Friday, 26 February 2010


Thought I would write about something I really dont understand but recognise in my day job as a surgeon and my hobby as an ironman.

The concept of flow to me is what it feels like to be travelling effortlessly downstream in a fast moving river where you are in control and expending minimal effort. This not to be confused with flow of blood in an artery for instance which whilst important is something altogether different. I will try to expand upon this...

Complex operations can take 4-6 hours to complete and are not unlike an ironman (ok maybe a half ironman event) in many ways. There is always a lot of preparation involved in undertaking planned major surgery, there is the event itself and then there is the recovery period afterwards (both for me and my patient!). Leaving aside the patient side (although not to ignore it as there are plenty of things I can do for my patient before they undergo a procedure to improve there chances of a successful outcome) there are plenty of things I need to put in place before an operation in much the same way as you would plan your race before you do it.

Assuming the planning goes well and the organisation works I can sometimes find myself operating without stress or worry. Whilst the process is challenging anything that disrupts the progress can be rapidly circumvented and overcome and the operation seems to flow seamlessly through to a hopefully successful completion. Some people talk about being in "the zone" which I guess is much the same thing.

Experience tells me that this situation can be difficult to sustain. External and internal factors come into play. Most external factors can be controlled; keeping the environment quiet without unnecessary interruptions such as mobile phones, not having other activities requiring my attention planned into the same time period, having clear understanding of the working relationship and responsibilities of those around me. Internal factors such as self confidence, frustration, anxiety and so on are more challenging but again are overcome by familiarity with the procedure, planning for the unusual or unexpected and maintaining a sense of progression towards the goal of completion of the procedure all help to sustain the flow.

Now tell me there are not parallels in IM racing. The external factors are largely beyond your control by the time you start your race but will hopefully be accounted for by your preparation, training, equipment, nutrition plan and so on. Finding the flow or getting in the zone comes when you have got all this controlled and after 20 + weeks of focused training you find yourself in the race doing the things just as you planned. The challenge comes when things start to "get complicated" much like they can in a complex operation. It is how you respond at this point and how you get back into the flow that can determine your race. When the legs start hurting, the nausea kicks and fatigue starts to limit your performance how do you manage it.. can you focus adjust and then get back on track or do you splinter and come to a messy halt?

The resilience and resolve to stay on track is clearly crucial to my patients when I am operating and I think is enhanced by my knowledge of the physical and mental reserves I have developed through IM racing.

Monday, 8 February 2010

Thoughts on running and training for an IM marathon

The standard question for those starting out and to some extent those experienced IMers it would seem is:

How fast should my IM mara be if I can do a standalone mara in X?

So how fast can you run and how fast should you run? A straw poll of tripetalk/slowbitch suggests about 30 mins add on is not unreasonable. Those with a faster standalone marathon time e.g.sub 3 may see less slippage whilst those with slower times may see more. Alan Couzens has written extensively on this topic and gives a lot of science behind this topic but still I some times find it hard to find the "take home message" in what he writes.

After 5 IM races I have a few thoughts on pacing IM marathons based on personal experience and observation. Sure I am pretty MOP but my performances are consistent with my training. Here are a few rules as I see it!

1. The stronger you bike fitness the faster you can run. The secret is holding back some of that speed on the bike in the race- which for most of us is nigh on impossible! I still find it hard to believe that if I finished my bike leg 5 mins slower it would have any other impact on my IM time than to make it 5 mins slower!

2. I train by doing all my runs at IM pace and almost none faster. I am older (42) and prone to running injuries. I find that by running at IM pace the fatigue of the rest of my training and life makes this plenty fast enough thankyou. Toying with speed sets incurs risk of energy and for what benefit. The only speedwork I might do is a HM or 10Km race. I would love to do more hill running as I think this is a great source of running strength but hackney is very flat! Having said that my best IM marathon has yet to happen!

3. You gotta get your calories right on the bike. I judge my bike speed by feel and the need to get the calories in. For a 5 hour bike I use 1 litre energy drink for first 45 mins then 12 gels 3 energy bars and water for the rest. If I am doing it right the food all goes down and stays down and I may be able to stick in that little bit extra calories in the last 10 mins of the bike (also helps to keep focus). If I start feeling sick, hot sweaty unwell whatever I tend to slow a bit and drink water until the feeling passes. In effect this means I keep my HR below 140-145as I know that when my HR exceeds this I cannot effectively digest food.

4. Setting out on the run I always feel crap with my HR jumping all over the place, by back is stiff and I cant get straight and any leg worries I have will be there! In spite of this MY FIRST 10 KM IS ALWAYS MY FASTEST! I use this knowledge in two ways now. Firstly I no longer worry about feeling slow so dont try and chase any athletes pushing past and secondly I settle on trying to find a comfortable rhythm before working out what I can eat and when.

5. Eating on the Run- Experience has taught me that the coke will be fizzy, the drink at IMCH gives me cramps, the cup will split and I will throw most of it up my nose, but the gels are usually reliable and predictable. I now carry six gels for the first 2 hrs. I try and eat a gel every 20 mins just before a feed station and follow this with water. I try and work out where and what gels are on offer and then plan my restocking when I am on my last gel (they do run out sometimes). Again this gives me a focus e.g. concentrate on timing of gel before aid station etc but also avoids the vagaries of cups of variably mixed "EZO" or whatever 'nergy drink.

6. When I am feeling good eat... a common mantra but a true one. So when I felt good at 15 km in IMCH I ate 3 gel in 30 odd minutes which carried me on to the last 10km (at which point I lost my discipline or reached the envelope of my fitnees) where I suffered for not eating and thinking I could start racing!

7. Hilly rides take longer and have a negative impact on your run split. Stands to reason that if you are cylcing for an extra 45 minutes at the same power output you are likely to run slower afterwards. I also prefer more temperate race conditions and have struggled in the heat (either that or the reason for performing slower in Lanzarote is that I have not been as fit!)