I started my new training program today, comprised of a nutritional plan to help reduce my carb intake, and an exercise routine that balances cross training with running. This 12 week program will provide me with the base I need before I increase the intensity of my training in the spring.
The nutritional plan has me eating a combination of select lean protein and healthy carbohydrates every three hours to speed up fat loss and maintain stable energy levels. If I get hungry again in about three hours, my food portion sizes are correct. If I am hungry sooner, I didn’t eat enough. Still feeling full four or five hours later? I ate too much.
Our bodies work better with a balance of carbohydrates and protein. Not only is protein essential for building healthy muscle and maintaining a strong immune system, it stabilizes insulin levels, which leads to steady energy throughout the day. One more benefit: eating protein has been shown to reduce your appetite. Portion size is important to weight management. I employ a common sense approach, such as using the palm of my hand or a clenched fist for gauging the portion sizes of food. I need to focus on fixing my meals in advance and freezing them. I also need to plan grocery shopping at least once a week. I find that when I run out of nutritious food I become tempted to select unhealthy food choices.
My exercise plan is to weight train intensely, three times per week on alternating days with cardio exercise three times per week. My routine involves selecting one exercise and conducting five sets with it, starting with a set of 12 reps, then increasing the weight and doing 10 reps, adding more weight and doing 8 reps, adding more weight for 6 reps. Then reducing the weight and doing 12 reps. Immediately after, I perform another set of 12 reps for that muscle group using a second selected exercise. For each muscle group, I rest for one minute between the first four sets. I then complete the final two sets with no rest in between, wait two minutes before moving on to my next muscle group, and complete this pattern five times for the upper body training experience and four times for the lower body training experience.
Although my schedule called for an upper body workout today and cardio tomorrow, I switched my schedule to accomodate my attendance at a concert tomorrow night. Given that my gym is open until midnight, I plan to do weight training after the concert concludes. I decided to run tonight. I ran 7k at a 5:58min/km pace in snow while using my YakTraks for the first time. This was my first run in approximately 4 weeks or more, and it felt great. I took my time because I am still getting over the flu; the crisp air felt refreshing, and I was pleased with my performance.
At work I announced that I planned on starting up a lunchtime run/walk club. When I trained for the Ottawa Half-Marathon in 2004, I found running 5-6k at lunch four days per week very refreshing; if I was not tired by the day's end, I would then hit the gym for 2 hours of aerobics and weight training. Given that there are a few recreational runners in my branch at Queen's Park, I thought it would be a welcomed initiative. The feedback was incredibly positive. Looks like I'll have a few more running partners.
February 26, 2007
February 23, 2007
New Blog
Hi everyone,
I am creating a new blog discussing my personal philosophies.
If you click the link "View my complete profile," and scroll to the bottom of the page, you will see the link to "Beautiful Spirit" or you can enter the url http://chi-spirit.blogspot.com/
This blog will be more personal, as I discuss my beliefs and thoughts on what really matters. It's a chance for me to share my ideas, and expose the personality behind the blogger.
I hope you enjoy.
I am creating a new blog discussing my personal philosophies.
If you click the link "View my complete profile," and scroll to the bottom of the page, you will see the link to "Beautiful Spirit" or you can enter the url http://chi-spirit.blogspot.com/
This blog will be more personal, as I discuss my beliefs and thoughts on what really matters. It's a chance for me to share my ideas, and expose the personality behind the blogger.
I hope you enjoy.
February 21, 2007
Life Update
Well, the stress continues to take a toll. I had another bout of night sweats last night; however, the severity was considerably less in relation to those I've experienced over the past week. I did need to change my night clothes at one point and grab a towel to sleep on something dry. The emails of support continue to pour in, offering reassurance that I am not alone in my experiences. Thanks everyone. The downfall of AS being such a hidden disease--and a very uncommon one as well--it's very difficult to connect with other people who share these personally-challenging experiences. It is very isolating when you envision that people don't understand when you talk about feeling tired, being in pain, or not being able to emerge from your bed. I'm sure this probably sounds like whinning; being in the midst of a flare that seems neverending can really alter one's mood. I have been trying to stay positive and upbeat, but I am so emotionally and physically exhausted by the end of the day, and that's when I tend to update my blog.
Today I switched my prescriptions from my local pharmacy to Women's College Hospital
pharmacy. The pharmacist assured me that Enbrel is eligible for reimbursement under my new health benefits with Manulife Insurance. I am counting down the days until I can pick up my first box of Enbrel. I will need to find a few select people who would be willing and able to inject the medication into the subcutaneous tissue over my triceps (it's not an easy area to reach on your own). The photo to the right shows subcutaneous sites where Enbrel can be injected safely. Rotation of sites is recommended to minimize complications. When I rotate sites, I tend to prefer self-injecting into my abdomen as I find my thigh an extremely painful site. To inject elsewhere, I need to request assistance.
One of my concerns with starting Enbrel, particularly now that my primary mode of transportation to work is public transit, is the resulting suppression of my natural immunity to infections. People taking Enbrel are especially susceptible to respiratory infections. Taking public transit is like attending daycare during flu season. I currently have some bug at the moment: over the last week I have presented with a very sore throat (it feels like I am swallowing razor blades) and a low-grade fever. I'll have to determine if I should start Enbrel while experiencing these symptoms or if I should wait until my health has returned to baseline.
Today I switched my prescriptions from my local pharmacy to Women's College Hospital
pharmacy. The pharmacist assured me that Enbrel is eligible for reimbursement under my new health benefits with Manulife Insurance. I am counting down the days until I can pick up my first box of Enbrel. I will need to find a few select people who would be willing and able to inject the medication into the subcutaneous tissue over my triceps (it's not an easy area to reach on your own). The photo to the right shows subcutaneous sites where Enbrel can be injected safely. Rotation of sites is recommended to minimize complications. When I rotate sites, I tend to prefer self-injecting into my abdomen as I find my thigh an extremely painful site. To inject elsewhere, I need to request assistance.One of my concerns with starting Enbrel, particularly now that my primary mode of transportation to work is public transit, is the resulting suppression of my natural immunity to infections. People taking Enbrel are especially susceptible to respiratory infections. Taking public transit is like attending daycare during flu season. I currently have some bug at the moment: over the last week I have presented with a very sore throat (it feels like I am swallowing razor blades) and a low-grade fever. I'll have to determine if I should start Enbrel while experiencing these symptoms or if I should wait until my health has returned to baseline.
February 20, 2007
Life Update
Today I learned my health benefit plan is effective March 1st, 2007. I receive 100% of eligible prescription expenses, and only pay a single-time deductible of $10. This is great news. However, to take advantage of direct billing to the insurance company, I am restricted to filling my prescriptions at the hospital pharmacy of either Sunnybrook Hospital or Women's College Hospital. Transfering my prescriptions out of my local community pharmacy would be a small price to pay for access to affordable biologics.
More questions answered about AS
Does AS affect other joints?
AS sometimes causes aching, pain and swelling in the hips, knees and ankles. Indeed, any joint can be affected. In most cases the
pain and swelling will settle down after treatment. It is particularly important to stretch the hip joint to prevent stiffening in a bent position making you lean forward. The heel bone can become particularly troublesome causing pain in two areas. Most common is the under surface, about three centimetres from the back of the foot. This is called plantar fasciitis and can last for many weeks. Patients with plantar fasciitis report increased heel pain with their first steps in the morning or when they stand up after prolonged sitting. It may respond to an insole for the shoe designed to take weight off that part of the heel. The less common posterior heel pain arises at the back of the heel where the Achilles tendon is attached to the heel bone. Bursae adjacent to the Achilles tendon insertion may become inflamed and cause pain. Pressure from the shoe may aggravate the pain.
I have found that squeezing the sides of my heel (vice grips are my tool of choice) or rolling my heel on a hard ball (like a baseball) very effective in dealing with heel pain. I only recently found out from a rheumatologist that my heel pain was associated with AS. Luckily I have not experienced this symptom for several months.
How does AS affect the lungs?
AS may affect the rib joints and the muscles between the ribs making breathing, sneezing, coughing or yawning painful. As a result, the lungs fail to become fully ventilated. Sometimes the lungs may get scarred, a condition know as apical pulmonary fibrosis. This will show up on an X-ray but does not usually cause any symptoms. In the late stages of AS the chest wall may become quite fixed and affect air entry in and out of the lungs. This does not mean you stop breathing! The diaphragm muscle continues to work and your stomach moves in and out as you breathe. Large meals and tight clothing will increase the effort of breathing so you may find it more comfortable to avoid these. It is also vital to avoid smoking since this will not only make breathing more difficult but it could cause potentially serious lung and chest infections.
What is the risk of passing it on to my children?
If a parent has AS there is a 50% chance that the B27 gene will be passed on to a child. However, not everyone with the B27 gene will go on to develop AS. Overall, the likelihood of your child developing AS will be less than 1 in 10 (or 1 in 5 if B27 positive). The chance of a child inheriting the condition from a grandparent will be less than 1 in 20. Should your child develop early symptoms of AS, it is advisable to ask your family physician for a referral to a rheumatologist.
Are any other diseases associated with AS?
A skin condition called psoriasis is associated with AS. Psoriasis causes scaly patches on the skin and scalp. It can also lead to a slightly different form of arthritis. A sexually acquired infection known as Non-Specific Urethritis (NSU) can be caused by an organism called chlamydia. This leads to urethritis and sometimes other features of Reiter's Syndrome. Ulcerative colitis or Crohn's disease are also related to AS but are not caused by it. The symptoms are bouts of bloody diarrhoea, often with fever, weight loss, and an associated peripheral arthritis in some cases.
What is the end result?
AS seems to affect everybody slightly differently. In general, though, you will probably find that the symptoms come and go over many years. In the classic case, the lumbar spine can become stiff, caused by the growth of additional bone, as can the upper spine and neck. If you pay attention to your posture, exercise regularly and avoid the stoop associated with the condition, you can prevent this from becoming too serious.
AS sometimes causes aching, pain and swelling in the hips, knees and ankles. Indeed, any joint can be affected. In most cases the
pain and swelling will settle down after treatment. It is particularly important to stretch the hip joint to prevent stiffening in a bent position making you lean forward. The heel bone can become particularly troublesome causing pain in two areas. Most common is the under surface, about three centimetres from the back of the foot. This is called plantar fasciitis and can last for many weeks. Patients with plantar fasciitis report increased heel pain with their first steps in the morning or when they stand up after prolonged sitting. It may respond to an insole for the shoe designed to take weight off that part of the heel. The less common posterior heel pain arises at the back of the heel where the Achilles tendon is attached to the heel bone. Bursae adjacent to the Achilles tendon insertion may become inflamed and cause pain. Pressure from the shoe may aggravate the pain.I have found that squeezing the sides of my heel (vice grips are my tool of choice) or rolling my heel on a hard ball (like a baseball) very effective in dealing with heel pain. I only recently found out from a rheumatologist that my heel pain was associated with AS. Luckily I have not experienced this symptom for several months.
How does AS affect the lungs?
AS may affect the rib joints and the muscles between the ribs making breathing, sneezing, coughing or yawning painful. As a result, the lungs fail to become fully ventilated. Sometimes the lungs may get scarred, a condition know as apical pulmonary fibrosis. This will show up on an X-ray but does not usually cause any symptoms. In the late stages of AS the chest wall may become quite fixed and affect air entry in and out of the lungs. This does not mean you stop breathing! The diaphragm muscle continues to work and your stomach moves in and out as you breathe. Large meals and tight clothing will increase the effort of breathing so you may find it more comfortable to avoid these. It is also vital to avoid smoking since this will not only make breathing more difficult but it could cause potentially serious lung and chest infections.
What is the risk of passing it on to my children?
If a parent has AS there is a 50% chance that the B27 gene will be passed on to a child. However, not everyone with the B27 gene will go on to develop AS. Overall, the likelihood of your child developing AS will be less than 1 in 10 (or 1 in 5 if B27 positive). The chance of a child inheriting the condition from a grandparent will be less than 1 in 20. Should your child develop early symptoms of AS, it is advisable to ask your family physician for a referral to a rheumatologist.
Are any other diseases associated with AS?
A skin condition called psoriasis is associated with AS. Psoriasis causes scaly patches on the skin and scalp. It can also lead to a slightly different form of arthritis. A sexually acquired infection known as Non-Specific Urethritis (NSU) can be caused by an organism called chlamydia. This leads to urethritis and sometimes other features of Reiter's Syndrome. Ulcerative colitis or Crohn's disease are also related to AS but are not caused by it. The symptoms are bouts of bloody diarrhoea, often with fever, weight loss, and an associated peripheral arthritis in some cases.
What is the end result?
AS seems to affect everybody slightly differently. In general, though, you will probably find that the symptoms come and go over many years. In the classic case, the lumbar spine can become stiff, caused by the growth of additional bone, as can the upper spine and neck. If you pay attention to your posture, exercise regularly and avoid the stoop associated with the condition, you can prevent this from becoming too serious.
3rd straight night of nocturnal sweats
Another night of awakening soaked in a cold sweat from head to toe. Grrr.
Mechanics of Temperature Regulation and Elevation
Normal human body temperature displays a circadian rhythm, and is generally lowest in the predawn hours at 36.1° C before rising to 37.4° C or higher in the afternoon (Young, 1988; Boulant, 1991, Dinarello and Bunn, 1997), so the fever/sweating events are probably linked with this daily cycle. There are three phases to fever. In the initiation phase, cutaneous vasoconstriction promotes heat retention and shivering generates additional heat. When the new (elevated) set point is reached, heat production balances heat loss and shivering stops. With lowering of the set point to normal, cutaneous vasodilatation promotes heat loss to the environment in the form of sweating (Young, 1988; Boulant, 1991, Dinarello and Bunn, 1997; Cleary, 1998).
Potential Causes of Night Sweats
When night sweats are due to an infection, the sweating usually occurs as the body temperature drops suddenly after running a fever. Non-infectious illnesses can cause night sweats as well. The first that comes to mind is a malignancy. The most common symptoms of lymphoma, a tumor of the lymphatic system, are swollen lymph nodes, often in the neck. In addition, some people also have fever, night sweats and weight loss. Several other malignancies and other diseases can lead to night sweats as well.
Tumour necrosis factor alpha (TNF-α)
Tumour necrosis factor alpha (TNF-α) is one of the peptide signalling molecules implicated in triggering night sweats in AS. Monocytes (a type of white blood cell) are a significant source of TNF-α. It is possible to reduce TNF-α levels. For example, thalidomide suppresses TNF-α production and helps to moderate the characteristic symptoms and signs of tuberculosis. However, care has to be taken when manipulating TNF-α levels to avoid reducing the person’s natural immunity. For example, it has been shown that when an antibody against TNF-α (Infliximab) is given in the treatment of rheumatoid arthritis, the patients have an increased risk of developing previously latent tuberculosis (Keane et al, 2001).
Literature on the subject of night sweats is scarce. Night sweats has been defined as drenching sweats that require the patient to change bedclothes. Tuberculosis and lymphoma are diseases in which night sweats are a dominant symptom, but these are infrequently found to be the cause of night sweats in modern practice. Any disease that results in autonomic overactivity (e.g., ankylosing spondylitis) may result in night sweats.I would like to express my sincere appreciation for the numerous emails I have recently received from friends and strangers concerned for my wellbeing during this personally difficult time as I struggle with my health.
Mechanics of Temperature Regulation and Elevation
Normal human body temperature displays a circadian rhythm, and is generally lowest in the predawn hours at 36.1° C before rising to 37.4° C or higher in the afternoon (Young, 1988; Boulant, 1991, Dinarello and Bunn, 1997), so the fever/sweating events are probably linked with this daily cycle. There are three phases to fever. In the initiation phase, cutaneous vasoconstriction promotes heat retention and shivering generates additional heat. When the new (elevated) set point is reached, heat production balances heat loss and shivering stops. With lowering of the set point to normal, cutaneous vasodilatation promotes heat loss to the environment in the form of sweating (Young, 1988; Boulant, 1991, Dinarello and Bunn, 1997; Cleary, 1998).
Potential Causes of Night Sweats
When night sweats are due to an infection, the sweating usually occurs as the body temperature drops suddenly after running a fever. Non-infectious illnesses can cause night sweats as well. The first that comes to mind is a malignancy. The most common symptoms of lymphoma, a tumor of the lymphatic system, are swollen lymph nodes, often in the neck. In addition, some people also have fever, night sweats and weight loss. Several other malignancies and other diseases can lead to night sweats as well.
Tumour necrosis factor alpha (TNF-α)
Tumour necrosis factor alpha (TNF-α) is one of the peptide signalling molecules implicated in triggering night sweats in AS. Monocytes (a type of white blood cell) are a significant source of TNF-α. It is possible to reduce TNF-α levels. For example, thalidomide suppresses TNF-α production and helps to moderate the characteristic symptoms and signs of tuberculosis. However, care has to be taken when manipulating TNF-α levels to avoid reducing the person’s natural immunity. For example, it has been shown that when an antibody against TNF-α (Infliximab) is given in the treatment of rheumatoid arthritis, the patients have an increased risk of developing previously latent tuberculosis (Keane et al, 2001).
Night Sweats
Last night I experienced my worst case of night sweats. My bed was completely soaked. I would awaken drenched and chilled, and would move to the nearest dry spot only to awaken drenched again. I was so frustrated. I don't understand what causes night sweats, but a rheumatologist confirmed that it was related to my AS. Perhaps as a result of the inflammatory process, I thought. I will investigate existing research and provide you with an update.
Below are the comments of others with AS on night sweats:
Below are the comments of others with AS on night sweats:
"My rheumatologist told me that my night sweats are a result of the pain... That was actually the first symptom I saw improve after I started taking Enbrel. I used to wake up completely drenched and freezing and have to change pjs and find other sleeping locations - the couch, the recliner, the other side of the bed. Then I started thinking about it and got some good silkweight capilene thermal underwear - they're designed for a little bit of insulation, but mostly to wick moisture away from your body. That helped a lot. They're kind of expensive, but Patagonia and Helly-Hansen make good ones. My guess is that any good exercise clothes designed to wick sweat away would work, too. ."
"I get night sweats as well. They seems to happen for several nights in a row and then start up again. I can go months without having them and then all the sudden have them for seveal nights. I am not sure what causes them, but it is listed as one of the common symptoms. Many people with AS get low grade fevers which could be one of the reasons. As far as what to do about I have no idea. I just have learned to live with it."
"Night sweats here, too. Always, when flaring, and sometimes just out of the blue. It can range from a bit sticky to completely drenched. Mornings when I wake up in the latter state, I know I am going to have a really bad day."
"I only get night sweats after I've gone through a bad flare. I always thought it was due to stopping pain medication, narcotics, too abruptly. Mine goes away within a few days and is not too bothersome."
"Hey guys!I also experience these night sweats. Usually I will get the chills before I go to sleep and wake up in the middle of the night or early morning all wet and shaking with chills real bad. That's when they are the worst. When I wake up and have to go change my all my clothes, not just like my shirt. Sometimes the sheets get wet a bit too. Once I get changed I usually just try to get warm, stop shaking and fall back asleep hopefully. Other times I might get the chills and wake up with a semi wet shirt and have to get up and change just my shirt. I do think it is from the A.S. inflammation personally, but since I don't run a high sedrate so far it's not something I could prove. I also know that my pain does increase after a night sweat. My body feels like it is more "sick" and the pain stems out from the spine more to all over. Oh and I would say I feel stiffer after. I used to take my temperature before I was diagnosed and for some time after but I don't really do that anymore. I did find that I often ran a low grade fever at night. But sometimes when I take it now it's below normal but that's when I take it after the night sweat when I wake up wet and cold. Also, it doesn't seem to matter the time of year or time of month. I haven't been able to correlate it with anything except the pain increasing. Hope this helps. Great topic by the way!!! "
"I have had the 'night sweats' for almost all the years I've had AS (about 20?) and the only thing that works for me is sleeping with a fan blowing right on me, hard, all night. When it's single digits outside, I still have the window open at least 4", and another fan bringing in air from there to 'intersect' with the path of the fan that's blowing on me. In the summer, I have an 8000btu A/C running on pretty much max, 24/7, and I rarely use any kind of blanket, other than a comforter that I roll up as a body pillow, and occasionally snuggle under 'a bit', in case the room gets extra cold. It's either this or wake up soaking wet from head to toe, freezing my ass of in the morning, and having to change the sheets every darn day. If it's not COLD in my room, I just can't sleep worth a damn. "
February 18, 2007
Update to "I'm so tired" post
After writing my post titled "I'm so tired," I called my Nutritionist and voiced my frustrations.
To provide some context for why I sought his support: he is a dedicated runner and my occasional running partner, he has been privy to the disabling symptoms of my AS, and he's truly the only person who has
insight of my private emotions, thought processes, and personal characteristics. He's obviously somebody I trust, and he's provided me with invaluable support during times of poor coping.
Our midnight conversation centred around my irritation with having frequent night sweats, eating too many refined foods composed of simple sugars, not having the motivation nor energy to exercise, and my feeling of general malaise. I spoke of how isolated I was feeling because I did not have the energy or desire to leave my home. Even the simplest of tasks, such as getting out of bed or answering the phone, felt like a chore. So I would curl up in bed under my blankets and wish the day would pass faster. I even spoke of my desire to not awaken at all (likely my annoyance expressing surrender).
Beneath it all, I feel guilty: guilty for not being able to muster the mental and physical strength to overcome the symptoms. I know I have not accepted that I have a disease that can limit my functional ability. It makes it more difficult to accept when you can perform certain tasks one day and not be able to function with minor tasks the next. Sometimes the thoughts and feelings of guilt are worse than the physical expressions of AS:
To provide some context for why I sought his support: he is a dedicated runner and my occasional running partner, he has been privy to the disabling symptoms of my AS, and he's truly the only person who has
insight of my private emotions, thought processes, and personal characteristics. He's obviously somebody I trust, and he's provided me with invaluable support during times of poor coping.Our midnight conversation centred around my irritation with having frequent night sweats, eating too many refined foods composed of simple sugars, not having the motivation nor energy to exercise, and my feeling of general malaise. I spoke of how isolated I was feeling because I did not have the energy or desire to leave my home. Even the simplest of tasks, such as getting out of bed or answering the phone, felt like a chore. So I would curl up in bed under my blankets and wish the day would pass faster. I even spoke of my desire to not awaken at all (likely my annoyance expressing surrender).
Beneath it all, I feel guilty: guilty for not being able to muster the mental and physical strength to overcome the symptoms. I know I have not accepted that I have a disease that can limit my functional ability. It makes it more difficult to accept when you can perform certain tasks one day and not be able to function with minor tasks the next. Sometimes the thoughts and feelings of guilt are worse than the physical expressions of AS:
- What does it feel like to have the energy of a "normal" person?
- Why can't I just get out of bed? What's holding me back?
- Just snap out of it!
- Am I really symptomatic or am I just being lazy?
- All I want to do is sleep.
- I don't want to talk to anyone. It's hard for others to understand.
We spoke until 1am. He listened and validated my impatience. It was all I needed. I was worried that having slept all day that I would be unable to sleep now. However, I tried to sleep at 1:30am and slept soundly until 9am. My body obviously needed this rest over the last 24 hours. I awoke feeling refreshed (despite the night sweat) and told myself that it was a new day, which I started off with a healthy protein shake in a water base with some frozen fruit. I then made a list of my plans for the remainder of today.
It's not an easy road for many afflicted with AS. We all cope differently at different stages of the disease. I cope better during the physical pain, but poorly during symptoms of fatigue, which has a mentally draining component. My coping is also poor when I am not able to exercise; being physically active is an integral part of my life, and to be prevented from engaging in that lifestyle wrecks havoc on my mental wellbeing. I have always been a harsh self-critic always striving for my personal best, and peripheral restrictions are the most difficult to personally tolerate.
Lesson learned today: We can't control what we feel, but we can control how we act on those feelings. If I feel guilty, frustrated, or tired, then I need to learn to accept those feelings and let them express themselves. What I can control is the blame I self-impose for those feelings. I must also learn to accept that I have a real diagnosis (this is the hardest part for me because it involves accepting having external limitations imposed on my functional ability, and I don't like to feel as if I don't have full control over my body). However, every day is a fresh start; now I need to take it one day at a time.
Training update
Sitting before you on the blogging pulpit, my Penitent begins by saying “Bless me Father for I have sinned, it has been 4 weeks since my last run."Unlike many of my running colleagues, I have a very difficult time running in the cold. My asthma does not help. I find it painful and most miserable, actually. Every year I ensure I have all winter-ready running apparel in hopes that of realizing that I have no excuse to stay indoors; yet, I feel that blustery wind and my motivation takes a nosedive. The cold is not the real deterrent: it's that bone-chilling wind. I confessed to a friend that I had not been running, despite still aiming to participate in the Around the Bay 30K race next month. Here was his response:
"Have you run the ATB before? It's certainly a challenging run with the last 10km being very hilling. This will be my fourth ATB race. I really like this run. If you're not running outside I would be running on the treadmill for sure!!! I know it is boring, I don't really like it either but I run at least 5 miles a day during the week on the treadmill and then depending on the weather I will run between 10 and 21km on Saturday and Sunday. I don't run any longer than an hour on the treadmill at any one time. I took a week off after Hawaii and have been running at least 5 days a week since. I also do a core and weight program as well. The spinning class will help but there is nothing like running!!!"
With this knowledge and guilt in tow, I arranged for my nutritionist to help me get back on track, I renewed my gym membership for another year, and I plan on running today (however, it may involve a treadmill).
AS Experiences
I would like to post the disease experiences of others with AS on my blog with hopes that this collective understanding would diminish our isolative perceptions and would contribute insight into the disease itself.
If you would like to share any aspect of your experience with AS, please email me at gymjunkie247@rogers.com If you prefer to share your experience with me but not have it published, please indicate that. Confidentiality will be respected.
If you would like to share any aspect of your experience with AS, please email me at gymjunkie247@rogers.com If you prefer to share your experience with me but not have it published, please indicate that. Confidentiality will be respected.
February 17, 2007
I'm so tired
8pm: that is the time I got out of bed today.
Since Jan 21 I have been subjected to inhumane amounts of personal stress. It all ended last night; however, as a result of cummulative events, I am grieving the loss of my dear friend, Matthew--a mentor I have admired and respected since 2002.
The emotional and mental stressors took their toll physically: despite awakening at 9am, the general malaise I felt was overwhelming. I did not have the energy to stand upright for long, and had to remain in bed all day. I tried reading to feel somewhat productive, but I could not concentrate. I could not even keep my eyes open for long. So I slept.
It's now 11pm and I still feel so lethargic, as if wearing a heavy lead apron, the kind worn when having an X-ray. I'm frustrated with this cyclical process: stressor-->flare-->stressed-->flare. I am frustrated with the effect this has had on my motivation to run, my ability to concentrate, and my nutritional habits. The cold weather has not helped either. I'm not usually one to complain about anything, but I am so tired of this disease.
Since Jan 21 I have been subjected to inhumane amounts of personal stress. It all ended last night; however, as a result of cummulative events, I am grieving the loss of my dear friend, Matthew--a mentor I have admired and respected since 2002.
The emotional and mental stressors took their toll physically: despite awakening at 9am, the general malaise I felt was overwhelming. I did not have the energy to stand upright for long, and had to remain in bed all day. I tried reading to feel somewhat productive, but I could not concentrate. I could not even keep my eyes open for long. So I slept.
It's now 11pm and I still feel so lethargic, as if wearing a heavy lead apron, the kind worn when having an X-ray. I'm frustrated with this cyclical process: stressor-->flare-->stressed-->flare. I am frustrated with the effect this has had on my motivation to run, my ability to concentrate, and my nutritional habits. The cold weather has not helped either. I'm not usually one to complain about anything, but I am so tired of this disease.
February 11, 2007
Ironman Canada update from an AS Athlete
Ironman Canada Race Report by Rob Williams
Sunday, August 29, 2006
The day began early. My first alarm rang at 4:01 am, but I was ready. I hopped right out of bed without needing the second ring or the second alarm set for 4:05 am. I had been getting to bed between 8:30 and 9:30 pm most nights recently, and combined with about ¼ of my normal exercise load for the past 2 weeks I was ready to get on with the day.
I threw on the race shorts that would adorn me for approximately the next 14 hours, then sweats and on to breakfast. We had made a boatload of waffles the previous day so I toasted one of those and had my standard race day (actually any day) breakfast: uncooked oatmeal mixed with yogurt and fruit overnight. The goal was to be finished with breakfast as close as possible to 3 hours before the race, and since the start was planned for 7:00 am, I was on target.
The previous day I had checked in my bike, my swim to bike transition bag and my bike to run transition bag, so all I needed to carry was my post race bag (consisting of the clothes I was currently wearing) and the special needs bags containing extra nutrition that I would pick up approximately half way through the bike and the run. I threw on a warm fleece cap as I walked out the door since the sun was not yet up and though it was summer in the Okanagen (the desert wine country on the east side of the Cascade mountains), it is still cold in the morning in the desert.
I was curious what the weather would be like. It had been getting warmer and warmer each day we came, and if there was no wind or a south wind the valley would fill with the smoke from the forest fires burning to the south. I did not spend too much time obsessing about the weather because there was nothing I could do and it would affect us all the same. While walking down to the transition area it was calm and the stars above foretold a clear day. The wind would be a mystery, but the swells on the lake from a couple days before were likely gone.
I took a page out of Erica’s book by getting to the transition area early. By 5:00 am I was in the transition area already having been body marked (had my race number applied) and dropped off my special needs bags. There was almost no one there and the quite calm was relaxing. After checking my bike I went for an easy 15 minute jog and felt like a salmon running against the stream of athletes walking towards transition area. I had plenty of time to stretch, make a couple trips to the port-a-johns, then with an hour before race time I drank the espresso I had picked up the night before.
No matter how much time you have before a race, there is always a rush that happens near the start, but despite the magnitude of this race it was not that bad. I found myself just before 6:45 am with my toes in the water of Lake Okanagen waiting for the cannon to signal the start for the pros. As I looked around I had to catch my breath and force myself to relax. There were over 2,200 people crammed into a small beach area and I was worried about getting clobbered on the head and having to fight my way around the swim course. After the pros started we had about 10 minutes for warm-up and the feel of the water gliding over my wetsuit helped restore that calm. I decided that I had nothing to loose by getting on the front row, so that was where I started at 7:00 am as the cannon sounded for the second time that morning.
After the first 500 meters I was quite surprised to find myself swimming smoothly in open water. Not only that, I was doing a three count bi-lateral breathing sequence that meant I was pretty relaxed. I did not feel the need to do much sighting in the first few hundred meters since the mass of people would probably generally be headed in the right direction. As I finally popped my head out to get a better perspective I was shocked to find myself in the front group of approximately 15-20 swimmers breathing relatively easily. I continued here for about 2/3rds of the first leg out when I either eased off, lost my focus, or drifted a bit off course without sighting properly. Despite the reason I lost the good draft I had and though I felt strong in the water, never really regained it. When I came to the swim finish my time was 1:01:38. It was a bit disappointing because I had set 1 hour as my goal time and was secretly hoping to break that by a couple minutes, but I was certainly in the ball game.
I ran up the chute, pealed my wetsuit off the top of my body and flopped down at the feet of two volunteer “wetsuit strippers” who grabbed the rest off of me quite efficiently. It was a bit more of a production to get my swim to bike bag, but then it was into the changing tent. For some reason I thought they would have towels in the tent, but luckily the guy to my left was kind enough to lead me his. I did a quick towel off of the feat, pulled on my socks, snapped on my helmet, put on sunglasses, and zipped up my bike jersey. (I wear a full jersey to cover my shoulders because they always get fried by the sun and I’m convinced that zaps energy, also I only have one bottle cage on my bike because there is no space on the aero down tube; therefore I just my bike jersey as my second nutrition bottle and an aero bottle on my handlebars just for water which I fill at every aid station.
As I mounted the bike I was not prepared for the crowd up main street – I had never experienced anything like it. Granted the Alp d’Huez crowd stretches on for miles, but this crowd was a similar boisterous tunnel that ushered you out of town. I knew that with the exception of one moderate hill, the first 40 miles were relatively flat. Though anyone can hammer down that stretch, the key is to be able to keep yourself in enough control for the hills the followed and the remaining 72 miles. I had therefore changed my bike computer to only give me the elapsed time (so I could take my nutrition and water every 20 minutes) and my heart rate. I had told myself to keep my heart rate under 150, but even at that rate I felt like I was thundering though people too quickly, so I reduced that upper limit to 145 and settled in for the long haul.
The first 40 miles were relatively uneventful, except for the aid station in Oliver where a guy went down HARD right in front of me (there is an unmistakable sound of carbon hitting asphault). I had one hand on my handlebars and the other taking a water bottle from a volunteer but miraculously made it around the tangle of athlete and bicycle on the ground. I was just marveling how I had made it when the guy behind me said, “Man, how did you get around that guy, I almost bought it and I was behind you.” I figured that with two rather serious bike crashes earlier this year my time on the pavement had passed for a bit.
When I got to the Husky station and the 90 degree right turn that basically marked the beginning of the first substantial climb, Richter Pass, I did a quick check of my average speed and was happy to see that I was over 24 mph which boded well for my overall average goal of 21.5. Now my goal for the bike was basically a three part strategy: 1) keep it under control for the first 40 miles, 2) spin the hills in control and waste no excess energy, 3) charge the downhills. Now that I found myself at Richter a few people blew past me, but for the most part I felt like I was holding my own and spinning in a controlled fashion. I was very glad that I had borrowed the 11-25 cassette from a friend instead of the 11-23 because those couple extra teeth were making all the difference. Even if I was not using the, just knowing I had a couple easier gears was a nice feeling.
After Richter I forgot how hilly it was. I had ridden the course the year before, but not as hard as I was at the moment, and last year was a whole year ago. Needless tot say I pushed on and found myself gaining on the people in front of me with no one riding through. Either I was riding well, or all the fast people were already ahead of me, or both.
When I got to the special needs bag I took it and stopped. Having just seen a guy go down in front of me at an aid station and a couple others with some tell tale road rash, I decided that I could spare the 30 seconds to take my two nutrition bottles out of the bag and drop off my other bottles. Somewhere around this point, I honestly can’t remember if it was before this point or after but I was hitting that lull that is inevitable somewhere between 70 and 85 miles. I found myself thinking, “What am I doing? Do I really have to run a marathon after this….and am I seriously thinking about doing this all again in October?” Then as quickly as it came the sentiment was gone and I was approaching the next major climb of the course….Yellow Lake.
Again I was greeted with a mini Tour de France crowd that could not have been more encouraging. I had a bit of a cramp in my left hamstring, but as I focused on a smooth pedal stroke the tension passed and I was at the top before I knew it. The rest of the ride was mostly uneventful and punctuated by more wind and hills than I had expected in the last section. I was especially chagrined to find that the first start of Main Street on the way into Penticton was slightly up hill, and no hill felt slight at this point. Since I had a goal of 5:15 for the bike I was pushing this section and was happy to cross the “bike in” mat at 5:13.
As I was running with my bike one of the volunteers was cautioning “no running….walk please.” I was tempted to turn to him and say, “Is this a parade, or is this a race?” but it certainly did not matter and I knew negative thoughts did nothing but chew up energy, so I focused on finding my transition bag and getting into the changing tent.
As I sat in the chair something did not feel right. I was not quite sure what it was, but I just knew something felt different. I was in auto pilot now, however, so I switched my top, changed my shoes, threw on my running hat and started moving again. I stopped to get sprayed with sunscreen and took a water from the aid station, but as I began running, something definitely felt wrong. While on the bike I had a few tense spots, but a tightness quickly developed in the left lower section of my back and then felt like a string ran up my back and connected to my front ribs and I was either going to give birth to some alien baby out of my solar plexus or my rib cage might just collapse.
A lot of thoughts started running through my head and I put most of them out of my mind just to see if over the next mile or so that I could relax and make it go away. It did not take long before the primary though kept surfacing, “You have 26 miles of this?” Though it was not easy to walk away from the course in the middle of putting together a decent race, it ultimately did not feel like my day.
I remember in the past hearing about people dropping out of races and thinking, “That’s a mistake, you want to finish what you started,” or “You don’t want to quit a race because that sets a bad psychological precedent and it will be easier to abandon in the future.” It is clear to say that I no longer feel that way having a bit more relevant experience. Going into this race I was already having trouble justifying a trip to Kona this year both in terms of work (having already been away for a few weeks in Australia) and finances with an impending house purchase. The thought that Erica and I might attempt to qualify together was another sentiment that rose to the surface as I walked back to the transition area. I also immediately thought of a few local races that I could still do this season because I did not beat myself up with 26 miles of running.
So I walked back to the transition area, stretched, had a nice conversation with a couple volunteers, got some more water and Gatorade, walked back to the house where I was staying and showered, stretched, ate, and iced. I then walked back to the race venue and wondered into the massage tent. After explaining my situation the therapist indicated that I had come at a good time since he had seen on one yet and there was no line behind me. Because I had stretched, iced and warmed up again he said, “Let’s get to work.” He spent over an hour working on me, gently and but persistently doing muscle release. He explained the entire muscle compensation mechanism that had caused me trouble and was a byproduct of my past accident. The irony was that I had been getting active release therapy on my left proneus (sorry if my spelling and anatomy and spelling is less than perfect – just say it’s the muscles running down the outside of my left leg) which was likely related to the car accident and though I had some back issues they had not affected my racing to date. I specifically told to doctor that I wanted to leave them alone until after Ironman Canada because I was afraid of stirring up some trouble….oh well. Now I guess I can get on with that treatment. Though it has been a difficult road of dealing with a variety of issues I am happy to feel like I am well down the path toward recovery.
I know that in the Ironman arena a swim and bike split really does not mean anything until it is all put together with a good marathon. I also know that my run training this year has been hampered by injury so I look forward to another effort in the future once I have a bit more running base. I also know that I am looking forward to taking a year off of Ironman training and focusing on having more fun in shorter distance races and focusing on some other priorities. Kona is still a calling and one that I do not think I will be able to ignore, but for now I will put it on hold.
Sunday, August 29, 2006
The day began early. My first alarm rang at 4:01 am, but I was ready. I hopped right out of bed without needing the second ring or the second alarm set for 4:05 am. I had been getting to bed between 8:30 and 9:30 pm most nights recently, and combined with about ¼ of my normal exercise load for the past 2 weeks I was ready to get on with the day.
I threw on the race shorts that would adorn me for approximately the next 14 hours, then sweats and on to breakfast. We had made a boatload of waffles the previous day so I toasted one of those and had my standard race day (actually any day) breakfast: uncooked oatmeal mixed with yogurt and fruit overnight. The goal was to be finished with breakfast as close as possible to 3 hours before the race, and since the start was planned for 7:00 am, I was on target.
The previous day I had checked in my bike, my swim to bike transition bag and my bike to run transition bag, so all I needed to carry was my post race bag (consisting of the clothes I was currently wearing) and the special needs bags containing extra nutrition that I would pick up approximately half way through the bike and the run. I threw on a warm fleece cap as I walked out the door since the sun was not yet up and though it was summer in the Okanagen (the desert wine country on the east side of the Cascade mountains), it is still cold in the morning in the desert.
I was curious what the weather would be like. It had been getting warmer and warmer each day we came, and if there was no wind or a south wind the valley would fill with the smoke from the forest fires burning to the south. I did not spend too much time obsessing about the weather because there was nothing I could do and it would affect us all the same. While walking down to the transition area it was calm and the stars above foretold a clear day. The wind would be a mystery, but the swells on the lake from a couple days before were likely gone.
I took a page out of Erica’s book by getting to the transition area early. By 5:00 am I was in the transition area already having been body marked (had my race number applied) and dropped off my special needs bags. There was almost no one there and the quite calm was relaxing. After checking my bike I went for an easy 15 minute jog and felt like a salmon running against the stream of athletes walking towards transition area. I had plenty of time to stretch, make a couple trips to the port-a-johns, then with an hour before race time I drank the espresso I had picked up the night before.
No matter how much time you have before a race, there is always a rush that happens near the start, but despite the magnitude of this race it was not that bad. I found myself just before 6:45 am with my toes in the water of Lake Okanagen waiting for the cannon to signal the start for the pros. As I looked around I had to catch my breath and force myself to relax. There were over 2,200 people crammed into a small beach area and I was worried about getting clobbered on the head and having to fight my way around the swim course. After the pros started we had about 10 minutes for warm-up and the feel of the water gliding over my wetsuit helped restore that calm. I decided that I had nothing to loose by getting on the front row, so that was where I started at 7:00 am as the cannon sounded for the second time that morning.
After the first 500 meters I was quite surprised to find myself swimming smoothly in open water. Not only that, I was doing a three count bi-lateral breathing sequence that meant I was pretty relaxed. I did not feel the need to do much sighting in the first few hundred meters since the mass of people would probably generally be headed in the right direction. As I finally popped my head out to get a better perspective I was shocked to find myself in the front group of approximately 15-20 swimmers breathing relatively easily. I continued here for about 2/3rds of the first leg out when I either eased off, lost my focus, or drifted a bit off course without sighting properly. Despite the reason I lost the good draft I had and though I felt strong in the water, never really regained it. When I came to the swim finish my time was 1:01:38. It was a bit disappointing because I had set 1 hour as my goal time and was secretly hoping to break that by a couple minutes, but I was certainly in the ball game.
I ran up the chute, pealed my wetsuit off the top of my body and flopped down at the feet of two volunteer “wetsuit strippers” who grabbed the rest off of me quite efficiently. It was a bit more of a production to get my swim to bike bag, but then it was into the changing tent. For some reason I thought they would have towels in the tent, but luckily the guy to my left was kind enough to lead me his. I did a quick towel off of the feat, pulled on my socks, snapped on my helmet, put on sunglasses, and zipped up my bike jersey. (I wear a full jersey to cover my shoulders because they always get fried by the sun and I’m convinced that zaps energy, also I only have one bottle cage on my bike because there is no space on the aero down tube; therefore I just my bike jersey as my second nutrition bottle and an aero bottle on my handlebars just for water which I fill at every aid station.
As I mounted the bike I was not prepared for the crowd up main street – I had never experienced anything like it. Granted the Alp d’Huez crowd stretches on for miles, but this crowd was a similar boisterous tunnel that ushered you out of town. I knew that with the exception of one moderate hill, the first 40 miles were relatively flat. Though anyone can hammer down that stretch, the key is to be able to keep yourself in enough control for the hills the followed and the remaining 72 miles. I had therefore changed my bike computer to only give me the elapsed time (so I could take my nutrition and water every 20 minutes) and my heart rate. I had told myself to keep my heart rate under 150, but even at that rate I felt like I was thundering though people too quickly, so I reduced that upper limit to 145 and settled in for the long haul.
The first 40 miles were relatively uneventful, except for the aid station in Oliver where a guy went down HARD right in front of me (there is an unmistakable sound of carbon hitting asphault). I had one hand on my handlebars and the other taking a water bottle from a volunteer but miraculously made it around the tangle of athlete and bicycle on the ground. I was just marveling how I had made it when the guy behind me said, “Man, how did you get around that guy, I almost bought it and I was behind you.” I figured that with two rather serious bike crashes earlier this year my time on the pavement had passed for a bit.
When I got to the Husky station and the 90 degree right turn that basically marked the beginning of the first substantial climb, Richter Pass, I did a quick check of my average speed and was happy to see that I was over 24 mph which boded well for my overall average goal of 21.5. Now my goal for the bike was basically a three part strategy: 1) keep it under control for the first 40 miles, 2) spin the hills in control and waste no excess energy, 3) charge the downhills. Now that I found myself at Richter a few people blew past me, but for the most part I felt like I was holding my own and spinning in a controlled fashion. I was very glad that I had borrowed the 11-25 cassette from a friend instead of the 11-23 because those couple extra teeth were making all the difference. Even if I was not using the, just knowing I had a couple easier gears was a nice feeling.
After Richter I forgot how hilly it was. I had ridden the course the year before, but not as hard as I was at the moment, and last year was a whole year ago. Needless tot say I pushed on and found myself gaining on the people in front of me with no one riding through. Either I was riding well, or all the fast people were already ahead of me, or both.
When I got to the special needs bag I took it and stopped. Having just seen a guy go down in front of me at an aid station and a couple others with some tell tale road rash, I decided that I could spare the 30 seconds to take my two nutrition bottles out of the bag and drop off my other bottles. Somewhere around this point, I honestly can’t remember if it was before this point or after but I was hitting that lull that is inevitable somewhere between 70 and 85 miles. I found myself thinking, “What am I doing? Do I really have to run a marathon after this….and am I seriously thinking about doing this all again in October?” Then as quickly as it came the sentiment was gone and I was approaching the next major climb of the course….Yellow Lake.
Again I was greeted with a mini Tour de France crowd that could not have been more encouraging. I had a bit of a cramp in my left hamstring, but as I focused on a smooth pedal stroke the tension passed and I was at the top before I knew it. The rest of the ride was mostly uneventful and punctuated by more wind and hills than I had expected in the last section. I was especially chagrined to find that the first start of Main Street on the way into Penticton was slightly up hill, and no hill felt slight at this point. Since I had a goal of 5:15 for the bike I was pushing this section and was happy to cross the “bike in” mat at 5:13.
As I was running with my bike one of the volunteers was cautioning “no running….walk please.” I was tempted to turn to him and say, “Is this a parade, or is this a race?” but it certainly did not matter and I knew negative thoughts did nothing but chew up energy, so I focused on finding my transition bag and getting into the changing tent.
As I sat in the chair something did not feel right. I was not quite sure what it was, but I just knew something felt different. I was in auto pilot now, however, so I switched my top, changed my shoes, threw on my running hat and started moving again. I stopped to get sprayed with sunscreen and took a water from the aid station, but as I began running, something definitely felt wrong. While on the bike I had a few tense spots, but a tightness quickly developed in the left lower section of my back and then felt like a string ran up my back and connected to my front ribs and I was either going to give birth to some alien baby out of my solar plexus or my rib cage might just collapse.
A lot of thoughts started running through my head and I put most of them out of my mind just to see if over the next mile or so that I could relax and make it go away. It did not take long before the primary though kept surfacing, “You have 26 miles of this?” Though it was not easy to walk away from the course in the middle of putting together a decent race, it ultimately did not feel like my day.
I remember in the past hearing about people dropping out of races and thinking, “That’s a mistake, you want to finish what you started,” or “You don’t want to quit a race because that sets a bad psychological precedent and it will be easier to abandon in the future.” It is clear to say that I no longer feel that way having a bit more relevant experience. Going into this race I was already having trouble justifying a trip to Kona this year both in terms of work (having already been away for a few weeks in Australia) and finances with an impending house purchase. The thought that Erica and I might attempt to qualify together was another sentiment that rose to the surface as I walked back to the transition area. I also immediately thought of a few local races that I could still do this season because I did not beat myself up with 26 miles of running.
So I walked back to the transition area, stretched, had a nice conversation with a couple volunteers, got some more water and Gatorade, walked back to the house where I was staying and showered, stretched, ate, and iced. I then walked back to the race venue and wondered into the massage tent. After explaining my situation the therapist indicated that I had come at a good time since he had seen on one yet and there was no line behind me. Because I had stretched, iced and warmed up again he said, “Let’s get to work.” He spent over an hour working on me, gently and but persistently doing muscle release. He explained the entire muscle compensation mechanism that had caused me trouble and was a byproduct of my past accident. The irony was that I had been getting active release therapy on my left proneus (sorry if my spelling and anatomy and spelling is less than perfect – just say it’s the muscles running down the outside of my left leg) which was likely related to the car accident and though I had some back issues they had not affected my racing to date. I specifically told to doctor that I wanted to leave them alone until after Ironman Canada because I was afraid of stirring up some trouble….oh well. Now I guess I can get on with that treatment. Though it has been a difficult road of dealing with a variety of issues I am happy to feel like I am well down the path toward recovery.
I know that in the Ironman arena a swim and bike split really does not mean anything until it is all put together with a good marathon. I also know that my run training this year has been hampered by injury so I look forward to another effort in the future once I have a bit more running base. I also know that I am looking forward to taking a year off of Ironman training and focusing on having more fun in shorter distance races and focusing on some other priorities. Kona is still a calling and one that I do not think I will be able to ignore, but for now I will put it on hold.
February 05, 2007
Life update
It has been suggested that I try to personalize my blog a bit more--"too technical" was one of the terms used. I agree that my blog does contain some medical jargon, but it's my attempt to educate the populace about a disease that can be very confusing to even those of us who must cope with the symptoms every day. The more we know, the better equiped we are to ask the most appropriate questions of our family physician or rheumatologist, and the more empowered we are to self-manage the disease. Knowledge is power, is it not?
On the other side, I want to also appeal to my audience, so I will try to soften the posts a bit without detracting from my overall intention: to educate using subjective and objective material.
So...something more personal....Hmmm.
Well, today I got great news: I received a long-awaited phone call indicating acceptance into an intermediate position in my organization. It's a new role at a new location in the heart of Toronto. I will be working with an amazing team of health analysts--one of whom I graduated with in 2006. He was thoughtful enough to send me the posting for this single position, so it looks like I'm taking him out for drinks. I felt quite confident during the interview, and he had indicated that the members of the interview panel were very impressed with my performance. One of the perks to this position is that it comes with health benefits, which means that I can return to taking Enbrel.
Lack of health benefits has been stressful. Blue Cross--the only insurance company that would provide the converage needed to afford monthly Enbrel--recently declined my coverage citing a diagnosis of AS as the reason for my ineligibility. I sent a letter and email challenging their decision, but they stood firm. What a blow! Pre-exisiting illnesses, even if you're asymptomatic, preclude people from acquiring access to needed medical insurance. From a financial standpoint I can understand their stance, but without assessing each applicant individually, I find it insane that your circumstances can be generalized--despite age, gender, severity of symptoms, and prognosis--and your eligibility is automatically determined. I am investigating further to learn of available options. Stay posted.
On the other side, I want to also appeal to my audience, so I will try to soften the posts a bit without detracting from my overall intention: to educate using subjective and objective material.
So...something more personal....Hmmm.
Well, today I got great news: I received a long-awaited phone call indicating acceptance into an intermediate position in my organization. It's a new role at a new location in the heart of Toronto. I will be working with an amazing team of health analysts--one of whom I graduated with in 2006. He was thoughtful enough to send me the posting for this single position, so it looks like I'm taking him out for drinks. I felt quite confident during the interview, and he had indicated that the members of the interview panel were very impressed with my performance. One of the perks to this position is that it comes with health benefits, which means that I can return to taking Enbrel.
Lack of health benefits has been stressful. Blue Cross--the only insurance company that would provide the converage needed to afford monthly Enbrel--recently declined my coverage citing a diagnosis of AS as the reason for my ineligibility. I sent a letter and email challenging their decision, but they stood firm. What a blow! Pre-exisiting illnesses, even if you're asymptomatic, preclude people from acquiring access to needed medical insurance. From a financial standpoint I can understand their stance, but without assessing each applicant individually, I find it insane that your circumstances can be generalized--despite age, gender, severity of symptoms, and prognosis--and your eligibility is automatically determined. I am investigating further to learn of available options. Stay posted.
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