Stress Fracture?

For two days after the race I could barely walk. My quads were especially tight, and I could feel a sharp pain along the lateral side of my right foot that I could not identify. By the end of Monday I was very frustrated with my inability to lift my feet off the floor and my shuffling gait; I made a one-hour appointment at Sutherland-Chan's massage therapy clinic located at Bay/Dundas for the following day. I took a taxi down to Atrium on the Bay and had a fabulous lower body deep tissue massage which produced a noticable improvement in my gait. What an amazing feeling to be able to walk normally again without the previous stiffness.

Today most muscular pain had disappeared, except for some soreness along my left shin. The pain along the lateral side of my right foot had worsened and I was starting to suspect a stress fracture. It was managable during the day; however, towards the end of my 6k run around Queen's Park with a colleague, the pain became unbearable. It was too late to see my family physician for a diagnostic referral; however, my goal is to have my foot assessed at Women's College Hospital tomorrow. I hope nothing is broken; it would hinder my performance at my next race in 2 weeks where I intended to really push myself.

Was it worth it? Hell yeah!

Hooray! It's over. I am so happy to report that I accomplished my goal of completing the Around the Bay 30K race with a chip time better than anticipated: 3:17:38.8. I was hoping to achieve 3:15, but anticipated between 3:15 and 3:30 as my race time.

The day truly started the night before. I went to Barbarian's Steak House at 7:30pm after mapping the course on my GPS during a day trip to Hamilton, and ordered a delicious bottle of French bordeaux, oysters to whet my appetite, followed by an entree of 10 oz filet mignon with lobster (tail and claw), baked potato (with sour cream, bacon, and feta cheese), topped off with blueberry cheesecake, 3 glasses of water (for hydration of course), and a teapot of loose-leaf chamomile tea to end the meal.

I organized my race gear before heading to bed. I didn't get to sleep as early as I wanted, and once in bed, I was too excited to sleep. I am sure I dozed briefly; it was hard to sway my mind to think of anything other than my strategy for tackling the Hamilton course. My goal was to take it slow in the beginning to warm up (after all, it's been a long time since I did any "real" running/training), kick up my speed in the midst of the race, and then drop it down a bit to conquor the rolling hills for the last 10K of the route. I did not want to focus on time at all for this event; I wanted to see if I could endure 30K in a decent time after a hiatus from routine running.

I awoke on the Sunday at 0630, got dressed, and ate my typical pre-race meal of three eggs (two if I'm doing 21K or less), large-flaked oatmeal, and water (sometimes green tea). I was out the door and in Hamilton by 0830. My Garmin was set and ready to go. I ran into several past running partners--how wonderful it is to reunite at a race. The weather never passed 4 degrees Celcius, although a low of 5 and high of 11 was anticipated. The air was thick with fog on the drive in (at least I think it was fog; it is Hamilton after all). I placed myself behind the 3:10 pace bunny, and made certain I never saw the 3:30 pace bunny pass me (a sure signal I was slowing down). As I passed the start line, I went over on my left ankle thanks to a pothole--luckily no injury; however, the first 5km I was plagued with terrible shin splints. Worried that this had the potential to hamper my performance, I stuck to a slow pace (6:15) and tried to avoid the potholes in the road. The first 10K of the route was through a very run down area that made downtown Detroit look like Forest Hill. Just before the 10K marker, as a group of us waited at a rail crossing for the train to pass (just our luck), a stench resembling that from a bathroom at a cheese convention for lactose-intolerants wafted heavily in the air. It was sickening, but was incentive enough to pick up the pace slightly. My shins felt better and I was feeling great at this point, and kept up my pace (5:45-6:00) until 19K. Now it was time to bear down and take those 10K of hills, keeping a slower but steady pace, anticipating the final steep hill around the 24K/25K marker. My IT band was aching a bit and forced me to walk half of one small hill for 2 minutes. By that time, I had recovered enough to keep going. I followed the tradition of high-fiving the midget playing Queen's "We are the Champions" on a huge stereo system around the 24K/25K mark prior to literally talking myself up the final incline, which felt similar to running up a ladder. Once at the top, I patted myself on the back, and ran at a pace I thought was quicker--but was not given my legs of lead--towards the finish line 4K away in Copps Collisium. I felt the urge to throw up for that entire stretch. It subsided somewhat when I was greeted by a tall fellow in the middle of York Blvd dressed as the Grim Reaper. He was standing near the cemetary along the road and asking passing runners if they were "ready to die yet." In my head I yelled, "No" and pushed my way into Copps to the sound of cheers. What a fabulous feeling!!!!

The day ended with a fabulous post-race meal: a large mojito to accompany a savory 10 oz sirloin, mashed garlic/idaho-sweet potato with vegetables, and mango passionfruit creme brule.

Now that I know I can manage a base of 30K, the rest of this year's training will be cake. I already have my schedule set. Mind you, I shuffle like a penguin and I cannot drive my car (it's a stick-shift). Thanks Steve for driving me to and from work today. Everyone's been calling me Happy Feet--mind you my mental spirits are the happiest of all!

Around the Bay: March 25, '07

For the first time I am nervous prior to a race. On March 25th, 2007, I will be running my first 30K race--Around the Bay in Hamilton, Ontario. I visited Hamilton last Sunday to drive the race route, which starts at the intersection of York Blvd and Caroline Street. The first 20k of the Around the Bay Road Race is an exciting, scenic, and fast route. The route was relatively flat until 10.5km, where the first small incline of a bridge was encountered. The remaining hills didn't surface again until around 18k: strips of continuous rolling hills lined by beautiful estates (at least I'll have interesting architecture to distract me from fatigue or aching muscles). The last 10k includes rolling hills through scenic North Shore Blvd. The final "hill' is a steep embankment along Valley Inn Road (starting at 26km). It's this hill that causes me the greatest anxiety of this whole race, likely because I have only run five times since the start of the year. Basically, the start of my 2007 training will be begining with Around the Bay (crazy, I know). I look forward to my grand finish into Copps Coliseum at York Blvd. and Bay Sts.

Live Results! for all runners will be available during the Around the Bay race this Sunday. Follow a Runner! You will also be able to select the runners you would like to follow and watch their times as they cross the Start, 10K, 15K, 20K and Finish Mats. My bib# is 2884.

Enbrel: Day 3 - In the leg

Last night I administered my Enbrel in my right thigh - a site I consider quite painful. As I inserted the needle the first time, the pain was so much I had to withdraw the needle from my leg. The second attempt was much better, but the site reaction was intense. The area became quite red, swollen, itchy, and hot to touch, with approximately 12 small bumps emerging around the injection site. Almost 24 hours later, the area is still visibly red, hot, and swollen.

Iritis...possibly

Guess who has iritis again? ^(&#$!@*(#&(*@^!

Feverish

I had a great 10K run last night with my new running partner. The weather was beautiful, if not a bit chilly. I felt great. Upon returning home, I became quite feverish and chilled. I could not regulate my temperature. Externally I was hot, but I was shivering. I was also so nauseous that the smell of my steak dinner was unbearable; I could not eat. All I could do was sleep.

I am not certain if this is related to starting the Enbrel, or the side of a flare I've never previously experienced.

Use of a low starch diet in the treatment of AS

The majority of ankylosing spondylitis (AS) patients not only possess HLA-B27, but during active phases of the disease have elevated levels of total serum IgA, suggesting that a microbe from the bowel flora is acting across the gut mucosa. Biochemical studies have revealed that Klebsiella bacteria, not only possess 2 molecules carrying sequences resembling HLA-B27. Furthermore AS patients from 10 different countries have been found to have elevated levels of specific antibodies against Klebsiella bacteria. It has been suggested that these Klebsiella microbes, found in the bowel flora, might be the trigger factors in this disease and therefore reduction in the size of the bowel flora could be of benefit in the treatment of AS patients. Microbes from the bowel flora depend on dietary starch for their growth and therefore a reduction in starch intake might be beneficial in AS patients. A "low starch diet" involving a reduced intake of "bread, potatoes, cakes and pasta" has been devised and tested in healthy control subjects and AS patients. The "low starch diet" leads to a reduction of total serum IgA in both healthy controls as well as patients, and furthermore to a decrease in inflammation and symptoms in the AS patients. The role of a "low starch diet" in the management of AS requires further evaluation.

Famous sufferers of AS

• Mötley Crüe guitarist, Mick Mars: AILING ROCKER MARS CAN'T MOVE HIS HEAD
• Ramses II
• Former England cricket captain, Mike Atherton;
• Former Australian cricketer, Michael Slater;
• Scottish poet, William Soutar was bed-ridden for the last 13 years of his life due to AS
• British comedian, Lee Hurst;
• Canadian radio personality, Mike Stafford;
• Norwegian Prime Minister, Jens Stoltenberg;
• World Chess Champion, Vladimir Kramnik;
• Former author and "Saturday Review" editor, Norman Cousins;
• Scottish former snooker player, Chris Small;
• Ed Sullivan, the Ed Sullivan Show, US
• Leonard Trask, "The Wonderful Invalid"
• Canadian musician, actor, and writer, Chris Michaud
• The Phillies' first baseman, Rico Brogna had a successful nine-year career in American Major League baseball. Ankylosing Spondylitis forced his early retirement, at 31, in 2001.
  

Enbrel Treatment: Day 1

I have chosen Wednesdays and Saturdays to have my Enbrel treatment. Tonight was my first treatment since February 2006. Below I have documented the procedure:

A package of Enbrel (below): Four of these come in each box and last 2 weeks. Note: alcohol swabs no longer come in the package and must be ordered seperately.

Solution prep: I previously instilled the diluent in the vial of powdered medication, allowed it to dissolve, and I am now drawing back the preparation into the syringe.






Site prep (below): Preparing the site properly is critical to minimize risk of infection. I am swabbing my chosen site (left lower quadrant of abdomen) with an alcohol swab.

Safety precautions (below): The far left photo shows my aspirating (pulling back on the plunger) before injecting the solution (right photo).

Injecting (below): The medication must be injected subcutaneously. To do this, pinch the skin and insert the needle at a 45 degree angle.

Complications: Site reactions are common after injecting Enbrel. This site reaction occured within 2 minutes of injecting Enbrel. The site became red, warm to the touch, and itchy, with small welts emerging. You can see a small bump above and to the right of the bloody insertion point. Beneath the site reaction I could feel the bleb of fluid beneath my skin, like a round pebble.

Three Cheers!!!

It was a bitterly cold day, but I didn't care. Today was the day I strolled across to Women's College Hospital's pharmacy, with a slight spring in my step, and picked up my prescription for Enbrel. I could not be happier. Two boxes, enough to last me a month, with each box containing four Enbrel dose trays of 25mg vials of etanercept, one diluent syringe, one 27-gauge needle, one vial adapter, and one plunger--all waiting for assembly and usage. Given that I need to inject Enbrel subcutaneously twice weekly, I need to pick days that are convenient. I am thinking Wednesdays and Saturdays would be suitable: I could inject my abdomen at work on Wednesdays and find someone to inject my arm on the weekend. Saturdays are great because it would preload my body before my long runs on Sundays, which tend to cause my body to experience a systemic inflammatory process (aka flare) that lasts well beyond the day.

Tomorrow I will post photographs of myself preparing the medication and injecting it. This would allow those contemplating taking this medication some insight as to the process that must be carried out twice weekly. For people who have difficulty preparing the medication, it also comes in 50mg pre-filled syringes for once weekly injection. Stay tuned.

New Running Goals for 2007

After much deliberation, I have decided to focus on distance, rather than speed, for 2007. I love my long runs: hours of solitude along stretches of road or trail, focusing on planting one foot in front of the other, getting closer to my destination. I have resolved not to place too much emphasis on time goals for Around the Bay, and to use the subsequent two races to concentrate on speed.