Tonight, I ran the JP Morgan Corporate Challenge. Last year, this was the race that got me interested in running and eventually into marathon running, completing 2 marathons over the last year.
This was my first race since the Wisconsin Marathon on May 1st. I've been hurt for 3 months, was lucky to complete the Wisconsin Marathon, and have only run around 8 times since May 1st, as I have been rehabbing my knees via physical therapy, focusing on strengthening my legs. This PT has definitely been working, as my knees and IT bands are much better. Biking has also improved my leg strength, and I definitely feel stronger and more stable in my legs. While my legs feel stronger, but there is no question that my endurance is far below where it was a few months ago. I haven't done any speed work in months, as I've been focusing on running pain free and easy (around 8:30 per mile).
Keeping all of this in mind, I went into tonight's race with 2 goals. 1) run pain free and 2) push the pace if no pain. My time goal was to be sub 8:00 per mile (last year, my pace was 8:05 per mile). I wasn't sure that I could hold a sub 8:00 pace today for 3.5 miles in very hilly Central Park. When I signed up for this race a few months ago, I thought that this might be the race that I could run at sub 7:00 per mile pace (my best pace for a 4 mile race was 7:11 per mile earlier this year).
Last year, I was very frustrated early during this race, as it was incredibly crowded (over 15,000 runners), so I had a tough time running fast. It took me over 3 minutes to get off the start line and there was no chip to track my time. This year, JP Morgan did it right. They put in place 2 elite corals for fast runners to start in, all the way at the front of the race (a red corral for elite runners and a yellow corral for fast runners). I got a yellow sticker and started near the front. This was key for me this year. It was still crowded at the start, but it opened up quickly and I was able to run at whatever speed I wanted early. They also but a chip on our bibs to track our time.
I really like this race, despite how crowded it is. There are so many companies represented, mostly financial companies. I love that people get out there to run this race.
So, I was probably 250 people back from the start line at the start. The horns went off and the race began. It started a little slow but opened up quickly. The great thing about starting near the front is that everybody around you is fast and wants to run a good time. This pushes me to push myself. Last night I had a gig with our band Come Together, a Beatles and Rolling Stones cover band, so I wasn't home until late and didn't get a lot of sleep. The gig was at the Essex House on Central Park south for a Mount Sinai OB/GYN resident graduation party (our drummer is a OB/GYN surgeon at Sinai). The gig was awesome. It was formal, and people were dancing from our first song. I love when people dance while we play. Anyway, I digress. I've been fighting a cold all week and have been very congested. I took some cold medicine in the morning because I felt crappy. I knew that this would likely elevate my heart rate during the run, but I felt like I needed it.
Mile 1
The first mile of the race is uphill, so I decided to take it easy out of the gate. About 0.25 miles in, I looked down at my watch and it said my pace was 8:07. A minute later 8:09. It felt hard and my heart rate was way up. All of the sudden, I felt some unexpected energy and started to push uphill. At about 0.90 miles I looked down at my watch again and my pace was about 7:10 per mile. At the 1 mile split, it read 7:03. "Sweet", I thought to myself. I was surprised at how easy I was running and questioned whether my watch was correct, but the mile 1 time clock read the same time, so I knew it was real.
Mile 1 split - 7:03, average heart rate 173
Mile 2
After mile 1, I thought to myself, maybe I have a shot at a sub 7:00 per mile race. I knew that my endurance wasn't strong right now, but I thought I would go for it. Mile 2 has rolling hills, so I decided to take advantage of the downhills. I looked down at my watch at 0.25 miles into the 2nd mile and my pace was in the 6:30s. I thought to myself "this doesn't feel that hard, let's see if I can maintain this pace for the entire mile". Sure enough, when I got to the 102nd street transverse, which I knew was uphill, I couldn't hold it, as I was totally exhausted. My endurance just wasn't what it was a few months ago. My mile 2 split time started to slip...6:50, 6:55, and finally I ended the split at 7:11. I didn't know what my heart rate was (I don't check it when I run races), but I knew that it was high, as I was working hard starting at 1.75 miles into the race.
Mile 2 split - 7:11, average heart rate 186
Mile 3
For me, this is the toughest part of the course. It is net uphill on the east side of the park until 90th street, then it has rolling hills. I said to myself, "keep pushing", but my endurance just wasn't there. I thought to myself "man, I need to do speed work with the 6am New York Flyers group again. Why are their runners able to hold their pace in the 6:30s? It is because they train for it. They work hard. You need to work harder". For most of this mile, I was averaging around 7:40 per mile, so I pushed at the end of mile 3 and ended up with a mile 3 split of 7:31, as I worked hard for the last quarter mile of mile 3 (I set my watch to show me my current mile lap only, so that pushes me to maximize my mile splits). At this point, I was totally exhausted, extremely thirsty (I actually thought about getting water but didn't because I didn't want to slow down). I felt a little queasy. My average heart rate of 189 was extremely high - I have never run a race getting it this high before.
Mile 3 split - 7:31, average heart rate 189
Mile 3 to 3.5 miles (0.50 miles)
I knew that I would get the benefit of the large downhill at Cat Hill during the last half mile. However, when I got to the hill, I just didn't have any gas left. My pace down the hill was 7:18 or so as I looked at my watch. I said to myself "that's fine, I really don't feel like running any faster right now". When I got to the bottom of the hill, I pushed the pace, running hard for the last 0.25 miles (hitting a pace of 4:51 per mile at one point). I finished with a 6:55 pace for the last 0.50 miles, crossed the finish line, and was exhausted but happy that I had no knee pain at all (not even a tweak) and that I finished with a good time. The bursitis behind my left knee bothered me a little bit, but not much.
last 0.50 miles - 6:55, average heart rate 191 (with a peak of 197).
Overall - 3.5 miles, 7:12 pace (a PR for this distance and 1 second off of my best 4 mile pace of 7:11 per mile), average heart rate 184 for the entire race, total time 25:29. My time this year was 3 minutes and 18 seconds faster than my time last year (28:47).
Click Here for the Garmin summary from my watch with my splits. Check out the player tab too.
After the race, I took an ice bath with Epsom salts and felt great. No pain!
I'm encouraged by this race and am very excited that I am getting healthy.
Thursday, June 17, 2010
Sunday, June 13, 2010
Finally Bought a Road Bike - a Cannondale Caad 9 5 (double)
Yesterday, I finally bought a road bike. I made the decision to get one about a month ago, as I want to try out a triathlon. I'm really looking forward to cross training on the bike and in the pool, particularly as I train for the Chicago Marathon on 10/10/10. I hope that my knees are healthy enough to do it. I also have 3 races coming up in the next 2 weeks (the JP Corporate Challenge on 6/17, which is 3.5 miles, which I plan on running very easy since I haven't been running a lot lately (and my company got me a sticker for my bib so I can start at the front of the race to avoid the congestion), a 5 mile race on Father's day for Prostate Cancer on 6/20, and the Gay/Pride 5 mile race on 6/26, which I ran last year when I first started running and loved it. All are in Central Park). I'm not sure that I am ready to run a 5 mile race yet. My knees are much better, but if they are hurting I won't race. Either way, I will run them easy.
When I decided to buy a road bike, I knew absolutely nothing about road bikes (which is pretty much still the case). So, I started asking all of my friends (and even one of my wife's co-workers) about what to buy. I've quickly learned that cycling is an extremely expensive sport! After getting advice from everybody, I decided that a middle priced bike with good components would do the trick for me. This price point was around $1,499. For this, I could get a light aluminum frame (I'm told that it is one of the lightest aluminum frames on the market and perhaps even less than some carbon bikes), a carbon fork, and Shimano components. Good enough for a first bike. If I decide to get serious, I can always upgrade my new bike or get a new one. Check it out here. I got it for $1,449. Of course, I bought clip on pedals, clip on shoes (I've never had either of these before or even ridden a bike with them on it), 2 pairs of biking shorts, water bottles, and air pump, a jersey, and a bunch of other accessories. All in, $2,250. Like I said, a very expensive sport!
So, after 2 trips and about 6 hours at the bike shop getting fitted for a 56cm frame (got it at Toga on 64th and Central Park West), I decided to go out to Central Park to try out the bike. I went behind my building to put on my shoes and to "clip in" to the peddles with my new shoes. I had heard that most people fall down often when learning how to bike with the clipped on shoes. Add me to the list. I was able to clip on to the bike, holding on to a garbage can next to some bushes. What I didn't account for was the high gear my bike was in, so when I tried to peddle, it was too hard. I didn't make it an inch and started to fall to the side (think of "TIMBER" like a tree falling down slowly). My mind was thinking "OK, clip out of the shoes" but my body just couldn't make it happen, and I fell directly into the bushes (and have a nice long cut along my left hip to show for it). Live and learn. After that, I made sure to keep moving so I wouldn't have to clip out, and luckily I made it to Central Park, did a loop (6 miles at 18.8 miles per hour, not bad for my first ride in very hilly Central Park), and got home without having to clip out.
Today, I went to Central Park at 630am to ride, which is when the serious riders are in the park, as going in the middle of the day is crowded and therefore not great for riding. I rode for 1 hour and 21 minutes, 24.33 miles, averaging 18.0 miles per hour, with an average heart rate of 143. I was very happy with this ride and feel like I can be faster once my legs get in better "riding shape" and also when I can figure out how to use my gears better (at one point during my ride I tried to shift while going up the Harlem Hill and my chain came off. I had to jump off the bike to put it back on. I was in the middle of the hill, so there was no way that I was going to be able to clip back on the bike and get the power to get up the hill without falling down, so I coasted back down the hill, clipped in, and turned around to go back up. Overall, I felt great during and after my ride. My knees didn't hurt and my legs felt great (although I felt a few twinges in my legs near the end). I'm hoping to ride farther next weekend. Any and all advice on how to shift gears is appreciated!
I have an appointment at Toga on Friday to have another fit test (usually $200 put they are giving it to me for $100 since I bought the bike there). They will test seat ankles, stem length, seat positions, and other things to make sure that the bike settings are optimal for me.
On Friday, I swam for 30 minutes. It was a great workout. My average heart rate was 151 and I was definitely pushing my pace. I read my friend LW's blog (he's an Ironman) where he said that his coach says "to be tall", so I interpreted this to mean to extend my arms out as far as possible while swimming and to follow through on my stroke deep into the water (I asked the lifeguard to critique my form, which I think is horrible, after one of my swims a few weeks ago and he said that I wasn't following through with my arms under water). I swam 54 lengths (1,350 yards, 0.77 miles) in 30 minutes, 4 minutes faster than I had done the previous week. For the last 6 lengths, my feet and calves were cramping big time! I had such a charlie horse in my right calf that I was in agony during the last length (which I had to endure because I was in the deep end and couldn't put pressure on it until I got in the shallow end). As of today, the area where I had the charlie horse is still sore. Is this normal? I have been eating more bananas since then to try to minimize the cramping.
Now I'm off to find a sprint triathlon to sign up for later this summer. All recommendations are welcome!
Today, I went to Central Park at 630am to ride, which is when the serious riders are in the park, as going in the middle of the day is crowded and therefore not great for riding. I rode for 1 hour and 21 minutes, 24.33 miles, averaging 18.0 miles per hour, with an average heart rate of 143. I was very happy with this ride and feel like I can be faster once my legs get in better "riding shape" and also when I can figure out how to use my gears better (at one point during my ride I tried to shift while going up the Harlem Hill and my chain came off. I had to jump off the bike to put it back on. I was in the middle of the hill, so there was no way that I was going to be able to clip back on the bike and get the power to get up the hill without falling down, so I coasted back down the hill, clipped in, and turned around to go back up. Overall, I felt great during and after my ride. My knees didn't hurt and my legs felt great (although I felt a few twinges in my legs near the end). I'm hoping to ride farther next weekend. Any and all advice on how to shift gears is appreciated!
I have an appointment at Toga on Friday to have another fit test (usually $200 put they are giving it to me for $100 since I bought the bike there). They will test seat ankles, stem length, seat positions, and other things to make sure that the bike settings are optimal for me.
On Friday, I swam for 30 minutes. It was a great workout. My average heart rate was 151 and I was definitely pushing my pace. I read my friend LW's blog (he's an Ironman) where he said that his coach says "to be tall", so I interpreted this to mean to extend my arms out as far as possible while swimming and to follow through on my stroke deep into the water (I asked the lifeguard to critique my form, which I think is horrible, after one of my swims a few weeks ago and he said that I wasn't following through with my arms under water). I swam 54 lengths (1,350 yards, 0.77 miles) in 30 minutes, 4 minutes faster than I had done the previous week. For the last 6 lengths, my feet and calves were cramping big time! I had such a charlie horse in my right calf that I was in agony during the last length (which I had to endure because I was in the deep end and couldn't put pressure on it until I got in the shallow end). As of today, the area where I had the charlie horse is still sore. Is this normal? I have been eating more bananas since then to try to minimize the cramping.
Now I'm off to find a sprint triathlon to sign up for later this summer. All recommendations are welcome!
Thursday, June 10, 2010
2nd Cortisone Shot - this time to my Right Knee along the IT band
On Monday, I got a cortisone shot to my right knee via interventional radiology, where they used an ultrasound machine to find out precisely where I needed the shot and then did the injection. The doctor said that I had fluid and bursitis in the right knee along the IT band from below the knee to well above the knee (he said that the length of the fluid "pocket" was abnormally long). The doctor that gave me the shot frequently gives professional athletes cortisone shots. I asked him if the shot he gave me would be the same as the shot he would give a professional athlete and he said "the shot I gave you for your injury is exactly the same shot I would give a professional athlete or anybody else. The only difference is that the professional athlete is likely to get back on the field tomorrow, whereas you will take a week off from running". He advised me to take a week off from running and said that I can swim or bike starting Thursday so long as I don't have pain. Hopefully, the shot will help my recovery.
My right knee has been significantly better over the last week. I've really focused on cross training (biking and swimming) to minimize the impact of running, and I am loving cross training. My physical therapy and leg strengthening exercises are also helping me big time. I have also found that warming up on the bike before running has loosened up my IT bands before my runs, which has been great. Also, I'm finding that riding the bike has strengthened my legs and gluteus maximus (I.e. My bum), where my physical therapists say I am weak, which in turn is causing my legs to buckle when running (my right leg is significantly weaker than my left knee), which is therefore putting more pressure on my knees and IT bands. I didn't believe that I was weak in my legs until they had me do a bunch of simple leg tests and I struggled. Now, I'm a huge believer in this explanation and have been doing my leg strengthening exercises religiously everyday. Almost all of them are done with a band (like a big rubber band). The band provides resistance to assist in the strengthening. I've also been rolling out my IT bands daily, which also helps. I bought "the grid" roller, which is orange and is made by Trigger Points I think. My friend LW recommended it and said "the best thing about it, other than the fact that it doesn't break down because it is made of hard plastic versus foam, is that you can put it in your suitcase when you travel and can stuff clothes in the hollow hole in the middle". Hardcore. LW did his first Ironman in Germany last summer.
Here is a summary of my workouts over the last week:
Monday - cycled for 50 minutes
Tuesday - cycled for 45 minutes
Wednesday - off
Thursday Morning - cycled for 40 immediately followed by a 20 minute run (8:09 pace, no pain)
Thursday Evening - swam for 19 minutes followed immediately by 10 minutes of cycling
Friday - swam 34 minutes
Saturday - cycled for 30 minutes immediately followed by a 22 minute run (8:14 pace, no pain)
Sunday - off
I've run every other day for the last week, most recently Monday morning for 24 minutes with no pain in my right knee (and I ran the last mile at 7:25 pace). My right knee is getting much better, just nagging little twinges a little after I run once in a while. I'm now officially in love with the bridal path. It is much easier on my body and I don't think that I am going to run the loop for a while. There is a whole sub culture on the bridal path
The bursitis behind my left knee still present, however. The doctor took a look at it again on Monday via ultrasound and said that the area still has fluid in it despite my cortisone shot. This could mean that the cortisone shot did not work. I asked if it could be drained and he said that the fluid is in an area that they don't typically drain. His advice was to see how it is doing in a few weeks and said that I may need another cortisone shot to the area (he recommended waiting 3 months but said I should talk to my knee doctor). I'm bummed that the left knee is still bothering me. They looked for the ganglion cyst again but couldn't find it. It sure does feel like it is still in there. I may need to get another mri.
I won't run for at least another week, but will start workouts on the bike and in the pool starting Thursday.
My right knee has been significantly better over the last week. I've really focused on cross training (biking and swimming) to minimize the impact of running, and I am loving cross training. My physical therapy and leg strengthening exercises are also helping me big time. I have also found that warming up on the bike before running has loosened up my IT bands before my runs, which has been great. Also, I'm finding that riding the bike has strengthened my legs and gluteus maximus (I.e. My bum), where my physical therapists say I am weak, which in turn is causing my legs to buckle when running (my right leg is significantly weaker than my left knee), which is therefore putting more pressure on my knees and IT bands. I didn't believe that I was weak in my legs until they had me do a bunch of simple leg tests and I struggled. Now, I'm a huge believer in this explanation and have been doing my leg strengthening exercises religiously everyday. Almost all of them are done with a band (like a big rubber band). The band provides resistance to assist in the strengthening. I've also been rolling out my IT bands daily, which also helps. I bought "the grid" roller, which is orange and is made by Trigger Points I think. My friend LW recommended it and said "the best thing about it, other than the fact that it doesn't break down because it is made of hard plastic versus foam, is that you can put it in your suitcase when you travel and can stuff clothes in the hollow hole in the middle". Hardcore. LW did his first Ironman in Germany last summer.
Here is a summary of my workouts over the last week:
Monday - cycled for 50 minutes
Tuesday - cycled for 45 minutes
Wednesday - off
Thursday Morning - cycled for 40 immediately followed by a 20 minute run (8:09 pace, no pain)
Thursday Evening - swam for 19 minutes followed immediately by 10 minutes of cycling
Friday - swam 34 minutes
Saturday - cycled for 30 minutes immediately followed by a 22 minute run (8:14 pace, no pain)
Sunday - off
I've run every other day for the last week, most recently Monday morning for 24 minutes with no pain in my right knee (and I ran the last mile at 7:25 pace). My right knee is getting much better, just nagging little twinges a little after I run once in a while. I'm now officially in love with the bridal path. It is much easier on my body and I don't think that I am going to run the loop for a while. There is a whole sub culture on the bridal path
The bursitis behind my left knee still present, however. The doctor took a look at it again on Monday via ultrasound and said that the area still has fluid in it despite my cortisone shot. This could mean that the cortisone shot did not work. I asked if it could be drained and he said that the fluid is in an area that they don't typically drain. His advice was to see how it is doing in a few weeks and said that I may need another cortisone shot to the area (he recommended waiting 3 months but said I should talk to my knee doctor). I'm bummed that the left knee is still bothering me. They looked for the ganglion cyst again but couldn't find it. It sure does feel like it is still in there. I may need to get another mri.
I won't run for at least another week, but will start workouts on the bike and in the pool starting Thursday.
Saturday, June 5, 2010
Cross Training in the Pool plus a waterproof MP3 player
Over the last few weeks, I have been cross training a lot. I've been riding a spinning bike at the gym daily and started swimming this week. The last time I went swimming was in high school when I had to swim 500 yard warm ups for a life guarding class. Then, I hated swimming distance, just like I hated distance running.
So, for the first time since high school, on Thursday night, I went to the gym with the goal of getting a good swim workout in. If I'm going to do a triathlon someday, I have to start swimming. Plus, everybody tells me that it is a great, zero impact workout that will allow me to get a good workout in while allowing my knees to heal. I had already worked out in the morning, spinning for 40 minutes and running for 20 (with no pain!). It was 9:30 P.M. when I got to the pool. Luckily, it wasn't crowded. I put on my swim cap (I couldn't find my black one so I had to wear my daughter's pink one) and some blue Speedo goggles that I bought 10 years ago but never wore (they had been getting banged around my bag for years, so they were in bad shape and leaked into my eyes when I swam). I also put on my Polar Heart rate monitor strap and my Polar S610 watch (which I've had for around 8 years and love).
So, I decided to try it again last night. My knee doctor is also a triathlete and former marathon runner that transitioned to tris to reduce the pounding on his body. When I told him that I wanted to make the same transition, he said "Bro, do yourself a favor and get yourself an mp3 player that you can use in the water and some audio bone headphones". I listen to music when I run, so it made sense to me to listen to music while swimming too (at least when you run outside you can look at stuff). I looked into it, spoke to a few friends (PN and AL), and purchased the Finis Swimp3 Waterproof MP3 player. This MP3 player has 1 GB of hard drive space and headphones that you put up against your cheek bones (not in your ears). When you are underwater, you hear the music through your bones (which is what my doctor was referring to as "Audio Bone"). Heaven. The boredom of swimming immediately was replaced by being able to listen to music while swimming, which was awesome (I listened to the new Slash album during my swim, it rocks). It really made swimming enjoyable.
I am encouraged by my first 2 nights of swimming, as I went into it wondering if I would be able to swim well enough to do a triathlon. Now I feel confident that I can do it (although not that fast). I am in it to enjoy myself and stay fit. Cross training on the spinning bike and in the pool has really opened up my eyes to the benefits of cross training.
I've also been looking into buying a road bike over the last week and I am getting close. I will write a separate blog post on this topic.
So, for the first time since high school, on Thursday night, I went to the gym with the goal of getting a good swim workout in. If I'm going to do a triathlon someday, I have to start swimming. Plus, everybody tells me that it is a great, zero impact workout that will allow me to get a good workout in while allowing my knees to heal. I had already worked out in the morning, spinning for 40 minutes and running for 20 (with no pain!). It was 9:30 P.M. when I got to the pool. Luckily, it wasn't crowded. I put on my swim cap (I couldn't find my black one so I had to wear my daughter's pink one) and some blue Speedo goggles that I bought 10 years ago but never wore (they had been getting banged around my bag for years, so they were in bad shape and leaked into my eyes when I swam). I also put on my Polar Heart rate monitor strap and my Polar S610 watch (which I've had for around 8 years and love).
I started to swim and felt pretty good. It was hard, but my friend PN, a very talented triathlete, told me to focus on my stroke and efficiency (and also that most of one's swimming power comes from the arms), so I focused on being efficient. Aerobically, I felt great. I could barely get my heart rate above 135. However, after 18 minutes of swimming my feet and calves started cramping big time, so I called it a night at 19 minutes, average heart rate 135. The pool is 25 yards, so I calculated that I made it 650 yards. While I stopped many times, often for a few minutes at a time, I felt pretty good after the workout. I swam farther than the 500 yard workouts that I hated in high school and wasn't winded at all (when I did them in high school I was dead tired after doing them). Without question, I'm still in pretty good shape after running a marathon a month ago. I was surprised to get the cramping but assumed that it happened because I haven't built up my "swimming muscles" yet.
So, I decided to try it again last night. My knee doctor is also a triathlete and former marathon runner that transitioned to tris to reduce the pounding on his body. When I told him that I wanted to make the same transition, he said "Bro, do yourself a favor and get yourself an mp3 player that you can use in the water and some audio bone headphones". I listen to music when I run, so it made sense to me to listen to music while swimming too (at least when you run outside you can look at stuff). I looked into it, spoke to a few friends (PN and AL), and purchased the Finis Swimp3 Waterproof MP3 player. This MP3 player has 1 GB of hard drive space and headphones that you put up against your cheek bones (not in your ears). When you are underwater, you hear the music through your bones (which is what my doctor was referring to as "Audio Bone"). Heaven. The boredom of swimming immediately was replaced by being able to listen to music while swimming, which was awesome (I listened to the new Slash album during my swim, it rocks). It really made swimming enjoyable.Finis Swimp3 You Tube Video - Check out this video to learn more about the MP3 player.
I got to the pool at 10 PM and felt good. I also picked up some new Aquasphere goggles which made a huge difference during my swim. With the music, the new goggles, and 1 day of experience, I ended up swimming for 34 minutes and 54 lengths (or 1350 yards), average heart rate 145. I more than doubled the distance I swam what the night before and was faster doing it. When I finished, I felt tired, almost like I was drugged. It was a good tired, with no pain anywhere in my body (unlike when I often finish running, where my body feels sore from the pounding).
As I write this tonight, my shoulders are sore from the arm strokes, but other than that, I feel great. I look forward to swimming more in the future.
I am encouraged by my first 2 nights of swimming, as I went into it wondering if I would be able to swim well enough to do a triathlon. Now I feel confident that I can do it (although not that fast). I am in it to enjoy myself and stay fit. Cross training on the spinning bike and in the pool has really opened up my eyes to the benefits of cross training.
I've also been looking into buying a road bike over the last week and I am getting close. I will write a separate blog post on this topic.
Saturday, May 29, 2010
Cyst Gone, but not via Surgery / Cortisone Shot Received for Bursitis Behind Left Knee
Yesterday, I went in to get a ganglion cyst removed from behind my left knee. My appointment was with a radiologist so the doctor could use an ultrasound machine (the same machine used when seeing a baby in a woman's stomach, except in this case they look for cysts). They use the machine to locate exactly where the cyst is so that the needle incision can be precise to drain it. I love this precision. Prior to yesterday, I had no idea that radiologists actually performed procedures (I always assumed that they just read xray, MRIs, CT scans, etc.)
The ganglion cyst showed up on an MRI on May 6th. At that time, it measured about 3cm x 2.2cm x 0.8cm (i.e. a pretty good size cyst). I had no idea that I had a cyst prior to the MRI. I also had some bursitis behind the left knee, so going into my appointment, I wondered if the bursitis or the cyst was the reason for my pain. I thought it was a little strange that I could not feel the cyst with my hand.
When the radiologist looked for the cyst, he couldn't find it. I anticipated this, so I had my MRI report and copies of my MRI films for the doctor to look at. I showed them where my pain was, and sure enough, they found the source of my pain. In this case, it wasn't the cyst at all. Rather, the bursitis behind my left knee had gotten worse (even though I'm not running these days). Given that I have had this bursitis for over 2 months and it hasn't gotten better, they said that I needed a cortisone shot to help it heal. I got the shot and immediately felt better - the lidocane numbed the area even though the steroid cortisone shot is slow releasing and therefore the drug won't kick in for a few days (and the doctor said that the drug could help the area for up to a year). Today, the area felt a little sore as the doctor predicted, but as the day went on, the pain behind my left knee was noticeably better. The doctor told me not to run for a week, but that I could bike or swim starting Monday. Riding a bike doesn't hurt at all, so I'll be doing that on a stationary spinning bike at the gym all next week. I may try swimming also.
I also asked the radiologist to ultrasound my right knee and IT band, given that it hasn't gotten better from the May 6 MRI (despite hardly running at all for the last 3 weeks and taking anti-inflammatories (Mobic)). I figured that if I was getting the cortisone shot to the left knee and couldn't run for a week, that it would make sense to get the shot to the right knee also so I could have both knees start to heal at the same time and limit the time I can't run to 1 week. My doctor hadn't written a prescription to ultrasound my right knee, so I got some resistance. I explained my thinking and the doctor did the ultrasound and found a pocket of swelling and a thickened IT band and said that a cortisone shot was needed there too. So they called my doctor's office to ask for the prescription, but unfortunately he wasn't in (2pm on the Friday of Memorial Day weekend). They said that it wasn't a medical emergency and that I didn't have a prescription so they wouldn't do the shot. When I asked if there was a doctor covering for my doctor that could approve it, they said no, only for emergencies. Of course, "it is an emergency to me" I explained, as (1) I don't want to have to retake the same tests I just took to determine that I need the shot, (2) deal with getting an another appointment at this hospital (Hospital for Special Surgery ("HSS") which was extremely difficult to do the first time and very tough for me to get there again because I'm very busy at work), (3) have to take 2 weeks off instead of 1 because I won't get the second shot, at the earliest, until next week). I got no sympathy whatsoever. It made total sense to get both shots at the same time. It's not like I was making up the injury. The radiologist clearly saw the injury on the ultrasound exam. The radiologist had no ability to write his own prescription for the shot (which is surprising to me because one would think that the ultrasound test he conducted is far better evidence that a shot is needed than calling my knee doctor who is just going to ask the radiologist what he thinks anyway or read his report, which the radiologist told me was to get the cortisone shot). Where I come from, people want to help people. A doctor would have called another doctor and somebody would have figured out how to write me a prescription to get it done so I wouldn't have to go back again to get it done. Yesterday, me being the squeaky wheel made me feel like I was the bad guy. A bad guy simply for wanting to get the best possible care so that I can recover faster, at a top rated hospital that prides itself on taking care of athletes. It feels like the best possible care comes in a distant second place to the schedule and inflexibility of doctors and hospitals.
At the end, I asked the doctor to look for the cyst. He did and couldn't find it. The doctors said that it is likely that it went away on its own because, as the Doctors put it, "I was behaving myself" (translation - when I reduced the overuse of excessive marathon running, it went away).
The ganglion cyst showed up on an MRI on May 6th. At that time, it measured about 3cm x 2.2cm x 0.8cm (i.e. a pretty good size cyst). I had no idea that I had a cyst prior to the MRI. I also had some bursitis behind the left knee, so going into my appointment, I wondered if the bursitis or the cyst was the reason for my pain. I thought it was a little strange that I could not feel the cyst with my hand.
When the radiologist looked for the cyst, he couldn't find it. I anticipated this, so I had my MRI report and copies of my MRI films for the doctor to look at. I showed them where my pain was, and sure enough, they found the source of my pain. In this case, it wasn't the cyst at all. Rather, the bursitis behind my left knee had gotten worse (even though I'm not running these days). Given that I have had this bursitis for over 2 months and it hasn't gotten better, they said that I needed a cortisone shot to help it heal. I got the shot and immediately felt better - the lidocane numbed the area even though the steroid cortisone shot is slow releasing and therefore the drug won't kick in for a few days (and the doctor said that the drug could help the area for up to a year). Today, the area felt a little sore as the doctor predicted, but as the day went on, the pain behind my left knee was noticeably better. The doctor told me not to run for a week, but that I could bike or swim starting Monday. Riding a bike doesn't hurt at all, so I'll be doing that on a stationary spinning bike at the gym all next week. I may try swimming also.
I also asked the radiologist to ultrasound my right knee and IT band, given that it hasn't gotten better from the May 6 MRI (despite hardly running at all for the last 3 weeks and taking anti-inflammatories (Mobic)). I figured that if I was getting the cortisone shot to the left knee and couldn't run for a week, that it would make sense to get the shot to the right knee also so I could have both knees start to heal at the same time and limit the time I can't run to 1 week. My doctor hadn't written a prescription to ultrasound my right knee, so I got some resistance. I explained my thinking and the doctor did the ultrasound and found a pocket of swelling and a thickened IT band and said that a cortisone shot was needed there too. So they called my doctor's office to ask for the prescription, but unfortunately he wasn't in (2pm on the Friday of Memorial Day weekend). They said that it wasn't a medical emergency and that I didn't have a prescription so they wouldn't do the shot. When I asked if there was a doctor covering for my doctor that could approve it, they said no, only for emergencies. Of course, "it is an emergency to me" I explained, as (1) I don't want to have to retake the same tests I just took to determine that I need the shot, (2) deal with getting an another appointment at this hospital (Hospital for Special Surgery ("HSS") which was extremely difficult to do the first time and very tough for me to get there again because I'm very busy at work), (3) have to take 2 weeks off instead of 1 because I won't get the second shot, at the earliest, until next week). I got no sympathy whatsoever. It made total sense to get both shots at the same time. It's not like I was making up the injury. The radiologist clearly saw the injury on the ultrasound exam. The radiologist had no ability to write his own prescription for the shot (which is surprising to me because one would think that the ultrasound test he conducted is far better evidence that a shot is needed than calling my knee doctor who is just going to ask the radiologist what he thinks anyway or read his report, which the radiologist told me was to get the cortisone shot). Where I come from, people want to help people. A doctor would have called another doctor and somebody would have figured out how to write me a prescription to get it done so I wouldn't have to go back again to get it done. Yesterday, me being the squeaky wheel made me feel like I was the bad guy. A bad guy simply for wanting to get the best possible care so that I can recover faster, at a top rated hospital that prides itself on taking care of athletes. It feels like the best possible care comes in a distant second place to the schedule and inflexibility of doctors and hospitals.
At the end, I asked the doctor to look for the cyst. He did and couldn't find it. The doctors said that it is likely that it went away on its own because, as the Doctors put it, "I was behaving myself" (translation - when I reduced the overuse of excessive marathon running, it went away).
Thursday, May 27, 2010
MRI Results
Unfortunately, for the 2 months before the Wisconsin Marathon (May 1), my knees started to hurt. I managed through it, but I don't think that I had a run without pain during these 2 months. Rest and ice baths helped, so looking back I was extremely fortunate to have actually completed the marathon. As one of my friends said "you got lucky". I also know now that I was lucky not to hurt myself more. Live and learn.
So, I saw a doctor the Monday after the marathon and got XRays and MRIs of both knees and legs.
Here were the results:
Right Leg -
1. Xray - No stress fracture in my right leg (I thought 50/50 I had one, although it did show thickening of the bone which indicates that I may have had one in the past). Good news. The xrays of both of my knees were completely normal.
2. MRI - Right Knee
Since I haven't been able to run much, I have been riding a spinning bike at the gym. Luckily, I can do this without pain. I'm really enjoying doing something other than running and hope to keep up cycling when my knees are 100%. I'm actively looking to buy a road bike now, so any and all advice is greatly appreciated!
My next marathon is on 10/10/10 in Chicago, so this is a great time to take some time off to let my body recover.
So, I saw a doctor the Monday after the marathon and got XRays and MRIs of both knees and legs.
Here were the results:
Right Leg -
1. Xray - No stress fracture in my right leg (I thought 50/50 I had one, although it did show thickening of the bone which indicates that I may have had one in the past). Good news. The xrays of both of my knees were completely normal.
2. MRI - Right Knee
- (1) severe IT band syndrome in my right knee (I have had this before and can fix it via physical therapy, ice, rest, elevation, and anti inflammatories). Despite the fact that I roll out my IT bands everyday, I still had this injury, and my physical therapist said that it will likely take 6-8 weeks for me to fully recover.
- (2) arthritis in the knee (I have had this in the past)
- (3) a small Baker's cyst behind the right knee (unexpected but it is small and doesn't really bother me, so nothing to do with it).
- Right knee bottom line - everything is fixable, no major problems.
- (1) Bursitis behind my knee around my medial gastroc (I thought I had a gastroc strain, so this was good news).
- (2) A very large ganglion cyst behind my left knee (over 3 cm by 3 cm large). These occur normally in people (and I have a history of cysts in my body due to my Crohn's disease), but this cysts (non cancerous) is pushing under some tendons and around the bone and is really bothering me
- I am having this cyst drained tomorrow (5/27). I'm told that I will feel better almost immediately.
Since I haven't been able to run much, I have been riding a spinning bike at the gym. Luckily, I can do this without pain. I'm really enjoying doing something other than running and hope to keep up cycling when my knees are 100%. I'm actively looking to buy a road bike now, so any and all advice is greatly appreciated!
My next marathon is on 10/10/10 in Chicago, so this is a great time to take some time off to let my body recover.
Saturday, May 1, 2010
Wisconsin Marathon 2010 - a 4:17, a tough day, a humbling experience
Today, I ran my 2nd marathon.
Location = Kenosha, Wisconsin
Date = May 1, 2010
Weather = low 60s at the start, sunny, extremely humid (100%), 20 mph winds. Temperature near 70 during race.
My time = 4:17, half marathon split 1:55
Comments:
Tough race today. Despite not meeting my goal time, I'm still proud of my performance, as I was feeling really bad starting around mile 9 and I really did not want to run 26 miles at that point. It was extremely hard for me to simply finish this marathon (versus my first marathon when I ran a 3:58 in NYC and didn't walk at all). Today, I probably walked 5 miles of the course. When I saw my friend RFL at mile 12 as he was finishing his half marathon, I yelled to him "I'm going to be right around 4 hours". He said "that's ok, that's great". This motivated me to keep going. When I saw my friend BGR at mile 19, I said to him "I think I'm going to be at around 4:40". At one point, I actually thought that I might not break 5 hours, that's how bad I felt.
I'm proud because I kept going. I'm proud because I decided that having fun and staying healthy was more important than pushing myself to misery trying to break 4 hours. I run to feel good, stay fit, keep my Crohn's disease in remission, and so that I can run tomorrow. I had a great time once I decided to walk. I knew 4 hours was gone at that point. I really enjoyed talking to other runners (I think I spoke to every single runner around me except those wearing headphones that couldn't hear me, which is funny, because I normally don't talk to anybody when I run because I listen to music. My xm radio died at mile 12 so I ran the second half without music). Talking to other runners totally changed my perspective forever. It made me truly appreciate how tough it really is to run a marathon and that everybody has good and bad days. It was extremely humbling for me. I felt, for the first time as a runner, that I was living the experience with others. Most of all, I'm proud that I ran my 2nd marathon!!
The race ran through the neighborhood that I grew up in (and my mom met me on the out and back, out and back course 4 times, which was great!). My friends BGR (first full marathon, from New York) and RFL (half marathon, from Highland Park) also came to Kenosha to run the race, which is great. I also met my friend MT (half marathon) and SJ (first full marathon) at the race. My friend CBS came to play the his steel drum for runners, which was very cool (and it was great to see him too). I also saw many old friends before, during, or after the race, which was very cool.
My time was 37 minutes below my goal of 3:40. All of my friends that ran the marathon were 23-40 minutes below their goal time. Tough day for all. My average heart rate was 171 for mile one (during the race, I saw that my heart rate was in the low 170s around mile 8, although I didn't realize that my average heart rate was 173 for my first 2 miles until I checked after the race). Way too high and very abnormal for me. At mile 8, I knew this meant trouble. I had a wicked cold early in the week, but I thought I was recovered by the race. Perhaps the cold contributed to the high heart rate? Even when I was walking after mile 13, it was in the 140s, also very abnormal for me. I've had training runs where I have run long runs at an 8:35 pace where my heart rate averages in the high 140s (although the temperature was in the 40s or 50s and the humidity was low). The high heart rate shows why I felt like running was so much harder today.
I started out strong and stayed to my gameplan of running an 8:20-8:40 pace for the first 10 miles or so, but I just didn't have it today after that. I was hot, tired, and my average heart rate was way above normal for this pace. The humidity, heat, wind, and loss of my iPod at mile 12 killed me (the battery died, one of my worst nightmares).
Today was quite a humbling experience. I'll use it as a learning experience for my next race, where I will force myself to go even slower at the start (around 9:00 per mile). Even if I would have started out slower, I'm not sure that I would have had any energy at the end. I'll never know.
I started to feel bad around mile 9. I was bloated from drinking water/Gatorade together. Plus, there weren't enough water stations, which was a killer with the temp in the 70s and 100% humidity plus the sun and wind. I really wish that the water and gatorade stations would have been staggered one mile apart (instead of being together every 2 miles), so that I could drink water at one mile then gatorade at the next (I saw the race director after the race and recommended this to him for next year's race). This would have been beneficial because (1) runners would have had a liquid every mile, somthing that was badly needed because of the heat and humidity, and (2) it would have helped me drink less liquid at one time, as I would not have felt the pressing need to drink both every 2 miles (which caused me to get bloated and feel sick). I actually thought that I might pass out at a few points (and one woman did with a 107 temperature right as she finished the half marathon - she's in Intensive care). I considered dropping out of the race. I have never considered dropping out of a race before. Generally, it is not a good sign for a marathon runner if he/she is tired of running before getting to double digit miles. When I saw my friend RFL near his half marathon finish (mile 12), I thought to myself "man, I wish I was done". Then, I saw my mom at mile 12, which perked me up. Before the race, I was worried about my xm radio battery dying but I couldn't find a replacement battery the day before. Therefore our gameplan was for me to run with my iphone for the 2nd half of the race if I needed it. So, my mom gave me a couple of GUs at this point but I told her that my xm radio was ok. Oops. About 40 steps later my radio died. I thought about running back to her, but didn't. 2 minutes later, I saw a family sitting on their lawn to cheer runners along. I said to them "do you guys live here?". "Yes", they responded. I said "would you mind if I leave my radio with you and I'll pick it up after the race?". They said yes, and I threw my radio on their nice lawn as I continued to run.
The night before the marathon, there were severe thunderstorms and the temperature was around 80. When the race started at 7am, it was already 61 degrees, with 100% humidity and 20 mph winds. The forecast projected the temperature to reach the 70s during the race with sunshine. Unfortunately, the wind was not coming from Lake Michigan either, so it was not a cool breeze.
Over the course of my marathon training, I have learned that each person is different. Some people like running in cold weather (me) and others like it a little warmer. No marathon runner likes temperatures in the 60s or 70s with 100% humidity and wind. I have only run one other race with this type of weather (a half marathon last fall in New York, and I had my worst race ever, walking a fair amount during the race, logging a 2:04). Until today, that was the only race that I walked in.
My goal for this marathon was to finish in the 3:40s. I was properly trained for the race, having run three separate 20 mile training runs in the 8:23 - 8:35 per mile range (a 3:43 marathon would be an 8:30 per mile pace). My natural comfortable running pace is usually between 8:20 - 8:35 per mile, and lately I was running many of my short runs below 8 minutes per mile.
Other
- After the race, I sat in Lake Michigan for 20 minutes to "ice" my legs. The water temperature was around 38 degrees. It definitely helped my recovery.
- After the race, we went to the Kenosha YMCA to sit in the jacuzzi and to shower. The jacuzzi really helped us feel better.
- It was great to see my friend CBS playing his steel drum for runners during the race. Very, very cool.
- It was great to see my friend SH (a triathelete) watching the race with his 2 dogs (he said that the dogs like the "socialization"). This made me laugh.
- After the race, it was great going to dinner with my friends JL, TM, SJ, MT, and RFL. We had a great time.
- My splits from my Garmin 405 GPS watch for the entire race
At the 4 mile point....
Location = Kenosha, Wisconsin
Date = May 1, 2010
Weather = low 60s at the start, sunny, extremely humid (100%), 20 mph winds. Temperature near 70 during race.
My time = 4:17, half marathon split 1:55
Comments:
Tough race today. Despite not meeting my goal time, I'm still proud of my performance, as I was feeling really bad starting around mile 9 and I really did not want to run 26 miles at that point. It was extremely hard for me to simply finish this marathon (versus my first marathon when I ran a 3:58 in NYC and didn't walk at all). Today, I probably walked 5 miles of the course. When I saw my friend RFL at mile 12 as he was finishing his half marathon, I yelled to him "I'm going to be right around 4 hours". He said "that's ok, that's great". This motivated me to keep going. When I saw my friend BGR at mile 19, I said to him "I think I'm going to be at around 4:40". At one point, I actually thought that I might not break 5 hours, that's how bad I felt.
I'm proud because I kept going. I'm proud because I decided that having fun and staying healthy was more important than pushing myself to misery trying to break 4 hours. I run to feel good, stay fit, keep my Crohn's disease in remission, and so that I can run tomorrow. I had a great time once I decided to walk. I knew 4 hours was gone at that point. I really enjoyed talking to other runners (I think I spoke to every single runner around me except those wearing headphones that couldn't hear me, which is funny, because I normally don't talk to anybody when I run because I listen to music. My xm radio died at mile 12 so I ran the second half without music). Talking to other runners totally changed my perspective forever. It made me truly appreciate how tough it really is to run a marathon and that everybody has good and bad days. It was extremely humbling for me. I felt, for the first time as a runner, that I was living the experience with others. Most of all, I'm proud that I ran my 2nd marathon!!
The race ran through the neighborhood that I grew up in (and my mom met me on the out and back, out and back course 4 times, which was great!). My friends BGR (first full marathon, from New York) and RFL (half marathon, from Highland Park) also came to Kenosha to run the race, which is great. I also met my friend MT (half marathon) and SJ (first full marathon) at the race. My friend CBS came to play the his steel drum for runners, which was very cool (and it was great to see him too). I also saw many old friends before, during, or after the race, which was very cool.
My time was 37 minutes below my goal of 3:40. All of my friends that ran the marathon were 23-40 minutes below their goal time. Tough day for all. My average heart rate was 171 for mile one (during the race, I saw that my heart rate was in the low 170s around mile 8, although I didn't realize that my average heart rate was 173 for my first 2 miles until I checked after the race). Way too high and very abnormal for me. At mile 8, I knew this meant trouble. I had a wicked cold early in the week, but I thought I was recovered by the race. Perhaps the cold contributed to the high heart rate? Even when I was walking after mile 13, it was in the 140s, also very abnormal for me. I've had training runs where I have run long runs at an 8:35 pace where my heart rate averages in the high 140s (although the temperature was in the 40s or 50s and the humidity was low). The high heart rate shows why I felt like running was so much harder today.
I started out strong and stayed to my gameplan of running an 8:20-8:40 pace for the first 10 miles or so, but I just didn't have it today after that. I was hot, tired, and my average heart rate was way above normal for this pace. The humidity, heat, wind, and loss of my iPod at mile 12 killed me (the battery died, one of my worst nightmares).
Today was quite a humbling experience. I'll use it as a learning experience for my next race, where I will force myself to go even slower at the start (around 9:00 per mile). Even if I would have started out slower, I'm not sure that I would have had any energy at the end. I'll never know.
I started to feel bad around mile 9. I was bloated from drinking water/Gatorade together. Plus, there weren't enough water stations, which was a killer with the temp in the 70s and 100% humidity plus the sun and wind. I really wish that the water and gatorade stations would have been staggered one mile apart (instead of being together every 2 miles), so that I could drink water at one mile then gatorade at the next (I saw the race director after the race and recommended this to him for next year's race). This would have been beneficial because (1) runners would have had a liquid every mile, somthing that was badly needed because of the heat and humidity, and (2) it would have helped me drink less liquid at one time, as I would not have felt the pressing need to drink both every 2 miles (which caused me to get bloated and feel sick). I actually thought that I might pass out at a few points (and one woman did with a 107 temperature right as she finished the half marathon - she's in Intensive care). I considered dropping out of the race. I have never considered dropping out of a race before. Generally, it is not a good sign for a marathon runner if he/she is tired of running before getting to double digit miles. When I saw my friend RFL near his half marathon finish (mile 12), I thought to myself "man, I wish I was done". Then, I saw my mom at mile 12, which perked me up. Before the race, I was worried about my xm radio battery dying but I couldn't find a replacement battery the day before. Therefore our gameplan was for me to run with my iphone for the 2nd half of the race if I needed it. So, my mom gave me a couple of GUs at this point but I told her that my xm radio was ok. Oops. About 40 steps later my radio died. I thought about running back to her, but didn't. 2 minutes later, I saw a family sitting on their lawn to cheer runners along. I said to them "do you guys live here?". "Yes", they responded. I said "would you mind if I leave my radio with you and I'll pick it up after the race?". They said yes, and I threw my radio on their nice lawn as I continued to run.
The night before the marathon, there were severe thunderstorms and the temperature was around 80. When the race started at 7am, it was already 61 degrees, with 100% humidity and 20 mph winds. The forecast projected the temperature to reach the 70s during the race with sunshine. Unfortunately, the wind was not coming from Lake Michigan either, so it was not a cool breeze.
Over the course of my marathon training, I have learned that each person is different. Some people like running in cold weather (me) and others like it a little warmer. No marathon runner likes temperatures in the 60s or 70s with 100% humidity and wind. I have only run one other race with this type of weather (a half marathon last fall in New York, and I had my worst race ever, walking a fair amount during the race, logging a 2:04). Until today, that was the only race that I walked in.
My goal for this marathon was to finish in the 3:40s. I was properly trained for the race, having run three separate 20 mile training runs in the 8:23 - 8:35 per mile range (a 3:43 marathon would be an 8:30 per mile pace). My natural comfortable running pace is usually between 8:20 - 8:35 per mile, and lately I was running many of my short runs below 8 minutes per mile.
Other
- After the race, I sat in Lake Michigan for 20 minutes to "ice" my legs. The water temperature was around 38 degrees. It definitely helped my recovery.
- After the race, we went to the Kenosha YMCA to sit in the jacuzzi and to shower. The jacuzzi really helped us feel better.
- It was great to see my friend CBS playing his steel drum for runners during the race. Very, very cool.
- It was great to see my friend SH (a triathelete) watching the race with his 2 dogs (he said that the dogs like the "socialization"). This made me laugh.
- After the race, it was great going to dinner with my friends JL, TM, SJ, MT, and RFL. We had a great time.
- My splits from my Garmin 405 GPS watch for the entire race
At the 4 mile point....
My friends BGR (full), MT (half), SJ (full) and RFL (half) after the race (with Lake Michigan in the background)
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