Monday, May 23, 2016

IV Carrera Popular Ciudad de Pozuelo

This year, all four of us (me, my wife and both my kids) "ran" the 5K race. I put "ran" in quotes because, of course, I am not yet allowed to run anywhere in my condition, so I decided I would power walk it with my youngest. As he was too young to officially take part in the race, I signed him up for a shorter race and he entered the 5K race with a race number for the shorter distance.

I had had to get up early to go the hospital to get my (last) steroid jab before the race. As we were the slowest in the race, the coche escoba (the car that marks the end of the race) - which was, in fact, a police car - was in hot pursuit of a guy who was doping accompanied by an underage boy who had not paid the entry fee. Just as well I didn't get drug tested at the finish line.

I enjoyed walking and talking with my son, while my wife and other son were running ahead. In the end, they didn't have to wait all that long for us but, for some reason, my chip didn't register so I'm not even sure what time we did. Not that it matters.

Enjoying it was the main thing, but I couldn't help feeling pangs of competition. The last two times I have run it I have been 4th in my category and fairly high up the overall rankings. This year, much less people were running because it coincided with a very popular 10K in the centre of town. This would have been the year to get on the podium! Still, if I ask myself what that would have meant, I would say that I would have liked for my kids to be proud of their dad. I think they are more proud of me spending good quality time with them and not being in such a bad mood.

I do miss running though. A week today I have my appointment with the spine specialist. It will also be a week without medication, so it will be interesting to see how both my symptoms and my sleep patterns evolve, not to mention my mood.

Thursday, May 19, 2016

MBSR / Mindfulness on steroids

I'm now starting my forth week of the 8 week MBSR (Mindfulness Based Stress Relief) online course that my wife got me for my birthday. I don't want to come across all gushing or - worse - tell you that you HAVE to do this because it will change your life. After all, the proof will be in how I am, not in how I say I am and, everyone is different. But as this is a blog that started life as a document of my journey from a midlife crisis to becoming an Ironman, there are a few things that I want to share as well as writing them down so that I can refer to them later.

Remembering back to when I started this stage of my life, I had realized that I had invested all my self-esteem into my work so that, when something happened that was out of my control, it threw me completely off-balance. Most jobs have a large component that is out of one's control and so it might seem surprising that I should not have been used to this, but I was writing mathematical models and, as far as I was concerned, my yardstick was an unbending but utterly rational and objective one. I scrabbled around desperately for something to plug the self-esteem gap and, after a few un-recommendable attempts I found that running was an excellent complement. It took me several years to get it under control, going through the typical boom-bust injury cycles that I've written about at length, until I was recently forced to stop for an extended period of time. Unlike the previous time - when I got a stress fracture in my foot in 2009 - this has been more insidious. When I started building up to running again after my stress fracture I used the opportunity to retrain my running gait; this time I am retraining my mind - or, if you like, my mind-body relationship. (It's hard to say this without sounding all mystical but, if you think about it, the mind and body are all part of the same organism.) Most significantly, I am deriving a source of self-esteem just from being able to react differently to situations that normally drive me crazy - from things as stupid as headphone wires getting tangled up, to having to wait in a queue. And, consequently, the need I have to run or compete has diminished (but not the desire).

The other thing that I have noticed and already commented here is a tremendous increase in energy and decrease in need to sleep. I'm beginning to wonder if it is possible that the energy I am saving from not going over and over things, not getting frustrated or, indeed, not trying to sleep mean that I need less of it. Or it could just be the steroids - I will have my last dose this Sunday, so I'll soon know (although my mum says they stay in your bloodstream for a couple of weeks). Having said that, I am not aware of one of the secondary effects of steroids being a dramatic reduction in stress - so dramatic that I have only just begun to appreciate how stressed out I was. My family almost don't recognize me (my son said this morning "Rob Smith 2016"). Hell, I almost don't recognize myself. I am just a little scared that this is only temporary. We'll see in a few month's time whether the effects are lasting or not!

One thing to be "mindful" of is not to get too obsessed with the whole thing. I have a tendency to do this. If I find something works then I tend to take it to such an extreme that it stops working. In some sense, it is almost impossible to be obsessively mindful by definition, as the whole practice is one of being in the moment. I think the only danger is becoming obsessed about analyzing and talking about the effects of practicing it... So if I get boring please tell me.

For now, my objective is not to enjoy life, but to experience it as fully as I can.

Tuesday, May 10, 2016

'Roids

So in spite of taking Valium to get to sleep last night, I woke up at 3 am and have been awake since then. Given the - let's say - unpleasant environment at work, you'd think I would have been up going round and round conversations I had had or worries about what was to come, but it wasn't like that at all. I felt really awake (and still do) - in fact, had the family not been at home I would have gone downstairs to do some nocturnal deejaying. Instead, I watched a film and tried a bit of meditating (which just work me up even more) and even some yoga for goodness sake. In a way I enjoyed it and knew that I was somehow resting, even if I wasn't sleeping.

I don't know where this energy is coming from. It could be the steroids or it could be the release from annoying but fairly constant pain / discomfort. Another explanation is something I have experienced one or two times in my life when I am faced with a point of inflection in my life: a change of girlfriend, a change of country or a change of job. I don't think I will be doing any of these things but I believe that my organism goes into a kind of hyper-alert "survival mode". In the past I have had up to months of needing very little sleep, feeling very energized and alert, but also aware I am living on borrowed time. It could also be the Mindfulness that I am doing that is somehow waking me up. I've certainly noticed it bleeding over into daily situations like driving, waiting in doctor's to be attended, meetings, etc. It's too early to tell, but just two weeks in to the 8 week MBSR (Mindfulness Based Stress Reduction) course my wife got me for me birthday it really seems to be starting to have a positive effect.

The drugs are definitely helping too, and my symptoms have all but disappeared, which means that I can do my rehabilitation exercises that much more effectively and hopefully put this thing back in its box. I suspect I will have to "manage" it, just like I have to manage my Morton's Neuromas - something to be aware of, a warning to be heeded but not necessarily a stopper. My physio pointed out something interesting to me. I have two protruding discs - one between C5 & C6 and one between C6 & C7. The point is that the one between C5 & C6 is on the right hand side and yet I have no symptoms on that side of my body. It is quite possible I have been living symptom-free with these underlying problems for years without realizing it. This paints a much more optimistic picture. It may be that the "crisis" I had which lead to my back and neck locking up concentrated the pressure from the protruding disc on a small area of a nerve, leading to its inflammation and the subsequent numbness and referred pain in my left arm. This would be consistent with the order of events, because I only noticed this once the other problems had gone away and, in spite of not running, before I started medicating it just got worse and worse.

I've continued to make an effort to improve my posture and people have commented that I look taller and sit straighter. In fact I have more or less stopped using my Lumo Lift as I feel that awareness of my posture (and the typical causes for breaking it) has been internalized now (here Mindfulness helps with the awareness too). So I'll probably lend it to my wife for a bit, as she could do with minding her posture a bit more. My Shoulders Back brace did arrive after all (albeit with an unexpected customs bill of about 30 €...) and I really notice that it helps me stand up straighter and taller. It's comfortable to wear during the day under a shirt (and I have found a way of taking it off and putting it on discreetly when I get changed in the gym) but I think that I would have to wear it on the outside of a t-shirt if I were to run with it, because otherwise it would cause too much chaffing. I expect that it will help strengthen some of the muscles that are indirectly implicated in a more upright posture - such as the internal neck muscles I have been exercising recently - but others, like those that help stabilize my scapulas, are probably having too much of an easy time of it and need to be strengthened separately. I'll see what my physio has to say on the matter. Lastly, I bought yet another gadget to help me on the road to recovery: a goose-neck support for my Kindle, so that I can watch movies and series while on the elliptic, without having to crane my neck. I hope that all these measures (plus the new chair I mentioned last time) will help me be in better shape for when I come off the meds and - hopefully - gradually re-introduce myself to running and cycling.

Thursday, May 5, 2016

Whoopsie

I got the results back of the MRI - which, by the way was a form of torture as my nerve was compressed during the entire 20 minutes which seemed like an eternity. So it turns out that I do have a slipped disc. Actually, it is not a herniated disc but rather a protruding disc (slightly between C5 & C6 and more "voluminously" between C6 & C7) which is pressing against my nerves. So I have been prescribed a course of corticoid injections for which I have to present my bum to a nurse every morning for the next couple of weeks. I'm also on anti-inflammatories (Enantyum) and have a follow up appointment with the spinal column specialist at the end of the month. I hope that the combination of the meds and the rehab prod the disc back into its little space and that I can avoid surgery.

It's been a difficult time one way and another. At work there is a dour mood as about 25% of the workforce will be cut in the next couple of weeks: we are just waiting for the axe to drop. If its not you, it might be a friend or someone you count on to be able to do your work. Also, my mum has been in hospital for over two weeks, recovering from (her second) bone fusion in her lower back to conserve the discal space lost to degenerative disc disease* and to relieve pressure on the sciatic nerve. It's funny that I should have a similar (less serious) problem at the same time as her. When she had her bunions operated I was having problems with mine; she had problems with Morton's Neuroma at the same time as I did. I wonder if I am suffering from some form of maternal stigmata.

Still, when patience is called for, I can be patient, and this is one of those times. My wife gave me a course on Mindfulness for my birthday which requires a fairly serious commitment (I am meditating for almost an hour every morning). I have to say I don't feel like taking anything else on right now, but I think it is helping. It's time to look after mind and body.

I got a new chair at work, which is much better for my back than the previous piece of crap. I had to go through some bureaucracy to get assigned one and, by a strange coincidence, the whole floor got given a new ergonomic chair (worth about 700 euros) the day before. This at a time when we are wondering whether we will be moved to another office or shipped out of here altogether. Unfortunately I found this chair (a Steelcase "Think") to be worse than the chair I had before, as it is impossible to block in an upright position, so you end up leaning backwards. Looking around the room, not a single person is sitting with good posture: some are leaning back with their necks craning forward, while others are slumped down in the chair as if they were watching the TV. I had to make an extra special fuss to get assigned one of the other orthopedic chairs - a Karnapps - which I think is much better.


I mentioned in my previous post that I had ordered a "Shoulders Back" brace to try to help with my posture. It hasn't arrived yet due to a peculiar limitation in Spain whereby individuals are not allowed to take delivery any item that is classified as "for medical use" - even if it is just a piece of cloth - instead, you have to order through a pharmacy. As I understand it, the pharmacies in Spain operate under a slightly communist regime in that you can only open a pharmacy where there was one before or, in rare cases, if the local government decides there is enough demand to open a new one. So, in practice, they get handed down through families and are a bit of a monopoly. Once I get my money back for the two failed attempts so far, I'll have it delivered to the UK instead.

You may remember that I bought a little device - the Lumo Lift - some time ago, before the problems with the pinched nerve were noticeable. This gadget buzzes every time you slump in your chair or while standing. I've just realized that the pinched nerve has exactly the same function, although it is a good deal more effective: whenever I lean forward or assume a bad posture, my thumb and first two fingers on my left hand go to sleep and I get referred pain in the triceps and the lats. It is doing wonders for my posture, I can thoroughly recommend it. The only difference is that I can decide not to wear the Lumo Lift but I can't turn off the pinched nerve just yet.

Having said that, the steriods (corticoids) I am taking are already having a noticeable effect. On the plus side, the symptoms from the pinched nerve have retreated to where they were 2-3 weeks ago after just one injection. On the minus side, I was totally hyper last night (and in fact, still am this morning) and only slept 3 hours. The best (or worst) thing about it is that I don't even feel tired. I feel almost euphoric, like running a marathon which, of course wouldn't be a good idea right now.

* I discovered in that place of all true knowledge more commonly known as the internet, that "degenerative disc disease" is neither degenerative - in the sense that there is no reason why the discs will necessary degenerate further - nor is it a disease. It just means that your discs have degenerated, but you already knew that.

Tuesday, April 19, 2016

Update

So, this thing is still dragging on. I am much better in many ways, but I have a pinched nerve which is causing pain and numbness to radiate down my arm to my fingers. Occasionally - perhaps after sitting still for a long period of time - it can feel like someone punching me in the arm, painful enough to make me stop in my tracks, but then it subsides after a few seconds. It's rather like the nerve pain I started to get in my feet almost exactly 2 year's ago, due to the Morton's Neuroma, in the sense that the pain is probably worse than the damage itself. The difference in this case is that there is a chance that the nerve could become permanently damaged and you can't just have it removed (unlike the nerves between your toes) without serious consequences. I've been to see a "traumatologist" who wants to rule out the possibility that the nerve is being compressed by a slipped disc in my neck: this would be one of the worst outcomes and could require surgery. (She told me that she wasn't scared of surgery; I said I was.) So I am getting an MR scan this Friday.

In the meantime, I am seeing the physio once a week and she is prescribing me exercises to mobilize and strengthen certain areas. It's slow progress but it is progress. One of the exercises, for example, is something known as "nerve flossing" where you basically slide the nerve back and forth through its sheath. This has to be done in a range that doesn't cause pain (and therefore inflammation).


She also gave me a book about pain which I will probably read some time over the next two days, as I am going down to Málaga where my mum is having a fairly serious back operation. But the book is for me, not for her. It's interesting how pain works - the pain I am suffering from is not that extreme but it restricts me, and I associate it with certain movements and activities. Above all, it is frustrating. I haven't read the book yet, but I can imagine that the intensity of pain is not the only important aspect, but what it is associated with, how constant it is and what our attitude towards it is. I remember how I got a bit obsessed with the pain in my feet from the neuromas; now I can't remember the last time I felt it.

In terms of "proper" exercise, I am only really able to use the elliptic machine, without moving my arms. It's better than nothing, but it does make me dependent on the gym which I can only use during the working week. Right now, things are pretty difficult at work as there are severe cuts and many people will be made redundant. This is exactly the time when having an outlet like running is so valuable. Instead, I am finding myself going back to an old remedy: listening to music or, more precisely, my previous hobby of deejaying. In other news, my treadmill finally got fixed yesterday after almost 6 months. In the end, the rollers and the belt had to be replaced (on top of the already new board annd springs). As the guarantee is up in a month's time, its probably just as well to have it renewed and, if my running continues at a lower intensity from now on, there's a chance it might last me a few more years yet. The custom made plywood running deck is much better than the one that came as standard, and is much less springy.

I've been using my Lumo Lift device every day at work and my sitting posture has improved noticeably. I'm wearing glasses which I can get away with not using, but they help me avoid craning my neck forward to read the small writing on my screens. I've also managed to get approval for a special chair at work which is more supportive, especially for the neck. My first focus is on correcting my "tech-neck" and then I will turn my attention to my Anterior Pelvic Tilt. Following a recommendation from my osteopath, I've bought a brace that helps hold my shoulders back, encouraging a more upright posture that will ultimately strengthen muscles in my neck and upper back. I noticed that there was a huge variety in designs so I initially had trouble choosing between them, until I had the idea of Googling for "shoulder brace running". I discovered that Alberto Salazar has his star runner - Galen Rupp - run with a shoulder brace that was actually designed for jockeys - the Equifit Shoulders Back. I'll let you know how I get on with that when it arrives.

Tuesday, April 5, 2016

Redefining "best"

Nowadays many schools have "non-competitive sports days" which I think a bit "oxy-moronic". My wife and I don't quite see eye-to-eye on this one but, while she will tend to say to the kids "The important thing is the taking part, not the winning" I usually add that "As long as you feel you've done your best, that's all that matters". But always doing your best is quite a tall order. It never ceases to amaze me how the best athletes in the world are not only able to put out stratospheric performances, but they seem to be able to do it time and time again with extraordinary consistency (notable exceptions like Paula Radcliffe aside). I expect that this is no coincidence and that consistency - especially in training - is key to being at the top of your game.

I have never been particularly consistent. I have run 10 Marathons, approximately half of which I have been very happy with and half I have been disappointed with. My most recent Marathon - in New York last November - was one which fell into the "disappointing: could do better" camp. At the time friends and family couldn't understand my disappointment, and some even tried to convince me to be satisfied with my result but - after a few weeks of grouchiness I must admit - I chalked it down to experience and started to think of the next one. The odd sub-par performance is an inevitable result of my strategy to get as close to my optimum level as possible.

As long as it was just a question of the odd disappointment, it was no big deal; in fact, it made victory all the sweeter when it finally showed up. But I have started to suffer other negative effects that are perhaps not too surprising given that I am getting on a little bit (about to turn 44). I just need to search through my blog for "back", "neck" or "shoulder" to see just how often. I have continued to soldier on - most times without having to skip even one training session - but the stakes have started to get too high and interfere with other spheres of my life.

How can I redefine "best" so that I can still feel satisfied with my performance? I don't feel enough motivation to train just to fun-run a Marathon. One approach would be to just run for the pure enjoyment of being outside, the endorphins, and feeling good about my body - and forget about races altogether. I'm not sure that that is motivation enough for me just yet - although, right now, I'd do anything to be able to go outside for a run, however slow.

Being a mathematician, I think of my theoretical best performance as being a red line, rather like the red line on the rev-counter of a car. If you can train and race as close to that line without ever crossing it, then you should get your best possible result. Up until to now, crossing the red line has has fairly manageable negative consequences, but that seems to be changing. So, if consistency is represented by a bell-curve - the wider the bell-curve, the higher the inconsistency - to avoid crossing this red line means shifting the intensity of all your training downwards.

This is somewhere between my previous extreme of always trying my best and the other extreme of just running for fun. I tend to be a bit of an all-or-nothing guy, so I feel uncomfortable in that grey zone in the middle. I'd always ride my bike in the lowest gear to get started and then immediately shift up to the highest possible gear - what was the point of all those gears in the middle? I always used to listen to my Walkman at the highest possible volume and found the volume control to be a nuisance. Where do I set the intensity dial for my training?

I think the trick is to shift the time horizon out beyond the current training session, the current week and even beyond the race I might be training for. If consistent, problem free running is a must, then "doing my best" means "doing my best while minimizing the chance of crossing the red line". I'm not sure yet how this translates into a training program, but I can try doing all my training at an "easy" pace (not slack, mind you), scaling back the long runs and mixing in some cross training and weights, and I can try running races at a pace that feels lively but not demanding. If I cross the red line - which I suppose will happen now and again, especially as I get older - I just have to be prepared to shift everything downwards. I've got into Chicago with a qualifying time so it seems a shame not to take advantage as training for and running Marathons like this is unlikely to lead to qualifying times in the future (and, in any case, I have paid my $210 already).

More than anything else, I need a challenge that I feel that is just within my reach and is within my control. Work is a challenge but it depends on so many other factors and people; running has been a great complement (and indeed compliment) to my self-esteem in this respect. Running my best in the long run will probably be the hardest running challenge I have ever undertaken.

Probably the closest I ever got to that red line (since I took up running again) was when I ran New York City Marathon in 2:47:42 in 2013. I am extremely proud of that achievement because it was the culmination of years of training, of overcoming injury and low self esteem, not to mention the 5 years it took me to be get into the race in the first place. Many times I have thought of getting a discreet tattoo - somewhere where it doesn't look like boasting, but somewhere where I can be reminded of it - but it has felt too much like giving up and admitting that I will never run that fast again. Now I am thinking again of that tattoo but not as a resignation, instead as the closing of one chapter and the start of another.

Wednesday, March 30, 2016

I spoke too soon...

I don't know whether it was the easy 20 minute run I did last night, the effort of keeping a good posture or just simply sitting down for so long, or maybe having slept in an awkward position - but my neck has seized up again. This pisses me off a lot more than just my shoulder hurting as it makes it difficult to go about everyday life and certainly puts running on hold again. Got an appointment with the physio in just over an hour and, tomorrow, I'm seeing the osteopath.