Monday, July 28, 2008

good reason to respect the swim

When I read that a triathlete died in the NY Triathlon during the swim leg, it only cemented the respect I have for being careful when wet in a triathlon.

Now, the NYTimes has published an article examining triathlon swim deaths -- not only the NY Triathlon death, but two more than came this past weekend (making 8 this year so far) and all of them have happened during the swim leg.

I've always joked with my friends that I like the swim leg the least of all the sports in triathlon because "it's the only leg in which I could die trying to finish it."
Any medical problem in the water is more likely to turn fatal than one that arises during a bike ride or a run. “Water is not a forgiving environment,” Dr. [Pamela] Douglas said. “It’s really hard when you’re swimming to sit down and say ‘I’m going to take a breather.’ ”
And it seems I'm not alone in my "respect" for the swim leg:

Many triathletes point to the swim as a triathlon’s most stressful segment. Most swims take place in open, often cold, water with hundreds or even thousands of other swimmers vying for position. “Nothing can prepare a newbie for the start,” said Russ Evenhuis, a triathlete in Olympia, Wash. “It can be like jumping into a washing machine. You will get swum over, kicked, hit and banged into.”

A triathlon’s open-water swim hardly resembles the pools where most triathletes train, said Neil Cook, a New York City based triathlete and coach. “There is no wall 25 yards away, you can’t see the bottom and the 50 to 150 people around you are more than you’ve probably swam with in total during your training,” he said. “Oh, and you are wearing this wetsuit that’s tighter than a girdle and you can’t breathe.” Raise your heart rate and blood pressure under these conditions, he said, and “any weakness you have will become apparent.”

I do know that since my first triathlon earlier this year, I've concentrated on becoming a stronger swimmer, and that's taken the edge off my concerns about the swim. But I think no matter how hard I train, I'll always look forward to T1 more than any other part of the race.

Tuesday, July 22, 2008

rock n roll half marathon discount via Twitter

Thinking of running the Rock 'n' Roll Half Marathon in San Jose on October 5?

If you still need to register for the race, you can save $20 by doing two easy things:
  1. register before July 31 deadline when the reg fee goes up by $10
  2. send a request via Twitter to @elite_racing for a $10 off coupon code.
Of course, if you already followed me on Twitter (I'm @itsthomas) you'd know this by now, and if you aren't already following @elite_racing, you're missing out on other race-related goodies.

I just registered for the RnR San Jose today, and it will be my first half marathon, ever. I figure this is as good a race as any to get me on the road to training for my first half Ironman next summer (I've got my eyes on the Vineman in July 2009).

Hope to see you in San Jose in July October!

Saturday, July 19, 2008

training with varicose veins

left calf and varicose veinsA few folks asked what, exactly, these varicose veins look like so here's a picture (right) that I took just an hour ago. The angle is my looking down from above and rotating my heel in so as to get a better shot of the side/back of the calf.

The spot of the initial injury is in the upper right part of the picture, and all the bumps and lumps you see throughout my calf are the result of cascading failures in the valves of my superficial veins.

What I learned from the Family Doctor web site completely gels with what I'm experiencing day in and day out:
All the leg veins have delicate valves inside them, which should allow the blood to flow only upwards (towards the heart), or from the superficial veins to the deep ones through the perforating veins. The valves protect against the head of pressure that would otherwise exist in the veins of the legs on standing. If there were no valves, there would be a pressure in the veins at the ankle equivalent to the height of the column of blood all the way up to the heart. It is this head of pressure that causes symptoms and damage when the valves stop working properly, as they often do in varicose veins. A valve occurs every five to ten centimetres in the main superficial veins of the legs.
It seems as if my calf is a battlefield of failed valves, and the more I think about it, the more this might explain why I've had such trouble with my calf cramping during swimming: there's reduced blood flow to the calf because of the failed valves, and with reduced blood flow, the cramping occurs. Hmmmm, I might be on to something that the insurance company may need to heed.

In any case, I'm now 100 hours into wearing my snazzy (not) knee-high compression sock, and me no like it. Never been a fan of tube socks, so you can imagine how much I'd enjoy having just one of my calves covered all day and night. Yes, I understand it's good for me, but having this thing gripping my calf 23 hours a day is annoying to say the least.

But, it's what the doctor ordered, so I'll keep wearing it. I just don't know if I'm ready to wear it while running/biking/swimming. It's rather a hideously nerdy looking thing.

Tuesday, July 15, 2008

varicose veins: cosmetic or catastrophic?

As I blogged previously, I had to visit the doctor yesterday to get the varicose veins in my left calf looked at by a professional.

I needed the doc to take a look before I plunked down even more registration fees for the events I want to do later this season (triathlons, half marathons, etc) on the off-chance that I'd be sidelined by a corrective procedure.

Little did I know my insurance would render my concerns moot.

I experienced a moment of sheer joy watching the computer-based records system ask "Are you sure?" when the nurse tried inputting my weight (189 lbs fully clothed), as the last time I'd seen the doc, in April 2007, I weighed a meaty 223 pounds. Yes, I've lost some weight!

Aside from that, however, I have to admit I'm none too pleased at the appointment.

My doc took a look at my left calf and examined it tactilely in comparison to my right calf and confirmed what I suspected: the bulging veins on my left calf are abnormal. But they're abnormal to the point that I heard him tsk as he found the veins all over the back of my calf as well as starting to pop up on the front of my leg.

When I asked if there was anything to be concerned about, he replied he needed to consult his colleagues to see who'd be best at taking the problem from here and left the examination room.

When he returned, he informed me that the next group who should see me are the vascular surgery team, but my (HMO) insurance wouldn't cover their procedure.

Long story short: if I want to take care of the problem, I'll have to pay out of pocket. If I'd rather just manage the problem (keep it from getting worse), it's simply a matter of wearing a compression sock 24 hours per day, indefinitely.


Given the predicament (rather: my refusal to pay out of pocket for corrective surgery), I peppered my doc with questions:

  • If I start training harder to complete a 70.3 race, will I endanger my health? no
  • Do I need be concerned a clot will develop that might be fatal? no
  • Will I find myself collapsing due to these varicose veins while training/racing? no
  • Is there anything I can do to keep this from getting worse? yes: wear compression socks
  • Is there anything I can do to make this better? yes: get surgery
  • What will it take to get my insurance to pay for the procedure? wear compression sock for six months or develop pain in the calf from the veins
So, now I'm wearing the compression sock (20-30 mg Hg) and paying close attention to whether or not I experience pain in the area.

And I'm studying up on varicose veins, too.

We'll see how long it takes before my calf starts to hurt.

Tuesday, July 8, 2008

old sports injury drives me to see the doctor

About 20 years ago, I was playing an intramural soccer game at college and got kicked, hard, in my left calf by someone I'll graciously recall as going for the ball I was dribbling.

At the time, I thought I'd simply get a really deep bruise in my calf. Long story short: I actually got a blood clot in my calf from the blunt trauma and had to go on blood thinners and until the clot finally dissolved (quite the painful experience, as I recall).

Within a few weeks though, I'd fully recovered from the injury, and the only way to tell anything had happened was the fact I had a few bulging varicose veins in my calf where the clot had been. The veins were most noticeable when I'd exercise, but they never got any worse.

Flash forward twenty years, and it seems that my increased activity over the last year has aggravated the veins in my calf to the point that there's now a freakishly large field of varicose veins popping out all over my left calf. There's no pain associated with this phenomenon. It's simply aesthetic as far as I know.

But I've had enough people ask about the veins (not to mention my wife and my mom are growing more concerned with each race I run), it's time to see the doctor to get an all clear to continue. Given all the time I spend in the air on travel, plus my triathlon training, no doubt there's some wear and tear going on. Last thing I want to do is fall victim to another clot forming and breaking free.

So, I've got an appointment with my doctor next Monday afternoon to get my calf looked at. I'm hoping he tells me it's just an aesthetic condition and I can keep training as I have been (if not step things up to prepare for a 70.3 half-Ironman next year). If I don't get the all clear, I'll at least know what my course of action to resolve it is.

I'll keep you posted.