Better Living Through Chemistry?

Suzanne and I were on the west coast...of Michigan, last week, for our son's wedding.  We were changing into our fine attire and lacing up our tennis shoes - a 'fashion statement' if you're not a runner; otherwise it's another day in rubber soles - when Suzanne asked, "do you have any ibuprofen?"

"Well, no," was my reply. 

When Suzanne and I travel, the first thing/s packed are (one or more pairs of) running shoes, shorts, socks, t-shirts, and my Garmin 310XT.  Whatever space I have in my luggage after that goes to "civilian" clothes once the personal care items, electronic device chargers, reading materials and drugs are tucked away.  This was not a "typical" road trip for me; I did not plan on running, therefore I did not expect to endure (my) "typical" running-related aches and pains.  Fortunately for me there was a store up the block from the reception hall, so I was able to grab up a non-steroidal anti-inflammatory drug (NSAID) of choice, in this case ibuprofen. 

Suzanne can get pain relief from almost any over-the-counter NSAID (aspirin, acetaminophen, ibuprofen, or naproxen being the most common versions), whereas I am a little more picky.  I have to be.  I rummaged through the kitchen cabinet, desperately searching for ibuprofen last week, when Suzanne pulled out a box of "ibuprofen with diphenhydramine" capsules.  I graciously declined, and informed her that the Benadryl she offered along with the ibuprofen would make the ache go away to my satisfaction, but I would be on the couch for the afternoon.  Sometimes I'm anal retentive like that.  (One of the few times where my 14-year medical transcription career was beneficial after college.)

So why can some folks take any NSAID and others (like me) require a specific compound? 

When we do damage to ourselves the body begins to repair the damage through the inflammatory response.  This response involves the release of enzymes and chemicals which begin the restoration of damage...and transmit "it hurts when I do that" messages to the brain so we will stop doing what hurts.  NSAIDs are divided into two categories: selective inhibitors and non-selective inhibitors, based on the enzyme which is inhibited from production (and transmission), known as COX-1 and COX-2.  Inhibit the COX-1 enzyme too much and you run the risk of ulcers, stomach bleeding, and prolonged bleeding time.  Most of the over-the-counter NSAIDs are pretty much non-selective, which means they inhibit  both enzymes in varying degrees.  Selective inhibitors (all of which require a prescription) focus more closely on the COX-2.  Runners who might be taking drugs to thin their blood, or bruise easily might want to take an NSAID other than aspirin, since aspirin can slow the clotting of blood for 4-to-7 days, where other drugs only slow blood clotting for a few hours.

The best over-the counter NSAID for each person, like any training plan or shoe, depends on age, cause and severity of the pain, as well as what your stomach can tolerate.  After a week take the time to figure out if the drug helped ease the inflammation with no side effects.  A single-blind test of over-the-counter NSAIDs found naproxen gave greatest relief from pain, followed by aspirin and ibuprofen.

But NSAIDs do not heal pain, they decrease the inflammatory response and the pain messages sent to the brain.  No drug can replace the common sense factors of rest, analysis of what caused the pain, and correction of the causes.  After you figure out what happened then it's time to get back out on the road.

ISO A Guy With Initials After His Name

(EDITORIAL COMMENT: MY USE OF THE MASCULINE FORM DOES NOT MEAN I AM A MALE CHAUVINIST - USE OF MALE FORM ONLY MAKES FOR EASIER WRITING.)

Spent a few minutes after getting my weekly Six at Six beat-down talking to Mark. He asked me what I knew about chiropractic, & whether I had ever been treated by a doctor of chiropractic. I had to admit a certain degree of ignorance about the benefits of chiropractic; while I've read much in the running world about athletes being adjusted on a regular basis, I also had to look past some formerly/deeply-held (religion-based) convictions. I'm not in the mood to get into the theological side of this, so I'll stay with the semi-scientific side.

I spent 14 years working in the medical field, as an administrative person (transcribing doctors' orders), a file maintainer/receptionist & a transcriber (history/physical examinations, ER visits, progress notes, discharge orders, treatment notes, and so on). During that time I had close working/personal relationships with most of the relevant medical professions (doctors are willing to engage in some back-scratching to get their work expedited), which gave me the chance on many occasions to ask 'what's the difference between...?'

So, if I were to place the three forms of medicine on a spectrum, I would consider osteopathic medicine (practiced by doctors of osteopathic, or D.O.'s) at the center of the spectrum. Chiropractic, Homeopathic, Chinese and Ayurvedic would be on the left side; allopathic medicine (practiced by doctors of medicine, M.D.'s) would be on the right.

A V.A. friend of mine is a D.O. I would visit him on occasion in the Rehab Medicine department when I had an issue, or just to ask 'what would you do in this situation?' I always found his approach to medical issues to be pragmatic & holistic. He was more likely to try something outside the box than fall back on more traditional methods of treatment. I decided to see what Wikipedia had to say about osteopathic medicine, and whether I had gone far afield with my description to Mark.

Wiki says: "...osteopathy has been considered a form of complementary medicine, emphasizing a holistic approach and the skilled use of a range of manual and physical treatment interventions in the prevention and treatment of disease. In practice, this most commonly relates to musculoskeletal problems such as back and neck pain. Osteopathic principles teach that treatment of the musculoskeletal system (bones, muscles and joints) facilitates the recuperative powers of the body."There's a time & place for pharmaceuticals in the treatment of medical issues, but I'm always amenable to something a little more on the natural side. Mind you, the most important issue is not so much the type of initials after the name as much as whether they are compatible to your needs.

I have spent more time over the past two years in dental offices than doctor's offices, so it wasn't that important to me. However, after my episode in Panama City I knew I did not want to visit the general practitioner near my home. There's nothing worse than being an athlete who has a medical issue; a physician's visit usually leads to the typical 'stop running/cycling/swimming altogether' advice. I also could tell from the first visit the practice would not be compatible; contemporary religious background muzak & copies of Christianity Today are not preferred waiting room material for a recovering fundamentalist.

Fortunately for me, I was able to get the contact information for the physician my friend Steven sees. The guy's a masters' swimmer & does some of our long swim events, so he recognized me right away when he came into the examination room. Right away, I knew this would be a fairly comfortable fit.

And when it comes to your life, your health & your avocation, comfort is darn near everything.

Brain Frittata

While I haven't been to the point where I wish the ESC key would beam me up off the Planet of Training and Education and back to the Starship, there have been brief, transient moments where my brain couldn't handle it...at all. Take, for instance, contract administration. A program guy like me knows (of course!) this is the reason contract officer's representatives exist. I mean, come on, for what other reason would they? It's certainly not for making coffee.

However, my CAPT is asking for a document I will probably give a working title (and a tip of the cycling cap or running visor to a former boss for this one...) Contract Administration For Bears Of Little Brain.
Fortunately, we're past the hard part of the Information Professional survey, so I can focus on one thing, and one thing only for at least a week. One of my weaknesses has been the (relative) inability to multitask. Some tell me it's a guy thing. This might be true, but I think my loving wife suffers from the same weakness. Well, she can multitask, but there are details she (IMHO) should remember but doesn't...that's where I come in to save the day. While I can't walk and chew gum at the same time I can remember the formula of which the gum was made.
My caffeine and bagel pusher (for want of a more genteel term), Mike, told me the 'Evil Empire Barriobucks' chain-wide training session is not a first for them. (NOTE: I stopped using my iTunes Song of the Day card as a bookmark after the lunch break where I received the third degree from Mike...the "S" word is pretty much a vulgarity of the highest order at Cafe' Espresso on Barrancas!) I guess it's like coaching, too. You can either guide and counsel a small number of athletes up-close-and-personal, or you can be Coach On-Line. I'm not throwing stones at Mssrs. Carmichael, Allen, Friel, et. al.; they have the knowledge and are willing to pass it along to the public for a price.
There's something cool about being able to take the time and talk to an individual. I laugh more standing on the side of the track than I ever did trying to do two things (train and administer workouts) at once. There might be coaches who can run and coach at the same time...once again, I can't multitask, and prefer not to. Besides, I'd rather not hammer a workout...or blame my hammered workout on the folks I've decided to help.
I mentioned something about PED last autumn after reading books written by Floyd Landis and David Walsh. In the world of triathlon the idea of testing age-groupers is starting to take hold (most tri-geeks are in a more-comfortable financial position, save for guys like me...), and it's suspected road racing (at least at the highest caliber races) might begin testing to level the playing field. While I doubt road runners are taking PED I've no doubt in my mind trackies (especially sprinters) play the let's see if I can be caught game. Okay, not all of them are taking drugs, but every time you turn around there's another athlete getting busted for something from years back and giving the sport a huge shiner...not to be mistaken with the beer from Texas.
Of course, there is a difference between tri-geeks and road runners: tri-geeks have to purchase a national governing body (USA Triathlon) membership in order to participate in an event. That membership includes a form which states the athlete will follow the USADA/WADA (anti-doping) rules. Roadies at USATF or RRCA events aren't bound by such constraints, unless they participate in a major sanctioned event (Azalea Trail, Peachtree, Boston, and the like)...where money or titles are at stake...and then they probably can expect a cup to be handed to them when it's all said and done.
I was going to ramble mindlessly on about religion of sport, especially running, but as you can tell if you've read this far...my brain is pretty much toasted. I need more coffee and probably a day to sit in the sunshine, reading a good book...which won't happen for at least another week.

Summer Reading

I've always tried to take some time during the summer - vacation - to read some different books from the staples I enjoy during other times of the year. A couple of my recent acquisitions grabbed my interest from the bookshelf of the local major chain bookstore.

The first, Positively False: The Story of How I Won the Tour de France, is Floyd Landis' cycling autobiography, as well as his take on life as a member of the US Postal Service cycling team under Lance Armstrong and Phonak Hearing Systems cycling team under Tyler Hamilton, and life as a team leader while at Phonak. Landis talks in great detail about the meltdown in Stage 16 of the TdF, his evening after the meltdown, and his Stage 17, which has been heralded as the greatest one-day comeback in cycling history. After reading Positively False, I haven't changed my take on the use of performance enhancing drugs. I'm not completely certain that Floyd didn't take PED, but the procedural screw-ups on the part of the French anti-doping laboratory, WADA, UCI, USADA, and all of the individual parties involved within those organizations makes the Stage 16/17 episode, as well as the implications of PED use, a conspiracy theorist's fantasy. I began to tally in my mind the number of former associates of Armstrong who have been dinged for PED/doping: Frankie Andreu, Dr. Michele Ferrari, Tyler Hamilton, Roberto Heras, possibly Floyd Landis...is this the European cycling establishment's attack against an athlete blessed with fantastic cardiovascular gifts and the ability to literally outride all comers, or is it proof that professional cycling is dirty, through-and-through?

It's one reason I cannot speak well of a local sprinter, who happens to be an Olympic medalist and took a coach known for doping infractions after he earned his medal...later earning a two-year ban for PED. The operating question that comes to my mind isn't so much 'what the hell are you thinking!?' No, there's too many words there. 'Are you thinking!?' Yeah, that's better. Poor guy's busting his @$$ doing local public appearances and all, I think he'll be helping to coach one of the local high school athletic teams, too, while he's serving his suspension. I hope like hell he gets up in the morning and kicks himself squarely in the @$$ each day. It would beat having someone like me stand by and remind my guys/gals that they, too, are vulnerable to testing.

Athletes who take PED, and the coaches and trainers who actively or tacitly tolerate or encourage its use, are engaging in fraudulent acts. Ignorance of the law (or the conconction being taken) is no excuse.

HOWEVER:

I think the World Anti-Doping Agency and it's US counterpart, USADA, are failing on the procedural side of the issue. Let's begin to take a look at doping as a criminal act - fraud - and use some legal ground rules on evidence, guilt/innocence, right to counsel, and punishment befitting the 'crime.' I wonder if I could get away with a bumper sticker that says, 'TEST THIS, USADA?'
The second book, From Lance to Landis: Inside the American Doping Contreversy at the Tour De France, is a follow-up (in English) to the broad-brush attack by Irish sport columnist David Walsh on Lance Armstrong. His previous book L.A. Confidentiel: Les Secrets de Lance Armstrong, was co-written with French journalist Pierre Ballester, and has not been translated into English as far as I can tell.

Walsh continues to interview the increasing circle of former Armstrong associates and teammates. I've read the first three chapters, and find the pace to be very slow. If Walsh has an argument forthcoming, he is developing it in a very cautious manner. Does he have an axe to grind against Landis? I cannot tell at this time. It's evident he has one against Armstrong.

Reading Daniel Coyle's Lance Armstrong's War, Landis' book, and even in Armstrong's two biographies, you can tell Armstrong has little time for former associates (especially whose who parted on less than friendly terms) and seems to hold a grudge against persons he feels have done him wrong. The only book - books - I've seen so far that holds Armstrong in a completely positive light would be Brad Kearns' How Lance Does It and Chris Carmichael's training books, co-authored with Jim Rutberg and Armstrong.

Is Armstrong - or any of us - an absolute saint? Not hardly. We all are subject to hard days, hard weeks, errors in judgment, slips, falls, single (or multiple) tokes over the line. The best lesson I can pass along after reading Landis, is to provide a simple, truthful story, at all times. It might not make for entertaining press, but it keeps them from coming back and saying to you: 'you said (fill in blank with lame-@$ excuse) last (fill in blank with time interval), now you're saying (fill in blank with new, improved, but still lame-@$$ excuse)...'

It's always easier to remember the truth.