As an athlete, whenever I’ve needed to see a physician about a sports-related injury, I’ve had choices in medical specialists and know I can get an appointment relatively soon and close to home. Just ask a fellow athlete and you’ll get several sports med doctors in your community. Kids with arthritis must see “the next best doctor,” which means a family practitioner unfamiliar with the nuances of childhood arthritis, or a rheumatologist who treats adults. Infants, toddlers and youths get arthritis, too, not just adults. Here are some numbers that are rather eye-opening:
Feb. 2013 data
The U.S. has approximately 300,000 children – ages one day to 16 years – with juvenile arthritis.
The U.S. has around 300 pediatric-rheumatologists. (I see a severe shortage here!)
The U.S. doesn’t have even one pediatric-rheumatologist in 11 of its 50 states according to the map at left. (Oh boy, let’s take a long trip just to get to one, and then expect a long wait for appointments!) 24% of pediatric cases must travel over 80 miles to see a pediatric-rheumatologist.
The majority of pediatric-rheumatologists work in teaching hospitals, which reduces the time they can be available for actual patient care.
To serve these 300,000 children, each of our current pediatric-rheumatologists have, in theory, 1,000 patients. If these pediatric-rheumatologists examine, and treat their patients once a week, which is common in the world of juvenile arthritis, each pediatric-rheumatologist would need to see 25 patients an hour, during a 40-hour workweek. (I sure wouldn’t want my kid seen on a Friday!)
If each of these doctors used all 120 hours of a 24-hour-per-day 5-day workweek, he or she would still need to see 8 patients an hour. (I still wouldn’t want my kid seen on a Friday!)
That gives each doctor less than 8 minutes with a patient.
My estimates are inflated, of course. My fear is not.
The U.S. has an incentive program that reimburses a medical intern/resident in pediatrics up to $35,000 to complete a subspecialty education for kids with arthritis.
Please, help spread the word.
Click the following link for a presentation by the Arthritis Foundation with more eye opening stats
Thanks Teena for your input!
The triathlon season hasn’t started yet, at least in the cold climate areas, but that hasn’t stopped the planning! My brother Marc, found a great way to include our sister Teena in the sport. In July, a group of us will take part in the Door County Sprint Triathlon in Wisconsin. It’s a full team effort with Teena front and center!
Team Triumph is a national organization that helps pair able-bodied athletes with people, who for reasons of disease progression, aren’t able to accomplish certain feats on their own. So as a team of Angels (we’re actually called Angels!), Marc, Cindy-a coworker of Marc’s, my wife Karol and I, will be Angels assisting the Captain of the team, Teena, through all three portions of the triathlon!
It’ll be a challenge for us all. For Teena, who hasn’t taken part of any of these sports for many years (I hear she’s been training!), and for the rest of us in learning to handle new equipment and new situations. One angel will pull a raft during the swim, another will ride an adaptive bike, and another push an adaptive chair, all with Teena aboard. The 4th Angel assists at the transitions helping the Captain get ready for the next leg. And the event is in beautiful Door County Wisconsin to boot!
It’ll be a blast for sure! Come see us compete or keep your eye on the results page, better yet find a chapter near you and become an Angel!
I’ve recently rediscovered a passion that had me going to some pretty exciting places 25 years or so ago. Exciting both geographically and emotionally. With all the biking and running that I’ve done the last 6 years on the roads, and all the peril that goes with the roads, I’ve found I’ve needed a break. The rediscovery is trail running!
Trail running is a different kind of running. It requires lightness of feet, quick reactions, orienteering skills and a love of the outdoors. If you don’t have those you’ll quickly gain them. We’re blessed to live in an area that has 10′s of thousands of acres and 100′s of miles of trails in state parks, national and state forests and wilderness areas, all within about a 30 to 45 minute drive. I thought the local roads provided hills! The logging roads, horse and hiking trails wind their way through some pretty big hills, some 200-300 feet in ascent. That’s pretty much like a 20-30 story building!
Stream crossings, ponds and small lakes, wildlife encounters, remote areas with limited access all make for a great outing. Too bad some of the wildlife of a 100-150 years ago have been hunted or driven out of the area. I still may come across a bobcat or the like though.
Hoka One One Bondi 2
I’ve had to change shoes too, for more protection from rocks and other sharp objects on the trail. I read quite a bit about a newer shoe call Hoka One One (pronounced o nay). The company has several shoes both for road and trail use. I decided on a road shoe and it turns out it works great on the trails too. It’s easier to go that direction than from trail to road. It’s kind of a goofy looking shoe reminiscent of a moon boot, but the cushioning, support and lightness it provides is wonderful.
Over the winter I’ll have my work cut out for me. 2014 is an off-year from Ironman and I’ve targeted a marathon in May, one in a series of four called Dances With Dirt Gnawbone in Nashville, Indiana. I’ve already done some trail runs this fall and the rediscovery has me really eager to get off the road and back into the woods. But before that of course, is the Jingle Bell Run/Walk for Arthritis in Indianapolis this December. Take one of the two links under RA Links in the side bar to donate to a worthwhile cause!
Wow it’s been a long time since my last post! Ironman Louisville has come and gone. I’ve recovered physically and have actually gained a couple of pounds. The last 6 weeks have been awesome as I’ve totally been out of the training mindset and instead have tackled yard jobs that I’ve put off all year. With the help of a flexible work schedule, and a new (used) pickup truck, I’ve dirtied my hands in garden soil and mulch, pulled and cleared ivy and weeds in preparation for vegetable and flower garden planting next year. Man, that backyard is gonna take a while!
I certainly haven’t forgotten about the Jingle Bell Run/Walk for Arthritis fund-raising event this December and decided this week I’d better lace up and run a few steps to remember what running is like. I also came across an email from the Arthritis Foundation that has a link to my own personal fund-raising page. I didn’t realize I had my own page! So for the remaining time til the run the link will be posted here and on the sidebar for easy access. And no, I’m not in the photo!
Donation page for the Jingle Bell Run/Walk.
More to come!
What a weekend! Ironman Louisville, for me, was a success. While I didn’t reach my time goal I made improvements in other areas of the race, namely, preparation. I had some big training weeks prior to tapering that I think made all the difference. “Racing” Ironman is, for the bulk of participants, all about endurance, not speed, and I think those big weeks helped. Especially since race day was forecasted for 90 degrees!
This event had a rolling start for the swim, different from most events which have a mass start in the water. The venue was in a protected area of an island in the Ohio River, off boat piers in a docking area and it worked pretty well. Karol dropped me off at the Transition area just after 5am so I could set up nutrition on the bike and inflate tires etc. She’d park the car and meet me at the swim start area. To get to the swim start I had to walk about a mile up river with 3,000 other people. As I approached the start area, I saw the line for the start stretching further upstream. Another half mile of walking and I finally met up with Karol. Another half mile and we finally reached the end of the line! Almost 2 miles of walking before even starting the race!
You guessed it! When the cannon went off at 7am we walked about a mile back downstream to the start gate/pier. Make that 3 miles of walking. This time the line was quickly moving and I was in the water about 7:30am. Computer chips worn on our ankles recorded our actual start time. The rolling start was great! No clawing my way through the masses. I had pretty much open water all around me so I found my pace and rhythm quickly. The course went upstream, past where we stood in line, made a left turn around the island, and headed downstream to the transition area. The swim was pretty uneventful. It was really a matter of pacing and staying relaxed.
Transition 1 (T1) was smooth. After getting my bike and gear, I headed out and got a big boost by seeing Karol just after exiting the transition! The first 10 miles of the bike were flat and fast so I was able to down the first of many bottles of sport drinks. I was keen on staying hydrated the entire day and this was one of my biggest improvements. I downed 20-30oz of fluids from the aid stations about every half hour. At times I felt bloated so I made adjustments when needed. The bike course didn’t seem as difficult as I was expecting. Long stretches of flat road interrupted by long stretches of hills, none of which posed much difficulty. It didn’t seem as hilly as what I ride around here at home! I kept low to moderate pressure on the pedals keeping my heart rate in zone 1 for 75% of the day and about 25% in zone 2, nothing above that. My legs weren’t bothering me, it was my arms and neck! The course was scenic and it was tempting to tour some of it as it wound through the horse farms!
T2 was slower than I expected. I seemed to fumble gear in the changing tent wasting time and energy. Fortunately, a helpful volunteer saved the day! Thinking of the sun, the heat and the marathon, I had another volunteer lather me up with sunscreen hoping it’d help keep me cool.
The run was two loops of an out and back course that went through downtown, neighborhoods and Churchill Downs, though we didn’t see anything of the Downs except the security walls. The run was my big concern and why I hydrated so much on the bike. In the previous 3 IM’s I’ve had to walk a big chunk of the 2nd part of the course, in part because of dehydration. Not this time! I was carrying a water bottle in a hip pack for fluids in between the aid stations which were every 1-1.5 miles. My goal was to run through the stations stopping only to refill the bottle when needed. It turned out I had to walk the stations anyway to get ice and cold water to pour over me! And, I used the porta-potty 3 times! At one point, a fire tanker truck helped by spraying Niagara Falls on us! The course was flat and I was able to settle in to my goal pace of 9:15-9:30 min/mi. That lasted only about 5 miles though as the heat rapidly increased. It was pretty tough starting the 2nd loop with the finish line visible one block away, aargh! By mile 20 I had to walk about 1/3 mile to settle some nausea issues (no, didn’t vomit) but was able to start a shuffle that took me to the finish line.
I had a bandana around my neck for the run and as I trotted into the finish shoot I took it off and waved it like a lasso signifying I came, I saw, I conquered! And wow was it loud! And more volunteers to help hold us up on our two feet til we regained our composure. Almost immediately, I saw Karol and got a big congratulatory hug and kiss!
So my times:
Swim 1:11=1:41min/100yd avg; T1 7:10; Bike 5:46=19.4 mph avg; T2 6:56; Run 4:46=10:56min/mi avg; Total time 11:58:12; 26th out of 158 in the 50-54 age group. Nope didn’t Kona Qualify, only in my dreams. A couple of hours faster and I’d be on a plane. Those qualifiers are just not human!
Calories intake (approx): Oatmeal breakfast 150; before swim start 300; bike 3300; run 2000; total 5750. Months leading up to race-millions!
Over all I’m quite pleased with my result. I had three primary goals, finish in 11:30, run the marathon in about 4hrs, and run the entire marathon with the exception of some of the aid stations. Secondary goals were to improve my swim time and finish the bike feeling good. I didn’t make the first 2 primary goals but I consider the run a success because I met primary goal 3! Both secondary goals were met. I really think the heat was the culprit for my time goal as engines tend to run better when cool. Next IM will be in a cooler climate! The next planned event is the Jingle Bell Run/Walk for Arthritis 10k in Indianapolis this December-see ya there!
I’m in my first week of a 3 week taper and am reflecting on the past months of training with all the early morning workouts, sweat, food, minor set backs and fun. And while I do long and ultra distance triathlons for fun, in the end I do them because I can.
That’s where the hope comes in to play. I’m not able to track any donations to the Arthritis Foundation via WordPress or the AF and can only hope that readers of these pages have made a financial contribution. People from over 21 countries have viewed these pages. One thing I know for sure is that arthritis doesn’t recognize borders. So wherever you live, please donate by using the arthritis link on the sidebar or to your local foundation.
As far as hope and Ironman Louisville, I hope I can be confident in knowing I’ve put in the time and effort to accomplish my goal. It’s very easy to start second guessing yourself. In this first taper week I realize just how tired I really am. The training blocks used were very effective and netted some solid miles. So now I find that all I want to do is rest, but know that’s only part of tapering. From here, reduced miles and time will help my body repair some of the abuse I’ve put it through. And doing something I’m not used to doing, limiting my caloric intake!
Thank you if you have donated to the arthritis Foundation and if you haven’t, I hope you will!
Ironman Louisville is five weeks from yesterday and based on my day yesterday I’m ready to roll! The last few and the next couple of weeks are the Build phase of training when workouts resemble the actual race. That means long swim, bike and run workouts.
My recovery from the 70.3 in June was good up until a couple of weeks ago when my right knee started bothering me. Fortunately, managing the discomfort has prevented it from getting worse, but it’s not getting much better either. It hasn’t stopped long workouts like yesterday when I rode 100 miles and ran 4 afterward. Sometimes when transitioning from bike to run, I almost dread the feel of rubbery and sore legs. Yesterday though, I was giggling and joking with Karol as I racked my bike and donned run shoes to make my way to the Bloomington Trail. During both the bike and the run, I hit my goal paces for Louisville, and afterward the first thing I told Karol was “I’m ready!”. There are still a few long workouts to do before the taper starts on August 5th so I must keep my enthusiasm in check so I don’t do anything to wreck my momentum.
At this stage of the game I think about the riders in the recently completed Tour de France and what they do to transition from a multi-week race to say the US Pro Challenge being held in Colorado mid August. Oh to have massage therapists, chefs, trainers and other staff to ease the transition! I Guess I’ll have to rely on my own stretching routine, Karol’s great cooking and my own sense of well-being to guide me. My diet has been key the last few months, especially with my knee discomfort, to recover from the long hours of training. Supplements like Magnesium to aid muscle recovery, Zinc to boost the immune system, foods rich in omega 3s for inflammation control and increased fruits and vegetables for all kinds of nutrients. Did you know the RDA for fruit is two cups a day and vegetables is two and a half cups a day? Two good sources help explain in the ins-and-outs: Harvard and the CDC.
So here’s to Chris Froome and Team Sky in winning the Tour de France! Watching the tour the last 3 weeks has been super motivating and hopefully I can parlay my own readiness into a “victory” too!