What is Time?

To quote Saint Augustine, “What then is time? If no one asks me, I know what it is. If I wish to explain it to him who asks, I do not know.”

A quantitative expression of time, defined in physical terms, is that it is a measure of changes of a system. However, from a philosophical perspective if we are the system, this will have a large impact on how we think about time and the temporal aspects of reality.  So, why the venture into the thorny subject of time, and run the risk of getting all bogged down in quantum physics? Well, it seems that it’s been a few weeks since my last blog entry, yet ‘lymphoedema-time’ has different characteristics and, in my system, time is on a go-slow.

It’s been a tough learning curve to realise that for my body, the healing process is now incredibly slow-moving, that an injury which should realistically have cleared up within weeks has instead taken months. My new reality has undergone a temporal shift but finally I am getting to a place of equilibrium and acceptance. I now fully understand that time moves at a different pace to my pre-lymphoedema entity and having acquired a new life-skill of patience (though not particularly graciously!) I am now on the road to recovery. My softly, softly approach and willingness to spend hours doing laps in the swimming pool seem to have paid off and this week I have managed a couple of hours of riding and even a 1 hour walk / run session. My knee isn’t completely fixed, but I have a handle of what I can do without ruining all the good rehab work that I’ve done, and as long as I continue to take small steps forward, I feel optimistic. This is a major breakthrough for me and means I can start to contemplate the prospect of riding the 520K from London to Paris this June.

I signed up for this event back in November last year, blissfully unaware of the problems that were to follow, and managed to persuade one of my friends from my days at University to do it with me. Imagine how troubled I’ve felt recently when I didn’t know whether I’d be able to participate, especially when I tell you that Rich is coming all the way from Brisbane! It may still all go horribly wrong, but if I can manage back-to-back 2 hour rides this weekend, followed by back-to-back 3 hour rides next weekend, Coach Helen and I reckon it is 'game on'. We then have eight weeks to build the necessary layers of fitness.

The other example of ‘lymphoedema-time’ is the period that has followed since my diagnosis pre-Christmas and obtaining relevant and useful assistance. I come from a long-line of problem solvers and there are more than a few ‘project managers’ in my life, all of which I can pretty much hold my own with. Hence the tasks of identifying specialists, making arrangements for consultations, and following up with practical applications should all have been straightforward to tick off the list. Not so. Being proactive, I have been lucky enough to build a network of people that can help me, notably experts like Prof Mortimer. But from a day-to-day lymphoedema-management perspective I have had no sway over the time it takes to get into the local NHS system. Thankfully this has started to happen in recent days and I am now under the care of a registered lymphoedema therapist, I have been prescribed with the first tranche of medical compression garments and a request for funding for Manual Lymphatic Drainage has gone to my local PCT.

Adopting a new ‘take’ on time has helped me build on the Zen state of mind alluded to in my blog entry on 13^th January and not to get completely stressed and depressed either about being injured or having to deal with lymphoedema. Is there any relevance of time in the present in connection with time in the past? I guess not. Focusing on the now, it all seems to be coming good again, and I fervently hope this augurs well for the future. Tick tock.

Softly Softly Catchee Monkey

After a mixed response to last week’s slightly unorthodox blog entry (that took the guise of some fascinating discussions but also one or two yawns!), this week I return to more commonplace topics of Lymphoedema and exercise, or rather lack of exercise and too much oedema.  This is the eighth week since the injury to my knee forced me off my bike and into the pool. Since then I've covered almost 45 miles of swimming, spent hours in the weights room and have stubbornly endured almost 13 hours on the hand cycle. What should have taken 3 to 6 weeks at the most to heal has shifted expectations of normality and brought home how much things have changed since the lymphatic system in my right leg gave up the ghost.

To give my malfunctioning healing-system a much-needed boost, I had an injection in my knee around 10 days ago. The standard theory post an intervention of this type is 3 days of rest; I had 5 days off as a sort of ‘belt and braces’ approach and because we just don’t know what is ‘normal’ for me yet. Extremely tentatively, I have since started back training. Alternating between the cross-trainer and low wattage cycling, supplemented with yet more swimming, I have managed 20 minutes, then 30 minutes and am now progressing to 45 minutes back on the bike. Nervously I am monitoring every second, and there is still some soreness, but it is a different type of discomfort. A few years back after a heart-breaking Achilles injury that ruined my pretensions of being a competitive runner, I experienced a similar pain when I returned to the treadmill. Then it was just a case of the muscle memory hanging on to the pain sensation, and this time round I’m fervently hoping it is the same. So softly, softly I am following yet another rehab plan, and if I can survive this week unscathed, there will finally be a light at the end of the tunnel.

This will be just as well as during this injury period my ability to manage the lymphoedema has been woefully inadequate. Without the tool of exercise, lymph clearance has been pretty much nonexistent and my leg has swollen substantially, dealing another blow to my wretched mental state that has been under siege for a number of weeks now. Here too though, I see the light breaking through. My diagnosis of lymphoedema was delivered on December 14^th, and now almost four months later, next Wednesday 6^th April, I have finally arranged an appointment to see a Lymphoedema specialist in Brighton. This is the culmination of a good deal of effort in finding the right person to deal with and waiting while referrals are made, but it is quite a relief to have identified someone who has a wealth of experience in dealing with Lymphoedema. This means I can get properly measured and fitted with medical-grade compression hosiery, perhaps not the most aesthetically pleasing garments but significantly preferable to a distended and swollen limb which is the alternative! I should also be able to get a course of Manual Lymphatic Drainage, as and when needed, and be tutored in the skills of self-massage rather than replicating what I have read in a pamphlet. Moreover, it will be a comfort and encouragement to have someone to talk to on a semi-regular basis, who understands lymphoedema, and can guide me from a practical perspective on the management of the condition.

Don’t say it too loudly, but ‘softly softly’ could bring a fresh glow into my life next week, with a return to training and access to much-needed professional help on the Lymphoedema front too. Fingers crossed that it’s an easier roller to ride.

Natural Laws

It is not often that I talk about my work. Mostly this is because it’s quite difficult to explain what I do, that when I do it’s not easy to understand and more fundamentally it’s just not that interesting unless you are a maths or markets geek. However, currently there is some relevance, so the short of it is that I earn a living from meticulous analysis of the movements in price series in the financial markets. Using a number of proprietary mathematical models to map the characteristics of a series, I try to gain an insight into forthcoming price action. With my principles rooted in Gann analysis, one of the techniques I employ is the Law of Vibration.

This is a universal law, with many and varied applications. It refers to the premise that the essence of all things is vibration; that everything in the universe is composed of packets of energy and each of these vibrates at specific frequencies. In a pure form it is a simple process to map a standard vibration or oscillation about a stable equilibrium point, be it, for example, the periodic motion of a pendulum or the sine wave produced by a tuning fork.  Bizarrely, the law of vibration is often cited on self-help sites as an essential element of wealth creation, that successful and prosperous people have a common emotional frequency. It’s said that aspiring individuals only have to identify and adopt said frequency to change their lives and wealth. This is not something I buy into, but it does illustrate how natural or universal laws can be applied.

What is important to understand is that even within a system that is well documented, like the financial markets, there are shifts in the resonance or rhythm which alters the nature of the vibration, and this is where an analyst worth their salt will make their money. It’s knowing when the parameters have altered and adjusting accordingly.

The transition from a stable to an unstable system can have devastating effects, in physics terms this can be related to the difference between free vibration and forced vibration, when an unexpected shock is applied. In recent weeks we may all think that the world has gone mad, but perhaps it’s all down to a monumental force applied to an increasingly unstable new vibration mode. We have seen seismic shifts on a geopolitical level that have swept through the Arab world resulting in regime change in a number of countries and now the prospect of a conflict in Libya that has extended the reaches far beyond geographical limitations to the international world. The geophysical system has also been shaken to a new vibration period, amplitude and frequency by the recent earthquakes that have wrecked havoc and resulted in mind-boggling and heart-wrenching loss of life and livelihood in Japan and New Zealand, not forgetting the floods and cyclone that hit Australia. These disasters have shaken to the core the physical foundations of our natural world.

On a fractal level, my natural vibration has had an external force applied and my rhythm has been thrown off balance. I feel like bad luck is piling up, that not only have I had the diagnosis of lymphoedema, a condition that I’m going to have to deal with every day for the rest of my life, but to compound it, I have suffered a particularly nasty injury that means I can neither do the things I love, like cycling and running, nor can I manage as effectively the swelling in my leg.  Sometimes I just want to scream why me? Don’t get me wrong, I’m not comparing my situation with the suffering elsewhere in the world, on that scale it doesn’t even register, but to me it is not inconsiderable.

Looking forward, on a rational perspective, people in Japan, New Zealand and Australia will rebuild their physical lives; the nations whose political systems have been dismantled will also emerge with new governance and hopefully fledgling democracies will endure. I too will manage, adapt and move on. The law of vibration can be used as a vehicle for good; it’s up to me on a personal level to make sure this is the outcome that I achieve.

Wednesday’s Child

For those of you familiar with the nursery rhyme Monday’s Child, which tells a child's character or future based on the day they were born, you’ll know that “Wednesday's child is full of woe”. This is rather apt as I am a Wednesday Child and have been known to carry round my own little bag of woe. That’s not to say that I suffer from anything as serious as depression but I do sometimes just feel inherently sad. There is nothing specific that heralds its arrival or departure, nor is there any pattern to how long it may last; it is just something that I’ve learnt is a part of me.

Right now, I’m going through one of these episodes, hence the absence of a blog update for a couple of weeks. My time-honoured ‘coping’ strategy is to disconnect with the outside world until the view brightens, I tend to internalize rather than wanting to share. But I realise that if I’m going to be true to the blogging process, I should contribute when I’m feeling blue as well as when things are looking rosy.

Obviously my knee injury is a major factor in how I’m feeling. Not only is it incredibly frustrating and has completely destabilised my day-to-day equilibrium but it also means that I’m not getting my ‘happy fix’ of endorphins from the strenuous exercise that has been a part of my life for so long. Nor do I have the self-satisfied feeling of achievement when another training goal is attained. The injury is probably the worst I have suffered, ever, not in terms of severity but in that it is particularly pernicious and has persisted for so long. There is still no end in sight and even with all the treatments my physio is throwing at it, we are still looking at weeks before my knee is fully rehabilitated. Tentatively we’ve attempted a couple of efforts of very gentle cycling but these have led to post-exercise pain and have obviously been premature. So I’m forced to process another delay, and to wade through another cycle of anger, bargaining, depression and finally acceptance. I feel like I’m in mourning, and when I put it like this, it’s not such a surprise that I feel so sad. In the bigger scheme of things I’m incredibly fortunate and have so much to be thankful for, this especially on a day when another natural disaster has devastated large swathes of Japan, but mentally I am weary and am carrying a heavy heart.

Interestingly though I did have an enlightening and edifying experience this week when I was lucky enough to have a consultation with Prof Peter Mortimer, who is considered to be the leading clinician in the UK in the field of Lymphoedema management.

Until this appointment I'd been floundering around with regards to the specifics of my condition; sure I'd read all I could and had gleaned and applied those parts that I considered relevant but had had little help from my local resources. Unfortunately there isn't a Lymphoedema clinic in Brighton and although my consultant requested a referral to the community nurse over a month ago, I'm still waiting to hear back.

This lack of support is something that a great many Lymphoedema sufferers encounter and they often feel isolated and forgotten in the system following their diagnosis. Certainly I've been left to fend for myself for the three months since my diagnosis. Everyone close to me has done a great job in helping me find things out but at times it has in truth been a case of the blind leading the blind.

To have access to a respected expert was a genuine coup. I had been pinning a lot of hopes on my meeting with Prof Mortimer. Coach Helen came along too so we could cover all the angles from an athletic / physiological perspective as well as the day to day advice that I needed, and neither of us were disappointed. He was at great pains to explain in layman terms how the lymphatic system works and what dysfunction means, and more specifically what the implications are for me. He spoke with genuine interest and a desire to help me, and I really felt at ease with him. We found out that my lymphoedema should have little or no impact on my athletic performance, and that I should not need to compromise on the higher intensity workouts that are an essential part of preparing to race.  All this was very encouraging. He is also going to put me in touch with a Lymphoedema specialist in my area for the day to day tasks. After a very productive discussion we agreed to meet again in a few months time; quite a fillip to have someone of such high regard interested in my case.

Ironically, it was a remark by Prof Mortimer that brought home how Lymphoedema is changing my life. I mentioned my knee injury and speculated whether the swelling around my knee may have played a part in throwing the tracking out. He thought this unlikely but did suggest that the healing process would be compromised. In hindsight, this is now obvious. Without a functioning lymphatic system, my body will struggle to heal the inflammation and repair the damage. What would take a ‘normal’ athlete six weeks to recover from is going to be far longer for me. This explains why my knee is taking an age to mend, and also that this process is going to go on for a while.  

Strangely, knowing that my rehab from my knee injury could take a lot longer has, if anything made me more sanguine. My only concern is whether I’ll be fit enough to ride London to Paris this summer, but Helen assures me I’ll be fine. I just need to wait for the cloud to lift, for my knee to mend, and then I’ll be back.

Moving forward

Frustratingly my injury has still not cleared. It is a whole lot better but I still have a nagging pain that is stubbornly refusing to shift. This means that I’m rather stuck in limbo. The rehab plan has been sketched out, but we can’t put this into action until my knee is 100% pain free. So I’m waiting patiently. I found a hand cycle at the gym and have added this to my 'survival' techniques. It’s amazing how tough an hour of this exercise is; not only does it work arms and shoulders but it also challenges core stability and requires the recruitment of the majority of trunk muscles to maintain posture. This, together with swimming and a couple of upper body routines in the weights room have provided sufficient variety to keep me motivated.

All the upper body training has also produced a transformation. Let's face it, endurance cyclists are not well known for their upper body muscle (why put on extra mass that has to be lugged up climbs and which adds zero to the ability to produce power?). I’m no exception to this rule. Yes, I have always been toned with quite distinct muscle definition, a throwback to the days when I was a ‘circuit training queen’ but no bulk and I was definitely more Olive Oyl than Popeye. However, in recent weeks the growth in my arm muscles has been quite spectacular. As part of my lymphoedema management, I measure the girth of my legs in several places on a daily basis. Upon reflection it would have been really interesting to a numbers geek like me to have been doing the same to my arms and seen what the difference is. These pictures probably tell the story best though! Anyone for an arm wrestle?

Mentally, I’ve also moved on. One of the favourite sayings that I grew up with was “worry about things you can change”. My Father has many of these mantra’s (some of them of more questionable perspicacity than others), but this is an adage that has much merit. I’ve processed the stress and disappointment that my injury generated and armed with the knowledge that I can’t make it mend any quicker, I’ve progressed to accentuate the positive. The silver line to my injury cloud is that I’ve been able to research and acquire a shiny new toy.

One of the common characteristics of cyclists and triathletes is that we all adore new gadgets and equipment. Magazines are full of ‘tech’ sections with glossy pictures of new components, shiny bits and pieces and freakishly light parts. Even a non-mathematician will appreciate that two race bikes and eight wheels don’t quite add up when I can only ride one bike and two wheels at any one time, but I absolutely consider all this equipment to be totally essential. Half the fun of ‘buying’ is the research that goes into making the ‘right’ decision. And with time on my hands, I’ve been able to secure and try out a new piece of kit, the NormaTec MVP.

To be fair, I’ve known about this equipment for some time. I read it about it when the pro-cycling team Garmin blogged about the MVP (“Most Valuable Pump”) back in July 2008, http://www.slipstreamsports.com/2008/07/11/our-secret-recovery-weapon. Coach Helen and I started researching this in more earnest though once I got the diagnosis of Lymphoedema. One of her contacts at British Cycling opined that by far and away the most effective way of reducing oedema was through the use of a pneumatic compression device, and time and time again our inquiries and investigations kept leading us to NormaTec.

The reason why the MVP is so directly applicable for me is that it was developed initially as a medical treatment for lymphoedema (www.normatecusa.com) but has also successfully transferred as a sports-specific recovery-aid; a double plus for an athlete with lymphoedema. I made contact with the company and sparked up a great relationship with Gilad Jacobs, who leads NormaTec's Sports Medicine division (www.normatecsports.com). Knowing that Gilad’s degree was in communication, I’d expected his delivery to be extremely professional, and it certainly was. But what I also noticed from a lengthy chat with him via Skype was a real passion for the product, the company, and his total belief that the NormaTec MVP would truly help me. It really wasn’t just marketing hype. He was especially interested in my unique position as a ‘hybrid’, someone who can benefit from the MVP from both a medical and athletic perspective. It probably helps that NormaTec is a family run company and that they have all bought into the mission of improving the lives of patients; it feels like they do care.  I got a great vibe from our contact and, thanks to some generous support from Gilad, a deal was struck.

This is the thrilling news that I alluded to a couple of weeks ago. As part of the decision making process I’d asked around for other athlete’s viewpoints. Luckily enough, thanks to Si (my go-to man), I got in touch with Chrissie Wellington, triple World Ironman Champion in 2007, 2008 and 2009 and NormaTec user. This is what she said about the NormaTec MVP, “They are really good. They compress really well, and also pulsate with peristaltic movements up and down the leg. I rate them, although obviously it’s hard to isolate one thing as being the cause of improvement (athletically at least).” It was with great excitement and trepidation that I unpacked the box a few weeks later,

Although the use of the MVP was scheduled as part of the Lymphoedema management plan, when this was shelved as a consequence of my injury, so too was the timetable for introducing this management tool. Helen and I decided that with the anecdotal evidence of its efficacy we should press ahead and start using it anyway; we could always revisit the testing protocol at a later stage.

Fully aware that the NormaTec MVP is neither a cure nor a panacea for all the lymphoedema ills, that is certainly doesn’t replace any of the other management techniques such as compression and SLD, what I can say from the initial results is that I am VERY impressed. Its early days but I really believe that this piece of equipment can make a real difference. It has produced a massive boost to my state of mind and the sun is shining again. Much more on this in blogs to come.

Limping Along

Time has stood still and I remain cast adrift; all a result of the persistence of my knee injury. The Lymphoedema management project has been shelved, for now at least, and all my energies have been directed to my knee. The injury has proved far more pernicious than I first thought or hoped, and has really tested my mental resources. Although by nature I have a definite “glass half-empty” character, when it comes to what I believe I can achieve, I am the eternal optimist. If this means nailing a tough session, I always believe I am equal to the task; if this means ‘healing myself’, I have faith that I will be cured within a few days. Positive self-talk is a marvellous attribute but is unfortunately not always foolproof, and inevitably I am left disappointed. Ten days on from the first stab of pain, I am not healed and it is desperately tough.

The initial visit to the physio over a week ago was a relief as she diagnosed a tracking problem that should have been relatively easy to fix, no cycling or running but cross training was an alternative. Thankfully I have access to a well equipped gym and I duly trotted out an hour here and another hour there, at least feeling that I was salvaging some remnant of fitness and controlling my lymphoedema. I became fully acquainted with the delights of daytime TV pumped through a bank of TV’s to the audience of middle-aged, middle-classed masses – what a strange world, but that’s another story.  But the pain has persisted and after pushing through a painful final 20 minutes of a one hour cross training workout earlier this week, I conceded defeat and stopped all lower body exercise. Back to the pool I went, pull buoy and hand paddles at the ready.

A huge amount of upper body work in recent days has allowed me to keep my spirits up for the most part but this too is starting to take its toll and has its own problems, such as developing shoulder issues and weariness. It would be just like me to throw myself into something that in reality I’m totally unconditioned for, and then create another injury! Going from zero kilometres of swimming back to my old levels of 10K-12K in one week sounds like a recipe for swimmers shoulder!

A visit to my Sports Med Doctor today has shed more light on the problem, and I should be pleased that it is not serious, it is patellofemoral pain most likely caused by tightness in my quad (rectus femoris) muscle. But the prognosis is rest, stretch, rest, stretch and more rest, stretch. Repeat, until the pain has vanished. Not what I wanted to hear. I already stretch religiously and can quite easily get my head round doing more. Far harder is dealing with more rest, but this is what I know I have to do.

Coach Helen and I have discussed the options over our usual latte this afternoon. I always put a considerable amount of faith in the fact that she will be able to help; she has the uncanny knack of getting straight to the relevant point and knows me almost as well as I know myself. We are very similar in outlook and very often I get a virtual mirror image straight back of what I project out. Perhaps that’s why we get on so well? So another plan has been hatched, just to get me through the next week before I return to the physio. I will continue to swim, even though my aversion to the water is every bit as strong. Encouraging tweets from triathlon queen, Tamar, have spurred me on in the pool. And, at least while I trawl up and down the lane I feel that in some small way I am doing something positive to preserve a small element of my fitness and manage my lymphoedema. Right now this is all I have to hold onto, but it will do!

Wipe-Out

Just as nature abhors a vacuum so I have a deep loathing of swimming. Not because I can’t swim (in my triathlon days I used to average around 12K of swim training a week) but because I really do not enjoy it.  I’m not blessed with natural talent in the pool and I really suffer from the cold. I guess I just don’t have the body composition that is suited to hours in the water. Swim sessions were a means to an end back then, essential in ensuring that I was still in with a chance to claw back lost ground when I came into my own on the bike and run sections of a triathlon. Unfortunately, today I’ve have to resort to the same philosophy. Those who know me well will fully appreciate that something quite serious must have occurred to force me back into the water, and yes it has. I have a knee injury. Without being too much of a drama queen, an injury really is an athlete’s worst nightmare. In surfing terms this is equivalent to a calamitous wipe-out.

There I was rolling along, managing my lymphoedema carefully and meticulously, recording all the data and completing every workout exactly as prescribed. In previous blog posts I’ve already mentioned my zeal in following the plan that Coach Helen and I had devised, this is one of my strengths, but can also be my downfall as I become wedded to it. One of the risk factors of a testing sample of just one, is that it needs that ‘one’ to be able to fulfil the all the requirements of the testing protocol; illness or injury was always going to be a threat, and lamentably the worst has happened.

Without any prior notice, last week I suddenly felt a sharp pain in my right knee; it felt like I’d been kicked right on the tip of the knee cap. It was hard to work out what had happened and for quite a few days I continued to train. Although for many sufferers Lymphoedema is completely pain free, for others it can be quite excruciatingly painful. I wondered if this was the explanation behind my soreness, especially as just the day before I had started to wear compression during exercise in addition to general day-to-day use. There was swelling around my knee, but then there has been quite a lot of swelling around my knee for months, a consequence of the Lymphoedema. I ignored the warning signs and kept pushing on, but eventually the pain was too much and my knee was getting noticeably more swollen. I knew already in my heart, but it was just too overwhelming to admit, that I had to stop IMMEDIATELY. Thankfully the sound advice from my good friend Fi on Monday evening finally made me take notice.

Had I suffered this sort of pain pre-Lymphoedema, I would have stopped training at once, but this time I allowed myself to get duped into believing that I didn’t have an injury. In the rational light of day this seems to be utter madness, but I know why; the ‘Lymphoedema Management Plan’ has been my lifeline, it’s enabled me to feel that I’m in control of it, not it of me. To stop and admit that I had an injury that would ‘break’ the plan just wasn’t an option I was prepared to consider. Ceasing to train would have a massive impact on the rigour of our study, and would invalidate the data we are so carefully collating.

Once the decision to stop was made, I was suddenly cast adrift, and that pathetically sorry feeling washed over me again and again and again. Yes, there were tears, but I’m getting better at dealing with this and processing my self-pity, so it hasn’t lasted too long! Two days of rest, ice and ibuprofen gel have made a difference and the pain has lessened somewhat. Tomorrow I see Alison at Sportswise for a physio appointment and am sure that she will get to the bottom of the problem. Then I’ll just have to enact a new plan, a rehab plan. For now, the Lymphoedema-management plan has been delayed but not forsaken.

Missing Out

Today my Coach and good friend Helen flew out to Mallorca to set up her annual training camp venue. On Saturday she'll be joined by my fellow PBscience athletes. This is the first year that I've not been able to attend. Over the last couple of years her training camp has been a vital part of my early season schedule; a time to really focus on training and to plan the competitive season. It is a first-class springboard for the build up to the National Time Trial competitions that take place in May and June. Aside from this it's a fantastic opportunity for the amateur to experience the lifestyle of the pro cyclist if only for a week; to remove the stresses and strains of normal life, and to concentrate on little else other than training, recovering, eating and sleeping. I have found it invaluable in focussing my mind on what it takes to succeed and to get the best out of the limited time I have for training when back in the real world.
 
This year though, my real world has changed. Pre-Christmas, I had deferred the decision on whether I would attend the camp this year until I got to the bottom of the problem that was causing the swelling in my leg. Once I got the diagnosis of Lymphoedema, I must admit that attending a training camp was far from my mind. After Helen and I held our council of war though and concocted our ‘Lymphoedema Management Project’, we revisited the decision about whether the training camp was a viable option. My heart said ‘yes’ but unfortunately the call of wisdom was far more vociferous and my head won through. There were two main factors behind the decision; firstly we are employing a flat training structure during the current 12-week testing phase while we evaluate the efficacy of the various management techniques. This means keeping the training stress even. This would be daunting to achieve on camp when there is the opportunity to train harder, longer, and generally push out the boundaries. To have gone and not participated fully would have been frustrating; to have gone and trained harder would have invalidated the findings; a no-win situation. The other factor is the impact of flying. Although having Lymphoedema does not preclude me from flying, it certainly has an impact on the swelling and will require broader and more embracing management. Introducing this additional stress during the testing period would have biased the results and made it hard to interpret them. So, with a heavy heart, the decision not to attend this year was made. Helen and I both knew that this was for the best, but still I feel that I am missing out.  

Nevertheless, I would like to wish all my fellow PBscience athletes the best of time on camp. Embrace it for what it is, make the most out of every minute, and enjoy a superb trip. I understand that even the weather is going to be nice for you!

Treading Water

The transition from my ‘Lympho-mania’ state continues and it has become ever-easier to resist the cacoethes. The immediate and churning emotional response of a month ago was temporary; let’s face it, it was just too draining to keep up indefinitely and it was never going to be something that I could endure for more than a brief time. It was clearly sink or swim time and I’m glad to report that I am gently treading water quite happily. In fact I’ve reached a surprisingly contented place.

Patience has never been one of my virtues but one thing I’m exceptionally good at is following a plan. If I was completing one of those personality questionnaires where I had to select words to describe me, meticulous and its many synonyms would feature prominently (fastidious, painstakingly precise, rigorous to the point of obsession, are just a few adjectives that have been levelled at me in the past!). Not for nothing does my Coach refer to me as ‘Robot’ – I have a knack at doing everything exactly as instructed. That’s not to say I’m a rote automaton; I need to understand the whys and the wherefores first, but then I can take on a task and follow it to the letter. This has been a life-line in the past three weeks and has almost completely removed emotion from the equation; life has been easy.

Training cycle №1 is over. For the number-nerds reading this, some figures for you; training hours have come out at 15:35 in week 1, then 16:20 in week 2 and, a finally 13:20 in what was an easier week 3. Associated weekly Training Stress Score (TSS) is 915, 900 and 769 respectively. I finished this 3-week cycle with a Chronic Training Load (CTL) of 98.1. The target is to maintain CTL around 100 during this 12-week testing phase, so Coach is doing well in her role of managing the bigger picture too!

Levels of anticipation are high as I embark on the next cycle. This means I can add the next layer of ‘lympohoedema management’, and all the exercise that I do from now on will be with the added benefit of full compression on my swollen leg.  Two of the four cornerstones for treatment of lymphoedema are compression and exercise, and I’m genuinely excited about combining these on a full-time basis. Up until now I have been wearing full leg compression for recovery and compression socks during exercise, but not both together. It is my expectation that we will see a clear improvement and I hope to be able to report good things in the coming weeks.

As an aside, I’ve also got a truly thrilling prospect in the pipe-line, so watch this space for a special update in the next couple of weeks.

Clean surf – becoming balanced

“Clean or glassy surf is a smooth water surface with aesthetically balanced waves”

What I hoped to acquire in the last week was equilibrium. The plan for managing my lymphoedema was in place, and all that I had to do was be objective and stand back from the emotion. For the most part, this was achieved and I have enjoyed a satisfying or ‘aesthetic’ calm. Two weeks of the twelve week testing period are complete and we have obtained some decent baseline measures. Training stress, although high, has been kept constant and at a level that is sustainable for this 3-month testing period. I am shattered and at times feel shrouded by a web of fatigue, but all athletes will testify that these efforts do bring rewards and most of us subscribe (much to my father’s chagrin) to the adage that “what doesn’t kill you, makes you stronger”.  

A formidable task, and one that I will have to deal with for another week, has been keeping to the minimum techniques for controlling my leg swelling. When we were planning the testing protocol, Coach Helen probed to see if I could endure the first three week period completely devoid of ‘lymphoedema-management’, working on the principle that we introduce the training stress and see how bad the reaction was. Now, I can see where she was coming from, and for academic rigour I fully understand her asking the question. However, we both knew in our hearts that this would put an unhealthy strain on my mental resources, and agreed to compromise on certain ‘baseline’ methods. This has meant me holding back on controlling the edema. I can’t deny that there have been times when I’ve not wanted to do it the precise way and be patient, it’s tough knowing that I could be doing more to reduce the swelling and yes, I’ve wanted to snatch at things to make it better straight-away. But, it is in my nature to be meticulous and I have managed to keep to the plan. That is the most satisfying part; thankfully my state of equilibrium is stable, so when I have a wobble, I am able to return to a restful and pleasing place.

Funnily enough it has been the exogenous factors that have knocked me off my ‘floater’ this week. By word of mouth, more and more of my circle of friends have been drawn to this blog, and have found out for the first time what the true extent of the condition is and how it has affected me. Their outpouring of sympathy and kind words has been truly wonderful. In fact some special people have been so genuinely upset for me that I felt a bit of a fraud! Maybe because writing this blog has become a cathartic release for me but I was overwhelmed by the response it provoked. It has been propitious as it has made me realise how paltry my condition is in the bigger scheme of things; it’s not serious, it’s not life-threatening, ok it may be life-changing but it is really just a nuisance, nothing more.  This is how I feel when I’m floating the clean surf.

That’s not so say that I haven’t also had a petulant episode in all of this and my confession is that I lost it while out on a recent group cycle ride. It might be going too far to say I’m a loner, but I’m pretty self-sufficient and never feel the need to train with others. For whatever reason, though, this weekend, I decided that I’d join in with an organised ride around Sussex. Mistakenly I thought it would be nice to have some company for a change. As we cycled and rotated around there was plenty of time for ‘small talk’; all the standard questions, how’s training going, when are you racing, are you going to Nationals? It really forced home to me that I didn’t want to explain my situation anymore; I didn’t want to relive it all again and again and again.  I guess I’d got into a pattern where I wrote about it and then buried it! The more I clammed up and gave monosyllabic responses, the more questions it solicited. By the end I wanted to shout NO, NO, NO to the questions, no I really am not racing, no I really am not going to Nationals, don’t you realise I’VE GOT LYMPHOEDEMA...... It wasn’t the fault of my fellow cyclists, how are people who are just acquaintances supposed to know? But, it was a rude awakening for me that there are factors outside of my control and that every now and then I’m going to be knocked into the ‘soup’ of churning waters of emotional wave activity. In hindsight, perhaps this is just as big a challenge for me? A salutatory lesson that this is a long journey that I’m only just embarking on.

A Zen state of mind - conquering the fear

“In surfing, when wiping out or being held under for a long time, prudent advice is to relax instead of fighting against the churning white-water. This can be an effective way to ward off mental panic.”

This is what I have tried to practise in the last week. Prior to that, with so much information flooding in it had been difficult to keep my head above water. I was drawn into the melee, thrashing around, trying to grab at every lifeline, every hope of defeating ‘the swell’. I didn’t want this to be happening to me, I didn’t want to deal with this for the rest of my life and, yes, I felt the panic rising.

Guides, pamphlets and DVDs covering lymphoedema management and self-help exercises dropped through the letter box onto the mat, and there I was, like a waiting hound, sniffing out all the information I could. I spent hours scouring websites, researching products, snatching at any techniques I could that might make ‘it’ go away, all to the point of obsession. I guess this response is not unusual, certainly it’s a characteristic that I have; when a dear school friend of mine died of cancer in her late twenties I spent two years thereafter devouring every book I could find about death and dying so I could rationalise how I was feeling!

Luckily sense started to prevail; I was wearing myself out and my poor partner was bearing the brunt. She even christened it “Lympho-mania”. I’m a great believer in fate and in the last two years my life has been enriched by my cycling buddy, Coach and on-hand Buddhist, Helen.  She was the one that came to the rescue.

I’m sure she could sense the unhealthy energy and duly set up a Coach-Athlete meeting, ostensibly to chat over ‘Competitive Goals for 2011 and Lymphoedema Management’ but more probably to get me onto a steadier emotional path. Over latte (soya, decaf for her, the full-on caffeine blast for me) we devised a plan. I relaxed, the emotional waters stopped churning and suddenly blue skies and bright sunshine were visible again.

 There wasn’t any rocket science in our plan; although as with anything to do with Helen, there is always scientific rigour and discipline (she’s almost as much of a maths head as I am). We listed my first goal as the HotChillee organised London2Paris event in June (www.londres-paris.com). (My 2^nd is the UK National Hill Climb competition in October, but more on that another time). 23 weeks between then and now; 23 weeks to control my condition and get me in peak form for riding 520K over 3 days at an average speed of 33-36 kph. Clearly the number one priority is to control the Lymphoedema, but what exactly does this mean. Well, we aim to find out. We have designated a twelve week testing phase, comprising of 4 blocks of 3 weeks. Keeping my training stress pretty constant throughout this period, we will introduce a different ‘management’ technique in every new block. We aim to quantify and document which work, and which don’t. We are in week one of the first three-week cycle and while it’s hard to hold back and not grab at techniques that I firmly believe will help now, at least this way I have a systematic plan to follow. And at the end of the 12 week period we will have a much better handle on controlling ‘the swell’ and will know for sure rather than just guessing. Then the fun can start; 11 weeks of building my fitness for London2Paris.

A New Year – A New Challenge

What’s so new about this? Loads of people will have greeted the start of 2011 with good intentions, new goals and fresh motivation? Every amateur athlete knows how this feels; we all do it every year. Driven to achieve, we set ourselves bigger and better challenges. For me, this has taken on a different hue though as on December 14^th, after 18 months of intermittent swelling in my right leg, I was diagnosed with late-onset Lymphoedema. 

This is a condition that has no cure and if you really want to see the alarming consequences, just Google “lymphoedema” and click on “images”; I scared myself senseless doing just this.

The report of the lymphoscintigram scan that confirmed the diagnosis added to my fears, words like ‘grossly abnormal’ jumped out the page at me, as well as the additional blow that my left leg was also at risk of developing oedema at some stage in the future.

This blog is my journey, how I am dealing with the initial diagnosis and, over the coming months, my experiences trying to navigate the choppy waters of finding information, sourcing help and developing coping strategies. Some of you may find it helpful to read my story if you too are coming to terms with Lymphoedema, some of you who’ve gone through this may be able to help me, and others may just be curious.

A bit about me; I’ve been a competitive athlete for many years, a runner turned triathlete, turned marathon runner, and now re-invented as a cyclist when in 2007 an Achilles injury put an end to my running days. I don’t mind saying I was pretty good, as club athletes go, and have stayed competitive even well into my forties. You can see from the photos that I’m slight and in the last 20 years my weight hasn’t fluctuated much from an average 53kg. To be frank, yes, I have a strong fixation with body image, what athlete doesn’t?  This is the real heartbreak for me. I hate the thought of getting fat, I hate that I can’t conquer the swelling in my leg, and coming to terms with this is where my struggle will lie.  My performance has also tailed off in the last season, an additional blow. Nevertheless, exercise does help and if I had to choose between an ailment that meant I’d have to give up training or one where activity is encouraged, it’s not hard to work out which I’d opt for. 

The first day of the diagnosis, I immediately took positive action. I’d been told that exercise and compression were the best ways of controlling the swelling, but I was already doing both of these. Obviously the compression tights I was using were not powerful enough. I needed help and a good friend of mine, Simon at the TriStore in Eastbourne, was the first to the rescue. He recommended Zoot (www.Zootsports.com) compression recovery tights that are medically designed and boast a graduated degree of compression from 30-35 mmHg at the ankle to 18 mmHg at the waist. A swift order was dispatched. At least I felt I was doing something.

The second day I descended into an emotional well of self-pity. I alternated between anger and depression. Not a pleasant day.  Even rationalising how much better off I was than many people around the world didn’t help. I just wanted to feel sorry for myself.

The self-loathing didn’t last long though and with the help of my buddy and cycling coach at http://www.pbscience.com/, Dr Helen Carter, we started taking other lines of action. She made contact with experts in the fields of competitive cycling, sports science and medicine to see if there were other athletes with this condition. I started the process with my GP for a referral to my local Lymphoedema clinic and joined the Lymphoedema Support Network (LSN); a London based charity run by people who live with Lymphoedema that is the largest information provider about the condition in the UK. I signed up for every factsheet that I through relevant! If you’re interested, find out more here, http://www.lymphoedema.org/Index.asp.

Things got better when a few days later the factsheets from the LSN arrived and the tights from Zoot made it through the post despite a virtual standstill of deliveries caused by the worst winter conditions the UK has experienced for many years. It was quite a feat to get the tights on, but the difference they made straightaway has given me hope (thumbs up to Zoot, your tights DO live up to your marketing hype). Another friend, massage therapist Tracy, has helped to shift the swelling, and although the effect of this is temporary, it is sort of under control. There are still bad days, and I need to learn so much more, but I’ve taken the first baby steps in coming to terms with this horrible condition, and I’m sure not going to let it beat me. A new challenge but one I am equal to.