Wednesday, September 12, 2012

Race Week!

So the nerves are definitely building up... Ironman Wales is on Sunday and it's looming like, umm, some giant terrifying thing. I went for a swim on Monday, which felt good. I ran yesterday, which felt nice and easy (despite being fairly fast). Then today I committed the cardinal sin of adjusting the bars on my bike -- the maxim "nothing new on race day" being violated here -- and so that it wasn't quite so unknown I went out for a ride in the Hampshire countryside.
It was cold, but that helped me sort out what I'll be wearing on Sunday. There were a few exposed patches too, where a few gusts of wind started to build my fears that the weekend will be a windy one. The long range forecasts were looking good two days ago. Yesterday they started to diverge and a couple of forecasts suggested that the weekend might actually be quite a windy one. :-(

All I have to do between now and the race is get to Tenby, set my race gear up, and sort out my nutrition. Oh, and work out how to stop worrying, because I think it might be counter-productive.

On the bright side, two things are making me happy:
1. Despite still having about a million eye drops a day to do, I'm feeling good about my eyes as the left (recently upgraded) is still inflammation-free.
2. Fundraising for Olivia's Vision is going well and I really appreciate the support. No matter how hard it gets out there, I will keep going and I will earn every penny for Olivia's Vision.

Thursday, August 30, 2012

Cataract surgery #2

Less than 20 days to Ironman Wales, but I just had my second cataract surgery. My previous op was back in January, and I "reviewed" the procedure here. Well, second time around was an easier experience. The anaethesia wasn't as uncomfortable and I was less nervous about the surgery (but more nervous about the anaesthesia). I'm one day post-op now, and I'm sat at home passing time since I'm not allowed to lift anything heavy, do impact exercises, or swim. So nothing fun then... at least I'm off work again today, I think I'd have left with a headache by mid-morning!

So how did this one compare to the last? It was nearly 8 hours before I could open my eye and not feel nauseous from the wonky vision. When the muscles that control the eye are put to sleep your eye can rotate to a different angle, making the world in that eye rotate. Add the blurriness from the operation and the dilation, then throw in a healthy measure of "new glasses" feeling and you're approaching the evening after the surgery.

One decent, but not stellar, night's sleep later... I'm actually seeing a lot better. There's occasional double vision and there are certain distances that just don't work, right now. That should improve. My right eye was the one done previously, and that's set for long distance. The left eye (done yesterday) was supposed to be set to focus about 20 inches (50cm) away. That was so I'd have good vision for computer work, the dashboard while driving, cooking and food prep. Then I could have reading glasses for close-up work. Well, I'm currently focussing at about 8-10 inches, which wasn't the plan. One reason I didn't want this (which is the "normal" monovision they give people), is the larger difference between what the eyes can actually see. It takes a while to get used to it, but it's not a problem for people who don't have other eye issues. For me, if I have another flare-up of macular edema in one eye then I'm essentially down to only one useful eye. In this scenario having extreme short-sightedness in one eye is kind of pointless.

There are options though:
1. Within about 6 weeks of cataract surgery you can have the lens replaced. Much later and the little pocket that the lens sits in will have "shrink-wrapped" the new lens and the surgery is less advised.
The real downside here is that it's yet more eye surgery.
2. After a couple of months the vision can be corrected using laser refractive surgery. The downsides here are that healing takes at least as long as the cataract surgery and that the vision needs to be "stable" before the surgery. For uveitis sufferers, a "stable" eye is often a dream. My eyes have periods of medicated stability, typically lasting 3 months, during which time I switch from worrying about distorted vision to worrying about glaucoma.

Anyway, in general the vision is somewhat improved. This time didn't feel quite like the magic bullet of the first cataract surgery, but given time it should settle in and I'll know for sure how the vision is going to end up. Then I can make decisions about lasering the eye to fix my focus.

For now, it's time to continue resting up and making sure my eye recovers quickly. Then I can get back to the serious business of tapering for Ironman Wales, where I'm hoping to raise money for Olivia's Vision. I'd love people to check out their website and maybe sponsor my Ironman on their behalf...

Sunday, August 19, 2012

Los Alamos Triathlon

Yesterday was the Los Alamos triathlon, a local sprint race (20km bike, 400m swim, 5km run). Today marks exactly 4 weeks to Ironman Wales.

The Los Alamos triathlon last year was my second multisport event and my first triathlon. It was nice to be able to return to it this year, see all the new people I've met through the sport and have a great race. The LA tri is run in an unusual order: bike, swim, run. Since it's a pool swim, this is done to spread people out by the time they hit the water. Also on offer for the first time this year was a time-trial start for the "elites". I got talked into signing up for this group, so I gathered with the fast guys and gals at the start and waited my turn to leave. One every 30 seconds... a friend snapped me about 50 yards down the road from the start (that's why I'm the only person in the picture, I'm really not that fast).


Waiting around at the start, it was pretty chilly, so it took a while for the legs to warm up. Training for the ironman distance doesn't really emphasize the short efforts, so I think I may have under-paced the ride. On the other hand, riding harder might have bought me another minute at the expense of time on the run...

I got back and had a minor nightmare unclipping at the dismount line. Left foot, out. Right foot... come on right foot... On my first attempted dismount I started to lift the bike with my right foot and had to give a good sharp twist of the foot to get out of the pedal and off the bike. Next step, almost running past my rack at transition! Anyway, it wasn't that bad, but it was good practice at not getting flustered and practicing "less haste, more speed". So then I was off to the pool, for my worst swim of the year. My arms felt like lead, my legs would only kick slowly and the water felt like hot treacle. A swim that should normally take me seven minutes and change without pushing too hard took over 8 and a half minutes. Maybe some of it was the residual of Thursday's 2 mile swim session, but frankly I don't think that was it. Sometimes you just have a bad day, and I apparently can't swim after cycling.

But I can run (apparently)! Once I got out of the pool I was back to zip through transition (well, it felt speedy, but it was longer than T1) and see whether I could catch anyone on the run, having been overtaken in the pool. Well, one personal best 5k run later (18:49) I was crossing the finish line having shown an improvement in all three events over last year, for a final time of 1:05:16. Even better, it was enough to take 6th overall! Signing up for the elite wave took me out of contention for an age group prize, but I don't need the glassware and it was super fun to do the time-trial start.

So now back to my regularly scheduled training... I'm looking forward to the week after next, where I start my taper (yay, less training!) and get my left eye operated on (yay, vision!). Then it's all recovery until the big day in Pembrokeshire, Wales.

(You can still sponsor me and raise money for Olivia's Vision, a uveitis charity. For details, see this old blog entry.)

Friday, August 10, 2012

4:59:30

Since my last blog entry I've done two races, I've had 5 doctor's visits and one job interview. That kind of thing can really take it out of you...

Anyway, as a result of the 5 doctor'svisits I have been proclaimed healthy (apart from my failing eyeballs) and I have cataract surgery scheduled at the end of the month. Yup, cataract surgery two-and-a-half weeks before Ironman Wales. Still, after a rough couple of weeks where my vision was frighteningly bad I can see again! Okay, only one is is really useful, but cataract surgery should bring that up to two. :-)

I'm still waiting to hear on my job interview, and between opthalmologists, rheumatologists, cataract surgeons and optometrists I'm totally over doctors right now. But training and racing is still good...

So what races? Well, there was the Cochiti Lake triathlon, which was a lot of fun, and Ironman 70.3 Boulder.

Cochiti Lake tri is a feature on the local calendar, and I can see why. It's a nice lake swim, followed by a relatively tough bike (nearly half is on bone-jarring chip-seal, and it has a couple of small hills to slow you down) and then a run that starts with a steep hill, continues on false flats and then bakes you alive in the heat. Did I mention that it was awesome? Okay, so there were some timing SNAFUs, but they all got sorted eventually. Also, by my GPS the bike was about a mile long and the run was 0.3 miles short. Everything went as expected really... the bike was a couple of minutes slower than I would have liked, but my run was a 10km PB at 40:42! Of course, the course was slightly short, and I don't run 10km races very often. I'll take it though. It got me my first podium of the year - 3rd in the M35-39 age group, with a total time of 2:27:51.

Now, the highlight of the last month: Boulder 70.3!
I'd been really looking forward to this. Technically it was a "training race". It was my second ever half-ironman, fifth ever triathlon and the litmus test for my Ironman Wales training. It was also to be my redemption for falling apart doing Ironman 70.3 Austin last year.

Boulder is a super-cool town. I have friends there, so accommodation and good times were sorted. The girl was my driver for the weekend as my eyes were in pretty bad shape, and she was an awesome support team and cheerleader.
The race itself was well-organised. It was a lot more low-key than Austin, but everything was done well. The volunteers were brilliant and the porta-loo to athlete ratio was good (except on the run course).

I'll get pictures and put them up some time, but this race had me nervous and I'll explain why. There's a mantra that applies to many sports, and triathlon is no exception: "Nothing new on race day". I broke that rule in several ways: new bike - I bought a used TT bike less than a week before and had only 60 miles on it by race day; new wheels - there was a sweet deal on used Zipp 404s that I couldn't pass up, so I picked them up in Boulder on Saturday and raced them on Sunday; new goggles - probably not so bad, but I have a collection of goggles that fog, so I bought new goggles (a brand/model I've not worn before). I'm sure there's more, but you get the point. Race day was full of surprises.

I actually warmed up before the swim. This is something I've never done before any oopen water events. Still, it felt good and gave me a bit of confidence in my new goggles. They worked like a champ and I could actually see well enough with my blurry eye to sight for the buoys and stay on course. The water was around 70-71F and was good until I got a slight stitch, probably from the pretzels I was snacking on before the start. Swim Time: 35:08

Dolphin diving out of the shallows, I jogged up the chute towards T1 looking for people I knew. I heard a shout of "Go Bike Works" and failed to see who shouted. Anyway, thanks to that unknown supporter (I was wearing a tri top from Bike Works on Hawaii's Big Island). My plan was for leisurely transitions, to practice for Wales. So I dried my feet, pulled on socks. Next step, sunscreen. I got my bike shoes and helmet on and loaded my pockets with gels. I figured I'd start with a gel in transition and washed it down with a little drink, then unracked the bike, double checked my transition area and jogged to the bike start. A slow transition, but I felt happy and relaxed.

As I got on my bike the guy in front of me lost both bottles from his behind-the-seat cages and all his sports drink spilled. Shame, but he should invest in better bottle cages! The girl was here cheering for me too, so I started the bike ride hoping that I could handle the TT position for the full distance. The road quality on the Boulder course was good. There was no debris to speak of by the side of the road, the surface was fast and smooth, and the hills were subtle: false flats, gentle descents and just a couple of steep bits to keep you honest. Near the end of my first lap I was passed by two female pros just finishing their ride, sadly I didn't recognize them to cheer them on. My second lap was good, and knowing the course by then I felt really confident about the (small) hills and corners. After 56 fun miles I got back to transition - bike time: 2:33:22, by far the fastest I've ever ridden that distance.

The run was around Boulder Reservoir. Since it was an exposed course I took my time in transition again and layered up on sunscreen. After the fact I guess I missed some bits, so I've got some red stripes as souvenirs, but I did a decent job. Then the run... I didn't bother to time my swim, and I used my Garmin Edge bike computer for the bike leg, so I had my Timex Global Trainer watch to time the run. To make sure I'd get GPS lock quickly I'd taken it on the bike with me and turned it on. It auto-powered off during the ride, but as soon as I got to T2 I turned it back on. No GPS lock until about mile 4. I even had to reset the GPS 3 times. I'm really not impressed by that watch. So I ran the first few miles by feel, which included feeling the need to stop. First aid station - one portaloo with a green "vacant" sign... except that the lock was broken, so I stood and waited for a minute before deciding to move on. Second aid station... same problem. Fortunately this one vacated quickly and thirty seconds later I was back running again. The lack of facilities on the run course was my only complaint for the whole day.

After the first lap I decided that I'd try to hold my pace until mile 10, then if I still felt as good I'd go for a fast last 5km. The day was getting hot (around 88F/31C) by this point, so at every aid station I was grabbing ice water for my head, ice for my shirt, ice water for down my back... I even grabbed coke by mistake at one aid station, so figured it was rude not to drink it. More calories are good, right?
Anyway, at mile 10 I felt good and tried to up my pace. My effort went up, but glances at my watch didn't show me a corresponding increase in pace. Never mind, I settled into a rhythm and waited for mile 11. My pace managed to creep up through miles 11 and 12, then with about a quarter mile to go I gave everything I had. It's really amazing how good it feels to run fast, especially after that kind of effort. I felt like I was flying when I got to the finish line, a marked change from Austin last year, and I was all smiles as I got my finishers medal, some ice water and went to find shade. Total run time: 1:43:32.

So my race time was 4:59:30. Over an hour faster than my last half-ironman. I'm still having trouble comprehending how I got under 5 hours (even just 30s under), and the fact that I felt great afterwards. Sure, my legs stiffened up when I stopped moving, but I had plenty of energy left and since I'd not tapered for the race I'm a lot more confident about Ironman Wales now.

It looks like I'll be getting to the start line in Wales with two working eyes and some solid training behind me. I'm actually starting to shake some of the feelings of impending doom that I've been having about the race!

Monday, July 16, 2012

At least I train more than I blog...

I admit it - I'm absolutely terrible at keeping a blog. There are extenuating circumstances, but it basically has to do with three things:
1) I'm fundamentally lazy. This is why I'm effective at work - a smart, lazy worker will find the most efficient way to do something (or so I believe).
2) I'm mono-obsessive. Basically I'm overcoming my inherent laziness by obsessing over my Ironman training. As a side-effect I'm having trouble remembering to buy groceries, let alone write a regular blog entry.
3) I can't really see. My left eye is all just fuzzy shapes and colours right now; it needs cataract surgery, among other things. My right eye has good distance vision, especially near the start of the day. Computer screens are hard, especially after a long day in the office.

So, better late than never, here's what happened at Storrie Lake...

The race organisers had put on a 10km run the night before the triathlon, on the triathlon run course, which was great for the non-triathlete significant others. I made good use of this by sending my spy out to check the run course and report back on road surface, hills, etc.

So race morning: despite rumours about the swim not being wetsuit legal, the water was actually at 63F and quite comfortable in a full-sleeve wetsuit. The start wasn't too hectic, and I only got hit by flailing arms a couple of times. I did get a decent hit in the goggles from someone's foot as they cut a nice zig-zag course in front of me, but before too long I had worked my way through to nice (relatively clear) water. It took about 27 minutes before I was out, but I was pleasantly suprised by Storrie Lake. New Mexico isn't famed for any of it's bodies of water, but it was really quite nice.

Into transition, after a wobbly run up the boat ramp, and I had a fairly slow transition. I can't pin down exactly what was slow, so it must've been everything. I had some watch troubles too, leading to some very odd splits on my Timex Global Trainer... anyway, transition was a good opportunity to clear the mind and before I knew it I was heading to the mount/dismount line and jumping on my bike.

The ride was great, with the exception of the giant rumble strip that ran along the outer edge of the shoulder. I had to cross the rumble strip several times and my bones and teeth didn't appreciate the experience. It was an out-and-back course of 40km which was mostly uphill on the way out, then mostly down coming back. The total elevation gain was less than 1500ft (I think) and that made the ride nice and fast. One thing that really stood out to me was just how much faster all the guys/girls with TT bikes and aero gear went on the downhills. I was in the drops, spinning my biggest gear, and the full time-trial setups kept cruising past me with barely any pedaling going on. Still, I loved the ride and had a great time cruising past people on the uphill sections.

Two notably stupid things I did on the bike course:
1) took the turnaround too fast. I had to lock up the back wheel and skid it round the last few inches so I could avoid running into a table.
2) on one section of hill I dropped my head for too long (watching the white line disappear under my front wheel) and looked up to see a traffic cone. Well, I ran that traffic cone down! A little shift of bodyweight around the bike and the cone just popped out to the side when I ran over it. No harm done (but silly, especially considering how much I ride).

And that just left the run. The course was about 65% paved road, 30% packed dirt road and 5% trail. It was really a lot of fun

So overall it was a good race. The day wasn't cool, and the course wasn't shaded. Heat was starting to play a role as the day wore on, but I finished my day in 2hrs 28min 26sec. Age group place: 5th. Overall place: 23rd.

Next there will be words about the Splash'n'Dash series I've been doing. There will also be an update on how my eyes are coping just as soon as I have news. I've got a checkup on Thursday to follow up on the Ozurdex implant I had put into the left eye on last Saturday.

Until next time...

Sunday, June 17, 2012

The good, the bad, and the injured

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.

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.