-By Kaitlyn Patterson, Team Athletic Mentors cyclist

The question of the perfect Iceman bike is a favorite perennial debate. The reality that there is not just one ideal Iceman bike was illustrated in the past several years where the men’s race has been won on bikes ranging from full-suspension to full rigid with drop bars. I’ve split the difference over my five previous Iceman races- two on a full-suspension, three on a hardtail and this year is yet undecided.

I started out the sport on an entry level full suspension, 27.5 Giant Lust which was my Iceman bike in 2014 and 2015. In 2015 it was enough to hang with the leaders but ultimately end up fifth. In 2016 I upgraded to a Giant 27.5 XTC Advanced hardtail which was a factor in vying for the win and ultimately ending up second. I selected the XTC as a race rig for the Michigan fall classics as the simplicity, weight and versatility is hard to beat and it has represented well over the past three years. The responsiveness and quickness of the smaller wheels is definitely a benefit when trying to make the definitive moves necessary to break up a lead pack on the high-speed VASA highway. Although my fitness level was only high enough to do this (almost) successfully in 2016, the bike was definitely a factor in gapping the field on the Boonenberg climb that year.

However, this year with my partner in crime, Alex Vanias prioritizing ski training, his full-suspension Anthem Advanced 29er has been generously offered as a potential Iceman rig. Now it is my turn to weigh the pros and cons of full suspension versus hardtail. Although it rides very fast, much of the Iceman course is not particularly smooth, especially by the end of the day when many of the downhills are rutted from thousands of prior tires. Although the number of punchy climbs especially in the second half of the race are deceptively hard, there is not a lot of total climbing, negating some of the benefit of a hardtail setup.  Given that my descending and handling skills remain my weakness and I haven’t clocked as many hours on the bike this year, the handling itself may be worth the costs in weight and stiffness.

Although I think they would be neck and neck when raced side by side, I’m sure there are many theories in both directions. I will decide in the coming week and be looking at Peak2Peak for a test run of the chosen Iceman bike!

The post The Iceman Weapon Selection appeared first on Team Athletic Mentors.

–By Kaitlyn Patterson, Team Athletic Mentors cyclist

The first Saturday in November is a date circled in red for the past five years and stands as my favorite bike race/party. Thinking about riding into Timber Ridge into the celebration zone usually gives me goosebumps all year.

I would love to say that every year I carefully crafted my training to arrive at Iceman as fit and fresh as possible, with my equipment dialed and mentally ready. In reality, most years my build-up has been less than perfect and the race itself has felt like pulling a rabbit out of a hat, with me more surprised than the crowd about the result. Starting medical school in 2016 has been an awesome ride but also a complicating factor in bike racing, mostly in the unpredictability and uncertainty of the process. The constantly changing schedules, clinical demands, testing schedules, and travel were things I didn’t necessarily expect when I started but were actually just as challenging as the material itself. However, exercise has always been my way to recharge which is why I prioritized it, even if not in the form of structured training on the bike. Every year certainly brought its own different challenges and it has been simply good timing that the fall was possible to spend more dedicated time on the bike and the season that I would get the itch to race.

Now in my final year of medical school, this season is turning out similar. I have spent the last two months living out of a suitcase rotating at different institutions and will begin interviewing for Physical Medicine and Rehabilitation residencies in the coming weeks. Although I didn’t plan to race given my interview schedule this fall, it looks like I may be able to line up in November. My summer and fall have been filled with plenty of explorations in new places by foot and bike, but certainly not structured training. However, Iceman is calling yet again and I will see what I can put together this year. The last several years have created some pretty high expectations but this year I’m just hoping to be able to stay in the mix.

In reflection of the past five years of Iceman and preparation of this year, I wanted to add to the Iceman banter. Over the following couple weeks, I will share a series of blogs sharing my thoughts and experiences on bikes, training and strategy for the big dance. Happy Iceman season!

The post Iceman Cometh Yet Again appeared first on Team Athletic Mentors.

-By Kaitlyn Patterson, Team Athletic Mentors athlete

As a rising fourth year medical student, I enjoy writing as an opportunity to reflect on ideas relevant to both medicine and athletics as this is an obvious reflection of my daily life.  I am intrigued with the parallels between the process of physician and athlete training and it is a fun challenge to try to organize these ideas into cohesive posts.

One of my college cross country coach’s mantras was to “trust the process.” I didn’t give it as much thought at the time, but have come to recognize the weight of this task. The “process” is usually not glamorous or social media worthy. It involves consistency and a steadfast commitment to the basics. In athletics, this means doing the “boring” things right everyday- sleep, nutrition, stress management, recovery and training stimulus. In medicine, the process is less straightforward but still requires meticulous attention to the foundations everyday- asking the right questions, meticulous exams, thoughtful clinical decision making and effective communication. When you are in the midst of either process, sometimes it can be hard to measure progress or judge success. Feedback is a powerful tool but sometimes the feedback we receive isn’t as straightforward or easy to interpret as we would like.  This grey area, where we are working hard but a bit unsure if we are making progress, is the most challenging for anyone- be it athletes, students, physicians, or any professional.

The process of medical training feels like occupying the grey area constantly. Medicine in itself involves more uncertainty than we like to admit, making the process of learning that much more challenging. It involves constant questioning of your own capabilities as a healthcare provider, decision maker, and communicator without obvious feedback. Despite benchmarks and evaluations, quantifying meaningful advancement in this space is challenging. Occasionally there will be glimpses of progress – sometimes with patient encounters that go especially well, moments of being spoken to as a physician colleague, or reminders of the transformation undergone over the past several years. However, feedback can be subtle and identifying both strengths and weaknesses requires practice in self-reflection.  Although the learning process is formally measured in years and benchmarks, it has become increasingly apparent that the process never actually ends as it is persistent curiosity, reflection and attention to the basics are habits of the best physicians.

In athletics, it is easier to quantify progress in numbers: training hours, distance, power, and heart rate. Races are concrete and straightforward benchmarks of success: podiums, age group places, times, rankings. However, the grey areas still exist- such as the off-season, long training blocks, performance plateaus, or races that are not satisfying, yet not epic failures. Sometimes in these spaces, it seems like failures would be more satisfying to at least allow for more obvious feedback or take-away lessons.  These are the analogous grey spaces that requires a bit more self-reflection and attention to less-obvious feedback to continue the upward trajectory. However, these are also the hardest days or times to describe to others and process for ourselves.

I think we all have a baseline aversion to uncertainty and “grey areas.” I think this may be accentuated by the age of social media but I am not sure.  I do think it is the commitment to the process despite the noise, uncertainty and self-doubt that makes for the most sustainable and ultimately satisfying progress.  Definitely easier said than done, but something to strive for nevertheless.

The post Trusting the Process appeared first on Team Athletic Mentors.

-By Brian Reynolds

It’s winter in Michigan and you know what that means for us triathletes.  It’s the Off-Season! Hopefully most of you are back training again after taking a break from the season.  I’ve always enjoyed the off-season because you can make big gains to set yourself up for a good season. The best way to make big gains is to work on your limiters because let’s face it we all have something to improve on.  So the question you may be asking yourself is “What should I work on this off-season”?

A good place to start is determine what your big races are next season because this will give you a better idea on what to work on in the off-season.  What are your goals for your big race(s)? Do you want to win or podium in your age group? Do you want to qualify for USAT Nationals or Kona? Do you want to set a new PR?  Whatever you want to accomplish at your race you need to determine what it’ll take to meet those goals. For example, if you want to podium in your age group you can look up the podium finisher’s past results to find out their splits per each discipline.  Base on those race results you can figure out which discipline you need to improve on to become more competitive. It’s also important to assess if the time improvement needed is realistic per that discipline because if it’s not then you may need to get faster in the other areas.  When you know what it’ll take to meet your race goals you’ll have a better understanding on what you need to focus on during the off-season.

It important to have off-season goals to help keep you on track and accountable to your training.  You want to make sure that your goals are measurable. For example, some measurable goals could be to increase your FTP on the bike, threshold swim pace, or threshold run pace.  What should I target for my goal paces and power? Good question! For the bike you can use tools such as Best Bike Splits to help estimate the power required to do the bike course in a certain amount of time.  If you know roughly the power you need to sustain in the race then you can correlate that to a FTP number. For the swim you can compare your paces to the paces of your competitors. If your competitors are swimming 5 – 10 sec per 100 faster than you then you can set your threshold pace goal to be 5 or 10 seconds faster.  Similar to the run you can check out your competitors run paces.

When you have your specific goals set for the off-season the next most important question becomes “How are you going accomplish your goals”?  For the bike if you are not too familiar training with power you probably need to consider getting a training plan or better yet getting a coach.  For the swim if you are swimming between 1:40 to 2:30 per 100 it would be a good idea to look at improving your swim technique. Athletic Mentors offers a video swim analysis and have experts on deck to help critique your swim stroke and will provide helpful tips and drills.  Better yet you can join a winter swim program to work on technique, speed, and stamina such as the program that Athletic Mentors offers. If you are proficient swimmer (under 1:40 per 100) then you can consider joining a master swim program to swim with other faster swimmers. Finally for the run you can join a run camp or if you are a experienced runner the best bet is to hire a triathlon coach to help optimize your running while balancing the other disciplines during training.

Finally if you fall short from hitting your off-season goals don’t sweat it you have time during the race season to continue your improvements.  Remember that the most important question is that “Are you faster than you were exactly one year ago from today?” If that answer is “Yes” then you made progress which is what all endurance athletes are striving to achieve.

The post Off-Season Goals appeared first on Team Athletic Mentors.

-By Kaitlyn Patterson, Team Athletic Mentors cyclist

I’ve been intrigued by the endocrine system and nervous system for quite a while and after the grand tour of the major medical fields over my second and now third year of medical school, they continue to be my favorites. They are dynamic and responsive, influencing our eating patterns, sleep, body composition, happiness and performance. The endocrine system works through pulses of hormones – growth hormones, stress hormones, insulin – all with different patterns but always dynamic.  In fact, the hallmark of a dysfunctional endocrine system is a stagnant or non-responsive hormone. The nervous system is also constantly changing- toggling between different modes: the sympathetic, commonly referred to as “fight or flight” and parasympathetic or “rest and digest.” Similarly, there should be a cycle to this as well since either one isn’t meant to be always on. The nervous and endocrine system work together to make sure your physiology matches whatever situation you happen to be in. Quite impressive really.

Image: Wikimedia Commons

One of the themes I have been struck by during my clinical training is the number of medical problems associated with chronic stimulation of the sympathetic nervous system. Most of these are common chronic diseases- sleep apnea, COPD, congestive heart failure, type II diabetes. It is an appropriate response by the nervous system as it is answering to a real threat- be it a lack of adequate oxygen entering the lungs, episodes where breathing stops, or a heart not pumping adequately. However, the constant activation of the sympathetic nervous system eventually creates its own problems- including reduced sensitivity to hormones like insulin and even depression. A sustained stress response is actually one of the possible mechanisms of the high rate of depression after heart attacks or strokes.

As athletes, we depend on our sympathetic nervous system every time we jump on the bike, in the pool or lace up the running shoes. It helps orchestrate the physiological response to exercise to allow us to do physical feats, feel good doing it and induce health benefits. As long as the stressor is episodic and followed by a shift to parasympathetic (recovery) mode for a time, all is good. However, it can be all too easy to abuse the sympathetic nervous system. Whether it be becoming greedy about training volume or intensity, additional life stress, lack of sleep, or under-fueling, sometimes the balance can be tipped into spending too much time in “fight or flight” mode.

At first, this is not obvious and we can get away with asking a lot of our sympathetic nervous system and even feel good doing it. However, it is ultimately unsustainable and can create the same type of maladaptive changes as seen in chronic diseases discussed earlier. Although performance might not decline initially, the first signs  can include waking up too early and not being able to fall back asleep, feeling irritable, hungry, or losing motivation to train. If it continues it essentially can create a state of nervous system exhaustion when performance is significantly impaired. This spectrum is often referred to as “overtraining syndrome” although it is still a poorly understood phenomenon.

I personally believe this process is what many people refer to as “burnout.” Burnout is a bit of a buzzword especially in medicine right now, but it is often used as an ambiguous term. However, it appears there are parallels between athletic and professional burnout and both consistent with a maladaptive stress response with a big factor being the constant sympathetic nervous system stimulation.

I am guilty of phases of nervous system abuse, but feel I have gotten better at both identifying and respecting it. One hurdle for me is admitting I’m tired (even if I don’t think I “deserve” to be) and actually resting in response. For me and probably many endurance athletes, resting can take more discipline than training and it can initially be difficult to trust that resting more can lead to going faster and feeling better. Although race results are not everything, still being able to perform well while training less provides positive reinforcement. This process requires constant attention and I think it is one of the biggest challenges of being an athlete and a future physician.

Although a constant vigilance for this phenomenon is important for athletes and people in high pressure careers such as medicine, this is an important awareness for everyone. Unfortunately, the society we live in does not necessarily have built in cycles of rest and recovery. I think everyone should be aware of the need for natural ebbs and flows and the importance of respecting and protecting our nervous systems, not just to be good athletes or professionals, but to be healthy, fulfilled people.

The post Be Nice to Your Nervous System appeared first on Team Athletic Mentors.

By Collin Snyder, Team Athletic Mentors cyclist

Continued from Part 1: A Dark Road and Part 2: Hope on the Horizon

A little after 3 weeks after surgery and 7 weeks since I first came in, things were finally heading in the right direction. I was putting on weight, eating real food, and ready to go home. Upon release, I set a goal for myself that I would finish Iceman this year. Some of my teammates looked at me skeptical but said they’d cheer me on.

First outdoor ride!

Five weeks post-op, I got on my bike for the first time. I rode for just over 20 minutes and I was exhausted. My power output was less than a third what it once was, yet my heart rate neared race efforts. It was great and demoralizing at the same time. The next day, I rode up to my local bike shop to say hello. I managed around a 15 mph pace (with a tailwind) at a hard effort and had to hang out for the next hour to prepare for the half hour return trip.

Each day, I was able to go a little harder, a little longer.  Three weeks after getting on the bike, I rejoined my Monday Night Crew. That night we rode for nearly 30 miles, and I even found myself pulling at the front. Each time I logged into Zwift, I would have to slide my FTP bar slightly higher to ensure I was working out in the proper zones. After each ride, I look at my power curve and see a new personal best. On one Monday night group ride, my buddy titled his ride on Strava as “Last ride ever where I’ll be faster than Collin.”

On top of a climb on the Harlow Lake trails in Marquette during my first MTB trip post-op with the guys

I feel great now. I am now back up to my old weight, I can eat just about anything I want without fear of it causing me pain and symptoms. My fears of never being able to race again have passed. My power levels are now to the point where I have to adjust my overall Iceman goal. No longer is the goal just to finish, but to place in my age group. I’ll be doing it with gears for the first time in 9 years, but I think I have a slight excuse.   

Once again, I want to thank all the wonderful people in my life who helped out while I was out of commission. My wife, for being there at my side through the darkest hours. My parents for daily visits and helping out my wife with child care each night. Friends pitched in to set up a meal service for my wife and toddler. People teamed up to mow my yard and weed my garden. Heck, one of my riding buddies did a full tuneup and detailing of my mountain bike. The outpouring of love and support was overwhelming. I feel blessed to have the friends and family I do.

Living with an ostomy is not the scarlet letter I had envisioned. Off the bike, I feel completely normal. No longer am I eyeing where the bathroom is at every new place I visit. I can sit at work and actually work straight without having to get up every 20 minutes. I can dress in the same clothes I’ve always worn.  On the bike, its not the death sentence I thought it was going to be. With support groups online such as the Facebook group “Ostomy Lifestyle Athletes,” I’ve learned ways to adapt to my new body. My fears of constant dehydration have not materialized. Most importantly, I’m back home with my wife and children enjoying life. Comparing the alternative, I am completely happy with my decision to go ahead with surgery.

I have gone back and forth whether or not I wanted to share my story, but if this can give just one person hope, then this amount of sharing is worth it. While I sat in that hospital bed, I scoured the internet looking for any high level athlete who managed to compete with an ostomy. I really didn’t find much which only added to my fears and anxiety. If you are reading this and in the same uncomfortable hospital bed as I was, let this give you hope. Life will get better, and you will once again do what you love.

Selfie, home with my Daughter

If you have persistent GI issues, see a doctor right away. Early treatment can spare you from what I had to go through. If are interested in learning more about Crohn’s or Ulcerative Colitis visit these sites for information:

U-M Inflammatory Bowel Disease Program 

Crohn’s and Colitis Foundation

“Ostomy Lifestyle Athletes” Facebook page

The post Part 3: Coming Back appeared first on Team Athletic Mentors.

By Collin Snyder, Team Athletic Mentors cyclist

Continued from Part 1: A Dark Road

That night, after running to the bathroom for the upteenth time, I looked in the mirror and could barely recognize the frail body in front of me. I could see every rib, my eyes were sunken in, and I felt as bad as I looked. At this point, I could barely lift my girls, hadn’t been on the bike in over a month, and could barely muster a few laps down the hall without feeling exhausted. I was so weak, and nearing a month since my first day in the hospital with no improvement, I knew what I had to do. I had to accept my fate. Although it was less than an ideal outcome, it would lead to a path of healthiness and out of this hospital.

Surgery went well. My surgeon said that my colon was one of the worst he’d ever saw that didn’t rupture. He said that if I wouldn’t have had the surgery, it probably would have ruptured within a week and sepsis could have set in. The next day when I woke up, I felt as if a cancer had been removed from my body. Everyone who saw me that day said I looked a million times better. I started to have hope.  

A couple days later, the first complication arrived. I started to get extremely nauseous and then started vomiting everything that I had ate or drank since surgery. That is when they found out I had an ileus. At the basic level, its a side effect from surgery where the guts just go into this dormant state and there is nothing they can do about it except to wait it out. While you wait for your guts to wake up, they put a tube down your nose, into your stomach to suck out any stomach acid and bile that gets produced which would lead to further vomiting. This meant no fluids or food until it was removed. They placed me on IV nutrition to slow my starvation process down. I kept losing weight along with my spirit. I was down to 116 lbs, about 50 lbs less than my race weight. At one point, both my parents and wife were scared I may not make it.   

One thin face

This continued for weeks. There would be signs that my guts were ready to wake up, only to go back to a dormant state. Online, everything says an ileus should last for 2-14 days. Mine lasted for 3 weeks. Going that long without food makes you feel less and less human. Nurses who were on vacation would come into my room and be surprised to see me saying “you’re still here?”

During this time, there were so many dark and depressing days. You become bitter at those who eat and drink garbage, while I lived a clean life, yet I’m the one sitting in the hospital. It’s hard when you go from a top local cyclist to someone who can barely get out of bed. Luckily I have an amazing wife, parents and friends who would visit me daily to keep me going. My “Monday Night Crew” who I’ve ridden with nearly every Monday for the past decade decided to surprise me and ride to the hospital one night for a visit. So many people from the cycling world would text or call me asking if there was anything they could do to help. Any visit would momentarily take my mind off the reality I was living. My number one dose of hope was the visits from my two year old daughter who was always happy to see me. Without the amazing people in my life, I’m not sure how I would have gotten through this dark time.

A happy moment in the hospital

Check back tomorrow for the last chapter in my road to recovery.

The post Part 2: Hope on the Horizon appeared first on Team Athletic Mentors.

–By Kaitlyn Patterson

I love empowered, passionate people. And when such people have a mission that especially resonates with me, I will likely be a long-time admirer (albeit possibly a quiet admirer).

Emily Schaller is one of the people who has won me over. Emily came to our first year medical school class last year as one of our “patient presentations.”  One of the more impactful parts of the first year of medical school, patient presentations involve volunteers dealing with chronic diseases come talk to us about the textbooks don’t tell us, namely what life is really like.  I was highly impressed with all the people who volunteer to be honest and vulnerable with 170 future-physicians, often year after year. 

Emily has cystic fibrosis, a condition that causes mucus to be thick and sticky, causing chronic lung problems as well as difficulty absorbing nutrients. It can be devastating and even with current treatments, the median life span is 41.  Emily is an exceptionally charismatic person and captivated all of us as she told her story of essentially taking back her lung function and life through running and improved nutrition. Her story is also captured in a series of short videos by BreadTruck films.

She started the Rock CF Foundation in 2007, an organization devoted to CF awareness, fundraising and advocacy in the greater Detroit area. This involves raising money to donate running shoes and race entries to people with CF through “Kicks Back” and advocating CF research, including integrating exercise as as a treatment tool.  One of the big Rock CF events is the Rock CF Rivers Half Marathon held around Grosse Ile in March.

She gave a quick plug for the race during her talk last year and it has stuck on my radar since then. I have been fortunate enough to remain injury free while running this winter and when my clinical schedule was free this weekend, I decided to go for it.  I hadn’t been specifically preparing for it but felt that my running was consistent enough that it wasn’t a stupid idea either.

Yes, it was cold enough to justify the ski suit!

This was the eighth year of the race and it has grown to thousands-strong, a testament to Emily’s efforts and the strong sense of community and purpose surrounding the foundation and the race. The event was extremely well run and it was awesome to see so many people out and excited to race on a windy, chilly day in March.

Although I’ve identified as a cyclist for years, it is always fun and a bit nostalgic for me to jump back into an open running race. With minimal fitness tests and irregular training over the winter, I had no idea what to expect. I managed to pace it pretty well and ended up 3rd in 1:25 in a strong women’s field. 

Kudos to the Rock CF Foundation and Emily for an impressive mission and great day!

Full results

The post Why I Raced an Impromptu Half Marathon appeared first on Team Athletic Mentors.

-By Kaitlyn Patterson

The sport of cycling has enough quirks and intricacies to occupy athletes, coaches and fans for a lifetime.  It is an easy sport to obsess about numbers, both physiologic: power, weight, heart rate; and mechanical: rolling resistance, tire pressure, gear ratios, wheel size, and so on. However, I find it interesting that all of this can be totally overshadowed by what is between a rider’s ears. A VO2 of 70 and a decked-out bike doesn’t guarantee podiums, and instead can easily overshadowed by a sub-par mentality.

Confidence is a huge part of riding and racing that can present a challenge to everyone across the experience curve.  Coming from a running background with an aerobic engine but no bike handling skills, developing and maintaining confidence has been work in progress for years.  It quickly became apparent that being confident on the bike is the product of both experience and mindset.  Even after logging hours on the trails, some days I can regress to a newbie rider if my mind isn’t in the right place. More experience on the bike has made these fluctuations somewhat less dramatic but it has become obvious that confidence is something that needs to be deliberately prepared, just like bodies or bikes.  This can be an exceptionally difficult thing to do, especially in a sport in which brakes and doubt have the potential to relegate you over the handlebars. However, training myself to recognize and tame thoughts that interfere with the task at hand has been an exceptionally useful and transferable skill.

As importance as confidence is, the confidence trap can also be dangerous on the other end of the spectrum. Confidence to the extreme can take the form of arrogance or recklessness.  Even with optimal preparation, anything can happen in bike racing.  Reminders of the fickle nature of the sport often surface during moments of over-confidence- pulling up before the finish line, riding outside your abilities and making mistakes, or underestimating others’ abilities before races.  It never hurts to bring a dose of humility with every race and ride regardless of race resume.

Even in the absence of frank arrogance, there are a couple lessons in humility that we can all take from cycling. First is the acceptance that there are only a limited number of variables we can control.  Optimal preparation and race execution can still be derailed by mechanicals and other racer’s mistakes. Second, even though the regulars on the podium may get a disproportional amount of attention, there are countless “races within the race” and untold stories that are even more impressive than clocking the fastest time.  It can be easy to attribute podiums talent and hard work but it also takes an undeniable contribution of luck and privilege.

This delicate balance of confidence and humility is played out nearly exactly in medical training. Especially early in training, confidence is a difficult thing to cultivate with an experience base much smaller than the other members of the team. But we soon realize that the learning curve never actually ends and the best physicians continue to balance leadership with awareness of the limitations of their abilities and knowledge. Professional confidence will come with growing experience and knowledge base, but also needs to be deliberately developed, just like on the bike. Similarly, humility should be a constant companion with every encounter with patients and other members of the healthcare team. The consequences of neglecting this might not be as dramatic as an endo, but the impact can be much more significant.

Extrapolating life lessons from a sport seems a bit trivial but I’ve been reminded of these themes often in both cycling and medicine. Navigating the balance of humility and confidence in either sphere is exceptionally difficult and probably can never really be mastered. But I think this elusive task that is part of the intrigue of both cycling and medicine.

The post Confidence and Humility- An Elusive Pairing appeared first on Team Athletic Mentors.