OK…so last Wednesday I walked from the foot of the Oakland Bay Bridge , along the embarcadero all the way over the Golden Gate to the bridge to the vista point, and then back to the Bay bridge, for a total of 16.3 miles. The weather was picture perfect and my breathing was good. Maybe a little too good.

Why do I say that? Because I was breathing so well during the walk that I went crazy and started going way too fast. The following day , my legs ,calves and shins were so sore I could barely walk, and for the first time ever, my biceps were actually cramping up on me. That’s right..my arm muscles were cramping up! My right calf muscle is still so sore that I’m going to have to skip this Sundays 10 miler.

My lungs didn’t fare too well either. Though I was breathing great during the walk, it finally caught up with me the next morning. Not as severe as the last walk, but still bad enough to make me miserable for a few days.

I think these are some of the mistakes I made.

1) effexor xp I was breathing so well during the walk , that I went hog -wild and started racewalking . I know better than to racewalk during an LSD, but I did anyway. And not only did I racewalk , but I racewalked at least 10 of the 16 miles. Shame on me!

2) Rather than doing this LSD walk at a recommended pace of 18-20 min/mile, my average pace was more like 12:30 (faster than race pace).

3) I tried to break in my new racing flats . 16 miles is way to far to try out new shoes, especially racing flats .This is what probably caused the shin splints and calf pain. Instead , I should have worn shoes that had more cushioning and a higher heel , which would have not only saved my shins, would have also discouraged me from racewalking ( it’s too difficult to racewalk in running shoes).

4)

success rate clomid I think the reason my biceps were cramping , is because of all the racewalking I did (when you racewalk, you swing your arms a lot).

5) coreg classification Though I thought I was well hydrated before the walk, I didn’t count on sweating as much as I did. Following the walk, I had all the symptoms of hyponatremia . Loosing too much sodium is probably another reason why I had such a problem with muscle cramping .

6) Finally, I just plain over- did it. I jumped from 13 miles to 16 in two weeks. Too fast , too soon. My body hasn’t acclimated to the longer distances yet.

So , with all this in mind, hopefully I will do a better job with my next LSD , which is 18 miles 2 weeks from now.

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Seems to be the new theme around here. Do a long training walk……get sick. ( by sick I mean an asthma exacerbation)

Thursday I did the second to the last of my really long training walks for the Boston and Rome marathons (18.1 miles to be exact), and now, a day later, I’m having a tough time keeping my peak flows out of the red zone. For the first time in a long time, my FEV1

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actually dipped below 30%. Ive managed to hold my own by increasing my neb treatments to every 1-2 hours , but Ive been huffing and puffing just walking around my house. Funny how I can walk 18 miles one day, and then have a hard time walking 18 feet the next.

Maybe I over did it, though I’ll be damed if I know how. I felt fine during most of the walk , and to play it cautious , I even walked slower than usual and took half a dozen 3 minute rest breaks along the way. Total time to finish the walk was 4:58 . Other than the noticeable humidity in the air and the smell of fresh cut grass near Crissy field (which can sometimes set me off), overall Id say my breathing was better than average. If anything, it was my arms, legs and feet that were really starting to bother me near the end of the walk.

There are probably numerous environmental and intrinsic factors at play here that are causing me to flare-up after these long walks, but I think the reality is, my disease is simply catching up with me. My lung function and my tolerance for strenuous exercise is declining , and short of a bilateral lung transplant, there’s nothing that will change that. All the more the reason I suppose,to do these upcoming races while I’m still able.

I was asking my friend Mike how he trains for a marathon. His response was, that it takes too much out of him to do traditional mileage building and training walks, so instead, he does core strengthening ( pilates) and a few stair climbs races. Hmmm, maybe he’s on to something. Maybe that’s why he doesn’t have as many breathing flare-ups as I do. Geese, I’d love not to have to do training walks for months on end and risk dying every time I train for a marathon, but there’s no way on earth I would have the endurance or the breath to finish one if I didn’t train the way I currently do. Still, I wonder if the means justifies the end..( or something like that) Oddly, I seem to get sick after almost every training walk , but I’ve only gotten sick one time after finishing an actual marathon.

Btw, here’s a Google Map I plotted out of my 18 mile walk. I like this route because it gives you a little bit of everything. City streets, views of the bay, park paths, vistas from the Golden Gate bridge and just the right amount of hills and straight aways.
To take a virtual tour of my course, click on “view larger map”, zoom in anywhere along the purple course line and use the street view feature to see what I see when I walk this course.
Happy Training!

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I wonder what it would be like, for someone like me, to walk the mother of all races? To be allowed to participate in the most prestigious marathon in the world?
I’m referring of course, to the Boston Marathon

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Well, stranger things have happened , and in a few weeks I’ll know if it’s gonna to happen to me.

Finally, a possible explanation of what’s been causing the numbness and pain in my right arm, hand and shoulder.  After more than a year of seeing different specialists and doing what seems like a million tests , it turns that I have something called Thoracic Outlet Syndrome…or TOS for short. 
In a nutshell , because of my anatomy I have a lot over developed muscles in my neck and shoulders that are pinching some nerves and arteries that run through the area, making my right arm and hand numb and making my neck muscles hurt all the time. Lifting weights at the gym was actually making it worse, which would explain why I always felt crappy after working out.
A really cool Sports Medicine doctor at UCSF made the diagnosis last week.  Kind of a relief to finally know whats been going on.  For a while there I didn’t think they’d ever get to the bottom of this.

The plan for now , is to treat it conservatively with Physical Therapy . They want me to go to PT twice a week for 6 weeks , then they’ll re-evaluate. If it doesn’t get better, there are other options, including surgery to cut away some of the muscle( yea..right )
Hopefully the Physical therapy will help and I’ll be able to resume some upper body strengthening in the future,  but for now it looks like the only exercising I’ll be doing is walking and stretching…..It’s always something huh.

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It’s time once again to decide on a shoe to wear for this years long training walks ,and of course , the race itself. So far, Ive narrowed it down to either the Asics Hyperspeed 2s, or the Loco Banditos . I’ve used the Asics on my 5 milers a few times and they worked out well for the racewalking segments, but because of their extremely lightweight design I’m not sure how my feet and shins will hold out over the longer distances. I’m going to wear them this weekend for my 15 miler and see how they do.
For the actual marathon walk , though not as comfortable, I’ll probably have to go with the Locos again. They have more cushioning over the mid foot ,which really helps absorb the shock when you’re walking over the cobble stone street of Rome.

It probably sounds silly, but if you walk /racewalk as much as I do, you tend to be real picky about the shoes you wear. If you pick the wrong ones, they can really screw up your feet and potentially cause injury to other parts of your body. A good shoe can make all the difference in completing a marathon distance with relatively minor foot discomfort or finish in total agony. You need shoes that are kind to your feet though, but also that are functional and designed for the sport your doing. I’m proud to say, that after walking 3,500 miles and training for and completing 4 full marathons and 9 half’s, that Ive only suffered one black toe, and 5 or 6 blisters . The last two full marathons….. no blisters at all!

You wouldn’t believe how many shoes Ive purchased and had to return just to make it to this point. Either they didn’t fit right or the heel was to high to racewalk in.  And it’s not cheap!  On average I pay  $80.00 for a pair of shoes that will last about 3 months.
Most companies that sell racewalking suitable shoes are web based ,which means not only do you have wait for them to be delivered, but you don’t know if they are going to fit until you receive them. And, if they need to be returned or exchanged, you need to pay for the return shipping which can average $6-10 . 

One of the challenges for me in shoe selection (and I’m sure for most racewalkers and/ or marathon walkers) is finding a shoe that I can walk actually walk marathon in , but at the same time, a shoe that I can also racewalk in over different types of terrain. Unlike bulky running shoes, I need a pair of shoes that not only offers decent cushioning, but also a shoe that is fairly wide in the forefoot (I have fat feet) , and one that also has a low profile heal . There are tons of racing comps or track type sprinting shoes on the market, and those work fine for racewalking shorter distances, but I need shoes that have enough substance to them to allow me to walk for 7 hours without trashing my feet, toes and shins.

Most of the shoes out there that are suitable for racewalking/marathon walking are sprinting shoes, or what they call racing comps.   There are only two shoes companies in the world that I’m aware of,  that make shoes specially for racewalking.  One is a Chinese company called “New Health”, which produces and ultra light weight racewalking shoe..  The other is a company here in the USA called “Hershey” that custom makes all of its racewalking shoes, but they are very expensive , and frankly, very ugly.   I own a pair of the New Health shoes which I really like , but they have virtually no cushioning and are designed primarily for very short distances , 5K or less , on a soft surface (They’re more like slippers than shoes).

My favorite racewalking shoes of all time are my New Balance RC550s . Sadly, Ive had to retire them as Ive worn the tread down to nothing . New Balance no longer makes them.

Earlier this week I got a chance to sit down with my Pulmonologists to discuss the problem Ive been having with these acute flare-ups that seem to develop a couple hours after doing my longer walks. (Sorry, this post has a lot of medical respiratory jargon in it, but I couldn’t find a way around it)

The thing that seems to perplex everyone the most , is why the delay in onset of symptoms? Why are these exacerbations occurring several hours AFTER the exercise event. These types of flare-ups seem to be more characteristic of an allergic response than exercise induced asthma. Made even more baffling when you consider the reason I walk along the waterfront in the first place, is to avoid the inland landscape that I’m definitely allergic to.

One of the theories being floated, is that I’m not getting the appropriate anticholinergic response or coverage I should be getting from all the Atrovent I take ( Atrovent works differently then Albuterol). They think it’s possible that I’m either immune to, or that the effect of the drug is wearing off long before I finish these longer walks. A possible explanation as to why my asthma symptoms don’t surface during the walk itself , is because vigorous exercise triggers what is known as a “sympathetic response” …..the release of bronchodialator type chemicals into the blood stream that actually helps dilate the airways in asthmatics. When the exercise seizes, so does this bronchodialating effect, and all of a sudden…I have a problem breathing. (You’d think it would be the other way around.)

To test some of these theories, they’re actually going to devise a special exercise stress test to see whats going on with my lungs in real time AFTER I finish a long walk . I’ve done several exercise tests in the past , on a bike in the lab, but because I can walk such far distances without a problem, they have never been able to induce an asthmatic response in the time allowed . For this new experiment, I’m actually going walk 15 miles along my normal route on the San Francisco waterfront ( including crossing the Golden Gate bridge) and will end the walk at the doors of the UCSF airway research clinic.
As soon as I walk through those doors, their going to do a series of pulmonary function tests spaced over several hours, in hopes that they can catch any delayed symptoms or exacerbation that might occur and If my peak flows bottom out, at least I’ll be in the right place.

They haven’t told me yet, what they hope to achieve with the data they collect , other than possibly increasing my daily doses of Atrovent, but I think this will be a worth while experiment and I appreciate all the effort that my doctors and the researchers at UCSF are putting forth in trying to solve this problem.

You know , despite all the incredible things Ive accomplished through fitness and exercise, no one has ever never been able to solve the mystery as to why I sometimes get critically ill after walking. What causes it , what are the triggers, why does it happen?
Five years ago , the answer to that question would have been ” You’re crazy for doing what you’re doing…or…You’re disease is too advance… or… You’re over doing it! ” and the recommendation would have been…” Stop training for marathons” .
Well, times have sure changed. I think through all my achievements and of proving people wrong time and time again, that Ive actually gained the respect of these scientists. Now instead of telling me to stop doing marathons, they’re actually encouraging me!

One of the biggest reasons people with severe asthma or chronic lung disease don’t exercise in the first place, is for fear that they will become even more short of breath. The truth is, if you don’t exercise regularly, you risk becoming so de-conditioned that it actually gets harder to breath. Hopefully, small experiments like this will shed some light on possible solutions.

Because I’m in the middle of training for the next marathon, we’re trying to work out the logistics and the best day in which to schedule the test. I’ll be sure to post more about this experiment in the coming weeks.

Here are just a few of the wonderful people who take care of me on a regular basis and who are involved in cutting edge asthma research:

Dr Gold
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Dr Innes

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Here’s a picture of some of the UCSF clinical airway researchers ( and muah) taken a couple of years ago in Golden Gate park for the ALA’s asthma annual walk.