Sunday, May 31, 2009

Sunday May 31, 2009

Swam at Life Time Fitness in the indoor pool, short course meters.

400 swim, 200 kick, 400 pull
8 x 50 @ :50 drill/swim
Main set: 100/200/300/400/300/200/100 pyramid on 1:30 base, went 1:20, 2:48, 4:10, 5:35, 4:10, 2:45, 1:18
100 easy

Friday, May 29, 2009

Friday May 29, 2009

Swam at Nitro with Steve, David, Greg, Tom, James, and Anthony. Lifted weights last night but didn't swim yesterday because of an early morning meeting downtown. The pool was set up long course. I arrived late because I had stopped to answer a page, and left early to see a patient in the ER. Clint coached and shot some video of us.

400 swim
10 x 50 pull @ :50, breathing every 5th on the odds, and every 7th on the evens
10 x 50 swim @ :50, six beat kick on the odds, eight beat kick on the evens
10 x 50 @ :50 choice; Greg led the set and mixed it up a bit (stroke, corkscrew, no breathers)

Later in the morning, while I was waiting for the tech to process a nuclear study (not to be confused with W's "nucular"), I dropped by Life Time Fitness to squeeze in a main set. I swam indoors (short course meters).

400 swim
4 x 150 @ 2:30, held 1:58
50 easy
3 x 150 @ 2:30, held 1:56
50 easy
2 x 150 @ 2:30, held 1:54-1:55
50 easy
1 x 150, went 1:52
100 easy

Wednesday, May 27, 2009

Wednesday May 27, 2009

Swam at Nitro next to Anthony, Todd (Bartee, visiting from TXLA), and Lynne. The pool was set up short course. Tom coached.

500 swim, 200 kick, 300 pull
10 x 50 @ :40 pull

Main set, 4 x through, with one minute rest between rounds:
200 DPS @ 2:40, held 2:26
2 x 25 kick @ :30 fast
100 build, working the walls, @ 1:15, held 1:11
2 x 25 kick @ :30 fast
50 fast, held :30

8 x 25 @ :30, odds fast/easy, evens easy/fast
100 easy

I will try to post video of my 500 in Belton-by-the-Sea later this week.

Tuesday, May 26, 2009

Tuesday May 26, 2009

Swam at Nitro with David, Tom, and Eric. The pool was set up long course. Clint coached.

600 swim, 400 pull (breathing 3/5/7/3 by 100)
5 x 100 @ 2:00 drill/swim by 50
2 x 4 x 200 IM @ 3:30, descend 1 - 4, 5 - 8; fastest was 2:57
100 easy

Monday, May 25, 2009

Memorial Day, 2009

Slept in again today, then swam at Life Time Fitness (short course meters) with my daughter.

400 swim, 200 kick, 400 pull
5 x 100 @ 2:00, 1 & 2 "twinkies", 3 easy, 4 & 5 "zingers"
9 x 50 @ 1:00, fly/back, back/breast, breast/free 3 x through, all drill
8 x 25 kick @ :40, no fins
8 x 50 @ :40, made 'em; I have only made 8 on this interval once before in Masters
200 easy

Back at Nitro in the morning. Very hard to get up at 4:30 when I don't have to work.

Saturday, May 23, 2009

Saturday May 23, 2009

Slept in this morning after a late dinner last night with my sister and her family who are in town this weekend. My wife had invited me to accompany her to Life Time Fitness this morning to workout, so how could I say no? I swam indoors, short course meters.

400 swim, 200 kick, 400 pull
5 x 300 @ 5:00 descend, went 4:20, 4:15, 4:08, 4:04, 3:58
100 easy

I plan to start pushing the yardage up to 4000/day, but we had some errands to run this morning, and I didn't want to keep my date waiting.

Friday, May 22, 2009

Strange Days

Swam at Nitro this morning but had to leave early for a meeting in Killeen. Shared a lane with David, Tom, Lynne, and James. Clint coached. The pool was set up long course.

1000 swim
800 pull, breathing 3/5/3/7 by 100s
600 kick with fins

This week we took my son to see his orthopedist for a follow up visit at Dell Children's Hospital to discuss possible reconstructive surgery on his foot this summer. He had had an operation at Duke in December of 2006 which we thought would be his last. Unfortunately, his foot began tightening up several months later despite ongoing PT. When we arrived in Austin, we planned to continue physical therapy but were told that we would need a referral from an orthopedist. He in turn told us that based on his experience he did not believe there would be any benefit from additional PT, but rather a second operation would be necessary at some point. He reiterated that in December and advised us to follow up with him in the spring so that we could finalize arrangements for surgery during the summer break. But after weeks of dealing with inefficient office staff who failed to return our phone calls, I finally contacted the orthopedist's nurse practitioner who scheduled an appointment for us. On Wednesday we discovered that the appointment had been changed without notifying us, so when we arrived at the appropriate time we found ourselves worked into an already overbooked morning.

Now here is where things get really strange. When the orthopedist walked into the exam room, he brightly announced, "Sounds like we need more physical therapy!" When I gently (no, really) reminded him of our prior conversations, he insisted that he would never have said such a thing. Then he proceeded to fill in the gaps in my son's medical history by asking us questions which we had answered during prior visits. At some point he admitted that he had not reviewed the chart before entering the room. Finally, thinking out loud he talked us through what he wanted to do surgically, seemingly flying by the seat of his pants. Before leaving, he assured us that his scheduling nurse would have the paperwork on her desk that afternoon.

When we called his office the following day to schedule the surgery as instructed, the nurse's voice mailbox was full, and we were told that she most likely would not be calling us back until after Memorial Day. She was so busy, in fact, that she could not come to the phone and tell us this herself. Because we had planned the entire summer around my son's surgery, trying to minimize the impact on the school year, I decided to call his nurse practioner directly to enlist her help once again. She seemed surprised and promised to look into the situation and call me back.

About an hour later I received a call not from her but from the orthopedist himself, chastising me for being rude to her and instructing me to apologize. He indicated that he could not go into a procedure under these conditions. He also informed me that he still had my son's paperwork in his pocket, that scheduling surgery can take a week or more, and that he most definitely had not told us that his office would have the paperwork that same afternoon. He admonished me to think about the conversation I'd had with his NP, with whom he'd worked for years and trusted implicitly.

Needless to say he will not be allowed to operate on my son. Having served on peer review committees throughout my professional career, I have frequently encountered impaired physicians or those with behavioral issues, some quite serious. Not uncommonly they lack insight into their problems. Nevertheless, dealing with such an individual as the parent of a patient is a very different and disquieting experience. I will advise him to seek counseling with little hope that he will do so.

Thursday, May 21, 2009

Thursday May 21, 2009

Swam at Nitro with Kirk, Tom, Jeanne, and Erin. Clint coached. The pool was set up long course.

4 x 200 free/50 kick
10 x 100 drill (catch up with eight-beat kick and weak side breathing)/swim (six-beat kick) @ 1:45
20 x 50 @ :55 IM order
8 x 50 @ 1:00 swimming with fins, odds easy, evens fast with six-beat kick; averaged 32s on the fast ones, breathing to the weak side
100 easy

Wednesday, May 20, 2009

Wednesday May 20, 2009

Swam at Life Time Fitness this morning because my son had an appointment at Dell Children's Hospital. Of course, the scheduling person had moved the appointment to next week without notifying us, and the orthopedist was overbooked as usual, so we were there 2 1/2 hours. I was going to order out for lunch when they finally released us. I really wanted to fill out a patient satisfaction survey like we provide all of our patients, but they didn't give me one. I guess I looked satisfied to them.

400 swim, 100 kick, 400 pull
8 x 50 @ 1:00 drill/swim
16 x 100 @ 1:40 (short course meters), descending 1-4, 5-8, 9-12, 13-16. This is a set I borrowed from my old coach in New Bern, Frank McGrath. The first 100 in each round of four is to be swum at En2, the second at En3, the third at En3-1, and the fourth at En3-2. I averaged 1:22/1:20/1:17/1:15.
100 easy.

Tuesday, May 19, 2009

Rules

Swam at Nitro with Kirk, David, Tom, Jeanne, Jordan,and Jay. The pool was set up long course. Clint coached. The Masters group had four out of the ten lanes. A small craft advisory was in effect.

400 swim, 100 kick (no fins), 300 pull (breathing 3/5/7)
16 x 50 @ :55 drill, reverse IM order
6 x 200 IM @ 3:30, descend 1-3 and 4-6, went 2:58 and 2:57 on numbers 3 and 6
100 easy

I had to get out early for a Department of Cardiology meeting at the hospital where we learned that two cardiologists on staff who were being asked to take ER call like the rest of us felt that we were just jealous of their practice, which is primarily office-based with an emphasis on lucrative imaging studies.

Found out today that the Blue Seventy has been banned by FINA ostensibly because it traps air. I still have a Fastskin II full body suit which is in good shape, but I had hoped to swim more than four races wearing my Nero Comp. The Rocket, constructed of similar material, is still legal, at least until January, because of a fabric panel in the rear (which apparently allows air to escape!). It is reassuring to see that corporate America, as represented in this case by Speedo, is still capable of changing the rules for the right price.

Monday, May 18, 2009

Back to work

Swam at Nitro with Tom, Lynne, and Eric, next to Jeanne, Jordan, and Chuck. The pool was set up long course. Clint was on deck but mainly worked with the fitness swimmers/triathletes.

800 swim
800 kick with fins, even 100s without a board
800 pull, breathing 3/5/7/9 by 50
800 swim for time, went 11:31, splitting 5:45/5:46 (went 11:14.79 at Long Course Nationals in Savannah in 2004); had to pick it up a notch to pass Chuck (who left 5 seconds before me) in the last 100 meters
8 x 50 @ :45, made 'em
100 easy

Saturday, May 16, 2009

Results

Arrived at the pool in Belton-by-the-Sea just in time for warm up. Nice facility with an eight lane 25 yard competition pool and a three lane pool for lessons which we used for swimming down. Similar construction to Nitro, with a minimum depth of 5 1/2 feet. Tom drove up after practice to provide on deck coaching for us. I had my usual breakfast of champions: a grande latte with three raw sugars, a banana, a smoothie, and two Aleve.

Warm up:
400 free
4 x 100 @ 2:00, comfortably held 1:10 or better, HR 150
4 x 50 @ 1:20, held 31s, HR 150 or less
200 easy

Changed into my Blue Seventy, then swam the second heat of the first event (500 free) in lane 4. Richard (Hahn) was in lane six, also swimming for Nitro. Felt very strong throughout, concentrated on not over kicking in the beginning. Also concentrated on not jamming any of my turns, which was a problem in warm up. Jennifer is filming a documentary about the tech suits for film class and needed some footage of washed up swimmers, so David's daughter recorded my race using a camera on loan from the school. I had not seen my stroke in over a year, back when Mindy was coaching and I still owned a camcorder.

Swam a 5:35.71, my third fastest 500 in Masters, four seconds faster than at Zones and just two seconds slower than at Nationals last year (I was actually ahead of that pace at the 300). My splits were:

30.87
32.92
33.27
33.90
34.03
34.13
33.94
34.15
34.51
33.99

Jennifer will burn the race footage onto a DVD, then I will be able to post it on my blog. I have been working on my stroke for the past two years and was very happy with how it looked today. A couple of the race organizers complimented me as I was walking over to the warm down pool (probably because my age on the heat sheet was incorrectly listed as 58!).

Tom thinks that I can handle a higher stroke rate, and I will experiment with that in practice. Planning to take another shot at the top ten for the 400 meter free (scm) in the fall before the Blue Seventy is banned.

Friday, May 15, 2009

Friday May 15, 2009

Slept in today and swam at Life Time Fitness in the indoor 25 meter pool.

400 swim, 200 kick, 300 pull breathing 3/5/7
4 x 100 @ 2:00 moderate, held 1:17, HR 150
5 x 50 @ 1:20 400 race pace, held :35s, HR 150
200 easy

Felt great.

Thursday, May 14, 2009

Boring swim talk

Swam at Nitro with David and Lynne. Tom coached. The pool was set up long course.

400 swim
100 kick
2 x 200 pull @ 3:15
4 x 50 drill @ 1:00
8 x 50 @ 1:10 race pace, held :37s
200 easy

My goal for this weekend at Belton-by-the-Sea is to break 5:30 in the 500. According to Maglischo in Swimming Fastest, I should be able to swim my first 200 within 5-6 seconds of my best time (2:01.66) for that distance and split the second 200 within 2-3 seconds of the first. In November at the DAM (scm) meet, wearing a Blue Seventy for the first time, I swam a 4:47.73 400 free, which converts to a 5:28.88 500 free. I split the first 200 2:21.23, which converts to a 2:06.54 in yards, and the second 200 2:26.50. I went out in a 33.30, which converts to a 29.84 in yards, faster than I have taken out any 500 in Masters. My average for the last 8 50s was a 36.48 pace, which converts to 32.69 in yards, nearly a full second faster than my fastest pace previously (33.58 at Nationals in Austin last spring).

Wednesday, May 13, 2009

Follow up

Swam at Nitro next to Chuck and Anthony, Lynne and David. Had my own lane as the age groupers do not swim on Wednesday mornings. Trying a "drop" taper for Belton this weekend. The pool was set up short course yards. Tom coached. Chuck, who has swapped his board shorts for a pair of jammers, has "arrived", posting a 6:02 500 and a 2:14 200. Like Steve, David, Greg, Mark Doyle, and others before him, he has caught me, but of course he is not swimming with a piano on his back.

400 swim, 200 kick, 400 pull breathing 3/5/3/7
4 x 100 @ 2:00, held 1:09 comfortably, HR 140s
6 x 50 @ 1:00 race pace, held :32s, HR in the 150s
200 easy

An EEG performed on the patient from the other night demonstrated a postictal state and a low threshhold for seizure activity. In the locker room Larry and I spoke about the current state of health care and the role that hospitalists have assumed in the management of patients. Back in the day, the primary care physician developed relationships with his or her patients that continued for decades. When a patient was hospitalized, he or she was then treated by the very same physician, ensuring continuity of care and, perhaps more importantly, a sense of comfort and reassurance at the time of a potentially life threatening illness. Today, upon admission to a hospital, a patient is assigned a hospitalist who typically works 12 hour shifts, rotating with other hospitalists, none of whom have ever met this particular patient before. What have we created?

Tuesday, May 12, 2009

Tuesday May 12, 2009

Swam at Nitro this morning with Steve, Lynne, Jeanne, and Tom. Alex coached and swam a few lengths in honor of his birthday. The pool was set up long course.

400 swim
4 x 50 kick @ :55 with fins
400 pull breathing 3/5/3/7
3 x 300 @ 5:00, swam these easy/aerobic pace, held 4:24s
8 x 50 @ 1:00 race pace, held :37s
100 easy

Sonce I missed Nationals, I will be swimming the 500 at Belton-by-the-Sea Saturday morning and am tapering this week. Would like to improve on my 5:39 at Zones and plan to take it out stronger.

Monday, May 11, 2009

Go figure

Swam at Life Time Fitness in the outdoor (25 meter) pool.

400 swim, 200 kick, 400 pull
8 x 50 drill/swim @ 1:00
3 x 100 @ 1:30 moderate, held 1:20
3 x 100 @ 2:00 moderate, held 1:17 or better
8 x 50 race pace @ 1:00, held :35-:36
200 easy

Called back to the hospital last night by one of the hospitalists to see an elderly woman from a nursing home who was found unresponsive. She had been eating dinner alone when the monitor picked up a fast heart beat, triggering a call to the "rapid response" team. When the nurse arrived, her heart rate had normalized, but she was still unarousable. Immediately everyone's attention shifted to a possible cardiac problem, this despite the fact that she had a known seizure disorder and a subtherapeutic dilantin level on admission. My diagnosis, as a cardiologist, was that she had suffered a seizure and was postictal, thus explaining both her unresponsiveness and her incontinence. The diagnosis was confirmed later in the evening when she had a second, witnessed, seizure. At which point someone ordered another dilantin level.

Saturday, May 9, 2009

It's 2 am...

Called in again at 2 am for a STEMI, and by the time I finished it was after 4. As I tend to feel even worse after an hour or two of sleep, and I needed to be back at the hospital to start rounds at 7:30, I decided to stay up instead. Fortunately Life Time Fitness is open 24 hours, so I was in the water by 5:30. Swam in the outdoor 25 meter pool. Needless to say I had the place to myself. I enjoy swimming outdoors, but I have been told that the pool really heats up in the summer since they do not have a cooling system.

500 swim, 200 kick, 500 pull breathing 3/5/7/5/3
5 x 100s @ 2:00, 1 & 2 were Twinkies (breathing 2/3/4/5 by 25), 3 was easy, 4 & 5 were Zingers (breathing 5/4/3/2)
10 x 100 @ 1:30 (scm), held 1:20 without having to struggle; HR was 156 at the end. This set, although pretty basic, is usually a good indicator of what kind of shape I am in.
200 easy

Friday, May 8, 2009

Business

Swam in the outdoor 25 meter pool at Life Time Fitness because I had a 7 am meeting at the hospital. Water temp was good, and I had my own (7 foot) lane.

400 swim , 200 kick, 400 pull
Main set: "Double up" 4 x through--50/100/200 on 1:00 base per 50
First round went :42, 1:25, 2:50 (nice and easy),
Second round :38, 1:18, 2:40,
Third round :37, 1:15, 2:35,
Fourth round :36, 1:15, 2:30 (my fastest 200m free in practice)
100 easy

We met with hospital administrators from St. David's (our primary hospital in Round Rock) and Scott and White (a competing health care system with its own insurance plan and a closed medical staff). For over a year the Scott and White facility has been performing coronary interventions without an on site cardiac surgery program. Most of these have been elective daytime cases since the hospital does not provide 24/7 coverage. Consequently, STEMIs are diverted to St. David's at which point we are called in on nights, holidays, and weekends to perform emergent interventions (caths and stents) on their patients. After discharge, however, the patients are then obligated to follow up with a Scott and White physician locally or in Temple. Until recently the standard of care was to perform these procedures only at facilities with a cardiac surgery program; the American College of Cardiology is reconsidering this ostensibly because of the need to offer PCI (percutaneous coronary intervention--ie stents) to STEMI patients in rural areas served only by community hospitals.  Interestingly, one of the leaders in this movement is in fact a Scott and White cardiologist. 

Thursday, May 7, 2009

Thursday May 7, 2009

Back from DC (more on that later). Swam at Nitro and shared a lane with Chuck who hung with me on every set. Alex coached.

800 swim, every 4th length non-free
8 x 25 kick @ :35, no fins
8 x 25 @ :30, odds underwater, evens easy
5 x 200 @ 2:45, held 2:29s, felt slow
5 x 100 @ 1:20, held 1:10, felt harder than it should
5 x 50 @ :40
10 x 25 @ :30, odds easy, evens fast
100 easy

May swim at Life Time in the morning because we have an early meeting at the hospital. The water there is cooler for some reason, and I usually have my own lane, but I have yet to locate a Starbucks nearby.

Tuesday May 5, 2009

On my way to the airport to catch a flight to DC. Swam at Life Time Fitness (short course meters).

500 swim, 200 kick, 500 pull (breathing 3/5/7/5/3
8 x 50 drill/swim @ 1:00
Stopped to answer a page since I was still on call;
8 x 50 @ 1:00 400 race pace, held :37s
100 easy

Had to cut it short because I wasn't sure what the traffic would be like, but it was nice having an easier day after yesterday's long course workout.

Monday, May 4, 2009

Monday May 4, 2009

Lifted weights yesterday. Swam at Nitro this morning with Jordan, Chuck, Melanie and Larry. The pool was set up long course. The water felt a bit warm. Clint was on deck.

800 warmup
8 x 50 kick with fins, odd @ :45, evens @ 1:00
4 x 400 @ 7:00 descend, went 5:56, 5:52, 5:48, 5:44; slower than last summer, but we have not been training long course consistently yet
12 x 50 @ :45, didn't get much rest on these after the 400s
100 easy

Flying to Washington tomorrow and returning Wednesday night. I will probably swim at Life Time in the morning since it is on the way to the airport. Signed up for the 500 at the Belton meet.

Saturday, May 2, 2009

Saturday May 2, 2009

Last night my (adult) daughter invited me to swim with her today at Life Time Fitness, an offer I could not refuse.  The chance to sleep in on a Saturday sealed the deal.  She and I are pretty evenly matched except in breaststroke where she kicks my butt.  She wrote the workout, a modification of one of our old ones I believe.  The pool is short course meters.  We each had our own lane.

500 swim
4 x 25 kick @ :40
300 pull breathing 3/5/7 by 100
4 x 25 kick @ :35
Main set :
4 x 16 x 25 @ :30 IM order; I suggested that we lower the interval to :25 for the last round.  This was actually tougher than it appeared on paper.
100 easy