Medical Drama

I've taken part in three marathons and two half marathons overseas in the last few years, and the procedure has always been the same. You register online and pay the entry fee well in advance to secure a place and then set about making the necessary travel and accommodation arrangements. Later, a couple of weeks before the event, an email arrives with full instructions for the race and an official looking attachment which you present at the race headquarters a day or two before the race to collect your race number and timing chip.

Having followed the first part of this procedure for this Sunday's Florence Marathon, I grew increasingly anxious as last week wore on and I had still not received anything at all from the organisers. On Wednesday I sent an email, but by Friday evening it remained unanswered. I decided to search through the event website for any information about the whereabouts and timing of any joining instructions. What I discovered did not make good reading!

Tucked away, a little obscurely I felt, was a statement to the effect that confirmation letters, necessary for collection of race numbers and entry to the start line, would only be issued upon receipt of a completed medical certificate. Oh no, I thought, there's not much time left to get that sorted. But the situation quickly got a lot worse. Scanning anxiously down the page, my eyes alighted on the deadline date for submission of the certificate, Wednesday 15th November. I glanced quickly at my watch to confirm the date, it was Friday18th. I was already too late.

What to do? First step, beg for clemency. I immediately fired off another email apologising for having only just realised that a medical certificate was necessary and stating confidently that would have one by the middle of the week. Having invested a lot of money in arranging my trip to Italy and many months of hard training, I continued, would they please, please, please forgive me for being a few days late and let me fax a copy of the certificate next week and bring the original with me.

It was at this point, however, that I printed off the medical form from the website and discovered that obtaining medical clearance was going to be far from easy. The wording on the form was Draconian. I was going to have to persuade a Doctor to declare him or herself "fully responsible and accept the consequences for falsely declaring" that I am "in good health and fit to compete in a 42,195 metre marathon according to current laws" based on a "sport physical exam" carried out by the Doctor. Eek, if I was a doctor I'm not sure I'd be prepared to put my name to that based on a five minute consultation with a patient, even if I did have access to their relatively robust looking health records. What if they keeled over on the finishing straight, I'd be thinking? What do they mean by consequences? I've seen those Godfather films. Would I be in danger of waking up one morning with a blood-stained horse's head on my pillow?

Still, I had to give it a try, and even though there was a 10 day wait for the next available appointment at my local surgery, the very nice receptionist managed to squeeze me into a recently cancelled appointment for Wednesday at the practice's sister surgery on the other side of town. A few hours later I received further good news - an email from the race organisers containing my entry confirmation, conditional on presentation of the medical certificate on my arrival in Florence. Things were looking up, but that wasn't the end of the drama. Oh no!

Earlier today I arrived at the surgery across town in good time. Sitting in the waiting room five minutes before my appointment was due, I casually pulled the form out of my pocket to have it ready to hand over to the Doctor. Except it wasn't the medical form! I had picked up the race entry confirmation letter by mistake. The medical form was still on my desk on the other side of St Albans, at least 10 minutes drive away even in the unlikely event of no traffic hold ups. I hurriedly explained what had happened to the Receptionist, and asked whether she could possibly jiggle the appointments around and let the next few people in early while I rushed home to get the right form.

"I can't guarantee anything, but as long as you're no more than 15 minutes, it might still be possible for the Doctor to see you", she remarked rather sternly.

15 minutes! I'll be lucky to get home in that time, let alone back here again I thought, but kept to myself.

"OK, I'll be quick. See you in 15 minutes." I replied over my shoulder as I ran to the car.

Twenty three minutes later, I was back facing the Receptionist.

"How can I help you?", she asked.

"It's me, Martin Crisp!" I gasped having covered the distance from my car to the surgery even faster than Usain Bolt would have managed. "Am I back in time to see the Doctor?"

"Ah yes, Mr Crisp, take a seat. The Doctor will see you next."

Phew!

The Doctor was young, female, gorgeous and sympathetic to my situation. Unfortunately, though, she was a locum, and said she would have to check with one of the permanent doctors whether it would be OK to sign the Italian form or issue something a little more general saying that I am generally in good health and that there seem to be no obvious medical reasons why I should not attempt to run a marathon. But first, I needed to undergo a couple of basic checks, pulse, chest and blood pressure. And yep, you've guessed it, as a result of my frantic certificate-chasing dash across town, my blood pressure came out a little on the high side.

"Just relax, take a few really deep breaths", reassured the Doctor, "you're bound to be a bit uptight after all that stress and rushing around."

So, after a short break she measured my blood pressure a second time. And guess what? It had gone up even more, and I was in danger of trying to chill out so hard that I was achieving exactly the opposite effect. It was third time lucky, though, as I finally relaxed sufficiently to produce an acceptable reading, and I was pronounced to be in good general health.

I left the form with the doctor; the surgery would call me when there was something ready to collect. I hoped it would be the official Italian form, but realistically a watered down declaration seemed more likely, meaning that uncertainty would remain until my arrival in Florence. So when I returned to the surgery later in the afternoon, I was delighted to discover that, undeterred by the possibility of waking up next to a horse's head, the lovely doctor had gone ahead and signed the official form. I would be making it to the start line on Sunday after all. Mind you, I had to pay £25 for the certificate, but after such a big pallaver to secure my entry, right now I consider it money well spent.

Trussed and OK

Well, the compression shorts arrived in the post on Tuesday, and very unyielding they are too. Believe me, there's very little scope for a groin to misbehave when under their iron grip. Furthermore, when I read the accompanying leaflet, I was delighted to find out that not only do these shorts offer firm support to troublesome groins, they also have very effective "moisture wicking qualities" to help keep the area in question dry and fragrant. Things are definitely looking up!

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I gave the shorts an initial try out on a two mile treadmill run at the gym on Wednesday morning, and was very pleased to make it through with not even a hint of a twinge. More than that, though, my whole running action felt a lot more efficient than it had for a long time. Somehow I felt more upright, which in turn made me feel lighter on my feet and this in turn placed less stress on the knees and hips. Not content with providing compression, these are "go faster" pants too. 

On reflection, I think perhaps the injury that surfaced last weekend has probably been bubbling under for a while, as in spite of covering a lot of training miles in the past couple of months I have struggled to show the improvement in performance that you would normally expect to accompany them. At least initially, shoring up the injury seemed to have had a much more holistic effect than I'd hoped for.

Putting this hypothesis to the test, I set forth with gusto on a four and a half mile run on Friday morning, and kept up a good pace to the end to beat my previous best for the route by a minute, and again I felt that I was running much more efficiently. This morning I was up early to set off before sunrise on a 17 miler. After last week I needed to complete a lengthy run but with Florence only two weeks away, the 20 miles I had intended to run last week would have been too much to recover from in such a short space of time.

Sunrise over the outskirts of St Albans

Apart from the health benefits, one of the things I enjoy most about my running exploits is getting out in the open air and taking in the beautiful countryside. As dawn broke today on a glorious mild autumn morning it was fantastic to be outside breathing it all in. The run went well too, especially for the first fifteen miles. In the final couple of miles, though, all of my leg muscles tightened up significantly and felt almost at breaking point. However, nothing that a rigorous sports massage won't be able to address, I feel. I've had similarly taut muscles before, and a visit to the physio has always made a massive difference. I did encounter one unexpected and, for me, unusual problem on today's run, though. Blisters. Two whopping great big ones, one on my left big toe and another on the instep on my right foot.

I'd like to think this was caused by my blistering pace......

Why I've suddenly succumbed to them, I've no idea but I don't see blisters as a serious threat to my performance in Florence, and although last week's difficulties have set undoubtedly my preparations back a little, I'm now feeling much more confident about my prospects. Bring it on!

Injury Time

I set off at 6:20 am this morning for my final long training run for the Florence Marathon on 27th November. 20 miles was the aim, but after less than one mile I started to feel a disturbing soreness in my right groin area. It's often possible to run off this kind of discomfort and so I pressed on optimistically, but by the time I had covered three miles the pain had become so sharp and insistent that I was left with no choice but to stop running and endure a very uncomfortable two and a half mile limp home, feeling increasingly disconsolate.

An injury free groyne at Worthing, West Sussex

A very similar thing happened to me at exactly the same point, three weeks, before my first London Marathon back in 2006. Back then it was my right knee that suddenly and very painfully gave way. After some treatment, treading gingerly in subsequent training and the use of a knee support, I was able to take part in the race and even finish with a respectable time, although not without pain. Ever since I have been wary of any knee twinges, and this year in particular I have been careful not to place too much strain on them. So far they have done me proud.

This is the first time I've ever experienced groin problems from running. I did need an operation to patch up a protruding hernia on the left over ten years ago, but this was in my pre-running days and apart from the occasional dull ache it hasn't bothered me since. I found out yesterday that, whereas with careful handling, it is often possible to continue with a dodgy knee, the groin area is so pivotal to the action of running that grinning and bearing the pain for this this type of injury is not an option.

What to do? Well after resting it up for a number of hours, it's feeling a lot better, so I'm going to take a complete rest from running for a few days, try a couple of gentle treadmill runs towards the end of the week and then attempt another final long training run next weekend, although probably a little shorter than 20 miles. I was planning to go for a sports massage next week anyway to revitalise the legs in time for Florence, so if the groin is still playing up at that point I can ask Stan to have a go at manipulating the old nether regions.  I have also discovered a product, compression shorts for the prevention and treatment of groin injuries and I think I'll give them a try. Hopefully they will offer more support than the lycra I often wear under my shorts (and I was wearing lycra tights yesterday) without the compression element of their design adversely affecting other components of that particular body region, if you know what I mean.

The therapeutic effect of writing this blog has increased my confidence that I'll be OK. In addition I've been feeling very tired since returning from Japan, so a few days enforced rest from running may be no bad thing.

Great South Fun

Landmark time. This is my fiftieth Project Five O entry, although regrettably I'm writing it a number of days after the event, the Great South Run, which took place on Sunday 30th October. This lateness is a result of a combination of feeling completely exhausted after driving home on Sunday evening and the urgent need to make significant inroads into the backlog of work that awaited me on my return from Japan.

Portsmouth's iconic Spinnaker Tower

I've now taken part in the Great South Run six times. It's one of my favourite running events for a number of reasons:

• it's very well organised
• there's always a great atmosphere with big crowds and lots of bands playing on the course
• the course passes a number of interesting sights, historical and modern
• it's almost entirely flat (although this benefit is negated a little by the strong headwind that usually prevails for the final two miles along the seafront)
• ten miles is a great in-between distance; long enough to require training reasonably seriously but short enough to enjoy without being able to walk properly for days afterwards
• taking place in October, the temperature is usually in the mid-teens, ideal for running

All of these factors combined in 2005 to help me complete the race in 1:37:33, a time which I haven't got close to since and which, looking back, I sometimes have to pinch myself to believe I was able to achieve in the first place. However, it's in the record books, available for anyone to find on the Great Run website. Although I'd started the year hoping I might just be able to better this, reality has since prevailed and so I set myself the aim on the day of further steady preparation for Florence, and to come in below 2 hours, ideally even challenging the 1:50 mark.

I stayed overnight in a travelodge in Hampshire and drove to Liss, where I boarded the train in order to avoid the monstrous traffic jams that have plagued my departure from Portsmouth after previous GSRs. Overall this proved a successful strategy, although the walk from the station to the start took considerably longer, half an hour plus, than it looked on the map and felt even more of a slog to my tired legs on the way back.

The start area was buzzing by the time I arrived. I think most of the 24,000 starters were already there. Any event of this size brings with it an invasion of portable chemical toilets, the quality of which (if quality is indeed the right word) has definitely improved since I started taking part in this kind of event. It did amuse me, however, that every single one of the hundreds of portaloos available on Sunday was proudly displaying a misplaced apostrophe.

Pedantic, me? What do you mean? Now, where did I put my copy of "Eats, Shoots and Leaves"?

A funny thing happened a few minutes before the start. I was surprised to be approached by a fellow runner who looked vaguely familier asking whether I was Martin Crisp. "Umm, Yes" I replied a little warily before he introduced himself as someone I had worked with at Midland Bank in Bromley nearly 30 years ago. I'd already been working for the Bank for three years when he joined around 1982. He was on a special scheme, in which he worked at the Bank for a year and was then sponsored through University before presumably having to work for Midland Bank for at least a specified length of time after graduation. A very cushy arrangement, and he was a nice enough lad, although perhaps bordering on the arrogant side of precocious at the time. The over-confidence of youth and all that. We caught up briefly before the race began. My self-deprecating final comment was that in terms of my running career "my best days are probably behind me" to which, rather uncharitably I feel, he replied "let's be honest, your best days were behind you when you were at Bromley" before sprinting off ahead of me as if to prove a point. As I said, on the arrogant side of precocious, and clearly having failed to move on in the meantime. What he thinks of me is of little or no interest to me, but I must admit I was rather taken back by his rudeness, more so by its stark contrast to the friendliness and civility I had experienced in Japan in the preceding days. How I would have loved to catch up and pass him in the later stages of the race, but sadly I dont think I did. Even in such a large field I think I would have noticed.

I started the race smoothly and steadily, as always enjoying the historic dockyards section of the route nothwithstanding the short stretch of cobblestones that demand extra careful foot placement.

Nelson's Flagship, HMS Victory

My time at the half way was 54:10, a little under 11 minutes per mile, and on course for sub 1:50 if I could maintain even a marginally slower pace. The second half of the race is less scenic but still fairly well supported and, although I could feel myself slowing slightly, I was still feeling fine and really enjoying myself but once again the final two miles into a very strong wind finally took its toll. I kept running, and eventually sprinted strongly along the final two hundred metres, but all along the seemingly endless seafront I felt like I was running with a length of strong elastic attached to my back. A real struggle.

Fighting the wind along the seafront at Southsea

My finishing time was 1:54:10, which was in line with what I'd hoped for and I was pleased with it. Some way off my PB, but also considerably better than my slowest finish at this race. In fact it was my third fastest time in six attempts, and my best since 2006 so all things considered a good day's work.  Once again the Great South Run had proved to be a fun and fulfilling experience - I was nowhere near the back of the field, and in the closing metres overtook a lot of runners much younger than me and, always pleasing, even a few 'proper' runners wearing official running club vests. There's just one more chance left  to achieve a PB this year. It's all or nothing now for the Florence Marathon, and if I can just build a little more on where I am now, there's a small chance I may still do it.

(Photographs of Spinnaker Tower and HMS Victory were taken on a visit to Portsmouth with Hannah in July 2009) 

Taking a bow

Wow, what a hectic week it's been. I'm starting to write this at my seat waiting for the aeroplane to begin taxiing it's way to the runway. In just over twelve hours we will be back at Heathrow after a fascinating, whirlwind five days in Japan. Here are just some of the highlights.

Perhaps my overriding memory will be the amazing politeness, good manners and hospitality of the Japanese. Their culture is much more formal than any I have experienced before, and took a while to get used to but everything is done so cheerfully and with a level of humour that took me by surprise that it was impossible not to fall in love with them. There is a lot that we in the UK could learn from the Japanese about respect, humility and good service. I found the custom of bowing to greet, say thank you or to bid farewell particularly charming, but after meeting so many people in such a short space of time, my neck felt as though it had extended to giraffe proportions.

Professor Hideo Nakata organised our schedule in Japan and accompanied us throughout. He  has spent much of his academic career fostering cooperation between Universities in different countries. One of his recent collaborations has been to support teacher trainers in Afghanistan to write their own training manual for special educational needs. Hideo loves british detective and spy novels and we spent a lot of time discussing Ian Rankin, Len Deighton and John le Carre amongst others.

In total we visited five mainstream schools, two special schools and the Board of Education at Tsukuba City Hall and ran a worksop at Tsukuba University. Everywhere we were treated almost like royalty. In addition to the already outstanding Japanese hospitality, we hadn't realised just how much of a big thing it was for them to receive two lecturers from England. They really considered it an honour to have been chosen, and wanted to give us the very best possible impression of their schools. Beautifully presented food and drink awaited wherever we went.

Two types of persimmon, beautifully presented

We were subjected to paparazzi levels of photography wherever we went, and soon found ourselves being featured on the schools' websites. Click here to catch us in action. Shoes worn outside are not permitted inside the school buildings, and on arrival we would be presented with a pair of slippers to wear indoors. Again, a lovely custom, but unfortunately even the largest pair I was offered was at least 3 sizes too small causing me to hobble around the schools like a penguin with corns. The children we met were delightful, ever ready with a "konnichiwa" (hello) and a beaming smile. My favourite was the nine year old who with a mischievous grin asked via our translator "How is Prince William doing?"

At one school, a Kindergarten, the outdoor area was set up to provide a place where the children could play and explore in natural surroundings. This school was towards the north of Japan, and although still some distance away from Fukushima, site of the nuclear reactor disaster, between 30 and 90cm of the topsoil had had to be removed from the outside area due to contamination from radiation. Another reminder of the environmental dangers ever-present in Japan was the slight but clearly felt rumble  during one of our interviews with a teacher. Hideo immediately identified it as a tiny earthquake. Sobering.

Skyscrapers in Ginza

Although we were fortunate to have such a wonderful introduction to the Japanese people and their culture, there was very little time for sightseeing. We did manage to squeeze in a couple of hours in the Ginza area of central Tokyo en route to a school visit. Ginza is Tokyo's upmarket shopping, eating and entertainment district, and looks spectacular with a very similar feel to midtown Manhattan. I would love to return to see it all lit up at night. It's certain a very cool and buzzy place, and my desire to come back was stoked further by the rather dreamlike experience of watching "Lost in Translation" at 2:00am one morning after downloading it in response to my jet lag induced insomnia. There is some absolutely stunning cityscape photography in that film.

Street signs in Ginza

An older part of town.

Tsukuba, on the other hand has the relaxed feel of a University city with plenty of green empty space and many people travelling by bicycle.

The area around the University guesthouse felt especially peaceful. The guesthouse didn't do breakfast so we would buy ours from a local store and eat it sitting by the small lake on the campus. The temperature, reportedly milder than than usual for the time of year, made this a very pleasant experience in a tranquil setting. We were joined for each of our five mornings by a beautiful stripy spider, whose web remained undisturbed and able to accumulate a growing horde of food as the week progressed.

Our stripy breakfast companion

We were treated to a wide range of traditional Japanese food during our visit. I was surprised to find how much I enjoyed the raw fish and the tuna was especially exquisite. I was less keen on the horse meat we were served one evening. It would have been rude not to try the raw horse kidney in particular, and although it didn't actually taste too bad it just didn't feel right and I won't be rushing to repeat the experience in the near future. All of the food was freshly prepared and felt healthy. For our Sayonara (farewell) dinner we sat around a low table and were treated to Shabu Shabu, wafer thin slices of beef that are boiled very briefly in a bubbling pot in the middle of the table and served with dipping sources and fresh vegetables, which are also boiled in the pot. Accompanied by copious amounts of beer, sake and another delicious drink distilled from sweet potato (I'm not sure of its name), this meal gave us a wonderful send off, albeit making getting up early for the journey to the airport the following morning far from straightforward.

Fresh looking accompaniment to our Shabu Shabu

What a week! I loved what I was able to experience of Japan, and it has left me desperate to return with more time to explore all of the country and Tokyo in particular. For now, though, the really hard work begins - we've got to write up the research.

(Please note that this is an edited version of my original post)