Doc On The Run: December 2011

Tuesday, December 27, 2011

The case of the blues.....

Wanna know something, I, myself find incredibly ironic?

Well.....did you know, that the symptoms of overtraining and depression are almost impossible to differentiate?

No....seriously!!!!

Let's just list down a few symptoms that most of us will think of when we utter the word overtrained.

Tiredness.....general feelings of fatigue.....poor appetite (and perhaps coupled with loss of weight)......loss of drive.....feeling empty....loss of focus.....disturbed sleeping patterns......irritability......loss of interest......feeling low in mood.....

(of course there's also high resting heart rate, poor immune system and the works depending on whether it's the sympathetic sort of the parasympathetic type of overtraining....but that's another topic all together)

Flip open the DSM-IV directory and scroll around to Depression.....and you'd probably find the same symptoms listed as well.

Are you surprised?!

Well.....I kinda was.

I mean here we're touting exercise as a natural remedy towards curing a mild case of the blues and you're telling me that too much of a good thing makes one depress!?!?!

Wow.......they weren't kidding about moderation.

So now the golden question.

How do you differentiate?

Well.....if only I knew!!

Here's the annoying bit about medicine that the general layman does not seem to understand.

Most of the things in medicine are never black and white.

There's a huge chuck of things left in the grey, unsure area and sometimes what you think is correct at the moment will indefinitely be proved wrong in a couple of years time?

In fact....the word diagnosis literally means "an educated guess".

(at least that much I understand why some people gravitate to orthopaedics.....you see a fracture, you fix the fracture, everyone goes home happy....)

So if you find yourself in such a fix, what are you gonna do about it?

(well...for one, don't message me on Facebook for an online consultation.....that would be good for starters!!)

Well....try talking to someone.

Someone with perspective. Someone who knows what he or she is talking about.

You could also try laying off your sport for a duration of time. That is after all the whole basis of the word, REST.

Fuel up properly......no more nonsense on getting to or maintaining "race weight" at this point.

It honestly won't help you score a PB if all you feel like doing is ending your freakin life.

If "conservative" management doesn't work.....well, there's no shame in admitting that you may have a problem.....even if that problem goes by the name of Depression.

And....if that's the case......seek help.

Trust me on that. It was the best thing I've ever done for myself.

Merry Christmas, and God bless.

Later!!!

Friday, December 23, 2011

Dang....

I was told that I'm not blogging as much as I was previously.

Honestly I didn't think that I was slacking off in the blogging department....

But seriously....there ain't anything interesting to blog about lately especially all I have to look forward to in the past several weeks was exams and more exams.......

Not exactly news-worthy.

Anyway, in view that there's nothing much in the running front to talk about.....let me just put up another photo-log about one of the few things I hold dearly to my heart.....EATING.....

* I met up with Sumeet over a Wednesday night for dinner at Ben's General Food Store, located at Bangsar Village 1.

I've never heard of this place until Sumeet mentioned it.

She said the salad bar looked terrific.

I never cared much for salads even during my vegetarian days......(man, I don't miss those days!)

* The menu reads like a newspaper classified. The pizza list was almost endless. Needless to say, reading through the menu was kinda exhaustive, and I just picked the first thing that caught my fancy.

* It has a very quaint feel to this place....very food-court/cafeteria chic except the prices are triple (if not quadruple). Fancy sharing tables with complete strangers?

* Sumeet was adamant that we must take photos......

* Pina colada milkshake.....yea, I know...that combo is such an oxymoron. But surprisingly, I really like it!

* I LOVE mushrooms and I LOVE the Funghi pizza with mascarpone.

* Sumeet decided for what seemed like a Hawaiian pizza.....

* The portion was huge!!!! I recommended sharing but Sumeet didn't agree with mushrooms, and I wasn't too keen on pineapples.

Despite not being able to finish.....both pizzas were delicious!!!!

* Thankfully, they let us doggie-bag it home. It became my breakfast the following morning after gym session.

Anyway.....am looking forward to the Christmas celebrations.

Will be busy throughout.

Sigh......and I thought I'd have more time to sleep!!!!!

Later!!!

Monday, December 19, 2011

Thank goodness Monday is done and over with.....

Ahhh.....finally....Monday is over!!!!!

I had a viva exam this morning that was stressing the hell outta me over the past one week and it didn't quite help that each time I think about the exam, I automatically feel extremely exhausted and sleepy.

Needless to say, I spent more time sleeping the whole of last week than I did studying.

Can't blame me exactly...ain't my fault that my natural defense against compounding stress is to snooze.

That or I have a case of undiagnosed narcolepsy.

(we doctors just LOVE to diagnose ourselves......)

Anyway in between the slumber, I did manage a few moments of being awake, enough to actually cramp in some useful facts and information.

Thankfully whatever that was cramped in in those short periods of time, worked.....and I don't think I did that badly in the exam.

Phew.

Just as my cortisol level starts to decline back to baseline, I'm reminded again that I will be having another similar exam with a lot more topics to read early next month.

Gosh...and suddenly I feel so so sleepy.......

Now....just why in the hell did I decide that I was still up for post-grad studies!?!?!?!

Anyway....over the weekend, Richard had decided to celebrate his birthday one week in advance.

Smart move too...considering if your birthday is on Christmas eve and most people are too busy at church/opening presents/holidaying overseas/in a state of drunken stupor somewhere in Bangsar.....to actually attend your birthday bash.

* Before heading off from Richard's place....

Richard, Syerol, Ellya, Rupert, David, Kevin......yours truly.

* Yes I know...I still have bad posture....and yes, I'll get those clip shoes....erm, soon!

* The entire group at Petronas, Ijok.

* Arrived back safely.....thank you GOD!!!!!

In true Ironman fashion, Richard decided to celebrate his x-th birthday (I figured it was kinda rude to ask) by organizing an "easy" ride from his house in Kota Damansara to Ijok (somewhere around Kuala Selangor.....but don't take my word for it. My sense of direction ain't as well developed as my sense of sarcasm) and then continuing with a pot-luck lunch at his place.

Although it was more of Claris cooking than it was pot-luck.

I was a little (ok...VERY!!!) hesitant to join this ride.

Here you have the line-up of the who's who in the local triathlete scene....and then, there's me.

I had my doubts that I was gonna be able to keep up.....(I was right...I wasn't able to)

And I wasn't very keen for an 80km "so-called-easy" ride as my first ride post-Powerman.

Yea...Tobias has been taking some down time for quite a while.

Anyway.....aside from getting chased by a pack of stray mutts and a couple of close calls with huge arse lorries driving way too near you for you to appreciate Bernoulli's Principle, I arrived back at Richard's place with limbs all in its rightful places and skin fully intact.

Note to self.....never believe when someone promises that they will ride with you no matter how slow you are.

Fact is that....once the ego takes over....and the need to out-ride another cyclist presents itself.....you'll find yourself riding alone all the way behind.

But in the spirit of Christmas....I'll just be thankful that I survived!!!

*yawn*

Sorry...I just had a brief thought about my upcoming exam.

Later!!!!!

Wednesday, December 14, 2011

TGIT!!!!!!

Remember a couple of months back when I posted about the VO2 max machine...??

No??

Oh well...figured as well.

Anyway I took the initiative to dig through the archive of the blog to ease the search for you guys.

Click HERE.

Well...good news and bad news about the machine (as viewed in relation to me and my job scope...mostly just good news!!!!).

It's broken.

Not the treadmill....but the system that works the VO2 device.

Yea...I know.

Several weeks after fulfilling my job description as a guinea pig, we were using that machine as part of the exercise prescription program......and it started giving us a lot of problems.

The tech guy came in to try and fix it.....but the problems recurred.....

And so we deemed it faulty and no longer use it.

Phew....

What a relief!!!!!

The whole system was a pain in my gluteus to work with.

Well...I know some of you out there would be pretty bummed with this piece of news...(but in all honesty, I'm damn happy!!!!)

....so that's YOUR bad news.

Recently, we were loaned a stationary bike fitted with the system to test the Astrand protocol.

No...not speaking French...

Click HERE for more information......(word of caution: it's a tad bit wordy)

It's not exactly VO2 max....but rather it's testing for submaximal VO2.

It's more user friendly as one cycles for a mere 6 minutes at a RPM of 55-65 while only wearing a heart rate monitor.

The computer does everything else.

Of course we were made guinea pigs again......and this time I scored slightly higher than while on the Bruce protocol......my VO2 peak (not to be confused with VO2 max) was 52!!!!

And apparently, that piece of equipment at the back of our clinic is one of the 3 that is available in the whole of South East Asia.....

Although frankly I'm not sure if boss is saying that out of sheer pride or just stating the facts....

On another note, I just returned from my first sports biomechanics lecture.....and was aghast to find out that there is NO place in this whole entire country available for the regular Joe's to get their biomechanics checked out (if they wanted to).

Nope....not even one proper place to get their gait properly videotaped and analyzed.

Sigh.....

And my thoughts about barefoot running got shot down...again!!!

Double sigh......sometimes you really gotta hate conventional thinkers.

But on the good side, the lecturer did provide an idea on how to set up my own gait-analysis testing platform.......

Now I only have to wait to graduate....head my own sports medicine department....and bug someone up there in the administrative ranks for funding!!!!!

Heck....I can always dream, can't I?

Later!!!!

Monday, December 5, 2011

Singapore Marathon - 4th December 2011

The alarm goes off at 3am.

I vaguely remembered just falling off into snoozeville a couple of hours ago.

In fact, I was trying not to think about work when trying to sleep, only to have dreamt about work for that few precious hours of shut eye.

It is amazing how ironic the mind can be.

The MRT system was working overtime for the race and thankfully, the Bedok MRT station was really near Nard's place.

We headed there just before 4 and arrived to Orchard MRT station, packed with runners and that was when the confusion started.

Runners, runners EVERYWHERE and no one quite knows where to go.

Everyone was assigned a end-time starting pen.

Mine and Nard's was sub-6:00.

Volunteers were giving obscure instructions and most likely were as confused about the whole situation as I was.

After being directed to the wrong pen and forced to walk half the Orchard Road twice, finally did find the right pen and nicely warmed up for the race.

Of course no one could find the entrance into the pen since the entire street seemed to be fenced off, we did what most Malaysians would have done in such situations.

We climbed over the barrier, totally ignoring the rules and regulations.

Of course it turned out that most other nationalities present on that morning were doing the same thing out of sheer frustration.

There you go....we aren't that bad after all.

* I forgot how crowded Singaporean races can get!!

* Thankfully met up with the usual suspects...here with Agnes, Vron and LeeYong.

* After climbing over the barricade, proceeded to walk to the starting line as the crowd moved forward at 5am.

Thankfully no baggage deposit this year as I heard it was more horrendous than the year before.

* Maybel who is recovering from Plantar Fasciitis, came to support!

* Finally...after a nice slow 5 minute walk, we reached the starting line....and now the race begins!

It was warm and humid.

I wasn't sure if it was the weather (likely) or the number of runners that could equate to the total population of Singaporeans all packed into Orchard (most likely!) that was contributing to the warmth and humidity.

The race started on time.

But of course it took quite a bit of time to walk to the starting line.

And then we're off!!!

The initial few kilometers were very slow.

It was difficult to run due to the perpetual wall of people in front of you, next to you, behind you....everywhere!!!!

.....and the narrow roads with its frequent bottle necks.

I've never felt to claustrophobic in my whole entire running life.

* Running through the tunnel....people, people, EVERYWHERE!!!!

* Found Daryl.....

* ......and the 5:30 pacers.......which Vron and I overtook and tried our darnest not to let them catch up with us!!!

* Teresa on her 70th birthday running her birthday marathon!

* Me and Vron...

The first few water stations, we gave it a go.

It was almost impossible to get any water.

You literally have to dive in, kicking and screaming to get near enough to the table to grab a quickly disappearing cup of water.

I decided I wasn't the kicking and screaming sort....at least not since after I was 3 years of age.

At the fourth water station, I helped myself (coz everyone else was!) to pour out some 100-plus from the large bottle into my water bottle since there weren't enough volunteers manning the station to distribute the fluids.

Turned out that the large bottle contained undiluted 100-plus solution, which to my dismay, only found out after taking my first swig from my bottle.

It was so sweet and concentrated that the instant wave of nausea almost made me puke out breakfast.

The gastrointestinal system didn't quite agree with the super-hypertonic solution in the stomach....and at 12th kilometer, just as we were making out way into the East Coast park (ECP), it made its way back up the oesophagus and out the mouth.

I was relieved.

Second time vomiting during a race.

I should have went and bought a lottery ticket.

ECP was a dry and boring stretch.

Thankfully, runners were now more spread out as the roads in ECP were kinda narrow.

It was just boring..boring...BORING!!!

* Mizni and Vron at 20km mark.

* Heading to the never-ending turnaround......

My feet started to hurt.

I tried ignoring it.

I've done that many times before and it usually works....except that there was nothing much to distract you at the ECP.....

I was also getting really tired.

Perhaps dreaming of work made me even more fatigued than completing a marathon.

I tried to keep up with Vron.

She's rather determined to get this race under her belt in 5:30.

I was rather determined to get this race over and done with in the least amount of self-inflicted pain.

In the end....I could no longer run at her pace and promptly lost her in the midst of other runners.

I knew the 5:30 pacers were right behind me.

I struggled to stay ahead.

But the fatigue was overwhelming...

I told myself.....forget it.....just walk and enjoy whatever that is left of the race.

...and I allowed myself to fully walk.

....and they overtook me.

Part of me wanted to keep up, at least with the 5:30 group.

The other part of me that concurred with my painful feet vetoed and decided that walking was what's best at the moment.

I walked.....

The only consolation was that other runners around me were now walking as well.

Oh...and the other good bit was that I was done with the ECP!!!!

Run/walked the remaining distance with EeWey and Roy whom I bumped into and who also decided that they'd be walking most of the way back.

I finally had people to walk and talk with.

Misery definitely loves company when it comes to marathons.

And.....we just walked....and walked....and walked...under the sweltering heat of the late morning sun.

None of us were keen to continue running much.

All of us were pretty much contented to walk all the back to the finishing line.

Anyway....in an anticlimax fashion, photo-log will tell the remaining story:

* Trying to keep up with Vron....who was trying to keep away from the 5:30 pacers.

She was aiming to 5:30 it (and eventually succeeded!!!) for her 3rd FM.

* In the end, I could no longer keep up at Vron's pace...and lost her just before 30km mark....and about 10 minutes later, was passed by the 5:30 group.