Tuesday, August 14, 2018

California: The First 300 Days

My first ~300 days of cycling since moving to California. Blue rides are "Pace" rides, ridden at my fastest comfortable speed. Green rides are "Recovery" rides ridden very slowly. Red rides are "Brisk" rides where I go all-out. Yellow rides are "Long" rides where covering a lot of miles is the goal. The numbers in the MON through SUN columns are how long the ride was in minutes. The grey, Miles column is total miles ridden for the week. Given the impact of hills on how hard and how fast a ride is, I switched to recording my rides in miles to recording them in minutes when I moved, the Miles column is a holdover from my Texas days. In the min/wk column is the total number of minutes for the week. I highlight those weeks where I met the medical community's minimum (green) or optimum (yellow) recommendations for minutes of aerobic exercise per week.


On June 10, 2017, Agi, my wife of 42 years, died and with her, the life I had been living. Since then, I have been trying to put together a new life, one based based on my new reality. Good news, it looks like bicycling is part of my new life, but just as my life is changing, so is my cycling.

The first step in creating my new life was to move from Houston, Texas, where Agi and I had lived for almost 30 years, to California's San Francisco Bay Peninsula where my two sons live with their families. I have now been cycling in California between ten and eleven months. I considered if I should delay this post for another month or two so that it could be about my first year of cycling in California, but I have things to say now, and a year is a completely arbitrary time period in any case, so this is the story of my first 300 and some odd days cycling in California. What have I learned while designing the new cycling plan for my new life?
  1. "Man Plans, God Laughs." Guess what? I still have a life, and it still gets in the way of cycling. Over a year after her death, I am still enmeshed in dealing with my wife's estate and establishing a stable life in California (health care, daily maintenance, etc.) Also, lucky me, I have purpose in life! My older son has two children, one two years old, one two months old, he and his wife can most definitely use my help, and helping them gives both meaning and joy to my life. So, whatever cycling I do has to fit around that.
  2. "Cycling is Essential for my Health." By the fall of 2016, Agi still had 8 months to live, but the writing was on the wall. Even so, being the wife that she was, she worried about me, about my health, and insisted that I find a doctor (my previous one having retired), that I schedule a physical, and that she be there during the physical to make sure I was properly cared for. My new doctor realized, to nobody's surprise, that I was clinically depressed. (The anticipated loss of a spouse will do that.) I was very lucky (or clever?) in my choice of doctors, because she also realized that, despite the widespread use of medication to treat depression, anti-depressants were the wrong choice for me, and to my delight, prescribed bicycling as my treatment. Thus, whatever other reasons I might have to ride or not to ride, I have to ride to maintain my mental health (not to mention the many benefits of cycling for my physical health.)
So how has that played out over the last 300 days? I arrived in California on September 18, 2017, moved into my rental house on September 22, and by October 10, was sufficiently settled to start establishing a cycling routine.  One thing I have learned about myself is that I find making decisions, even simple ones, difficult. If I am to maintain a riding schedule, I have to have a "go-to" ride that I can do without thinking about it, and shortly after moving to California, I found such a ride. Although it was about the flattest of the pretty rides I could find (I really don't want to ride the Freeway access roads), it is still pretty hilly, with 1300 feet of climbing over its 23 miles. It usually takes me between 1:45 and 2 hours to complete and my average speed varies between 11 and 13 mph. Because of the hills, this ride is a mix of light (downhill), moderate (flat), and vigorous (uphill) exercise, as defined by the medical community. Compare that with my MAF test ride, my go-to ride at the end of my stay in Houston. That ride was completely flat. 45 minutes were spent on the Rice Track, riding with a heart rate monitor so I could remain strictly within the bounds of moderate exercise. Another 45 minutes were spent riding to and from the Rice Track, which was done slowly, qualifying as the light exercise disdained by the medical community. My speed on the Track averaged between 14 and 16 mph, but I claim that the slower speed of my current ride is due to the hills, and in fact, that my current ride is significantly more strenuous even with its lower average speed. For the first four weeks after restarting, I repeated that go-to ride three to four times a week, meeting or exceeding the medical community's optimal recommendation for aerobic exercise. For the next five weeks, my older son Michael was able to join me on my rides, and as a result, my riding became more varied, more challenging, and more fun. At that point, life intervened and my cycling collided with one thing after another. First, there was holiday travel. Next, there were out of town guests. And just when I thought I could settle back into my routine, my granddaughter Julia ended up in the hospital with an Respiratory Syncytial Virus (RSV) infection. Although this experience was scary and disruptive, she was never in any great danger, and at the end of the week, was home again. But of course Michael, her mother Robynn, and I had all been thoroughly exposed, and developed RSV infections ourselves. I will discuss the impact of that infection more below, but briefly, my cycling was disrupted for 10 weeks. In the 17 weeks since then, I have done a pretty good job maintaining a schedule, with the exception of 1 week where I was babysitting Julia full time because she had an illness which kept her out of daycare. Overall, on a week by week basis, I have met the medical community's optimal exercise recommendations about 50% of the time, the minimal recommendation about 75% of the time, and have managed to get in at least some riding about 90% of the time.

What is the efficacy of my go-to ride for managing depression? Despite the fact that exercise is commonly prescribed for depression, as far as I know, there is no data indicating how much and what kind of exercise, so probably the exercise recommendations for general health should be used. The recommendations for general health are at least 150 minutes of moderate exercise or 75 minutes of vigorous exercise a week, ideally twice that. After lots of reading and soul searching, I have decided that my go-to ride, despite its uphills and downhills, qualifies as moderate exercise as defined by the medical community. By doing three of my go-to rides a week, I meet not just the minimum recommendation of the medical community, but the ideal recommendation, and I am currently managing four of these rides a week. More subjectively, I know my mood is better when I ride, and it seems that riding more provides more benefit. When I started riding after the RSV infection, I spent three weeks doing easy rides around my neighborhood, just meeting the minimal medical recommendation. I then ramped up to the optimal recommendation, and it was only then that my family started commenting on how much my mood had improved.

Pneumonia


I have briefly mentioned my RSV infection in two previous posts (in March and again in June) but I wanted to summarize the whole course of this illness, and in particular, talk about some lessons I learned along the way. Michael, Robynn, and I first developed symptoms about a week after exposure (the week of 1/29/2018) and at first the symptoms were flu-like and severe. For those few days I wisely and appropriately stayed off the bike but as the illness retreated into more cold-like symptoms, I decided I was mostly over it and started riding again. Even though I started slowly, 30 minute rides around my neighborhood, it quickly became apparent that this had been a mistake; every time I rode, my infection got worse, so I stopped riding entirely for two full weeks. I slowly and carefully restarted cycling, starting once again with short rides around the neighborhood, and at first it seemed to be going fine, but as I began ramping back up to a normal schedule, my infection went from "upper respiratory" to "lower respiratory"; it turned into pneumonia. Typical pneumonia, caused by a handful of specific microorganisms, is a serious illness which often required hospitalization. What I had was atypical pneumonia, of which RSV is a well known cause. It is much less serious disease which usually does not require a hospital visit. Even so, I found that exercise, normally a health benefit, was, in the face of this pneumonia, quite the opposite.

Once I realized I had pneumonia, I stayed completely off the bike for almost four weeks until all pneumonia-like symptoms had gone, and that worked. I spend three weeks doing easy, neighborhood rides, and then ramped up pretty quickly so I could participate in "The Art of Survival", a group ride with one of my high school cycling buddies, and now have returned to my "normal" schedule of three or four of my 23 mile go-to rides a week.

This is as sick as I have been for as long as I can remember. I have known for a long time that fighting an infection and exercise compete for the body's resources, but this particular episode brought that lesson home in a much more powerful way than ever before. As I first began working on this post, I had grandiose ideas about how to explain the theoretical basis for this competition, but the more I pursued that idea, the more I realized how little I knew, and for that matter, how little the medical, scientific, and exercise communities know. Thus, I am going to take a more practical approach, describing my experiences and the immediate conclusions I draw from them, with little attempt at any kind of theoretical explanation. I have a bad habit, on this blog, of over-interpreting one or two personal experiences, and I am probably doing that again. On the other hand, I sure don't want to go through this again, and so I will try to learn what I can from my experiences, and here are my conclusions to date:

Listening to my body is important, but sometimes my body is wrong. In this case, I am guessing my body underestimated the infection I was fighting. Had it correctly understood its severity, I would have experienced symptoms which would have strongly discouraged me from exercising. However, when I went for bike rides before I was fully recovered from my infection, the cycling felt great, and I felt like it was doing me a lot of good. It was only days later that I noticed my infection getting worse. Based on this experience, the next time I have an infection, I will stop exercising altogether until I am truly symptom free, even if I feel like a ride. Even then, I think I should restart cycling slowly. There are two reasons for that. Firstly, to make sure that I am really over the infection and to minimize the damage caused by exercise should I be mistaken. Secondly, even if I am over the infection, this slow start probably is a more effective way to regain fitness and good health than to try to return too quickly to my optimal routine. An experience I have had repeatedly, over many years, is that a very modest amount of exercise provides a disproportionate share of benefits.

Stress and Fatigue


I am following the medical community's guidelines for the amount of aerobic exercise I should be getting by cycling at least 300 minutes a week. As I hope to discuss in a future post, these guidelines rest on pretty shaky evidence and are somewhat controversial even within the medical community. In addition, the primary reason I am being so diligent about exercise is for mental health, something not covered by the standard medical recommendations. I have commented that my mood seems to improve more with higher levels of exercise, why limit myself to 300 minutes a week?

In the first place, I am not limiting my cycling to the medically recommended 300 minutes. I can obtain that 300 minutes with three of my go-to rides per week, but four weeks ago, I increased my riding from three to four rides a week. I did that for reasons that, in retrospect, seem suspect. Admit it, seven is an awkward number of days to have in a week. If I ride three days a week, most rides are every other day, but once a week, there is two days between rides. (It turns out it is very helpful for maintaining my routine to ride on the same days of the week, Monday, Wednesday, Friday for example, so simply riding every other day doesn't work for me.) When I was riding three days a week, I felt like the first ride after two days off the bike was harder than the other rides, and so decided to try eliminating that gap. That meant, instead of having two days between some rides, I now do two rides back to back, with no rest day in between, and I am definitely more tired on that second day in a row. Looking back, I am less sure that two days off the bike was as harmful as it seemed at the time, it may not have been harmful at all, but I seem to be handling four days a week OK, so am sticking with it for now. That said, there are limits to how much I can ride. As noted at the beginning of this post, I have a life to lead that is not just about cycling, and cycling makes me tired. At present, I am riding in the morning to take advantage of cooler temperatures, and despite getting home fairly early in the day, I find that I am unable to get much work done, I'm just too tired. Thus, everything I need to do needs to get done in three days of the week I don't ride. Sadly, there seems to be only so much exercise my ~70 year old body can handle.

I have already discussed the devastating effect of illness on my ability to exercise. Another thing that affects my ability to ride is stress. I am an introvert, so one common source of stress for me is human interaction. Don't get me wrong, I love being with people, I am often the last guy to leave a party, but I pay a price; the next few days, I am exhausted. (The difference between an extrovert and an introvert is that extroverts gain energy by interacting with other people, while introverts lose energy.) Other things, like driving, I also find to be stressful. Two recent events really brought the impact of stress on my cycling  home. The first was a delightful trip to my home town of Modesto. My older sister Alice had a school reunion there, I drove her, and while she was at the reunion, I had brunch with two of my high school cycling buddies, Paul and Eldon. Afterwards,  Alice and I visited the grave of our younger sister, Deana. I then drove Alice home, had dinner with her and her family, and then drove a final two hours back to my home in San Carlos. Before I had time to recover from that trip, I participated in a once in a lifetime opportunity, a cemetery consecration, again involving driving and human interaction. Although I did not miss any rides due to these events, I definitely felt their effect; my legs ached and my speed was reduced for my next several rides. Although nowhere near as harmful as illness, stressful events make me tired without providing any training benefits, so definitely take their toll.

Fun


Isn't it boring to ride exactly the same ride four times a week, week in, week out? For some folks, it is. My son Michael, after riding with me for just a few weeks, has announced that he will never go on that ride again. I, on the other hand, am pretty resistant to boredom, as evidenced by the years I spent riding 5 or 6 MAF tests every week, week in and week out, each one consisting of 40 or 50 laps around the Rice track. Also, this boring schedule is my fallback, not my plan. In my first post after arriving in California, I announced my plan to attend Eroica California that year. That plan was disrupted by my bout of pneumonia, but a plan it was. When I ride with my son, he often takes me on beautiful new routes, and those rides, though not organized, are most definitely fun. Although I was not able to participate in Eroica, I made up for it by riding The Art of Survival with my friend Roger a few months ago. During my visit with him, he mentioned that his goal was to ride a metric century (a ride 100 kilometers or 62 miles long) every month. Given that he is a much stronger rider than I am, and given how much trouble I had riding a 200K brevet (a ride twice that long) this seemed to me to be an excellent aspiration, one more in line with my capabilities than some of the harder goals I have set for myself in the past. There are many ~60 mile rides available, supported group rides like The Art of Survival, populaires with a randonneuring club, and casual rides, like a ride to the coast and back my son has been wanting to do. If I could figure out a way to complete a ~60 mile ride of one kind or another every month, this would add to my fun both by giving me a goal and by providing variety. I have thoughts about how I could change the regular cycling routine I do for my health to support such an ambition and look forward to discussing that in a future post. Stay tuned.