Saturday, September 17, 2011

Crescent Moon Sprint Triathlon Race Report

Well, I guess no training had to catch up with me sooner or laterJ. Really, my training declined precipitously after Ironman St. George in early May, but I pretty much proved that you can maintain a pretty good level of fitness off solid ironman training for at least a few months. However, since doing the Boulder 70.3 six weeks ago, I’ve literally done next to nothing. I probably swam a few times (at the most), ran intermittently, and did get in several bike rides (all of them relatively short). So, today was about guts only. I planned to race as hard as possible, and just see what happened.

The swim was a beach start, which is always interesting. I knew that it would be a running start, and I had decided that from now on I need to start my swims as hard as I can, in order to keep up with the lead swimmers, at least until the turmoil settles. For an in water start, this is one thing, for a beach start, it’s double the challenge, but I was up for it! So, I started at the front, in the middle, and ran as fast as I could into the water, did one dolphin swim and then started swimming as hard as I could. If someone pushed into me, I kept swimming hard, no slowing down. I got past the first buoy (about 30 yards), turned right and kept swimming hard. Now, my swim fitness probably sucks, so sooner or later this was not going to work, but what the heck! At about 150 yards, I could still see the lead people right in front of me, decided to take a breath to my left to see what was there, and whammo, inhaled a mouthful of water. Usually, when this happens, I keep swimming and just let the breathing come to me. That idea lasted about 2 strokes, when I quickly realized that I was already anaerobic and not being able to breath was not very compatible with this. So, I did a couple of breast strokes, and the lead group quickly put distance in front of me. I actually felt a little panicky for about 30-40 seconds, but just tried to relax and start swimming easily. I figure that I lost at least a minute doing this. I then got into a nice relaxed rhythm and just kept that until I hit the half way point, I then tried to intermix some harder efforts, until I briefly inhaled a little more water. I actually realized somewhere along the way that my nose felt stuffed and it was affecting my breathing. I also knew that the run from the beach to T1 was all uphill and that if I came out of the water winded, I wouldn’t be running. So, I just kept a solid and relaxed effort for the rest of the swim. Got out of the water, felt reasonably good and started jogging up the hill and stairs. I never walked, passed a number of people and got to my bike and found the guy next to me, Allen, (in my age group and probably a better swimmer than me), still getting ready for the bike. My swim time (including the run up to T1) was 18:06, which was ~100th/470 people. I probably lost 1-2 minute due to my breathing issues, which would have put me much closer to the top of my age group. Considering my lack of swim fitness, have to be pretty happy with this. I made my usual quick transition (just losing about 10 seconds getting my wetsuit off inefficiently, and ironically my 64 second transition was 8 seconds slower than the fastest transition in my age group) and actually got out of T1 before Allen. Mounted my bike, got my left foot in my shoe and made my way as quickly as possible on the bike path to the rode, headed down the road and got my other foot in the shoe and got the straps on. I tried to start out reasonably fast and solid, and shortly thereafter Allen passed me. I stayed right behind him (3 bike lengths) and realized that it was feeling too easy and so I ultimately passed him. Not sure how close he stayed behind me, but he ultimately passed me again on the longest uphill. I kept a solid effort and pace, in fact no one else passed me, not surprising based on the timing of the age group starts and my lackluster swim. I hit the first short hill and hammered up it, and then stayed solid going up the longer hill that Allen passed me on. I didn’t get on his wheel this time, although I probably should have thought about it, but kept him in visual range until T2 (although he kept getting a little further ahead). At the top of the hill I wasn’t able to shift into my 53 front chainring for almost a minute, probably losing some top end speed coming down the hill. My battery was low, oops, my fault! Stayed aero the whole bike, tried to keep a solid effort, but didn’t want to blow up and be trashed for the run. Interestingly, my average power was only 145, and Normalized Power was ~155, less than my half ironman efforts, and probably ironman as well. Still managed to average about 22mph over the roads. My bike split was 33:46 (61st overall).
Got to T2, good dismount and got to my rack, Allen was still getting his shoes on and actually just headed out of T2 several seconds in front of me. My transition was 55 seconds, again, just 10 seconds slower than the fastest transition in my age group. My legs felt good, my breathing was ok, but, per my usual recent M.O., I just wasn’t very fast. I got into a rhythm and kept it the whole run, trying to keep my breathing about every 3rd step, which meant that I was going as hard as I possibly could. Passed half way on the run by John, who never beats me, and he looked fresh, so I just kept pounding away. Hit the finish line, I was tired, as usual, felt like I gave it everything I had, but I didn’t really have that muchJ. My run split was 26:26, 8:32 pace, the slowest sprint tri run I’ve had in a very long time (ranking me 160th overall). My final time of 1:20:16 was 5th in my age group (out of 19) and 70th overall (out of 470 people). Still, not bad for 52 years old, but not up to the standards I’ve been setting for myself. Imagine what I can do if I actually train!

Just as I realized as I finished Ironman St. George that I needed to reduce my training and focus on my life, as I finished the run today, I realized that it is time to fully reengage in training. I needed to focus on life, but that’s under control now, and I want to focus on training and getting back into shape, or at least the kind of shape that I want to be in!

Wednesday, September 14, 2011

Let's run Medicare like a business!

I've spent the last 22 years of my life trying to deliver the best care to seniors. I've also tried to develop new and innovative programs during that time period. I have evidence that the care I deliver as a Geriatrician is less costly than the average physician. Yet, all I hear from our legislators when it comes to our Medicare program is "we want evidence". Do you think that Steve Jobs asked for "evidence", or a 5 year pilot program, before putting out the first Mac or the first I-pad? Do successful businesses run tests for 10 years before deciding to roll out a new product? Of course not! They hire the best and the brightest and they let them do their jobs.

We Geriatricians understand that less is often more in the care of our patients. Listening to patients and families will often supply us with important clues as to the best course of action. Reducing or stopping medications that haven't helped, but are producing side effects, often helps patients feel better. How do I know this? I've been doing these things for the past 22 years. I have cared for thousands of 80 year olds during that time period. If we put together a room full of Geriatricians with years of experience won't we get better answers on how to care for the older population than by doing a five or ten year pilot program on a limited number of patients? I've been part of such groups and we have developed our recommendations. And our government keeps asking for more "evidence".

We hear daily about the unmanageable costs of the Medicare program. If we're serious about fixing the problem, we don't need any more studies. Let's run Medicare like a good business. Get the best Geriatrician's in the country together and let them tell us what to do. I've offered to share what I know with my legislators on numerous occasions. I have many colleagues that would readily do the same.

It couldn't be worse than the way things are now, could it?