As of yesterday I have three calendar months until Ironman Wales. Today it is exactly 13 weeks.
This month is turning out to be really busy, so what are my good, bad and my injury?
Well, I'll start with the good, which was this weekend.
The good:
Yesterday was a gorgeous day. Slightly overcast, a light breeze, not too warm. I went down to Cochiti Lake with the tri-club and did some open water swimming. According to Google Earth, about 2 miles of open water swimming. Other than some residual soreness in my right shoulder (an old war wound from a motorbike accident in the mid-90s) it was great. I felt awesome for the first mile or so, then I still felt good but a fair bit slower. Afterwards a few of us ran (45 minutes easy).
Today was one of my "A-races": The Tour de Los Alamos! The race has a "citizens" category, for people who don't regularly race (and hence don't have USAC licences). So that's what I ride, and have done for three years now. Today was great weather and a great result.
The race started out fairly slow, and at the 'back gate' there were a dozen people packed together at the front. Normally there's a sprint to that point and then the top 6-7 is already decided. The rest is just placing. Not today... it was tactically conservative (=slow) for the first half. Then two guys made a break coming out of a canyon, and the rest of us didn't respond. Well, not exactly. I thought about the sprint to break with them, but decided it was too big a risk. Instead I upped my pace slightly and pulled about half the remaining group with me. Slowly creeping the pace up we came through White Rock and could occasionally see the leaders. As I started feeling like my pace was too high to respond if anyone else tried to break I sat back, hoping someone else would lead the paceline. On a couple of occasions that worked, but I had the choice of driving the pace or sitting back and letting the break get away, so I drove the pace.
The race finishes with a big climb (~4miles, >1000ft) that's not super-steep, but is just relentless. About 2.5 miles in I made my move and hit the power. Two people stayed with me for a while. Then we passed one of the breakaways. Then it was down to me and my "nemesis". Last year we sprinted for the finish together and I got it by about a wheel. This time I went for the gradual approach and managed to put down a sustained effort that bought me a 7 second lead at the line.
Second in the citizens category, and 1st in the 30-39 age group for three years in a row. Time was 1:19:56 - a personal best on that course by a good 5 minutes.
The bad and the injured:
Last weekend was the Valles Caldera "Run the Caldera" marathon and 1/2 marathon. I was signed up for 13.1 miles of trail running and was feeling pretty good. In fact, I ran the first 4 miles at about a 6:15min/mile pace and it felt great! Just before mile 5 we hit a giant, steep hill and the pace dropped to 15min/mile, but I was still gaining on the two guys I could see ahead of me. I'm pretty sure that they were 5th and 6th place.
So I crested the hill, blew past the aid station and started on the descent: which was rocks, rocks, rocks. Fist-sized pointy rocks and Fivefingers (Bikilas) do not mix, especially not at high speed. One rock bit the sole of my foot, there was a sharp stab of pain and I knew my race was over.
It was all I could do to keep moving - limping down the hill with people starting to pass me. I could barely put enough weight on it to limp and after a half mile I was almost ready to sit down, have a good weep and decide whether to quit or walk in. Another half mile later and I was back on a dirt road, so I experimentally tried to jog. Not a great plan, so I started a slow, limping jog towards the finish. Another half mile and my foot had quit screaming quite so hard at me, probably because the ground was softening up, so I started to move faster )and with a little less limp).
I pulled back a couple of places and finished 24th, in 2:00:29. Good, but not as good as the 1:40 pace I was on before I bruised my foot. Still, I should be thankful. I finished without serious injury, I ran well up to the injury and even though (a week later) my foot is tender and bruised, I am recovering and can still train.
No more rocky trails in Fivefingers for me though. I'd been bruised before, and thankfully nothing worse, but no trail injury had ever stopped me running before. I have increased my level of foot protection with a pair of Merrell Trail Gloves for my off-road adventures.
So what's next?
Well, the training continues and so does the heavy race schedule. Next weekend I'll be at Storrie Lake, NM, doing my first olympic distance triathlon. I haven't got room in my Ironman training schedule for a taper, so I'm looking at another big training week. Hopefully it won't get derailed by any eye stuff... I'm overdue for an implant in my left eye, which will keep me out of the water for a few days. Hopefully I can get that done in the first half of the week, or wait until next week.
Sunday, June 17, 2012
Saturday, June 9, 2012
Options
I'm reminded of the Gomez song "... that's okay, at least I've got options".
As of yesterday I now officially have options back on the table. I went to Albuquerque to see a new uveitis specialist who only moved to the area late last year. The last actual specialist I saw was over in Dallas, Texas. Not that my regular quack doesn't know what he's doing, but he's a vitreo-retinal specialist and I'm his only uveitis patient.
So anyway, up till now I've been getting local treatment for my symptoms. Mostly that means some sort of steroid in my eyeball to control inflammation and bring down the cystoid macular edema (swelling in the central part of the retina). The doc in Dallas suggested immuno-suppressant treatment, which I eventually went on, but my local doc is unwilling to manage that. His consistent suggestion has been vitrectomy (surgically removing the vitreous jelly from the eye). So both I and my rheumatologist are getting frustrated with having no guidance. Until recently my best option for input was another trip to Texas.
That has all changed! The new uveitis specialist in Albuquerque (at UNM Hospital) is really good. She laid a bunch of options out for me, rather than just focusing on one. So here's a quick summary, split into groups:
Local:
- More ozurdex implants to control the swelling. I need these every three to four months currently.
- A retisert implant. Downside is that I'd probably need some kind of device put in my eye to help manage the pressure, since this is another steroid option and I 'respond' to steroids (i.e. my intra-ocular pressure shoots up). Brightside: lasts well over a year, can cause cataracts, except not in me since I already had one lens replaced and my other eye will be done soon.
Surgical:
- Vitrectomy. I don't like the idea of this since it's a 50/50 shot in the dark. One thing they usually do with this procedure though is laser the inside of the eye (in my case it'd be the pars plana) to help reduce the chance of inflammation.
- Cryotherapy. This sounds super-cool [/pun]. They freeze the pars plana from the outside, so it's non-invasive surgery. It has the same effect as lasering the inside, like they'd do in a vitrectomy, except there's no surgical removal of anything. The only downside is the local anesthesia, which is my "favourite": retro-bulbar injection!
Systemic:
There are a ton of options here.
Currently I'm subjecting myself to Methotrexate, which is used to treat various nasty things like rheumatoid arthritis and leukemia. It's been doing exactly squat for me. Well, it has taught me to inject myself on a weekly basis, which I'm sure is a useful life skill.
- Increase the methotrexate. I'm on a lowish dose right now, and I'm tolerating it well. So increasing the dose is a first step before thinking about anything else.
- CellCept. Apparently a much more potent drug that works in a similar way to the methotrexate. It's a twice daily thing, rather than weekly injections, but could work. Same issues as my current regimen, which means regular blood testing to check on my liver function.
- Other drugs. The only name I remember here is cyclosporin, but there were two other "categories" of drugs that could be considered. I also recall "T-cell inhibitors" being discussed, but I can't remember whether cyclosporin was one of those. Regardless (I can google that later), there are other systemic options that the doctor is happy to manage herself, which is a massive change for me.
I was also amused by the eye test where they checked for my best-corrected vision. They managed to correct my left eye so that I could read the giant E on the top line. Very exciting.
So my plan:
- Schedule another ozurdex implant for my left eye and then schedule cataract surgery.
- Go see my rheumatologist and double my dose of methotrexate.
- Review situation in a couple of months. If there's no clear improvement from the methotrexate then we'll try CellCept.
- Cryotherapy. Despite the retro-bulbar injection, this seems like a low-risk option for improving things. It might be on the cards later this year.
Mostly I'm glad to know that I've got options. I wasn't that hopeful about seeing the new doctor, but it turned out great. All I have left to worry about this weekend is a trail half-marathon that I'm running up at ~8500ft.
As of yesterday I now officially have options back on the table. I went to Albuquerque to see a new uveitis specialist who only moved to the area late last year. The last actual specialist I saw was over in Dallas, Texas. Not that my regular quack doesn't know what he's doing, but he's a vitreo-retinal specialist and I'm his only uveitis patient.
So anyway, up till now I've been getting local treatment for my symptoms. Mostly that means some sort of steroid in my eyeball to control inflammation and bring down the cystoid macular edema (swelling in the central part of the retina). The doc in Dallas suggested immuno-suppressant treatment, which I eventually went on, but my local doc is unwilling to manage that. His consistent suggestion has been vitrectomy (surgically removing the vitreous jelly from the eye). So both I and my rheumatologist are getting frustrated with having no guidance. Until recently my best option for input was another trip to Texas.
That has all changed! The new uveitis specialist in Albuquerque (at UNM Hospital) is really good. She laid a bunch of options out for me, rather than just focusing on one. So here's a quick summary, split into groups:
Local:
- More ozurdex implants to control the swelling. I need these every three to four months currently.
- A retisert implant. Downside is that I'd probably need some kind of device put in my eye to help manage the pressure, since this is another steroid option and I 'respond' to steroids (i.e. my intra-ocular pressure shoots up). Brightside: lasts well over a year, can cause cataracts, except not in me since I already had one lens replaced and my other eye will be done soon.
Surgical:
- Vitrectomy. I don't like the idea of this since it's a 50/50 shot in the dark. One thing they usually do with this procedure though is laser the inside of the eye (in my case it'd be the pars plana) to help reduce the chance of inflammation.
- Cryotherapy. This sounds super-cool [/pun]. They freeze the pars plana from the outside, so it's non-invasive surgery. It has the same effect as lasering the inside, like they'd do in a vitrectomy, except there's no surgical removal of anything. The only downside is the local anesthesia, which is my "favourite": retro-bulbar injection!
Systemic:
There are a ton of options here.
Currently I'm subjecting myself to Methotrexate, which is used to treat various nasty things like rheumatoid arthritis and leukemia. It's been doing exactly squat for me. Well, it has taught me to inject myself on a weekly basis, which I'm sure is a useful life skill.
- Increase the methotrexate. I'm on a lowish dose right now, and I'm tolerating it well. So increasing the dose is a first step before thinking about anything else.
- CellCept. Apparently a much more potent drug that works in a similar way to the methotrexate. It's a twice daily thing, rather than weekly injections, but could work. Same issues as my current regimen, which means regular blood testing to check on my liver function.
- Other drugs. The only name I remember here is cyclosporin, but there were two other "categories" of drugs that could be considered. I also recall "T-cell inhibitors" being discussed, but I can't remember whether cyclosporin was one of those. Regardless (I can google that later), there are other systemic options that the doctor is happy to manage herself, which is a massive change for me.
I was also amused by the eye test where they checked for my best-corrected vision. They managed to correct my left eye so that I could read the giant E on the top line. Very exciting.
So my plan:
- Schedule another ozurdex implant for my left eye and then schedule cataract surgery.
- Go see my rheumatologist and double my dose of methotrexate.
- Review situation in a couple of months. If there's no clear improvement from the methotrexate then we'll try CellCept.
- Cryotherapy. Despite the retro-bulbar injection, this seems like a low-risk option for improving things. It might be on the cards later this year.
Mostly I'm glad to know that I've got options. I wasn't that hopeful about seeing the new doctor, but it turned out great. All I have left to worry about this weekend is a trail half-marathon that I'm running up at ~8500ft.
Subscribe to:
Posts (Atom)