Grasping for Thoreau….

29 May

This blog has been one that I’ve wanted to write for a long time but have been too scared.  I was worried that making this information public would hurt my chances of getting sponsorships or with USA Triathlon and the ITU racing path.  I do mostly non-draft racing now, I have great sponsors who support me tremendously,  I have a triathlon coach who is also a dear friend and a great RMR coaching/teammate support; I feel free to write whatever I want now…

In 2007, I went into an operating room thinking that I had a simple meniscal tear in my right knee. This is a pretty standard operation, the recovery time is very short and it is a pretty shallow speed bump for any runner to overcome.  I woke up in post anesthesia psychosis with someone telling me not to put my leg down on the ground.  Although I was out of my mind, I knew something didn’t sound right. I had a simple arthroscopic surgery and I knew the post-operative course didn’t include avoiding weight on the leg. My confusion was more than just the drugs.  I managed to get in the car and into bed at home- all while obeying these strange instructions.  The next day I went to see my orthopedic surgeon.  She explained to me that I didn’t have a meniscus tear. I had a meniscal cyst- which required a lateral menisectomy (taking the lateral meniscus out).  Ok, I can deal with that.  Bummer, but I’ll be ok- I’ve got a medial meniscus and some good youthful articular cartilage on the other side of the joint. Then she explained that this was the good news…The bad news was that I had a full thickness articular cartilage lesion down to the bone on the other side of the joint.  The lesion was larger than they size of a quarter- about the entire size of the femoral condyle.  She explained that she had to perform a micro fracture surgery that wasn’t even indicated for this size of a lesion but she didn’t have any other option at the time because the lesion was an “intra-operative surprise” (never a good thing).  I really didn’t know what she was talking about at the time so she put it is simple terms: I had almost no native cartilage left on the femur side of my knee joint and no meniscus (a different type of cartilage-like material) left on the tibial side of the knee joint. These things never grow back.  They are like brain cells- once you lose them, they are gone permanently.  She explained that this injury ends the careers of many pro basketball and football players (including most recently Greg Oden of the trailblazers- his lesion was only the size of a pencil eraser though).  She clarified that what this meant for me was that I probably would never run again and if, for some reason, I could run- it would be a very bad idea to try.  In the short term, I would not be able to put my leg down on the ground for at least 3 months and I wouldn’t be able to walk long distances, ride a bike, elliptical or anything else of low impact for at least a year.

UMMM!?!!! This was a shock. I expected a 2 week recovery from a simple meniscal surgery and now I am looking at a recovery of years in duration.  Running for me was like air, I couldn’t live without it. To run pain free was the reason I elected for this surgery in the first place.  “Devastating” was an understatement.  Running was my life in college.  In fact, it is what got me into college and probably not insignificant to my acceptance into medical school.  Running had been one of the few things in life that I was both really good at and loved.

A few months later I moved to Charlottesville to start medical school (still on crutches) and I was resolved to being a student, trying not to get too fat and thinking about other passions I could pursue.  I got off my crutches and started to feel pretty sorry for myself. I was in a haze of self-pity most of the time. Then something happened that put me in my place pretty quickly: My mom was diagnosed with an aggressive breast cancer that she would pass away from 3 years later.  Suddenly my little knee didn’t seem like such a big thing anymore; my egocentric world suddenly seemed pretty small and insignificant.

In regards to how I handled my knee, my mom’s cancer helped me do two things that seem paradoxically opposed to each other.  The first was that I chilled out about the knee big time.   I didn’t try to come back too fast, in fact- I might have waited longer than a year to ride a bike.  I would swim occasionally with a pull buoy without touching the wall but, other than that, I did a whole lot of nothing.  It would have been nice to have the stress relief of going for a run during those times but the neurotic aspect of my running was gone. I was ok just to sit and heal.

During that year- I did go to two different well-renown orthopedic surgeons (one at UVA).   I asked for a second opinion about the running and they both told me not to do it even if I could. They told me I would have disabling pain within a year and a knee replacement would be imminent.    I also combed the internet trying to find runners who had recovered successfully from this surgery. Almost every blog or thread I read was not good news; Just pain, complications and failed attempts at running. I did find one guy who ran a marathon after micro fracture, but he described his lesion, again, as the size of a pencil eraser- not the size of a quarter like mine. After a while, I gave up hope on running and picked up cycling about a year and a half after my surgery.

I actually wasn’t too bad at cycling.  I ended up riding for the UVA team and got 2 first places and a second place (in a sprint) in the three races I went to. (for any cyclists- this was in B, I never did enough races to cat up to A). I did the womens cat 4 Virginia State Championship Road Race and won that on a hill top finish.  I think I was wearing a running singlet and got a few curious stares by all the seasoned cyclists there.  I also started swimming again. I swam as a kid but swimming had always taken a back seat to soccer growing up (how I wish I had done year round swimming as a kid now!!). Being in the pool with some friends was fun and I was actually starting to get into some type of unintended swimming shape.

So I mentioned that my mom’s cancer did two things for me in regards to my knee. It slowed me down, helped me be patient in healing and took away the neuroticism that running develops in you to do stupid things like return from injury too soon. I don’t have any pain in my knee today, haven’t had any pain and don’t expect to have any pain anytime soon. I think this is because I took so many years to heal- my mom gave me this patience and calm during this time.  The other thing my mom’s cancer did was encourage me to give a big “F YOU” to my doctors. (Not really, my doctors were all great and I am going to be a doctor but there is something empowering to the little helpless patient in me about saying it like that).  About 2 years after my surgery, my knee was feeling great and I knew now that life was pretty short and  I wanted to investigate the possibility of running again.  I went to see Dr. Wilder at UVA and that was a good decision.  After looking at my surgery pictures, reading the reports and listening to me when I told him I was a NCAA national qualifier, multiple Division I all-NCAA region/all conference…blah blah blah crap…he responded with a shocker.  He said, “ok, your knee is pretty messed up- but that is what it is. How about we try running and see what happens.”  WHAT THE??!!  You got to be kidding me! There was something that Dr. Wilder knew about me that I hadn’t told him.  I am not interested in having a perfect knee when I am 80 or 50 or even 40 maybe.  My mom was 52 at the time of her cancer diagnosis. I was interested in living a full life right now. There are doctors that save lives and then there are doctors that make life worth living. I needed the latter.

After some physical therapy and another slow year of gradually introducing my knee back to running I decided to try a triathlon. The year of cycling 200+ miles a week paid off.  I won almost every triathlon I entered (2nd in one).  I then won the 2010 Collegiate National Championship as probably my 4th triathlon after my return to running. I got my pro card and the rest in history. The past two years, I have travelled around the country (and around the world some) living this surreal dream of being a professional athlete that can actually make a living doing a sport I love. I cannot even describe how amazing this experience has been. Never in a million years would I have thought I would be doing what I am doing today. I am getting ready to return to med school next week so I’ll be juggling racing, traveling and school now. But I am leading a full life, and one I think is extraordinary enough for me. It is almost painful because I know I will pine for the drama and excitement of these days in the future.  I have a frame a reference now.  Whether, years from now, I have knee issues again or not- it doesn’t matter. I have lived today.

Maybe I have struck gold once here. Maybe, for once, I have managed to muster up both some patience and some urgency in life in just the right dosages; the correct proportion of Sidhartha to Thoreau…Like all things for me- mostly credited to luck and the influence of my mom.

The Myth of the “Insulin or Sugar Crash” during exercise…

28 Mar

I have been discussing this topic recently with a teammate (thanks for the mind fodder Jason!). There is an idea out there that people need to consume “slow burning” sugar (or carbohydrate) during exercise or else your body will experience a “sugar crash” and you will die… (ok-that last part is not really what people think)…but if nothing else, your race will be sabotaged by “quick burning”, “insulin spiking” types of sugar.

I want to tell you all that this IS NOT TRUE and, in fact, THE OPPOSITE IS TRUE about what you should eat during exercise!!!

First, I want to define the difference between a “simple” and “fast” vs. “complex” and “slow” sugar. “Simple” and “fast” do not mean the same thing. Simple means that the sugar is a monosaccharide or disaccharide- ok what the hell does that mean?  It means that the sugar is made of one or two units of something.  For instance, fructose is just one block of fructose and glucose is just one block of glucose.  Sucrose is a disaccharide (or made up of 2 units of something). Sucrose is made up of a block of glucose and a block of fructose stuck together.  According to the National Institute of health, a “complex” sugar is one that is made up of at least three “blocks” of something. (http://www.nlm.nih.gov/medlineplus/ency/article/002469.htm)

Maltodextrin is by definition a “complex” carbohydrate because it is a polymer and made up of many “blocks” of glucose pieces stuck together (In turn, starch is a bunch of maltodextrin pieces stuck together and is also, obviously, complex)  Here is why I have to define these terms though- Maltodextrin is a COMPLEX carbohydrate that acts like a “FAST BURNING” sugar…ok that is just crazy but it is true…

So I obviously have to prove it.  How quickly a sugar “burns” or is digested, absorbed and has an effect on your bloodsugar is described through the glycemic index (the higher the score, the more quickly the sugar is digested, absorbed and affects blood sugar).  This index is subject to a lot of influencing factors, including whether or not you are consuming fat, protein and fiber with your carbohydrates- but putting that aside and just looking at the sugars- we get an idea of how quickly these sugars act. Here is a very rough (but hopefully ball park accurate list- it is tough to get this information because the glycemic index is almost always represented in real foods for practical reasons):

Glucose 85-111
Maltodextrin 105
Honey 32-87
Sucrose 58-65
Lactose 46
Fructose 12-25

So you see now that maltrodextrin is a “complex” sugar that “burns fast” and fructose is a “simple” sugar that burns “slow” (However there are other problems with fructose in the way it is processed in the body that go beyond the scope of this article that don’t really make it glycemic index friendly in large quantities- but this is a separate issue).

So getting back to what to consume during exercise.

During rest, you can experience a “spike” in blood sugar and a subsequent rise in insulin that causes a “crash” or mild hypoglycemia (low blood sugar) a bit later.  This is true, DURING REST. See graph below:

(source: http://www.trifuel.com/triathlon/nutrition/carbohydrates-for-endurance-000418-print.php)

BUT…this graph is NOT TRUE when you are exercising or racing!!!!  This is the myth that a lot of people carry around that is insane in the membrane.  We have evolved (if you believe in that type of thing) to fight tigers and ligers and dinosaurs (right?) and that is why we have historically exercised.  To do this our body produces an adrenaline response when we exercise, similar to a “fight or flight” response.  When we exercise today our body thinks we need to fight something or hunt something so it is smart and increases our heart rate for the battle, shuts down our digestive system and shunts blood to muscles, adjusts our pupils so we can see better – and lots of other stuff too- but it also decreases insulin production out of our pancreases so we have consistently high bloodsugar levels for the battle with the dinosaur.   And this is why you will not have an “insulin crash” during exercise!!!  (this is also why you need to worry about sparing your glycogen stores during exercise- because that glycogen is getting broken down to keep blood sugar up but that is a separate discussion for another article as well)

So why does this matter- it matters because sugars that are higher on the glycemic index typically absorb quicker than those lower on the index.  Gastric emptying times (how fast the sugar gets out of your stomach) are shorter.  And this matters A LOT during moderate to hard exercise.  Remember how I said when you are fighting the dinosaur that your body shunts blood from your digestive system to your muscles for the battle??  That is also what happens when you exercise.  So gastric emptying is a BIG DEAL!! It is an even bigger deal if you are racing or exercising hard-  I am sure everyone who reads this has experienced that truth in all its vomiting glory at one point in their lives during a hard interval or race.

Therefore, high glycemic sugar is where it is at for exercising and immediately after exercising (for quick absorption recovery purposes- beyond the scope of this discussion).  Hammer Nutrition is  super researchy with their products and they have found that maltodextrin has the fastest gastric emptying time. Hammer gels use maltodextrin almost exclusively (a little fruit juice too) as their carbohydrate source and that is why I use them – most nutrition companies do not use maltodextrin at this time because it is a more expensive ingredient to use than alternative sugar sources.

Conventional wisdom is currently that one should eat low glycemic index foods during rest and prior to exercise and high glycemic (preferably maltodextrin for during) during and immediately following exercise.

Now if someone tells you to eat whole wheat bread or some crazy sh#t like that during exercise to avoid the “sugar crash” you can call BS on them and know exactly why they are whack….

First Professional Win- REV 3 COSTA RICA!

21 Mar

This race was one of the toughest, hottest, most fun races I have done yet.  It was about 12 minutes long for an Olympic, 97 degrees for the day, 10+ extreme UV index, high humidity, super steep hilliacious climbing for the first 2 miles in and out of transition and fairly hilly run- a quarter or which was on sand!

Race morning I was a little nervous about my gearing on my bike- this course definitely requires a 28 cassette and I only brought a 23.  This was my major learning point of the trip. Always always make sure you know the course in case your gearing is off.  With the grade of hills out of transition, I was imagining myself walking my bike up the road ( “please let there not be a Slowtwitch gallery picture of me WALKING my bike on the course, God!”). Blaaahhh!…

Swim

This was one of the first swims that I was actually able to draft the whole time- wow, what a difference! The effort felt quite a bit easier than usual but I didn’t feel I had the power to get around and make it on my own so I sat in and let my super speedy Profile Design Macho speed suit do its thing.  I knew it was going to be a long, hot, death-march type day so I was happy to be a little conservative in the swim.  I came out with 2 other girls and we were about 1:20 down from the leader (kind of a lot of time but I felt great out of T1 so I think this was the right choice- I am rarely under a minute down anyways…)

What is a speedsuit you say?:  http://www.youtube.com/watch?v=ZGgdxXnlto0

Bike

Straight out of T1 we rode on a gravel dirt road for about 200 meters.  Pretty awesome- just have to cross your fingers with your tires and hold on tight…..but made it out the other side ok…

Then we started climbing…grades were really high in some places- like probably 15+%… I said earlier that I had a 23 cassette (EVERYONE else has a 27/28) and it was a total standing, grind-fest for the first 2 miles up and down these crazy climbs.  I got caught at the top of the last hill, which didn’t surprise me at all but then really pushed hard on the downhill and got away again.  One of the things that is really awesome about my Quintana Roo CD0.1 bike is that it is soooo super aero. Riding downhill I am able to stay with people much heavier than me- which rocks going downhill in races. Thank sooo much to Skip at Nytro for helping me with my bike..Nytro does so much for the triathlon world- they rock!!  http://www.nytro.com/

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I had the new Altair profile design wheels on and they rode super fast too- very happy with them and an AMAZING value if anyone is in the market. Also had the new Profile Design Volna Aero bars for the first time- which literally have taken 1.5 pounds off my bike- amazing how much aerobars matter!! I had no idea!!

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http://www.profile-design.com/profile-design/products/aerobars/carbon-aerobars

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….Anyways, I got to the front of the bike race by the middle of the first loop, but it took me quite a while to catch Bree Wee- who was in first most of the bike. Super strong cyclist and super fun person…and awesome picture of her racing a cow on the rev3tri.com site:  http://rev3tri.com/live-posts/pro-bike-action-photos/ganadores-2/  With about 8 miles to go, I started to get really really hot. This is when I learned my second lesson of the day.  Remove the vent block in my Rudy Project Wingspan aero helmet when it is 97 degrees out…you think I would have figured this out by now.  The Wingspan has this great design where you can interchange the vent space pieces depending on the weather:

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    Check out all the massive vent area if you freaking remove the cover!!

But obviously there is user error if you don’t actually use this great function =)  So my head was getting very hot – I decided to start singing to myself. I figured this might take my mind off the fire burning under my helmet…so what better song to sing than “Ho Hey” by the Lumineers:

I came into T1 first off the bike with about 30 seconds- so figured I had some time to put on some socks…and Yes, I am the only pro I know who wears socks in an Olympic distance race….

Run

I was fairly confident that I was one of the faster runners in the field but you never want to be too confident of anything so I definitely tried to get into a comfortable cruise rhythm pretty quickly- not too fast, not too slow.  The one issue I was having was the heat but three things saved me:

1-      Lots of salt the night before. This is a trick that a lot of pro use…I literally drowned my food in salt the night before a hot race and have not had a cramp since doing this..(but no guarantees!)

2-      Hammer Endurolytes and Hammer Heed- such great products and such a great product company!!  Being a biochemistry major and a med student, I have researched nutrition products a lot and I am absolutely convinced that Hammer has the best stuff- which is why Team IE only uses Hammer.    There are several specific reasons for the superiority of these products…I am doing a full write up on hammer products this week so check out the TEAM IE blog this week for more details on this if you are interested:  http://teamieelite.blogspot.com/

3-      CARRY  YOUR WATER WHEN IT IS HOT!!  Big deal.  Mark Lorenzoni and Dana Thiele of Ragged mountain racing have repeatedly pointed out to me how Ryan hall carries his water bottle with him away from the bottle station for miles after pickup- while all of his competitors take a few sips and drop the bottle.  This is a big deal when it is hot and water can be a major unrecognized resource on the run.  Water on your head – also very important to keep core temps down in hot weather- use water however you can on the run to stay cool. Once core temps rise, trouble ensues so you have to prevent against this.

The run was super hot, hilly and a significant portion was in the sand so it was epic.  After the first loop of the two loop course I could tell I was pulling away pretty comfortably so I tried as much as I could to back it down. No need to burn any more matches than you have to in March.  However, I was getting super hot and just wanted to stop running so I think my mind and body were battling with what pace they wanted to run…

Mind:  “Slow down, chill out, don’t be stupid, do what you do best- chiiiilllll”

Body: “Just hurry up and finish, this kind of sucks, hot, painful, don’t slow down – I just want to lay down- get there so we can lay down and eat”

Funny- because usually the mind and body have the opposite conversation; I think they met in the middle this time.

Crossing the finish line for my first pro win was huge- I was so happy that it was at a Rev3 event too.  The race director and event directors are such warm, nice, caring people. I had a blast with them.  Thanks so incredibly much to my genius genius coach Greg Mueller!!!

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Thanks to Champion Systems for making the best suits in the world! Cant wait for the new pink one I just got!

Lastly, here are some cool interviews and videos  on me at the race:

Thanks for all your cheers!!

Nicole

VERY VERY INTERESTING NY TIMES ARTICLE!!!

5 Oct

http://www.nytimes.com/2011/09/20/health/nutrition/20best.html?pagewanted=1&_r=1&ref=nutrition

Very interesting- The NY times is reporting on some recent research on the mental component to athlete limitations.

In short, elite cyclists used a computrainer to establish power and time for an all-out 4,000 meter time trial. The cyclists were then split up and one group was told that they would be racing against a computer generated competitor putting out 2% more power- this group could not match the effort of their virtual competitor. However, the other group was deceived and told that the computer generated cyclist was them at thier established max effort (in fact, the computer image was outputting 2% more power and 1% more speed than the cyclist had ever done before). In this situation the cyclist was able to match the computer image and go faster and harder than they ever had before. Very interesting stuff and a huge clue that our limits are heavily influenced by mental factors.

Interestingly, money did not motivated the cyclists to go faster or harder in similar experiments. Expectations of ourselves seem to motivate us more than anything else previously considered a motivator….

Dallas- Short and not so sweet

5 Oct

Terrible race…Just not back in shape from my hip injury and then 3 week long sickness- time to take a break- time to get body back together with eating pizza, drinking beer and laying around!! No more race reports until next year…

LA Tri

28 Sep

photo by Kevin Koresky of FLMSTri.com

LA has been a great trip because I have gotten to hang out with my dad, brother and brother’s girlfriend- the weather is ridiculous here, I met a very cool homestay triathlete from west hollywood and I always love going to the conejo valley multisport masters swim group here. We are missing Wes though!

As far as the race, I am still on the upswing after being sick for 3 weeks so I am looking forward to continuing to get stronger going into Dallas next week. LA is defiantly a swimmer’s race I believe- the swim was very choppy and some notable surf- nothing like year but still very challenging. The majority (middle 2/3rds) of the course is only marked with corner buoys without any sighting buoys along the way so it is really hard to sight off anything in the water- this was a major issue for me and the swim pack I was in – (we resorted to breaststroke more than once)- Definitely a course for the open water swimmers…

After the swim I was pretty far behind- more so that usual – I pushed the bike and was happy to catch a few people but the swim really took me out of it and I was still way back after the bike so I decided to cruise the run and save my legs for Dallas next weekend. The run was actually fun as I got to interact with people on the course and my family who was there to watch. I am looking forward to next weekend and Dallas and continuing on the upswing from here…

The big story of the weekend was really superstar Kaleb- who was 3rd at Elite Nationals!!! Ridiculous!!

Looking forward to having fun at Dallas!!

The Hy-vee Triathlon

14 Sep

Well, as far as a race report, I don’t have too much to say. I woke up Wed before the race with the flu and just got over it a few days ago (10+ days) so my race was definitely not what I expected. I was very disappointed about the bad timing of getting sick but I was actually proud of myself for even doing as well as I did considering how I felt and I didn’t feel like I gave up mentally even though my body was not cooperating. I finished 20th out of 30- at least 10 spots back from where I expected to be on a regular day- but these things happen and all in all I was happy with my mental toughness to get through the race. Next time my luck will be different and my preparation will show itself. (I flatted in New York 3 weeks ago after having my best start out of the water by far- so I am now due for some good luck!!)

What I do what to talk about it how much Hy-vee is doing for our sport. The event was unbelievable. I couldn’t have imagined a more spectacular production in my wildest dreams- they had fireworks at the start and end, the gin blossoms played a concert for the event, there was great TV coverage of the event- it was just unbelievable. I was so happy just to stand on that pontoon with the entire city of Des Moines there to support us- I didn’t even care that I was sick – I was just so happy to be there and have that experience. The money that Hy-vee provides for the pros is an awesome display of how supportive they are of our sport- they are actually changing pros lives for the entire year or more- making it so we don’t have to work side jobs and can focus on training. That event is single handedly changing the lives of the 30 people there- it is really an amazing thing that one race can support our careers and our sport so incredibly well. I am very grateful to Hy-vee, the people of DesMoines and the incredible volunteers. I can’t imagine that there is anything close to this in the world- maybe Kona is as spectacular but even that is quite hard to imagine. THANK YOU HY-VEE!! I cannot wait to be back next year, 100% healthy and ready to enjoy the entire event!! Thank you!!

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