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.

Eating The Elephant

(inspired by today's comic...)

Look at a 16-to-26-week training plan for a marathon, or a half-marathon.

Count the miles, or minutes. Better yet, consider both measures; duration AND distance.

It's daunting to look at a plan in terms of distance, minutes (hours!) and workouts. Especially when you compare training time to the (relative!) brevity of the race distance and duration.

If we try to take the entire thing in at one fell swoop the odds are great we'd "choke" mentally, emotionally, socially, maritally, and maybe...physically!

Now, cover up all but a single week. Even a "long run" week seems more achievable.

Get a little more granular and look at a single day. Training for one day is simple - which might not necessarily mean the same thing as "easy."

But that's all you can deal with; all you should deal with at a time. One day.

(It's the reason I don't provide much granularity announcing my workouts. I don't want to scare anyone off with a workout that appears too difficult. I don't want to tie myself to a particular distance, modality or intensity only to find an athlete is feeling poorly, or the weather conditions suddenly change, or - like recently - the track is being repaired. That kind of stuff.)

Becoming a good or a great runner, becoming a lifetime runner, all boils down to doing what can be done in the space of one day...and replicating it as often as our minds, emotion, life, family and body will bear. We can use those days which won't allow us to replicate to rest, recover, repair and reload.

It's the answer to the riddle: "How do you eat an elephant?"

Time For A Few Small Repairs

"...days go by, I'm hypnotized, I'm walking on a wire; I close my eyes & fly out of my mind..." - "Sunny Came Home" (Shawn Colvin, 1996)

The thought didn't cross my mind until my last dental appointment. The dental hygienist who works on my mouth has done so for the past two and-a-half-years. She knows a great deal about me, seen me come in with my shoulder & arm in a sling, limping, or tired after a race. She knows me well, & the sudden decline in my dental health told her things she did not like.

"There are a couple of bad spots back there, & it's starting to look like it was during one of your first visits." She gently tapped on a couple of my molars and asked, "have you had any pain in these areas?"

I told her there wasn't anything out of the ordinary, but that my sinuses had been acting up all summer; it seemed like every time I hit the pool for a workout I'd end up hacking for two to three days. She didn't say much but provided a topical treatment to the area, scheduled me for a follow-up visit in two weeks, & suggested a few small changes to my care plan: Hydration, mouth rinsing, a different toothbrush, to name a few.

But, as always, that was only the tip of the proverbial iceberg. Waking up to a mild case of otitis externa (swelling of the ear canal) - or "swimmer's ear" - on a Monday morning three weeks after the dentist's visit made me think about whether the problems I had with sleep (bed at nine, up at five, back to bed until seven...), diet (why won't this weight come off!?), infections, & motivation (in all areas, not just athletics) this summer was more than being sick, more than being tired, but perhaps overtraining. Perhaps it was closer to overreaching back in the spring, as I approached 70.3 NOLA. But even at that point, a week out from the event, I could sense something was very wrong. I'm not a strong swimmer, & the thought of getting back in the open water after a disastrous day last November in Panama City - triggered by a discussion about swim courses at a race director training course - took me to a state of sheer, physical panic. Thank heavens for the "no-swim" choice on the day, a (very thin) silver lining to the black cloud of trying to get through a very warm day - including an open water swim - under your own power.

The following week was a road trip down into central Florida for the Road Runners Club of America convention. I felt pretty good for a couple of morning runs; nothing stellar, but good...good being defined as state of fitness a week after bicycling and running 69 miles. A swim at a local pool showed the fatigue was still there, though. And then, reality set in after the second mile of a 10K on Saturday. I was reduced to alternating walking & running sections, in the same manner I got through the 70.3 run course. After finishing in a time which was nearly a minute slower than my average performance, I knew it was time to take some time away. A month of easy workouts on the elliptical trainer & swims in the pool were good, but the aches & pains I had getting up every morning were disconcerting. Feeling like a person who is much older & much slower than you prefer to be is not fun. So, Vicki's concern about my dental health, added to the state of mental health - burned out - were possibly little more than manifestations of a greater problem of overreaching or overtraining.

As I've started looking at the training plan for Rock n' Roll/Mardi Gras 2011, the mantra less is more is making sense. I guess at 48 we take a little bit longer to recover from our indiscretions than at 28. Ibuprofen is no substitute for the occasional rest day. And there's no nutritional supplement that can help you perform when your mind just isn't into it.So far things seem to be going well. An extra day of rest, & listening to the need of my body to do only the amount of training necessary for the next event (why train for 14 hours a week if you're 9 weeks out from a half-marathon?) has felt wonderful, both during the two-or-three cross-training sessions I'm doing each week, as well as the workouts. I'm not eating ibuprofen like candy, either.

Every so often, like Shawn Colvin's "Sunny," we have to sit down, take a hard look at what we're doing to ourselves, & make a few small repairs.

Hating Goodbyes

Dinner last night at a Thai restaurant with Christian and Petra, our German friends. Normally we would hold off on dinner and do the New Yorker Deli on Friday evening, but they're now temporarily billeted in the Officers' Quarters on NAS.

The bad news is there's no kitchen.

The good news is there are no dishes.

So, we ended up talking triathlon and training over dinner, trading notes and looking forward to future events. For them it's Ironman Germany in Frankfurt. For me, it's probably going to be either a sprint triathlon or a couple of long races in the autumn. It depends on the work schedule and how busy we are at Chez' Bowen.

Since they're doing IM.de, we'll be able to keep track of them courtesy of IronmanLive. Christian comes back to finish his tour, then goes back to .de. I have the sneaking suspicion they'll remain close (enough) to us in the coming years. I certainly hope so, for a number of good reasons. A life always benefits from diversity:

The more closely your companions and confidants resemble you, the less likely you are to stretch your horizons or consider differing viewpoints. Without the encouragement (or would that be a dare?) of Christian and Petra, I never would have considered doing a half-iron distance triathlon. No, I would not have run the numbers and considered a half-iron triathlon (or a full Ironman triathlon, for that matter!) as an achievable goal.

Christian and Petra also saved me from tuning in to the BBC to get a diverse take on the news; we could always ask what Deutsche Welle, ARD, ZDF, or BRW were saying about American policies and politics. We were able to clue them in on some of the incomprehensibilities of the American political system, usually with much eye-rolling and humor.

Race, religion, culture, sports icons..."third-rail" topics were always fair game, because we knew we could speak in honesty, truth and candor to each other. And for that we have been grateful these past couple of years.

I hate goodbyes. I do poorly with them. Doesn't matter how much you promise to drop an e-mail to each other monthly, or pick up the cell phone (especially if they're on your network!) to stay in touch, it seems small orbits become large ones; large ones become like the orbit of comets that show once every 75 years. Of course, there's Web 2.0 and Skype and all those other things, but it isn't the same as killing three (four? five? I don't recall...) mini-kegs of Heineken on a Saturday, then going out into the front yard to watch the International Space Station whiz by.

Some people bring joy by their arrival, others by their departure. As for Christian and Petra, it's been a joy to be in their presence. Every time I see a triathlete walking a flat-tired bike on a training run I hear the "don't ever go out on a training ride, no matter how short, without a flat kit" lecture.

We will see you soon, my friends. Until then, I'll do my best to hold the tears.