Saturday, 4 November 2017

What I am Reading Now

 My current reading diet is mostly inspirational. This is what I need right now, tales of what humans can endure on their own two feet. I just completed the longest event of my life but I still consider myself to be in recovery from earlier injuries. Rest period; I need ideas, motivation.

I’ve been travelling for the last two weeks and on my birthday in Columbus Ohio I was given three books; one each from Jane, Cam and Molly; and they were all about running and mountains. Perhaps this was a signal that it’s OK to carry on where I left off in Cartmel 4 weeks ago. Or perhaps that’s just wishful thinking; we’ll see! 

I stayed on in the states after the family went home and I chose the two paperbacks to read on the planes, leaving the huge glossy hardback for when I got home.

Run or Die – Kilian Jornet

I have known about Kilian Jornet for some years now but this is the first time I have read anything that he has written (or at least read a very well translated version of it). Not only is he an amazing runner and mountaineer but he has an engaging narative style and paints a picture much wider than his incredible achievements.

I was surprised a few weeks back to learn that the husband of one of my wife’s clients has just appeared on Kilian Jornet’s Instagram page.
Dave is a bit of a running and BMF star locally and he knows how to grab attention. He was running at the recent Glencoe festival when Jornet, passing by, snapped a picture of him climbing in a pink tutu!

Jornet clearly loves a story and his book is a great tale of the life of a world class cross country skier and mountain runner.

He asks himself some powerful questions including "why do we run?", and "where do you go when you have surpassed the feats of your idols?" Where do you find inspiration now?  Clearly this will never happen to me but we all need to learn how to re-set our goals. As we grow older we grow slower and it is important to grow wiser, to sometimes look outside the box when setting our new goals. 

Jornet's goals have spread to cover the globe, and his prowess at ski mountaineering has enabled a world of high-altitude possibilities for racing and adventure. Jornet is still a young man and I worry that with his love of danger (just check out his Facebook page!) there may only be an all too familiar one ending to his story. How many of the authors of the mountain adventure books on my shelves are still around to tell their tales?

This book was written a few years back and Jornet is still at it, breaking records (including the fastest ascent of Everest this year) and seemingly smiling all the time. And the very fact that he was there in Glen Coe smiling and taking photos of pink Dave from Sussex and posting that on his page suggests to me that he is on a relatively sound path forwards.

Running Man – Charlie Engle

Charlie is an alcoholic, an addict; and he is a world class ultra runner. Right away this book got my attention. I often struggle to answer the question of why I run, why it is that I will happily go out and endure discomfort and pain for several hours at a time. Once or twice I have described it as an addiction, but never having been addicted to anything else I was not sure that the description was a fair one. Now I am.

A good book about running is often not really about running at all, it is about some other struggle, some other story. Running is just the medium through which the tale is told.  This is true for Running Man. Right from the start we know that Charlie is no ordinary athlete; he wanted to be great at everything he tried and he longed for recognition from those he admired; on failing to achieve this recognition he turned to alcohol and become a recognized champion at that instead.  

I have not read a better account of addiction to alcohol and drugs, of the way it affects the individual and all those around. Maybe it is the fact that Charlie consistently returns to running as a form of salvation that attracts me to him – surely many people would right him off as a looser from the start and perhaps only because I know where the story is going I force myself to listen to the depths of depravity and desperation that he seems incapable of escaping, despite its effects on family, career and friends and Charlie himself. I wanted Charlie’s escape to come sooner but he kept sinking lower, at times I almost wept for his mother, his kids and for him.

I have never really understood how Alcoholics Anonymous works. Now I do and I have learned an important lesson. Charlie has not drunk for 20 years but I understand that he is still an addict, and there are times when only another addict can understand the torments that he still encounters and help him to face up to them.

As a side note it was interesting to learn that Charlie was one of the very few people to be jailed as a result of the housing crisis that hit the US in the first few years of this century. Not for miss-selling mortgages (as so many bankers were happy to do and were not jailed for it) but because his accountant lied on a mortgage application form.  In spite of this awful injustice he used his time in prison well and when he couldn't run in the Badwater Marathon he ran the 136 miles with 540 laps of the prison track instead.

In the end escape did come, in  the form of an addiction to adventure running (a bit like ultra running but harder). Only something so incredible as running across the Sahara was enough to replace to hold that drugs had on an otherwise well loved and respected man.

Now I am looking forward to reading the glossy hardback Running Beyond by Ian Corless

Closing off a neat circle this book, with a foreword by Kilian Jornet is chock-full of great photos and descriptions of Ultra racing.

It was just such a book that last Christmas got me interested in running another big Ultra, and it was Ian’s photography, particularly of runners descending Halls Fell Ridge on Blencathra, that fired my enthusiasm for the Lakes In A Day race. He was there in the clouds taking pictures again 4 weeks ago but I was too busy watching my footing to smile for the camera!

Time to pour a glass of red wine, put my feet up and dream….

Monday, 9 October 2017

Train Low Race High - The Lakes In A Day

In all of the events that I have run since starting on the Low-Carb High-Fat diet I have set out to show what can be achieved when competing on very low carbs.  I have run my fastest off-road marathon on almost nothing but fat and I have successfully trained at very high intensity on a low-carb diet. But I am also aware that many proponents of the diet actually rely on carbohydrates to fuel the prolonged high intensity work that often comes when competing.

I hoped that with good pacing I could stay within my fat-burning zone (perhaps 80% of my VO2 max) for the time taken to run a fast marathon. And I think I have proved that I can. But some events place unavoidably high demands on your strength and endurance; mountain running is a good example.

When I entered a 50 mile Ultra across the Lake District National Park I was under no illusion that I could do it carb-free. The ascents would be long and grueling and would doubtless have me burning glycogen whether I liked it or not. So it was time to experiment with Train Low Race High.

You could be forgiven for thinking that this post's title was a reference to the fact that I live in Sussex where the hills rise to a mighty 250 meters above sea level, somewhat lower than the Lake District peaks I would be running over, but that's almost as far as I'll go with that metaphor, much as I like it!

So here is an account of the longest race of my life and my approach to nutrition.

Last Saturday morning at 8 a.m. I stood on the start line of the hardest event that I have ever entered. It had been a long road to get there and I had no idea if I was going to finish it, but I was determined to try my hardest.

Last Christmas Jane gave me a book entitled "50 Races to Run Before You Die", and brimming with confidence I entered The Lakes In A Day Ultra a 50 mile event that traverses the Lake District from north to south by way of nearly 4,000 meters of mountains.

I've always wanted to run a long one in The Lakes and being fighting fit at the time I laid down my plans in the depths of winter; perhaps I could finish inside 13 hours. That would be something special. Then in February I injured my knee and could not run properly for the next 7 months. If you are a regular reader of this blog you may have wondered why there have been so few posts this year, and the truth is that there has been almost nothing to write about!

I've spent a lot of time this year cycling and walking, and slowly building some jogging into my walks. I completed a 100 mile bike ride in 5.5 hours. I knew that I was fit but would I be able to run? 

Sometimes a little gentle jogging worked and sometimes the pain returned. The consultant looked at an MRI  scan and said rest, and so from May I rested from running completely for 3 months. The training plan changed and there was no room for any more injuries, but it still looked sort-of achievable, perhaps. 

All of my endurance walking was completed on a low-carb strategy. This included several 20-30-mile walks on just eggs & bacon for breakfast and a few bottles of water. 

The essence of Train Low Race High is to train your body to burn fat as effectively as possible and then add carbohydrates at the last minute to give you more power just when you need it. Adding carbs earlier or relying on them entirely would leave me susceptible to bonking into The Wall. I was sure that I could go all day on fat, I just needed a top-up for the hard bits.   Only in my last training walk/run did I experiment with an energy drink just to learn if my stomach could tolerate it. It's been a few years since I used an energy drink and I look back on Powerade and the like with some distaste. The Tailwind drink was not so bad as I'd feared so into the bag it went.

In France on holiday I learned more about how far I could push my injury on longer walks. After an hour or so my right knee would hurt a little, but after easing up the pain would subside and I'd be good for several more hours with no problems afterwards. I also figured that for a 50-mile mountain event "walk/run" was a pretty good strategy. There is no way that most entrants would be running more than half or even a third of the event and approaching it as a walk with a bit of running rather than a run with a lot of walking made good sense to me. I certainly put the miles in, the only thing missing was the altitude. As I mentioned before Sussex is not blessed with mountains and so my long walks had a lot of ups and Downs.

A typical training walk/run on the South Downs
I hit my reduced training targets in the nick of time without having run for more than 4 miles at a time since April. I was concerned by this of course but I drove up to Cumbria with Jane just hoping to finish the event at all. Above all else I was determined to enjoy it.

Jennings Ale - The fuel of champions!
In the two days before the event I started adding more carbs to my usual low-carb diet. Mostly in the form of bread and potatoes. The night before the race I enjoyed a couple of pints of Jennings in the pub at Caldbeck - it is a fell-run after all! Breakfast was an energy drink, a big bacon bap and a bowl of Alpen.  I carried 3 sachets of Tailwind energy powder and planned to scoff pizza, flapjacks and soup in the 3 feed stations along the way.  

Ready to roll
The first half was brutal. 27 miles, 2,500 meters of mountains, driving rain, a horrendous wind on the high tops and deep bogs on anything remotely flat. It had me cold and wet in the first two hours. I couldn't fault my Haglöfs jacket, OMM shorts or Salomons. But in order to keep warm I had to keep moving quickly.

I had planned not to take the direct route down from Blencathra as I feared for my knees, but the longer easier route was directly into the wind for the first mile; there was only one way down. There were queues of nervous runners inching their way down Hall's Fell ridge. 

Looking down Halls Fell Ridge to Threlkeld on a good day
It's not the steepest ridge but it's up there with them and a fall would have been serious. The wind was in our faces one moment and on our backs the next, not good on steep wet rock. We were all on all-fours on the steepest sections. Luckily I've done this sort of thing a few times before. I took a few risks to overtake the crowds and my knees held firm. 

Seeing Jane at the aid station at Threlkeld was a welcome sight. I refilled my drink, ate a quick ham&cheese roll and a flapjack and I was off. Only another 40 miles to go!

I then broke a walking pole crossing a slatted wooden bridge and had to manage the 17-mile Helvellyn range with one pole. All of my training has been with my lightweight Black Diamond carbon z-poles and so the ascent of Clough Head was all the harder with only one. I was working as hard as I could for 45 minutes. Taking turns with the remaining pole my arms were hurting badly; even so I was ascending faster than everyone around me.

Surprisingly when I got onto the long Dodds ridge I was able to run a good deal up there; it was bleak and I just wanted to get down! The wind picked up more with the altitude and being on a west-facing ridge - it was gusting well over 70 miles per hour and the horizontal rain was stinging our faces.  I ran with a group of about 10 others and we all seemed desperate not to get left behind; visibility was very poor and at times it was scary up there! Looking at the GPS tracker playback of the event I can see that several runners made some big mistakes on the ridge. Luckily I knew the route reasonably well and with just my compass I made a few good choices when the others were fetching their maps out. That kept me in touch. My running was slower but my climbing was faster. Then my left knee started hurting badly on the descents and I feared that I would have to stop. I got left behind on Helvellyn and I was very slow heading down to Grisedale tarn. I was hobbling, hurting and on my own. I felt low on energy but perhaps more from the cold than from the running.

Just beyond Fairfield I bumped into a lady who had fallen and was dazed. This was a section that I've never done before; she had but she didn't recognise anything. We soon got moving but we were heading up when we hoped that we should be going down!  I trusted the compass and I stayed with her until she knew that we were not lost. By now I was shivering badly. Just checking the compass meant having to stop and get colder still. On the decent she passed me as I was hobbling and cursing. This section of the route took an hour longer than expected. I'd finished my energy drink and was  feeling very low.

I was about ready to give up at Ambleside when Jane appeared out of nowhere high up on the ridge above Sweden Crag with a fresh pair of  Z-Poles and a big smile. And just at this time the clouds parted to the south and we shared one of the classic Lake District views over Windermere. That did it for me, I was determined to go on.

First smile in 15 miles
The loss of 800 meters of altitude and a few slices of hot pizza at the food station in Ambleside warmed me up nicely. I soon felt strong again and I set out on the second half with a spring in my step. My knee was getting much better now that I was away from the rocky descents and I was soon able to run again.

The sun went down and it felt like I was on the home straight (albeit a 24 mile one). I knew the way alongside the lake and through the forests after walking this section on a family holiday at Easter. The sky was clear and a full moon rose over Windermere; a beautiful sight.

The lake was full too and at times I had to wade through it as the path skimmed the shore. Oddly this was a pleasure as it soothed my feet and I soon warmed up again from the constant effort. Jane met me three more times with encouragement and the miles flew by. 

Despite not having trained at night I was happy to be on my own in the dark. No one passed me in the second half and my energy levels were still high. I can't shake off my competitive spirit and it felt good to be steadily passing people. Even the incessant mud was not a big problem, with two poles I was able to stride confidently through it.  I think it’s fair to say that I ran (or at least jogged) everything that was runable in the last 20 miles of the race.

Two cups of soup and a sausage roll at the last aid station and I was off again into the moonlit mudfest; the bog was up to my knees in places.  When I finally hit the lanes I ran the last 2 miles down into Cartmel at 11 O’clock with a big grin on my face and half a bottle of energy drink left in my sack. 

It had been a wild adventure. I was down an hour and a half on my target time for the first half but the second half was as quick as I had expected (and nearly 2 miles longer!) and I finished in 15 hours; inside the top 20%. There was cheering from folks outside the pubs and I ran through the village like I was finishing a 5-miler. Such a great way to finish my first Lakeland Ultra after 8 months of pain and doubt.

Still smiling!
The organisation for the event was impeccable. The marshals were great, popping up in the most unexpected places; the aid stations were packed with good food and good cheer and the whole atmosphere was perfect.

On the day I estimate that I consumed between 2,000 and 3,000 calories (I'm not one for counting), mostly in the form of carbohydrates and mostly in the first half of the event. This compares to the 9,600 calories that Strava estimates that I used over 15 hours. I was able to deal with the mountainous first half with the aid of some glycogen and I was able to keep going strongly in the second half due to my long-term adaptation to fat-burning. This is not a proof of anything but the Train Low Race High strategy appears to have worked very well for me.

Thanks Jane, for putting me up to this challenge and seeing me through it!

Here is the Strava Route Profile

Saturday, 30 September 2017

The Long Road to Caldbeck

It’s been another strange year for running and me. Much like last year I was injured in the spring and couldn’t take part in the Brighton Marathon. I have not made the start line for 5 of the last 6 classic Brighton road races and the 6th was cancelled due to high winds!  

I picked up an injury training for the Brighton half and it persisted for a lot longer this time; I ignored the warning signs and suffered badly when I had to hobble home in pain one weekday lunchtime during a light jog around the village.  After several false and painful re-starts an MRI scan in May showed the problem to be fissuring of the patella cartilage which make your knee look like cracked mozzarella (on the inside that is) and does not mend quickly.

Mozzarella Knee
Luckily my first big target for the year was the Prudential London-Surrey Ride 100 cycling event at the end of July and despite not being able to run I could cycle pain-free.  Also I was unemployed for two months in April and May so I was able to get stuck into my training in a big way four months from the event. Regular long rides around Mid-Sussex enabled me to ensure that my ‘hopeful’ target of six hours for the 100 mile ride was an achievable one. I have never ridden this far on roads before (the South Downs way is almost 100 miles but it’s off-road and it took more than twice this time) and I wanted to ride the 100 miles without stopping, so nutrition was a big focus of my attention while training.

The temptation to run kept calling, but each time I tried, even for a 1 mile jog, the pain would return. So I decided not to run at all from late May through to our annual camping holiday in August. That was hard. I love running!  Luckily the cycling got better and better and I approached the 100 mile event in a cloud of excitement and trepidation. The roads were closed and there was a big field, and not having ridden in a group for more than a few miles before I had no idea what the excitement and the drafting effect might do to my speed and endurance.
Waiting for Le Depart
I started from the Olympic Park in Stratford on time with 24,000 other riders and had the best day out that I have had for years. Drafting was easy with no fear of red-lights or dash-outs. No one got too close and I probably spent half the time on someone’s wheel and half with someone on mine. I felt strong at the start of the hill climbs that come after 65 miles and cruised up Leith Hill and Box Hill with bags of energy in store. 

I had originally intended to ride on very low carbs for the day, much like my recent marathon runs but during training rides I had felt tired after 4-5 hours and decided that ‘train low, race not-so-low’ was a fine approach, limiting myself to a pair of Cliff Bars cut into chunks and stored in my frame pack so that I could get at them easily on the move. The day was not too warm and surprisingly I managed the whole ride on just two standard size water bottles. I didn’t felt thirsty until after I’d finished. I probably consumed about 600 calories of carbs during the day including eggs & bacon for breakfast and perhaps the same in total in the 3 days leading up to the event; this compares favorably with the 2-3,000 calories that is generally recommended to get you through a 100 miler.

Much like my experiences running marathons as a fat-burner my energy levels remained high all day. The last 20 miles back into London were fantastic and I rode them at about 22 mph. My average for the whole ride was 18.3 mph, hills and all. This compares rather well with my 18 mph average for a 50 mile training ride just two weeks earlier. No mechanicals, no toilet stops and no accidents all led to a finishing time of 5 hours 30 minutes, which I am very, very pleased with.

My second big target for this year is the Lakes in a Day Ultra. 50 miles of varied peak and forest trails with 4,000 meters of ascent from Caldbeck on the northern border of the Lake District National Park to Cartmel on the southern border, via Blencathra, Clough Head, Helvellyn, Fairfield and the whole length of Windermere.  This is a hard event, a good deal harder than anything I have ever done before and with such a bad knee injury there have been numerous times when I have been sorely tempted to give up on my attempt for this year. I have been living on the knife-edge of a training plan for six months and until 8 a.m. on the 7th of October that’s where I will remain.

I decided that I could train for this event by focusing on long distance walking (which luckily I can do without very much pain) and building in some running from the summer onwards if my knee responded to the period of relative rest from May to August. There was little room for failure here as this left only two months to turn a walking plan into an Ultra plan.

To be clear, no one actually runs all of this 50 mile event; it is a mixture of running where possible and walking on the steeper sections, which make up a large part of the route. The record time of 9 hours 12 minutes was set at an average pace of about 5.4 mph. This may sound slow but remember the 4,000 meters of ascent and decent; the equivalent of scaling Ben Nevis three times. 

Progress was slow in the early summer but I had the 100 mile ride to focus on. My consultant hinted that he could provide a cortisone injection if the pain didn’t recede but he also reminded me that this might lead to a false recovery. Knowing me I’d be tempted to run before I could properly walk and in the long term this approach would probably speed up my inevitable decline. I hope to keep running for a good few years yet and so a proper recovery was clearly the best way forwards, even if it meant not making the start line once again.

As has happened before (see my BHM post) things started to improve during our camping holiday in August. I'm sure that being on my feet all day rather than sat behind a desk is very good for the legs. I managed a little jogging at first and this progressed to a 15-mile walk-run by the end of the fortnight. This together with several brisk long walks of between 20 and 30 miles in length at a pace of 4 mph left me feeling much more positive about my ability to complete. I had hoped to beat 13 hours (if I am fit I normally take the record time and add one third) but my "I’d be happy with this" target of 14 now seemed just about achievable. Although having never walked or run this far before this does leave a lot of scope for error! 

There was pain during the long walks and I’ve spent many hours on the point of packing it in and calling for Uber and a pizza; but often as not the pain would melt away after an hour or two leaving me able to walk happily for another 4 or 5 hours. I’m not suggesting that we should ‘run through the pain’ as many hard-as-nails fell runners would advocate; when the pain comes I slow down, change my gait, have a drink of water or pick some blackberries. The challenge has been more mental than physical, and as we get older I think we get stronger mentally.

I may have mentioned once or twice before that I love running fast and challenging myself. My wife, a personal trainer, often remarks on how most people need someone to motivate them to get their trainers on and do some hard work. But that’s not my problem at all; conversely what I need is someone to hold me back. With typical over-enthusiasm I returned from France with a desire to burn up the hills in anticipation of the mountains to come in October. As soon as I’d unpacked the trailer I put my Salomon’s on and tore up and down the Tank Tracks 4 times. It felt great, up until 100 yards from the end of the last hill when a tiny prick of pain stabbed my left calf.

Over the following month that prick of pain has receded but only slowly. I’ve cursed my stupid self many times but oddly it may have turned out to be a good thing in the end. The mild pain spreading from a tight ball in my calf has not stopped me from completing a series of brisk 30-mile walks and I’ve thrown in some light running too including an pleasant jog along the 7 Sisters from Cuckmere Haven after 7 hours of brisk walking. 

Cuckmere Haven looking like a watercolour
Without this restraint I may well have started to focus too much on running and not enough on fast walking. Long hill runs require lots of recovery but my target-paced walk/runs are much lighter on the limbs and very much more specific training for what I am hoping to achieve. It’s going to be a long slog but I’ve been slogging it out at about the right pace on a regular basis for several months now. 

When I decided to continue training for this event with a bad knee I set myself a red-line, a target training effort that would decide whether Jane and I would make the long-haul up to Cumbria for a weekend away from the kids and mostly away from each other. I try to be realistic and I like to finish what I set out to achieve. I have DNF'd only twice before and I did not feel good. I want to enjoy this experience and I knew that if I was not in a fit state to perform then there would be little chance of that. Better to be in the garden weeding!

And so in order to go to The Lakes I had to complete a 30 mile route with at least 1,000 meters of hills in under 7 hours with no bad knee pain with at least 3 weeks to go before the event. Ordinarily this would not be such a challenge for me but from where I was sat back in April I clearly had a mountain to climb. A fortnight back, with no time to spare I passed the test and now my bags are packed and ready - despite the fact that I write this post from Portland Oregon! I’ve seen enough of the South Downs Way for this year and now it’s time to head north. 

With one week to go I have just about enough miles in my jet-lagged legs, I have a willing chauffeur (actually Jane put me up to it in the first place), I have the hotels booked, I have the shiny new kit required, I know the route (I receed the second half while on holiday in the Lakes at Easter and I know the first half from the past) and, most importantly it looks like I really will be there on the start line with 450 other runners in Caldbeck on October the 7th.

What could possibly go wrong?

Tuesday, 21 March 2017

PCSK9 Inhibitors - the new way to screw the NHS for every last penny

Did you hear the “Amazing” news about the new generation of Statin drugs that was announced at the weekend? The new PCSK9 inhibitors like Evolocumab are even more effective at lowering LDL cholesterol and according to many this makes them a wonder drug.

The issue with statin trial data was simply a question of whether it is actually valid to rate a drug on a surrogate endpoint such as lowering cholesterol rather than that of saving lives. However the trials for Evolocumab went further than this, they provided real data on the expected outcomes for patients. Great?

It was a surprise to me that these new drugs need to be taken as well as a statin; so the question of the side-effects of statins is still very much alive. Again the advocates such as Professor Rory Collins will claim that the benefits vastly outweigh the side-effects, but this article in Today’s Times puts that argument to the sword.

Put simply, the number of people that need to be prescribed Evolocumab (at more than £10 a day) to prevent one of them having a stroke or heart attack is 74. Yes, 74 people need to take the drug every day for two years, in addition to a statin, to prevent just one of them having a stroke or heart attack.  

Just to repeat, that is 74 people and £540,200 of NHS funds in order to save one stroke or heart attack every 2 years. 

Does that sound like good news to you? Spend that money on dietary intervention and you might prolong hundreds of lives.