Monday 23 January 2012

Blood (literally) and sweat en route to running 21.1 km.


Imagine this :

It's the Friday before your first marathon on Sunday, and you are out on your last training run, to keep the muscles warmed up and ready for the big day. On the last 50 meters of the run, you hit an obstacle on the road, and go flying forward and land directly on your face and knees.

To make matters worse, you are on blood thinning medication, which does not allow the flow of blood to stop. If that was not enough, imagine you have asthma, and a history of epilepsy which can make running hard. And to top it all, you have had open heart surgery two years ago and have never run after your school days. And did I mention, you are 68 years old!

Before you cringe any further at my imagination, let me remind you that truth is indeed stranger than fiction, and such a person in flesh and blood (with a little loss of it :)) does exist and this unique individual is Surendra Dasadia.

Every year more than 70 heart patients from the Cardiac Rehabilitation department at the Asian Heart Institute participate in the Dream Run of the Standard Chartered Mumbai Marathon to prove to themselves and to society that heart disease is not the end of life, but is a new beginning. To further drive home the point, another 15 or so participate in the half marathon. Each year, several Dream Runners want to 'graduate'and move to the half marathon, for which they consult with me in the month of July. Last year, there was a 'fresh' batch of 6 patients wanting to upgrade to the half and Surendrabhai was one of them.

Let me be honest and mention at this point, that I was in mixed emotions about his participation. On the one hand, his enthusiasm was palpable and that to me is the most important ingredient in endurance training, but on the other, I was skeptical about his ability to 'go' the distance, especially to run it. He had started jogging for the first time for a few hundred meters in June of 2011. To make matters complicated, he had an epileptic attack a few weeks later and had to be hospitalized for it. At this point I tried to dissuade him from participating and could see that he was clearly dejected. My heart went out to him, and we arrived at a compromise, that we would take a week at a time, and make a final call closer to the end of the year.

In mid September, he joined our friend and chief motivator, Mr. Venkatraman (who is an inspiration himself) for outdoor runs at the MIG club. At the end of this post, I have copied the training plan Venkat put him through, for those interested in following his progression. Surendrabhai was remarkably regular in his training, both at cardiac rehab and with Venkat for the outdoor runs. Day by day he progressed, and by early January he looked ready and raring to go.

On that fateful morning of Friday, Jan 13, I got an SMS from Venkat which informed me of Surendrabhai's fall, and both of us were very concerned, about his injury and health. Surendrabhai was also very concerned- not about his injury, but about the fact that we may ask him not to participate !

Participate he did, and he finished in a very respectable time of 3 hours and 14 min, and what's more important is that he stuck to all of Venkat's pre-run commandments.

1. Complete the distance,
2. On foot and
3. Enjoy the participation

There are many kinds of heroes in this world, from whom we can draw inspiration. You have the swashbuckling hero who runs into a burning building and rescues a damsel in distress (do they exist outside of the movies ?), and then there are the quiet ones, who look just like you and me, but what differentiates them is their sheer determination to rise above the ordinary. Surendrabhai is a shining example of the latter and exemplifies the words of Rudyard Kipling, in his epochal poem, IF.

"If you can force your heart and nerve and sinew
To serve your turn long after they are gone,
And so hold on when there is nothing in you
Except the Will which says to them, "Hold on!"

We will continue to draw inspiration from him as he climbs greater heights.

VENKAT'S POSTS:

This was posted the next day Dec 17th, 2011

So coming back to SD and his training plan.
First some don'ts
- Since he was epileptic there was going to be no pushing him into 'stressful' situations. Stress is a known trigger for epilepsy incidents.
- Also since he was asthmatic no anaerobic training either.
Besides the above, here is something by way of his training background.
- He was already running on tread mill for about 30 minutes each time for 3 times a week at the Cardiac Rehab. His HR used to be under 150 at the end of each run.
- He also did some minimal weights for strength training.
With this background, he wanted to do the HM and felt that he should train with a group so that he can be motivated better. With him going to Rehab for 3 days a week, it was decided that he would join me for runs 3 times a week. Tuesdays, Thursdays and Sundays were deemed the most practical based on the calenders of both.
He has been very punctual and regular. Very driven. In the first few weeks, I wanted him to get the mental exposure / sensory overload to running on the open ground. The enclosed ground at MIG was very suitable for this purpose since it gave him a protected environment to start running. Far better than running on unpaved roads.
His initial focus was on feet time. He was slowly graduated to combinations of running with walking. He began with first two days of only walking around. I wanted to be sure that his 'chassis' can take the load in progressive basis. After that he was told to run one length of the ground ( 100 mtrs ) and walk 3. Slowly the mix of running was increased. No attention was paid to his pace at all. As long as he ran comfortably it was OK. He voiced an opinion ( often ) that he could do better than this, since aerobically he was doing 30 minutes on the treadmill. I assured him that I was slowing him down for his own good, since his body should be able to adapt. I also assured him that a stage would soon arrive when I would be 'pushing' him and he would find excuses to avoid training. It bought a smile in him, knowing that he was a go-getter by nature, who was being restrained in the initial phase of his training.
All along his strategy has been to do a run/walk. He is quite happy with that. He also knows that his proportion of running will increase as he trains and his walking will decrease. After about one hour of feet time..which was about 3 weeks into training, he did his first Kalina loop of 9 kms. Again a run/walk but he did it quite comfortably.
On the Sunday that Raj ran his second 100 kms, he came to Marine Drive and did 14 kms ( two loops ) and went home very happy.
In a progressive manner he has been slowly inching up his distance and last Sunday he did 18 kms. Today again he did 18 kms and I must add rather very comfortably. Dec 31st, he is determined to do 21 kms.
In order to meet with his business commitments, he has taken to taking flights to Ahmadabad and Baroda so that he does not miss training.
He has had no injuries, which was my major fear. He ices himself religiously after each run. He ensures that he controls his diet on evenings prior to training so that he does not face digestive issues.
He also does steam inhalation on mornings before the run so that his chest passages are clear of phlegm.
I learnt today that out of the 11,000 or so runners who register for the HM, only about 7,000 show up at the starting line. In each of these 7000 there is a 'human interest' story like SD. I felt that if I did not share one such story then I would be doing injustice to the readers of this forum who are the silent majority and each one of whom may have something similar to narrate.
Cheers...and more as we go along.
Venkat

++++++++++++++++++++++++++++++++++++

Posted on Dec 20,2011

I have told SD that there are 3 objectives for the SCMM 2012. They are:
1. Complete the distance,
2. On foot and
3. Enjoy the participation
He has often come to me and told me the distance that he did on the treadmill and at what speed. Even today he calculated his projected timing and was hoping to do it within 3:30 hours. I do not want to set any time goals on him. I have told him how to improve things it is a multi-year plan not a few months plan. But after each run the notes that get compared are the time, distance and speed metrics. This is what I want to avoid and this is what I meant when I said that recreational running often talks in the language of athletic running.
As can be understood he is an aggro Type A personality. He wants to do it all in one year. My fear is that he should not do too much too soon and then suffer injuries which would invalidate not only him but the entire old folks running movement in the eyes of the non running society.
Most times my main job is to slow him down and hold him back.
Venkat

++++++++++++++++++++++++++++

Posted on Dec 27, 2011

My first concern when SD wanted to be trained was his level of physical fitness...in short his chasis..and how much of beating it could take.
We had about 3 months to go..and I knew that about 2-3 weeks would go in getting his body to rigors of running 3 times a week. Once he passed this test, then it would mean scaling up his time on feet till he did a decent mileage, decent enough to see him through his 21K on Jan 15.
It did help that he was a regular at the Cardiac Rehab for 3 days and was doing 30 minutes of tread mill on regular basis. But however the first order of day was to see how he does on open grounds. Having known that each sides of the MIG ground is 100 mtrs long and the perimeter is thus 400 mtrs helped. He was started with a few days of walking only.
He was feeling that I am making him do lesser than his capabilities, but I also knew that the bio mechanics of running on open ground are different from doing it on a treadmill.
Having passed this test he was slowly put on increased combinations of walking / interpersed with running. Different combinations were worked through...one side run / one side walk..then two sides run / one side walk etc..he kept progressing satisfactorily.
One of the milestones for him was to run a full round non stop....he was thrilled to being able to run 400 mtrs in one go.
His next milestone was to run 2.5 rounds in one go...which happened after a few more weeks....he was thrilled to being able to run 1 km in one go.
When he had come to doing a run/walk for more than one hour or so on the grounds..he was taken to do the Kalina loop on open roads..9 kms of run walk. He was maha thrilled.
And so on he progressed...when on Saturday the 17th Dec he ran/walked
18 kms..everyone in the group cheered him with a standing ovation. He was told that doing 21K on Jan 15th was now a given...but SD was made of more firmer resolve. He wanted to do a 21K run next week.
So last Sunday the Dec 25th I got him to do the NCPA / PM Bath, 3 laps of 7 kms each. He adopted a 200 mtrs run / 100 mtrs walk strategy and did it in under 3:30 hours. We started at 6:30 am to simulate the near conditions of the run day. And finished by about 10 am or so...
He was thrilled...and now the taper starts for him. Today I met him and he complained of some DOMS...but natural and understandable. I have lent him my foam roller so that he can recover better.
Cheers to SD...
Venkat

The full discussion thread is at...it ofcourse went into all tangents
about competitive running v/s recreational running...but a very
interesting read nevertheless.

http://runnersforlife.com/group/mumabimarathonrunners/forum/topics/sd-does-21

Monday 16 January 2012

From 136 kg to 2:17 in the Marathon in 11 months !



The ninth running of the Standard Chartered Mumbai Marathon was held yesterday, and once again it was a joy to see the city come out and run, in all its vibrant colors. As Medical Director of the race, I am privileged to come across several stories of exceptional grit and determination. I would like to chronicle some of them, with the hope that they will serve to inspire thousands more.

I have realized that in endurance events, as in life, all it takes for man to achieve what seems impossible, is to know that it is possible. The 4 minute barrier for running the mile (1.6 km) was considered to be unbreakable for decades, but once Sir Roger Bannister broke it in 1954, it was done several times more, in that year itself. I do hope that some of these tales will make people revise their views of what they consider impossible targets.

The first story I would like to share is that of Nithiij Arenja. Before we go any further, I must make a disclaimer that Nithiij is a very close friend, which gives me the advantage of knowing the 'full story'.

Nithiij has struggled with his weight, ever since he was a young man studying in England, and at his peak (or should I say at his nadir) topped the scales at a whopping 160 kg. His weight has yo-yo'd over the last 15 years, but has mostly remained in the red zone. In February of 2011, he was 136 kg, when he decided that enough was enough, and he had to turn things around, for his health's sake and for the sake of his young family.

He went on a low cal, low fat diet and included a high volume of exercise in his daily routine. He had his 'Polar' wrist watch and heart rate monitor on at all times, which was a surrogate for the amount of calories he burned during the day. His aim was to create a deficit of over 500 cals daily. As expected, in the initial few months the pounds fell rapidly, and that spurred him on to increase his exercise volume even further. The next phase of inspiration to lower the weight even further were the comments and look of awe he got from people he had not met in a while (more than a few of which were young ladies, I might add). While all of this sounds fairly mundane, it's important to know how much good food means to Nithiij. He truly enjoys his food, (whether it's from a roadside dhaba or caviar and foie gras), and an occasional drink or two, or three.

As part of his exercise routine, he started jogging /walking on the treadmill in September 2011, and this proved to be a struggle initially. When there is a 100kg weight pounding on your knees, they will protest and they surely did. However, he did not let this setback pull him down, but on the contrary it spurred him to increase the distance. As he lost further weight, his ambition grew and on more than one occasion I have chided him on getting 'too greedy', and I am happy to say that he has proved me wrong. In November he ran more than 10 km at a stretch for the first time, and in the beginning of December I entered him for the Stan Chart Mumbai half Marathon, without his knowledge (being medical director of the race does have some privileges). I revealed this information to him only in the middle of December, since I was unsure myself of his ability to run 21 km. To complicate matters, he developed a bad flu at the end of the year, and was out of commission for over two weeks. Rather than make him give up the task, as it would do for most of us, it only made him more determined. To make it more meaningful, he decided to run for Indian soldiers who had been paralyzed in the Kargil war (read his appeal below and do suppor the cause).

On the eve of the marathon, I had a long chat with him and worked out a 'sensible' strategy, which would have him finish in 2 hr 45 min. Nithiij being Nithiij, wanted to do it in under 2:30, which I felt he was not ready for. Well to cut a long story short, I was on medical duty at Hotel Ambassador, and it was 8:15 am and the early wave of half-marathoners were coming through. Suddenly in the distance, I saw this black and yellow spandex covered thin man running towards me, and I looked at my watch in disbelief. There he was, looking pretty fresh, and kicked about the fact that he had proved me wrong- again. Nithiij finished in an amazing time of 2 hr 17 min, and is an inspiration to me and all those around him. Here is his official race timing and photos.

http://www.timingindia.com/raceDetails.php?event=scmm12hm&bib=23845

http://www.marathon-photos.com/scripts/event.py?event=Sports%2FCPUK%2F2012%2FMumbai+Marathon&new_search=1&match=23845

Oh, I forgot to mention one little detail- he is now 83 kg ! Thats a 53 kg weight loss in 11 months. Nithiij is happy to share his weight loss tips and efforts, should you like him to. He can be contacted at narenja@gmail.com.
Read below, his call for support for the soldiers' charity:


A CALL FOR SUPPORT,


I am going to attempt the 21km Mumbai Half Marathon on the 15th of January and I am making this attempt for a cause I feel strongly for:

The paraplegic Rehabilitation Centre in Kirkee, Pune:
http://para-rehab.org/..


This is a Fauji institution set up for our soldiers medically disabled by spinal cord injuries. Most of them fought for us in Kargil and were badly wounded in war. I wish to highlight their need for financial support and run this 21km for their cause. This is a wonderful institution , please take a minute out and read this article:
http://www.outlookindia.com/article.aspx?213641


Contributions can be made by cash/ crossed cheque in the name of "Paraplegic Rehabilitation Centre" and I can have them collected and handed over to them after the run on the 16th at the Army Office in Mumbai.


Our soldiers deserve a second chance at life- So grateful for your support

Thursday 12 January 2012

The Importance of Pacing and Pacers

There are 3 days to go for the Standard Chartered Mumbai Marathon, and most runners are discussing their 'goal' time and how to get there. In my capacity, I am lucky to interact with several runners and I am amazed at their lack of a plan to hit their target time, or a plan which is clearly not going to succeed.

The best way to succeed is to have a plan, which takes each km into account. Most runners talk about positive and negative splits- which basically indicates whether your first half is shorter, or longer than the second half of your run. Going by the nature of the Mumbai terrain and weather, I think its very difficult to do a negative split (faster second half) for the full marathon. If you are not used to setting a pacing schedule for yourself, the easiest way would be to try and achieve an 'even' pace throughout the run.

Make a simple excel sheet which has the goal times that you need to hit each km marker (or you can split the race into 5 km segments- though you risk losing accuracy by doing that), miniaturize the sheet, and keep a printout in your pocket. Trust me, even if you are good in math, after 25 km in the blazing sun, your mind will not be functioning at its sharpest. Of course, an even easier way is to get yourself a GPS enabled watch, and adjust the 'virtual partner' to your goal time.

If your goal is to run at any of the times, that the pacers will be running at, then I strongly recommend running with a pacer. It takes away all the tedious calculation, and all you need to do is stick with the group. You need to choose your pacing group wisely, and I would suggest selecting a group, which is within 5 minutes of your goal time for the half marathon, or 10 min for the full marathon. Any further and you risk 'blowing out' too soon if you are with a faster group, and risk not meeting your goal time if you are with a slower group.

Here is a link for the various pacing groups for this Sunday's marathon:

http://www.procamrunning.in/scmm//pacesetter.php#MyAnchor

And here are the top 5 reasons why you should run with a Pacer in the SCMM. These reasons have been sent to me by my friend, Mr. Venkat, who is the pacer for the 3 hour bus for the half marathon.

1. You are in safe hands.

- Pacers know the route well and being accomplished runners know how best to tackle the distance. They are skilled in completing the distance and now running below their race pace have a lot of 'reserve' to do things well. You are in safe hands.

2. They do the maths.

- Pacing can be quite a complicated affair. And when you are mentally exhausted numbers can befuddle you. Pacers run with a pacing chart / plan / strategy and know their numbers. They can get you there without you having to do the numbers. You mentally run more 'lighter' and enjoy the event.

3. Gain tips / advice.

- Pacers being experts have quite a bit of knowledge under their belt.
When running along they are quite willing to share running tips with you. An interesting conversation all along with the Pacer and with others makes the distance very light work.

4. Running in a group can be fun.

- You have a choice on race day. Run alone and suffer it out. Or Run along with the pacing group and enjoy the picnic. And Pacers know how to motivate you as the Peddar road flyover comes in or the Sun beats down on you on Marine Drive.

5. And lastly - It's free.

- That sure is a clincher...running with a Pacer is free...courtesy of the good souls who agree to run slower than their own race pace and Procam the organizers of SCMM


HAVE A GREAT RUN.

Tuesday 10 January 2012

THE FINAL COUNTDOWN TO THE MUMBAI MARATHON 2012

The Final Countdown Begins- 7 days to go!

WHERE SHOULD YOUR TRAINING BE TODAY?

Full and Half Marathon:
By this point, all the hard work has been done and you should be in ‘taper’ mode. You should have completed at least one long run of 30 km or more. If you have not done that, you should reconsider your decision to run the full marathon, since without adequate preparation, the chances of injuries (even serious ones), increase greatly.

During the last week, the hardest thing for those who have trained regularly, is to REDUCE your usually weekly mileage. After all, you have been running 30-50 km per week, and now you have to cut back drastically. I recommend running 2-3 days this week, and the distance should be between 5-8 k, at a relatively relaxed pace (though one of the runs can be at your 'race pace').


GENERAL GUIDELINES FOR ALL:

Irrespective of your age, it would be a good idea to obtain medical clearance from a registered medical practitioner/doctor allowing you to run in the event.

Please review the following questions before Race Day:

 Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?
 Do you feel pain in your chest when you do physical activity?
 In the past month, have you had chest pain when you were not doing physical activity?
 Do you lose your balance because of dizziness or do you ever lose consciousness?
 Do you have a bone or joint problem that could be made worse by a change in your physical activity?
 Is your doctor currently prescribing drugs for your blood pressure or heart condition?
 Are you pregnant?
 Do you have insulin dependent diabetes?
 Do you know of any other reason why you should not do physical activity?

If you have answered YES to any of the above questions, we strongly recommend that you seek advice from your doctor before you run the race. Do not run if you have been suffering from any sort of virus or fever in the TWO weeks prior to race day. If you feel feverish, or have been vomiting, have had severe diarrhoea or chest pains or generally are feeling unwell, then it is unfair to you and your family to risk serious illness and become a medical emergency. Most medical emergencies during the race occur in people who have not adequately trained or are unwell but do not want to miss the race.

Tips for the race and the day before:

1. Make sure you get adequate hours of sleep the night before the race. Actually, make sure you sleep very well on Friday night, since its quite likely that the night before a big race you may not sleep too well.
2. One the night before race day, have a dinner rich in carbohydrates as that is your main fuel for exercise, but do not overeat !
3. Have a light snack before leaving home. Arrive at the start point well before the start time to avoid last minute anxiety and chaos.
4. During the race, run at your own pace. Avoid getting carried away by those around and running at their pace.
5. Consume water or any other oral rehydration fluid at regular intervals. Ideally, you should know your ‘sweat rate’ and consume fluid in proportion to it.
6. If you experience any chest discomfort, unusual shortness of breath, nausea or giddiness during the race, stop and take rest for a few minutes. Seek medical help if the discomfort persists more than a few minutes.
7. Write down your emergency contact number, and any significant medical history at the back of your running bib
8. There are several medical aid stations along the way, as well as at the finish line. Do seek help the moment you begin to face a problem, rather than wait till the last minute.
9. Have a wonderful race !