M2 Begins, training continues

Hard to keep up lately with starting my second year of medical school and training. We have our first exam already in less than 2 weeks from today so I need to stay on my game. Training has been going well, I have been doing the workouts as best as I can but I have had to cut some a few minutes short. Definitely getting anxious for race day: 18 days, 7 hours and 51 minutes from now I will hear the cannon to start my journey to becoming an Ironman.... NOW THAT, is insane.

4300 meter Swim and 45 minute run

Today I did my long swim. Unfortunately the pool at the NAT was closed but that made me use the 50 meter pool at the SERF on the UW Campus. It was a great work out...and easily the farthest I have swam non-stop = 2.7 miles! :) I'll take it, still not my favorite. I felt pretty good until about the last 500 meters and then I noticed my form just started to crash.

I then ran in the warm weather. It is and will always be my favorite thing to do. Now I have my feet up and am watching CBS news / Channel3000 WISC-TV Channel 3 for a story featuring my work with the arthritis foundation and my journey to Ironman. Overwhelmed by the support of the community and the spotlight.

23 miles today running at a really great pace!

I have never felt as strong as I do right now with running. I stopped today because of the time that I needed to hit not because I was tired or couldn't keep going. It was a pretty big realization for me on how far I have come in my endurance training, maintaining a 7:30 pace. That is faster than my first and second full marathon. On another note, I got a high-five from an awesome little kid on the bike path. He was so excited to see me running by and he kept looking at his parents to make sure it was okay that he stuck out his hand for a high five. It made me smile. :) Thanks buddy. The best part is he had no idea how long I had been running or awesome his little gesture was to me.

1:45 -- Bike

Well, headed out today and it was a warm and windy one. Great day though so just tried to soak in the sun. I installed my aero-bar hydration system for the long run to get practice using it on my 112+ mile ride tomorrow. I was not prepared for the sound of the liquids sloshing around so that was something to get used and going over any bumps in the road. The back of my leg also is a little sore, right on the tendons but looking at these past three week how could it not be with this volume of mileage.

This weekends work outs are a doozy. Tomorrow I am going to ride the full Ironman course from the Monona Terrace out to the loops so am looking at doing around 112 miles. After that I will have a 45 minute recovery run. On Sunday I have a 4125m swim as well as a 3 hour run (which will be 20+ miles). Then next week, I come off the gas pedal to have my body absorb some of this crazy training. Go back up for one more hard week featuring a 5 hour brick and I will already BE TAPERING FOR IRONMAN!! I can't get over it.

In other news, I am being interviewed by a TV reporter on Tuesday morning where they are highlighting my Journey to Ironman through the UW Health Marketing and Public Relations Team. Needless to say I am nervous, but happy to that my journey and this blog are finally serving a larger purpose other than me reaching my goal. I am definitely really embarrassed by the attention but know it is for a really great cause.

Keep on keeping on everyone!

1:45/40 Bike/Run Brick High Intensity

Today was all about pushing the whole time. It was hard to do with the traffic not the bike but on the run, I averaged a 6:30 min/mile and finished my last mile running 5:30-5:15. Needless to say, my legs are sore and I am tired!

3300 meter Swim and 2 hour bike

After a long day at research office trying to tie up all of my lose ends by August 12th, I finally headed out around 4pm to try a new swimming pool. The Shorewood Pool located to the right of La Brioche...now as a warning, I discovered that this is a membership only pool and they do not let people swim there every day. Lucky for me, I had called earlier and the pool wasn't busy so the manager said he'd let me "test it out today" to see if I wanted to buy a membership. I will tell you something, having that 50 meters and a relatively open lane (shared at max with 4 people) was amazing. It was great to go the whole time without stopping and only using the wall to push out. I feel like I got a way better work out that is for sure and definitely have some sore upper arms!!

After that I went on my two hour bike ride which was great. I found a new loop going out on Old Sauk that plops be down right on the Ironman bike course so that I could climb two of the "three bitches" aka massive hills that I will need to do twice come race day. It started to get dark so I had to take off my glasses today and unfortunately had a ton of bugs in my eyes which is never pleasant. I finished the workout strong, feeling like my legs are stronger than ever. I was incredibly hungry though so I think I got a bit behind on my nutrition today. Need to keep in mind with me working out at this high of a volume that I should be eating something almost constantly through out the day.

Also got my Bib Number yesterday so say hello to #455. A guy from the Ironman Wisconsin Facebook group was creating these awesome Facebook cover photos. Thanks Erik!

12 hours of sleep and a 12 mile run!?

Well today I ended up sleeping in a ton. Since my last flare I have been trying to give my body what it wants with high training while I can until school starts again on 8/18. Last night I ended up doing 2:10 on the treadmill which is just as horrible as it sounds and I fell asleep around 11:30pm. I woke up this morning at 11:45AM...that is 12 hours of sleep. I could not believe it, I had slept straight through without waking up.

For a workout today I ended up doing my Wednesday run in combination with the 20 minutes from the run yesterday I missed so it ended up being about 12 miles of running at a 7 min/mile pace which was really great considering I ran about 17 miles yesterday. I also just felt like I wanted to run today with music so I decided to switch up the workout routine. I also made the mistake of looking ahead, and the next three weeks of training are absolutely rigorous. I thought they might be winding down but it looks like I stay at this intensity until August 26th. It will definitely be tough to juggle with school but for now it is full steam ahead.

I also received a lot of great news related to the Arthritis Foundation and Ironman. Drum roll please, say hello to BIB NUMBER #455 at the 2014 Ironman Wisconsin! I also found out that I will be serving as the Medical Honoree for the Arthritis Foundations Run/Walk to Milwaukee Irish Fest on August 16th. In addition, the AF intern Molly has reached out to UW Healths Marketing and Public Relations Office and a staff person there seems really interested in my story and recently asked me if I would be okay with a TV interview. To be honest, I am extremely overwhelmed by the spotlight and humbled. I finally feel like these six months of training and all of my good days and bad have a deeper meaning beyond myself reaching my dream goal of completing an Ironman. Hopefully I can inspire and raise awareness for the millions of people living with arthritis. Feels good to do good.

280 miles on the bike and 2:30 long run

Well, this past week was a really challenging training week for me. I rode another century ride on Saturday which went really well. I was amazed at how busy the Ironman course was, there were a ton of people on the course. It was great motivation. After the ride, I rushed up to Sheboygan for a wedding weekend with Jenny. Sunday became a rest day so now this means tomorrow Monday I am running for 2 hour and thirty minutes. With two weeks left until school starts again, I am definitely getting anxious on so many levels (school, Ironman, etc.)

1:45 Bike & 4200 yard swim

The bike was pretty good. The IM loop was really busy today and I always find it extra motivating to have other people out there. I finished the bike and went right into the LONG swim...I swam 2.4 miles!!! Now to refuel and get ready for the 100 mile bike ride early tomorrow morning before a wedding up north!

2.5 Brick -- 1:45 Bike/45 Run High Intensity

This afternoon I had a pretty tough brick workout where I pushed the whole time. Towards the end of the run I definitely started to slow down and just mentally wasn't pushing anymore not that I was tired, I just wasn't doing it so that was kind of frustrating. The heat was also another factor today so I sweat a lot and drank lots of gatorade to try and replenish what I lost.  Still trying to rap my head around biking another 100 miles on Saturday... definitely need to eat and sleep a lot!!! nom nom nom. T-MINUES 38 DAYS HOLY COW!

1.85 Swim / 8 mile Run

I surprisingly felt really great today following the 112 mile bike ride. I continued on with the training. I also had a lot of time to think about my training as school vamps up here in 2.5 weeks so I am without a doubt going to be doing two century rides over the next two weeks because I know once school starts my training will have to be cut back. Fortunately this mirrors what my training plan calls for so I feel ready. I know now that I can complete the distance....from here on out its about mentally preparing and getting faster. Here's to the next 38 DAYS.... UNTIL IRONMAN WISCONSIN!!!! GAAAAAAH!

112 Miles!

Well, today we are 39 days away from Ironman Wisconsin and I officially know that I can swim 2.4 miles, bike 112, and run 26.2... now just to do it all in one day. The ride was nice, I didn't push very fast and I also had to fight the wind but all in all it was a great ride. I also started the recovery with diet right away so I'm hoping my legs won't be shot for the rest of this weeks work outs. 39 DAYS...wow!

IRONMAN Racine 70.3 - The Report

Lake Michigan 5:45AM

It's been over 24 hours since I finished the race and I still cannot stop smiling. 70.3 miles was everything you think it would be, challenging, painful, and exhilarating. The weather conditions were absolutely perfect for racing. Lake Michigan on was 62 degrees and almost as smooth as glass. One of my favorite parts of the day was coming up over north beach and seeing the sun rise. I knew that it was going to be an amazing race.

Erin and Myself Ready to get after it.

I also had my older Sister, Erin competing in the event as well. Yesterday, is my favorite memory of us together by far. The picture below is us, right before she started. Here is how I felt through all three disciplines and the end.

Swim: I would not be telling the truth if I didn't say my warm up swim was really intimidating since the water was so cold. It took some getting used to but after you got going it felt really nice. I decided to take a new approach to my swimming strategy. Normally I am pretty timid and stay in the back but this time I wanted to be aggressive in the water as well as with my positioning so I started in the second row from the front. However, within the first 250 meters of the swim, I was kicked so hard in the face that I actually choked on water like I had never choked on water before. I came up and was absolutely GASPING for breathe. It took me some time but I regained my composure as well as some distance from the lead pack. From there on out, I had a really strong swim. Eventually the age group waves started to mix and I found myself catching up to the slower swimmers who were not going in a straight line. Unfortunately, I've found that you have to body roll and swim over those people otherwise you cause congestion behind you, it slows you down, and it also puts you in danger of other people swimming over you. I was also really impressed with the visibility in the water--at one point towards the end I tried to touch the bottom thinking I could and it was still too deep. I stood up from the water, relieved i twas over and felt pretty decent except a little bit of dizziness.

Bike: The bike begins with a climb out of the transition area which is always eventful. There were a lot of people falling over and crashing but I had learned from watching lasts years race to have my bike in the low gear. Off I went and I was feeling really strong on the bike. The bike course overall had rolling hills. My one really big negative on the course was how bumpy it was. I passed probably 7 people changing flat tires which is a lot! I honestly think
my butt was more sore following the 56 miles than form any of my long 100+ mile bike rides I have done on the IMWI loops. My nutrition also got a little wonky towards the end of my ride since I only had two water bottles. I ended up throwing a bottle so I could get a water at one of the aid station. I averaged 21.7 MPH which was WAY faster than I was planning to go. In hindsight, I think I may have pushed myself too hard and paid for it on my run since I didn't run as fast as I think I could have or wanted to.

Run: The run was an out and back, two loops course along the beach. It is my favorite part of
the triathlon and I always feel so relieved to have 2/3 of the events over with. I started off at a 7:05 pace which was what I was hoping to hold for the entire course, if not get faster, however about mile 8-9 I began to have some significant side aches which you can clearly see by my running splits dropping to a 7:45-7:50. I'm not sure where the side ache came from but it was right on my diaphragm. I continued to run through the ache, even attempted drinking some warm, non-carbonated cola at the aid station thinking it was my body telling me I needed more sugar/calories. My other favorite part of the run was seeing all of my fellow Badgers from the UW Triathlon team and most importantly my sister running the course at the same time. At first I didn't even know I had passed her and then I heard "I love you Brock Polnaszek" being yelled from behind me which made me laugh and smile. From that point on, we high-fived each other every time we overlapped on the course. I couldn't have asked for a better boost!!! I also think, the run is when it hit me.....I was actually doing an a half Ironman....something most people will never do. I loved seeing all the athletes stretched out over the course, watching the volunteers rake the hundreds of cups into trash cans and offer words of encouragement, knowing exactly what each athlete was experiencing since I was doing it as well.... it is a memory that will always give me chills.

Volunteers: I also want to give a shout out to the amazing volunteers and the residents of Racine. The volunteers went above and beyond to make sure I had everything I needed and their energy really helped make the race memorable. I appreciated the few resident who put sprinkler heads on ladders that showered us with cold water on the run.

The feels: I definitely had a lot of emotions over this race. Setting up transition and wracking my bike the day before, I got really  teary eyed thinking about how hard I had trained to get here and the 9 day arthritis flare I just overcame. Crossing the finish line was like nothing, not even qualifying for the Boston Marathon, I have ever experienced. I felt absolutely like crap, nauseous and I just hurt in places I never knew I could and yet, I couldn't stop smiling. I always get emotional after working out for a long time (hours on end) and it was amazing to have my awesome support crew (pictured below) there to give me hugs and to congratulate me. I am so very lucky to be doing what I am doing and blessed to have all of the amazing love and support around me. I also want to give a huge shout out to my girlfriend for driving out of her way to help me reach this goal. After the race, all I could think was how in the hell am I going to double this distance in September. I tried to stop thinking like that and just enjoy the accomplishment.  A day later, I would without a doubt sign up for another 70.3 and am still trying to wrap my head around the 140.6 mile journey that lies ahead for IMWI. For my first half Ironman I finished in 4 hours and 58 minutes, placed 25th in my age group (25-29), and 196 overall. Not bad for a guy with arthritis. :)

Amazing support crew that helped me reach my goal. L-to-R: (Brother-in-Law Eugene, Older Brother and person responsible starting the Ironman journey Alex, Sister Erin, me, Girlfriend Jenny, and Sister-in-Law Mae)

WE DID IT!!!

Can't believe it happened.

Arthritis Related News!: Today, I had the pleasure of life coming full circle. I finally had the opportunity to work alongside a Pediatric Rheumatologist at the American Children's Family Hospital. To be honest, I was surprised by how much I enjoyed my time with the team. I have never been so engaged and I think I could see this specialty as a career in my future. Still keeping all options open but I think the ability to relate to patients and families after going through the journey, not knowing the side effects of new medications that enable me to do things like Ironman and marathons, will be unparalleled. I hope to pull on these things over second year when I am spending hours in the library studying the various systems.

Brick Day 2hr bike/45 minute run

Had a pretty big brick today onto of a busy day. I am working on finishing my manuscript from the research I did this summer with the hopes of having it submitted by August 2nd and I also participated in a paid study here at the UW. Funny story was that it's an exercise study and they couldn't get my heart rate very high haha, so Ironman training is good for something I suppose!

The brick workout went well, I ended up doing it pretty late so the bike was a little cold and I started to get the swarm of bugs. I branched out onto a new road with some hills which was fun. I also had one of those days during my workout where my stomach gets these sharp aches the entire time during my work out. I'm never sure what causes it, my fruit intake has been lower than normal but still weird. Hope it doesn't happen on race day.

Racine is coming so quickly!!! Gaaahhhhh. Keep sending me positive thoughts.

Peak Phase of Training

Well, I've finally made it to Week 17 of the 24 week program which marks the beginning of the "Peak Phase" of training. At this point, I can likely finish an Ironman event but now the training is to help me get faster so I can enjoy it.

Today I had a 1:40 bike and a 42 minute run w/speed drills built in. The weather today was beautiful, a little on the cooler side so I was able to really push on the run. I dipped down to a 5:55 pace for awhile there which is really fast for me. Feeling great and about to take a nap. Getting really nervous for this Sunday but a good kind of nervous! It's RACE WEEK!

Back into the pool

I finally got in the water today after the flare and things went alright. Still my weakest sport. Swimming always nocks me out too and makes me really tired AND HUNGRY.

I also had a shift tonight at Salvation Army volunteer for MEDiC which is our student run free clinics. We had a very busy night and the shelter was very full. Always a great reminder of the good medicine can bring. I hope to have made a difference in some of my patients lives tonight.

"Be grateful for what you have because not everyone is so lucky" 

Back at it - 40 miles on the Bike, 10 mile run Sat, 20 mile run Sunday!

Well, I finally broke down and went back out on the bike--I took it easy but managed to squeeze out about 40 miles. So far so good and it was really nice to get back out there. Makes me really appreciate it and I'm hungry for the training again.

T-minus 6 days until my half Ironman Racine 70.3...I cannot believe that race is here already. Gahhh, so nervous.

Flare - Day 8

I went on a walk down to the Bank and Barrique's coffee shop down on Monroe street today to get out of bed. It was nice to get moving around again but I am definitely feeling really strange--I think it is a side effect from the steroids. Kind of a weird feeling to describe but my legs just feel like they have a ton of energy but yet I feel tired so I've been napping on and off all day. My joints also feel really strange-not painful or stiff. My elbows can extend farther than they have been able to in a really really long time so I guess that means the meds are working. I've decided to hold off on working out until Sunday and take a full week off to let my body sort things out. All in all, I can't wait to get back on my bike, or back into the pool, or back with my music on a run.

I also want to give a huge shout out to all my family and loved one who have been so amazing at helping me and making sure I know I have people I can count on. You guys are awesome and I don't know where I'd be without you.

"If you can't stop thinking about it, don't stop working for it"

Arthritis Flare - Day 7

Woke up this morning feeling about the same as yesterday. I'm finally feeling human (and way better than on the worst day of my flare, Monday) but still not back to normal so another day laying around in bed which if you know me at all then you know it is REALLY starting to drive me absolutely insane. The stiffness and pain is pretty much gone away but I still feel crappy and drained.

I also got a cryptic message in my chart last night from my doctor:
"no concern about doing ironman after steroid injection, however I think there is a real risk that exercise might cause the arthritis to worsen"

To be honest, as a patient I was very frustrated especially because during my appointment I point blank asked about my Ironman training and we had made decision about my care so that I could finish my 70.3--was he just warning me that it could get worse? Was he telling me to stop? Was he being like all the other doctors who told me I would never play sports, run a marathon (I've run 4--including qualifying for the 2015 Boston Marathon), do an Ironman. He was just being my doctor, telling me that this is a risk...which of course it is-I have a debilitating disease...BUT that doesn't mean I shouldn't try for something I really want... Mind over matter.

 My newest thought as of this morning is that my goal for Ironman is moving from being competitive/being one of the top finishers in my age group---to just being able to cross that finish line at all. I just want to hear those words... I don't care at this point if it takes me 11 hours or if I barely make the cut off time. I just want to be able to do it, to tell my kids and my patients how I did an Ironman while in medical school despite everything saying I shouldn't. I am confident that I will be able to do the half ironman distance in 11 days at Racine but my confidence level for completing the full Ironman is definitely wavering. Given the recent events, my plan now is to cut back on the intensity of my training...my training program was following a Level 6 of 10 levels which is described as a triathlete who has a goal of qualifying for Kona and crushing your first IM. I will drop back down to a Level 3-4 and just really watch my body and listen to how it responds to the training. If I flare again and thing get worse, well then I think I have my answer but maybe this is just my body's way of telling me that I need to slow down and that I can't do it all. Funny, it has a way of doing that sometimes. I also have to think realistically about all of this occurring as I am about a month away from starting the hardest year of medical school and attempting to do this...yes, I hate to admit it but even I have limitations.

So today, I'm laying in bed thinking about all the things that could go wrong and hoping that they don't---wishing and praying that my body and my arthritis holds up long enough for me to hear those sweet words..."Brock, you are an Ironman" on September 7th in Madison WI. Keep sending me any positive mojo you have.

Arthritis Flare - Day 6 + Rheumatology Apppointment

Well, I had a pretty awful day yesterday and ended up calling my doctor to set up an appointment. I really felt like I was run over by a truck, almost flu like without the fever/chills but just absolute fatigued and in a lot of pain. I have to give a huge shout out to my rheumatologist at the UW, Dr. McKown who is the head of the department. He is an excellent physician who discussed my plan of care and always helps me makes decision that will meet my goals. We ended up deciding to move onto a systemic steroid injection to help me get things under control and feeling back to normal more quickly. He also could tell how awful I was feeling as soon as he walked in the door. As a future physician, I hope I am able to remember my patients as well as he does.

I have to say it was a first for me today in terms of treatment haha, but now I can say I know what it is like to get a shot in the good old cheeks (yep, in my @$$). I feel pretty jittery and got a headache shortly after the injection. He said I'd probably have increased energy, appetite (as if my IM appetite wasn't enough) and insomnia. I get insomnia when I just take the pills so I'm sure it'll hit me pretty hard but I should feel better in 48-72 hours. Thank goodness--I am sick and tired of feeling sick and tired. I have to say this is probably the worst flare I've had since high school/beginning of college when my knee was drained the last time and I was on crutches for a week. Yesterday, I was moved to tears I just felt so awful so I am grateful for the medicine today.

The best part of the appointment (and probably the conversation I was the most scared to have) was that he told me I still have the green light to train and compete at Ironman Racine 70.3 in 12 days and Ironman Wisconsin. I'd be lying if I didn't say that I had been starting to lose sight of why I was training so hard day in and day out for this race. This flare up, for whatever reason, is an amazing reminder of how fortunate I am that the medications allow me to be as mobile as I am able to be. I think back to when I was on the Juvenile Arthritis Family Network Panel, listening to a young high schooler discuss her mobility issues and joint replacements... I am a lucky one. I'm not doing Ironman just for myself, but for all those patients who have arthritis or anyone who is physically disabled due to pain and who struggle to complete simple daily activities like brushing your teeth or washing your hair. At the peak of my flare this week, I started to experience some of those devastating limitations....honestly, it doesn't get any more motivating than that.

For now, finally watching the show Dexter on Netflix and lots of rest and relaxing until the injection takes effect. Thank you for all the well wishes, prayers, and positive thoughts. They have been heard.

"Whether you believe you can or believe you can't--you're right."

Arthritis Flare - Day 5

I ended up calling my rheumatologist before the holiday weekend to get some Prednisone just in case and yesterday, I finally caved and started the dose. I am a big supporter of less meds is more but I know that I would not be doing what I am doing without my medication. My right elbow is still giving me a lot of trouble so I  just want to get it under control again. I knew its as bad when I was having trouble reaching out to pick up things or even washing my back in the shower / brushing my teeth. Today I woke up feeling pretty overall just drained and ill so just going to plan on taking it easy. I unfortunately had to cancel a clinic shadowing experience which is always just an added hassle. I hope that the medications start to work and that I am feeling better soon. My plan is to call my doctor tomorrow if I am still not feeling well to see if I should come into the clinic. I forget how frustrating this disease can be when you just want things to be normal. Makes me appreciate everything that I am able to do when I am able to do it. I found this website that made me chuckle and I'm hoping it can help some of my other fellow RA patients as well: http://www.rheumatoidarthritisguy.com/you-know-you-have-rheumatoid-arthritis-when/

I had a pretty successful training weekend (except for the fact that I haven't done any swimming since last week Wednesday) and even managed to get a bike/run preview of the half Ironman Racine course  while Jenny was taking her USMLE Step 1. Shout out to her and so proud that she is finished the biggest exam of her medical career - I know she rocked it. I can't believe Racine is already in 13 days AND that today marks the 2 month point from Ironman Wisconsin so things are getting real. I think a lot of people wonder how I am able to run/bike while flaring and its not that I don't have pain, of course I do, but I have found that the exercise often helps me stretch out and feel better by getting the adrenalin going and joints moving. It is way better than just laying in bed for hours on end. I find my mind wandering to all of the what ifs..what if they have to drain my elbow, what if I need a cortisone shot, what if I can't keep swimming training as much as I want to/need to, what if this is the time the medications stop working for me... but I keep reminding myself that there is no point in worrying about anything I can't control. Just need to take it all in stride. Here's to hoping the flare turns around soon. Sincerely, one frustrated Ironman-with-rheumatoid-arthirits-in-training.

Bike/Run 7/2 and Arthritis this AM

I had easily one of the scariest biking experiences of my training. Yesterday, I was coming back from 1:35 minute ride and I was traveling on Whalen, one of the main straight aways of the IMWI course which has a lot of bikers on it. I attached a map with where it happened outlined in red. Yesterday, there were a lot less bikers on the course because the weather wasn't ideal. Not to mention the road isn't idea, on the sides there are huge chunks of the road that are missing, which makes staying out of the lane of traffic even more difficult.

Defensive biking is mandatory because just by probability with how long I spend on the bike an accident may happen. I heard a dump trunk coming behind me, when I looked back I could see that he was traveling very fast with no intention of slowing down. As I turned my head forward, I could also hear another car coming over the hill and I knew that they were going to meet at the crest of the hill and I was going to be caught between them. The dump truck didn't slow down, in fact I think he sped up and before I knew it I was caught between them with two options 1) get plowed over by dump truck or 2) head for the ditch. I veered off to the right down into the ditch and unclipped. I managed to keep my bike in control and stay upright. Moral of the story: Please be aware of other cyclists/bikers on the road. We are 1,000x more vulnerable out there, especially when we are clipped in. I was definitely a little shaken up but I had nothing left to do but press on and finish the bike. I was grateful to be running with both feet on the group after that for about an hour.

Arthritis: Today my right elbow is giving me trouble. Interesting that it is asymmetrical but I have a feeling it was from the way I slept last night. Lots of stretching to hopefully get it feel better and increase my range of motion. I also took some NSAIDs to help. I feel like most people who hear that I am doing an IM and I have arthritis don't understand how that is possible. To them I say, arthritis is a part of who I am and it's something I live with every day. I feel like most people don't know what arthritis actually looks like and that is what's tricky. To someone who has never had it, you can't really see it unless my joints are actually swollen. My elbow is a little tender and it does have some fluid in it but that is my training as a medical student that allows me to see it. For patients like me with RA, we feel some sort of pain or fatigue almost every, single, day. I attached pictures showing the limit in my range of motion on my right side of almost 25 degrees this morning. I also have pain with movement, particularly flexion/extension or any type of exertion (e.g., carrying groceries, washing my back in the shower). Arthritis sucks sometimes and there is no and if or buts about it. Hopefully it clears before the holiday weekend!



I leave with my motivational quote for this week: "Pain is weakness leaving the body"

ITU World Triathlon Recap - PR 2:21

This past Saturday I competed at the ITU World Triathlon in Chicago. It was an amazingly fun, fast, and flat race that helped me to shave off 11 minutes from my previous time. The race was extremely spectator friendly and the back drop of the Chicago skyline couldn't have been any better. I also loved watching Gwen Jorgensen dominate the women's elite field (Go Badgers!) I had to deal with some of rain especially during checking in my bike and setting up my transition. Luckily, it was beautiful by race time.

Finish Line

The swim was right in front of Grant Park in Lake Michigan. The water was crystal clear and very calm because it was in a breaker area. Starting race waves were separated by about 20 minutes to prevent congestion on the bike course. My age group 25-30 was the largest one of the Olympic distance with 118 people and man were there some great athletes. Compared to previous races, there was a lot more congestion. I got kicked in the face and also had someone grab my ankle and kind of pull me under. I also had to body roll some people mid stroke when they started to swim completely sideways to stay above water. All in all, it was great practice for Ironman races and have everyone start at the same time. Again while I was in the water I realized this is my weakest sport out of the three and that I like it the least. Just kind of need to grin and bare it.

Swim Area

The bike was absolutely the fastest and flattest course I've ever done, I averaged 25-26 mph over 4 loops! My favorite part was when we went on Lower Wacker into the tunnels. It was like a vacuum that seemed to suck you in it and make you go even faster. By the time you turned round, you had to go up a little bit of an incline but nothing compared to IMWI. Once you exited the tunnel, we had a pretty strong head wind that slowed the entire field down around the U-turns and long straight aways. The other factor was just dealing with the size of the transition areas and trying to find your bike. At one point, I ran right past it.

Transition Zone

The run was hot and centered around Buckinham Fountain and included 3.5 loops. Compared to marathons that normally don't loop, run portions of triathlons frequently loop or overlap and make you run the same area so that is something I am having to train my brain into doing...it takes a lot of will power to keep pushing yourself knowing that you are doing the same thing over and over again. My best tactic so far has been to focus on the positive so instead of saying oh man 2.5 loops to go, I say 1 loop down. Sometimes its the little things. I still managed to have a pretty great run split but had to deal with cramping that I think was caused by gatorade during the bike so it is definitely something I need to figure out nutrition wise for the longer 70.3 & 140.6 distances because it can be a   deal breaker. Overall I ended up 33rd in my age group and 251 overall at a big race.

Finisher Certificate

Brick 1hour bike, 1 hour run

Both workouts went well, a bit windy tonight and very hot. I definitely lost a lot of fluid! Overall feeling the training in a great way, feeling stronger and my endurance is getting a lot better. Great work out and now for some shut eye!

Arthritis Foundation Reminder

Well, I got back after it today and ran about 36 minutes. Legs felt much better and it was definitely the right choice to take a day off. I also did some more pictures, filming, and videos of short answers for the Arthritis Foundation. It was a great reminder of how lucky I am to be doing what I am doing and a huge motivation for ITU Chicago this weekend!

Added rest day!

One thing I've learned in training for these crazy distances is that you need to listen to your body and today I woke up really drained with some pain in my left calf. I decided to take an extra day off given what I accomplished this passed weekend a head of my training program and especially with ITU Chicago this weekend. I also bought some awesome compression socks for my calves and have to say I'm a believer. Lots of stretching, rest, and rolling out of the muscles so hopefully I can get back after it tomorrow!

3300 yards (1.88 mile) swim and 16.30 mile run (2:06)

Finished out this weeks training today since I took an early rest day. Man was it tough. It was really hot out so I sweat a lot. I ran the same path I did last week and in the exactly same spot started to think about the Ironman finish line. My older brother who did IM Wisconsin last year tagged me in a picture of the finishing chute....and it was a much needed pick me up after a long weekend/Monday. Thought I'd share it for some inspiration. Add it to the things to visualize when the pain/tiredness sinks in!

My first century ride!

Sunday, I woke up determined to see 100 miles on my garmin and I got it with 104! It was really tough, I did the Ironman loop 2x. I am realizing I need to ride that loop more as it helps my legs learn how to climb the hills and turnover so that I can be really fast on the straight aways. It was also a really big mental game because you do the same hills so you know exactly what is coming. Yesterday was cool because I started out and it was 86 degrees and sunny and then a storm rolled in as I finished. Now to get faster....and the Chicago triathlon is this weekend!!!!

Wed/Thursday Workouts

Wednesday: I had a 45 minute run with 12x1 minute sprints. First set of those in a long time and it felt good to just be able to run fast and really get my heart rate up there. I always feel like an idiot doing sprints cuz I feel funny trying to do it but man do they help you get faster. I was actually riding alongside a father/daughter on one of those random bikes and the girl would say hello to me every time they passed me on a recovery minute. haha, made me smile.

Thursday is BRICK DAY. I had my softball game get cancelled due to the rain so I was able to really push today which was nice. I had a 1:30 bike/30 minute run. My bike got a little dice-y around 5pm with all of the traffic in and around verona. My run was extremely fast, I averaged about 6:30 min/mile pace which is really great.

I read this article today about increasing my marathon time following the swim/bike during my Ironman. Interestingly enough, it's all about volume volume volume on the bike so hopefully my training program is doing it right. http://home.trainingpeaks.com/blog/article/how-to-nail-the-ironman-marathon

This weeks training has been difficult with the amount of storms and rain we have been getting. Verona actually had a tornado come through the town and I hear there was some significant damage along the course but no deaths. Crazy what mother nature can do.

Finally, a great quote that I have been repeating to myself lately: "Good things come to those who work there assess off and never give up."

And then I ate 3 doughnuts

Todays workout = 2,800m in the pool with 8x100 sprints, and 4x200 max. Needless to say my arms were on fire. Followed by an 1:20 bike ride which turned into an 1:40 because it was such a nice day out I just kinda lost track of time. I did my workouts separately today instead of back to back so took extra recovery and I feel really good. With this weekends passed work out, I still can't stop eating. On top of a huge dinner, I have consumed 3 doughnuts, and will likely keep eating. Kind of amazing.

Weekend Work Out Summary: Relentless

That's how I would describe my workouts this weekend. Saturday I had a 4.5 hour bike ride which ended up translating into ~90 miles on the bike followed by a 35 minutes recovery run (~4.25 miles). I also started to really pay attention to my nutrition so I played a lot with Gatorade, Hammer's Perpetuem, water, and some PB&Js. This was the first time I didn't feel a crash at all so that was great but I also started to get a little nauseous because my stomach was full. My bike ride on the Ironman course had some terrible winds. One thing that I think is really hard to understand is that out there on this course, there is no where to hide and wind really builds your mental toughness. On a windy day, my average miles an hour can go from 21 mph to about 14...it just really breaks you down because it is constant force pushing against you. I started to think, what if Ironman race day is like this.... well, thats why I'm training in all weather. Sunday, I swam 2,050 meters followed by a 2:15 run which translated to just under 17 miles. All in all, a successful training weekend but I am so grateful for a rest day today. I still can't believe how quickly race day is approaching...this is the end of Week 12 of training which means I am halfway done with training. Crazy! I really hope that everyone is right when they say the training is harder than the race.

I also just realized that ITU Chicago is in 12 days!!!! It's a great way to break up the training.

Hill Repeats

Wednesdays are hill repeats, I am on a partial recovery week in training so I only had 7x1 min over a 40 minute run. I also got my Hammer nutrition products deliver in the mail today so I am excited to put those to great work during my 5 hour work out on Saturday and my 4 hour workout Sunday.

First Olympic Triathlon!

Brother-in-Law Eugene, Jacks 1st Place Division

Definitely behind on posts, especially regarding training. It's getting easier and more routine, you kind of just become a robot! This weekend I have a really tough work out so we will revisit things after that.

I competed in my first triathlon yesterday, consisting of a 0.93 mile swim, 24.8 mile bike, and a 6.2 mile run. I finished 22nd overall and took first in the male 20-24 age group! My run was by far the stronger portion and I am really proud that my training hasn't made me lost any speed! The swim was everything as terrifying as they say. It was an overcast day with lots of wind to start out with, making it really wavy.Within the first maybe 5 minutes, I had swallowed a ton of the lake water and started to panic. Could I do this? Am I okay. I had to stop, stick my head above the water and say okay, obviously what you are doing isn't working but you are a triathlete, adapt. What can you change to make this better for yourself. So I began to rotate more to lift my head higher above the water so I wasn't just breathing in water. I even at one point started swimming the wrong direction and definitely zig-zagged a few times so I need to practice "spotting" or sighting landmarks to help me swim straight. I also had an issue with my goggles fogging up. I was not prepared to be so disorientated when I got out of the water...you just feel really slow, almost like puking, and you are telling your body to walk/run and it just doesn't. It's a really interesting feeling that only a triathlon has ever given me.I was very pleased with my bike time, averaging about 20.6 mph as well as running a 6:51 min/mile on a trail with some pretty serious inclines and slippery terrain. I actually felt I had too much in the tank left over when I crossed the finish line so when I compete at ITU Chicago in three weeks I will be sure to push myself a lot harder! All in all, I have no complaints and found that I actually really enjoyed it. You kind of ride the roller coast of emotions, what the hell am I doing, can I survive this, but in all reality I had a ton of fun and appreciate the challenge of the sport. I did keep thinking, how in the heck am I supposed to double this distance for my half Ironman Racine 70.3 in a month or even triple that for Ironman Wisconsin in September!!!!! Only answer, was not to skip training and to really invest and give it my all. I definitely need more practice in the open water haha. 

Beautiful Hilly Run @ Governor Nelson State Park

Today, as a medical student I spent some time as working with a rheumatologist in clinic. Until this point, I have yet to shadow or partake in any speciality or form of medicine that has had me as engaged as I was today. I was fascinated to learn about all of the different forms of diseases rheumatology studies from systemic lupus erythematous to scleroderma to mixed connective tissue disease and all the way to ankylosing spondylitis. I had an amazing day, taking histories, performing physical exams on patients and really seeing what goes on behind the scenes. I have to admit I was very surprised by how much I enjoyed my time. Who knows, maybe I'll be a future rheumatologist. I was invited back for clinic and I also was able to get the name of a pediatric rheumatologist here at the American Children's Family Hospital that I will likely pursue this summer. I also learned bout a great resource for patients...www.rheumatology.org. It is worth checking out!

Girlfriend Jenny, huge supporter!

Update on my RA - I have to say things have been really well. I have way less morning stiffness with the increase in exercise, I feel my body growing stronger and my joints feeling better, my pain seems really under control. I'm just extremely grateful and reflective on all the good things that are happening in my life right now. I am very thankful for it all and for all the people around me. :) This week, let the training and journey to 140.6 continue!

IM is no joke

Well this week, I had a pretty big awakening to what I signed up to do. This is nuts. I mean absolutely crazy, and I have a whole new appreciation for anyone who has ever trained for and competed in an Ironman event.

Friday, I went to the NAT to do my swim and the pool was closed. So, I just said screw it and I decided that I would do my first OWS. It was definitely a lot tougher so I am glad that I started sooner. The water temp was about 57 degrees and the water was so green it looked like lettuce. Ironically, two of my classmates were there right before I got in the water so I got some awesome pictures thanks to them.

Saturday was a really long work out - I rode my bike for 4 hours and covered about 80 miles and then did a 30 minute recovery run right after. It was intense, I felt pretty crazy afterward and that is also when I just thought..this is insane, can I really do this? Does working out for this long ever get any easier? To be continued with that thought.... I also started to play with my nutrition a little bit during the long ride. I had one of hammers products and it seemed to really help me not die, and since I'm addicted to caffeine not have me get a huge headache.

Sunday - I did another OWS but this time on the IM course infront of the monona terrace. It was the nicest water I found yet. After that, I ran for 2 hours covering about 16 miles. For the first time since I can remember, I had to walk. I haven't had to walk since I first started training for long distances about 4 years ago. I'm hoping to look at it like a new challenge. I honestly don't know if I can actually do this which is EXACTLY why I need to do it.

The other part of this that I don't think anyone talks about is how much you EAT. Sunday, I probably have 4 dinners...including a huge breakfast (pancakes, eggs, fruit, cottage cheese), 3 brats at brat fest and corn, qdoba burrito and a sandwich later that night. I mean honestly, that is so much food!

All in all, I am proud of this passed weeks work out but am still wondering, can I really do this?

5/22 Brick Day

BRICK DAY - 1hour bike and 20 minute vo2max run dipped into 5:49 min/miles! Softball tonight too haha

I'm a pool cramper

Did 10 hill repeats for about 45 minutes in the warm weathEr-my favorite kind of a run. Swam 2000 - couldn't finish the last 350 because I got really really bad cramps. It was awful. I just kept thinking, if this happened in open water what would I do. Lesson of training: always swim first.

50 miles in sunshine!

I had my first really great bike ride in warm weather with no wind today. I also hit a squirrel on my bike-the strangest things happen while you are out there. I did a part of the IM loop-figured the more times on there the better. It feels great to finally be able to work out when I want to and not have to worry about studying. Hopefully my posts will be more regular now.

Jaw Update: I officially have a retainer to wear at night to try and take off some of the stress on my TMJ joint. I also have been going to see an OT who was great. We did ultrasound and massage today and it helped me feel a lot better. I go back in about two weeks to see how this helps and if it isn't better-I will get an MRI of my jaw to make sure the joint isn't degenerating.

5/2-5/4

I had my first what I would call really intense work out of Ironman training this passed weekend. This included swimming and running on Friday (2 hours),  Biking 60 miles on the Ironman loop and running 30 minutes Saturday, and yesterday was a 1.25 mile swim and a 13 mile run at a pretty descent pace. I am really enjoying the new challenge of a triathlon. It's funny, I'm sore in places I never thought I could/would be. Today is a rest day thank goodness and I am hobbling around like an old man.

Arthritis Update: After a lot of back and forth with my doctor and insurance companies, I finally found a clinic and a physician who will see me at the UW Hospital for my TMJ problems in my jaw. I am excited and nervous to see what they will have to say. I also am hoping it is a quick solution and not something more drastic. The doctor is unfortunately retiring so it won't be a quick fix, but at least I will be able to make sure I am not doing more damage than good.

Surround yourself with people who provide you with support and love and remember to give back as much as you can in return.

Karen Kain

4/26 - First time on IM Loop and Crazylegs

It was a great day - had a PR at the Crazylegs race finishing in 30:27 and I also road the Ironman loop for the first time. One thing I learned, Ironman is no joke. The course, the level of training, the commitment is something that you can't understand until you actually start doing it. I am really excited to continue on this journey as well as to be able to compete. 

Busy busy busy

Haven't posted in awhile - school at the end of the year is always crazy busy. We just finished 5 exams and are already only 3 weeks away from the final round of the first year of medical school. Training is difficult to squeeze in with school as the workout keep getting longer. I took Lola out for the first ride outside on Tuesday of this week and am really excited for this Saturday since it is my favorite race in Madison, the Crazyleg's classic! 

CRAZYLEGS TEAM RACE BIB - LOOKS AT ALL THOSE COLORS! :)

Lola and my first experience outside - clip in are tricky everyone!

Workouts 3/23 - 3/30

Workouts

Wednesday - 1 hour bike (2-3min hard, 7-8 easy)

Thursday - 45 min swim, 1 hour bike (2 min hard, 8 min easy)

Friday - 1 hour bike (constant revs)

Saturday - 1:15 bike, 25 minute run

Sunday - 1 hour bike, 1:35 run (14 miles)

A little behind -- and an appointment with my Rheumatologist!

Workouts
Sunday - 1 hour bike, recovery
Monday - Rest day (sometimes these are nice)
Tuesday - 30 min swim, 1 hour bike

Arthritis Update
Yesterday I finally got in to see my rheumatologist after having about 2 weeks of pretty intense jaw pain, at times being unable to chew food. Unfortunately, I was given more meds and a referral to an facial surgeon at the UW if the pain doesn't get better in a week. Turns out, that as a child with juvenile arthritis, your jaw and cervical vertebrae (neck region) are really susceptible to the RA and in some cases it causes those bones to not develop properly. My doctor suspects that I am both flaring and having some combination of this abnormality from when I was a kid that will continue to get worse slowly over time. It explains why my neck has always been my worst place for pain. I am pretty nervous about what that means for the future in terms of steroid injections into my TMJ and eventual surgery. All I can do is take it one step at a time. I also am finding it really weird as I progress in school and actually begging to understand things; for example, do you know how many nerves and arteries are around your TMJ?!? I had a pretty hard time kind of accepting and digesting what my doctor told me so I was really reliant on my family and girlfriend yesterday to help me understand what all of this meant for the future and what my best plan of action was. A lot of phone calls before clinic yesterday at the Salvation Army.

After a solid nights sleep, I find myself using some of my experiences with kids who have also have RA and have already had hip replacement surgeries at such young ages and if they can handle it, I can handle it! It also brings even more meaning to my Ironman training and I know crossing that finish line in September will be one of the biggest moments in my life. Who knows if I will ever be able to do it again. I also am doing it for all those who don't have the opportunity to compete. So, keep me in your thoughts and hopefully all the medications we added on board will really help over the week. I would by lying if I said I wasn't disappointed that I went from one shot a week to 6 pills a day + the shot again (still below my record of 12 pills/day though as a kid!).

I leave with a final, positive thought as I head off to a day of school, lectures, practicing physical exams, etc.

Never give up and don't ask why because every situation does not need an answer. I'm a firm believer that I don't worry about anything I can't control.

Eric Davis

Bike Workout - 1:15

Bike 1:15 - went well, march madness was a good distraction.

14 mile run

Warm and 50 degrees, decent 7 min/mile pace but legs felt sore. I couldn't believe there was ice on the sidewalks still!

Workout - Bike 2.5 Hours

Went well, a lot of mental games to stay on the bike that long indoors.

More meds -- thumbs down

I've been in close contact with my rheumatologist since I've been having a lot of issues lately not related to the training. Primarily in my elbow and this passed week in my jaw. I wasn't able to chew food without having pain or close my mouth. It has just been a lot of problems which tells me something is going on and I need to get on top of it. My rheumatologist and I have a really great relationship and he is absolutely excellent at his job so first a shout out to Dr. McKown at the UW! We weighed the pros and cons and we both agreed that it was a good idea to restart my other two medications. It is always disappointing to hear you need more medications to manage something, no matter what disease you have. I like to think that my experiences as a patient will help me be a better doctor in the future, and who knows maybe even a rheumatologist. The new meds mean weekly blood tests for awhile now and some unpleasant side effects. We both agreed it was probably the best move with the stress of school and my increase in training just as a safe guard. So like anything in life, there is some give and take but at the end of the day you have to take care of yourself.

I also think that as someone who has had a chronic disease I cannot emphasize enough the importance of talking with your physicians. Letting them know your goals and your wants and listening to what they say. Together you can reach a plan that will fit your lifestyle and you will be more likely to follow through since you had a say in the matter. Don't ever be afraid to speak up as a patient or say no.

"Running has given me the courage to start, the determination to keep trying, and the childlike spirit to have fun along the way. Run often and run long, but never outrun your joy of running." -Isphording

Positive thoughts like a proton!

I did an hour on the bike and an hour run (8 miles). This week I've been having trouble with my left elbow and my left jaw. I had my medicine today which seemed to help a lot.

A classmate and myself who are both competing in Ironman have officially decided to get some 1 on 1 help from the UW Triathlon team's coach. Hopefully that will improve my swim.

Warmer weather!

Today was an amazingly beautiful 50 degree weather day, especially after this really harsh winter. I celebrated with an 1.5 hour bike ride and an hour run in shorts and a T-shirt! I haven't felt this motivated to work out and overall rejuvenated since qualifying for Boston in November. It's great to have some skip in my step. I also realized I am long over due for new shoes and I think that might explain why I have been having so much ankle pain lately after runs....no support. My shoes are the same ones that I did my 100+ mile training week for my fall marathon and ran the Madison Marathon. Needless to say they have a few holes and are not getting me the support I need. Definitely time for a new pair! In the words of my wise anatomy tank mates, "you have to take care of yourself!"

Arthritis has been feeling okay, with the exercise a lot less stiff. I woke up last night with the usual elbow issues after sleeping on them bent up so I did a few of the physical therapy exercises which helped. I also remembered to order my medications; amazing what one flare will do to help you remember things like that.

This week in school is busy with my younger brothers basketball team making it to the WIAA state tournaments and playing Thursday and the beginning of spring break on Friday. Hard to stay focus or have any motivation especially after just finishing exams. While working out today, I thought about how I'm not sure I would have had the discipline and determination to have survived medical school if it wasn't for running and training for my first marathon. There are just so many great analogies to real life. You hit walls, you get injuries that set you back, you feel at your highest high and your lowest low all at the same time, but you always ALWAYS get up and keep going to the finish line, no matter what life/the race throws at you. I think my training for Ironman alongside my work with the Arthritis Foundation will help me learn something new about myself and continue to push me.

Today, I am thankful for my ability to compete in races and the skills that being an endurance athlete have taught me.

Finally feeling like training is underway!

I survived another round of exams!!! In the same week, my bike also arrived from California (Lola -- see picture below), and my hometown high school basketball team (including my brothers who both play) have made it to state and will be here this week to play at the Kohl center. I did a lot of 5-8 mile runs during exam week. Today, I did my first 2 hour bike ride on Lola and it was great. I definitely have a LONG way to go to Ironman WI. I also received my USAT Carb so it's official!! Let the games begin.

10 miles

I woke up this morning with a huge headache from my meds the night before and probably a combo of lack of sleep/studying. Right on time for my neuro exam haha. Afterward, I did a 10 mile run to help clear my head and get rid of the headache! 1 of 3 down. Keep on keeping on!

8 miles, treadmill and never ending amount of cranial nerve/studying

With exams Monday through Wednesday of this week, I have not been able to get in as much exercise as I wanted to this week. As any medical student will tell you, you only have ~15-16 hours in a day to keep up with school and stay sane unless you want to start cutting into sleep. So today, I had to study and run.

This week I am reminded about how much we, as medical students and future physicians, sacrifice and will continue to need to sacrifice for our patients. Maybe it's not being able to compete at a track meet or not being able to make it to your younger siblings basketball game back home (SO: Thorp Cardinals playing in tonights regional finals!) or maybe even its your grandparents birthday or having coffee with a friend who is just passing through town. Regardless, at some point because of this career path and it's demands, we all have to make that sacrifice and believe me it is NOT an easy choice. If I could be in two places at once, I would! Today I want to give a shout out to my classmates, family, and girlfriend this week who have helped to keep me sane. You all rock.

Lots of new words...

Well after trying to study the cranial nerve tracts for many solid hours, I finally caved and needed a break. I got in about 25 miles on the bike for a late night work out. Great refresher with adrenaline, sadly don't know those pathways any better though.

Having a weird time with my ankles today, just a little achey and sore still so taking it easy doing lighter impact things I think this week. Lots of stretching in my future. Survived another Monday full of words like superior/inferior colliculi, cerebral/cerebellar peduncles, pterygoids, and too many pathways for my head. You'd think since they are all in there, it'd be easier to memorize?

Back at it!

Finally felt like the arthritis and calmed down enough today so I went for a 5 mile run on the treadmill before watching the walking dead. Run went well and it felt awesome to sweat again; running will always be my favorite of the trifecta. I am feeling pretty nervous for this week, I have to go into robot mode where all I do is study all the time to prepare and do well on exams next week. Here we go!

"Even when you have gone as far as you can, and everything hurts, and you are staring at the specter of self-doubt, you can find a bit more strength deep inside you, if you look closely enough." - Hal

Arthritis Foundation's Upper Midwest Juvenile Arthritis Foundation Network Panel

Today, I was very fortunate to be invited and serve on a panel for kids with juvenile arthritis and their families. While I was initially hesitant to do this because of how crazy medical school has been, it was without a doubt a great reminder of why I wanted to be a doctor. I hope that it will fuel me through the coming difficult weeks of exams. I was really inspired and surprised to hear the commonality in each of the panelist four stories as three of us were around the same age and another one was a little younger. While treatments and medications have come a long way to treat RA, parents, kids, and families all go through the same struggles....not coping with the disease, being angry at the world, depression, refusing to take medications, and ultimately, the best part, acceptance and embracing RA. It was really great for me, to finally be around people who actually understood what I was talking about. How that disgusting color of methotrexate makes me physically nauseous and throw up, how alcohol swabs never remind us of good things, and how waking up in the middle of the night stiff and in pain is the worst because you know it will only mean the next day will be that much harder.

Within our four stories as panelist, you could tell that RA has really molded us into the people we are today: someone who is involved in legislature and advocacy, a radiographer who is passionate about working with kids at the JRA summer camp, a young adult who has undergone hip replacement surgery at such a young age and has dreams of becoming a genetic counselor, and then me, a small town kid with big dreams of becoming a doctor and an Ironman Athlete. RA has really been a positive thing and I'm not sure who I'd be without it? Thank you to the families and the Arthritis Foundation for putting on this event.

I also was able to talk with a representative (Megan) from the Arthritis Foundation, who said they will be bringing on an intern to help tell my journey with RA and the Ironman. They also told me about some other really exciting news regarding a sponsorship between myself, the Arthritis Foundation, as an honoree at the 2014 Jingle Bell Run in Madison, WI. I can't thank Megan enough for helping me tell my story and I hope it inspires just one person to pursue whatever it is that they never thought they could do, but always wanted to do.

I forgot to order my meds...

As anyone who has a chronic illness will tell you, it's really hard to be on your "A game" with your disease all day and every day. I owe a lot of what I am able to do to my medications and this week I was reminded of that.

On Sunday, I was stuck in my head trying to get ready for this week with classes, a visit with my preceptor, a great opportunity with families and the Arthritis Foundation, integrating my training plan into my schedule, and keeping myself fueled, rested, fed, and sane! I noticed an alarm on my phone that it was time for my medications but when I went to the fridge to gather the syringes, I realized that I had forgotten to place my order. I knew this was bad news. I often like to think of arthritis flares as perfect storm of little things that need to come together; for every patient with RA it seems that it is different but for me it is lack of sleep, stress, and an inability to exercise.

After an intense workout weekend with a two hour bike ride and a 16 mile run, wouldn't you know it, my right ankle swelled up and began to give me trouble. I found myself not being able to flex it as I should and even having trouble while doing low impact things like biking and swimming. I knew I couldn't exercise and without exercise my stress levels from school started to slowly creep up and so before you knew it, I was in pain not just in my ankle but also my neck. I even started having a hard time getting out of bed in the morning, my sign that I need to take it easy. This week, it seemed, my arthritis was winning.

On my worst day pain wise, I was fortunate enough to interact and practice some new physical skills on a standardized patient who also had arthritis. I say fortunate because they reminded me that my personal struggles with arthritis will help me be able to relate to my patients and be an overall better physician. It also reminded me of why I personally wanted to be a physician in the first place. I am a big believer in mind over matter and sometimes it's little interaction like that which help bring me out of a rut. So this week, I was reminded that arthritis is a part of who I am..but I refuse to let it determine what I will do.