Wednesday 24 June 2015

Doctors and Dieticians !

Doctors and Dieticians

For the last few years, I’ve often been invited to give motivational talks to runners. 

At the end of such talks, I’m often asked two questions.  These questions are invariably about running injuries and about a runner’s diet.

These are hard questions to answer and I’m not competent enough to answer them. Both these issues lie in the realm of medical professionals. 

So the real question which very often actually needs asking is not how to deal with a particular injury or whether to adopt a particular diet, I think the most important question for a runner is: How does one find the right doctor and the right dietician? 

A runner is never an island.  All of us rely on our family, friends, doctors, physiotherapists, masseurs, dieticians and so many other people to help get us to the finish line. 
Selecting our team is an art.  For me, it’s been an acquired art.   In fact, it’s been a long time in the acquiring and is still a work in progress.

But I want to share my experience with this critical question.  I understand that people may not agree with my opinion and they have a right to do so.  That is the essence of democracy.    What is true for me may not be true for you.  I'm simply explaining my point of view.       
When it came to choosing a doctor for medical issues, some excellent advice was given by Dr Tim Noakes, MD. in his classic book, The Lore of Running.  

In the Chapter titled “Staying Injury Free”, Dr Noakes gives his 10 laws.

Law #8 states: “Never Accept as Final the Advice of a Nonrunner (MD or Other). 
Dr Noakes suggests 4 simple criteria in choosing a medical consultant:

1) Your advisor must be a runner.   Dr Noakes felt that only a runner will have insight into your running issues.  This does not mean that his advice will always be right but there is a greater probability that it will be correct.

2) Your practitioner must be able to discuss in detail the genetic, environmental and training factors likely to have caused your injury. This will be more likely when he is a runner.

3) The practitioner must be able to understand your passion for running.  This is also more likely if he is a runner.  It is patently ridiculous, says Dr Noakes, to accept advice from someone who is antagonistic to your running in the first place.

4) Your adviser shouldn’t be expensive, as most running injuries can be cured without recourse to expensive treatments.  In support of this concept, Dr Noakes, quotes Tom Osler who said, “God heals and the doctor sends the bills.”

I have generally come to accept these rules when it comes to choosing my Doctor for medical injuries.  

I have only modified them slightly.  I am willing to take the advice from a Doctor who isn’t a runner as long as I know that the doctor is passionately involved in some sport.  I want him to have played some sport during his life with the same passion that I run.  

I modified Dr. Noakes criteria because I think it would be hard, for example, for a swimmer to find a doctor who swims or a badminton player to find a doctor who plays badminton.  But I think to share a passion for sport’s is good enough.

My biggest struggle however, has been with dieticians. 

Over the last 10 years, I’ve been to a dozen dieticians. It’s been an eventful journey. 

To begin with, I felt the need for a dietician.  I concede that someone may not feel the need.  There may be some runners who may simply have instinctive knowledge of what their body needs and so are able to naturally eat the right quality and quantity of food.  There may be some who feel that they can do their own research and sort out their diets themselves.   

I am not one of them.  I didn’t mind seeking professional advice. 

The first dietician I went to meet, 10 years ago, was an elderly gentleman who was very famous.

In the first meeting, he gave me a list of blood work I needed to do.  He weighed me and announced that I could easily lose 25 kgs of weight.  That surprised me a bit.  10 kgs might have seemed reasonable. 25kgs seemed a bit over the top.  But the idea pleased me.

It was a very short meeting because he said that we would discuss things only after I get the blood work.  That was end of the consultation.  

I had however noticed that his assistant, who actually shared the desk with him, was slightly overweight.   But I was focused on myself.

In my next meeting even before anyone spoke a word, he put in front of me 3 large photo albums and with a shake of his head, asked me to look at them. The albums were full of those 'before-after' pictures which we see in weight loss advertisements.

After I glanced through them and conveyed my admiration for his expertise, with a similar shake of my head, he looked through my blood work results.

His slightly overweight assistant then input some data from the reports into the computer.

There was a large dot-matrix printer on the next table and out came one sheet of paper.  

She then explained to me that this was list of all the stuff I could eat.  It was generic list: rice, wheat, lentils, vegetables, cooking oil etc given in terms of weight and volume.  She said cook whatever you want with this quantity and eat it.

For the first time, I felt the real need to speak.  I then explained to them that I was planning to run a marathon and I was hoping for some diet advice with that in mind. 

The old gentleman said, “Eggs!! Eggs!! Eat lots of Eggs!!”

After saying that, the old gentleman and the slightly overweight assistant just sat back and didn’t volunteer any more information.   They simply sat and started at me. 

After an uncomfortable silence I asked, “What happens when I eat out?” 

With lightning reflexes, the old gentleman, whipped out a book which he had apparently authored.  He said, “This is a book which explains how to order in a restaurant. It’s for Rs 500/-”. 

After saying that, the old gentleman and the slightly overweight assistant just sat back and didn’t volunteer any more information.  They simply sat and stared at me. 

I left their office.  I’m ashamed to say that I bought the book.  I felt angry that I had given a vial of my blood to no end.  I felt angry that the man had not asked me a single question about my lifestyle and my goals. 

I was traumatised by that experience.  The emotional scars from those two meetings with the old gentleman and his slightly overweight assistant might never heal. 

It was few years before I gathered the courage to go meet another very well established dietician.  

This one went to the other extreme.  After the routine blood work, this one asked me so many questions that I felt I was being interrogated for entry into India’s counterespionage agency.  

They seemed to want to know all my most intimate secrets.  I think, they have with them now, stored somewhere in their hard drives, more information about my personal habits than Neepa, my wife, will ever know.   

This team asked me my goals, my long term and short term plans.  I felt I was in good hands.  

This dietician’s office was inside an establishment which also housed her husband’s shop.  

He owned a shop which sold diet and protein supplements and although I saw a complete conflict of interest, I happily bought more than 10,000/- worth of vitamins and minerals from him which she prescribed.  Actually she stood right next to the counter and asked the salesman to get the stuff ready.  I also bought different types of protein powders and amino acid supplements.  I didn’t mind buying stuff which I felt might be lacking in the basic diet.

I had given them an exact idea of my goal.  I had explained to them that I didn’t come to them for weight loss but to become stronger. I told them I that I wanted to increase my immunity levels.  I told them that when the energy drop comes during my run, I did not want it to come due to lack of nutrients in my diet.  I wanted to eat healthy.  I wanted to run strong.    

They made me report back on every small molecule of food which went into my mouth. I was made to generate data for them at an atrocious rate.   Recording data actually become time consuming.  I had to email data every day and carry hard copies with me. 

After two weeks, they started removing all carbs and fat from my diet.  They were high on proteins which I felt was good but they didn’t add anything else which I could use as fuel during my runs. 

By the end of one month I was finished. I had no energy left in my body and my runs became unbearably tiring.   I had bought thousands worth of supplements from her but they wanted me, an 80kg man, to live on a frugal carb and fat deprived diet.   

I guess they had never consulted with a marathon runner before.  I think that they simply had a large clientele of people who went to them for weight loss.  So although they had asked me my goals, they had no idea on how to help me get there.  They had put me on a weight loss diet.

I vowed to stay away from dieticians. 

But, of course, I couldn’t.  I knew I needed some help to sort out what to eat.  In my opinion, reading about diets is never enough because there is no one perfect diet for all.  A diet has to be tweaked to each individual’s requirement.  That is why one needs a living breathing person advising.

So let me tell you how I finally solved my problem.  It took me close to 10 years to sort it out.  Let me tell you how I came to see the light. 

It happened at a seminar organized for runners.  I was one of the speakers and so was one dietician.  I was sitting in the audience awaiting my turn while the dietician was speaking.  

Someone from the audience asked a question. “Ma’am, you advice that we eat two hours before the run, but you know in Mumbai sometimes we have to start our long runs very early because it later gets very hot.  How do we eat the breakfast which you suggest at 3:00am in the morning if I have to leave my house at 5:00am?”

The dietician didn’t miss a beat, she cupped her cheek in the palm of her hand to suggest that she was lying in bed with her face in the pillow and answered in a sing song tone. “Eat as you sleep, Eat as you sleep”.  The audience laughed and the next question was asked.  I wanted to punch myself in the face.

I am forever grateful for that moment because at that moment I saw the light!  I had realised what was wrong with every single dietician I had met so far.  

None of them were runners.  None of them were interested or played any sport. 

They were professional dieticians yes, but none of them had run even a 5K in their entire life.  

This lady couldn’t answer that man's question because she had no instinctive idea about the issues a runner faces.  

She had no firsthand knowledge of what a runner needs and experiences.   She simply didn't understand running the way even a novice runner does. 

What Dr. Tim Noakes has written about doctors is true even for dieticians.   His concepts for choosing your medical practitioner can be applied for choosing your dietician. 

So finally after a 10 year search, just 3 months before Comrades 2015, I found such a dietician.  Someone who was not just a runner but someone who was a Boston qualifier and someone who ran like I would want to run. 

She did not sell me a single supplement. She simply introduced a massive amount of natural foodstuff in my diet.  She added all sorts of seeds and nuts.  She added far more protein than I was eating. She added more vegetables than I was eating. She allowed certain fats.  She allowed certain carbs.  

My weight stayed stable and my energy levels increased.   She understood that losing weight wasn’t my goal, running strong was. 

She gave me different diets based on my weekly volume.  She gave me different diets based on my daily volume.   My pre-run meals differed based on intensity and volume of that days run. 

She gave me a different diet during my peak training weeks and she gave me a different diet for my taper weeks.  
She helped me to hydrate with healthy homemade drinks during the hot months of March, April and May when we did our peak training in the hot and humid Mumbai weather.  

She gave advice which was specific to a runner.  She knew all this because she was a runner.  I will always remain grateful to Roopali Mehta for what she did for me.

I have now learnt to never take advice from a dietician who is not a runner or someone who is not passionately involved with sports. 

But all good things come at a cost.  Finding this dietician also had a couple of major drawbacks. This new food regime drove Neepa nuts for all the new cooking and shopping which had to be done.  But Neepa going nuts, was acceptable. It wasn’t the major cost.   We actually ended up buying an additional refrigerator because of the amount of different things we ended up eating.   But then, who said that running was inexpensive.   

For those 3 months before Comrades, we stayed with her diet.  But now after Comrades, I’ve backed off for a while.  For now, I have been eating everything in moderation. 

And I believe that in the long run, perhaps that is the ideal diet. 

Eat everything in moderation!  

It's been 24 days since Comrades and I have been eating everything and more.   I have even been eating lots and lots of desserts and drinking alcohol.(these perhaps not as moderately as one should) 

I am simply enjoying the feeling of having finished another Comrades Marathon.  

But soon Neepa and I need to restart our training.  

Moderation, unfortunately, will again have to wait for later. 

Friday 19 June 2015

Comrades 2015: Dig Deep

Comrades 2015: Dig Deep

My African friends have a way of explaining their troubles during Comrades.  They use a particular phrase.  Often times a friend who has had to fight fatigue, cramps, nausea or other traumatic issues during Comrades will say to me. “Amit, I battled from 60km onwards.  I had to dig deep” 

To battle! To dig deep! I love these concepts.  They mean to convey that you were suffering and you were in pain but that you went way within yourself and pulled out some courage and fortitude and perseverance to continue your battle.  The battle is as much with your mortal self as it is with the distance, with the hills, and with Time.

Digging Deep! I like that concept. Comrades is all about battling it out and digging deep. 

I’ve been digging away at this Comrades road for some time now; with mixed results. 

There are different ways to evaluate a race.  There is the tangible evidence and then there is the intangible.  ‘Time’ is pretty much the easiest way to explain how well or how badly one ran a race.  It’s pretty tangible.  An 11:52:17 Comrades would mean that I ran a slow race and just made it to the finish by not much more than the skin of my teeth.  People might admire me, my spirit, and my endurance.  But the irrefutable point is this: I was pretty slow. 

Another way to evaluate my race is perhaps to explain how I felt during the race. 

I have a history with Comrades.  It’s a love-hate relationship.  I love the race.  I hate my athletic ability.

Coming into Comrades 2015, I was so worried about my ability that for the first time in my life, I became superstitious. 3 Masters degrees and superstition!  Even I find that hard to believe. I started seeing patterns.  The pattern I felt, was plain to see:

2015: ???

There was another pattern which I saw:
2009: Stay in hotel: DNF
2010: Stay with South African Friend: Finish
2011: Stay in hotel: DNF
2012: Stay with South African Friend: Finish
2013: Stay in hotel: DNF
2014: Stay with South African Friend: Finish
2015: I was Staying in a hotel : ???

Of course there was another data point:
2010: Down Run: Finish
2011: Up Run : DNF
2012: Down Run: Finish
2013: Up Run: DNF
2014: Down Run: Finish
2015: Up Run: ???

I saw these patterns and as race day came closer, I ignored the months of hard work I had been putting into my training.  I started ignoring all evidence that clearly showed that I was a far stronger runner than I had ever been in my entire life. 

Then two week before the race, Comrades announced an additional distance of approx 900 meters and slightly more stringent cut-off times.  Norrie Williamson, a well respected Comrades Coach went apoplectic!! He said that due to these stringent cut-offs an additional 4000 runners in the last G and H seeding will get cut-off . 

This additional distance and Coach Norries predictions, when added to my own idiotic conclusions (based on observing cloud patterns in the sky) seemed to seal my fate. 

Two weeks before the race started. I concluded that this was another DNF.  And from that point on, the negativity just fed on itself.  My hamstrings started hurting, my back started hurting.  I went into the worst place someone can be in the days before Comrades.  

As the day drew closer I tried again and again to remember the amount of quality training I had done since Feb 2014.  It was not just that I trained hard in 2015.  I had totally changed my training regime since 2014 and that had worked for me.  I had a physically comfortable finish in 2014 and once again I knew in my heart that although I would not make any significant ‘time’ gains, I should be able to finish 2015. 

But the negativity was just overwhelming my thought process and killing the little voice in my heart which said that I should be able to finish.

I started the race conservatively. I took early walk breaks. I knew that the first 37 km of the UP Run are simply brutal and any mistake in pacing will be lethal.  I had hoped to reach half way around 5:30. I reached half way in 5:40 but I wasn’t too concerned because I felt fine.  I could recollect how I had felt at the half way in 2011 and 2013 and could compare my present state.  I told myself that I was OK.

The heat kept increasing and the sunlight was blinding but this time I noticed that there was no hot head-wind like in 2013.  I was very focused on eating real food as opposed to a lot of artificial stuff.  Every half hour I kept eating.   

All through the day, I could keep on moving towards PMB.  There were no real down moments.  There wasn’t a point where I thought that I can’t do this.  
There wasn’t a point where I felt I am in pain and I need to stop.

When the 12:00 hour bus caught up to me, I didn’t feel any panic. I simply decided to run slightly faster than them since I didn’t like getting crowded-out by the huge bus.  I may have felt similarly in the past years but in those years I didn’t have the ability to put the thought into action.  In those years I didn’t have the ability in those late stages to run faster than the bus.

Throughout the day I was able to watch my surroundings.  I was able to make judgements on what I needed to eat and on picking up the right number of water pouches. I was in charge of my senses.  This was not something I was able to do in the years gone by.

With 7km to go, I decided that in spite of the discomfort, I would no longer walk. I ran all the way to the finish. I ran all the small nameless hills in these last few km.  With 2km to go I had 20 mins to finish and I know that in the past I would have walked because I would have felt safe. But this time, I had the ability to think. I decided that I could keep running and I ran into the finish.  I had the desire to run the 2km even when I had the luxury of walking into the finish.

And yet, it was only when I entered the stadium that I truly believed that I would finish 2015.   

Knowledge of history can be a positive source of encouragement. But it can also destroy your present, if you allow negativity to overwhelm you.  I had been so destroyed by my past Up-Runs at Comrades, that I very nearly allowed it to ruin all my hard work.

The mind has the ability to destroy the body way before the body even gets tired.  In fact the mind will tire the body before such time actually comes.

So now I had finished another Comrades Marathon.  But in a way, it never is just another Comrades. 

People ask me my time and I have to say 11:52:17.  I cannot help but think that thousands of runners finished before me.  The number of runners who finished ahead of me were more than those who finished after me.  People who trained far less than me finished before me.  People who were novice runners finished before me.

But is that really a measure for me?  I think not.  Perhaps I need to measure myself, only against myself.

‘Time’ does not explain my experience.  For the first time, I kept running throughout the race.  For the first time, I was in charge of my mind and my body for the duration of the race.  Although I had no faith in my ability to finish, I knew that I could keep moving forward. 

For once, I was able to notice the day around me.  I was alone but I was with myself.  I was so focused that I only spoke to 3 people during the race.  I had 3 short, 1 minute conversations.  But I spoke to myself all day long.  I strategized and I planned my race as I ran it.

So how do I feel about my race finish time of 11:52:17 ?

I feel that it is not something to write home about.

All that hard work that I have put in over the last two years hasn’t yet translated into 'Time'.  It has however made a difference in how I feel during the race.  And I think that if I continue to work hard, the next stage of changes will happen and I now have faith that my time can improve. 

However, I think on these lines for a few hours and then again it hits me.  11:52:15 is pretty darn slow !

Will Comrades always be, for me, such an intense battle just to finish? Will I ever finish in comfort? Will I ever have time to go to the International Tent at the finish and celebrate with my fellow runners? Will I ever be able to sit back and relax on the finish-line and share war stories with my friends? Will I be able to meet my friends on the finish line before they all go home?

Will my time ever improve? Is this an adventure worth continuing? Is there anything left for me to prove to myself? Must I work so hard to just simply finish with a few minutes to spare? And on some occasion not even finish? 
Should I now decide to simply give Comrades a rest and go and run other races or do I need to seek my true fullest potential at Comrades?  Must I continue this insane slog at the same target?

I sit back and think.  I come to a conclusion.

I have to continue to Battle.  I have to dig deep.

Osho tells the story of the great Sufi mystic, Jalaluddin Rumi.  “One day Rumi took his disciples to a field where a farmer had been trying for months to dig a well. The disciples were feeling a little reluctant -- what is the point in going there? Whatever he wants to say, he can say here. But Jalaluddin insisted: "You come with me. Without coming you will not understand."

What the farmer had done was, he would start digging in one place, he would dig ten feet, twelve feet, he would not find water and so he would start digging in another place. He had dug eight holes and now he was working on the ninth. He had destroyed the whole field.

Rumi told his disciples, "Don't be like this idiot. If he had put all this energy into digging one hole he would have found water, howsoever deep it is. He has wasted his energy unnecessarily."

And that's what everybody is doing. You start, you go a little bit, and then you start again sometime later, or some years later. You go a little bit from a different direction.

These little bits are dangerous. Your effort should be concentrated, and once you start, then go on digging, no matter how long it takes”

I will continue to Battle.  

I will continue to dig deep no matter how long it takes. 

I will never give up.  

Comrades 2016, here we come. 

Thursday 18 June 2015

42.2 or 21.1 ? Chaos or Ease?

42.2 or 21.1 ? Chaos or Ease?

Authoring “Dare to Run” got me some amount of recognition and made me many friends.  Many of these friends often ask me for advice when it comes to running.  But often times, I think that they haven’t read the book thoroughly enough.  They seem to be asking advice from the wrong person.
But recently, for the first time, I met a runner who actually knew whom to ask for advice.  Let me explain.

Moushumi is a passionate runner.  She has run a few half marathons. She is currently wrestling with a problem which is typical for many half marathoners. 

As the training season for the Standard Chartered Mumbai Marathon begins, she is not sure whether she should train for another half marathon or should she move up in distance to the full marathon. 21.1 km or is it time for her first 42.2 km? That is the question!

She has so many questions.  She has so many uncertainties.  All of them are relevant. 

Her questions basically get divided into two groups.  Those to do with the running itself and those that have to with the effects of running a lot, on life in general.
Although she hasn’t asked me for advice, she has over the last few weeks, articulated the questions to me.
Following is her list of concerns in no particular order:
1) Am I capable of running 42.2km?

2) Have I done enough half marathons to move to the full?

3) Should I first improve my half marathon time before I move to the full marathon?

4) Will I be able to physically handle the additional volume of training?

5) Will I be able to finish the full marathon under 5:00 hours?

6) Will I get injured with speed and hill training?

7) Will my coach agree to let me run 42.2?

8) Will I be able to commit the time to the training necessary for 42.2?

9) Will I be able to do justice in terms of my time and attention to my husband Manish and to my two children?

10} Will my social life remain in existence?

11) Will I be able to meet my friends as often as I wish?

All valid questions!

Before committing herself, she was searching within herself, for some definite answers.  She wanted a firm answer. She wanted her question solved. She wanted a guarantee given.  A surety, as she leaped into the unknown, that there was a safety net somewhere beneath to break her fall.

For once in my life, I didn’t answer these questions.  

The reason being, she didn’t ask me. She was simply ruminating aloud over the questions.

I of course had answers. If only I were asked!

My answer would have been based on what I’ve imbibed from Osho.  
I would tell her that there is no way to know the answers to these questions because unless one engages with life and the future, one cannot know what they hold.

“Life is insecure”, says Osho. “When you ask for security, you become insecure.

Life is insecure-that means life is free. If there is security then there is bondage; if everything is certain then there is no freedom.  If tomorrow is fixed then there can be security, but you have no freedom.  Life can be a security only if you are dead, then everything can be certain.

But tomorrow is beautiful because tomorrow is total freedom.  Nobody knows what is going to happen; whether you will be breathing, whether you will be alive at all- nobody knows. 
Hence there is beauty, because everything is in a chaos, a challenge, and everything is existing as a possibility.

Accept insecurity.  
Then the insecurity disappears and you are no longer insecure.  It is a paradox, but absolutely true. 

Up to now you have existed, so why be worried about tomorrow? If you could exist today, if you could exist yesterday, tomorrow will take care of itself too.

Just having the understanding, immediately you feel at ease.  But that ease is not that of security, that ease is not that of death, that ease is not of the grave.  That ease has tremendous chaos in it, but it is still ease, there is no tension. 

A chaos at ease – that’s how man should be.”

I would have told my friend Moushumi to welcome the chaos of the 42.2.  I would have told her that there are no guarantees in life.  Life is Chaos.  But that Chaos will bring her freedom.  She might face every single problem that she is worried about in her 42.2, but then she will have the freedom of responding to them and that freedom is Life. 

I would have told her that she is about to sign up for Chaos.  I would have told her to face the chaos at ease.

But she didn’t ask me for advice.  She asked Neepa, my wife.

A couple of days ago, Moushumi sent me a ‘What’s app’ message.

“Amit, I met Neepa earlier today and asked her whether I should run the 42.2 or the 21.1 and she said without hesitation that I should run the 42.2.  She explained that once I register, I will have committed and once I commit, I will train and once I train, I will finish.  I am glad I spoke to Neepa this now seems very simple to me.”

Well, I’m glad too.  Things are so much simpler with my wife, Neepa.  

She deals with Chaos at Ease.