The next step in Plantar Fasciitis

My issues with plantar fasciitis have spanned more than a decade, but this recent bout with it has been going on for about 8 months now. I've just made the decision to bail out of the Surf City Half Marathon since my pain from running was escalating rather than improving. The last race I was in was July, which means I've been on the sidelines for a good 7 months now.

I'm very certain I could end the pain in my feet in a few seconds given a chainsaw, a bottle of Jack Daniels, and someone to clean up all the blood, but that might cause some undesirable issues. As opposed to something that radical, my coach suggested something earlier this week called "dry needling," and I (of course) responded that it scared the hell out of me. The concept is similar to acupuncture, in that needles are inserted into your body, but unlike acupuncture, the purpose is not to cause changes in the energy systems of your body, but to actually do physical things to your muscles. In some cases, dry needling is actually supposed to cause damage, so that your body can heal itself properly--and in other cases, it's supposed to actively release muscles by stimulating trigger points in them. A case study I found piqued my interest--by repeatedly puncturing the plantar fascia, a trial produced a 95% cure rate for its subjects. Anyone who has dealt with plantar fasciitis is likely to understand that this is probably 94% higher than most conventional methods for dealing with it.

It turns out that the state of California is in the dark ages when it comes to dry needling. Our government explicitly bans the practice by physical therapists, who are the health care professionals that do this in at least some other states in our country. So, I started looking to see if I could find acupuncturists that perform this procedure, and I came up dry (pun very definitely intended). I gave up on this glimmer of hope for rapid recovery, and focused on what I've been doing--stretching, strengthening, and more not-running.

Joanna, my triathlon coach, wound up suggesting to me to give a straight-up acupuncturist a try--and very correctly identified that the myriad of issues that I have might be aided by this type of treatment.  Stress, insomnia, depression, anxiety, and long term pain have all been shown to be improved by acupuncture.  I really like that she was able to take a step back, look at the bigger picture, and wake me up by pointing out to me what might be glaringly obvious to some people--"You have bigger issues than your foot."  Well, she didn't quite say it that way, but that pretty much sums it up.

So I redoubled my efforts in looking for an acupuncturist--and failed again this morning. I posted on Facebook wondering if any of my friends knew of anyone they'd recommend, and it turns out that Brian was the person to respond, and his recommendation is an athlete that's a licensed acupuncturist who has experience treating plantar fasciitis through trigger point dry needling. Sometimes the answers lie a lot closer to home than you think they do.

I'm looking forward to getting in for an appointment--and maybe fixing some of my issues.  More posts to come!

The Incredible Adaptability of Humans

I'm currently on travel for work in Oslo, Norway--which presents a number of challenges for training in general, not the least of which is the cold weather.   Before going any further in this description, it's important to realize I am a cold-or-wet-weather-chickenshit-pansy when it comes to training.  Before my last couple of years of training, I would prefer to run 16 miles on the treadmill than risk getting a little wet from running in the rain.   Getting caught in the rain on a bike was simply unacceptable, so if there was any chance of precipitation during the few months of potential rain that there is in Los Angeles, I simply wouldn't get on my bike. 

My coach, Joanna, has slowly made some progress in helping me to let go of some of this wimpiness of mine, but I'm certain if she's reading this, she's thinking I've got so very far to go.   To be clear, I'm pretty certain my balls shrivel up into tic-tac size nubs and I transform into a sniveling little cry-baby whenever the temperature drops into the 50's or a light mist approaches my training venue.   Mom????  Got any hot chocolate?

So, I went running in the cold the other day in Oslo--it was just below freezing, which is unseasonably warm for the city for this time of year.   I was decked out in warm running tights, a long sleeve sleeve running overshirt, a hat, gloves, and some smartwool socks.   Other people were dressed in virtually identical clothing on the running trail--I nailed it!   Of course, my hands got a little cold and my lungs aren't used to breathing the cold air so it was a bit of a different experience, but I was very proud that I dressed as the locals do when they run in this type of weather.

But the thing I couldn't get past is that I saw a couple of people on bikes in this weather.   They were dressed warmly, but there were patches of snow, ice, and slush on the ground.   In my mind, this would make for an immediate free-pass from biking outside, and that's when it hit me.   People adapt to their surroundings in every way, in every efficiency possible.  It's cold, snowy, and dark here a substantial part of the year, and for people to not find a way to adapt to this would mean giving up what they enjoy doing.    This is their normal, while my normal is 72 degrees and sunny.   

For the record, I'll be glad to get back to California sometime in the next week--but in the meantime, I'll approach the cold weather with a little less disdain.

Wrapping up my year and the LA River Path

I had several high school English teachers tell me that writing would be my way of dealing with things as I grew up.   Some told me things as simple as "You're going to get bored with science and math, and need a creative outlet" and others were a little bit darker about it saying things along the lines of "Writing is your therapy--I'll be very concerned about you if you stop."   It's interesting to me how teachers can take a look at a young kid and sometimes nail their personalities on the head.   I haven't been writing recently--but I think I need to start again.  This post is all about the therapy side of it.

Yesterday, I was riding my bike down the LA river path, which is where I have done the majority of training that has made me the better cyclist that I am now.  In Los Angeles, there are very few areas that you can ride for any significant period of time without encountering stoplight after stoplight after stopsign after stoplight.   I've long known that areas of the LA river path are unsafe from the perspective that they run through low income neighborhoods and are claimed as territories by gangs in the city.   My partner was once mugged within a mile of our house while out for a run on this path in broad daylight.  He got away physically okay but was shaken mentally to the point that he'll never run on the path again.  He only rarely rides a bike down the path, and only does that when riding with other people.  You don't get a gun pulled on you without having some lasting imprint placed on your psyche.

I left for my ride at about 2:30 in the afternoon--there was plenty of sunshine and it was a bit cool.  By Los Angeles standards, the 60 degree weather called for most people to break out their parkas and fur-lined boots.  My ride was going normally, and the path wasn't excessively crowded.  About 25 minutes into it, I saw a couple of teenage kids ahead of me and called out to them to signal I'd be passing them--they were riding one behind the other, and the kid in the back turned to look at me and then pulled to the left to let me pass--it's absolutely the wrong thing to do, but I've gotten used to people on this path not knowing what they hell they're doing and I'm often just glad when people do something to open up a pathway, even if it's not moving to the right so I can overtake them correctly.   The kid in the front moved to the left at the same time as the other one, so I proceeded forward.   As I was getting ready to pass the kid in the front, he started veering into me, and I started screaming my head off at him--no expletives at this point--I was just trying to get his attention.   I saw him yank a headphone out of his right ear, and he quickly followed up with "SHUT THE FUCK UP.  I'LL KNOCK YOU OFF THAT BIKE."

Something in my gut told me I needed to respond in-kind, or he might try, and in a split-second decision, I did just that:  I yelled back in a severely mocking tone:  "Yeah, I bet you could.  You SHUT THE FUCK UP."   I cleared his front wheel and accelerated as best I could.   The interchange that happened afterwards could make Andrew Dice Clay look like a good candidate for teaching preschoolers.   I got away physically ok, but realized in the minutes afterward that if my instinct had been wrong and he'd been carrying a gun, it would have likely ended very badly for me.  The simple fact is that when someone comes at you that aggressively for no good reason, there's something else going on--a mental instability?  A severe chip on his shoulder?  Or, what I believe to be the case--a feeling of superiority based on something like ownership of this territory.   This kid will likely go on to be one of the dregs of our society.  If he does not end up in prison, he will doing nothing good as a contributor to our lives in Los Angeles as a whole.

I pedaled on--I had 4 minutes left until the start of my first interval. I was approaching the 105, and as I shifted into gear for this effort, my power meter spiked to 300 watts--I immediately understood this to be an effect of the adrenaline coursing through me from my interchange, and managed to back this off to a much more reasonable 240 watts.   A minute or two into this interval--I saw, up ahead in the distance, a couple of children who were maybe 6 and 8 years old riding down the path.   I once again called ahead, and these kids both turned to look behind them.   The older one got out of the way to the left while the younger one put his foot down and seemed to just stand there, fairly far to the right on the path.   This also happens all the time on the bike path, but what occurred next I didn't expect at all.  

The younger kid decided to push his way across the path to who I assume was his older brother at precisely the instant that I'd committed to going through the fairly significant gap between them.  The gap closed--I would not be able to stop in time.  The two of them effectively blocked the entire span of the bike path, and I veered to the left to avoid smashing directly into them.  The exact words I screamed were "JESUS FUCKING CHRIST MOVE."   The younger kid half whimpered/half screamed.  I would not be surprised if he peed his pants.  The older kid moved his bike out of the way just before I had to make the decision to either smash into him or send myself careening down the incline to the LA river.  I pulled away and finished my 12 minute long interval.    I went on to finish this interval and then stopped my bike to turn around and send Brian a text message that said that I was certain I could not continue living here and riding a bike. 

If I didn't scar that 6-year-old mentally for life about riding bikes, I at least left him with the fear that there would be some monster bearing down on him at 23 mph anytime he's on that bike path.  Brian says it's good that he should learn that sort of thing, because people in the area don't respect cyclists on the bike path.   I don't know what to make of it--but I'm sure it's not the way I would have wanted to learn how to ride a bike as a kid.

Stupid stuff happens on bike paths everywhere--that's a constant rule that applies to every path in every locale in every city of our nation.  The rest of my ride went on with the usual density of getting around people who don't quite understand the rules of the road on a bike, but was without incident.   The problem here is that the violent, aggressive behavior of the first kid I dealt with seems to be unique to the low income/gang territory that the LA River Path travels through.   The second interchange, while completely innocent, may have been averted had those kids' parents taught them the basics of riding on a bike path.  The lower income families that use this path think it's a safe place to let their kids do whatever they want to since it's free of motorized vehicles--they simply do not care about the existence of cyclists on this path.

Whatever the case, the LA River path is not a safe place to ride, and I need to move on from it.  Brian and I have talked about moving to a better neighborhood, and the neighborhoods we've discussed lie closer to the San Gabriel river trail, which seems to suffer less from these issues.   The collapse of the housing market will make this move difficult at this time, so until we can make that happen, it looks like I'm spending a lot of time on my indoor trainer, or driving my bike to a safer place to ride.   I'm two-tenths of a mile from what should be an ideal place to ride, but miles from reality.

SPMS Champs Swim Meet

Today and the rest of the weekend, I'll be competing at the SPMS SCM Championship meet.  (Acronym decoder for those not "in-the-know"--SPMS:  Southern Pacific Masters Swimming, the swimming organization for old people in Southern California. SCM:  Short course meters, a 25 meter pool not typically used for competition in the United States, but a standard in most of the rest of the world.)

My thoughts on this:  I've been plagued with back and foot injuries that have really cramped my style for a while--I'm simply headed out here to have fun.   I've entered all sprint races, and I'll be swimming 6 individual events and 5 relays.    The catch here is that these are some of the races that were arguably my best events in high school and college.   My major goal is to go out, compete, have fun, and not get obsessed over performance or comparisons to the swimmer that I once was.   Anyone who sees evidence of me getting obsessed over these things--feel free to give me a good smack in the ass and tell me to stuff it!

As I went through workout last night, I came to the realization that I've spent the past several years training my body to keep going for races lasting 5, 6, or 13 hours--and that's just a little bit difficult to translate to races that last a minute or less than 30 seconds.   I mentioned this to Erin (Grunion Masters Team swim coach), and she gave me her recommendation for how I should warm up to have a good race--it flew in the face of how I warmed up for these races 20 years ago...but then, I'm a completely different athlete than I once was.   Effectively, the advice was to hit the race dripping wet from having just gotten out of the warm-up pool after swimming a set that would effectively be the beginning portion of descending to an all out effort, which I would do in the competition pool.   This stands in stark contrast to my days of warming up an hour ahead of time with a couple of 5 second sprints to the get the muscles moving, and then collapse somewhere and relax until it was time to get to the blocks. 

I realized I have no idea what I'm doing in a sport that I've spent so many years gathering experience--so it's time to sit back, relax, and just have fun with seeing how things go.  Erin's advice is certainly right given my recent background, so that's what I'm doing.   Time to go have a good time!

Coming out of the closet

So, you all know that I'm gay--that's not what this post is about.  It's about the little thing that goes on in my life that people tend to tiptoe around me about, because it's somehow more taboo than the sex of the person I share my life with.  Since I was a kid, I've always dealt with some level of sadness, to the point that my family and friends didn't think it was normal.  And while mood swings are typical of teenagers, what occurred during my college years was clearly not the norm.

I had my first significant episode of what was classified as clinical depression during college, shortly after I quit swimming, during the summer following a semester that began with binge drinking and wrapped up with a case of mono and scarlet fever (yes, scarlet fever--that thing you read about in Little House on the Prairie).   Being the first time I'd ever experienced depression, I thought there was something physically wrong with me, and going to doctors at the Student Health Center, and then the medical center at the Air Force base near my school didn't help to speed along the diagnosis, until I blurted out this litany of frustration to one of my docs--and all he said was "Do you think you might be depressed?"

I was a 20-year-old-typical-pig-headed male at the time and denied this without missing a beat, and then went home and thought about it for several days, and called him back and told him he was right.  I was put on an ancient antidepressant (because military doctors prescribe the cheap stuff first), which eventually landed me in the emergency room.    I went on to try some other antidepressants, finding that either Zoloft or Wellbutrin tended to work well for me.  Over the years that followed, I would either medicate with these drugs, or bury myself in training, either swimming or pursuing triathlon, as a natural fix to this issue.

Exercise has been studied as being as effective as medication in the treatment of depression.  These medical studies run in seeming opposition to the knowledge that excessive exercise can cause depression.   It's a delicate balance, and sometimes things get thrown out whack a little bit.  I've recently stumbled across this article that mostly focuses on the need to identify incidences of depression in athletes (http://www.endurancecorner.com/Mimi_Winsberg/depression).   The sentence that jumped out at me is:

"The main pattern to worry about in the endurance athlete is the athlete who seeks to manage his mood swings and self-esteem with endurance exercise and then gets drawn into a destructive cycle of needing more and more exercise to feel good, while at the same time experiencing increased fatigue, diminishing performance, and a diminishing sense of self-worth."

Beyond this, post-Ironman depression is a well known, if not documented, fact of life of doing triathlon.  The level of demand on your body for racing for an entire day like you do during an Ironman places you into a physical state of extreme disrepair.  Most people take off training following an Ironman for a long period of time as well, which likely adds to the problems.   Additionally, people doing an Ironman have created a significant goal for themselves, and when they achieve that goal, they're often left bewildered--wondering what to do next with their lives.  

I've had many episodes of depression in the past 18 years.   Some of them have been more significant than others, and some were precipitated by a particular event, and some were not.    Some of those events are things you wouldn't argue with being hard to handle:   the first time I dated someone who was HIV-positive (I remain negative to this day, so please don't worry about that), my "divorce" from my ex-partner many years ago,  and times when I've changed jobs and landed in places that really didn't work out for me.

The symptom of medically relevant depression that stands out the most to me, to set it apart from just being sad, is when I don't recover in a normal way from that sadness.  There's a catastrophic spiral down where one event feeds on another to seemingly overcome my world on a daily basis.

Currently, I don't doubt for an instant that I've had a rough year.  I spent a total of 8 weeks on business travel to the east coast at the beginning of this year, and followed that up with a foot injury, a race that I caused more damage to my foot, and then the death of my cat.   I got married, happily, but that event creates a lot of stress in anyone's life.   Without changing companies, I've changed jobs, and I'm having some level of difficulty settling into a routine.  So, I've started medicating.  

I began with dealing with anxiety recently by just taking Klonopin, and found myself taking it every night to go to sleep for the better part of a month.   It took a while for me to recognize this as a depressive crash, but my interest in training, in my every day life, and in the feelings of accomplishment I usually get from doing a good job at work just slowly dwindled away for me.   I met with my doctor and started on Zoloft, which seems to have not done the job by itself, so I've added in Wellbutrin.   Zoloft seems to be a good choice for me because of the obsessive thought processes that I actually have, so I'm a little surprised I haven't already turned the corner.   

Last week, I was instructed to begin tapering off the Klonopin, which left me with about 3 nights in a row that I didn't get much sleep at all.  That lack of sleep knocked me down enough that I've now come down with a nice little head cold.  (Nice way to kick me when I'm down, huh?)

In any case, I think the combination of Zoloft and Wellbutrin will have me feeling better fairly soon.   Just hangin' in there for now...

Saying Goodbye to Norman

On Friday night last week, Norman and I spent the evening with him snuggled into my left armpit while I was watching TV.   For most of his life, Norman's favorite spot was sitting directly on my chest while I petted him, but with the balance issues he had in his final days, this was really as close as he could get.   He was peaceful that evening, and I'm very glad I got to spend some time with him just relaxing and giving him some comfort.

Norman in classic chest-sitting position

Norman died on Saturday after a long fight with chronic renal failure (CRF) which is common in older cats, and lymphoma, which is, in all probability, what actually killed him.   During the final 6 months of his life, he lost upwards of 8 pounds, which was down from a fairly hefty 17 pounds.   The intestinal lesions from lymphoma, combined with the dehydrating effects of the CRF made it difficult for him to consume enough calories over a long haul.   We watched as his back legs deteriorated over months, and did what we could to make him comfortable until then.   A last ditch effort of steroids, IV fluids, and subcutaneous fluids gave him a few more days, but didn't provide the bounceback we were hoping for to give him a little more time.   Our veterinarian at Uptown Animal Hospital in Long Beach was amazing in helping us through this difficult process.

In the beginning of Norman's battle with CRF, managing his blood pressure was a concern, so that the high blood pressure that is common with kidney problems in cats would not add to further kidney damage--it's quite an evil cycle, but in Norman's case, it was caught quickly enough that he was able to go for a couple of years that he may not have otherwise had.   People sometimes asked me how you take blood pressure in a cat, and here's how they did it for Norman--a blood pressure cuff at the base of his tail.

Once, when we were having a rodent infestation in the house, a rat took up residence in our oven, and we had to have a technician come out from Sears to replace all of the insulation in the oven.   We thought we had actually gotten rid of the rat before the guy came over, but as he opened up the oven, the rat jumped out and ran through the house--I remember watching Norman bolt towards the rat, across the living room floor, through the dining room and ultimately back into the oven.   The technician said he wouldn't work on the stove anymore until the rat was gone--which is understandable, but good job kitty!

Norman used to drink out of any water containing vessel he could find.    We'd catch him drinking out of water glasses, hunched over the toilet, the dog water bowl, and on very rare occasion, his own actual cat water bowl.   When Brian and I moved in together, he questioned why I always got a fresh water glass to drink out of, and it didn't take long for him to agree it was a good plan once he saw Norman nearly get his face stuck in a pint glass of water.

When I first got Norman and his brother Milo from the SPCA in Hampton, Virginia close to 18 years ago, I was a co-op engineer (kind of like a summer intern) at NASA, Langley.   I shared an apartment with 3 other co-ops, and when we first moved in, we had something like 6 mattresses in the apartment--I don't really remember why we had that many, but a couple of them wound up leaning up against the wall of a hallway in between bedrooms.   My roommates and I would come home from work to find both of them had clawed their way to the top of the mattresses and gotten stuck and couldn't find their way down.    A while later, I rented a house for a summer in Austin, Texas that didn't have air conditioning (yes, the sacrifices you make as a student).   When my parents came to visit, they remarked how the cats would hang out by the back screen door, simply saying "Get us the hell out of here...now!"   Cats know when things can be improved.

And they are sometimes better judges of people than people are.   My family often remarks that Norman determined my ex wasn't worthy long before I did.   Norman had a certain penchant for pissing all over my ex's suitcase, which was pretty much the only time that he could be certain none of my stuff would be involved.   It would turn out that I wouldn't act on the problems in our relationship for years later (and a hell of a fight over a mortgage).   If I had listened to Norman, I may have saved myself a lot of grief.

Norman, like all cats, had a tendency to get into places he didn't belong, and to be honest, I staged this picture of him in the books in the closet--but I know he'd been in there before.   He'll be missed not only but Brian and I, but by his brother Max and his sister Josie.

I'm sure that Norman is now up in kitty-heaven with his brother Milo fighting over bowls of tuna water, running up mattresses and haunting Jeff's condo to find more suitcases to piss on.   I miss you, big guy!  Take care of yourself up there.
 

Goodbye, Norman!

Finding my way back

Two days ago, I raced in the Vineman 70.3 triathlon, and 3 weeks ago, I decided to quit doing triathlon forever. My road forward for the past couple of weeks has been (to say the least) a little bit rocky. To understand where I've come from, it's probably necessary to backfill with a little detail.

For the past several years (and possibly longer), I've dealt with nagging issues with my right hamstring, glute, and lower back. The pain would range from sharp stabbing issues that prevented me from running, biking, or swimming to dull aches and sometimes not be present at all. I've been horribly inflexible, usually unable to touch my toes, and it seemed that no matter what I did, nothing would release my hamstrings. I competed at Ironman Arizona last year while suffering from this dull ache, and happily got through it. Since that time, I've had a couple of flare-ups, that tend to knock me out of training for a couple of days at a time--until a few weeks ago, there was no change in how this long duration injury had been treating me.

That's when my coach convinced me to meet with someone trained in what's called the Egoscue method--which I won't go into here, but feel free to google it. Simply put, there are a number of stretches that I have to hold for set durations of time, and the total time for stretching daily amounts to between 1 and 2 hours, depending on whether I do the extra credit stretching. The results on my right side have been very promising--the pain is diminishing, near to being gone, and my flexibility seems to be increasing for the first time in a decade or two.

So, three weeks ago, I went out on what was, without a doubt, a hard training run--and I handled it reasonably well--nothing stellar. But it was a good effort with decent speed. I woke up the next morning to find that I could barely walk or support my weight while standing on either leg. The plantar fasciitis that has plagued me since about 1999 instantly overcame my left foot and was a more severe, sharp stabbing version of it than I've ever felt. My right side hadn't yet gotten to where it is now in recovery, and I could barely stand up in the shower--I wondered how I would make it from my car to my desk at work. I decided this sport wasn't worth the pain I was going through and made up my mind to end it. My coach talked me down off that cliff later that day.

It turns out that your body traveling back through previous injuries is a common occurrence in the Egoscue method--and (as painful as it is) a positive sign that the postural deficiencies I've accrued over the course of years are being corrected. To sum it up, plantar fasciitis drove me out of the sport in 2000, and as I came back to it in training for my first Ironman, my body compensated for my left foot and created the issues on my right side. Through the exercises I'm doing my posture is traveling back to where it should be naturally, which includes a stop along the way at the posture that exacerbates my plantar fasciitis.

Yesterday, I told a friend of mine (over wine) that I thought racing on Sunday might go down as one of the stupidest things I have ever done in triathlon. I ran a half marathon, while injured, after not having run for 3 weeks due to that injury. Actually, let's just say I hobbled through a half marathon. In reality, this may be one of the most tactical decisions I've ever made in the sport. I know this injury, and I know it's recoverable in a reasonable amount of time--and triathlon is as much about physical issues as it is about mental ones. I simply needed to belong to the sport again and suffering through 13 miles of running I probably shouldn't have done is what it took to get me there.

So I had really good swim and bike splits and then hobbled through a 2:18 half marathon. I think it's a great sign that I view that run split the way I do, because a couple of years ago, it was faster than anything I could have hoped for. Now it's time to continue fixing my injury and see where I go with racing for the rest of the year.