Monday, August 15, 2011

Race Report: Luray Sprint

Ok- this race was a long time coming, and I wasn't sure it would ever happen, so this will be a long race report. It has been a rough year. Some of you know all of my medical issues and injuries, which have been frustrating and emotional at times. Ultimately, I am just thankful that I could race this season.

Goal for the race: Finish (Being someone who needs a more concrete goal, I wanted to finish within 2 hours)

Things I knew going into the race:
1. My swim fitness is not anywhere near where it needs to be, but I will get there.
2. I was really looking forward to rocking my new Kestrel on the bike course.
3. I needed to win the mental game on the run.

The weather forecast was not good (50% chance of thunderstorms all morning). It was overcast and raining when I left home at 4am for the 2 hour drive to Luray. The rain was intermittent, but the fog going up over the winding mountain road was enough to get me nervous.

I checked in and got racked. (I was at the far end of a rack in a less-than-optimal spot). I had a trash bag to set my gear on (folded in half so I could cover my gear if it rained and at least keep my shoes a little dry). It was during transition set-up that I realized the value of those pre-race "I forgot my [insert important item here]" dreams. It lets you work out all the anxiety. I didn't have any pre-race dreams, and therefore was really worried I was forgetting something.

I think I was the only person praying the race wasn't wetsuit legal. I have an incredible TYR Cat 5 wetsuit, but hadn't ever tried it on (after all of my issues this year, I wanted to get back to "fighting weight" before trying it on). Wouldn't you know- wetsuit legal race. I got the most fantastic pre-race pep talk from Tommy (who was headed home from working a 24 hour shift). He reminded me that this season should be about determining what I need to work on for next year, and not about finishing fast.

I got into the wetsuit, and it fit like a glove! My only race injury was self inflicted, when I punched myself in the jaw while pulling up the sleeve of my wetsuit (slippery sucker).

The Swim:
750m- 18:57 (28/39 AG)
Yes- that was a horrendous swim. Thanks to my awesome teammate Andree, I just finished reading "I'm Here to Win" by Chris McCormack (2010 Ironman World Champion). One of his phrases (my favorite from the book) is "embrace the suck". Essentially, there is a part of every race that sucks. Know it, and embrace it.

My first 25-50 meters seemed great. The wetsuit was fantastic, I was swimming along, but there was lots of contact. Then I felt this incredible fatigue in my arms. I know I haven't been swimming long distances, but what the heck?! I was ready to quit before the first buoy. Then I started breast-stroking. Not leisurely breast-stroking, but I'm going to hunt down some slow freestylers kind of swimming. Periodically I tried to swim freestyle, but for some reason it didn't work. I knew I was fatiguing my legs, and by the last leg of the triangle-shaped swim I was doing all freestyle. I don't know what happened here, other than the fact that I need to get my act together and swim A LOT more. I think the swim time included the run across the beach and up the stairs to transition, but I'm not sure.

T1(2:28, 11/39)- I was exhausted from the swim, and honestly had a hard time getting my legs out of the wetsuit. After that, I got my helmet and shoes on quickly and ran out on the bike (I was about as far from the "bike out" as you could get).

Bike 17 miles (1:03:42, avg 16mph, 11/39)
I raced the Luray Olympic two years ago, so I knew the course. The bike has a lot of false flats, and a couple of good hills. It also has some fantastic flats and downhills that were awesome on my tri bike. I passed several of the women in my age group, and no one from my AG passed me, so I considered that a "win". I don't have a computer on my tri bike yet, so I was going purely by how I felt, and estimated distance/time. The last hill is wicked (and I am learning how to tackle hills on a tri bike vs my road bike), but having Team Z there cheering everyone on was a huge help. I passed one girl right before the turn back into the park. I felt a little bad about this, but it wasn't an unsafe pass and I didn't think I should hold back just because we were nearing the end of the bike.

T2: (1:35, 21/39) Not sure what took so long here, except a long run with my bike in transition, and getting used to the laces on my Avia Bolts.

The Run: (28:44, 18/39)
The run is where I tend to lose the mental battle. It is an out and back, with a few decent hills in each direction. I told myself I would not walk. I pushed hard to the turnaround. I pushed up the hills (thinking of Andree's feedback when we ran together in Puerto Rico). I knew I was on target to make my goal of completing under 2 hours. I made it to the turnaround, and past the two mile mark. I had First Endurance Liquid Shot with me for a little oomph. One on of the hills, I felt something in the bottom of my shoe (I thought a stone). Stopping was the biggest mistake EVER. I had to fight hard not to walk after that, as my right glute (which gives me trouble because of arthritis in my pelvis) kept tightening up. I did walk a couple of short sections, and wished I had never stopped. Again, the crowd definitely motivated me. At 2.9 miles I thought I was going to vomit or pass out for sure, then at 3 miles I made the last turn and something clicked. I sprinted the finish (I actually passed a woman right before the finish- she was 1 second behind me in the results). It was nice to see Ashley (awesome Rev3 staffer) and Krista from She Does Tri at the finish. :)

It wasn't pretty, but I definitely embraced "the suck". I was glad Tommy was home watching the kids, but definitely wished he was there for a hug at the finish line. He has been by my side through so much this year, and finishing this race was huge for me. I almost cried, but instead plopped down in one of the kiddie pools they had filled with ice. :) This is a great race. (Small town feel, minimal swag, but nice venue and nice people).

Final Result: 1:55:23, 13/39 in my age group, and gloriously happy to have been able to race in 2011.

Tuesday, August 9, 2011

Cardiac Arrest During Triathlons

With all the buzz about the two tragic deaths at the NYC Triathlon this weekend, there have been a lot of emails going around our triathlon club. Working as a Nurse Practitioner in Cardiology, this is obviously my area of specialty. That being said, the following blog is my insight (based on medical expertise), not meant to diagnose anyone. If you have cardiac symptoms, stop sucking it up and SEE YOUR DOCTOR.

This year there have been several tri deaths/cardiac arrests.

In May, a man competing in a tri in Florida collapsed. A nurse who was competing in the race stopped, resuscitated him using a defibrillator from nearby police officers, and finished the race. (She saved his life, by the way). Read the story here.

Also in May, this time in Colorado, a father and daughter were running the marathon in Fort Collins together. Her goal was to qualify for Boston. She came upon a man in cardiac arrest and stopped to help. She then realized it was her father. Thankfully, he did well. Read about it here.

So while the highest number of deaths are during the swim (less opportunity to identify/help people in distress), endurance sports in general are dangerous to people with diagnosed and undiagnosed cardiac illness.

The good news? (Yes- there is good news). Regular exercise significantly reduces the risk of sudden cardiac death.

So now for my cardiac insight:
There are three different areas of cardiac issues (and I use this same analogy with my patients):

Plumbing Problems: Coronary artery disease (blocked arteries). This is what causes your traditional "heart attack".

Modifiable risk factors for CAD (things you can change- most of these aren't an issue for triathletes):
-Tobacco smoke
-High cholesterol
-High blood pressure
-Physical inactivity

Non-modifiable Risk Factors:
-Increasing age (63% of people with heart disease are 65 or older)
-Male gender

Warning Signs of CAD (from American Heart Association):
- Chest discomfort (this may be pressure, fullness, or pain)
- Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
- Shortness of breath with or without chest discomfort.
- Other signs may include breaking out in a cold sweat, nausea or lightheadedness.
Not everyone has chest pain with a heart attack! I can't tell you how many people I see with vague symptoms like fatigue, weakness, nausea/vomiting, and NO chest pain!

"But I'm a triathlete who trains 6-7 days a week and I don't have any problems". By definition, triathlon is "painful". Sometimes vague symptoms of cardiac problems can be masked by all the wonderful things we feel during training/racing. (Who hasn't felt nauseated, short of breath, fatigued????) In an article outlining 19 years of the Marine Corps Marathon, there were 4 deaths. 2/4 had run marathons before. On autopsy, 3/4 had significant coronary artery disease but no previous symptoms or diagnosis.

"Electrical" Problems
These can be abnormalities in the way the electricity travels through the heart, or arrhythmias (abnormal heart rhythms- either too fast or too slow).

Too Fast- Some of these rhythms can be non-threatening (read about my own experience with Supraventricular Tachycardia here), while others can be life-threatening.

Too Slow- Yes, most endurance athletes have slow heart rates, but some abnormal heart rhythms (such as heart blocks where not every electrical signal goes through the heart)can be dangerous. I have a friend in her 30s with such a problem. She is on her second pacemaker and runs marathons (much faster than I do!).

Causes of Abnormal Heart Rhythms:
-Congenital abnormalities
-Underlying cardiac problems
One of the conditions we see most often in otherwise healthy people is Cardiomyopathy. This is an enlarged, weakened heart. Heart attacks can cause this, but also viruses, pregnancy, alcohol, and sometimes idiopathic or unknown causes. I have taken care of two alcoholics recently who were diagnosed with severely reduced heart function (both young), and previously unaware. This is the condition which is most often implicated in the deaths of younger athletes who suffer sudden cardiac death.

-Illicit drugs
-Over-the-counter and prescription medications

Risks of Serious Arrhythmias:
-Sudden cardiac death (these patients may not have warning or symptoms prior to the cardiac arrest)

Symptoms of Arrhythmias (From American Heart):
- Arrhythmias can produce a broad range of symptoms, from barely perceptible to cardiovascular collapse and death.

- A single premature beat may be felt as a "palpitation" or "skipped beat."
Premature beats that occur often or in rapid succession may cause a greater awareness of heart palpitations or a "fluttering" sensation in the chest or neck.
- When arrhythmias last long enough to affect how well the heart works, more serious symptoms may develop:

-Fainting (syncope) or near-fainting spells
-Rapid heartbeat or pounding
-Shortness of breath
-Chest pain
-In extreme cases, collapse and sudden cardiac arrest

Structural Abnormalities
Valvular (“heart murmur”)

Why are there more issues on the swim?
-Cold water (This may induce some abnormal heart rhythms. Treatment for one of the rapid rhythms in the Emergency Department used to be sticking the patient's headin a bucket of cold water).
-Sudden surge of adrenaline (This can increase heart rate and blood pressure, increasing the risk of heart attack or arrhythmia).
-Inexperience/ Inability to stop or ask for help

What should you do as an endurance athlete?
Have an annual physical.
It is reasonable to ask for an annual ECG (electrocardiogram). This will not necessarily show CAD, but may show an enlarged heart or other problems).

If you have symptoms, see your physician. The phrase "better safe than sorry" is definitely appropriate here. What can they do?
- A cardiac stress test to look for CAD, blood pressure changes with exercise, abnormal heart rhythms with exercise
- An echocardiogram (ultrasound of the heart) to look at the heart structure and function
- An event recorder or home monitor to capture abnormal heart rhythms

Again- none of this is meant to replace the advice of your physician, but hopefully it sheds some insight.

DOES EVERY TRIATHLETE NEED A STRESS TEST? NOT NECESSARILY!!!!! See your physician, assess your risk factors, and go from there.

The #1 thing I think all of us can do as athletes? LEARN CPR. CPR can save lives (as indicated by those two stories at the beginning of this post). It may not be another athlete you save, but a friend, family member, or complete stranger. If I haven't bored you completely, this is a very cool video about a patient I took care of whose life was saved by her running buddy. The neatest part about this? We were at a swim meet this summer and Tommy was timing two lanes from Shari. He recognized her and said hello. There isn't much in life more rewarding than seeing someone who was so sick doing so well!

Sunday, August 7, 2011

I Had a "Good Mom" week

I don't think I could put this out there if I didn't know several (dozen) other Moms who feel frazzled and unprepared some days. I feel like there are so many days when I am not fully present for my kids, or don't have enough patience. I'm not saying that hasn't happened in the past few weeks, but I feel like the past week or so has been wonderful.

My son capped it off by saying "Mom, you are a good person". We had a wonderful family vacation last week. We crossed off all of our vacation "bucket list" items, and added more:

- A day at Kings Dominion (no one melted in the heat, the lines were short, and my daughter rocked on the roller coasters with the bigger boys). D-man also held his own on the kiddie rides.

- Bay kayaking at the beach (many thanks to my brother-in-law for this suggestion). We had a blast splashing, paddling, and laughing.
- Waterslides at the beach (it is so nice now that the kids are old enough for us to watch them but give them a little leeway, too)
- The Boardwalk at Rehoboth (ice cream, video games, cheesy stuffed animals)

Even when Tommy worked, I took the kids to Target for school supply shopping and we made it out unscathed. We also got to meet my newest "sibling" (my Mom's new horse "Razzle"). The kids helped brush the horses, muck the stalls, and take Raz for a walk. (Of course then my son said "I love shoveling poop!"). I love the moments when I can just be present, listen to what they have to say, and enjoy the time with them. Don't get me wrong- they still argue, and I still yell sometimes, but this summer has been fantastic!

"Surviving" Swim Team

This summer brought about big changes in our family schedule. The kids are starting a new school in the fall, so Tommy held "Camp Dad" on his days off. To get some regularly scheduled exercise, improve their swimming, and introduce them to friends from their new school, we signed the kids up for swim team.

Whew!!! I tip my hat to all of the parents who have done this year after year. As a parent, you literally "dive in" to the swim team season. Practice every day (when the kids weren't at daycare), volunteer responsibilities (in which we were delinquent due to scheduling), even getting our head around all of the details was overwhelming. (Swim team veterans are laughing at me right now).

When I was a kid, we were total pool rats. We played sharks and minnows for hours, but there was no formal swim team (which haunts me now as a triathlete).

So here I am, with one on the swim team and one on pre team. The season was a blast. Cheering my daughter and son on was even better than racing in a triathlon myself! Tommy and I definitely learned some lessons (he made an awesome timer, and also rescued a girl in distress during the pre-team meet), but I think we will do it all over again next year. I'm very thankful for my "parent buddies" who helped us learn the ropes!

I Have a Race Schedule!

After months of seemingly random (but perhaps somewhat connected) health issues and injuries, I have actually been training somewhat consistently. I am not fast (my former "easy" pace now pushes me to the limit), and I am not going far (I told myself I would not do longer than a 10K run this season), but I am out there. My "fat" pants are loose again (thank goodness!), and I'm starting to feel my body getting more athletic. It is amazing what these changes do for your state of mind.

The most important race I have registered for isn't mine, but for my daughter. It is her first ever Kids Tri. Of course she is learning tri rules early. Her birthday is December, so she is 8 but will race as a 9 year old. This means she has to swim 100 meters rather than 50. We also have three weeks to get her over her fear of biking without training wheels. I'm seriously crossing my fingers. She is eager and enthusiastic, though.

The biggest omission from my own race calendar is Rev3 Cedar Point. Racing the 70.3 there (healthy), and with a tri bike, will be a huge thing for me. It looks like 2012 will be the year for that. I am so excited to race with my Trakkers teammates in Anderson, SC at the Rev3 race there in October.

So my schedule is a bit about going back to my "roots". I'm doing two of the races I did my first season as a triathlete (they are both local and familiar), and then ending with Rev 3 Anderson. Even though it is in SC, the Rev3 crew makes it feel like home!

Sunday, August 14 Luray Sprint Triathlon
Saturday, Sept 24 Make-A-Wish Olympic Triathlon
Sunday, October 9 Rev 3 Anderson

So I have a plan. Next week will be the test. I am excited to pack a transition bag, to toe the line, and to see where I stand with my fitness. I'm also excited to race my new Kestrel. She is raring to go!