TSA Medical commission response

Here is a copy of an email I send to TSA (Triathlon South Africa) regarding the issue whereby a medical commission will propose measures to prevent deaths in endurance triathlons

The link to TSA website article: http://www.triathlonsa.co.za/Public/ViewNews.aspx?id=725

Good day

Hereby my response to the TSA website bulletin regarding the investigation by the Medical Commission relating to the recent deaths in Triathlon and proposed plans to but safety issues in place.

I appreciate the effort TSA is putting in to prevent future deaths in triathlon races, especially due to heart related issues, but I believe that the new proposal to implement a rule that one must qualify at an Olympic distance race before participating in an endurance triathlon event would not add value or prevent future deaths. In my view this will only enrich race organizers and put a financial burden on athletes to enter races of which entry fees are already very high.

I am a competitive endurance athlete who have done six Ironman events and also completed in more than a dozen half Ironman events over the past seven years. This year alone I have done two half Ironman races and two Xterra off-road triathlons. I specialize in long distance triathlons and do not compete in sprint or Olympic distance races. In the majority of these endurance events over the past couple of years I have finished in the top ten of my age group and have also competed in the Ironman World Championships in 2009.

My reasoning behind this is that I suffered a heart attack just after finishing my last race (Xterra Grabouw, 24 February)

I would propose that in order to "qualify" to do an endurance triathlon an athlete would need to produce a doctor's certificate after completing a medical/physical exam to clear the athlete to participate in such an event.

In my case this wouldn't have help as they still don't know what caused the heart attack as I don't have a heart condition, history, any medical condition or high cholesterol but in many instances through an exam, ECG, etc. it may be determined if an athlete do have a medical defect and if such athlete will be capable to participate in an Ironman race.

Most athlete’s do have a medical aid and this won’t put any additional financial strain on the athlete. One might see a drop in participating numbers but it might just save a live or two and might make a specific athlete aware of a medical condition they might have.

One might consider the following criteria whereby an athlete must qualify for an Ironman event by doing a Half Ironman distance race as there is a huge jump from a half distance race to the full but to do an Olympic distance race to qualify for a Half Ironman distance race won’t prevent deaths in my opinion.

Regards

Johan Stemmet

How do you feel?

 

Me and Eddy, my training partner on our walks

 Lately I've been asked the question a lot. "How do you feel" and I appreciate every one's interest about how I feel after the heart attack. It's already been four weeks since the mishap and there's two parts to this, one is the physical side and the other the mental.

Physically I am doing great and I am glad that the recovery is going well. The Doctor told me that I will recover faster than the average person due to me being very fit and healthy and I am glad he was right. I've started walking with Eddy the week after the heart attack and started with 100 meters a day and slowly building it up and is now up to 2.5 km. I must constantly remind myself to walk slowly and take it easy.

Physically I feel like I can almost start running and need to force myself to walk slower than what I want to. According to the Doctor I can start training again after six weeks (two weeks to go) but only at 70% of max heart rate. Can't wait!

Picture above is my Training Peaks performance management chart and the blue line is the Chronic training load (CTL), [basically it is my fitness level and it is quite disturbing seeing the chart taking a nose dive the past four weeks].

Even with the alarm switched off, the body clock still wakes me up at 4am after all these years

Mentally it is not going that well. Being used to train twice a day for seven days a week most of the time and now only walking once a day at turtle pace for half an hour is hard. I really miss the training and that feeling you get after a hard training session or a race.

My emotions is also divided in two. One moment I am so thankful that I am alive and been given another chance. The next moment I am upset that this has happened to me and ask the question, Why?
Living healthy, being active, no health issues, no signs of an attack coming and then Bam!
Cancelling all my flights, accommodation, race entries etc. for upcoming races I've already booked was also not helping.

So unfair but then I think back to that day and am thankful again and realize that this will be a long road to recovery but I must enjoy every day being alive.

Tomorrow I am going back to work after my forced "holiday" and am exited to be back at the Dealership again but am going to miss the extra family time with Kim and DJ which I got so used to

Cervelo P5-six review

Recently I've upgrade from my Cervelo P4 to the P5. Been riding the P4 for three years and to be honest I wasn't that happy with it compared to the P3. So when the P5 became available I had a good excuse to upgrade.

Initially Cervelo SA decided to only bring the P5-three to South Africa with no option of the "six". The main difference between the "Three" and "Six" is that the "Three" is UCI legal. The "six" comes with an integrated Anduro aero bar and stem, a deeper fork with the front brakes inside the fork. It also have the carbon option Magura RT8 Brakes and the front brake is covered by a faring.

Seeing that I don't participate in Road race events and prefer long distance triathlons I decided to rather get me the "Six"

Only problem, it wasn't available in SA but thanks to Marco at Cycle Tech, with whom I've been dealing with for almost ten years, he made a plan and got me one.

 I've done a  fair amount of training on it and also two Half Ironman and must say it is just superb. Much better than the P4 and remind me of the P3. One thing I like about it is that it is a solid bike and I get the feeling that you won't ride this bike to pieces, not like the P4 which I felt was a bit too "fragile"

The Bike is very stiff but at the same time it is a very comfortable ride. There is also very little flex and power gets transferred better. Handling is also great and when you point it into a direction it goes with a twitch.

With all the different options on the handlebar I could play around with the setting without too much change to my initial set up. What I also like about it is that Cervelo made sure that one can add components and accessories to the bike without compromising the aero, set up or look.

One thing I am very glad about is the Magura hydraulic brakes. The brakes are potent and worlds apart from the P4. It was something to get used to applying the brakes, been a while since I could lock my rear wheel as the P4's rear brake was just pathetic. Choosing a crank I opted for the Rotor Flow aero crank with 54/42 chain ring.

 I've opted to go with the Shimano Dura Ace Di2 group set. At first I had them build the Sram group set over from the previous bike but the angle at the stem is very tight and I found it difficult at some stages changing gears. The Di2 electronic system is flawless and I am very impressed with it. I haven't had any issues with it even under load and shifting gears rapidly.

After riding with a Fizik saddle for all these years I took a chance and swop to the Adamo Aero saddle. Best move I've ever done. The saddle is so comfortable and I can stay in the aero position much longer. No more shifting around on the saddle during my long rides.

As I said before one thing I am very impressed with is how one can add accessories without an issue. The Xlab stealth pocket uses two screws to fix it to the top tube. The Di2 battery is also stored within the frame close to the rear brake and it is easy removing it to charge it. I've decided to hide the Di2 indicator inside the stem. Only disadvantage is I can't see when the battery needs to be charged.

The Aero bar also has a base plate on which one can add a water bottle holder without adding extra brackets to fix the holder to the bar. Fitting a rear bottle holder to the seat post is also no problem as the seat post has a hollow "tube" whereby the water bottle holder "rot" slide into.

In Summary the Pro's and Con's

Pro's

The whole bike, no seriously this is the best TT bike I've ever ridden

Stiffness and handling

Power transfer and the frame not flexing

Magura brakes

Making provision to the frame to add accessories without issues

Con's

With the performance and handling of the bike I couldn't find any faults yet and the only downside is the Matt finish to the paintwork. It does look good but keeping the bike clean can be an issue

I think I'm Dying, No Really, I am

Just need to apologize in the beginning  for this long post. Like to keep things short and simple. Promise the future posts will be short again.

Picture above, my home for three days, the Medical ICU.

How many times have I said it, " I think I'm dying" especially after a hard race or tough training session but Sunday after the race I really meant it.

So what does it feel like having a heart attack. One thing I can say, it is the worse pain I've ever experienced. Not even breaking two ribs and my collarbone at two places last year when I had my bike accident can come close to this pain.

As I was driving back to the airport after the race we stopped at the" Petroport" on the N2 towards the airport and I went in to buy some water as I was very thirsty. While standing in the queue to pay I started sweating and was really feeling bad with the heart burn very intense. When I got to the car I asked Kim to drive as I couldn't.

 Just after coming out of theater 

While Kim was driving I had this immense pain all over my body, as if my body can't get oxygen and is suffocating. My arms were numb but at the same time had this intense pain. My calf muscles were trembling and I tried to feel what my heart rate was but couldn't get a pulse. My whole body was in pain with the heart burn just out of this world. I stuck my head out of the window just to get some air.

We don't know the area and instead of looking for a Hospital, Kim drove to the airport as they have medical staff on duty, or so we hoped. When we arrived at the drop off zone at the airport Kim ran inside looking for the emergency people. Some friendly porter guided her to their offices. While she was doing that I got out of the car and laid on my back outside the airport entrance. I was feeling terrible and people came to ask me what's wrong but I couldn't even answer them.

It felt like forever but Kim came back and said she found them and an Ambulance is on it's way. How many times have I heard an Ambulance siren but hearing it after a while was the most beautiful sound I've ever heard.

They got me in the ambulance and started assessing me while driving to the EMS offices. There they started treating me while they waited for another Ambulance to take me to Hospital. Can't remember how long it took but while we waited they treated me and gave me tablets under my tongue and put me on a drip.

 The day after the heart attack

The Ambulance came and took me to the Hospital's ER. It was quite scary as the ambulance drove and the guy working on me was talking on the two way radio (I think so), saying to them "We have a code red" and they must be ready this is critical and keep asking if the doctors are ready. That was scary, hearing all this and in all this pain.

As we arrive at the Hospital they were ready and the ER doctors and staff were amazing. The treatment was just out of this world, giving me tablets, pumping, I don't know what, into the drip and eventually got me stable. They kept telling me to open my eyes and not fall asleep as I just wanted to close my eyes and rest. I can remember at one stage the pain was so intense that I started crying and they told me to take it easy, my heart is taking strain. They kept giving me all these medicines and looking at the heart monitor that was hooked up on me. They also kept Kim in the loop of what's happening and comforted her.

They then got me into theater and inserted a stent into one of the arteries. Coming out of theater I felt much better and was already eating something that evening. One of the ER staff came to visit me that night and also the ER Doctor the next day, saying that people don't survive such massive heart attacks and I can be very lucky.

Can't remember every one's name but to the Paramedic, Mbuli, keeping me alive in the EMS rooms and to the ER doctor, Dr Karin, thanks for saving my life. Also to Dr. Pillay doing the surgery. Thank you so much!

Also, Thank you to Dirk, helping me and Kim at the airport to check inn and to get my bicycle on the plane.

 Kim's gift to me 

 Xterra race organizers gift 

The race organizers of the event came to visit me and Kim and gave us these gifts. The first three days I felt very tired but better everyday from then onwards. It's been almost two weeks now since the little mishap and feeling much better. 

I went for a follow up at one of the best Cardiologist in the country today and he did some tests. He say he can only say after six months if I have permanent damage but everything looks good and he feel comfortable to say that I should recover 100% and return to Triathlons. Say my heart is looking good, pumping as it should be, with no blockages or issues (firing on all cylinders, haha). I am not allowed to do any activity (high heart rate) for four weeks but can go for walks. After that I can start training very slowly but nothing over 70% of max heart rate.

 

Flying back home on the Friday (5 days after the attack) and waiting with the "silver brigade" to be "loaded" into the airplane. Just didn't feel right but I was too tired to walk and I just wanted to get home.

Me the night before the race, relaxing and talking to DJ. Unaware of what would happen the next day and who knew, maybe the last time I would have talked to my daughter without realizing it.

So why the heart attack. That was a mystery to the Doctors as I don't have Cholesterol, Sugar, any heart conditions or family history of heart attacks in the family. They did a lot of tests in the Hospital and everything came back negative, just couldn't pick up anything.
The Doctor said going on medical terms I shouldn't have had the attack. I am super fit, eat healthy, don't smoke or drink a lot.

One would never know but after today's visit to the Cardiologist he gave me two possible reasons after I told him exactly what happened and both make sense to me. Maybe it's not the reason but I will take it to put my mind to rest and move on, not going to stress about why.

Reason number 1
I told him that I was fine until the 3 km mark on the run. It was very hot and taking a look at my Garmin, my heart rate at that stage was 172 bpm. What I never thought about was at the 3 km mark there is a river crossing and seeing that it was very hot, I dived into the river cooling my whole body with the ice cold river water and not running through it only for my legs to get wet.
He say the sudden cold water could have let my heart go into a spasm (compared it with getting a cramp in your calf muscle) and that triggered the attack. The reason why I had the heart burn, dizziness and arms full of needles and pins directly after crossing the river make sense now.

Reason number 2
It could have been that one of my arteries had a small tear from all the endurance training/racing and this caused the artery to block temporarily and not supplying blood to the heart also causing the attack.

Well that's it, now on the road to recovery and back at a Triathlon soon, I hope.

Xterra SA Race Report

Next race was Xterra SA in Grabouw, which was also the South African Championships. For those who don't know Xterra is an off-road Triathlon and the distance was a 1.5km swim, 27km bike and a 11km run.

Results:
Finish: 3h38:50
Swim: 32:30
T1: 2:07
Bike: 1h50
T2: 1:25
Run: 1h12*
Age Group: 16th out of 72
Overall: 136th individual out of about 600

* Walked from Kilometer 3 to 5, (19:30 minutes for 2 km's). First symptoms of heart attack, Heart burn, dizzy and arms full of needles & pins

 With a 8:30 am start the day started quite relaxed and no rush to get things ready in transition. We stayed at a Guesthouse in Gordon's Bay and it was less than a 30 minute drive to the event. The swim was a fresh water lake swim and lucky for me the water temp. was 19c, so wet-suits were allowed.

 According to my standards I had a great swim. I started to the far left of the bunch and although it was a little further to the buoy, I had no "fighting" at the start, which happen quite often at Triathlon swim starts. I exited the water in just over 30 minutes and then had a longish run to T1

 The Bike was very good from the word go and I overtook a lot of athletes as the beginning of the bike course was uphill with no scary downhills. Just as I thought that this course is great with no downhills or rock gardens, I quickly realized this is no easy course. Had my ION camera rolling on my helmet and will post some footage later. Funny to see yourself overtaking a lot of people only to be passed again going down the rock garden. Apart from that the rest of the course was great with a little bit of everything.

 The run started very well and I was maintaining a 4:30 min/km pace for the first 3km. At the 3km mark I started getting heartburn and didn't know why as my nutrition was spot on and I felt great on the bike. I also felt dizzy and thought it must be the heat, as it was a hot day. I also had needles and pins in my arms. I slowly walked for 2km until I reached another water point. I felt better and started running again. Little did I know that that was the first signs of a heart attack on it's way.

The remaining 6km to the finish was good and I felt "normal" again and could maintain a good pace, passing a lot of athletes again. After spending some time re-hydrating in the athlete zone, I went to collect my bike when transition opened and wanted to start packing the bike in my bike case as we had a 17h00 flight back home.

My heartburn was back again and I said to Kim I need to get something for it at the Medical tent. They gave me something and said I could lay on one of the beds for a while. The medical staff took my blood pressure and after about twenty minutes I felt better and went to the car to pack everything.

Picture of Grabouw dam from air

After packing we left the venue on our way to the airport. I started to feel worse and I asked Kim to drive as I couldn't drive anymore. As we drove my whole body was in pain, sweating heavy, and muscle trembling with no vain in sight and I tried to feel my pulse but couldn't get a pulse. That's when I told Kim I think I am having a heart attack and she must get me to a Hospital.

More on this in next post

Prestige Ultra race report

 Three weeks of hard training and it was time for the Prestige Half Ironman*. Took the decision not to taper for this race and rather build mileage for Ironman in April.

Result:
Time 4h28:57
Swim: 42min
Bike: 2h15*
Run: 1h29*
Finished 7th in age group 40-49 (not the usual 40-44 group) and 28th overall

* Don't know why but race was not full half Ironman distance and bike leg was 83 km and run 20 km. 8 km short in total
The whole race was a two lapper, two swim laps, two bike laps and two run laps. Not bad.

 Swim was again a non wet-suit swim. Was actually hoping for a wet-suit swim just to prepare for Ironman and see if i could sort out my breathing. Took my old wet-suit, that is one size bigger than my current one, but obviously couldn't try it out. Swim was super slow but nothing new. One thing I can say is that although swimming is not my favorite leg of a triathlon, I just don't like swimming in the Vaal river. Super dirty compared to Buffelspoort dam or the ocean.

Onto the Bike and was keen to see if I could manage a good pace on tired legs. One thing about being a slow swimmer, you get that extra motivation overtaking loads of athletes on the bike. My legs were screaming from the start to finish but I was happy with the power output and could almost manage the watts I aimed for.

The run was also hard but luckily it was not a hilly route and I could manage a decent pace. Just before the start of the second lap I had to do a pit stop and lucky for me the whole run route was through a neighborhood but just before the turn around there were some bushes. Lost about a minutes there, but hey, had to stop. Runners know that feeling when you have to go and actually struggle to run. From then on-wards the second lap was actually faster than the first, haha. One thing about doing a Half Ironman on tired legs is that it takes a lot out of you. Felt so tired afterwards that Kim had to drive the odd 250 km home as I just wasn't up to it, doesn't happen that often.

Happy with my race and now it's another hard week of training before Xterra South Africa in Grabouw this weekend. Haven't mention it but I'm with a new coach. Made the switch just after Iroman 70.3 SA. Happened by accident (if you can call it that) but more about that later.

Xterra Buffelspoort race report

Well it was only a week after Ironman 70.3 South Africa and it was time for Xterra Buffelspoort. I knew that it would be a difficult race, first of all I'm no off-road expert and obviously because it was only a week after a 70.3. Luckily, or so I thought, the distance was only 1.5 km/27 km/12 km but to my surprise it was very hard and a very warm day.

This was my first Xterra race and I must say I was surprised at the relaxed atmosphere compared to Ironman racing. I've done some Mountain bike races and some Trail runs before but never an Xterra.

Result:

Time: 3h22

Swim: 35 min

Bike: 1h28

Run: 1h16

Finished 8th in my age group and 48th overall.

The swim was a non wet-suit swim and do I need to say more. Luckily I didn't get a panic attack again or ran out of air but decided to just get through the swim even if it was slow.

Onto the mountain bike and I must say I enjoyed it. Not too hard with some amazing singe track and most importantly I didn't fall. Overtook a lot of riders on the bike which gave me some extra motivation. One thing when you don't have the technical skills and have been involved in a big accident is that I overtook a lot of people going uphill but then all of them overtook me again going downhill, and there were some serious downhills. One thing I realized again is that I will never be a downhill racer, don't have the courage for that. 

Then things became ugly on the run. Not nice running on tired legs after the previous week's race and also if the run route is going up a mountain twice.

First I had to negotiate running down next to the Dam wall over the low water bridge and then up again at the other side of the dam wall. OK, not running, actually walking when the gradient is 22% for 150 meters with the gradient as some point 45%

From there on it went OK until we hit the mountain. Only 2.3 km at 8.5%, with the last 1 km at 12.5% gradient but on tired legs that is brutal. Down the other side and before I could recover it was another uphill. This time it was just short of 1 km but at 13%.

Luckily that was the end of uphills but then the dreaded downhills on tired legs. At the end I finished and was feeling great finishing my first Xterra and more importantly not injuring myself.

Now it's three weeks of hard training before another Half Ironman, the Prestige Ultra