health

The 'Life-Juggler's' Guide to a Sub 3 Marathon continued....

London Marathon Race Week

Nursery Flu.

Brilliant.

One can read as much of the scientific and lay press as one likes - and hence apply logic to circumstance - but when it actually happens to you, you never fail to get this - why me why now face!

I upped the mileage in a pre-race mild panic that i wouldn't be able to cover the distance despite having run my fastest ever half marathon in Bath — didn’t down the other stresses and immersed in the viral milieu of babyhood - i got ill, as did everyone else in the environs. 

I don’t do ill very well - as i am sure not many of you readers do either. Taking to bed - admitting that you are not bulletproof is a toughie. I threw everything at it.

 

exercise pill
  • Lemon/Ginger/Manuka honey/Apple Cider Vinegar combo on waking
  • Oregano and garlic oil capsule three times a day
  • Doubled my probiotic powder (Had just started Dr Grace Liu’s BifidoMaximus)
  • Put turmeric and black pepper on everything
  • Drank rosehip tea like it was vintage pinot
  • Vintage Pinot ;)

3 days of night sweats, drenching the bed and the Friday before the marathon - after a short 20 min ‘test’ run - I followed this by lots of food and an afternoon in bed.. bod went into conservative mode as i battled with the voice in my head saying I really was not well enough to tow the line at a marathon. 

I know the medical director of the London Marathon - Prof Sanjay Sharma and asked his advice. 

The words - viral endocarditis - were mentioned and i was told to be sensible. If you experience a heavy colds with fever in the lead in to a race - medics will advise you not to race. The risk of the virus - even if feel better for race day - there will likely still be virus in the body - travelling to the heart and causing a potentially life threatening condition is real.

Now i am not sensible - never have been - although i have become progressively more and more responsible since having Sophia.
Medical words of caution heeded - but still - these are things that happen to other people?You read about them - but its rare… right?

Not as rare as you think. My friend and prior training buddy Parys Edwards experienced this after toing the line at the Ironman 70.3 Champs in Vegas a few years ago. She was hospitalised and given high dose anti-biotics through a drip for days. She was lucky but it took a long time to recover. 

Still I managed to convince myself that Parys and me were different. I have trained with many people over the years - but aside from Jodie Swallow and Declan Doyle - I have never known anyone who can over-ride their central governor and push themselves past exhaustion - like Parys.

I have never been able to do that - always cautionary - always holding out for that sprint finish. Brett Sutton always told me that this was my downfall - my continual self-analysis - ‘just shut that brain up and race’ .. ‘suicide pace’ always alluded me. Perhaps this is a good thing. 

Saturday morning before the Sunday race.

Still not decided. Eat - go back to bed ( not so easy when you have a 1 year old toddler climbing all over you!)

running hippo

4pm - Go to London and see how you feel.

'You can always run with a hippopotamus'

A Tweet i received which cheered my dour countenance  - you have a get out plan - always have a get out plan even if it does involve a slog with a hippo.

Slept on the train and arrived at my friend Kiri’s place - where a bounty of healthy foods awaited me and my race pack. Thanks chick! A positive sign for my recovery came out of the fact i was constantly hungry in these last two days and allowed myself to eat freely and increased the amount of carbs in my diet.

Although i am well fat adapted - as in i can burn fat to a relatively high heart rate - i still do have carbohydrates to maintain some metabolic flexibility. I just need less off them to maintain steady energy levels in an event.

 I think i ate almost whole loaf of home-made Deliciously Ella Seed Bread (gluten fee) with Avocado mash, amongst other delicacies.

More of said supplements above, a himalayan salt bath and bed.

Never sleep well before a race - even if I have low expectations - and I honestly did at this point. Not particularly helped by the fact Kiri lives a stones’ throw from the famous Fabric nightclub.

6.45am Race Day

I will run. 

There is a reason London Marathon is said to be one of the best marathons in the world.

It lives up to the hype. I was in the Club Championships (CC) entry having got a qualifying 1/2 mara time so was lined up metres behind the row of Kenyan Cheetahs. 

tamsin lewis london marathon

For many a common complaint is that it is difficult to run the first few miles of the mara at all as you are barging past aforementioned hippo’s et al. Thankfully being in the CC start meant it was full pace from the start.

I found myself next to Hywel Davies - someone who I usually think of as an endurance nutter - i then reminded myself that to many I myself am an endurance nutter. 

He was aiming for sub 2.30 and blazed into the distance. Steady and Easy were my mantras. I rarely run with heart rate but the cautionary tale from Prof Sharma was ringing in my ears so i watched my heart rate like a hawk. It formed part of my decision to tow the line. Resting HR and HRV normalised in the 48hrs pre race - muscle aching persisted but its common to feel heavy pre race as extra glycogen in the muscles store water alongside. See how you feel. There is always the Hippo.

I generally felt ok during the first miles - i knew my legs were heavy - no real bounce - but i tried to stay in the moment - take in the crowds, keep my leg turnover high and not get carried away running threshold pace like many around me. Pacing is one thing I have always been good at. I prob under-pace rather than anything. It was quite cold at this point and i felt silly for ditching my gloves at the start. Body fine, peripheries not so. I noticed there were many discarded gloves at the side of the road, so i stopped and put some on. Bit cheeky but it took my mind of my cold hands - solvable discomfort - we like that.

At Tower Bridge we approached the half marathon mark and i was still feeling good - and really did draw energy from the crowds at this juncture. I reminded myself running past my medical school Kings College - that running a marathon at that time to me (2003/4) had seemed like an impossible task. Here i was trying to do it at a pace which i could at that time not even run for 5 minutes. 

There were some dark times at medical school - a severe head injury after a skiing accident, binge eating/starving/over-boozing - a story for another time. Suffice to say i felt a mixture of sadness and pride crossing that bridge.

At 13 miles i stopped for a quick pee… then noticed less felt heavy on starting again. Hang on - they didnt feel like this at the end of the Bath Half and i still had over half way to go….hmmm … turned to the guy running next to me - ‘Do your quads hurt?’   (misery loves company)…

“No.. The real pain doesn’t start until mile 22”.. Damn that is 9miles away.. i don’t think my legs will last. 

 

I am stubborn - often very stubborn - and like the majority of you reading this i do not like to quit. 

When the pain hit - I asked myself

london marathon tamsin

Why am i in pain ? 

Too little mileage ? But i never get quad pain? You’ve only run 27k as your longest run… Shut up coach said didn’t need to run long - must be the post-viral inflammation… muscle contraction less effective. 

Will the pain improve or worsen?

At Ironman UK the last (and only) time I ran a marathon I took paracetamol at the start of the run. Studies shows it can reduced perceived effort - especially in the heat. It wasn’t hot - but at this point i was thinking perhaps i should have considered having some on board. Considered asking a random member of the crowd - maybe a boozehound had some prophylaxis in his pocket. Decided was silly thought. Note I NEVER recommend pain-killers other than paracetamol in endurance events as studies have repeatedly shown they can cause kidney and even heart damage. Chronic use even worse. One of my criticisms of former coach Brett Sutton - used to dish out Voltaren like smarties. 

 

As a side note - NSAIDS like this can quite easily burn a hole in your stomach esp. when taken whilst exercising which generally increases gut ‘leakiness’ and acidity - As Multiple Ironman Champ Lucy Gossage will tell you from her personal experience of NSAID induced gut bleeding and subsequent anaemia (before she turned pro) - it is NOT worth the risk. Some say - 'well i’ll just take an acid-blocker alongside the painkiller' - we have acid in our stomachs for a reason - it aids digestion and prevents harmful bacteria/viruses/parasites from getting in. Do not recommend. GI Upset in endurance sport is obviously a blog post in its own right. I use activated charcoal - £3 on Amazon.. superb for gas/bloating - and also for mopping up the toxins from booze on a night out :)

 

The next 13miles went from being cheery/waving and - ‘isn’t this incredible, i am finally running the London marathon’ … to ‘bugger… i may not make this.. the pain in my quads was amplifying.

Looked at my watch - i had averaged 6.30 mile pace for the first half and was capable of talking all this time - felt easy .. then the leg pain - so CV discomfort (why would there be i was well below threshold).. energy felt constant.

Mile 19 - Do you legs hurt more now than they did at mile 15?

Not really.

Great … Its therefore not pathological .. they will not give way..  

Heart rate?  Steady not going over 150bpm.

pace had dropped to 4.30 pace for a couple of miles - i couldn't seem to keep my cadence up. Coming back past Tower Bridge I had another word myself. Its now or never.. you may not be in top shape but you have come here to run a sub 3hr marathon and if you want to do that - then its time to up your game. 

You play these games with yourself which in reflection seem a bit silly.

For me i was picturing my daughter Sophia (just 14months) and the tenacity she now shows lifting and walking with things.. what would she say to Mummy? You didn’t make your goal because you couldn't stand the pain? I pictured my Mum and Sophia watching the marathon on TV willing me on - they weren’t - they were on Bournemouth beach - but it is what i chose to believe at that time and it worked. Why do you run? 

I had my second gel - Torq Rhubarb/Custard and sipped it slowly - all the time practicing the psychological tip of externalising. I thought of my summers with my beloved Grandpa - eating freshly rhubarb - topped with steaming homemade custard. 

The Tunnel - at this point you only have a few miles left - a friend had told me the BlackFriars tunnel was a lonely place - but i welcomed the sensory change and felt somewhat energised by heavy based music. 

The Embankment - I saw a man collapsed just ahead. He looked in a bad way. I had to resist urges to go over and help as medical aid had just arrived. I learnt later he died. RIP David Seath.  You just never know when you card is up. This thought pressed me for a few minutes. Prof Sharma had told me that is should not race if i was ill in race week, yet i felt confident enough in my self awareness/physiology that i could at least start.

Heart Rate 152.

Those final miles were painful. I had imagined trotting along the embankment smiling at the crowds and taking in the atmosphere but all i was looking at was the clock fast approaching 3 hours. Now or never its just a bit of pain. I had to do a bit of elbowing past folks in the final mile as from somewhere i found some leg speed and finished with a sub 6.20mile. Always like a sprint finish me. 2.58 (which in my head is infinitely better than 2.59). Semantics.

 

marathon tamsin

I did my own personal high five and then had a few tears. Boxed ticked… you can be a little bit proud of this one. 

Yes my predicted time based on half mara performance was around 5 minutes faster - but all things considered - i am happy - and i’m ok. Heart rate dropped into normal range relatively quickly - and i didn’t feel unwell. I’d like to say i put my feet up with some of my wonderful friends who came to watch me (Kiri, Arianna - thank you for the fuel and massage) - I did - but only for an hour - as back to the mommy role… race to get home to see Sophia before she went to bed. I’ll pretend she is proud of me for now.. and maybe one day we can run a marathon together.

Key Take Away Points.

 

1.” It Doesn’t Have to be fecking Hard - But it Does have to be Consistent - which in turn makes it fecking hard. “    Thanks Sutto.

2. Long Slow Steady Runs in my opinion are not the pinnacle of marathon training.

3. Functional Strength training pays dividends.

4. Mental Resilience cannot be under-estimated.

5. Knowing that your Blood biomarkers are optimised is important - esp. if you are not feeling as ship-shape as you once have done. 

 

My (Historical) Issues

 

  1. Low Iron (Ferritin <20)
  2. Inappropriate Vitamin B12/Folate metabolism (MTHFR mutation - 23andMe > Genetic Genie)
  3. Low Progesterone ( Agnus Cactus and appropriately timed natural progesterone helped with this).
  4. Low free/available Testosterone (from years of being on the contraceptive pill which increases binding protein)

5. Low Magnesium

6. Too much Omega 6 compared to Omega 3 - measured as red cell Omega 3: 6 ratio.

7. Low Thyroid

My GP gave me ferrous sulphate which upset my gut (causes inflammation which as an athlete already predisposed to leaky gut is the last thing you need)

Floradix 2 full capfuls/day is my preferred effective option - although ferrous gluconate/bisglycinate with vit C is effective & tolerated well.

The other tests are not available through the NHS so we did them through my company www.curoseven.com - alongside a host of other integrative health testing (dutchtest.com, Metabolic/Organic Acids Testing, and Gut Function Testing.

Its only in the last few weeks after a few tweaks to my supplement regime based on the results of the above and through the help of incredible and infinitely humble Dr Tommy Wood that I have started to feel like a million dollars.  

Despite juggling of all the plates commonly known to fit, full time working, mums.

My house is not tidy, however.  I’m looking to out-source this one   :)

I recently presented with pal Ben Greenfield at The Biohacker Summitt and at The Public Health Collaboration event. 

Exciting, Busy Times.

I recently heard a term coined - "productivity addict" - anyone else like to put their hand up to this one? ;) Must Forest Bathe more.

Next Up I will be part of the Expert Panel with Dr Kelly Brogan and Dr Rangan Chatterjee (BBC Doctor in The House) at

This Event  in July.

Sure will be interesting. 

Cheers!

ben greenfield tamsin lewis

 

 

 

 

 

 

 

Running a "Sub 3" - The Minimalist Route

The only sporting goal I set myself this year.

Go under 3 hours in the London Marathon.

I have only run one marathon before and that was as part of Ironman UK - a day so full of emotion and joy that the pain of those last miles has been mooted. 

For those of you who just want to skip to the ‘how i did it part’ take a peak at my Strava profile - although this allows no reading between the lines.

Just over one year since giving birth; my priorities, my perspectives and my expectations have gone through a progressive shift as described in my previous blog. 

IMG_0125.jpg

I knew when I fell pregnant that I would never return to racing as a professional athlete. I knew the toll it takes on the body and mind and increasingly i was yearning to return to medical practice and learn more about a functional medicine approach to health and healing. 

In pregnancy - not ‘training’ felt natural for me. Replete with pregnancy hormones designed to relax and nourish the body, I exercised daily but didn’t push myself and rested as much as I could. I had another soul to think about. 

Often training becomes an aim within itself - and we do not feel ‘normal’ without our daily fix. 

Some go even further and exercise/training becomes a form of self-harm - of distraction - of cross-addiction - preventing us dealing with whatever we would have to deal with if constrained in four white walls with no way out. 

Post partum - its just your head and your body again.. and hormones levels drop off precipitously and that desire to move, to run, to get a glimpse of your previous fitness, comes rushing back. Despite facing chronic sleep deprivation, warped food cravings, emotional shifts and the fact you now have a whole small human to love and care for. 

To start with i did as much as i could within the confines of the above. Think about how you feel after acing a race - matching or exceeding your expectations - you are already entering your next race the same night - and eager to get going with training again - often foregoing the fact you need to reflect and absorb the race you just aced. 

 

But then real life kicks in. I went through a round of career interviews just 2 weeks after Sophia was born whilst she was still in the ITU - as I was due to return to the NHS to finish my training to consultancy. I started working as a locum when she was 8 weeks old (2-3 days a week) and all the time working on my business baby www.curoseven.com in the background. I will forever be grateful to my mum who travelled from Devon to London most weeks and stayed overnight so i could rest. Sophia woke every few hours in the night until she was 10months old.  I feel like i aged alot in this time!

Running is simple. Put appropriate - or sometimes not so appropriate - clothing on and get out the door. One foot in front of the other. 

I entered a half marathon 5 months post partum and used it as a goal to get myself running regularly. I ignored advice to wait for the 6 week checkup from your doctor. Pelvic floor exercises and core stability were essential but I started running easy at 2 weeks post partum. My legs felt like they do in the last 10k of a marathon from the outset. But slowly it improves. And the power of running to change your mood, emotional energy and clarity of thought is immense. Studies now show that it triggers neurogenesis - the growth of new brain cells (through BDNF production)- some stick around (esp. if you nourish them with healthy fats and anti-oxidant rich foods - some don't - esp. if you don’t sleep and drink wine like its 1999)

I had no training plan.

I just ran and listened to my body - sometimes a plod. Sometimes i hit a 6 min/mile.

I averaged around 40k a week over a 6 month period.

First 1/2 mara in Richmond I ran 1.23 which is pretty much the same time as I had ran a half marathon prior to pregnancy when I was training a huge amount more - but in three disciplines.

2 months later I ran Bournemouth 1/2 marathon in 1.22 and somehow managed to win the race. 

tamsin lewis run bournemouth

The next small challenge was the Endurance Life Coastal run - 16 miles of crazy terrain along the Dorset coast line. Anyone who has completed these races will know just how brutal they can be - not just in their geometry/elevation but how commonly one faces strong opposition from howling winds and rain. It took around 2hr 20 to cover that distance but I managed to win by a fair margin - although at the time - it felt more about survival in the face of gail force winds… which i often feel are a metaphor for life. You just keep on pushing and eventually you get there.

I finished strong on this day and it gave me hope that my years of endurance training were still buried in my physiology - despite not actually doing much in the way of long sessions at all at the current time.

After this Dorset trial race there was a bit of a hiatus until next towed the line approximately 4 months later at The Bath Half Marathon. I caught yet another nursery bug in the lead into this race and was without voice and snuffly on the start line.. but it was a chance to catch up with two of my favourite people and athletes Claire and Dunc Shea Simmonds - a good incentive. 

tamsin lewis pitchatpalace

Stunning race - wonderful support and even Chrissie Wellington showed up in her first 1/2 mara post baby (3 months?). I felt pretty blah throughout the whole thing.. it just passed in a blur and i just let my legs do the running, not actually breaking 155 heart rate. I managed a couple of near 6 min miles coming to the end, so clearly I hadn’t pushed as hard as i could, so it was reassuring to see the clock at 1.21 when i crossed the line, ahead of some super speedy girls - Vicky Gill being one. Chrissie ran a 1.25 smiling as she does most the way round. I was most impressed that she prioritised breast feeding her little one just minutes before the start. 

In the early months of 2016 I had been focusing on some career networking/business development for Curoseven and studying a mix of functional medicine, endocrinology and bio-identical hormones in my evenings when Sophia had gone to sleep

I was running 3-4 times a week with 1 or two strength sessions thrown in - of which i would count climbing stairs and superman flies with Sophia as part :)

My previous coach Tom Bennett of T2 coaching always said i could run a sub 3 so that rang in my mind when out running, as did the words of my other former, and perhaps more infamous coach Brett Sutton that women didn’t need to run long regularly in order to run long well as we were naturally better at endurance. Funny how selectively biased the brain can be - esp. as 1 i didn't have the time or 2. the inclination to run high mileage.

I periodically googled “how to run a sub 3”, I even downloaded the ASICS run sub 3 plan and would give it cursory glances now and then choosing a couple of the sessions, but ignoring the fact it told you to run every day pretty much and the 15mile plus runs every Sunday. I did 3 runs over 22km in the entire 8 month lead in.

As most of you children know - the first few years after they start nursery - they pick up every bug going and largely smear it all over you when home. I use one of those nasal suction devices to remove the snot from Sophia’s nose so she can breathe better. They work but its a messy process. She only attends nursery twice a week, my long suffering mum looking after her on the other days I work.. a choice made easier by the fact that almost every week she would bring home some foul virus of sorts (i watched a program where they looked at the bugs grow from hands of children in nursery - millions of virulent organisms) .. and almost every week my immune system was being challenged again. I do as much as I can from a nutrition/supplements stance to give my immune system a chance. I follow a high healthy fat diet, with periodic carbs (predominant pm as it helps bring down night cortisol and enhance tryptophan production and hence sleep) and lots of veggies. I largely avoid gluten, but do have a small amount of full fat dairy as tolerate it well and good source of calcium. When asked why i avoid gluten - i do not have coeliac disease, although have tested positive for blood antibodies to Gluten in 2010 - I only found out about this retrospectively when requesting my historical blood tests from my NHS GP - it was not mentioned to me. They reverted to normal when i worked on my stress and gut function/diet as my knowledge working through curoseven evolved. Who knew Sultana Bran with skimmed milk wasn't a healthy breakfast ;)

Go to supps when affected by a bug are :

but stress is a potent immune-suppressant and if you’re not sleeping well - working or multi-tasking like a mo-fo it will take its toll. HRV Monitoring through an app like HRV4TRaining can help manage this and if you heed its warnings - adapt your exercise accordingly. 

I often question now when athletes comment on their 'fitness' being lacking. Often this is based on perceived effort for a given pace/wattage. However if you are deficient in X nutrient or running too high or too low on cortisol or testosterone or other hormones are out of whack then perceived will feel infintely higher. Additional if life stress is high and then you stress yourself further by a high intensity session - reprimanding yourself when you dont hit your numbers - it becomes a recipe for poor health long term. A bit more on this here.

 

In the month leading into London did two of my biggest ever running weeks 70/80km. I know for runners out there this does not sound like much - but it was all quality and a lot of race pace and above race pace work. Race pace started to feel super comfortable. But the only long run i did of 30k 3 weeks out - reminded me of what happened at Ironman UK in 2014. Around the 15mile mark something starts to ache - whether the hip, the toe or just generally legs slow down - despite CV system feeling ok and not feeling low on fuel. This I have come to realise is just what happens when you are not used to running big miles. I have the endurance from years of triathlon, but not the mileage in the legs. I have however, remained injury free for the first time in years despite running consistently for a year. I put this down to the addition of some strength work - adding a heel wedge to my left shoe which has helped a chronic RIGHT high hamstring tendinopathy - and eating a higher fat, more nutrient dense diet.. and generally training less!

tamsin marathon training

London Marathon - The Race will be published as next blog shortly!

 

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