The Race is O’re…

The race was Saturday. After hints of rain earlier in the week, the day turned out to be absolutely beautiful. It was dry, about 60 when we started and 70 when we (well, I) finished. A little over 1100 in the half marathon, so the traffic wasn’t too heavy, but there are always people around you. A flat, flat, flat course, but at about 4500 feet altitude.

It all went pretty well for me. No problems (except for too little speed training and too much age). I was really happy that I was over 4 minutes ahead of my schedule at 5 miles, and a little further ahead of schedule at 10 miles. My downfall was the last 5k (a half marathon is 10 miles plus a 5k). I really slowed down in the last 5k, and lost the 4+ minutes I had banked at the beginning. The final result was a finish that was right on schedule: 2:37:30.. Just to show how bad the slow down was, I talked with a woman I had been running with in the first half of the race. She picked up in the second half and finished around 2:23. That’s a big difference

Overall, I was still pretty happy with my performance. I finished 4th in my age group. I’m still pretty unhappy to realize that I was running 2:10 less than 10 years ago. But, abdominal surgery and age took care of that.

I’ve largely accepted the age related decline I’m experiencing. But there is still that voice in the back of my head that says “more training and you’ll be back where you should be.” Another case of high expectations meeting reality, I guess.

Do you notice age-related declines in performance or ability? How do you deal with it?

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Home Stretch

Yesterday was my last long training run before next week’s race. 16km. Some easy runs next week just to keep up the routine, but nothing too long or hard. I went to the river again to watch the balloons, and once again they went somewhere else. Sigh. 

I did a short run this morning with my daughter, who is also running the race, and with her daughter. I love these 3 generation things even though I don’t see much of them after we start. I think it is the idea that they are still willing to go out with me that I like so much. 

The race is on a flat course parts of which I have run many times. It’s out and back, so no course complexities to worry about. The weather should be beautiful, just like it was today. So, the hard part will be finding a place to park. Aside from that, just go out and have fun with a few thousand of your best friends. 

Prostate Cancer – 2

In the winter of 2006, I was diagnosed with prostate cancer. The rough indicator of this is called PSA, a measure of a Prostate Specific Antigen in your blood. Mine was elevated and going up—not a great sign. So I had a biopsy (look here for a description of how much fun that is). Biopsy showed cancer, so what to do. This is not an easy decision, but, for a variety of reasons I chose surgery. That isn’t fun, either, and has nasty side effects, but they are better than the alternative.

After recovery, your annual ritual is a blood draw and a visit to your doc. For me, this has now been going on for 8 years. Fortunately, the doc is a nice guy, and I occasionally run races with his wife, so I see him around. (he is always easy to recognize because of his scrubs). But, this year was the end of the ritual. My PSA has been 0 all these years,  and there is no longer a need to go see him. WooHoo. Cancer docs never use the word “cure,” but he used it. He didn’t say it applied to me, but he did say that if he was inclined to use the word, I would be one that it would apply to. Not a definitive statement, but one that makes me happy none the less.

Mountain Top

One of our sons, the outdoor adventure guy, wrote to offer to lead us on a backpacking trip into the Grand Canyon. My Muse and I were floored. First of all, we were floored that one of the kids would want to do something like that with us—after all, we are their parents not their BFFs. Then we noted that we haven’t done anything like that before (at least not together), so we immediately began to wonder if we are actually still able to do such a thing. Adventure Guy argued that we are still doing half marathons, so surely we would be able to do this. For some reason, this argument sounded plausible, so we bought in to it and agreed. Yes, the half marathon distance is similar (actually greater than what the planned canyon trip would require), but I don’t usually do a half wearing a big pack or those damn boots.

We may not be experienced or have the skills needed to do multi-day hikes (or the equipment), but we are smart enough to realize that different muscles will be used, so we found a friend who would show us some of the local trails. We have also heard that the Grand Canyon involves some up and down, but we are lucky to have a mountain in our back yard, so we figured that up followed by down might suffice as training for down followed by up. We haven’t proven that yet, but I still believe it.

We started bravely, once a week, an hour up hill and then an hour down. It worked pretty well for the first couple of weeks. We’re tolerating the booPhoto Apr 29, 10:18:55 (HDR)ts but carrying only light packs—we’ll get to more weight than just 4 pounds of water, but we have time. Then our friend took off with her husband for a real hike—3 weeks on the Camino de Santiago in Spain—and we are suddenly on our own. We’ve used the excuse of busy schedules to explain why we are waiting for her return.

We haven’t gone as far as the mountain top. That would be about 3000 more feet of up, but we have certainly gone far enough to see why people get hooked on this. There is a feeling of altered reality up there that is hard to describe. In this picture, the “civilization” we came from is not quite visible at the bottom of the mountain. It was a little hazy or dusty on this day, but it is really much clearer than the picture would suggest—the next mountain west (the picture faces southwest) is just out of the picture to the right, 80 miles away. It would be clearly visible if the camera had been pointed in the right direction. The mountain is beautiful, and, most especially, it is not the city. You can experience it alone, even with other people around you.

I had a similar experience decades ago sailing off of Los Angeles. When you get a mile off shore, the city is beautiful, but you can’t hear it, and you can’t smell it. You can be alone on the ocean even when in the company of other boats. What a glorious experience.

So, much more than conditioning is happening as I walk up and down this mountain. I feel the silence. I see and feel the beauty of the world. The cares of life fall away. The pressures of our civilized world do not reach here, and I find I can love people again (as a whole) when I’m not constantly reminded of the senseless things we do to each other. My mind fills with loving kindness, and I can feel it begin to pervade the space around me (read this to understand the reference).

I am not of the generation that wants to measure and document every detail of my life. I am often content to absorb what is happening around me and weave it into my story. I don’t need to conquer the mountain, and I won’t have a need to conquer the Canyon. I won’t preserve everything I see in either pictures or words, but I will see it all and I will bring back stories, some of which I will relate. I might even relate some of them to Adventure Guy, just in case he didn’t see the right things. The Canyon, at least, will be full of loving kindness when I leave.

Primary Health Care

Today’s New York Times had an interesting article featuring Iora Primary Care, a startup with a business model more like Starbucks than your current primary care facility (except that you can’t walk in off the street and buy a cup). You can read the article, A Starbucks for Medicine, in the Business section.

Iora is a subscription service that only works with employer partners (not with individual patients), so your company has to buy in. The value proposition to the partner is lower costs that are more or less fixed. The value proposition to the patient is more individualized customer service, and, sometimes, service that goes well beyond what we have come to expect from primary health care providers.

One of the features of their model is a “health coach”, a much lower cost person than any of the medical staff, whose function is to help the patient with not-necessarily-medical, peripheral issues, such as transportation, diet, exercise and advocacy—at least within the practice office.

Iora is a startup, and there are still many issues to be resolved. They aim for a large number of practices instead of the one, or a few, that most innovators expect to have. Some things in the model scale well, such as knowing what to stock when a new practice opens. Some things scale poorly, such as the CEO interviewing most of the new staff. It isn’t clear yet whether they will actually be able to reduce costs for employers (mostly by trying to provide care that will head off trips to the hospital and ER, I think). On the other hand, the kind of care described in the article seems attractive from the patient point of view, and finding ways to move in that direction has got to be good.

From the provider’s point of view, they aim at far fewer patients per provider, allowing the provider more time with each patient. And, (here’s a note for you Victo) they have a staff of about 20 engaged in building their own proprietary EHR system. On the one hand, that means that individual providers will have more input into how it works, and more influence when it doesn’t. This could also be a cost reduction idea—EHR/EMR systems are already a very big business. On the other hand, as the number of small practices increases, this effort may be hard to sustain—another area that doesn’t scale particularly well.

On the surface, Iora looks like a good idea. I currently get primary care through a corporate entity. While I like and respect the providers and other staff, the corporation stands in the way of getting to them and pretty much controls what I get from the providers. I admit I haven’t yet had much interaction, and so far, I’m glad because the interactions have been painful or at least irritating. I’m interested to hear what others of you think of the Iora idea or other innovative delivery ideas, particularly those in the health care industry.

The Race is O’re…

DC-RnR-2015-medalThe race is over, and we’re back home. We left Thursday for the DC Rock and Roll Marathon and returned today.

The race was Saturday morning, and the temperature was perfect, in the low 40s. The rain, however, was not perfect. It had been raining since before midnight and continued until at least noon. By the end of the race at RFK Stadium, we were all soaked and pretty cold–the ambulances running from the medical tent at the finish were unusually busy.

I haven’t examined my splits in detail, but I was ahead of schedule at 5 miles and still on schedule at 10 miles. I finished about 4 minutes behind schedule, so I had to have lost that time in the last 5 k. I didn’t feel bad, and there were no notable terrain features. The rain got a little worse and the wind came up, and I guess that slowed me down (oh, Ok, I suppose the milage had some effect, too).

Surely the weather took some toll, and being somewhat under prepared had an effect, but overall I was still happy with the race. The worst part was standing around in the cold rain after I finished waiting for my Muse, who walks, to finish her race. There was almost no shelter and close to 30,000 people to be accommodated. There were lots of crazy folks there that day. And then there was standing in line to get into the metro station and trying to ride with a waterlogged metro card. When they are that wet, they don’t go through the machines.

Our schedules are pretty busy for the next few months, so we may not do another half until September. But, maybe we’ll try to find something close to here in June.

Aside from the miseries of the race itself, the weekend was wonderful. Our main purpose in going was to celebrate the return to health of Middle Daughter who has spent the last year dealing with breast cancer. We took Older Sister with us, and Brother lives in the District, so we had a glorious celebration. Saturday was, of course, Pi-day (3.14.15) so Daughter-in-law made pie and we all got together for that at the end of the day. Sunday was more family time. The ladies went shopping for running gear, and Brother and I played with the granddaughters.

“Cancer free”–a wonderful reason to celebrate!

 

Prostate Cancer

ColdHandBoyack posted a Public Service Announcement (pun) about his elevated PSA and prostate cancer biopsy. Fortunately, he did not have prostate cancer—congratulations to him.

Been there. Done that. Results not as good. As you pointed out, I had no concept of modesty left after the biopsy. The nurse did the ultrasound, the doc the biopsy. When the ultrasound was done, the doc was busy with something else, so I had to wait with the probe in place until he finished his coffee and danish. Of course, the nurse waited with me—she wouldn’t have wanted me to pull the damn thing out.

If you have cancer, the next step is figuring out what to do about it. There are 3 main treatments: surgery, radiation, and seeds. The problem is that the treatment outcomes don’t diverge until after 10 years. In practical terms, that means there is no objective way to choose. I had the good fortune (for me) to know a man who had had prostate cancer 10 years earlier and had chosen radiation. Then 10 years later, it had returned. Because the radiation causes collateral damage in the vicinity of the prostate, he could no longer have surgery. There was nothing to be done for him, and he died. I chose surgery. That was almost 8 years ago, and I am still here, and my PSA is still 0.0—woohoo.

I’m convinced that prostate cancer is something that every male who lives long enough will get. It’s a matter of when, not if. If you are over 50 or so, get a PSA along with your other blood work. All you have to do is ask for it. If the biopsy shows cancer find someone else in the club to talk to while you are deciding what to do. Despite the intimate nature of the problem, I have found others who have been through prostate cancer surprisingly willing to talk.

Entertaining Stories

I’m going to invite everyone to re-blog, tweet, and otherwise share this post today. We all wish our posts got that much love, but this one is important. If you are a man, love a man, or maybe both, this post is important.

I debated long and hard about sharing this at all. It involves personal information, and I like to keep a bit of privacy. I had to weigh the fact that my mother reads this blog, along with at least two co-workers, against the possibility of helping someone else. Someone else won.

Popular rumor holds that a man should have certain things checked medically once he turns 50. In typical male fashion, I waited until I was 53 and 8 months to schedule my colonoscopy. This is a degrading procedure that involves shoving a camera into places that aren’t visible by design. I thought it was degrading, but…

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