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Blood Don’t Lie.

19 April 2018

Lots of athletes use the phrase “blood don’t lie” to mean we may be feeling good or bad, but blood tests will tell you the truth about where your health is, and how you are improving or falling backward. Yesterday I visited my new primary care clinic, and had a history and physical, along with a bunch of blood tests.

As many of my longtime readers know, my number one fitness goal, the one that casts the long shadow over all the others, is “Don’t Get Diabetes”. I have the insulin resistance. I’ve had some troubling A1c scores in the past. And the only reason I’m not diabetic is that I fundamentally treat myself like I’m diabetic.

I also wanted to ask the provider about my lingering knee issues, a lump on my thumb, and a new issue with my foot. But mostly, I wanted those blood tests to see where I am with my metabolic control. I work like a dog at it, and I want to make sure that I’m seeing the results.

So the results: my A1c, which measures long-term blood glucose control over about a three month period, was 5.3. That’s stellar. Not even prediabetic. The number I was terrified of was my post-prandial blood glucose. That’s just my current blood sugar after a meal. It was 118. Again, stellar. Based on my glucose results, I am controlling and managing my risk of developing diabetes very well.

My cholesterol was 197, with an LDL of 121. Both normal. HDL of 53. Good. Blood Pressure is great. My diastolic was a little high for me, at 80, which is the top of the normal range, but I’ve had repeated measures in the high 60s recently so I’m not worried. BP varies rapidly. My resting pulse was down in the mid 40s.

So, the work I’ve been doing – and I know I’ve been writing less, but I haven’t been working less, has been paying off. I feel strong. I feel capable. And blood don’t lie: I’m in great health. Now if only that knee would ease up.

A Good Training Week.

16 April 2018

This week was definitely a step in the right direction. After two months (December and January) where I did essentially nothing, I was not in a good place, fitness-wise. I’d put on about 10 pounds, and found running even 3.5 miles at a 12 minute pace to be incredibly challenging. Painful, and exhausting. I was concerned that my fitness had fallen to the point that getting back to major racing distance would be a very long and difficult project indeed.

And I have been working very hard. Running four times a week, this week I made it up above 30 miles. I ran a fast 10km on Tuesday, turning in a 56:24. Fastest in a couple of years, I think. Then I did a hill run Thursday up and over Phinney Ridge, which anyone from Seattle will find impressive. That was good for about five miles. The weekend was a ten mile loop of Lake Union with a side-jaunt over Queen Anne Hill. Another of Seattle’s famous bastards. And then a trail run up to Wallace Lake in Snohomish County.

trail

I truly love the Pacific Northwest. It’s unlike anything else anywhere. The beauty and climate and culture and everything. It’s home, and it’s like living in my favorite destination city.

Other than Tuesday, my paces were on the unremarkable-to-slow side. But I also got a total of about 3900 feet of elevation gain in. It’s all about building. It’s slow and it’s a lot of work and a lot of time (my runs this week took a total of about six hours). I also did two hours at the gym, but less time on my bike due to the rain. This week should be better for that.

It’s still a long time until my big goal race in late October. But I’m getting myself to where I need to be.

Gone.

2 April 2018

Well, my father is gone. After about four days in hospice, kept comfortable but without food, water, or medicines to do other than relieve pain, my father died at about 5pm Friday, March 30th, 2018. He was born August 30th, 1941. He lived 27,971 days. He was 76 years old when he died. He was a dad, a Veteran, a chess player. He cared a great deal about the people he loved, and he was kind to everyone, even when he was furious.

He was my father and I loved him.

The weekend was surprisingly good, considering. I was strangely asked to speak at my AA meeting Saturday morning, to fill in for someone who couldn’t make it. It ended up being a messy, difficult talk, in which I misstated my own sobriety date by three months. But it was good to get to do.

BB and I did a long run on Saturday of 8.3 miles, and a trail run on Sunday of 5.6 miles, and then we went to be with my family on Easter. I saw my sisters, which was good, and my brother. I missed everyone, and I’m glad I saw them.

And so soon I’ll be heading down to Tucson to inter my father, and then we’ll have a memorial in Seattle. And that will be his life. And I’ll be grateful for all of that. And sad.

Middles and Endings.

27 March 2018

I signed up for my first ultramarathon. It will be a 50 km (31 mile) trail race near Bellevue, WA, in a park called the Cougar Mountain Regional Wildland. We’ll run over and around both Cougar Mountain and Squak Mountain. There will be a vertical gain of some 7500 feet. Nearly a mile and a half. I’m already excited an nervous. And yet there’s six months between now and then. Plenty of time to get fit and ready. And I feel confident that I can do it. It’ll be hard and painful.

My new office mate taught me about type 1 fun and type 2 fun. Type 1 is when you’re having fun during a thing, like a rollercoaster, or a fine dinner, or whatever. Type 2 fun is when you the thing itself is challenging and difficult, but afterwards you feel gratified and happy. That’s endurance running. And I think it’ll be a lot of type 2 fun.

One reason I wanted so badly to sign up for this today was to do something life affirming. My father has been moved to hospice from the ICU. He’s dying. How fast, no one knows. But sooner rather than later. I don’t have the emotional energy to write about it. Suffice to say I owe both my sisters an enormous debt of gratitude for being there for him, over and over again, in his life when I wouldn’t or couldn’t.

I am in the middle of my life. Realistically very close to the middle indeed. And my father is dying. Far away. If I hadn’t just begun a new job, I would go there. I’d just go there and wait and be there when he died. Instead, he will die without me. And that’s ok. It will have to be. That’s the way life is, and the way life ends. We don’t get to make choices all the time. In the end, we don’t get to make any.

But  I get to choose how I will live. I get to go run. Over mountains and through valleys and through mud and streams and among the tall trees of these forests. I will throw myself against the mountains with whatever I can muster in myself. And maybe that will help me connect to the part of me that finally, after all these years, has become a man.

Finally Some Real Progress.

26 March 2018

This weekend was a very good weekend for running. Both in terms of the weather, and the actual runs themselves. Saturday we did eight miles on the path from Wallingford to Ballard, at about 9am after my Saturday morning AA meeting down on Lake Union. We ran eight miles at a 10:07 pace, which is longer and faster than any of our recent runs. I was incredibly pleased.

Then, Sunday, we got up early early early and went out to Cougar Mountain Regional Wildland, which used to be a coal mine. Because of the risk of collapse, it’s not safe to build on, so it’s just a huge hill, covering several thousand acres, right near Bellevue, WA. We did a six mile trail run, with 1000′ of elevation gain. Trail runs with large elevation gains are often half hikes, and that’s what this one was. When you climb 750′ in less than two miles, it’s a tough half hour.

But the run leveled out some after that, and we ran for a total of 90 minutes to get six miles in. No mountain top views, but lovely forest the whole time, and a definitely inviting place to train for longer trail races. There are at least 15 miles of trails, and probably many more. There’s a bunch of trail races there over the summer and into the fall. I’m eager to try a few.

Today, my legs feel great, my core feels great, and I’m feeling very capable and fit. I’m looking forward to a couple of good weeks of training before my first race of the year.

Data Don’t Lie.

22 March 2018

I’ve been generally disappointed with my current fitness level as I attempt to return to good condition. It’s hard. Strength and stamina have both suffered. I’ve gained weight. I’ve lost definition. But an advantage I have over similar periods in the past when I rested for a bit and lost fitness is that I now have data about it. My Garmin keeps track in simple, intuitively visualized ways how much work I’ve been getting in each week.

Untitled

“Intensity minutes” are a weird stat where moderate exercise counts singly and vigorous exercise counts doubly. But I’m not sure where the threshold between the two is. It’s some calculation of my heart rate. But you can see the problem. From late November to early February I did effectively nothing. The low value at the very start of the graph is the lull post-half-Ironman.

So it’s no wonder that my condition dropped off. I’m making some changes to the way I’m exercising at the gym too: heavier wieghts. More upper body. I’m working toward the capability to do a 8-10 mile obstacle course race like a Spartan or Tough Mudder. To do that, I need to be able to climb a rope and swing hand over hand from rings. Those things are REALLY hard.

But I am coming along. My long run is up over 7 miles. I did some hard hill training on Tuesday that felt really good. Tonight I’m going to do an easy run of about five miles. This weekend we’ll be up to our usual tricks. Long run, maybe a trail run, maybe the gym. We’ll see. But I’m improving again, and I’m excited for the next step.

The Opioid Epidemic.

19 March 2018

I never abused opioids, and I almost never took any. Not even when I had a legal and appropriate prescription for them in my 30s, during my drinking period. I took a couple of pills of tylenol+codeine when I had my wisdom teeth out and I didn’t like it. I was given IM and then IV demoral when I broke my arm, and I did like it. I liked it a lot. But other than those times, opioids have not been a part of my story.

So I may be unqualified to talk about them.

But I am qualified to talk about addiction. I am an alcoholic, and and a former smoker. I remain addicted to both alcohol and nicotine. That means there is no safe amount I can use. Because of the addictions I have, I also abstain from any other addictive and mind-altering substances. I don’t use any drugs, and I will refuse narcotics or opioids for pain unless I am under the direct, immediate care of a physician.

The opioid epidemic is tragic and vexing. Most of us feel like we understand how it started now: as new classes of pain medicines became available, initially optimistic ideas about their addictive properties gradually faded into venal calculations about profitability. Patients love being pain-free. Humans love being altered. And the drugs themselves turned out to be incredibly addictive.

The question is what to do now. The instant anyone proposes restrictions to prescribing, the outrage brigades arrive shrieking that “people deserve pain management”. How dare anyone suggest that someone doesn’t need oxycontin to address their chronic back pain. How would YOU like to live in constant, soul-shredding agony!? It’s tiresome and disingenuous.

I usually wonder if these people are outraged on behalf of others (righteous indignation!) or if they are personally defensive about their use (or abuse) of painkillers. I suspect its the latter as much as the former. We react with fury against any threat to our own comfort and access to the “medicines” we “need” to “control” our “pain”. Usually that kind of defensiveness is reserved for protecting access to a drug we want to support our addiction.

The sad truth is, there’s not a lot of hope, at the population level, for the current (or any) generation of addicts. Addiction is common. Recovery is rare. Most of us die. Medicalized addiction treatment is generally ineffective, and in my experience simply trades the hell of addiction for a fresh one of withdrawal and relapse. Beyond primary detox, there’s little or no role for physicians and scientists in treating addiction. They make it worse, not better.

Only pain changes us. We need to come to the place where our pain in addiction is less tolerable that the pain we imagine the drugs are treating (but which often departed long ago). Most people never come to that point.

The solution to the opioid epidemic is not to save the addicts. That, largely, can’t be done. The solution is to stop making new ones. Stop prescribing opioids for outpatients. Stop giving people these medicines for all but the most severe pain. Never chronically. Stop making new addicts. The ones we’ve made already will either find their way to recovery, or die.