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  • Low T?

    Sunday, August 11, 2013

            What is low T? That is in fact a loaded question. First off in this era of fast marketing and government “oversight” in medications what are your expectations? Well you would expect in this day and age that a blood test would be both evidence and definitive. Anti doping began almost 100 years ago (1928). Doping has been a subject in Olympic competition off and on since. The IOC (international Olympic Committee) administered in the Olympics since 1960 that standards would be hard and fast. You would expect that the tests will tell the story and there would be research that will define where someone is gaining an advantage. Also we would also expect to know what is normal. Here is the WADA  (World Anti Doping Agency) explanation on not specifying a number: “Normative reference ranges are dependent on the laboratory and assay providing the analyses, thus it is not possible for WADA or USADA to outline definitive reference ranges.”  So the lab with no set methodology defines the “normal”. Which is actually the case for most lab data. You never get a researched healthy range all you may see is “normal” ranges. Try this next time, ask your doctor what the normal range means? Next ask him/her what is an optimal number for good health? Do that for say Vitamin D. and when the doc finally gives up that 100 is a toxic level ask what are the symptoms of toxic D levels. This is why you don’t see many people actually get stripped of credentials, and a large amount of lesser suspensions. The evidence is in question right from the git go.

                As you might have guessed, these seemingly foundational conditions are in great dispute. Here are some realities. Not even the society of Endocrinologists can agree on a testing standard. That they can not even agree as to the testing protocol. I found this out when while applying for a therapeutic use exemption for testosterone This is what I got in writing from USADA.

    1.Low-normal refers to a T value within the age-appropriate reference range, but toward the lower end of the range. This measurement in itself is not sufficient justification for diagnosis of androgen deficiency and granting a TUE. at least two baseline T measurements (i.e. measurements of T without any T therapy).  If the athlete has been on T therapy, it should be discontinued for 1-2 months and then two baseline T measurements should be taken in the morning on two separate visits). There should be at least one measurement of calculated free T using a validated formula or a free T by equilibrium dialysis. Measurements of free T by direct analog immunoassay are not an accurate measurement of free T and should not be used. LH and FSH levels are required to assess whether the diagnosis is primary or secondary hypogonadism and prolactin is needed if secondary hypogonadism is present.

    2. WADA clearly states that TUE should only be approved for androgen deficiency that has an organic etiology, thus this is the standard USADA evaluates all TUE applications for testosterone in accordance with the International Standard for TUEs. TUE will not be approved for androgen deficiency due to functional disorder.

    3.   It is extremely unlikely that a Therapeutic Use Exemption will be approved for "functional" hypogonadism (a diagnosis of hypogonadism based on low testosterone (T) levels but without a defined etiology).

    4. The etiology of androgen deficiency may be organic, in which there is a pathological physical change in the structure of an organ or within the hypothalamic-pituitary-testicular axis. Androgen deficiency may be functional in which there is no observable pathological change in the structure of an organ or within the hypothalamic-pituitary-testicular axis.

    5. It is extremely unlikely that a TUE will be granted for adult idiopathic hypogonadotropic hypogonadism.

    6. It is extremely unlikely that a Therapeutic Use Exemption will be approved for "functional" hypogonadism (a diagnosis of hypogonadism based on low testosterone (T) levels but without a defined etiology).

    7. As noted on the TUE application physician worksheet instructions, it is extremely unlikely that a TUE will be granted for adult idiopathic hypogonadotropic hypogonadism.

    8. Normative reference ranges are dependent on the laboratory and assay providing the analyses, thus it is not possible for WADA or USADA to outline definitive reference ranges.

    9. In a community-based, multiethnic cohort of middle-aged to older men, day-to-day variations in serum testosterone concentrations were found to be sufficiently large that single testosterone measurements were inadequate to characterize an individual’s levels, and at least two testosterone measurements were needed to diagnose androgen deficiency with greater confidence (Brambilla DJ, O’Donnell AB, Matsumoto AM, McKinlay JB 2007 Intraindividual variation in levels of serum testosterone and other reproductive and adrenal hormones in men. Clin Endocrinol (Oxf) 67:853-862)

    10. WADA and USADA are unable to provide advice to support a medical diagnosis. The TUE Committee need enough medical information, clinic notes and laboratory testing notes to make the same diagnosis, and arrive at the same treatment plan as the athlete’s physician without ever seeing the patient.  The TUEC evaluate against the criteria set forth in the World Anti-Doping Agency (WADA) International Standard for Therapeutic Use Exemptions (ISTUE 2011). A TUE will be granted only in strict accordance with the criteria as stated in the ISTUE.

    11. As a courtesy, we are providing the name of a resource which may be discussed with your physician. Testosterone Therapy in Adult Men with Androgen Deficiency Syndromes: An Endocrine Society Clinical Practice Guideline. This can be found on the Endocrine Society’s website.

     

                So now for the third time in 3 years I am coming off of supplementation to fulfill the required testing for a TUE. This process was twice initiated by me in attempts to try alternatives to naturally raise my androgynous (natural)production of T. This is a horrible experience on so many levels, and as far as training 3 months outright going backwards so the effect is 6 months of no training. This hole I climb into is getting harder and harder to climb out of.

                One might expect that I feel the USADA or WADA is the enemy, they are not and are merely functioning within strict guidelines. Guidelines that were meant for professional athletes/Olympians that are typically 20-35 years old for the most part. The testing of age group athletes yes some in their 80’s is clearly new ground. Testosterone levels have not been studied for longevity or performance for that matter. Even the Endocrinologists can’t agree. The issue has not really gained much popularity until a major pharmaceutical company developed a product to “correct” th evils of low T. Namely bedroom crap rather than the real issues. Do I have an absolute right to compete? Maybe, maybe not.  Does the Americans with disabilities act apply? But the WTC celebrates those with disabilities? At least obvious physical ones.

     

     

                If you are wondering why am I doing this? Let me bring you up to speed. About 4 years ago after being diagnosed hypothyroid I requested additional tests based on my research, that test showed a level of 107. That is about what a 30 year old woman packs around. I weighed #340 at the time. Long story short I hired a consultant for nutrition and also had him write a training plan for me concerning cycling. He changed my diet, got rid of wheat . 9 months later I did my first triathlon, a sprint tri-it at Fairview Oregon (Blue Lake), a month later I did my first Olympic triathlon . That October I went to the big island on the second Sunday and watched the 2009 WTC world Championship. At that time I decided that I too was going to participate in the big race. In 2010 WTC announced that all Kona qualifiers would be tested for performance enhancing drugs. Now testing of 80 year olds is in play. This testing has opened up the proverbial can of worms.

                At this point in my life supplementing T is a requirement for my health. Low T is serious business, dramatic increase in heart issues and other very serious degenerative conditions are the risks. I believe that some men who died of heart attacks or pulmonary issues had low T in the mix. The reason is that T is quite simply, a major Anabolic hormone. Anabolic is growth/repair. When rebuild/growth occurs faster than we destroy then we grow, such as a teenager. When repair is slower than degeneration we “age”.  So when your liver degenerates and does not have all the pre-cursors to build back up it declines in function. That decline in function in itself can directly cause issues. Or it may drive other organs past their limit and accelerate the degenerative process. Having low T is a lot more than bedroom performance, in fact that has never been an issue for me at all. But bedroom performance sells and if you are supplementing for that you are supplementing for the wrong reasons, and you will do more harm than good.

                Now the reason for low T is a very complicated one. From what I have experienced there are numerous factors that affect your level of testosterone. Check out this vicious circle- excessive fat will elevate estrogen levels, which promote fat gain.  Fat gain and added estrogen conversion reduces drive to be active. Then take all the emotional frustration, treat with alcohol, which further depresses T, and there you go. You can see it if you look for this vicious circle. I have not even tried to explain the intricate dance that all our hormones play with each other. It is very complicated to a point that even endocrinologist will argue about almost every aspect of hormone interaction. New information continues to this day and enzymes are being discovered as little as a few years ago. Let alone explain their interaction.

                Bottom line if you are looking for hard and fast rock solid science, hormones are not the place to find it. You are a study of one, you do need to make your own decisions. The less you leave up to the pop culture of medicine the better.

     

    Here are some links to some light reading

    The endocrine society home page

    Clinical Practice Guidelines-Androgens-in-Men

    USADA testosterone-guidelines

    WTC suspends Kona Qualifyer

    history of anti-doping

     

     

     

    Slàinte mhath!

  • Leadman Race Report

    Saturday, October 6, 2012

    I have never been so apprehensive about a race than this one. What bothered me most was the swim. At Ironman Canada I took 1:47 to do 3.8K and the cut off when I registered was 2:00, that meant that I needed to cover 1.2K in 13 minutes. That was not going to happen in fact the extension of distance came out to 2:20 and change at the same pace. Way too close for comfort even when the cut off was moved out to 2:30. On top of that the altitude was above 4000’ and I live and train at sea level. I had dropped 20 pounds in the previous 6 weeks before the race. This weight loss simply is not recommended in any body’s book. But toeing the line at 255 pounds on an extreme endurance event is either stupid or brave- you pick. I choose to loose and after the race I will loose some more for Thailand.

    I met my coach (Ben Greenfield who eventually won the 125 event) and a friend who is a pro entered in the 250. We drove the course and where confident. My plan was to fuel with UCAN super starch, VESPA and MAP amino acid supplement. I took a standard gel just before the swim and another at the halfway point on the swim. Everything was going according to our plan, me at 20 MPH for the first 2 hours of the bike. After that some climbing but the P-5 (Vanessa) was functioning flawlessly. The DI-2 was performing beyond expectations. I remained under 250W even on the climb. The plan was to be conservative on the first loop.

    Shortly after the decent the course stayed pretty flat but a significant headwind was present. Just before special needs (90 miles) there is a 5-6% grade for a couple of miles. I hit a wall in regard to energy. I felt that if I pushed and maintained power I would empty the tank. That would leave me with 50 miles and a significant climb left to go.  

    So I backed off the power and abandoned the nutritional plan. 11 hours was not going to happen. So do I back off and make sure I have a good time or do I push hard? Looking at my time it appears that I chose to have a good time, but It was not a conscious decision. I wished I had known that the race director modified the standard to 12 hours. I would have been at a higher level longer. Lesson learned don’t back off.

    At special needs I started consuming gels. I went to a gel every 20 minutes plus UCAN.  At mile 100 my feet had swollen to the point of severe pain. At an aid station I stopped and fortunately they had dumped some ice on the pavement. I took off my shoes and stood on the ice for 2 minutes. When I got back to business no more pain . My nutritional recovery was not complete until I got to the top of the last climb and was licking my chops at the 16 mile 2000’ decent into T-2 (Run).

    The decent at 50+ mph for more than 20 minutes is not as easy as you might first imagine. It takes concentration and upper body dexterity and strength. Everything is amplified at high speed. You need to get comfortable in getting pushed around. Several times I was pushed from one side of the lane to the other. It simply is not advisable to make quick corrections. Shorter hills are quite different while exhilarating just do not produce the stress a long one does. The long hills are none the less a total adrenalin rush big time.

    By the time mile 138 got there I was more than ready to get off and run. Ironman distance will do that to the athlete and the extra 26 miles just reinforces that feeling. Be careful what you wish for.

    When I got off the bike my legs felt fine, that was a real change from the past and taught me an important lesson: back off on the later part of the bike and DO NOT  come in as hot as you can. How long to back off is another question. I had a real hard time maintaining my motivation. Up to now my half marathon PR is 1:57, that time was in no danger because the cutoff for the belt buckle was soon to pass. I walked all the aid stations (every mile or so) and the steep hills. I finished with the help of my good friend and former colleague Mike Viles and his wife Carol. The run was plagued by excessive gas and eventually extended visits to the porta potty on 2 occasions.

    I finished utilizing the run/walk protocol without incident. The race welcomed me to the finish line and there were still people who cared there as well. The recovery was managed with 2XU compression tights and 4 Phenocaine, 8 Recoverease and a gluten free burger at Red Robin. A good nights rest after a 1 hour ride to my bed. I was feeling hot all night in spite of the 50 degree sleeping area. This is due to my body repairing itself. Often one does not notice an area actually heating up due to inflammation/repair. Because I had worked almost all of my body long and hard I had inflammation everywhere. I believe that having the basic nutritional building blocks just put my whole body into hyper drive repair.

    The supplements I take on a regular basis for recovery are: Mt Capra CAPRAFLEX, Tumeric extract, Vitamin C&D, COQ-10, MAP Amino Acids, Recoverease Amino Acids. A good diet rich in Omega 3 fatty acids also go a long way.

     The awards ceremony was conducted the next day and was professionally conducted What became quickly evident was the fact that I was not among the usual IM crowd. My competitors were studs. Especially in the swim and bike. I have some more work to do. My soreness was there but insignificant thanks to the recovery protocol the night before.

    I can not wait for the race that I am actually racing rather than “finishing”. I expect that transition will occur at Ironman Phucket or my first A race of 2013. Weight loss will be the key. By what was published in Lava magazine was that the run improves about 3 seconds per mile per pound. I believe that. 20 pounds being worth a minute per mile pace in an endurance event. Together with the free power on the bike will make me competitive with the old folks I can do that.

  • Leadman 250 Results

    Friday, September 28, 2012

    4 117 Jim MCINTOSH SPOKANE WA US 0 Total time 13:36:22       Swim 5K 01:41:08.403 T-1 00:09:04.311 Bike 223K 08:38:20.686 T-2 00:08:36.756 Run 13.7miles 02:59:12.290  

    http://athlinks.com/racer/65866717

    The swim was faster than my IM Canada time.

  • The Journey to Kona begins- There I said it

    Thursday, September 13, 2012

    JIM'S EQUIPMENT-BIKE

    it is a Cervelo P-5 Six.

    Specs DI-2 shifting (electric) Aux shifters are added to the brakes.

    Hydraulic brakes

    Wheel set- Rear: ZIPP 900 Disc with a 11-28 Cassete Front: 808 Firecrest each with Tangete tubulars

    Crank ROTOR Quark (power) with Qrings 56 X 44

    Speedplay zero Pedals

    Torpedo Bottle mount, behind the seat bottle mount -X-Lab, Bento pouch X-Lab

    Garmin 800 edge

    And I could not resist the Catlike Areo helmet it just was so perfect.

  • LeadMan 250 Preview

    Monday, September 10, 2012

              The 2nd ever Leadman 250 Triathlon will be held 22Sept starting outside Bend Oregon and ending in the Old Mill District in Bend proper. This is not going to be your daddy’s triathlon, this will truly be an EPIC event. While cutting almost half the run from an Ironman, It adds 1200 meters to the swim and adds 26.6 miles to the bike, for a total distance add of 14.8 miles over an Ironman.

                Last year’s inaugural event in Nevada yielded only 14 finishers. Jordan Rapp won in  9:32 more than an hour longer than his typical Ironman time(as if there is anything typical about an Ironman). Out of 28 starters only 14 finishers, and only 4 under 11 hours, the standard to earn a coveted belt buckle. Las Vegas Results

                Why am I doing it? Well I love the area, and have been training all summer so why not. No KONA trip for me this year, besides I need a buckle. This event will truly be a very strong test of both mind, body and equipment. I will be changing steeds, at the last possible moment my long awaited P-5 six has been delivered and is undergoing birth and modifications. The first Mod is to replace the Crank with my Rotor Q-Ring Quark 56X44. Second adding shifters on the brakes, DI-2. And the brakes are hydraulic giving more stopping power, although I don’t see much use on this course. The wheelset will be ZIPP, 900 Disc and 808 Firecrest with Tangete tubular’s.

                The swim was the hardest to prepare for and I am the most apprehensive about, my IM Canada time was over 1:45 for 3.8K. My swimming has improved greatly this summer thanks to the convenient Battle Ground Lake 2 miles from my house. I hope to get out of the water at that same time for 5K. There probably won’t be an abundance of folks to draft on so tactical decisions will be made early. Swimming straight and relaxed with a high cadence will be the key.

                The Bike will be challenging to get a time under 7 hours. There will be 3 climbs, The first will be Bachelor Pass the first time about 2500’ of straight up climbing from 4000’ to 6500’. Gradients will be mostly 5% but will range up to 8% in the later grades. Then a long fast decent ensues with a flat section then a sneaky climb of 4-5% back to the loop for the second trip through Bachelor Pass this time I will be much more tired. The thought of the screaming decent into Bend at 40+ MPH will pull me up the hill.

                The run will be purely one of willpower. By then the tank will be very close to “E”. Everything will hurt and everything will probably protest the enduring request for movement. I will be stoked if I hit this part near the 9 hour mark that would mean it possible to get the buckle. 8.5 hours will be my goal.

                Nutrition will be the key and I will be using a different product for most of the race. I have used it in training and am impressed with the results. More to come after the fact.

  • A Knee, Tailbone, and Flashlight.

    Thursday, August 16, 2012

    So I was training as usual and then all of a sudden one day I woke up with knee pain and stiffness. This was weird for me, as I had never had this happen before. So I got up and outside and continued training like all active folk do. I iced the knee 2-3 times a day and backed off the intensity, like coach said. I finally went to the Doc (a Greencoat), who said it looked like a level 2 MCL sprain. The advice was to go to physical therapy, proceed with caution, use a soft brace, and let pain be my guide, and come back if it gets worse.

                My training gets harder and harder over the next three months and the workouts are getting slower. Range of motion decreases dramatically and some swelling is evident. So I head back to the doc. The doc orders an MRI and here are the results:

    MEDIAL COMPARTMENT: There is a large, complex medial meniscal tear with two displaced fragments. There is a 10 x 10 mm fragment displaced superior to the posterior meniscal body and a 6 x 9 mm fragment displaced superior to the anterior aspect of the body. The intact portion of the meniscus has increased internal signal, consistent with an intrameniscal cyst. There is an extensive, complex para-meniscal cyst along the medial and posterior aspect of the joint which dissects cranially and caudally along the capsule. Meniscotibial ligament appears intact. The meniscal femoral ligament is torn. There is a full-thickness cartilage defect with subchondral edema involving the posterior non weight bearing surface and measuring 1.4 x 1.5 cm. This is contiguous with an approximately 1.5 cm focus of partial-thickness cartilage loss along the weight-bearing surface. There is diffuse thinning along the tibial plateau, with a more focal 10 x 12 mm area of near full-thickness cartilage loss laterally. Alignment is normal.

    LATERAL COMPARTMENT: There is a small horizontal tear involving the free margin/inner third of the posterior body and horn of the lateral meniscus. The cartilage is intact. Alignment is normal.

    IMPRESSION:
    1. Complex medial meniscal tear with two displaced fragments and moderate medial compartment degenerative joint disease.
    2. Small horizontal tear of the free margin of the lateral meniscus.
    3. Trochlear cartilage disease, as described.
    4. Large joint effusion

    Makes you kind of wonder how I was walking around

    I got the call that the orthopedic surgeon’s office would call me to set up an appointment. Let’s stop right here and shift to possible alternatives.

    1.     Cease all stressful activity for 3 to 6 months. But even a day’s work around the homestead creates discomfort. Who is going to till the garden, deal with the cattle, or haul in the hay?

    2.     Keep going and see if it gets even worse.

    3.     Take more anti-inflammatory supplements or even resort to non-steroidal anti-inflammatory, or steroidal injections.

    4.     Find a witch doctor, a lime, and a coconut.

    5.     Shine a light on it.

    Well I opted for the latter; I had someone shine a light on the area for 15 minutes. When I walked out of the office, I literally had a 50% increase in range of motion and a 50% decrease in pain—all from a 15-minute treatment with light. Then I drove home—about a 45-minute drive. A car ride would normally increase stiffness. This trip would even have an extra hour on top of that for rush hour traffic. This was the same day I had my MRI. When I stepped out of the car, I noticed even more improvement. OK.  Surely when wake up in the morning it will be just as bad as before or worse! After all, a fancy flashlight has to be a placebo effect. Placebo or not, my knee was even better the next day.

                OK so this really sounds like a fairytale complete with a fairy with a magic wand. That fairy has a name—Lisa Collins—and a wand, a very special wand, a cold laser wand. Cold laser is a real treatment and has been around for years. Lasers’ effects on the body were researched only years after the laser’s development in 1967; yes, 45 years ago and it has been in therapeutic use for almost 30 years outside of the US.            

    Well now that I had received the miracle of the magic wand, I headed off to Eugene, Oregon to watch the Track and Field Olympic Trials. Well, riding too fast in the dark in a strange town landed me on the ground. The result was a broken tailbone or Coccyx. This was no mere bruise or crack—I really smashed it and it hurt very much. So I closed my eyes and wished for my fairy godmother and her magic wand; A week later I was treated and the treatment did not disappoint—I had immediate relief. To add to that, my wife heard me describe my knee trouble to the therapist, and she told me her knees had felt the same for years. She also got the treatment and also received the pain relief that I had experienced.

     

    What is a laser? Light Amplification by Stimulated Emission of Radiation—LASER. That being said, the characteristics of a laser are that it is coherent light, which means that all the light is the same wavelength, and in phase. Light is divided into a spectrum and the spectrum is defined by wavelength. Therapeutic lasers are in the infrared part of the spectrum, which is not visible to the human eye, so most devices have a red LED (Light Emitting Diode) to show where the laser is directed. The first LASER used ruby crystals to propagate its light, but now the light is generated by using specifically grown crystals.

     

    So why have you not heard more about cold Laser? Laser is really a stepchild therapy right now with no defined channel for delivery in the US. The USFDA has approved the 820 nanometer (nM) for therapeutic use as laser treatment. The devices that generate laser light in the 820 nM as class 3b lasers and are very low power, less than a watt. Additionally there are lasers that emit in the 900+nM range, which is also in the infrared range. The 900nM lasers are typically higher in power, some up to 50W. So where do you find these devices? From orthopedic surgeons’ offices, PTs (physical therapists), LMTs (Licensed Massage Therapists), Naturopathic offices, to NFL locker rooms. In just about all cases, insurance does not allow for billing. These devices only exsist because they work! The 910nM lasers are sold under a heat lamp clause. But make no mistake: these are not your granddad’s heat lamps.

                Increased power does carry with it a degree of hazard, including skin burns. Increased power does not increase penetration, as penetration has more to do with the degree that the light waves are attenuated, or dispersed. Attenuation is more dependent on wavelength rather than power; the shorter the wavelength, the more it penetrates. There are also some manufaturers touting set programs which use different modulation rates for varying the treatment to suit the ailment. Inflamation detection is another feature that is advertised. The buyer must evalutate these features for yourself. Power does figure into dosage of light into an area, and is typically expressed in joules.

                There are two major competing technologies for creating the laser light; one is via a continuous wave, and the other is pulsed or “super pulsed.” Based on the evidence I have seen in studies, the effectiveness of the lasers are referenced to joules of energy delivered. Joules, or total energy, is a function of power and time, so pulsed lasers have higher average power ratings and treatments thus take less time.

                Studies, studies everywhere! Seems each manufacturer or seller has their own hand picked studies showing their product is the best. There are some independent studies, but each one is highly targeted to specific conditions and a very specific protocol. All I know is that it works. It reduces pain and increases range of motion on inflamed tendons. It eases pain on a broken tailbone. It increases flexibility of the Plantar Facia. One can only wonder why more people are not using it?  Follow the money? The devices are dirt-cheap as far as medical devices go. Training? None needed, an average massage therapist with a weekend seminar is minimally qualified. The only other segment left is insurance; yes, most insurance carriers consider this treatment “experimental” and therefore will not pay. That is the only explanation. Treatment cost what a copayment would under most plans. The patients simply do not know about the successes of the treatment, and when Whitecoats are asked they out of ignorance or snobery dismiss it.

                Until the rank and file consumers actually start taking charge of their own health this and other effective treatments will remain obscured by the system. Only the informed and pro-active folks will benefit from proven treatments. These devices are being used in professional sports training facilities, Olympic Training Camps. As consumers, we need to research and try different approaches to resolve issues. An approach to find and treat the root cause is obviously the best approach sometime we need to pinch ourselves to wake up to what any given treatment is really doing.

                So what is the status of lasers? Most manufacturers will sell to the general public, though there might be a pricing difference, and if you are not a “practitioner” some require you to sign a statement certifying that you only intend to use it on your animals. At the worst, depending on your state, you only need a cooperative doc to write a prescription; in some states can be a naturopath as well.

    How much do they cost? There’s a wide range here: they run from $1,200 to $12,000, and the most expensive is not necessarily the best. If you have an FSA or HCFSA and a cooperative doc to sign a letter of medical necessity, you can use pre-tax dollars to buy, which will essentially give you a discount equivalent to your tax bracket (approximately 25% for most of us). If you don’t know what an FSA is stay tuned for an article later.

    Which one should I buy? Right now I don’t have any specific recommendations. Lasers are allot of money for a consumer to buy. There is also some training and expertise needed.  The person applying the device needs to know some anatomy and is willing to read manuals, take the time for webinars and other training opportunities. Some companies offer training with each unit while others charge. Using longevity can also help weed out gimmicks and non effective devices. There is at least one brand and model of magic wand out there and I suspect there are many others. My plan right now is to actually seek out those massage therapists, chiropractors, and PTs who have different manufacturer units and get treatments from them. The real good news is that treatments should only run $30-$35 per treatment. If you don’t get pain relief in one or two treatments, that one does not work for you on that particular problem. It amazes me that folks will recoil at the thought of paying for healthcare when insurance won’t even cover the price you pay a whitecoat co-pay.

                What makes the photo therapy work? My opinion is from what I have learned, most wavelengths of light have profound effects on the human body. How about the body’s production of vitamin D? Ancient civilizations have long worshipped the sun, but many have also used exposure to the sun for therapeutic effect, such as Chinese, Indian, Mayan, and just about every civilization in the history of the world. Laser works for many problems. Other light will also heal and excite cells as well. Common facts come out of the research are that ATP production is increased. More ATP means more energy at the cellular level and the ability to recover is increased. How that ATP production is enabled is where the theories come in; some suppose the mitochondria go into hyper-drive, while others have electrical explanations.

                Drawbacks and limitations. While reducing inflammation and promoting healing are two quite dramatic benefits of Cold Laser, it will not treat any underlying problems or remove causes of injury. While the burn may heal, you will keep getting burned if you keep putting your hand on the hot stove. Also, because you feel so much better, it is tempting to go out and overexert yourself and possibly injure yourself even worse.

                As I post this blog today I am coming off a 100 mile bike ride followed by a 10 mile run the next with no knee pain, stiffness or range of motion issues. My tailbone feels like new. I am progressing in my training build phase for an Ironman length event in about a month.

                In conclusion, as always, make up your own mind, invest time in research, and invest out of your pocket. Set some priorities. You need to start putting your health first, that way you can help your family that depend on you. It is not selfish to get yourself happy and healed then work your inner circle and then expand that circle of influence. The cost of laser treatment is just a little more than a co-pay if you have a fee-for-service insurance such as Blue Cross. Heck, most folks will drop more cash on a meal out for the family than what these treatments cost. I for one will own a unit for my private use; they simply give too much comfort not to. The one I am currently being treated with is expensive and it is a decision I do not make lightly. The unit has a higher power output,  electrical-stimulation and an analytic tool to find trouble spots. These are all features that I will be evaluating to determine whether they dictate a premium.

  • Is it low T?

    Saturday, April 14, 2012

        Are you not the man you used to be? Have you lost the passion for the one you love? You could have low T and HERE IS THE SOLUTION XXXXgel in its new more concentrated form! Ask your Whitecoat today, in fact demand it you deserve the most important thing in life!! 
        All I am going say here is learn and think, first if you have Low T it did not happen overnight. You have been deficient for some time, so taking some time to study the whys and wherefores of deciding to supplement Testosterone would be the wisest decision. Yes you feel Tired, worthless, angry, weak and the magic gel or patch is NOT going to make a change tomorrow. The beginning a regimen of supplementation can be a no turning back proposition. The very day my doc had the test result (which I requested) in Her hands I had a prescription and I was desperate for answers and solutions so I like most I bit hook line and sinker. Even though I had unidentified sleep Apnea (which can be a cause of hormonal disfunction), there are other causes as well.
        I need to back up and over simplify Human hormone function. First rule is that most all hormones are dependent on other hormones and have a feedback mechanisms. That feedback mechanism keeps the levels at their proper value not too high or not to low. To accomplish this a gland say the pituitary monitors how much Thyroid  hormone (T-4) exists. T-4 is further converted to T-3 which is actually used on the cellular level.. If the pituitary thinks the level is too low it secretes Thyroid Stimulating Hormone (TSH) which is telling the thyroid to get busy. TSH is what most Whitecoats test for and call it good as far as diagnosing Hypothyroidism. There is a huge debate as to what constitutes low thyroid function, from levels of3.8 all the way to 2. "Normal Range" is a whole separate discussion. But for now there are opinions from symptom based diagnosis to strict "normal range " diagnosis. It has been said numerous times that hormones function as a family- if one is unhappy they all are.
        So lets bring this back to T, T needs to have Sex Binding Hormone (SBH) to transport T, and Lutienizing Hormone (LH) to get the sperm made. These hormones are regulated or originate in the pituitary Gland. By now you should have realized that the pituitary gland is a pretty important piece of gear, and you want to keep it happy. Sleep is very important to pituitary health if you even think you possibly, maybe could have a sleep issue STOP and get that fixed first. (CPAP is not necessarily the answer don't be afraid of this diagnosis). We as men are not often afraid of anything and we take pleasure of demonstrating our ability to ignore problems and move on. We carry that mentality into our later years so when body parts ache we expect it to pass if it does not then we might restrict our activities or just accept the condition of "getting old". The trick is to understand symptoms that are action items, excessive snoring Is one of them. SLEEP APNEA KILLS. Sometimes fast and other times a death of a thousand cuts. Take the example of Mr. Reggie White The Minister of Defense, If this Man was not the ultimate example of a manly stud specimen that was both a supreme athlete but a clean living family man (retired Defensive end for the Philadelphia Eagles) did not wake up one day at the age of 43. So if you think that you are as tough as Reggie White 6'5" #300 all American and Hall of Fame Defensive end then maybe you can beat Apnea.
        Now let's bring this back to T again- see how this could be a week long seminar- don't worry I will boil this dow to a take away message soon. Another myth is that sexual performance suffers with low T. While poor performance can be an indication it is one of the last to show up. I suspect that I have been in a low T state for 10 years or more and I chopped morning wood 3 days a week (one way or another). Listen up we are all different your symptoms will be different there are so many symptoms the only way to know is to test. Testing is not created equal, your T will start off at a high in the morning (morning wood) and will decline significantly over the day to a low at night. That is why we want morning relations while our female companions want evening relations. The "normal" range is 350-1350 So where do you belong? on the very highest end of course, that where men are men right? Well not so fast enter the Whitecoats and the "normal" range for your age. Also enter basic perspective, yes men decrease T levels with age, and at 50 it is 1/2 of your peak, but are all men created equal? If you supplement what is a safe level? Who makes the call you or the Whitecoat?


    Other factors that affect testosterone levels,
         1. Overall body fat, the more you have the more estrogen is produced (think of Estrogen as the anti-testosterone), the more you have the worse it is.
         2. Alcohol Yes that is not what you want to hear and the more often you drink and the more each time will suppress Testosterone.
         3. Diet The low fat High carb craze has been a major factor in reducing our overall testosterone, Hormones need good fat, Omega 6 fats are BAD fats. Omega 3 good fats. Don't underestimate diet you are what you eat. Soy -unfermented is VERY BAD.
         4. Blood sugar (insulin) management. elevated blood sugar suppresses testosterone, eating constantly does not allow your sugar to normalize and is not conducive to healthy Sugar levels. Get a meter and test and find out which foods spike your levels and get a A1C test that will score how your levels have been over the last few months. Try eating a slice of white bread and measuring blood sugar levels at 2, 3, 4, 6 minutes, then try a large spoon of white refined sugar.
         5. Exercise, We have all heard this before, but one step further the type of exercise does matter some. I have read that endurance is bad at one site and it shows pictures of a 100M sprinter and a marathon runner thinking that says enough, well it does not. Exercise also manages weight (to a degree) and blood sugar.
         6. Plastics: some plastics have estrogen like substances do a search for BPA. Heat will release these esters so keep plastic bowls out of the microwave. in fact throw them away and buy glass. It will last cleans easier, looks cleaner and we have more sand than oil.
         7.Exposure to cold, excessive warmth puts Leptin to sleep. only periodic exposure to cold can activate this fat burning hormone. yes you could take a pill but the Leptin will only go run and hide in some Adipose Fat.


        Can you do all the above and still have low T? Yes that is where you need to lean on your doctor to work WITH you. If your Doc will not make the time to talk to you or professes ignorance, or says there is nothing you can do to boost T, then place the Whitecoat label on Him/Her and get another.


        So why does not every man just juice up? There are many "side effects" I don't know them all but one that got my attention is the fact that prostate cancer is enhanced by testosterone. One of the many treatment options for prostate cancer is to remove the testicles and therefore removing testosterone. Also if you suddenly become SUPERMAN and start performing amazing physical feats, your support ing structure will probably fail tendons, ligaments muscles, and even bones can and will fail. And if you are older they mend slowly if at all.
    Take away advice, get tested even if you are 35 and everything is fantastic, at the least you have a baseline, if you are older and everything is fine again you have a baseline. If you are low you have some homework.       Remember you are in control, not the Whitecoats. Take your time research and make up your own mind. You have your work cut out for you from what is causing your low T or if there is any other underlying problems, pituitary, sleep, precursor elements.


    Dangers of T supplementation without research:
    By supplementing T you WILL SHUT DOWN YOUR BODY and if it is shut down for a period of time it may not start back up even if the root cause was external and you correct it. Once you shut down the boys they might not start back up. When you supplement T you run the risk of Estrogen conversion yes Estrogen and that is Very bad if you are a man, Man boobs, crying at movies, everything it really sucks. Your body could be low T just because of conversion. In fact most over the counter T boosting products work at blocking that conversion. You can test for that conversion, the test is called estradiol and that test should always be run along with T, LH, FSH, DHEA, and Prolactin.

  • Jim's Race Schedule

    Monday, April 2, 2012

    Desert Tri  http://www.kleinclarksports.com/page3/page3.htmlOlympic 3 March Done!! 1500m swim(almost a mile), 40k bike (24 miles), and a 10K (6.2 mile) Run.

    Wildflower http://www.tricalifornia.com/index.cfm/WildFlower2012-main.htmLong Course 70.3   5 May  well 4 broken ribs will knock me out of this one 1.2 mile swim, 56 mile bike and 13.1 mile run

    Pacific Crest http://www.racecenter.com/pacificcrest/halftridu/index.htmLong course 70.3June 24th  Bend Oregon1.2 mile swim, 56 mile bike and 13.1 mile run

    Leadman 250 http://www.leadmantri.com/page/show/391875-bend-or22 Sep Bend Ore 5k(3.1 miles) swim, 223K(138.5 miles) bike and 22K(13.6 miles) run

    Laguna Phuckethttp://www.lagunaphukettriathlon.com/ Thailand 70.3 25 November

    IM 70.3 Asia pacific Championship http://ironmanphuket.com/Phuket Thailand 2 December

    Plus many Olympic and sprint races in the Northwest

  • The Short Story

    Tuesday, March 27, 2012

    I was sitting in a Doctors office  51 years old and #340 this Whitecoat told be there was no doubt that we should set up Bariatric Bypass Surgery that I was grossly Morbidly Obese. A year later I had lost over #100, Identified 2 major health issues,  cured 3 others (GERD, IBS, Acid Reflux) yes cured (I got rid of the root cause) AND completed a triathlon. 2 1/2 years later I completed Ironman Canada (2.4 mile swim, 112 mile Bike, 26.2 mile Run) in 14:35.
    Today Ben continues to coach me with the goal of Kona in 2013 and to be competitive within my age group and with Ben's guidance it will happen, it has to.
    Jim McIntosh www.aintdoneyet.net
    gonna soar till the day I die!

  • Arrive the Blackcoats

    Monday, March 26, 2012

     Lawyers  are key and this is how they effect the system. Let me tell you a story about shoulder surgery, I had surgery in 2004 here in Spokane by a wonderful surgeon who is part of the most efficient and customer centered organizations I have ever heard of. In the surgery my shoulder was found not to have a torn rotator cuff but I did have allot of scare tissue and some bone growths that made impingements the impingements were ground off and the scar tissue was gobbled up by a handy little device. They even gave me a video with audio commentary, that was cool. They installed a lidocaine pump post op that put lidocaine at the surgery site. I had no post op pain, 2 days later I pulled the catheter out and one night of Tylenol 3’s and I was good to go , rehab and get on my bike.

    Now roll the date forward 3 years and those who have had shoulder surgery know you see the man twice. I did, well in the mean time I see an add on TV from an Ambulance Chaser and Associates trolling for idiots who think they have been harmed by a lidocaine pump. The add is slick, and centers on the big bad companies and how you can get some easy money. Later that year I found myself sitting in the doc’s office and I ask will I get the pump this time, the answer is NO. I ask why? Did they have any problems with the pumps? No Did that doctors office have any adverse cases? No! How could that be? I was told the manufacturer took them off the market, the clinic had a wonderful record with the device. I asked if they had any in a safe somewhere and a waiver, nope, but I bet they have a couple stashed away for family or themselves I would. With the second surgery I was in hell and taking big time pain killers that put me in a fog for a week.

       So are these class action lawsuits really helping the general public or just enriching lawyers?And the lawyers say that they are protecting the public. Think about all the extra expense that existed on the second surgery. The pump looked like about a $10 item I am sure it cost about $50 just because. I am absolutely sure that the device company has to factor the lawsuits into their costs. In the pre op room I got general agreement on the real social status of lawyers and I believe the consensus was below a car salesman. Oh my god I was one for 9 months but I could not lie good enough!

        The shoulder surgeries were a complete success in the result, my rehab stories will come next and also tell two different tales of PT. Later I had an incident with my shoulder and it completely locked up , I got an MRI immediately and I was in the surgeons office in 2 days after injury on set (I told you this was a good clinic) and the Doc looked at my “reading” of the MRI and it said that I had a probable tear and arthritis of the rotator cuff, I was really concerned until the doc explained that the Radiologist saw a 50 year old male and automatically adds arthritis and a probable tear just to cover his/her ass and that I should let things sit put some cold packs and get some PT. Well it healed and I was 100% after 2 weeks. Other true Whitecoats would have sharpened their knives and gone to work. These true Doctors I am going to label Green coats for their caring and diligent approach to medicine.

    White Coats = Avoid    Green Coats = Seek.

    If you find yourself with a shoulder problem such as mine do not wait. The insurance companies want you to try other futile efforts before surgery. I will say it right now that the longer corrective surgery is put off will lengthen your recovery significantly. the injured limb will atrophy and that atrophy is more pronounced and harder to get back the older you are. Also in the case of shoulders and knees an once of prevention is worth a TON of cure. Don't wait until you are full on hurt bad to go see the doc and the inevitable PT (Physical Theropist)  Some insurance companies do not require a physician's refferal for PT. Like everything take some time in seeking out a knowledgeable PT, and hopefully a group of them so when yours is unavailabe you can see an equally good one. Next post will be about PT's these folks come in every size and shape and expertise. Most are the MVP's in your health care plan.

    Ain’t Done Yet- Gonna soar till the day I die
    hopefully I can get the song licensed on the site to share. Can’t wait it is my personal anthem second only to the Star Spangled Banner OK third with the USMC Hymn.

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