network has recently announced that she's had diabetes for three years.

If you go to her web site, she talks about how she'd like to help her fans see "Diabetes in a new light."  Click on that link and it takes you to an advertisement for Victoza, the new diabetes drug that she is endorsing.

It's like me putting a cigarette vending machine and a hamburger stand in my waiting room, and then subsequently doing angioplasties on those patients.  But then again, unlike Paula Deen, I took the Hippocratic Oath to "Do No Harm".

When interviewed by Al Roker last week, she claimed, “Here’s the thing, you know, I’ve always encouraged moderation,”  But seriously, since when is a hamburger inside of a glazed donut moderation?  And does someone who proclaims that she can't live without butter or a deep fryer have the right to say she encourages moderation?
 This is moderation?   

"Moderation" is about the biggest cop-out there is.  Who can't legitimately claim they eat "in moderation"?  Compared to a stick of butter or a tub of lard at each meal, anything is moderation.

What do you do if you're a chef who has earned her reputation as providing recipes for decadent food, and you yourself end up succumbing to one of the diseases that results from eating that food?  I don't know, but signing an endorsement deal with a medicine to treat type 2 diabetes is not the ethical answer to that question.