Chronic Triathlete

I'm Moving My Blog!

After careful consideration I've decided to move this blog to a new platform and location. I'm going to build it in Wordpress which will make maintaining it easier (and cheaper) for me. It should also make reading it easier for you since I'll be able to customize it more than TypePad currently allows.

You can find the new site here: http://www.chronictriathlete.com

I'm still in the process of setting it up and migrating all of the content over (everything that's here will be there). I hope to have this done in the next week or so. In the meantime, there will undoubtedly be things that are broken or missing. Please bear with me.

I'll be keeping this site up until the end of July, but after that it'll be gone. Please update your bookmarks and/or RSS feeds.

Thanks!
/CT

Under Our Skin in NYC

UNDER OUR SKIN begins its national theatrical release this Friday, June 19th at the IFC Center in New York City. If you haven't seen it, this is a great opportunity. Show times are here. More info on their blog here.

I'm not a lyme activist, but I do agree with the folks who are when they say that this is the single most important opportunity we've had to raise awareness about the disease. Or, better said... make people aware of the real issues that come with a little 'ol tick bite.

Race Report - 2009 Brooklyn 1/2 Marathon

For the last 12 weeks I've been training a group of runners for the 2009 Brooklyn 1/2 Marathon. I badly wanted to try and train up for the event along with them, but was unsure if I should even attempt such an effort or if I could even finish the race. It's been over a year and a half since I ran that far.

I greatly feared that even if I somehow managed to finish it I'd wake up the day after feeling like I did the day after I did that 50 mile bike ride in September 2007... like a truck had run me down and then parked on my head.

But... the starting line is literally four blocks from my house and it's always been one of my favorite events. Throw on top that they reversed the course this year making it far easier than the previous times I'd run it and I couldn't resist. During my mental debate I remembered a quote from my favorite cyclist, Jens Voigt:

"If you try to win, you might lose. But if you don't try to win, you lose for sure."

Not exactly Shakespeare, but he's German and rather practical. Give him a break. Anyway, I knew I was not going to win, but to his point, if I didn't try I would obviously not make it. This reminded me of my other favorite Jens quote:

"When in doubt, just go!"

Okay Jens, you sold me
So I signed up, but didn't really tell anyone. I didn't want to have to answer a lot of questions or make bad excuses if I needed or wanted to drop out. This behavior made me sad as I'm usually the type of person who likes to talk about his goals. I've always found that talking about them helps make them real and get me there. This time, however, I just didn't want the heartbreak of explaining myself if I had to drop it.

I won't bore you with all the ups and downs of training, but it went pretty well. Each weekend we upped our long run milage by a mile. We peaked at 12 and I used this final run to make my decision. My running partner, Paul, and I kicked it out comfortably and I felt like I was good to go. I would feel more tired than usual after the run and different things hurt, but nothing to concern me too much.

Ice, ice baby...
One thing that I have to say that helped me A LOT was taking an ice bath after each long run. If you've never taken an ice bath, try it. It's a special experience and proof that runners are all masochists. It's easy, just turn on the cold — and only the cold — water in the bathtub, fill it up about 7 or 8 inches, throw in a tray of ice cubes and then sit in it with your legs outstretched for 10-15 mins. It'll be the longest 15 minutes of your life. Horrific, but I'll tell you... do that, drink a good recovery drink and you'll significantly cut any inflammation. I did it and had practically zero joint and muscle aches.

Anyway, race day comes and even though I tossed and turned all night worrying about what I was about to put my body through, I decide to go for it. The race goes exceptionally well. I ended up feeling really strong and except for my right hamstring tightening up (the side that I have most of my neuro symptoms on) I was good all the way. I even dropped Paul at about mile 10 (and he's 5 years younger than me).

Holy shit I PRed! What?!
I finished in 01:33:42 @ 7:09 pace for a new 1/2 Marathon PR. I was shocked... literally speechless when I did the math and figured out how fast I ran. I kept looking at my watch and then again at my math thinking my Lyme-brain is forgetting how to divide. I was shooting for 01:38:00, my previous best, but I completely blew it up!

So obviously I'm pretty stoked about all this. The race was on Saturday and I tried to run again on the following Tuesday, but it seems the damage to my right hamstring was worse than I thought. It doesn't bother me at all to walk on it, but to run hurts a lot so I took the week off which was actually nice.

What's next?
I need to focus on cycling now anyway because my coach does this 100 mile ride on the night of the summer equinox, June 21st, here in Prospect Park. It's an absurd bit of fun. 30 laps of a 3.4 mile loop in the dark. I had to miss it last year because I was too sick, but this year I'm determined to at least give it a try. When in doubt, just go!

Hemobartonella Or Mycoplasma

I mentioned in a previous update that I would post my Bart (or whatever) pix. Here it is.

I've looked around the web for other pix of Bart, but didn't see any that looked like mine. Most show little dots floating around both inside and outside of the cells.

I'm becoming increasingly focused on this aspect of my infection. I recently read this by Dr. Burrascano...

"Indeed, there seems to be a fairly distinct clinical syndrome when this type of organism is present in the chronic Lyme patient. However, several aspects of this infection seem to indicate that this tick-associated strain of Bartonella is different from that described as "cat scratch disease".

For example, in patients who fit the clinical picture, standard Bartonella blood testing is commonly non-reactive. Furthermore, the usual Bartonella medications do not work for this- they suppress the symptoms but do not permanently clear them. For these reasons I like to refer to this as a "Bartonella-like organism" (BLO), rather than assume it is a more common species.

Indicators of BLO infection include symptoms involving the central nervous system that are out of proportion to the other systemic symptoms of chronic Lyme. There seems to be an increased irritability to the CNS, with agitation, anxiety, insomnia, and even seizures, plus symptoms of encephalitis, such as cognitive deficits and confusion.

Other key symptoms may include gastritis, lower abdominal pain (mesenteric adenitis), sore soles, especially in the AM, tender subcutaneous nodules along the extremities, and red rashes.

These rashes may have the appearance of red streaks like stretch marks that do not follow skin planes, spider veins, or red papular eruptions. Lymph nodes may be enlarged and the throat can be sore.

Because standard Bartonella testing, either by serology or PCR, may not pick up this BLO, the blood test is very insensitive. Therefore, the diagnosis is a clinical one, based on the above points.

Also, suspect infection with BLO in extensively treated Lyme patients who still are encephalitic, and who never had been treated with a significant course of specific treatment."

I find what he says to follow along with my situation. I've been treating for a year, have not experienced any dramatic resolution in symptoms, tested negative for Bart via Igenex and have CNS symptoms that are off the charts in relation to any typical Lyme symptoms. In fact, they seem to be the only symptoms I have. The only thing I don't have from that description is the rash. I've never experienced that.

If anyone has any insight into successful Bart treatment, please shoot me an email. I'd love to talk to you about it. I want to gather as much info as I can before my next LLMD appointment in a few weeks. My email address is ChronicTriathlete (at) gmail.com.

New Yorker Article: The Cost Conundrum

There's a fantastic (and sad and scary) article in a recent issue of The New Yorker about the terrific gap between the cost and quality of health care in America. Here's a clip...

"There is no insurance system that will make the two aims match perfectly. But having a system that does so much to misalign them has proved disastrous. As economists have often pointed out, we pay doctors for quantity, not quality. As they point out less often, we also pay them as individuals, rather than as members of a team working together for their patients. Both practices have made for serious problems."

I know all of us suffering from Lyme have been raped financially in one way or another by our backwards and corrupt health care system. This article really helped me understand not just how fucked up it is, but how hard it's going to be to fix it.

Photo by: Phillip Toledano

Mолодец Menchov!

Good job, Menchov! What a great Giro d'Italia. 3400k of racing and it comes down to the last kilometer and a few seconds. Michael Barry had a nice summary article on VeloNews.com that provides a little insight from the front of the peloton.

Stage 20
I cued up the final stage on the DVR after coming home from a short bike ride of my own in the park. Time trials are generally a snore to watch on TV and stage 20 was no exception... but things changed quickly. One second I'm sitting on the couch fingering the off button on the remote as Menchov rolls towards his inevitable win. The next I'm standing in the living room in my bike kit and shouting at the TV like I haven't since Michael Jordan played in the NBA finals.

Props to Danilo
Du Luca's performance demands great respect too. Even though the way he flogged his team day after day was questionable he did his part by attacking Menchov at every opportunity.

And you gotta love YouTube
I just found these two videos. The first is the last 10 mins of the stage if you're interested.

The second is from inside the Rabobank bus during Menchov's ride. Classic.

My only dissapointment was that my boy Jens Voigt was pretty quite. Hopefully he's just riding himself into form for the Tour de France.

Update - May 2009

An absurdly long time since I've posted. Partly because a lots been going on, but also because not much has been happening. I've been too busy for small updates and nothing major has happened with my health to warrant me sitting down and writing. But now it's Memorial Day and I'm just sitting here in Cape Cod watching the tide ebb out of Town Cove. Thought I'd type up an update.

Antibiotic treatment continues
Of course it continues... seems like it's never going to end. I've more or less abandoned the IV idea for now. At the very least until the summer is over. My LLMD agrees. I was denied outright by my insurance company (Aetna) and don't have the mental energy to fight with them over it right now. If I was suffering horribly and/or bed ridden then I might have at them, but with the way life's going right now I'm cool with letting it ride on the orals.

Instead of the IV, I'm sticking with the new coinfection regimen of Rifampin, Mino, Zith and Mepron along with Diflucan for yeast (and maybe Lyme). I herxed my head off when first switching to the Rif. It's a wicked drug. In the first week or so of taking it there were times when I felt utterly and completely out of my mind. I experienced dramatic shifts in my emotional state on almost a continual basis. An hour of fierce anxiety and worry would blend into two hours of intense, almost manic attention on something. When I was focused on work it was a good thing, but when my brain decided it was time to, say, organizing my closet it was a fruitless and frustrating time suck.

It was as if my id sent my ego and superego on vacation. He kicked back, opened up a cold one and grabbed the controller of the PS3 that is my life. My usual laid back attitude was replaced by a pushy determination to get what I wanted. I feuded with store clerks, flogged a customer service representative and pretty much hated on everything my wife did. I don't know how she put up with me.

I also found it almost impossible to stick to any sort of plan or schedule. My brain just took my body wherever it wanted to go regardless of how many to do lists I made. I would be fully aware of the fact that I had something to do, but if my id wasn't interested enough to take action, we'd end up doing something else. I know this sounds pretty idiotic, but it's true.

Luckily, this behavior faded after about two weeks. I'd have moments of anxiety or manic feelings, but they'd pass. Now, after about seven weeks it's all settled down into a seemingly cyclical series of herxes. It's too soon to nail it all down, but I seem to feel something every two weeks or so.

Smile, Bart! You're on candid camera!
One major turn of events occurred last week when I went to see my LLMD. He'd sent some blood off to Fry for Bart and Babs testings during my previous visit. The results were back and I got a nice little photo of one of my red blood cells harboring some Bart — or "bart-like organism" as they seem to be being called these days.

This was kind of epic in a way. Even after all this time I've really only been 80% sold on the whole Lyme and friends diagnosis. I don't exactly know what else it would be, but since I (A) never saw a tick (B) never saw a rash (C) have never been that sick other than the first 2 weeks of illness and (D) haven't had any dramatic improvements after a year of treatment, the whole thing has been a little hard to buy into 100%.

When my LLMD handed over the page with the photo on it was like everything else just stopped. He kept talking, but I couldn't hear anything. Meeting the little dark squiggle inside my red cell was like meeting the psychopath that had murdered my family. For a brief second time slowed waaaaay down. I was emotionally torn between shredding the paper with my hands or crying into it. It was unnerving. I just kept staring at it and thinking, "you little motherfucker."

Anyway...the picture sold me. I'm 100% sold on the idea of some sort of tick born infection. I finally feel comfortable that I'm on the right track to getting healthy again. I still wouldn't be totally surprised if something else came up down the road, but for now, I'm comfortable with the path I'm on. I'll post the picture later in the week when I get back to Brooklyn.

That's all I got for now. There's some more (good) news about training and such. I'll make another post about that later.

Tyler Hamilton Continues to Cheat

Okay... I know that headline is a little rough on Tyler, but I can't help it. I elevated him to hero status after watching him win the Giro d'Italia in 2002 with a broken collar bone. Then I was crushed when he got banned for doping (twice). After that, whatever admiration I still had for him faded when he joined the all dopers Rock Racing team.

Anyway... there's a rumor floating around that he jumped in as a bandit at the Boston marathon last week. Tyler... come on.

LymeMD - "Lyme and Bartonella: A Tale of Two Herxes"

Dr. Lyme posted an interesting observation yesterday. Actually, all of his/her posts are interesting. This one's just more interesting than usual, especially since I'm embarking on a Bart hunt.

Speaking of which, I'm on my second dose of Rifampin and my heart is thumping away like John Henry racing the steam hammer. This one may be a bumpy ride.

Race Report - Run for the Parks 4 Miler

My latest group of beginning runners did their "graduation" race last weekend. Like I did the last time, I jumped in and ran along with them.

Things went pretty well. After the last race, which was on essentially the same course, I had a good sense of what I could accomplish and adjusted my goals accordingly. I aspired to better my time by :40 seconds for an even 0:26:00 finishing time. Chopping :10 seconds per mile off a four mile PR (personal record) isn't easy even when you're feeling 100%. I've also not been doing any speed training — or even fast running for that matter. I realized that if I couldn't run a faster race, I had to figure out a way to run a smarter race.

The strategy
After thinking about it, my strategy essentially boiled down to getting a better start. The last time I ran I was honest on my registration form and I said I was going to average a 6:30 pace. The way the NYRR organizes things this put me in the 3rd corral. Big mistake. It had been awhile since I'd done an NYRR race and I'd forgotten that everybody lies about their goal pace. Even though I was in the 6:30 corral (a semi-quick and respectable pace), I was packed in with the iPod and FuelBelt wearing leisure runners. No offense to those folks, but there's no way many of them were going to crank out a 6:30 pace for one mile let alone four.

Sure enough, after the gun, I was trapped behind a wall of slowpokes and people still trying to find the prefect play list on their Nanos. Things spread out after a mile or so, but since the race was only four miles long I was pretty much screwed. My first mile was the slowest by far.

So, this time, to prevent a repeat of the last start, I lied and said I was going to run a 5:30 pace. This dropped me in the 2nd corral. A good spot. I maneuvered my way up to the front of the box and, after they let us push up to fill in the gaps, I found myself about 15 yard from the front. Excellent.

The gun
The gun went off and almost right away I had a clear space to run. Still, even while holding back and trying not to go out too fast, I was slowly and steadily passing people. I think next time I'll bump my stated time up to 5:00 and see what happens.

 The finish
Anyway, the strategy paid off. My splits worked out to be 6:38, 6:25, 6:47 (hilly part), 6:17. My finishing time was 0:26:08. Sadly, :08 seconds slower than I was shooting for, but still significantly better than my previous race. All of the gains came in the start. The last time I raced this course the splits of my last two miles were 6:48 and 6:17 — basically identical to this race. I finished 204th out of over 5,700 people and snuck inside the 195 mark for the men. All in all I was very happy.

Things got even better
They had a kids race after the adult race and my daughter won the 4-5 year old girls heat — even beating the kids and their cheating parents who ran with (dragged) their children along the 25 yard distance. When she finished she got a medal. All of the kids got one, but my daughter didn't realize this. She was so completely thrilled to have gotten a medal that she was beside herself. Whenever I've come home with a medal I've given it to her to play with. For her to get her own was, I think, a really important moment for her. She wore it (and the race shirt they gave her) all day. Later, she asked me to put her medal somewhere safe where she could see it in her room. We hung it on the doorknob.