Heart to heart talk

Bunny Pages, my father who literally (at 6-foot-tall) and figuratively (as head of our family and business) stands tall, had a serious affliction the past few weeks. He had recently been complaining of fatigue and shortness of breath. After a battery of examinations that included 2D Echo and blood tests, an ECG, a stress test, and eventually, an angiogram — he was scheduled for open heart surgery.

My dad was the epitome of strength and stamina. He had exercised all his life. From winning 3rd place in a body-building contest (there were only three contestants; sorry to reveal that, dad) to his almost daily basketball games with BAPRO in Bacolod, to his 6 a.m. singles tennis matches with Dodong Hermosisima and Henry See — my dad was fit, robust, possessed an endless reservoir of energy (he could negotiate deals or give speeches all day long) and was a positive force whose outlook in life, never mind the darkness or storms outside, was eternally sunny.

The news to the family was “heart-breaking.” After more deliberation and thanks to the advise of my best friend, Dr. Ronald Eullaran, we consulted top cardiologist Dr. Francisco “Jun” Chio, who recommended an angioplasty. Exactly one week today and after a complicated two-hour-long procedure with three stents inserted in his arteries, my dad Bunny is fine. He doesn’t need a bypass and he’s feeling, in his own words, “like a 20-year-old.”

Praise God!!!

Today, when the romantic heart is coddled and pampered, let’s ponder also on this muscular organ the size of our fist that’s lumped between our lungs which pumps blood through our veins.

We have to take good care of our heart. How? For one, our food intake is most important. A balanced diet with plenty of high-fiber vegetables and fruits and low in fats and sugar is universally suggested. Eat more fish. Regular check-ups is a must. An annual Executive Panel, preferably with a stress test and especially for those involved in triathlon and 90K bike rides is needed. Don’t run a marathon unless you’ve been checked. Reduce stress. Relax. Take deep breaths often. Monitor your BP and, when prescribed with medication, take them without miss. Finally.. Exercise. At least 45 minutes of daily sweating is recommended. Dr. Jun Chio told my dad that had he not been a regular exerciser, he could have succumbed to a heart attack.

This Valentine’s Day, let’s heed the words of Jose Mari Chan: Please be careful with your heart…

Categorized as Fitness

Warning: Exercise is not all good

You and I will die. That’s a fact. It’s not a question of “If we’ll die…” but when. It may be tonight at 11:25. It may be this Wednesday. It may be in five or 50 years. Jasmin’s lola, Corazon Gayanilo, celebrated her 101st birthday last month. Jasmin has another lolo who biked at the age of 104. Many others, sad to know, leave us at such a youthful and untimely age. Such is the uncertainty of life: We never know.

But this we know: If we quit smoking, temper our refueling of Johnnie W.; if we eat more mongo than lechon, smile more and frown less, and, if we’re surrounded by people we love and who care for us, chances are we’ll live extra years.

One other formula for longevity? Exercise.

You and I know this. The more time we spend sweating, the less time we’ll spend in CebuDoc or Chong Hua. The formula is easy: More exercise = more years. Less movement today = more medicines to buy tomorrow.

So… Exercise. But there’s another malady afflicting us today. Because while exercise is good, too much is bad. In fact, some who exert too much effort, who punish their heart and pummel their body to such extremes end up with the most extreme of occurrences: death. The maxim, “Too much of a good thing is bad” applies to food, money, fame and, yes, exercise.

What’s my point? Several points. First, when you engage in sports, do it gradually. If you’re 275 lbs. and were inspired by watching the recent Cobra Ironman 70.3 super-athletes, don’t enlist in the 21K run. Do a 3K. Or a 5K. Take it easy. Our body takes time to adapt. We can’t–and shouldn’t–lose 30 lbs. in three weeks. Patience and steady bodily punishment are best.

I’ll tell you a not-so-funny story. As one of the lead organizers of the Cebu City Marathon, I had access to the records of the 42K participants. We interviewed several of the 1,500+ participants. And while the good news was that many of the 42K runners were first-timers, what shocked Meyrick and Perl Jacalan, Roy Trani, Jesse Taborada, and our CERC group was this:

Many of the first-time 42K runners only finished one 21K. Unbelievable. it was crazy. They’re unprepared. Of course, we couldn’t ban them. Many, we discouraged to join. Based on experience, you need a couple of years of running background, at least four or more 21Ks, and should practice one or two 32K runs before embarking on that full marathon. But, no. Many said… We want to that medal NOW! Never mind my under-training. I can do this!

Crazy. As if the 42K were a walk in the park. Sure, Plaza Independencia is a park and it’s part of the route… but marathon running is difficult and requires months of preparation.

My first point: Don’t jump. Be patient. The “10 percent rule” (increase your mileage or time exercising by no more than 10 percent per week) is best. (Kung Binisaya pa: ayaw patuga-tuga.)

Second point: Visit your doctor. Have an Executive Check-up. Allow the hospital and clinics to take multiple tests of your fitness level. Do a stress test. How are your cholesterol levels? (Which reminds me: mine was shockingly high, 271, over a year ago; I need to get another one.)
Before embarking on any strenuous target (the 21K or the 42K? a half-Ironman? biking 100 kms.?), have a medical examination.

Third point: During the actual run or race, if you’re feeling extra tired and are about to faint or are just feeling unusually weak… stop. Walk. Drink. Wait. I know we’re all pushed to push ourselves. But, there are moments when we should stop. And by stopping, I mean quitting. Nobody wants to quit. Nobody wants to face his or her friends after the race and say, “Sorry, ni undang ko.” Sure, uwaw kaayo mo undang. But, you know what? If it can mean saving your life, then stop. There’s always another race next Sunday. Our bodies are living machines. If pushed over our limits, we breakdown.

A good example was the Timex 226 Ironman in Bohol last December. The “226” refers to double the recent Ironman 70.3 distance. It refers to 3.8 kms. of swimming, a 180-km. bike ride and a full marathon (42.195 kms.) You know what happened? Out of the 70-plus participants who joined, everyone finished the race… except one: Neil Catiil, the elite traithlete who was supposed to win the whole race. He apparently got dehydrated and quit. Sad and embarrassing story for Neil but, looking at the brighter side, he lived to compete in future events.

You know what my all-time favorite running quote is? It’s the motto of the Singapore Marathon. In every kilometer along the route, huge placards of this message is broadcasted for the 50,000 runners to see. The words?? RUN YOUR OWN RACE. So, take it easy.

Categorized as Fitness

Injured and throbbing in pain? Read on…

Here’s an article on Injuries I first published last April 2009….

Dr. Jose Antonio San Juan is one of Cebu’s first-rate doctors to visit when you suffer a sports-related affliction. I should know. In the past two years of long-distance running, I’ve suffered knee soreness, cramps, plantar fasciitis, muscle aches and, the most painful one that got me limping during last year’s Hong Kong Marathon, the Iliotibial Band syndrome.

Who do I consult? Plenty of friends, I ask. And, unanimously, they supply me with a three-worded answer: Tony San Juan.

Trim and robust at 40 years young, Tony played soccer, basketball and swam competitively in high school. These days, he prefers to swat the badminton racquet and swing that 7-iron in this game of Angel Cabrera. (Tony’s handicap is an impressive 9.)

Trained at the UP College of Medicine, he went on further studies (Fellowship Training) in Joint Replacement Surgery and Arthroscopic Surgery/Sports Medicine at the Flinders Medical Center/Repatriation General Hospital in Adelaide, South Australia and at the University of Cincinnati Medical Center in Ohio, USA. At present, he is a partner of the Cebu Orthopaedic Institute at the Chong Hua Medical Arts Center.

I exchanged Qs & As with Dr. Tony SJ. Here’s Part 1:

Why do we get injured?

“In sports, injuries are generally classified into two: TRAUMATIC and OVERUSE. Traumatic injuries are what you may commonly call your sports accidents. By their nature, it is hard to say when, how, where and to whom it may happen. Whether you are a weekend warrior or an elite athlete, a fitness buff or the most conditioned triathlete, we will all eventually have some form of traumatic injury.

“These injuries may happen even if you have the ideal equipment, the ideal playing surface, the ideal preparation or conditioning. In short, this injury is unpredictable and hard to prevent compared to overuse injuries. The more common traumatic injuries are sprains (injury to the ligament that connects bones to each other), strains (pulled/torn muscle), contusions (bruising/swelling because of direct trauma to an area) and fractures (think Lance Armstrong recently breaking his collarbone).

“Overuse injuries may happen in the course of preparing for a sport or while actually participating in the sport. They happen because of poor conditioning, improper training regimen or techniques, improper equipment and simply “overdoing” it—not following the limits you had set for yourself and what your body can take.

“These kind of injuries are preventable in that if you have trained, conditioned and equipped yourself properly, the likelihood of getting injured during the event is significantly less compared to someone who wasn’t as prepared. Most overuse injuries are sport specific.

“For tennis buffs, there’s the tennis elbow (lateral epicondylitis) and subacromial impingement (shoulder); for golf aficionados, there’s the golfer’s elbow (medial epicondylitis; for teenage boys into basketball, volleyball or soccer, there’s Osgood Schlatter’s disease (knee) and Sever’s disease (heel); among runners, there’s the iliotibial band syndrome/ITB (knee); just to name a few.

“The best way to find out what your injury is to see your health professional be it your family physician, your internist, your rehab specialist or your friendly orthopaedic surgeon.”

What are the best ways to prevent injuries?

“Proper conditioning or preparation, using appropriate equipment and using equipment properly, employing proper techniques and “knowing your limits” (i.e. remember the ad with the slogan “I am Tiger Woods!”? Well, it’s a goal for excellence but we have to realize that there can only be one Tiger Woods.)

“As we mature (he-he, get older!) our body tends to be less forgiving. We get injured a lot easier and recovery takes longer compared to a kid barely in his teens. Kids could run all day long and hardly feel anything the day after. We, on the other hand, would feel aches and pains the morning after a full day of running and jumping…” 

Categorized as Fitness

More ‘Injury Tips’ from Dr. Tony San Juan

First published last April 2009….


Doc Tony (2nd from right) with (from left) Ogie Laranas, Gabby Cruz and Gerry Malixi during the ‘La Salle Goes Bad!’ tournament

When I asked one of Cebu’s top sports medicine physicians what the best ways are to prevent injuries, his answers were four-fold: 1) Proper conditioning. 2) Using appropriate equipment. 3) Employing proper techniques and, 4) “Knowing your limits.”

Dr. Tony San Juan added that to lessen the likelihood of injury, one must stretch before/after exercise, make sure the shoes fit well (and they’re still in good shape; e.g. mileage of running shoes), and, he adds, “during participation in the sport make sure you employ the proper technique (think Milo BEST clinics for basketball as an example, Jungolf summer programs, martial arts instructional).”

Is cross-training advisable?

“Cross training as a sport (e.g.triathlon): As a sport, cross training is what you may consider the ultimate test of conditioning and endurance. Since it involves at least two different sport disciplines, of which preparations will entail a variety of exercises, you may consider this the sport that prepares pretty much the entire “mind and body”… the best.

“Cross training as an exercise regimen: As an exercise regimen, I am referring mainly to the use of the cross trainer machine/elliptical machine. I recommend the use of this machine because it gives you almost the same cardio work out compared to a treadmill—except that the use of the cross trainer machine is more gentle on the joints (knee, hip and back) because of what you may call the “low impact” nature of the machine. Your feet do not float in the air and impact a hard surface with the use of the machine.”

Which is better: Cardio workout or strength training?

“We engage in a ‘CARDIO WORK OUT’ mainly to improve the function of the heart to the point that it could adjust to a certain level of exercise intensity/sport participation without compromising body function (passing out). As with any work out regimen, the efficiency of cardiac function increases or improves over a period of time and not overnight. For one to be able to enjoy the benefits of a good cardio work out, one should be able to sustain the regimen and commit to it (time).

“Strength training is mainly directed at improving muscle function and bulk (arms, thighs, chest, abdomen) while indirectly providing a ‘cardio work out.’ Strength training will give you the opportunity to perform optimally in certain sport disciplines as long as you develop the proper muscle groups.

“For optimal performance in sport activities with the least likelihood of getting injured, proper conditioning is necessary. Proper conditioning consists in a good balance between a good cardio work out and strength training.”

When injured, I’ve read so much about RICE. What is it?

“RICE – this is the first line of treatment for most (not all) acute injuries. Rest, Ice and Immobilization, Compression and Elevation is mainly directed at joint injuries, sprains, suspected fractures or contusions.
“One has to rest the injured extremity to prevent further injury and insult and to allow stabilization of the injury. Ice and Immobilization is applied to control swelling and lessen the pain which are the expected immediate consequences of the injury. Compression (wrapping the injured area with an elastic bandage) is applied to control swelling as well. Because our soft tissues (muscle, fat, skin) are soft and elastic, they will swell and expand as a result of the injury. If the swelling is uncontrolled, the pressure and fluid build up can be a source of pain and it can also compromise blood flow and nerve function to the area. Elevation is enforced to encourage drainage of the fluid/swelling from the area. Proper elevation requires that the injured extremity be elevated to a level that is higher than the heart.”

What cardio sports are least likely to injure?

“BIKING AND SWIMMING – mainly because of the low impact nature of the two disciplines.”