An absolutely gut wrenching story about the difficult decisions patients, families, and their physcians face, at end of life.

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Here are some photos from the week, more on Flickr of course:
- Down on the Farm
- Adam, Maria, and Family
- Jen’s 30th Night Out

   
   

   
   

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How it Went

In short… two-thirds well. The swim and bike felt great, but as often is the case, the run is what can break you, and mine was much rougher than expected. Looking back on it there are a few things I can do differently next time to improve significantly. I had the fitness, and executed my plan… just turns out the plan wasn’t quite right to begin with!

Here’s how it all went down, along with a few other thoughts and photos from the day.

SWIM 1.9km / 1.2mi

For only learning to swim a year and a half ago, this was potentially a scary part of the race for me, but one I felt reasonably well prepared for by raceday.

The swim only amounts to about 10% of your overall time in the race, so going a bit faster or slower doesn’t make a huge difference. I had been training for about 6 months with an endurance plan from SwimSmooth and was comfortable enough in the pool. Open water was another story but thankfully it warmed up early enough in the UK to get in the lake a few times with the
Barracudas.

My game plan was just to surive, enjoy it, and finish comfortably, and I’m happy to say I stuck with that. I was predicting 35-40 minutes and finished in 38:55. Add in a reasonably speedy T1 of 3:52 and I was well on my way. The only major thing I’d like to focus on for next time is sighting as I felt there was some unnecessary zigzagging going on!

BIKE 90.1km / 56.0mi

This was the part of the race I was most concenrned about. The course packed in over 3000 feet of vertical and I didn’t have much experience with that riding in East Yorkshire. Driving the course a few days before the race was moderatley frightening but the training ride on Friday made up for it. About a hundred of us set off with a full motorcycle escort to ride 1 lap of the course and I actually managed well. The climbs didn’t take as much out of me as I exected and I was left with more confidence that I could actually finish the bike in one piece.

On race day things went a little awry but I didn’t realize until well after the race just what happened. First, it was over 30C the entire time I was racing and I hadn’t experienced anything quite like that in training (bless mild English weather).

The plan, later revealed to be flawed, went something like this.
- stay in HR Z3 except for the hills where I just planned to get on with it and get up and over whatever it took
- eat a 100 cal GU gel every 45 minutes
- drink plenty of water and electrolyte throughout

Notice any issues with that? I haven’t worked out exactly what I ended up consuming in calories but suffice it to say, it wasn’t enough. In my longest training ride / run brick it worked out fine, but I don’t think I ever went far enough for the lack of fuel to to reveal itself.

But I’m getting ahead of myself.

The bike actually went really well in of itself. I completed the first lap in 1:27:20 and the second in 1:29:08 with an average speed of over 19mph and felt great. I kept reminding myself to keep it at a comfortable pace and not overdo it but I might not have fully appreciated what that meant.

Coming into T2 I was on a rush from the bike and clocked another speedy transition of 2:17. Elapsed time so far was 3:41:07 so a sub 6 hr finish seemed well within reach. Or so I thought!

RUN 21.1km / 13.1mi

I tried to calm down a bit on the run, but my excitement had me cruising out of transition at a 7:30/mile and it took some time to settle into a more reasonable pace. Unfortunately, after the first couple of miles I started running out of gas. It was blistering hot. I stopped at a porta john and thought I was going to pass out inside. My stomach wan’t happy. Suddenly I was concerned and wasn’t sure what to do about it.

Within the first 4 miles or so my average pace had slipped back to well below 10min/mile, then 11, then 12. It was soooo hot I literally thought about my legs cooking on the pavement as if running across a massive frying pan. I avoided eating anything and only sipped the smallest bits of water thinking my stomach was upset from overdoing it on the sports drink. Turns out this was probably the wrong decision as I’m confident now I was out of fuel. As a friend and 2 time Ironman commented afterwords, “The car wasn’t broke, it just ran out of gas.”

And so the back half of lap 1 was spent walking/jogging, trying to let my stomach recoup and to get my strength back. How I was going to do that without eating is now a mystery though! By lap 2 it wasn’t getting any better so I decided I’d stick with walking and, finally, start to eat and drink. I wanted to finish rather than fight to save 10-20 minutes and risk ending up in bad shape or not even making it. In hindsight I’m not sure if I gave up too easily and what sort of thought process I’ll have at the end of a full IM. That’s something I’m going to need to work on as much as the physical fitness.

In the end I made it, and couldn’t have been happier to see my family and friends at the finish. A 3:02:07 run (for a half… yikes!) gave a total of 6:43:15 and rank of 112th out of 136 starters in the M25 age group.

Other Thoughts

Here are a few other random things that come to mind.

Location and Organization

This was my first Ironman brand event and longest race I’ve done so don’t have much to compare it to, but overall things seemed well organized and much of the concerns or questions I had were based on my own inexperience with how it all works.

The location in Rapperswil-Jona Switzerland was gorgeous and easy to access from the UK with a short <1hr train connection from the airport to town. Accommodation was challenging to find with ~2500 athletes and countless others descending on the small town but Jen did a great job finding a little place in Hurden which was a 5 min drive away. The biggest drawback was that Switzerland isn’t cheap and we quickly found that eating out burned through cash quickly.

Cost of Ironman

I will say that overall the cost for entry seems a bit extortionate, let alone once you add in all the extras like merchandise, food, drink, welcome party, race license, saline drip (if needed) etc. At times it felt like forking out dough for every little thing which was exasperated by the already high prices in Switzerland. That said, the races regularly sell out so can you really blame them?

Future Plans

After much deliberation, I plan to enter a full IM with haste. Why? Because I’m lucky I can, and that says something in of itself. Plus I’ll turn 30 in April so seems a good milestone to break new ground. My buddy and I already tried to register for IM Lake Placid but could not get through the process online before it sold out so we’re now looking to Louisville or Madison. Time will tell.

Photos

Finally, I’ll leave you with some photos from Jen and my Mom. It’s great they captured so much of the event!

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More photos from Crete

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Packing is complete and all I can say is we’re going to use up every gram of that baggage allowance.



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Here’s one from CNN today that was particularly good.

Question: Is there anything in the bill about rationing health care?
Answer: No one is using the term “rationing” as part of the bill. But there is a term called comparative effectiveness. And that’s this idea that we figure out what works in medicine and make sure to pay for those things. This also means that there are a lot of things being done right now where there’s not scientific proof that it works and maybe those things won’t get paid any more. Some people call that rationing. Other people say, look, rationing exists under the current system. It’s just that the insurance companies are essentially rationing by denying payment or dropping people off their coverage.

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Our friend Jim has a great synopsis over at Bargaineering explaining what will change and when now that the bill has passed. The full article is worth a read but here are a few of my favorite parts, all of which go into effect in 2010 or 2011.

• Insurance companies will be barred from dropping people from coverage when they get sick. Lifetime coverage limits will be eliminated and annual limits are to be restricted.
• Insurers will be barred from excluding children for coverage because of pre-existing conditions.
• Young adults will be able to stay on their parents’ health plans until the age of 26.
• A tax credit becomes available for some small businesses to help provide coverage for workers.
• Medicare beneficiaries will be able to get a free annual wellness visit and personalized prevention plan service. New health plans will be required to cover preventive services with little or no cost to patients.

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Insurers would no longer be able to reject new customers with pre-existing medical conditions; new restrictions would be placed on their ability to set premiums. Patients would have greater access to preventive care and young adults would be able to stay on their parents’ insurance until the age of 26.

See the full article for details on how the bill addresses individual mandates, expanding coverage, coverage for seniors, taxes, industry fees, employer mandates, abortion, and even a revamp to student loans.

Also, here’s Ezra Klein commenting on the non-partisan Congressional Budget Office’s review which found the bill will actually save money:

You also get the single most ambitious effort the government has ever made to control costs in the health-care sector. According to the Congressional Budget Office, the bill cuts deficits by $130 billion in the first 10 years.

This was a hard bill to write. Pairing the largest coverage increase since the Great Society with the most aggressive cost-control effort isn’t easy. And since the cost controls are complicated, while the coverage increase is straightforward, many people don’t believe that the Democrats have done it. But to a degree unmatched in recent legislative history, they have.

Coverage for 32 million that don’t currently have it plus better protections for those of us that already do while saving $130 billion in the process sounds like a win-win-win to me.

Let’s get this done people.

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