Sunday, September 30, 2007

preliminary race report

We didn't get home until 8 pm so I'm not going to be able to write a full race report tonight. But the quick version is that it couldn't have gone more smoothly--everything I learned from the race in Anderson in August worked. I hurt less than the August race and went faster.

Swim 1.2 miles: 00:56:40
T1: 00:04:25
Bike 56 miles: 03:45:55 (14.9 mph)
T2: 00:04:15
Run 13.1 miles: 03:24:09 (15.34 pace)
Total: 08:15:23 place 102 out of 107 women. I was the last female finisher but there was a man behind me with a time of 8:32. My bike and run were at a faster pace than the race in August that was less than 3/4 the distances (38K bike and 15K run) but hillier. My swim was even slightly faster, and this time not in a flat calm. I may even have been third in my age group--there were five registered but I only see two ahead of me.

Tuesday, September 25, 2007

forgiveness (yet again)

I was shaken by a sermon on forgiveness this past Sunday. What came up for me was not so much the wounds of my childhood but finding the balance in marriage of standing up for what I need vs. forgiving or not keeping score. It is so easy for me to feel I am bad for standing up for what I need.

Someone said to me today: "You don't deserve to be blamed for what you needed to do to survive when someone failed to feed you." I think what that means on a practical level is that I should try to make sure my needs are seen first, and then forgive.

Saturday, September 15, 2007

a satisfying moment

I told off a doctor yesterday, at one point telling him he was wrong and the latest scientific research said something different from what he was telling me. I was very pleased with myself when I got off the phone.

The doctor I have seen for many years retired from general practice about a year ago. Because I see a gynecologist for my annual checkup and I haven't been sick I haven't had any reason to deal with replacing him. But I've got a cough lingering from a cold a month ago, and it wasn't going away using my usual system. So I figured I would start by making an appointment with my doctor's replacement, and see if I like him ok.

During the appointment I tried very hard to communicate that I don't like to take a lot of medication, in part because I tend to be very sensitive to side effects. However, I have learned by bitter experience that I need to take medication to nip these lingering coughs in the bud. My previous doctor had given me asthma medication to help quiet the irritation, and I like inhalers because not much medication gets into my system. Partly because I was out of town when the cold started, my usual system didn't work this time. So I was really to try something more than the short-acting inhaler I have used before (along with Mucinex and a Nasacort inhaler earlier in the cold cycle).

The doctor gave me a new medication, saying that the inhaler I was using was too short acting to be doing me any good. I don't know a lot about asthma medications, so what he told me he was prescribing Advair it didn't mean anything to me. I should have worried when he said "We are going to hit it hard." We talked a little about diabetes and he told me I didn't need to keep my blood glucose as low as I do, so I was already concluding he wasn't the doctor for me.

When I got the medication home from the pharmacy I read the Advair package insert. The top of the insert has a black boxed warning saying:
physicians should only prescribe ADVAIR DISKUS for patients not adequately controlled on other asthma-controller medications (e.g., low- to medium-dose inhaled corticosteroids) or whose disease severity clearly warrants initiation of treatment with 2 maintenance therapies.
I haven't tried a plain inhaled steriod--the inhaler I have been using is Albuterol, a brochodilator, not a steriod. I got on the web to read more about Advair and found people complaining about many serious problems other than worsening asthma symptoms. I decided no way was I going to take this medication without trying a low-dose inhaled corticosteriod first.

Knowing the problem of communicating clearly via a message left for the nurse, I faxed the doctor a letter telling him I didn't want to take Advair and requested instead that he write me a prescription for a low-dose inhaled corticosteroid.

He called me around 1 pm. He thought he could simply reassure me that the most serious danger of Advert didn't apply to me, as I don't have serious asthma (at most mild-cough variant asthma, and it may not even be that but just a post-infection irritation syndrome). I said there were other side effects listed that worried me. He told me that if I read those lists for something like Tylenol or Ibuprofin I would also find scary side effects. I said that is why I take those medications with care (I don't take Ibuprofin before or during exercise because there is some evidence that dehydration can contribute to side effects involving kidney damage). I said that some of the listed side effects, such as jitteriness and sleeplessness, are ones that I often have trouble with, and there was also a warning for people with diabetes. He said I am only diagnosed with prediabetes (that is what my previous doctor had written on my chart, but I think the distinction being made is that I don't take medication for diabetes). I said I keep my blood glucose tightly controlled after meals and even a small amount of steriods in my system could make that harder. He told me I didn't need to worry about blood glucose after meals, only the average (measured by the A1c test) mattered. That is when I told him he was wrong, that the latest scientific research showed otherwise. He said that research is paid for by companies that have medications that lower blood glucose after meals. (My main source of knowledge of the scientific research is this very persistent layperson.)

But by that point he was finally ready to give up arguing with me and agree to call in a prescription for a milder medication. I suspect his revenge was to not get it done--it hadn't been received when I went by the pharmacy around 4:30 pm but they were able to call and get it. He also prescribed a dose so low that my pharmacy didn't have that dose in stock, but the low dose is what I wanted. I'm using QVAR 40 mg.x2 twice a day. It hasn't worked magic, but I think it is helping and he said about both it and the stronger Advert that I should use it for two weeks before stopping so I won't give up on it quickly.

I already have a recommendation from a friend for another doctor.

Saturday, September 08, 2007

Tour de Paws

Wanting to do 56+ mile rides in training for the half-ironman, I signed up for Tour de Paws, a Spartanburg organized ride to benefit the Humane Society. I did it once before, two years ago, and I didn't remember how many tough hills it has (Bikely says 4,007 feet of climbing, MotionBased says 4,577). Mostly on lovely back roads with no traffic.

The ride was 61 miles, but I checked my time at 56 miles because that is the bike distance for the half-ironman. It took me 4 hours and 7 minutes. Total riding time for the 61 miles was 4 hours 31 minutes (average 13.3 mph), elapsed time something like 4:45. That was with a good bit of drafting in the first 20 miles, but I also pushed too hard trying to keep up with the people I was drafting off and once I was dropped I really dragged for a while. That was around the time I met the hill that is harder than our local famous hill on Maw Bridge Road. I didn't have enough water for the second leg of the ride, because it was longer between rest stops and because I didn't drink enough the first leg. I also didn't manage my eating well--there wasn't much appetizing at the rest stops. Useful lessons learned.

For the race I need to be able to do 56 miles in under 4 hours. I'm feeling close enough, since the course should be much flatter. My goal for the half ironman is mostly to make the cutoff between the bike and the run--I'm not expecting to make the 8 hour cutoff for the finish. I would like to finish even if I don't get a medal, but even if they pull me off the course after 8 hours I will have achieved my longest event.

Wednesday, September 05, 2007

more thoughts on empty nest

It has taken me a week just to begin to get clear on what I feel. For all that I do (and I'm feeling behind despite my extra hour a day not spent driving a kid to school), I still feel not needed any more because both my kids are now away at school. Obviously my kids still need me in other ways, but there is something that has changed. My first reaction is how can I take what they taught me to give them and spread it out to the world.

Monday, September 03, 2007

empty nest

My daughter and I both at times answered the question of what would I do when she went away with "train for an ironman." I did decide to sign up for a half-ironman at the end of the month, even though I'm not sure I can finish before the cutoff. So yesterday I did a 57 mile bike ride (with 5,700 feet of climbing) and today I ran 9 miles.

My daughter seems to be doing well--she has called only every other day and she is complaining mostly about wanting more. Her classes start Tuesday.

Today we have a Monday night football game here at 8 pm, so we get Labor Day off for the first time ever. Already the town was full this morning, and lots of people setting up their tailgating. Evening games give the fans too much time to get drunk; I'll be hiding out at home this evening.