Pictures from The Marathon

Before the race, on Ventura Blvd.

Somewhere in the middle of the marathon, chugging along.

The last mile, downtown. In pain.

Crossing the finish line!!!

The cheezy finisher's photo.

More on The Marathon

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

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

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

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

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

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

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

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

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

5,767 out of 17,011 finishers

1,390 out of 6,520 women

217 out of 778 women in my age group.

All in all, not too bad.

Photo courtesy of www.answers.com

4:57

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

Tlred, sore. More tomorrrow.

Race Day Strategery

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

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

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

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

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

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

Getting Psyched for the Marathon!

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

The elephant's rear will be on the back.

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

Shirt courtesy of Running Banana.

Burnout

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

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

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

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

Sick :(

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

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

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

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

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

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

Image from www.luckyoliver.com

I'm a cardiologist, not a pastry chef!

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


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

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

My Valentine

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

The Twenty Miler

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

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

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

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

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

The Suit Experiment

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

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

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

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

Maybe I should wear a suit more often.

Image from www.designerexposure.com

The Zetia Scandal

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

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

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

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

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

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

The Training

My week's schedule for training looks like this:

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

Spirit of the Marathon

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

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

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

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

Image from www.marathonmovie.com

Lentil Pilaf with Bulgur

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

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

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

Ironman Heather???

I think I've lost my marbles.

Ellen, a sorority sister from college, called me today. She's signed up for an ironman in November in North Carolina and since she knows I "do this crazy stuff" wanted to know if I wanted to join her. There was only one spot available, and I pondered it..... and now........

I am signed up for the Beach 2 Battleship Ironman on November 1!!!

Running Smarter

I have vowed to be a smarter runner. That means I take better care of myself so that I don't get injured. It also means being prepared in the case of an emergency.

The metal tag on my shoe is a Road ID. It is engraved with my name, date of birth, and emergency contact numbers. A good idea to have just in case something bad happens.

Athlete Physicians

Saoirse pointed out this New York Times article that describes how athletes often seek out physicians who are athletic.

Knowing this, how can I put it to work for me? Hmmm....
Photo from New York Times, Jan 3, 2008.

Why am I awake this early?

Lately I'm awake by 5 am, sometimes a little earlier, sometimes a little later. The morning is the only time I can reliably get my workouts in, and that way I don't have anything hanging over my head that I *have* to do later in the day.

It hasn't been a good running week for me. My iliotibial band (that's the band of connective tissue that runs along the outside of the thigh) has been very inflamed. I've felt tired. My running has been slower. My worst run was on Thursday, when I got on a treadmill in our hospital's cardiac rehab center in the afternoon, and even at 5.3 miles per hour, I felt completely wiped. Maybe it's because it was so warm in the room, but I've just felt so discouraged this week.

With the LA Marathon only 8 weeks away, I'm worried that I'm not getting in the miles that I need. And I'm afraid of any injuries that could sabotage my running the marathon.

So, this morning when my alarm went off at 5:15 am, I was not thrilled at all to roll out of bed and run an hour and a half on my apartment's treadmill. I'd rather run outside with the LA Leggers, but since I'm on call, I can't be that far away from the hospital.

Today ended up being my best run in the past two weeks. I did a walk/run workout, run for 9 minutes, walk for 1 minute. It averaged out to a 10:33/mile pace, which felt good, and I finished eight and a half miles in an hour and a half. My iliotibial band (ITB) only hurt a little bit.


This is a foam roller. It has been the savior for my ITB woes. By rolling on it with body weight, it helps dissipate scar tissue, and makes running much easier.

I'm very grateful for today's run. Had it not been so good, I really would have been discouraged.

Happy New Year!

My Resolutions:
1) Complete my first half ironman distance triathlon -- Vineman 70.3 in July.
2) Run the LA Marathon in 4:30-4:45.
3) Help my 53 year-old father complete his first triathlon.
4) Learn Spanish. Es mui importante en California.
5) Keep up with the cardiology literature.

I think that's enough.
Happy New Year everyone!

Passed!

I just found out that I passed my interventional cardiology board exam!!!

It was a lot of studying, and such a relief.

Training Update

I'm training for the Los Angeles Marathon, my first marathon in six and a half years. Even though I'm a few years older, I'm going to finish faster by training smarter. My goal is to run the marathon in 4:30-4:45. If I can maintain the 10:30 per mile pace from the City of Angels Half Marathon, then I can do it.

Part of my training is running with others, which is something I've never really done before. I've joined the Los Feliz Flyers, a group that does weekly track workouts. The group has all sorts. There are some rather hardcore members, and then there are the "TOG's" -- The Other Group. The TOGs are a little slower than the hardcore group, and we run a total of three miles for a workout. Last week, we did 800 m at 5k pace, then 1200 m at 10k pace, 800, 1200, and 800. It's a good group, not competitive, and I find myself somewhere in the middle of the TOGs pack.

Next, I'm joining a group for my longer runs, the LA Leggers. They have several pace groups and meet early on Saturday mornings. This morning I tried them out for the first time, joining the twenty or so members of the 10:30/mile pace group -- I wasn't sure whether to run with the 11 minute/mile group or the 10:30's, but I think I chose well.

Where Does Cholesterol Come From?

Of course it's not real shrimp. But it's tasty and nutritious -- VegeUSA's Vegan Shrimp with Sweet Chili Sauce. This whole plate of "shrimp" is 140 calories, 4 grams of fat, and zero cholesterol.

Did you know that "real" shrimp has twice the cholesterol as the same quantity of beef?

Lately, I've tried an experiment -- I've asked my patients with elevated cholesterol, "Do you know what foods have cholesterol in them?" The answers are interesting. Many patients just don't know. Sweets, oily foods, fat, they say.

The answer is simple: Animals make cholesterol. So anything that was an animal, or came from an animal, has cholesterol in it. Beef, chicken, pork, fish, seafood, dairy, and eggs are full of cholesterol.

A vegan diet, which is a without animal products, is cholesterol-free. And cutting back on animal product consumption, or better yet, following a vegan diet, will lower cholesterol.

Giving Back

Volunteering has always been something that is important to me. I feel very lucky to be where I am in life, to have had great family and mentors to guide me toward my career in cardiology. Because of this, I decided to put my talents to use, and I am the cardiologist of the Los Angeles Free Clinic. I volunteer one evening a month to see uninsured patients who need a cardiologist.

Tonight was my first shift. It was an interesting and rewarding experience. It's very different to think about practicing medicine in a situation where we can't order the tests we take for granted. Echocardiograms, stress tests, and cardiac catheterizations take months to obtain. So I have to rely on my clinical judgement and physical examination skills.

Easy Meal

A quck, easy, and healthy dinner from Trader Joe's:Sweet Potato Bisque soup, straight from the carton to the microwave. On the plate, lentils (ready to eat right from the bag) on leftover whole wheat couscous. And, a salad with baby beets and black berries, with ginger sesame dressing.

Thoughts from a Weekend On Call

It's been a busy weekend. I didn't get a chance to work out, which makes me feel like a complete sloth.

I do love my job. I save lives. Honestly. And it's a great feeling when I do get the chance to help someone.

Other times, I'm asked to see patients who are critically ill, who have already something very bad happen to them. Often it's like being asked to see Humpty Dumpty after he's fallen off the wall, and being asked to do what all the king's horses and all the king's men can't do.
This weekend has had elements of both, and I am emotionally exhausted.
Image from www.alphabet-soup.net

Rave Run

This might have been the coolest run ever.

Griffith Park has a holiday light display every year. You can idle through in your car after waiting in a long line.... I chose to run!

Ella Corre -- City of Angels Half Marathon Race Report

"Ella corre" is "She runs" in Spanish. I'm learning Spanish. It's a good skill for a physician in Southern California to have. So to practice, I may throw a little Espanol into my posts.

It was cccccooooolllllld this morning! As we waited for the start, it was about 41 degrees. If this were any other city I've lived in (Detroit, Rochester NY, Boston), it would be expected to be this cold in December. Not in Los Angeles. We huddled in Griffith Park by the heat lamps, then shivered in the porta-potty lines before the race started.

The first five miles were in Griffith Park, which is where I've done my training runs. My goal was to run 10:30 mile splits, and at the halfway mark to pick up the pace if I felt good.. My first four were about 10:00-10:15. Part of me was excited, and the other part of me was worried that I'd lose steam.

I lost a little bit of steam, and my splits slowed down, but not too much. The scenery was nice -- Griffith Park, Silver Lake, Echo Park reservoir, and then into downtown LA.

My main issue was gastrointestinal. My stomach felt heavy, like I would throw up, or worse. And while a well-timed Gu packet gave me more energy, five or ten minutes later my stomach was getting angry at me. This is an issue I need to figure out well before Vineman 70.3 in July 2008.

Even now my stomach is screwed up. I planned to have a Tofurky sandwich on whole wheat with lettuce, tomato, and guacamole. Instead I had a banana, sweet potato soup, and two slices of whole wheat toast with Earth Balance and strawberry jam, and my stomach didn't really like that either.

So, anyway, my lackluster time: 2:17:47. I ran two half marathons last year on 2:11 and 2:12. I've slowed down this year, probably because I've cut back to running 4 times a week, maxed out at 24 miles in a week, and I'm a year older. On the flip side, I have added a spinning class each week to cross train, and unlike last season, I haven't been significantly injured. Maybe for me slower is smarter.

Biggest Loser and Why Can't Everyone be So Successful

The reason I really like this show is that it demonstrates that people can become healthier by losing weight, exercising, and eating healthfully.

On the most recent episode, the remaining seven contestants met with the show's doctor. One contestant's cholesterol dropped by 100 points. Another who was pre-diabetic no longer was glucose intolerant. And, one contestant who had hypertension no longer needed to take blood pressure medication after his large weight loss.

These feats were all accomplished by a change in lifestyle -- not with medications.

Why can't I get my patients to do the same? Many of my patients are overweight, eating terribly, with risk factors for heart disease -- diabetes, high blood pressure, abnormal cholesterol. They're often fortunate that they have not had a heart attack or stroke YET.

I try to give them the knowledge to eat well and exercise on their own. Most are receptive to my advice and willing to make changes. But invariably, they come back a few months later.... HEAVIER!!!

Sometimes, I liken it to my high school cheerleading coach, who when she would get annoyed at us not listening to her, would turn around, face the wall, and continue to talk, until we all noticed and started giggling. I feel the same way -- I might as well be talking to a wall.

But, I think a lot of it is our society. Sedentary is acceptable. Restaurants serve non-healthful foods -- they really don't care how healthy their food is for the most part, as long as it tastes good. And when you're hungry on the run, what do vending machines have? Junk.

The Biggest Loser contestants are sequestered on "The Biggest Loser Campus". They aren't exposed to negative influences of society. They have personal trainers. They have healthy food.

I have had one successful patient who I cared for during cardiology fellowship. He was hospitalized with a heart attack. He was a smoker, overweight, with a history of high blood pressure and high cholesterol. I gave him my usual talk -- quit smoking, eat better, consume more fruits and vegetables and less meat (most doctors won't say this, but it's true, meat is not good for you), exercise and lose weight. He quit smoking, lost 50 pounds, and as a result, dropped his cholesterol and blood pressure. In the two years that I cared for him after his heart attack, he did really well, without any angina (heart-related chest pain), and lower blood pressure and cholesterol levels.

Lifestyle change is possible. It takes a motivated person. When successful, these people can live longer, healthier lives.

I Want to Swim!!!

Those are words you'll rarely hear me say.

In my two full triathlon summer seasons, here's how it works: I burn out toward September, and get sick of biking and swimming. Then I start running more and train for a half marathon. And then I do whatever on earth I feel like to stay in shape, treadmill, kickboxing, spinning classes, until March, when it's time to get back in the pool and dust off the road bike for another season.

But I have more ambitious goals now...... I'm training for a Half Ironman!!!!!



Yes, that's 1.2 miles of swimming, 56 miles of biking, and a 13.1 mile run.

This past season, I had no coach. But to do a half ironman, I definitely need one. So, I'm going back to my coach from Rochester, Mary Eggers of Train-This. She is a triathlete superstar and will be my online coach.

I've found a local masters swim group. And I want to swim! After the City of Angels half marathon on Sunday, I'm ready to start training for my first half ironman!!

Vegan Thanksgiving 2007

Tofurky

Stuffing, gravy, cranberry sauce, sweet potatoes

My plate!!!! Gone in no time. Clockwise from upper left: Corn muffin, tofurky with gravy, stuffing, cranberry sauce, sweet potatoes, green bean casserole, squash, and a generous helping of mashed potatoes and gravy in the middle.

Staying on Track During the Holidays

Sometimes we fall off the wagon and a few pounds creep on. We ease up from our good habits, cut out a day or two of exercise, slip up on the diet with a few extra cocktails or chips and dip at a few social gatherings. Over the course of a few weeks, they may lead to a few extra pounds.

Now, we don't just gain weight for no reason. Our weight reflects a balance of what we take in, food and beverages, and what energy we expend by exercising or through our daily activities. A gain in weight means we're either moving less or eating more, or both.

The first thing to do is to take a step back and analyze what it is we're doing wrong. Next we have to decide how to correct that.

For watching what we eat, one of the most effective strategies I've found is a food diary. Write down everything you eat, the quantities of each food, and the number of calories. Share the list with your doctor. Or, use it to be accountable to yourself. That way, if you're tempted to have another four cookies, you know you'll have to write it down, and will be less likely to splurge.

And, even if everything you eat is vegan, that doesn't automatically mean it's healthy. I'm a big fan of Turtle Mountain Purely Decadent vegan chocolate almond fudge brownie ice cream, but even vegan treats need to be consumed in moderation.

Exercise time is one of the first things to disappear at this time of year too. But, make a commitment to stay in shape. Write in exercise "appointments" on your calendar, just like any other appointment that you would make. Or, if your exercise routine is getting stale, try something new.

I find the show The Biggest Loser to be really inspiring. If you've "fallen off the wagon", I find it helpful to see people who are even farther off from their goals reach them through hard work.

Have a great Thanksgiving!

Back on the Bike

After my Long Beach Triathlon disaster, my bike has been sitting in my living room unused. I've been doing a lot of running to get ready for the City of Angels Half Marathon on December 2. My cycling has been limited to a weekly spinning class at Bally Fitness to keep my quads strong and avoid muscle imbalance issues that led me to major iliotibial band problems last year.


But, as I plan on finishing a half-ironman this coming year (1.2 mile swim, 56 mile bike, 13.1 mile run), I need to be riding on the roads. The LA Tri Club had a (mostly) women's beginner ride, 32 miles up the Pacific Coast Highway from Malibu. More experienced riders called the route "mostly flat". For me, not so much.

The first sixteen miles were okay. On the last sixteen, my legs felt like jello toward the end. Which tells me, I need to ride more.

Next: getting back to swimming. I haven't swam since my last triathlon either.

Veggie Stew

Sautee vegetables in oil for five minutes. I used potatoes, cabbage, carrots, cauliflower, and celery. You could easily use any other vegetables. Peas, corn, or sweet potatoes work well here. Then add broth. Simmer for 25 minutes. Then add soy sauce and flour. Cook another 10 minutes. Season to taste and serve over rice or pasta.

Creamy Corn Chowder

I have never made a soup that I thought was fabulous... until now. This is from the Blossoming Lotus 7 Minute Chef, an online book put together by the chefs of the Blossoming Lotus restaurant, who are the ones who catered my brother and Mary Ruth's wedding in Hawaii.

The soup is not hard to make. I started by sauteeing an onion with garlic, salt, and pepper. Then I added some potato, and then water, corn, carrot, and a little soy milk. After simmering, I added roasted cashews, blended half of the soup, mixed it back together, and added some more corn. This made for a very delicious and filling soup.

It's done!

The interventional cardiology board exam is done!!!!! Did I pass? I think so, but I won't know for a few months.

And now it's back to living normally. It felt good to go back to work today, to get out of my apartment where I've been studying for hours on end.

I accumulated a to-do list while studying. It includes baking cookies, getting an oil change, framing my diplomas from the past few years, and buying an ipod. And, losing the two pounds I gained while studying -- sadly, even with running 23 miles, a spinning class, and two days of weight training in a week, while sitting on my rear end the rest of the time a couple pounds crept on.

So back to life. And the picture? Yes that's me. I've decided I need a picture of my face on the blog, instead of the back of my head running past a bunch of port-o-potties.

Interventional Cardiology Board Exam Tomorrow

I've been studying for months. Hopefully, it will all pay off.

Those of us who became board certified after 1990 have to re-certify every ten years. It's a nuisance to study and take exams, but I suppose there's some merit to it -- medicine changes so much in just a few years. In my specialty, interventional cardiology, in ten years alone there have been revolutionary changes to how we perform angioplasty, the medicines we use, and the stents that were just beginning to come into use ten years ago.

One of my mentors, who certified years ago, likes to gloat to me about how he never has to take an internal medicine or cardiology board exam ever again. I jokingly remind him that that's because he's old.

So here goes nothing tomorrow. If I pass, then no more exams until 2012, when I have to re-certify in internal medicine.

More Eat Your Veggies Meals

Peanuty noodles, greens medley, and baby carrots.


Tofu scramble, yucca fries, and strawberries.

Eat Your Veggies Delivery Service. They've even fed Alicia Silverstone. And these two weeks before my interventional cardiology boards, they're making my life much easier.

Take your meds, please

One last important word on how to be a good patient: If you can't afford the medications precribed for you, please tell your doctor before you are discharged from the hospital. Especially if one of those medications is Plavix. And ESPECIALLY if you just had a coronary stent placed.

What are you dressing up as for Halloween?

I'm told that my office staff dress up for Halloween. It's festive, it's fun.

I'm not dressing up. Here's why -- I don't look like a cardiologist. As a young woman, I look nothing like your stereotypical, gray-haired cardiolgist. I'm mistaken as the nurse, the physical therapist, the nutritionist, the social worker -- you name it. And not just by patients, but by health care workers as well.

Some patients have even told me that because my last name ends in "-man" that they assume I'm -- a man!

In a world of stereotypes and preconceived notions, I need all the credibility I can get. Hence no costume.

Photo from paranormalworld.net

Curried chickenless wrap, Jicama slaw, and Banana

Here's day #1 from Eat Your Veggies vegan food delivery service.

What is jicama anyway? I don't know, but jicama slaw is tasty. With a side of cold lentils and watermelon for dessert, this was dinner. And it was delicious!

Now back to studying.....

Blog Slowdown

That's my niece. Aunt Heather buys her cool shirts.

The blog has been slow, and until after my interventional cardiology board exam on November 8, there won't be too many posts here.

For now, life is work, studying, and working out. I simply can't get by without my morning run or workout, so even if that means missing an hour or two of sleep, I'm better off for it.

In fact, to avoid grocery shopping and cooking, I'm trying out Christy Morgan's vegan meal delivery service, Eat Your Veggies. I'll post a few pictures and let you know how it is, but the meals she's dropped off look scrumptious.

How to be a Better Patient

Here are a few suggestions for how to get the best health care from your doctor that you possibly can:

1) Know your medical history and what medications you take.

Some patients have no knowledge of what medications they are taking, what their medical history is, or what medical procedures they've had.

Yes your information may be "in the chart", but sometimes that chart isn't readily available. You may have another doctor prescribing medications, and you may not be taking the medicines listed in the chart. For example, if your blood pressure is high it's important for me to know that the rheumatologist started you on prednisone two weeks ago, or that your primary care doctor stopped your lisinopril because of that pesky cough.

Also, it is very helpful to carry a current list of all of your medications and doses.

2) Describe your symptoms in simple terms.

We learn in medical school that 90% of medical diagnosis is taken from the history that we are given by the patient. The best descriptions are the simplest: "I have crushing chest pain that started two hours ago and radiated to my left arm." "I have angina" is not a description of your pain. As a doctor, I need to know your exact symptoms.

You do not need to describe to me the workup you've had since walking into the clinic or hospital. "My blood pressure is high and they did an EKG and drew blood from me" is not the information I want. I know this already. Tell me what symptoms brought you here.

3) Take your medicines as prescribed. This is especially true with hypertension (high blood pressure).

Blood pressure medications are not to be taken on an as-needed basis. You need them every day. Some patients tell me that they can "feel" when their blood pressure is high -- this is not true. That's why hypertension is called The Silent Killer.

If you have any doubts as to whether you should take a medication, ask me. I'd be glad to explain the benefits of the medications that I've prescribed you.

4) If you do not speak English well, please allow me to use a translator to converse with you. That way, we will understand each other better, I will know what your concerns are, and you will understand what your plan of care is.

Image from http://www.arealahec.dst.nc.us/medical.jpg

Vegetarian Wedding

My brother, Kevin, and his fiancee Mary Ruth tied the knot last weekend in Hawaii. The wedding ceremony, as you can see, took place on the beach.

Blossoming Lotus, a vegan restaurant, catered the event. The food was nothing short of amazing!!!

Noodles and edamame, spring rolls, and Migthy Aphrodite's Greek Salad (with "Feta" cheeze).

Senorita Bombia's Enchilada Casserole, with mole sauce and sour cream.

And, last but definitely not least, the cake. Ahhh... a vegan cake. I can't remember the last time I ate cake at a wedding. This was delicous and pretty!

I had hoped to submit this to VegNews magazine for their vegan wedding issue, but sadly it's too late this year. But here it is, an awesome vegetarian wedding.

How the Mighty Have Fallen

I used to cook a lot. In fact, my initial intent of having this blog was to show how easy it is to cook healthy vegan meals. But lately, I've done so little cooking. Almost none, in fact. Much of the reason is, ironically, time -- balancing a new job as a cardiology attending, working out, studying for my interventional boards, and occasionally spending time with family and friends. On top of that, it's so easy to call up Green Leaves for a seitan wrap and a miso soup to go.

Tonight, for the first time in a while, I cooked. I sauteed broccoli and onion in my wok with General Tso's sauce and paired it with some pre-cooked wild rice from Trader Joe's.

Once the boards are over, I'm going to cook more. I miss it.

Here is a nice positive article about vegetarianism, entitled "Protein a key concern for vegetarians"

It's very positive about vegetarianism. It talks about a restaurant in Atlanta called Cafe Sunflower -- I've been there and it's delicious.

But, I disagree that protein is a "key concern" for vegetarians. Anyone who consumes a balanced vegetarian diet will get plenty of protein. We only need 10% of our calories from protein. Most Americans are well in excess of that.

And why don't we talk about the "key concerns" of the standard American diet -- obesity, diabetes, heart attacks, stroke, osteoarthritis, hypertension, high cholesterol........ ???

Adventures in Raw

Leaf is a raw vegan restaurant with two locations in LA. My omnivorous friend Jodi absolutely raves about this place, so when I met up with her for dinner tonight, we headed to Leaf in Culver City.

We had the mock salmon nori rolls as an appetizer, which was really delicious! For a main course, we split a Bombay Burrito Wrap and a Rawzagna (that is, lasagna but made raw!). Both were pretty good. And, for dessert, we had apple pie. I was pretty skeptical about raw dessert -- last time I had a raw dessert item, a raw chocolate brownie, it did awful things to my gastrointestinal system. But, the apple pie was amazing, and there were none of the previously experienced after-effects.

I'll admit, I haven't had a lot of experience with raw cuisine. I've heard talks on the subject and how food is not heated above a certain temperature to preserve the enzymes in the food, and how the enzymes are beneficial to our bodies. I don't buy into this theory and there's really no science to back it up. But, what I can say, is that raw is healthy in that the food isn't processed, has no animal products or cholesterol, is full of fruits, vegetables, and fiber.

Is Bigger Better? Maybe not.

Here's a great piece on why height matters in sports.

Now it makes more sense to me why, at 5'10", I do well in the swim portion of the triathlon, but not as well on the bike or run.

One of Many Reasons I Love LA

This restaurant is on the way between the two hospitals I work at. I tried it out for the first time tonight for a Seitan wrap as dinner on the go. The wrap was delicious and the folks behind the counter were really nice people. They're going to be seeing a lot more of me.

I can't get over how easy it is to be vegan in LA!

Going Green

When I moved here, I was excited to be living in a greener community, one where people care about the environment. After all, I recycle everything I possibly can. It almost pains me to throw a piece of paper in the trash.

So, I was absolutely stunned to find out that my apartment didn't recycle anything! And neither did my office! Over the past few months I've collected my recyclables from home and hauled them up to my brother's place whenever I had the excuse to visit and play with my niece. In hopes that my apartment might consider recycling, I contacted the city to see if they might be able to talk our management into recycling.

Today I received a pleasant surprise -- a flyer on my door saying that my apartment now recycles bottles, cans and plastics! They don't recycle paper, but this is a nice start.

And, since joining the cardiology practice where I'm at, we now recycle pop cans. I've even gotten them to go vegan for lunch on my birthday, which is definitely a green thing to do. I'd love to see them recycle paper.

So, speak up -- you can make change happen.

Image source: www.bserecycling.com

Flat

That's the one word to describe my experience at the Long Beach Triathlon today.

I thought the race would be interesting for different reasons. I raced the day after Yom Kippur, the Jewish day of atonement, on which I fasted all day before the race, and I wondered if that would impact my race times. I entered in the Athena category, for women who weigh more than 145 pounds, when I normally race in my age group. The water was polluted and disgusting after a day of rain yesterday, which I thought was interesting, as all the other beaches in southern California are closed for this reason.

The swim went well. The water was gross, but I tried not to think about that. I got out of the water, onto the bike. "Your back tire is almost flat," I heard. And I could feel it, but I thought, maybe I can just finish this short 10-mile course with the tire being *almost* flat. No such luck. About two miles in, it was completely flat.

I was on the side of the road, panicked. I had two tubes. I had a lever to pull the tire off. But, I did not have a pump or a CO2 cartridge. I was absolutely panicked. My race is over, I'm going to quit. Then I saw a man fly off his bike and hit the pavement. I dropped my bike and ran over -- "Are you ok? I'm a doctor." Fortunately he didn't need my doctoring skills, or what little I could do out on a triathlon course, and he got back on his bike and kept going.

One woman helped me pull my tire off my bike, remove the tube, and put a new tube in. But still, I had nothing to inflate it. I yelled out to people riding by -- "Anyone got a pump?" A couple people threw me their pumps, but they didn't fit the presta valve on my tire. Another woman with two flat tires joined me on the side of the road. Then my hero, an 84 year-old man, pulled over. He had a few CO2 cartridges and was able to provide air to both me and the other woman with flat tires. "I'm 84 years old, just being here and finishing is all I want." Wow.

Next I fiddled with the bike and was able to put my back tire back on the bike. I sliced my finger and had chain grease all over my hands, but now about what felt like a lifetime later, though it was probably only 30 minutes, I had a functioning bike.

I thought about quitting. How embarassing a finish will this be? I'll be dead last. But I thought more about it. I'm no superstar. I just come here to do my best. And, I can cheer people on. I'm now officially at the back of the pack, with the people who need the most encouragement.

So, back on the bike, I rode past the Queen Mary ship, and finished my first loop of the bike course. There weren't many people out on the bike course, and I could have gotten away with pulling back into the transition area after doing only five miles on my bike. No one would have known, except me.

But I took the second loop. There were no bikes with me. I had an air pump in my back pocket to return to a racer who loaned it to me. I'm going to be last, I thought. Dead last. In this race, though, there is a prize for the last place finisher. That would be cool, I thought, last place prize. As I continued, I passed a couple dozen people on their bikes. When I rode by a photographer, I pulled the air pump out of my back pocket, waved it in the air and yelled "Whoooo hooo!" Yah! I'm the girl with the flat! And I'm gonna finish this stupid race!!!

Finally I got to the transition area. People were picking up their belongings and heading home. That would have been me. How frustrating. And I had three miles left to run. So I headed out for my run. Yelled for my back-of-the-pack brothers and sisters. Looking great! Way to go! Almost there! I was full of energy. Someone I ran past even asked, "Where do you get all that energy?" "I get it from sitting on the side of the road for 30 minutes with a flat!" Maybe I shouldn't have said that. Oh well.

Running into the finish chute, I was alone. The announcer had enough time to call out my name as I ran past. Cool.

And to top it all off, someone took my wetsuit home with them.

I would have loved to finish in style, no flat tire, giving it my best effort. What I've learned from this, first and foremost, is how to change a tire during a race, and to make sure I have all the equipment with me -- tubes AND CO2. Worse things have happened.

Hospital Cafeterias

When our patients are hospitalized, we work so hard to teach them how to eat -- low fat, low cholesterol, high fiber, and so forth.

But what does the cafeteria serve? Junk. The entrees are covered in calorie-heavy sauces. There are burgers, and fries, and onion rings. Maybe there's a vegetarian entree, and my hospital prides itself on always having at least one vegetarian option, but that item typically is smothered in cheese.

Yes there is a salad bar and garden burgers are available. But I believe we are sending our patients a mixed message by offering less healthful options.

It's a shame that hospital cafeterias sell out our patients.
Picture from www.roadfood.com.

Beaten Up in the Cath Lab

Reportedly, a physician at a San Diego hospital beat up on a patient during a cardiac catheterization procedure. While I don't condone this behavior in any way, I can understand as an interventional cardiologist how something like this could happen.

The cath lab is a stressful environment. The procedures that we do are very intricate and do carry significant risk. We're dealing with coronary arteries that are only a few millimeters wide. Often our patients are quite sick.

Further, we demand a lot of our patients. We ask them to lie flat and completely still on a narrow, hard table. This is uncomfortable, especially for older patients and people with back problems. While we give sedation medication, our patients are not completely knocked out and they do have to deal with the discomfort.

Often patients for various reasons find it hard to cooperate, and thus they move. Our equipment is literally laid out on top of the patient. So if they move their leg or arch their back to adjust themselves, they not only risk tossing important items on the floor, but they risk harm to themselves as they disrupt our delicate work.

While this physician who allegedly beat his patient is innocent until proven guilty, such violence toward a patient doesn't need to happen, and it shouldn't. The patient could be given more sedation. Or, soft restraints could be used. The patient could even be completely sedated and intubated to facilitate the procedure being done.

So, you combine the difficulty of a patient to lie still with the stress of a physician doing a complicated procedure. But beating up a patient is just not the right way to deal.

And the Birthday Celebration Continues

To celebrate my birthday, I had the opportunity to choose where we were ordering from for our Friday lunch -- we order out for lunch every Friday. I chose California Vegan. The office staff seemed to enjoy it, if you count second helpings, clean plates, and unsolicited "I've never eaten vegan but this is really good!"

And, going above and beyond the call of duty, they brought me a vegan chocolate cake! Mmmm yummy!

Happy Birthday to Me

Today I turned 32. My brother baked me a pineapple upside-down cake for the occasion.

How cute :)

Watch Me Finish the Triathlon!

This is too cool. Click on this, then enter my race number, 847. Then click my name and "select athlete".

You'll see me running about ten seconds into the clip.

My First Olympic Distance Tri -- Done!!!

Woo hoo!

Late Arrival
I couldn't find the shuttle buses in the morning. So I got to the transition area around 6:40 am. The announcer was talking about all athletes clearing the transition area. As he's saying this, I look around and see the very long lines for body marking (where race numbers and ages are written on our skin with permanent marker). As I was wearing my LA Tri Club gear, a woman comes up to me with her own permanent marker -- "LA Tri Club, can I mark you?" What a time saver! Membership has its privileges.

The Swim
The forecast calling for one-foot waves -- dead wrong. On top of this, we had a northward current. Watching the waves before me, I knew exactly where I had to sight while swimming in so as not to get taken off course. I started in the back of the pack for the swim, so as not to deal with thrashing limbs in my way. I relaxed, thinking about it as one of my leisurely training swims at Manhattan Beach. Venice Beach, however, has nasty water -- yuck. I kept a consistent pace, based on the people around me. When I finished and got out of the water, I didn't feel too tired.

Transition 1 -- Swim to Bike
While changing out of my wetsuit and into my bike shoes, I hear the announcer: "The last of the under 35 women are finishing in the water and the first of the over-35 women are getting out of the water now." Thanks for the inspiration. Not.

Bike
As usual, I am slow as molasses on the bike and everyone and their 65 year-old grandmother passes me. The ride was a nice course -- Venice Boulevard to Fairfax to Wilshire to Highland to Hollywood and Sunset and then into Downtown LA to the convention center.

Transition 2 -- Bike to Run
I was nervous that my bag that I dropped off yesterday with my running shoes wouldn't be there. Maybe it's my lack of luck with checked airline luggage. But I was pleasantly surprised. My bag, with my shoes and hat, was there. I still felt full of energy. And off to run.

Run
As I ran out of the transition area, I suddenly felt quite drained. Am I really going to now run 6.2 miles? Am I friggin crazy? And my stomach felt somewhat unsettled. Maybe I needed more fluid, or more Gu. But I just didn't feel like having it sitting there in my stomach. At the water stations, which were frequent, I grabbed a water cup from each, and would take maybe one sip before feeling the urge to get rid of the cup.

My pace was going to be an easy jog. I had no plans for speed. There were two loops. The first one took us way up the hill to the Disney Concert Hall. That hill was absolutely miserable. Many people walked it. I jogged it quite slowly. The second loop had us run halfway up that hill, which after 4 miles of running was also miserable.

But, being a club member does have its privileges. I don't know many people in the LA Tri Club, but "Go LA!" is always a good thing to hear on a challenging run. I yelled it to everyone in LATC gear, some yelled back, others ignored me, and some others just gave a thumbs up.

I finished in 3:33, three minutes off my projected time of 3:30. That's my stopwatch time; I have no idea what the official time is.

Relaxation
I spent my afternoon lounging on the beach. Ahh that felt good.

Next Race
Long Beach Triathlon on September 23?!?!?!?

Breakfast and my T2 Bag

Recently, I've changed what I eat for breakfast. Over the past year I've been working out most mornings before work, and I have found that just a bowl of cereal leaves me absolutely ravenous by 10 am. So, when I wake up I have a small bowl of cereal. Then, after my workout, I eat breakfast: oatmeal, soy yogurt, fruit, and orange juice. That keeps me full until lunch time.

The big triathlon is tomorrow!!! *fingers crossed* And this is the stuff that's going to go into my second transition bag, which I am dropping off at the race expo today. In a triathlon, there are two transitions: between the swim and bike, and between the bike and run. Because the LA Triathlon is a point-to-point course, and the bike begins at Venice Beach and ends in downtown LA, the second transition is in a different location as the first. So, today I have to pack my bag with everything I need for the second transition: shoes, socks, a hat, and Gu gel. And maybe a towel.

The "DB" hat was a gift from my program director back in Boston. It's a bizarre inside joke. But it's a good hat, fits well, keeps me cool during a run, so I use it a lot. And no one in LA knows what "DB" stands for :)

Hydration, klutziness, and other pre-race thoughts

I need sodium while racing. Worst case scenario, I'm on the course for four hours. Gu gel just isn't going to cut it, I'm told. And I hate Gatorade. I tried the PowerBar Fruit Punch drink, which I found to be decent. I'd rather have the taste of plain water for my hydration, but I know I need the sodium.

The sprained ankle is healing, I guess. It's been 3 and a half weeks, and it's still quite swollen. I can do everything on it -- run, bike swim, weights, etc. At the end of a work day, it does hurt, especially if I'm wearing heels. So I've been a bit lazy and wearing scrubs quite a bit to work.

And speaking of being a klutz, I faceplanted yesterday while running. I tripped on the sidewalk and landed on my right side, scraping up my right knee, hip, and both palms. I got up, shook it off, and ran another 45 minutes. I don't know how often normal people trip and fall while running, but it seems to happen to me about twice a year.

Oh and one other thing... I think my weight is fine at 159 lbs. I don't want to lose any more weight. I don't need to.

All this rambling... can you tell I'm a little nervous?

Sweat Rate

It was suggested that I calculate just how much I sweat in an hour. I decided to do this today, in 104 degree heat, as I rode my bike through Griffith Park up to the Valley.

I weighed myself before. Then, during my hour-long ride, I sucked down two 24-oz bottles of water and a Gu pack. I felt constantly thirsty. Normally the bike provides some air conditioning because you're moving at a decent pace. Not today. I felt hot and awful.

My worry with hydration during a long event, such as the upcoming olympic distance tri, is not only of drinking too little, but possibly of drinking too much. Slower endurance athletes like me are at risk of hyponatremia, a too low sodium concentration in the blood from drinking more fluid than what their body is losing.

Even after drinking so much, I weighed myself -- I had lost a half a pound! In that hour of cycling, I had lost fifty-six ounces of fluid. Almost two liters!

Maybe the moral of the story is to not ride in ridiculous heat like this. But at least now I know that in extreme heat, I sweat a LOT.

The Looming Olympic Distance Tri

After my ankle sprain, I thought seriously about whether or not to keep my spot in the LA Triathlon. My ankle was ridiculously swollen and black and blue. Running on it was painful, so I didn't run for the first week. Even kicking while in the pool hurt.

I changed my goal for the race to endurance, rather than speed. I've done plenty of sprint tris, now for my first olympic distance tri, I just want to finish. I may be DFL (dead f........ last), but I'll finish.

My training hasn't been crazy. I do weights for an hour three days a week with my trainer and then six cardio sessions, about 45 minutes to an hour and a half each. I haven't doubled up on workouts much either, in other words, usually just one workout a day. And I think I'm enjoying my training more that way.

One more week. I'm a little nervous.

Shunsh Kashish

That's Armenian for "Take a deep breath."

English is not the first language of the vast majority of my patients. In fact, more than half of my patients barely speak English. If only I spoke Armenian, the first language of 80% of my patients. Or Spanish. Or Tagalog.

I've developed a small vocabulary of Armenian. Just the medical basics. In chveses -- how are you? Lavay -- good. Tsav unis -- do you have pain? Barke -- lie down. Nustie -- sit up. Batz -- open. Pagai -- close. And a few others.

Pee pee and poop are universal words too.

I really do wish I spoke a second language. I took Latin in high school. Everyone told me how helpful it would be in medicine. What a waste. Don't believe the hype, kids. Learn Spanish.

Another Manipulated Story

I'm listening to the radio this morning, and I hear, "A mother in Phoenix is charged with starving her children. They were on a vegan diet."

Then the news man decides to editorialize, "You know, vegan diets just aren't good for kids."

Ok, who made the news man a nutritional expert? Further, there obviously was something missing from the story. There's a very detailed piece from a Phoenix newspaper here. I'll give you the highlights.

Yes, the family was vegan, but....

- The parents were terrified of childhood obesity.
- They shunned doctors. Their children had never seen a doctor, nor did they have any immunizations.
- The children had epilepsy, and even with that disease the parents would not take the kids to a doctor. Instead, they relied on a homeopathic woman who prescribed herbs.
- One child died of untreated grand mal seizures.
- The family limited the amount of time the kids could eat.

Vegan diets are getting more press and more acceptance. It is still frustrating to see stories like this manipulated to make veganism look irresponsible.

Riblet and Stir Fry

I'm all about preparing what's easy for dinner, as opposed to looking for new and cool recipes. Maybe if I cooked for other people besides myself I'd feel more adventurous. This is something a little interesting, I suppose. There's a Gardenburger Riblet, which is full of protein, and baby broccoli and shitaake mushrooms stir fried in a little canola oil and Soy Vay.

Sprained!

I'm on the disabled list again...

On Sunday, I was playing dodgeball. After hurling the ball at the opposing team, I ran backwards, landed on the outside of my left ankle, and fell to the ground onto my right wrist.

I sat down and iced for a few minutes. Then, bored, I joined back in. It didn't hurt too bad.

Now my wrist and ankle are sore. I'm limping and it hurts even to write.

And I'm supposed to meet with my trainer tomorrow morning.

This better heal fast. I have an olympic distance tri in 4 weeks!

Camp Pendleton Sprint Triathlon

It was a different kind of triathlon -- the first one that I've done that was entirely on a military base. It was also the longest bike in a triathlon that I've ever done -- 30 kilometers or 18.6 miles.

I'm awful on the bike. If I was good enough that I could contend for a medal, then this was the wrong race. But this was my usual performance: do well on the swim, get passed by lots of people on the bike, and pass a few people on the run.

I don't have the official results until Wednesday. But I know that based on the distance of the bike and the huge number of people passing me, this was not a shining race for me.

My next goal is to become better on the bike. I'm going to have my bike fitted, just to make sure that any mechanical issues that are slowing me down are taken care of. In other words, that involves taking my bike to a shop and having it fine-tuned to fit me. I think I need to raise the seat a bit, but I'm not sure. My trainer says he's going to be working with me on a spinning bike too.

Next Triathlon: Camp Pendleton Sprint

My next triathlon is on Saturday.

With all that has passed in my life recently, my training has at times been less of a priority.

My last triathlon was over a month ago. Before that triathlon, I put in all the hours, got in all the workouts, yet didn't do as well as I wanted to. This time around, I've done a few things differently.

I have been working out with a personal trainer three times a week. We do strength training, endurance, stability, and plyometrics. They're tough workouts.

Another experiment: I've lost a few pounds. At my last tri, I was 165 lbs (I'm 5'10"), and now I'm 159 lbs; in other words, my body mass index has dropped from 23.6 to 22.8. Both are well within the range of healthy for my height. But, theoretically, less fat moves faster. My goal is a 17% body fat percentage; at last measurement I had 27% body fat.

I can't wait to see how it all plays out on Saturday at Camp Pendleton.