Monday, August 3, 2015

Ironman Training with an Injury

On Sunday I ran 4 miles.  At 9 minute pace.  Pain free.

With just 10 weeks until Ironman Louisville, you'd probably laugh if I told you my Sunday long run was 4 miles.  I, however, couldn't be more thankful.

Exactly 6 weeks ago, months of consistent training came to a rather sudden stop.  My Sunday long runs had been progressing nicely and I finished a 2 hour run satisfied with my pacing and nutrition.  Monday I noticed some soreness in my right hip that felt muscular.  I flew to Providence for a conference that night and on Tuesday morning hit the treadmill for my weekly 10k pace tempo intervals.  My hip was still a bit sore, but after a mile warmup, it felt normal.  Things changed on Wednesday when I woke up with an achy sore hip that was particularly painful each time it extended when walking.  Still thinking it was muscular, I attempted to run an easy 5 miles with a friend that night.  Again, it was sore, but seemed to improve the further I ran.  Little did I know, that would be the last time I ran for 6 weeks.  Later that night the benign ache became a pain in the front of my hip each time I took a step.  It was an eerily familiar pain that ironically dates back 8 years ago when I first began training for triathlons.

2008 Ironman Florida 70.3
My debut race in the swim-bike-run world

The summer before I started medical school I defined myself as an athlete as a runner.  5k and 10k were my preferred distances to race, but more than anything, I loved escaping a busy day to run along the banks of the Chattahoochee River in Atlanta.  Without any signs of an impending injury, my 6 mile run one afternoon ended with a rather acute onset of pain along the front of my hip.  Over the next week I tried running several more times until I had sharp pain with each step and was left with no choice to not run.  X-rays and an MRI followed and soon enough I had a diagnosis - FEMORAL NECK STRESS FRACTURE.

The dreaded black line in a location that isn't so benign.

Without boring you with details, I spent the next 6+ weeks on crutches, including a trip to Hawaii and the start of medical school.  Since I couldn't run, I started swimming and biking, both activities I had never done before.  Out of that injury spurred my interest in triathlons, and less than a year later I crossed my first triathlon finish line at Ironman Florida 70.3.

Flash-forward now to 6 weeks ago, and that exact pain of past injury was fresh in my mind.  Each step I took hurt, pushing off the wall in the pool hurt, and if I tried to stand on the bike and climb it hurt.  Running was a definite no go.  At that point, x-rays and an MRI were the next logical step, but I couldn't fathom spending $1500+ (not even doctors have good insurance!) for a confirmation of a diagnosis that I already felt confident about.  So, I did as I knew I had to with a presumed femoral neck stress fracture - I stopped running.  For a very long 6 weeks.

At that point, Ironman Louisville was 4+ months away, but even still I hated to think about the potential that I'd never make it to the starting line.  Training had been going so well and I had  high hopes for my second-go at the Ironman distance.  After a week of rest, I was back in the pool and on the bike, determined to use the opportunity to strengthen those disciplines.  Training remained consistent, averaging 15 hours per week, and two back-to-back weekends with 100+ mile bikes boosted my confidence in the sport I consider my weakness.  Sunday long-runs were replaced with a second long bike each weekend, and I tried not to dwell on the fact that I couldn't enjoy the pain of a post-bike run with my friends and training partners.  I was diligent about strength training and recovery to rehab this injury and prevent another.  And most importantly, I tried to ignore the voices in my head questioning my ability to finish an Ironman after missing 6 weeks of running.

Conquering a very hot 100 mile ride
This past week marked 5 weeks of no running, and my hip had been pain free with all activities for almost 2 weeks.  In my mind, it was time to start running again.  On Monday I ran a slow 2 miles, and loved every minute of it.  Thursday brought yet another successful run of 2 miles.  Finally, on Sunday I decided to push the distance a bit while maintaining a very conservative pace.  With each step I was paranoid that the pain would return with the next stride, potentially sidelining my running yet again.  But, I finished 4 pain-free miles at 9 minute pace smiling ear to ear, so thankful to be lacing up my running shoes and hitting the pavement yet again.

So race day is a mere 10 weeks from yesterday and there's a bit of a difference between running 4 miles and running a marathon.  I'd be lying if I said I wasn't nervous about how the rest of my training will go.  For now, though, I'm focused on one week at a time.  Small increases in mileage and careful attention to recovery will hopefully get me to the starting line in Louisville with a pain-free hip that's ready to tackle 140.6 miles and cross the finish line to hear - "Crystal Perkins, you're an Ironman!"

Monday, July 27, 2015

24 Hours of Booty

There are so many Charlotte events that I look forward to each year, but 24 Hours of  Booty is definitely one of the highlights of my summer.  This 24 hour cycling event in the heart of Myers Park is a staple of the Charlotte community and draws together a mix of cancer survivors, families affected by cancer, members of the medical community, elite cyclists, and volunteers for one common cause - beating cancer.  

Friday evening, 1200 cyclists gathered to kick off the big event.  For the second year in a row, I rode with the Levine Cancer Institute team.  Our fearless leader - Dr. Kneisl - leads our team, and together with Dr. Vanderhave, we represented the CMC orthopaedic department.

The build up to the 7pm start is filled with heart-wrenching stories of patients and their families who are currently battling or have lost loved ones in the battle against cancer.  After the national anthem and raising our hands to the common cause of "beating cancer," the ride began.  The first couple laps (each 2.84 miles) were slow moving with tightly packed group of cyclists, but eventually the riders became more spread out and I knocked out 40 miles before returning to Bootyville for dinner and then riding a couple miles back to the house to sleep for several hours.

I was up bright at early to begin my ride at 5am.  Last year someone had recommended riding in the early morning darkness, and it is without a doubt my favorite time to ride.  The course is quiet, roads are lit only by some spotlights and blinking bike lights, and the summer air is relatively cool.  

By sunrise, I was 28 miles into my ride and took a short break for breakfast.  Between scrambled eggs and fruit, pecan swirl bread with peanut butter from Great Harvest, half of a glazed chocolate donut, and iced coffee from Dunkin' Donuts, I was energized for more riding.

I rode another 42 miles before making a very quick stop for a bathroom and to refill my water bottles.  Bootyville is filled with tents of participants who camp overnight on the football field at Myers Park Traditional school.  The benefit of living nearby = no need to sleep on an air mattress.

The final 42 miles grew increasingly busy on the course and required extra effort to maintain speed while remaining safe in the crowds.  Sadly, I witness a car pull out and hit one cyclist on the course, and although she appeared not to be too severely injured, I was more cautious the last few miles.  With 20 miles to go I was really starting to overheat and grabbed a few sips of ice cold coke hoping for a boost.  Just after 6 hours, my odometer hit 115 miles for the day and 155 miles for the event , and that meant my 50+ laps around the Booty Loop had come to a close.

The heat took a toll and I felt a little woozy getting off the bike, but after several minutes in the shade with cold gatorade, I was ready for lunch.  The taco bar catered from Moe's satisfied many hungry athletes bellies.

Compared to last year's Saturday long-ride, this year's 115 miles felt dramatically easier.  I spent far more time in aero, averaged more than 0.5mph faster pace, and was comfortable on my bike the entire time.  Last year I rode 87 miles before my base bar split, causing me to crash, and recall those last 20 miles were pretty painful.  Hopefully my improved bike fit and fitness will translate to a faster bike split in Louisville in October!

24 Hours of Booty concluded on Saturday evening and a total of $1.34 million was raising by the event to donate directly to local cancer beneficiaries (Levine Cancer Institute) as well as national cancer outreach programs.  Congrats to the 1200+ riders for dedicating their weekend to a phenomenal cause!  If you'd still like to donate, here's the link to my fundraising page.

Sunday, July 12, 2015

Stumpy Creek Aquabike + Recent Eats

JULY 11, 2015

1500M SWIM

Swim - 26:31 (1:46/100m)
T1 - 1:00
Bike - 1:20:57 (20.7mph)
Finish Time - 1:48:26
2nd Female Aquabike

Six weeks ago when I signed up for this international distance triathlon, training was going great, I was recovering well from the building volume, and I had absolutely no clue that an injury would pop up when I least expected it.  Fast forward a few weeks and suddenly I can't run at all due to pain in my hip.  I'm now 3 weeks into "no running" and the hip has started to improve significantly.  As much as I wanted to do a triathlon and not an aquabike, I also know that this race is only a blip on the radar as I focus on Ironman Louisville in October.  Since I had already paid my race fee, I had decided that I'd make the most of the situation and get in a quality swim+bike brick in a race environment.  In the back of my head, I kept wavering with the potential of trying to run, but ultimately on race morning I left my running shoes in the car so that it wouldn't even be a temptation. Breakfast was a PB&J Bonk Breaker and half a banana.

Water temperature was announced as a balmy 85 degrees.  I opted not to wear my swim skin, doubting how much extra speed it conveys at that distance and figuring that the last thing I wanted was extra warmth.  I was in the open swim wave with about 15 other athletes and we were the first wave to start.  Despite the few number of us, I couldn't get out of traffic and settle into a rhythm for at least 500 meters.  I kept trying to hang with the feet ahead of me, but constantly found myself slightly faster and needing to pass.  Finally I found some clean water, but still struggled to find my usual comfort in the water. The Stumpy swim course is a rectangle that incorporates the international distance athletes as well as the sprint racers, who swim a shorter rectangle.  This means that for the last few hundred meters I was suddenly in the middle of a pack of slower swimmers and once again fighting for clean water.  I exited the water and my Garmin read 26 minutes, which is 1:35/100 yards, a pace that is about 10 seconds/100 yards slower than what I'm swimming in the pool for that distance.  However, it was also more than 2 minutes faster than the same swim 3 years ago.  4th fastest female swim split out of 77.

It's a short run into transition and since I had opted to skip my swim skin, I was in and out very quickly.  3rd fastest female T1 out of 77.

I did this race three years ago, and remember hating the bike course.  It had been described as fast with rolling hills, and I remember cursing each and every one of the hills.  Looking back at my previous race report, I had also crashed coming out of transition, so perhaps that contributed my negative view of the bike course.  This year, however, I loved the course.  With the exception of some terrible stretches of uneven pavement (in some of the fastest areas), it truly is a challenging, yet fast rolling course.  Since I wasn't running, I told myself that I had to hammer the bike and put out my best possible effort.  I was back and forth in the first 10 miles with the girl who would eventually take 3rd overall female in the triathlon, before passing her and staying ahead for the remainder of the race.  I was passed by a couple guys, but otherwise rode without sight of anyone else for the majority of the 45k course.  Nutrition included approximately 24 ounces of Skratch pineapple.  NP 236 with an average HR 168 highlighted that this was the hardest effort I've put forth on the bike in a race.  And the end result was a time 5 minutes faster than 2012 and 4th fastest female bike out of 77.

I can't even begin to describe how tough it is to enter T2 and just stop, especially since I was 3rd overall at that time with a several minute buffer on my next closest competitor.  There is no official finish line, no announcement of your name, and no one removing your timing chip.  Instead, I packed up my gear and rolled my bike back to the car before wandering over to the finish line to claim my medal and some food and drink.  Although I wanted nothing more than to run (especially since that's my strength), I'm happy with my decision not to ruin the past three weeks of recovery and restart the clock on six weeks of no running.

Since I was already in the Lake Norman area for the race, I took advantage of the sunny Saturday morning and wandered through the Davidson Farmer's Market and shops, picked up coffee at The Fresh Market (sea salt caramel - so good!), and some cleaning supplies from Publix.  You can imagine my excitement when I walked into Publix and they were scooping bowls of their new organic ice creams!

Back at home I spent some much needed time degreasing and cleaning my bike.  It's a tedious task and one that I neglect, but worth the effort.

After an afternoon at NoDa Brewery with a large group from work, I arrived home starving and quickly whipped together this meal.  The plate included a veggie burger on Mom's home-baked hamburger buns, kale chips, and a cold corn salad with avocado and fresh basil.  It's was a perfect summer meal enjoyed on the deck.

Since my regular schedule means a 4am alarm on an almost daily basis, it's a wonderful feeling to curl into bed at night and not set an alarm.  Despite needing to bike for three hours, I had decided that Sunday morning was going to be a lazy one.  After enjoying a latte in bed, I made french toast with a cranberry walnut bread from the farmer's market.  Next time you make french toast, try adding almond extract rather than vanilla extract into the egg mixture!

Tonight's dinner was straight from the farmer's market with a great selection of local summer produce.  The coconut crusted mahi was the highlight of the plate and paired well with sweet chili sauce.  The okra was tossed with olive oil, salt, and pepper and roasted at 400 degrees for 15 minutes.  The other plated component was braised radishes.  I started by sautéing sweet onion in Earth Balance before adding the diced radishes to begin to cook.  Then I added a braising liquid of 1/4 cup vegetable stock, 2 tbsp red wine vinegar, and 1 tsp sugar and simmered uncovered for 10 minutes.  For the final few minutes, I added the chopped radish greens and a tablespoon of chopped rosemary from my garden.  I've never cooked radishes this way in the past, but will definitely make it again!

Tuesday, July 7, 2015

Peachtree Road Race

July marks the official end to my 4th year of residency, and start of my 5th (AND LAST!!!) year as an orthopaedic resident.  After clinic on Thursday, I hit the road bound for Atlanta.  Traffic was horrendous, but ultimately I arrived 5.5 hours later.  Friday involved an early morning swim - 4000 wonderful long course meters.  Then, Mom and I wandered through the Peachtree Road Race expo and picked up our race bibs for the 4th of July 10k.  Our pre-race meal was a carb-fest of spaghetti with vegetable marinara, salad, and garlic bread.  The Italian feast is one of my favorite meals!

Royce and Erin joined us for dinner and brought the newest addition to their family.  Kona is an 11 week old chocolate lab puppy and is absolutely adorable.  She's quite a spitfire when she's awake and full of energy, but then crashes hard when she naps.  Evidently a single Kong was not sufficient and she had to keep both hers and Bailey's close while she slept.

Saturday morning we were all up bright and early for a 5:30am departure toward downtown Atlanta.  After 10+ years doing this race, we have a well laid out plan to park near the finish, ride Marta to the start, and then walk back to our car.  We learned the tough way that riding Marta from the finish back toward the start is a miserable experience of being herded like cattle into very close proximity with hundreds of your favorite stinky and sweaty friends.

We woke up to heavy rain, and that was the forecast for the entire morning.  Garbage bags helped to keep us dry while we waited for the start of the race.

This year's race was much different for me.  Two weeks ago I had a rather sudden onset of hip pain, and since then I've been unable to run without significant pain.  Thus, running and I are on a temporary break.  A few weeks ago I was cursing my evening runs in the 95+ degree heat, and now there's nothing I want more than to lace up my Mizunos and pound the pavement.  With Ironman Louisville just 3 months away, I'm crossing my fingers that this is just a temporary set back.

Although I really wanted to run, I had fun walking with Mom and taking in more of the sights and sounds of the race than when I'm racing.  Unfortunately, the pouring rain meant that none of the live bands that usually provide entertainment were on the course.  The light drizzle lasted through the first 3 miles, but around mile four started to become heavier.  Lightening struck around mile 4 but fortunately was an isolated strike and then seemed to pass.  Later we learned that race officials had halted the race for approximately 30 minutes due to bad weather.  6.2 miles later, soaked from head to toe, we crossed the finish line and entered Piedmont Park to gather our coveted Peachtree t-shirt and snacks.

Later that afternoon the sun actually came out and we all gathered for a 4th of July barbecue.  Kona joined us again, and after playing fetch, eating plants, digging holes, and playing in the pool, made herself comfortable on Dad's lap.

Mom and Grandma prepared yet another fantastic meal for us all to enjoy.  The spread included veggie burgers, slaw, potato salad, watermelon, and homemade vanilla and lemon blueberry coconut ice creams.

Sunday morning brought the lazy morning I had been craving, featuring sleeping in, reading the newspaper, sipping a tea latte, and a casual breakfast.  Papaya topped with yogurt, a squeeze of lime, and coconut chips was Mom's creation and brought me back to our trip to Hawaii.  To accompany it, I made french toast topped with almond butter, raisins, chia seeds, and bourbon honey.  Terrific breakfast!

In typical fashion, the "long" weekend flew by in the blink of an eye and before I knew it I was packing my bags and driving back to Charlotte.  What happened to the weekend?  I guess we were too busy having fun and enjoying time together.  T-minus 1 year until Atlanta is home yet again!

Sunday, June 28, 2015

AOA in Providence

This past week I traveled to Providence, RI for the American Orthopedic Association conference.  Aside from the conference itself, I was most looking forward to a reprieve from the 100 degree temperatures in Charlotte.  Beautiful blue skies and temperatures in the low 80s was a welcome sight.

I arrived Monday evening and had two immediate goals  - find a takeout dinner and watch the US women's soccer team play Columbia in the round of 16.  I walked several blocks from the Omni Hotel to get dinner at The Grange, a local vegetarian restaurant.  I could have easily ordered one of everything from the menu, but ultimately settled on two small plates - 

Roasted Cauliflower: sweet chili sauce, green onion, cilantro ginger aioli, and peanuts
Po' Boy: Fried oyster mushrooms, cabbage slaw, pickles, remoulade, pretzel baguette

Both were excellent, but the cauliflower may have been the best vegetable side I've ever eaten.

Watching the soccer game because a bit of a challenge once I learned that the hotel didn't have Fox Sports, but after some stress, I was able to get the game to stream on my computer.  

I was up early on Tuesday to hit the gym for a bike + run workout.  Imagine my confusion when this was the sight out the gym window at 5:15am.  I thought for sure I must have mixed up my alarm based on the bright sunshine.  I wish the sun rose that early in Charlotte!

One of my goals when I travel is to find several great independent coffee shops.  Ellie's Bakery was the source of a spicy mocha and strawberry rhubarb hand pie for breakfast en route to the conference.  Although I normally would never chose a mocha over a latte, this was their house specialty and received rave reviews on Yelp, so I stepped out of my box.  It had a great spicy kick, but was a bit too potent for my preferences.

After a long day listening to various lectures at the conference, it was time for dinner.  Myself and my future Atlanta co-fellow had an incredible dinner at Gracie's.  If you're ever in Providence and are looking for a nice meal, run right on over the Gracie's.  There are several dining options, including a 10-course tasting menu, but I chose the 3-course prix fixe.  Each course was prepared with exquisite attention to detail both in artistry and taste.

Sherry Roasted Beet Salad
labneh, beet harissa, dukkah, local honey, mizuna
Tasting of Spring Vegetables
Trio of carrots, beans and greens in a savory miso broth, and triple baked potatoes with pickled vegetables and house-made aioli
(In reality, the description by the waitress my much more elegant, but I can't recall the details)

Strawberry Shortcake
Deconstructed, strawberry gelato, praline shortbread, whipped cream
A morning break during conference day number two took me to Bolt Coffee Company for a Cafe Miel (latte with local honey) and an almond pastry.  They only offer whole milk or hemp milk in their lattes, so this was the first time I've had a whole milk latte.  I'm a convert to 2% milk in my lattes, but I can't say I noticed a significant difference with whole milk that would make it worth the extra fat.  It was a bit strong for my taste since it was only a 10 ounce cup with two shots of espresso.

After a day and a half of lectures inside a cold conference room, I took advantage of the lunch break and walked a few miles along the river to explore a bit more of the city.  Despite the abundance of businesses and infrastructure, the city was much quieter than I anticipated.

For lunch, I returned to Ellie's Bakery to try more of their menu.  The English Pea Hummus sandwich featured house made sprouted wheat bread, roasted onion, pea greens, carrot, and fennel salad.  And because I lacked the will power to walk out of a bakery without something sweet, a slice of the seasonal Pistachio Rhubarb Roulade ended up in my to go bag.  They sandwich was spot on, but the cake was a tad dry and lacking in flavor.

Dinner on Wednesday night was at Hemenway's Restaurant and included hanging out with Ben, one of my former co-residents, and another girl that I met on the fellowship interview trail.  Ben requested to make an appearance on the blog, so this photo is for him.  On his plate would be a lobster (3 pounds!) stuffed with the claw meat and an assortment of scallops, shrimp, and crab.  We couldn't help but laugh when the bill came and he was shocked by the $30/pound price tag for the lobster.  I bet he won't make that mistake again!  My meal included a shared appetizer of Rhode Island Style Calamari (Pt. Judith squid, hot cherry peppers, garlic butter) and then the Chilled Seafood Medley Salad (Shrimp, crab, lobster, jeffery's greens, feta cheese, shaved red onion, toasted pistachios, orange supreme, preserved lemon vinaigrette).

The final coffee shop of the trip was Dave's Coffee on Main Street.  Their house specialty drink - Honey Latte - is made with soy milk and local honey and was my favorite cup of java in Providence. And, of course, nothing pairs better with a latte than a giant freshly made blueberry muffin.  I ate the crispy muffin top and saved the rest for a snack on the plane ride home.

In between some stellar meals, the AOA Resident Leadership course proved to my enlightening and a great networking opportunity.  Let the 5th and final year of residency begin!