Sunday, February 26, 2017

Stupid Triathlon Mistakes, Be Prepared Race Morning

"I've been told that swimming is a wimp sport. I don't see it. We don't get timeouts in the middle of a race, we can't stop and catch our breath, and we can't ask for a substitution."      Dusty Hicks

Just looks fast doesn't she? You bet.

A physicians comment on supplements: "Health food stores are wonderlands of promise.  If people want to burn fat, detoxify livers, shrink prostates, avoid colds, stimulate brains, boost energy, reduce stress, enhance immunity, prevent cancer, extend lives, enliven sex, or eliminate pain, all they have to do is walk in." 
                                                          Paul Offit, MD

This man's job is to prevent female athletes from inadvertently going into the men's changing tent. Despite an orientation the day before, after exiting the swim, at least 20 women tried!  It's Kona.


I was privileged to be in charge of pre-race bike check in Kona.  Maybe next year they'll get someone who really knows what they're doing!  It really went well, mostly thanks to the prolonged efforts of a hard-working group of dedicated volunteers.  We had 6 hours to check-in over 2300 athletes, age groupers and pros alike. 

The desire to race Kona is intense.  So many try for so many years and come up just short in their qualification race.  Each slot in the race is valued.  In fact the Ironman Foundation conducts an annual eBay auction for 4 of them and bids are upwards of $50,000 in some cases.

Thus, this is the most important athletic day of many if not most of these athlete's lives.

So, if it's of such a level of importance, why do some seem so unprepared?  Each receives a many paged set of instructions that has been developed over 38 years of racing leaving little if anything to question.  But some still show up for bike check-in without a helmet, without their bike and run bags, no number on their helmet, in need of bike repair, etc.  I suppose in any large group you'll have a few who make odd choices.  It's just that every athlete who toes the line has put in such effort to get here, it would be a shame to have this opportunity go awry for something so preventable.

Other athletes get nabbed by by the refs for drafting. While the rules are clear, on a rolling course like the Queen Ka'ahumanu Highway course in Hawaii, with so many athletes of similar ability, there's an ebb and flow, speeding up and slowing down, that's it's pretty hard to follow the letter of the law.  Just ask these three athletes I happened to notice toward the end of the race while working as a course guide on the pier.  The dreaded red slash of a violation.

In short, the take home lesson is clear.  Preparation for this race, for any race, is the key to success.  Perhaps like many things in life I suspect.  Check, recheck and then check one more time before you leave home that you have everything. (Have I ever arrived at the race site only to discover that my bike shoes were still at home?  Yes.  But, as importantly, will I ever do it again?)

Can you preview the course the day before?  Maybe a short swim at the venue then drive the run/bike course?  Have supper planned (need reservations?) weeks in advance and get to bed early with everything you'll need for race morning out and ready.  

Get to the event site way early, check in and get your transition situated.  Walk from water's exit to you bike slowly, mentally marking the path, picking a reference for your row of bikes.  Do it again.  Walk from your bike to the T1 exit.  Do it again.  This is enough, making the point that before the race cannon sounds you know everything you're going to do and every place you're going to go.  It will pay off at the post-race picnic when yours is one of the names called for an age group podium finish.  Your reward. 

Sunday, February 19, 2017

Triathlete's, Donate Blood. One Day the Need Might Be Yours!

The Athlete's Guide to Donating Blood

I wrote this for Ironman a couple years ago. With racing season still a ways away for those of us in the northern part of the country, we can still donate a unit and be back to full strength by Spring.  Even if you've never done this, when you walk out the door of the Red Cross or local blood bank after your donation, you have this same sense of pride, self-worth, that you do after a race. President's day is tomorrow and many have the day off. Why not put this at the top of your to do list. You'll be glad you did.
Athletes guide to donating blood
Nurse removing the transfusion

As professional triathlete Jordan Rapp knows, blood on the shelf saves lives. Here's a breakdown of the whys and hows.

Jordan Rapp is a professional triathlete and one of the best long-course athletes in the sport. For those of you who don't know, he had a horrific bike accident when he was involved in a hit-and-run crash in 2010.  He had multiple fractures, abrasions, lacerations and significant blood loss. He was injured so badly that he was initially placed in the intensive care unit and had significant blood loss requiring transfusion. "Two pints of A+," according to a recent email from Rapp.

"Blood on the shelf saves lives," says Beth Hartwell, former Blood Bank Director at the Memorial Hermann IRONMAN Sports Institute. "Each donation can help save three lives." Dr. Hartwell looks upon those who give blood as her "heroes. Their blood is going to an anonymous person in need. How cool is that?"

An athlete's concerns
With our healthy pedigree, triathletes are the perfect candidates for donating blood. It doesn't matter if it's the Red Cross or your local blood service—giving is the goal. Did you know that less than 10 percent of the population gives blood annually, for the benefit of 100 percent of us?

As an athlete, your first concern is how long it takes to return to pre-donation blood levels. That depends on specifically what you donate. For example, scientific studies have shown that if you donate plasma, the liquid part of the blood, or platelets, the cells that help blood clot, but not the oxygen carrying red blood cells, you’ll be back to normal in 48 hours. Even if you give whole blood (including the red blood cells), within a week or two you shouldn't see a difference in your training from pre-donation, although a 100 percent correction in your hemoglobin level will take about five to seven weeks.

There are many reasons not to give blood, such as a needle stick, a few days of sub-maximal training, rumors from the uninformed, to name a few. But there's never a shortage of reasons to give. Blood is used for patients getting dialysis, heart surgery, children with cancer, trauma victims, etc. Think about how frequently you read about one of our own colliding with a vehicle, or another cyclist. And blood is always available when we need it.
Your first time: What to expect 
So what happens when you, an athlete, go to donate for the very first time? You'll register and answer a few confidential questions to make sure the donation is right for them and right for you. They'll take your pulse, temperature and blood pressure. If this were a triathlon, consider that the swim. T1 is getting your arm really clean and prepping it for the blood draw. The bike, actually having the collection bag fill, takes only a few minutes—faster than some of us complete a an IRONMAN transition! In T2 they wrap your arm with a colorful "Why yes I did just give blood, thanks for asking," band. Then you run to the snack area where you can have unlimited Oreos, Fig Newtons, and juice, and in 10 minutes you're back on the sidewalk ready for action—a new PR for sure.

Imagine how good you'll feel doing something for others. And it's only April—many of us aren't even in racing season yet, making it an ideal time to give. Dr. Hartwell says that the infrequent donor will be ready to race at 100 percent in two months, the regular donor in three. And for those of you who are afraid of needles, the small prick of the skin is outweighed by the accomplishment you’ll feel at the end. Did I mention the Oreos?
So get out the phone book and find the nearest place to give. You'll be glad you did. Just ask Jordan Rapp.
John Post is a six-time IRONMAN World Championship finisher and the medical advisor for TrainingBible Coaching

Athlete comments from the website that you may find encouraging.
Karen Lethlean ·
After giving blood on a Monday, I attended my usual intense swimming training on a Tuesday afternoon, and fell very ill. When I next talked to the Red Cross they were adamant that I should have been told that any form of physical training within 3 days of donating blood is not advisable. Now, forewarned I make sure that either I am on a rest phase, or able to take a few days break before committing to donating blood. But aside from taking that kind of precaution donating can be a mini health check you find out how are your iron levels going.
LikeReply2Apr 1, 2014 7:37pm
Katerina Richardson
I did bike/run bricks same day no problem. Yes, slower but it's ok. Weight lifting is a no-no, though.
LikeReplyOct 3, 2016 9:00am
Wayne Jordan ·
Option is to donate plasma rather than whole blood. I am AB+ so they seem to prefer the plasma too. Recover a whole lot quicker too
Denise Hiller ·
Karen, NO strenuous exercise a full 24hrs after donating blood. Remember to hydrate well 3 days prior to your donation
Donald Oswalt ·
Thank you for sharing this. I am in training for the Boston Marathon and triathlon season and opted out of giving blood last week because I did not want it to effect my race performance. Now I know that about the recovery time but, I will wait until after Boston and give.
Katerina Richardson
I have been a regular blood donor for several years. Your body adjusts. Just take care of it.

Originally from:

Sunday, February 12, 2017

What Every Athlete Needs to Know Regarding Pain Relievers

Save the world, win valuable prizes. Be a triathlete.

This months meeting of our County Medical society was on pain relievers.  Things have turned nasty with the current opiod epidemic and each of us can help in some way.  Very enlightening.  Orthopedic surgeons prescribe 7% of all narcotics and have been given tools to head toward 6%.

I wanted to have some kind of reference that triathletes could turn to since pain, and pain relieving efforts, are so common to our sport.  I found this from Harvard to show us the difference between Tylenol (acetaminophen) and anti-inflammatory drugs (NSAIDs), why generic drugs are both cheaper and as effective, etc.

This might be one of those that you'd want to print off for reference, for maybe even next year, should you find yourself looking for information.


The Family Health Guide

11 things you should know about common pain relievers

Understanding the differences between acetaminophen and NSAIDs

Once upon a time, easing pain was relatively simple: take two aspirin and call the doctor in the morning. Now there are many pain relievers to choose from (see "Pain relievers at a glance").
Willow bark was one of the earliest painkillers. Extracts or teas of willow bark have been used to treat fever and pain for more than 2,000 years. Unfortunately, the active ingredient, salicylic acid, is very hard on the stomach. In 1897, a German chemist working for the Bayer Company found a way to modify salicylic acid so it was less irritating to the stomach. The compound he created, acetylsalicyclic acid, was called Aspirin. It remained the premier over-the-counter painkiller until the development of acetaminophen in 1956 and ibuprofen in 1962. Since then, more than a dozen others have come onto the market.11 things you should know about common pain relievers
The two main categories of commonly used pain relievers are acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), which include aspirin and drugs known as COX-2 inhibitors. Many are available over the counter; some are available by prescription only.
Picking the right one can be enough to give you a headache! Here are 11 tips to help you navigate the pain reliever aisle.
1. What's the difference? NSAIDs ease pain, lower fever, and turn down inflammation. They can be very helpful for pain arising from inflammation-related conditions such as arthritis. Acetaminophen eases pain and fever, but does not affect inflammation.
2. NSAIDs revolutionized the treatment of pain. But as is the case for all drugs, they have some drawbacks. Regular use of an NSAID has been linked to an increased risk of heart disease. All NSAIDs, including the newer COX-2 inhibitors, can be hard on the stomach, causing ulcers or gastrointestinal bleeding. These problems tend to emerge only after long-term or heavy use. Don't be scared about taking the occasional NSAID for a headache or aches and pains.
3. What applies to NSAIDs doesn't usually apply to acetaminophen. Acetaminophen is not an anti-inflammatory agent, and eases pain in a different way than NSAIDs. Acetaminophen is easier on the stomach than NSAIDs, but has its own set of problems.
Acetaminophen can damage the liver. Three thousand 250 milligrams (mg) a day — about 10 regular-strength acetaminophen tablets — is considered the safe upper limit, but that might be too much for some people. Large doses are the main risk, but there are reports of people developing liver problems after taking small to moderate amounts of acetaminophen for long periods of time. Drinking alcohol while taking acetaminophen can also cause liver damage.
Acetaminophen is an ingredient in many over-the-counter cold and headache medications. Some people may be taking more of the drug than they realize because of these "hidden sources."
4. COX-2 inhibitors — a new addition. A new family of NSAIDs, called COX-2 inhibitors, was developed in the 1990s. They were supposed to be better than "regular" NSAIDs: a new generation of medications that would relieve pain but spare the gut. Although these drugs were a bit easier on the gastrointestinal system, it turned out they weren't especially heart friendly. The first COX-2 inhibitor, rofecoxib (Vioxx), was pulled from the market in 2004 after it was linked to an increased risk for heart attack. Valdecoxib (Bextra) came off the market a few months later. A third COX-2 inhibitor, celecoxib (Celebrex) has stayed on the market. At doses of 200 mg per day or less, it doesn't appear to pose any greater heart attack risk than other NSAIDs.
5. Go generic. Generic over-the-counter pain relievers are less expensive than their brand-name counterparts, and work just as well.
6. Help for NSAID-related stomach woes. If you need to take an NSAID every day for arthritis or other chronic condition, and the drug bothers your stomach or you're at high risk for gastrointestinal complications, taking a proton pump inhibitor can offset this side effect. Proton-pump inhibitors include esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), or rabeprazole (Aciphex).
7. Take your daily aspirin before taking an NSAID for pain relief. If your doctor has recommended that you take a daily low-dose aspirin for your heart, and you also take an NSAID for pain or inflammation, timing is important. NSAIDs block the ability of aspirin to make blood platelets less "sticky." This helps prevent the formation of clots inside the bloodstream, which can cause heart attacks and strokes. One strategy is to take aspirin first thing in the morning, then wait 30 minutes before taking an NSAID. If you take an NSAID first, wait eight hours before taking aspirin.
8. Beware of blood pressure increases. All NSAIDs, including the COX-2 drugs, tend to boost blood pressure. The effect is strongest and happens more consistently in people who have high blood pressure already and are taking medication to control it, but there's evidence that people with normal blood pressure are also affected. Acetaminophen, in high doses and among women, has also been shown to cause small hikes in blood pressure.
9. Don't go cold turkey. If you take an NSAID regularly, don't stop suddenly. Sudden withdrawal makes blood clots more likely to form, and so increases the chances of having a heart attack or stroke.
10. Beware of kidney woes. NSAIDs, including the COX-2 drugs, can be hard on the kidneys and, in extreme cases, cause kidney failure. Signs of kidney disease include unexplained nausea or vomiting, loss of appetite, fatigue and weakness, changes in urine output, persistent itching, and other so-called nonspecific symptoms.
11. Genes matter. There is a lot of individual variation in how people react to pain relievers. It may take some trial and error to find the one that works best for you.

Over-the-counter pain relievers at a glance

Generic name
Brand names
Anacin, Pain-Eze, Tylenol, and 40 others; also in more than 150 combination products)
Not an NSAID; doesn't cause stomach problems like NSAIDs; common ingredient in headache and cold medicines; large amounts can cause liver damage.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Anacin, Bayer Aspirin, Bufferin, many others; also found in scores of combination products
Technically an NSAID, but its anticlotting properties make it unique; the development of alternatives and high risk of gastrointestinal bleeding mean it's not used as much today as a pain reliever.
Advil, Motrin, Nuprin
Favored because it acts quickly without staying in the body too long, so per dose it has a lower risk of causing stomach and kidney problems.
Aleve, Naprosyn
Longer acting than ibuprofen.

Prescription NSAIDs at a glance

Generic name
Brand name
Available as a generic?
Arthrotec, Cataflam, Voltaren, others
Ansaid, Ocufen
Indocin, Tivorbex

Sunday, February 5, 2017

Have You Ever Flatted in an Ironman? We Polled in Kona

Congrats to all of you who gave up beer, wine, scotch, brandy, you name it for January! 

We had a contingent of folks from, Twitter and this blog.  Hearty congrats to all.  This was much easier for some than others and if you had no problem with it, hold a place in your heart for those whom this may have been a bit of a struggle.  They learned that, just like in our sport, with the right motivation, just like they say at Ironman,

Does your warm up swim really help?

I'm a strong proponent of warm ups be you heading out for a swim, run, what have you.   Remembering that we save most of our stretching till after our work out, dynamic movement at a lower intensity and diminished range of motion gets you ready to train.  Ready while reducing your probability of injury as well.

Do you swim 100, chat. Pull 100, chat then rearrange your fins, pull buoy, and stuff on the deck.  Kick 100, greet new arrival two lanes over?  Think you get the same contribution to readiness to swim and over all swim fitness as the woman in the lane next to you who, even though swimming easily, does 300 swim, 200 pull and 150 kick stopping only to don/doff her pull buoy?  Try it her way for a week and see what you gain.


Every year at the Ironman World Championship in Kona, we interview as many of the athletes who'll talk to us, usually about things of which I'm curious.  This is from October.

Rehydration - Do you drink to thirst or follow a plan? - fairly controversial topic.  In one corner we have those who say that your body is the best indicator of thirst.  Listen to it and drink when thirsty.  On the opposite side of the ring would be the max hydrators who say to walk around the the transition area before race start sipping on a water bottle, and right before your wave is sent off, have a good pee such that you're starting the event with an empty bladder and super hydration.  Then keep a close track on what goes in your mouth drinking at regular intervals, thirsty or not.  This would, of course require some modification if you're racing in Hawaii vs Madison, WI.  Or, is there a middle ground plan where you're not looking to suck on a fire hose but you do use other indicators than basic thirst to determine when and how much to drink?

We also want to be reminded of hyponatremia, sometimes referred to as Marathon or Running Hyponatremia where the athlete consumes excess water diluting the serum sodium.  It has been reported that some athletes have taken this to such lengths that it's lead to their demise.  It's more often seen in the 4 hour or longer marathon runner, less hot conditions and women slightly more than men.

So knowing all this, what do the Kona qualifiers do?  It's an either/or question right?  Leave it to triathletes to come up with a third option of course.  So, this past October, 14% said they drank by thirst and 70% use a pre-race designed plan.  This leaves 16% who told us "both."  Thus, despite the teaching and preaching of a number of authorities, this group, which might be the finest and fittest on the planet that particular day have learned - likely though screwing it up - that for them some type plan will give them the highest chance of doing well in the endurance triathlon environment. 

Have you had stomach issues Iron racing to such a degree that it affected your race? This was a little more straight forward. 46% said yes leaving 54% negative.  One contributing factor might be that this group has, by nature of the Kona qualification system, raced a lot and perhaps had more opportunities from more races.  The 6 athletes I interviewed for Ironman, all legacy folks, had over 70 full distances races between them, and it didn't seem to be as big an issue

Lastly, I've raced Kona several times, and have even seen years where there were reportedly thumbtacks strewn on the course (a quick Google search will also report similar happenings at IMC and Coeur d'Alene.)  I've never flatted in an Iron distance race, or any race actually, and wondered if it were due to my, ahem, meticulous race preparation, or much more likely, blind luck.  So we asked racers:

Have you ever flatted in an Iron distance race?  This is when the fun began, a completely unexpected response.  A number of participants, when asked this seemingly innocent question, got angry.  Some, really angry!  Said we would jinx them if they answered.  Or even thought about answering.  Some "flat"ly refused to answer and just walked away!  Wow!  In any event, of those who did respond, without our fear of bodily harm, 79% had never been involved with flat repair racing Ironman.

If you have two more minutes, this was published a couple months ago and I think you'd enjoy reading "Can You Have Three Flats and Still Finish Ironman?"