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Why Tuesday?

The Girlfriend's Guide to Health will be updated every Tuesday.... Stay tuned dear readers and let me rock your world.

Tuesday, July 30, 2013

Fact Mongering

Just last week I found myself in front of a television in the middle of a weekday. You see my sisters- I had the stomach flu. Just the weekend before I sat next to an 11 month old child at a restaurant. Sure, he was in my dining party and yes he was adorable. But the cute ends there.

Innocently enough I gave him my cutlery to play with while we waited for the meal. Yes I know it may not be wise to give an 11 month old a fork and a knife for a toy- but hey, I am not a parent and these were desperate times- there were no crayons at this posh dining establishment.

And so this sweet cherub of a kid played with my dining utensils and amused himself while we waited for cocktails to arrive. He delighted the table with his cute little antics. He gave us joy and laughter as we watched his little show. And right then and there he also gave me a gastrointestinal virus. God bless the Daycare system.

Yes, I should have asked for new cutlery and no I did not. Why not, you ask? I am a doctor, I should know better. Well, I am not a parent. And NOT being a parent, makes you stupid in all things parent related.

So three days later I began vomiting during my clinic and PHYSICIAN HEAL THYSELF, I left work…. For two days.

There I was on a Wednesday afternoon, praying for death and drugs to kick in, hoping for a distraction….

And so I turned on the TV. What struck me most was the commercials. At 3 pm on a Wednesday on any given network, it has come to my attention that every second advertisement is for a commercial weight loss program.

Whether it is hyponotherapy or a bullshit program it has come to my attention that North Americans are getting bombarded with a variety of ill conceived promises.

I lost 35 pounds in 2 weeks and have kept it off for 5 weeks all with Raspberry Ketones.
My consellor at (insert weight loss program here) has 2 years experience in the business
Hyponotherapy really worked for me. After years of struggling with my weight I went to sleep and woke up thin.

I am not exaerating my sisters…. I am quoting from my television set. Now I know my sisters are smart enough to know that much of what we see on TV is indeed not real. But I could not help but wonder what this kind of relentless mind influence has on a vulnerable population who desperately want tot be healthy?

You would never see Jenny Craig pushing a new cancer therapy, nor would you dare see an add for hyponotherapy to cure your liver cirrhosis?

Sisters- do help. Shine a light on a mystery of mine. What is it that turns logical men and women in the world into the most gullible people in the world, ready to believe in anything?

Perhaps we are born to just believe in certain intagible dreams.

Think about it…. As little girls and boys we suspended belief on a daily basis- whether it was Santa or the Tooth Fairy or any Disney princess we just had believe.

Then we hit puberty and we moved on to bigger delusions involving video games and the internet.

As adults we follow suit with lottery tickets and weird fashion choices. Sure I buy a lottery ticket and yes, I’ve never won- but hey…. Someday.

Yes, the mirrors at my favourite boutique really are meant to make me look 10 pounds lighter- but hey- I am buying that dress because it makes my butt look good.

So why should I be surprised that everywhere across this great world at any minute there are thousands of men and women at this very minute willing to sell their souls for a promise some commercial makes for a better life, better face and a smaller ass.

Perhaps its that we all just want to believe in a little magic?

According to a study published in the Journal of Clinical Nutrition in 2007, an estimated 15.2% of American adults have used a weight loss supplement of some kind. Just over 20% of women in America have used a weight loss supplement while 9.7% have ever done so.

More than 10% of women have reported long term use of any agent for over 12 months time. Interestingly, less than 1% of users have reported successful effects. Of the agents used 73.8% contained some sort of stimulant, (either caffeine or ephedra). More than 50% of users used a supllement containing ephedra.

A Cochrane review published in the American Journal of Clinical Nutrition in 2004 looked at the evidence for over 25 weight loss supplements. The study involved over 35 trials and found no evidence that any of the supplements aside from ephedra offered any benefit.

There have been numerous studies pointing to the dangers of ephedra as a supplementation since.

In 2010 the FDA released a position paper warning consumers and patients against the harms of weight loss supplements.

In it the FDA cited a concern that some weight loss supplements are indeed tainted with stimulants and other prescription medication.

As a doctor I am constantly asked by my patients about the latest and greatest weight loss supplement. I would especially like to give a special shout out to Dr. Oz
For encouraging such behaviour. Promises, promises.

As a fellow girlfriend, I do indeed get it…. We all want to live the dream for a while and sometimes the dream is packaged just right. When I was 6 it was the Tooth Fairy, in my 20’s it was the lottery. These days it’s the skinny mirrors at high end retail stores.

AS for commercials on TV that promise to make me better, faster and thinner? I’ll stick with the skinny mirrors at Holt Renfrew…. At least I can see the look on my face while I’m trying on my next illusion.  

Tuesday, July 23, 2013

I have the flu.

It began at 10 am this morning. I blame the Royal Baby. Why? Because dude is getting far too much positive coverage lately and babies are know for their infectious properties. 

I know this sounds ridiculous, but yes (I’m gonna play the trump card) TRUST ME…. I’M A DOCTOR.

First began the nausea, then the vomiting. Man that was fun.I am now full on into fevers, chills and feeling like I was going to lose my stomach contents at a moments notice.

Make no mistake- I am not looking for sympathy. We all get the flu. Hell I am sure some patient somewhere coughed the wrong way and bingo I’m a Petri dish. It happens. I work around a lot of sick people… this was my first flu of the year… my time had come due.

And normally I would have taken it like a champ. Afterall- I could use a nap?

But, my flu came about on the morning I was in clinic. 

Everything is magnified when you have to be professional. 

Let’s be clear, I came prepared, despite my predicament. I do work in a doctor's office. 

I had an empty stomach, a fist full of Advil, a bottle of fluids, Gravol and the an amazing assistant. 

She would cancel my afternoon and I would work the morning with pharmacotherapy. 

The plan was simple.

Keep my stomach empty.
Take the Gravol first and a small amount of fluids, so as not to vomit up water between patients. 

1. Down the Advil 45 minutes after the Gravol giving the antiemetic (anti-vomit medication) time to work and allowing the anti-inflammatory to kill the pounding in my body and brain.
2. Cancel afternoon of clinic
3. Take bus home
4. Leave bike at work
5. Crawl in bed
6. Pray for death. 

So here I sit not doing so hot. Forgive me my sisters if GGTH will be a bit late this week. My post will no doubt cover the Royal birth as we are all shameless in our obsessions and I am no exceptions.... stay tune, my girlfriends and wish me well. 

Tuesday, July 16, 2013

Iron Woman

Yes, it is Tuesday my sisters, but truth be told, I wrote my blog this past Sunday. No I did not sit in a lovely café and channel the witty over an Americano and a prayer. Instead I spent just under 8 hours racing in the Subaru Vancouver Half Ironman.

Yes, my girlfriends, over the course of the day I dreamed up the following report during the swim, bike and run.

You see my sisters- I had 7 plus hours to kill as I physically pushed my limits to the limit. Yes it was a crazy race and no I was not allowed to wear headphones. Not only was I expected to swim 1.9 km, cycle 90km and run 20km, I was expected to listen to my inner voice for the duration.

Allow me to share with you the process….

After a bit of a fitful sleep the night before I woke up at 4 am. Having gone to bed at 9pm on a Saturday nothing says neurotic like waking an hour before your alarm just to mentally ponder the day ahead in an athletic crazy voice. There I lay with my beloved sleeping soundly next to me as I fretted….

What if I don’t make the cut-off for the swim?
What if they pull me off the bike course for taking too long.
What if I panic in the water?
What if ?

I should preface this little display, my girlfriends, by saying that this level of worry is very uncharacteristic of me. Ever a fan of self knowledge I should say that I am more of a get it done first, think about it after kind of girl. I rarely ponder implications that seem well beyond my control. Between this level of neuroses and the 4 am middle of the night up while everyone else was asleep- I found myself increasingly unsettled.

Sure enough, the hour passed and I met the dawn with a cup of Tim Horton’s (no product endorsement- it was the only coffee shop open 24hours and I AM Canadian, afterall) and a half of a peanut butter sandwich.

I should say that the one great benefit about committing to this extreme endurance type of exercise is the ability to eat whatever carbohydrates you like for a good 48 hours. There is a freedom in that- that somehow does make the pain to come more than reasonable.

I arrive at the triathlon at 5:30 in the morning. Having dropped of my bike the night before I make my way into the transition area to set up my little area that will act as my “locker-room” if you will for the day. This is the place where you put your cycling and running gear in preparation for each upcoming stage of triathlon and where you drop off whatever gear you have just used.

And now for a word from our wardrobe sponsors.
Triathlon, like any good activity in life is all about the outfits. I do believe what draws me to this sports is the fashion component. In triathlon there are not one, but two costume changes. For someone like me- this is almost as good as the guilt free carb loading I have engaged in the night before.

Allow me to talk you through it….

You begin the day in wetsuit. You swim 1900 metres in the ocean. You run up the beach for about 800 metres to transition. During this time you are expected to have unzipped your own wetsuit and brought it down to you waist. Once in the transition  area you pull the wet rubber off of your hips. Underneath is your tri-suit. A tri-suit is combination swim/bike/run number that is much like a spandex swimsuit meets cycling shorts. It is usually sleeveless and comes in one or two piece variations. There is a just enough padding in the crotch area; enough to protect the “good china” but not too much so as to make you feel like you are running in a diaper.

You then put on your helmet and bike shoes. Slap on the sunscreen and the body glide…. Place your “food for the road” in your pocket of your trisuit and head off on the bike for the 90km ride ahead.

After returning from said ride- you come back into transition and put your lovely bike back on its rack. You slip off your cycling shoes, remove your helmet and put on your running shoes and a hat. After reapplication of sunscreen and a stock up on a sugar source for the road ahead- you head out onto the run course for the 20 km hopeful that the finish line will not elude you.

As I write this, I am fully aware of the madness. As I lived it, it became more moronic than anything I have ever done.

There I am at 6:15 warming up at Locarno beach. I am in the water with about 100 other lunatics having a bit of a “practice swim” before the starter gun goes off at 6:30. I make sure my goggles will not leak and out of fear and need I pee in my wetsuit.

Oh, my sisters…. If you’ve never pee'd in a  wetsuit- go out and do it immediately. Seriously- you really must try it. It is nature’s “get out of jail free card” – no one knows you are doing it, it feels great on the bladder and nothing warms up a cold suit in a cold ocean like one’s own urine.

Fifteen minutes later I am on the beach at the start line. The gun goes off and the serious lunatic among us race to the ocean. I hang back, knowing that I am a slower swimmer, and not wanting to get punched in the face in the ocean by a type A personality with something to prove. My goal is to make it out of the water in 1 hour with a smile and all of my teeth.

Despite my warm up, the cold water still hits me. It takes me a good 200 metres before I calm down and find my groove. We must swim two rotations of a 950metre course. I swallow salt water liberally and veer off course at times- due to the ocean current, but overall, my swim is pretty invigorating.

Only once, about half way through the swim does the “bitch bully” voice in my head ask why we are doing this. I answer simply…. “because we can”.

After 57 minutes in the ocean I emerge from the deep and begin the run up the beach. People are cheering as I pull off my bathing cap and goggles and I wonder if I can hire some of these lovely spectators to come to my office and offer the same level of encouragement to me throughout any given day. I am convinced that if I had a cheering squad on, let’s say, a Wednesday, my day would go much smoother.

The run up the beach puts me out of breath. In my minds eye I think I must look like Halle Barrie in that James Bond movie when she’s running out of the water. In reality, I suspect I am more of a comedy montage from a Saturday Night Live sketch. Screw reality.

I get my wetsuit off of my torso but have to sit down in the transition zone in front of my bike and wrestle with the rest o it to get my legs free. Pulling a wetsuit off a wet body unassisted is like taking a bathing suit off of a harbour seal, while the seal is still swimming. I have never seen a seal in a bathing suit…. Having wrestled my own body out of a wetsuit during a race… I understand why. A wet body is just a bitch to undress.

Now breathing heavily I put on my bike helmet and dry my feet. I slip on my socks and my bike shoes and pack my pockets with energy bars and sugar laden sports gels for the ride ahead. I grab my bike and run to the MOUNT line. I get on my bike and begin.

I have allowed myself 4 hours for this 90km bike ride. This is a long time, but I am built for comfort and not for speed. The course if 4 loops around the University of British Columbia which included a motherfucker of a hill just to keep one humble.

I ride in silence. There is no music in my ears and I find my rhythm. My first lap of the course leaves me feeling strong and fabulous. I finish 23km in 45 minutes and I feel great. I have been passed by more riders than I can care to count. I am slower than the norm but I am loving this. Riders pass me up the hill and down the hill. They are all equally polite to tell me they are coming and some even offer encouragement as they go. Every few minutes a very fit man or woman with 2% body fat on an $8000 triathlon bike will whiz by at 45 km an hour and shout “looking good”. I offer an “awe shuck, thanks” response and keep pedaling.

I look forward to the time when I will whiz passed someone and yell “looking good” to THEM. This does not happen.

In the three hours and forty five minutes that it takes me to complete my bike course, I pass no-one. Instead I resign myself to the reality that as others pass me and yell their encouragement to me I will respond with “you look good too”. It works like a charm.

There I am the last one on the bike course…. The ambassador of it all. I feel like a queen holding court at bike camp. They have all seen me come and I have seen them all go. On my last loop around the course, I do the absolute unthinkable….. I pee on my bike.

I should say that I really love my racing bike. She is a Cervelo S5 (yeh, I name dropped) and she is perfect. But I read somewhere that most long distance triathletes have peed on their bikes as do athletes in the Tour du France.

In my defense, I had to go and I was just really happy that this was a good sign that I was not dehydrated. And so in the spirit of the great sportspeople before me I road down the UBC hill for the last time and let my bladder fly.

At 4:55 on the race clock I make my way back into transition. I rack my bike full in the knowledge that my ass is completely numb. I spent the last 90 minutes swearing in my head. I am covered in sweat and salt and yes, urine.

I slip off my bike shoes and put on my running shoes. I reload my energy gels and put on more sunscreen. I briefly think of my dermatologist and know that regardless of how I finish- he would indeed be proud. I place a large running visor on my head, my race number on my waist and off I go…. To run just short of a half marathon. No problem.

Truth be told the first 10km were indeed not much of a problem. That is until I hit the 11km mark and the bitch bully in my head reappeared encouraging me to either give up or cheat. I am NOT a cheater. I am honest to a fault, but I must say that 102km into a 111.9km race and I was seriously wondering about where I could cut corners.

I soldiered on hushing the voice in my head. I tried to focus on the beautiful day. There I was running along the beach, doing the craziest most intense activity I had ever done. Was this not amazing?

Not so much. My fatigue was at an all time high and I am someone who had been on call for decades. I was hungry beyond belief and my body smelled like salt and vinegar. This was not pretty.

But slowly 8 km to go became 4km and then 2. I was the last runner on the course and I had 2km to go. The race clock said 7:30. They close the course at 8 hours. I had half an hour to complete the last 2 km and I knew, even if I walked I would make it. There was no way in hell that I was walking across that finish line. I would run regardless of the fact that my legs had stroked out three kilometres ago.

You see in long distance triathlon- they cheer almost as loud for the last person on the course as they do for the first person off it. Cross the finish line first and yes, you are a winner who has achieved a triumph of serious physical and mental means. Cross the finish line last and you are someone who has achieved a triumph of the spirit.

And sure enough I approached the finish and heard the announcer,
“Gather round ladies and gentleman and welcome her home. Our last athlete on the course, Dr. Ali Zentner. Welcome to the finish line of the Subaru Half Marathon. You look great Ali!”

And there it was. And so it is.

I had a whole study laid out for you my sisters about the risks and benefits of endurance triathlon that I was going to insert here.

But as  I write these words, the tears fill my eyes and I remember that sometimes in life as in medicine the spirit is more powerful the science of it all. Sometimes there is no need for a full on fancy study to push our knowledge further. In those moments, thoughts and methods and disciplines fall away and all we are left with is the art of it all.

The art of a crazy lady with something to prove to noone but herself, racing towards a proverbial finish line on a perfect Sunday afternoon.

Tuesday, July 9, 2013

The Ultimate Power Suit

Happy Tuesday dear sisters. As I write this blog I am sitting in my latest new outfit. Yes, my sisters- may I say that I have made a rather fabulous fashion purchase.

No this was not a perfect pair of strappy sandals and no I did not invest in a new summer fabulous of any kind. Instead I  found my self in my ultimate new power suit….. my new wetsuit.

Oh sweet sisters- have you been in a wetsuit? If not… allow me to talk you through this fashion experience.

A wetsuit is basically a suit made of neoprene coated in rubber. It’s basically a body condom lined in scuba material. On the good side? It is the ultimate set of spanx. A wetsuit sucks “everything in” in all the right places. My wetsuit makes me feel like a superhero. In my wetsuit- I AM Wonderwoman. In my wetsuit I am a size 6 supermodel and I piss awesome.

This is of coarse all possible ONCE I am IN my wetsuit. Getting into my wetsuit is indeed the down side of it all.

Have you ever tried on a wetsuit? In short… it’s a bitch to get on. You know that scene where you are putting on a pair of control top pantyhose that are easily a size too small? You struggle and you suck it in and you bounce around on one leg and before you know it- you manage to put all of your wiggly bits into the right place.

Let me paint the scene. There I am in my fabulous new bathing suit that I will wear to my triathlon as I hold my wetsuit in front of me. It is a black rubber full length suit with just the right amount  of blue accents on the arms and legs. My wetsuit is beautiful black and laying there it looks like it might be the promise of perfection for my race this weekend.

And then I try and put this rubber suit on. And that is where the beauty ends.

Putting on my wetsuit is indeed a work out in itself. I stick my feet intro the rubber holes that are the legs of this suit. I then spend the next 5 minutes wrestling with this rubber suit as it fight its way onto my thighs. I feel as though I am wrestling a very large animal wrapped in rubber bungee cords. And the large rubber animal is my lower torso. I am sweating now. I muster a grunt- more for effect than anything. After much effort I have managed to put this rubber suit over my hips and thighs. And now I pull the suit up over my chest and torso and slide my arms into it.

By this time my body temperature is easily three degrees higher. I am now sweating but I am zipped in. I turn to look at my reflection in the mirror and yes…. Despite the sweat over my face and the fact that I look like I’ve just ran a few kilometers- I am in this suit and I am ready for my magical moment.

This morning I engaged in this very ritual at the beach at Kitsilano. My goal was to swim 2km in Kits pool in my wetsuit and then to take a turn in the ocean.

My plan was to get my “ocean legs” wet- to play in the ocean until I was really and truly comfortable there. You see my girlfriends- I have a 2km ocean swim ahead of me on Sunday and I am…well… a bit unsettled by the idea of an ocean swim.

 It’s the whole idea of putting your face in the water and seeing nothing but green. IN a pool you can see the bottom. In the ocean the view looks like pea soup. It can be a bit unsettling. If I am truly being honest- the first time I did it.... it scared the shit out of me.

It's like staring into space and having an existential crisis all at the same time. I think it's about feeling alone in the world.... that primordial sense of isolation that human beings find so alienating. Yes, I am being philosophical. To bring it down a notch? It feels like you are 6 years old and afraid of the dark. Instead "the dark" is the ocean and you are by yourself in it. You put your face in and can't see a thing. If you do see something it might be a shark..... okay, I'm being dramatic and a chicken shit. But hey, go with it.

And so I needed to rid myself of this irrational fear. My plan was to put a song in my head and may face in the water and not come up until the fear had washed away. 

There I was on a beautiful day off frolicking in the Pacific in my new wetsuit. I put my underwater MP3 on and listened to Vampire Weekend as I pretended I was one part Wonderwoman- one part mermaid. Thirty minutes later- it worked. There I was jumping and swimming and diving up and under to some fabulous tunes on a fabulous day in a fabulous new wetsuit. And I was anything but afraid.

Swimming in a wetsuit is indeed an interesting experience. There you are encased in rubber and I must say that breathing is a bit more laboured than in a regular bathing suit. It feels a bit “compressed” if you will.  This, however, gets better with experience. Ten minutes into my wetsuit swim and I was much better at the breathing/rubber combination.

With all of these adjustments, one must ask a sister- why even put on the wetsuit?

Turns out- there is an advantage to swimming in a rubber suit when swimming in the ocean.

Firstly there is the warmth factor.

When a swimmer is submerged in water- the water flows into the suit settling between the rubber and the body. The swimmers own body temperature will warm the water and therefore warm the swimmer. As you swim- the body warms up and warms the water further. Again this warms the body further. And so a wetsuit is the perfect way to keep you warm when you are in the Pacific Ocean in the pursuit of a dream.

Then there is the concept that a wetsuit improves your buoyancy and therefore improves you speed. Think of it like a boat driving on the water. The more you are able to stay on the surface- the faster it will be.

According to a study published in the British Journal of Sports Medicine in 1991, wetsuits indeed improve performance in both short and long distance swims. The study looked at 16 elite athletes swimming both in and out of wetsuits at 400m and 1500m distances.

While wearing a wetsuits the swimmers were able to reduce their speeds by 14 seconds on average for the 400metres and 35 seconds for the 1500 metres.

The interesting thing was that the effect was most pronounced for the thinner swimmers. The theory was that heavier swimmers were already more buoyant and had an added advantage.

And so this Sunday, my girlfriends I will frolic in the Pacific and swim for glory in my fabulous rubber suit. I will be warm thanks to the mechanic of it all and I may even pee shamelessly in the suit if I want to. Who knows if my time will be better with the suit than without…. As with most things, my girlfriends- I’m in it for the fashion statement more than anything else. 

Monday, July 1, 2013

And on this day, she rested

Oh my sisters. You will forgive me if I bail on you this week. We all need a bit of a holiday once in a while and, well, I am taking mine. So tune back in next week and I promise to be refreshed and rejuvenated and ready to start the summer of right.....