Wednesday, August 21, 2019

Saturday November 2- 2019, God's willing , I will be participating in my 18th Ironman competition in Panama City Beach ( Florida).

My number 17th was in Kona (Hawaii) the site of the yearly World Championship.
 One has to qualify in order to be able to compete there.
And to quality one has to have done another ironman event and ranked  first in the age groups.
The participants came from  over eighty nations. It was fascinating to hear people communicating in so many different languages.

In every one of those Ironman, one or more of my family members would travel with me. Most of the time my lovely wife would volunteer.   On October  2018, it was my daughter Eman's turn.
It is a long way to travel from Houston to Kona. Because there is no direct flight,  we flew through San Francisco.
This was the fortieth  anniversary of Ironman organization.

 On Thursday October 11, there was a motivational dinner ; with Hawaiian dances and instructions on the competition itself.
It is customary that  the organizers would present, on the stage, the youngest and the oldest participants. That evening,  the youngest was an 18 years old German who came with his father who is a participant  himself. They  both came to compete together. It is a  wonderful opportunity to have a son or a daughter competing together in a big event like an ironman.
 The  oldest competitor was  an unbelievable 96 years old.
When asked about his workout routine he said that he does aerobic and anaerobic exercise every day. I wanted so much  to talk and learn from that man. Unfortunately I was unable  to find him among the multitude  of people. In addition to the 2500 participants,  the five thousands volunteer's, the families of the athletes and the organizers. It was an impossible task to locate him, even though I tried hard.
I any of these demanding arduous competitions, we all learn from one another.
That man inspired me and will inspire me for the rest of my life. He is in my mind whenever I am training as a reminder of what is possible.
To summarize ,for those of you who are not familiar with this triathlon; it starts with 2.4 miles swim followed with 112 miles bike and then end up with a marathon 26.2 miles run. All that in one day.
The start time is 7 am and the finish before midnight.
I am a very average swimmer. It takes me an hour and forty minutes to finish. All along way  I am earnestly  praying, to Almighty, to get me out of the water safely. When you have over two thousands people jumping in the water at the same time!! it is a struggle.
In Hawaii we face three challenges;  the heat, humidity  and the strong  wind.
My wonderful daughter was following my progress up close,  and giving me encouragement. To this day,I remember two very significant  incidents  took place during the competition.
With thirty miles left on my bike segment, my electronically shifting gears  stopped functioning. Without being able to shift gears it is impossible to continue. I came to a complete stop thinking it was over. I stopped on the side of the road in the middle of no where. I was helplessly  watching all the bikers go by me and lamenting my bad luck. Not to be able to finish was something that I have never experienced before. Thinking that all the training, hard work, and  the expenses   were for naught!!!  I was on the verge of tears ,when  two young men appeared  asking what made me stop.  After explaining the problem I uttered the word that  it was over.
  " don't think that way" one of them uttered while stooping  examining  my bike.
 He stood back up and  said that the electronic shifting battery is out. He then proceeded to manually shifting the chain to a middle gear. Then  Each stood on one side holding the bike and  helped me mount and pushed up the hill. While peddling I hollered my thanks.
Who were they ? Where did they come from? What were their names, and how was it possible that one of them discovered what was wrong?
And with that I was able to finish the last thirty miles.
The strange thing is that this happened in a rare isolated part of the road.

  In the early evening an  unexpected rain began to fall bringing a welcomed  cooling of the unbearable heat. After a while my shoes  and my socks  became all soaked wet and heavy.
 Not long after I felt as if my left sock had   folded on itself  causing pain every time I stepped on it. I stopped and took my left shoe off to discover that there were    no folds, instead  I had two large blisters  at the bottom of my left foot.  It became very painful to continue. The doubt slowly crept in.
- " the pain is unbearable"
-" There is no way to finish in time, why suffer?"
All of those dark thoughts added to my heavy legs and tiered body, It gave credence to the idea of quitting. It made perfect sense and very plausible logic and above all the desired  justification.
- " I have done this before, I don't need to prove anything to anybody"

Suddenly the  site of my daughter on the side of the road at night , standing  in the rain and cheering me up,  not only chased out all of the negativity and gave me  the mental and physical strength to continue. "I am going to finish this thing" . I kept repeating in my head ; ten more miles only ten more miles to the  finish line. I started visualizing  in my mind's eyes crossing the  finish line, I barely noticed that the rain had stopped.
 As I got closer the I started hearing the announcer's voice greeting the finishers. Soon my name would be announced.
That voice got louder and louder. Then came a steep down hill that allowed me to increase my speed. I was flying, the  adrenaline was flowing in my blood erasing any pain and  the memories of the sixteen hours of struggle.
Now I smelled the  finish line.
 Over a stretch of half a mile the road was lined up with wooden barriers behind them thousands of screaming, applauding, pound  barriers people calling my name in a deafening sounds. Then came  announcer booming voice that filled the night air;  " here comes number 130 from Houston Texas the seventy eight years young , Abdel Fustok you aaare  an  Iiironmaaan




How our nutrition evolved

 Almost ten thousands years ago our specie went through a radical nutritional  change. We evolved from "hunters and gatherers" into an "agricultural" society.  In our specie's  history this is a real drastic  revolution.

 Suddenly we started producing our own nutritional needs instead of  running and walking looking to satisfy our constant daily  hunger.
Before long  we developed ways to preserve and store crops. This allowed   the  formation of  agricultural settlements and the potential demographic increase.
The direct consequences of that shift are many to list but for the purpose of our topic;
 -the wheat cultivation took place around major rivers; Nile in Egypt,  Tigris Euphrates in Mesopotamia and rice in China, that is how organized societies and  civilizations were born.
- this  new and sudden change created a major dilemma for our mankind.

Our digestive system  cannot adapt that fast. Ten thousands years is a blink of an eye.  It took millions of years to produce our organism with its intricate  enzymes, hormones,  proteins, digestion, metabolism, and so on. All  of these systems  are extremely complex and very slow to adapt to a new environment.

In time, the staple of our food consumption was based on carbohydrates, wheat  derivative in most of the world and rice in Asia.

 Two elements became associated with survival, bread and salt.
Bread for caloric source and salt for survival when traveling in hot climate; on foot or on the back of animals ( camels and horses).

Romans legions walked  across long distances carrying with them those two items as there pay. The word salt became the origin of salary.

The bread was not easy to produce. It took generations  to master the art of making bread.
 Milling the wheat kernels into flowers required the invention of  "millstones", and that took a long time to master.
The idea of then mix it with water to create a " dough" and then another invention; baking it.
In time the bread and salt acquired  cultural and spiritual dimension;
sharing them with a stranger became  a of way of connecting with our follows human beings.
Yet from a nutritional point of view, food became plentiful. Our body is used to go for long stretch without food. Our genes are very thrifty. For millennia famine was  around the corner. To survive ,our genes  had to save every ounce  of extra calories as fat. That led to our current struggle with weight.  More to come....

Monday, August 19, 2019

 Almost ten thousands years ago our specie went through a radical nutritional  change. We evolved from "hunters and gatherers" into an "agricultural" society.  In our specie's  history this is a real drastic  revolution.

 Suddenly we started producing our own nutritional needs instead of  running and walking looking to satisfy our constant daily  hunger.
Before long  we developed ways to preserve and store crops. This allowed   the  formation of  agricultural settlements and the potential demographic increase.
The direct consequences of that shift are many to list but for the purpose of our topic;
 -the wheat cultivation took place around major rivers; Nile in Egypt,  Tigris Euphrates in Mesopotamia and rice in China, that is how organized societies and  civilizations were born.
- this  new and sudden change created a major dilemma for our mankind.

Our digestive system  cannot adapt that fast. Ten thousands years is a blink of an eye.  It took millions of years to produce our organism with its intricate  enzymes, hormones,  proteins, digestion, metabolism, and so on. All  of these systems  are extremely complex and very slow to adapt to a new environment.

In time, the staple of our food consumption was based on carbohydrates, wheat  derivative in most of the world and rice in Asia.

 Two elements became associated with survival, bread and salt.
Bread for caloric source and salt for survival when traveling in hot climate; on foot or on the back of animals ( camels and horses).

Romans legions walked  across long distances carrying with them those two items as there pay. The word salt became the origin of salary.

The bread was not easy to produce. It took generations  to master the art of making bread.
 Milling the wheat kernels into flowers required the invention of  "millstones", and that took a long time to master.
The idea of then mix it with water to create a " dough" and then another invention; baking it.
In time the bread and salt acquired  cultural and spiritual dimension;
sharing them with a stranger became  a of way of connecting with our follows human beings.
Yet from a nutritional point of view, food became plentiful. Our body is used to go for long stretch without food. Our genes are very thrifty. For millennia famine was  around the corner. To survive ,our genes  had to save every ounce  of extra calories as fat. That led to our current struggle with weight.  More to come....










      

Friday, January 27, 2017

The foundational task of  any medical school is to prepare future health professionals for the purpose of diagnosing and curing illnesses, helping  a   sick person be well.

But wellness is not just the absence of disease. It is a mental and physical optimum state of being that we all should strive to achieve.
Unlike machines, our bodies are in a continuous  state of self renewal and balance. As examples;  in a few hours the entire lining of our stomach is new. In four to six weeks all our skin cells are completely replaced. Approximately every three months we generate new skeleton.
The  atoms from which every molecule in our cells is made, are like migrating birds, they do not sit still in the same place for long. Our DNA atoms  are entirely  replaced in a year.

There is always a" critical balance" between the dismantling and rebuilding. When this balance is disrupted, the body balance can be tipped in either direction which is not desirable. Too much rebuilding may cause cancer, not enough may accelerate aging or osteoporosis.

The example of the pH is very demonstrative. A pH level in the blood is highly regulated  to be between 7.35 and 7.4. If it shifts up or down it affects every chemical reaction inside each cell.  The body is akin to a river; it is never in a static state.

Nothing in the universe is idle and so is the body.  Just like we cannot step in the same river twice, it is not the same river, we cannot step  in the same body twice, it is not the same body.

To maintain the illusion of sameness of  our  outer public appearance, we go through daily under the radar routine steps; like showering, brushing our teeth, shaving, putting on make up, without which people will flee us like pest.

When my diastolic blood pressure did not go down like the rest of all my clinical parameters,  I knew I had to explore the world of nutrition. And exploring I did and still do.

I started reading about nutrition, one book at the time and progressively altered my eating habits. Soon I discovered the many perplexing contradictions between the experts. That explains the  continuous shifting of the  governmental recommended  food pyramid.

In my household the first things we dropped were the easy ones, like the fried  food, the  saturated fat, the hamburgers, the French fries, and all the obvious bad ones. Unlike many Americans, for us cooking is a daily routine. Eating out is a Sunday  deal. Our unhappy children were not enthused by the changes and were looking forward for the weekends so they could order what they missed at home. This trend led to more and more vegetables and green stuff while my work out regimen remained the same.
After six months  I paid another visit to my cardiologist for my third stress test.

To my utter surprise my diastolic blood pressure moved down into the high seventies  for the first time in almost three years. That convinced me, without any crenel of doubt,  that no matter how fit I became my heart had  to overcome some resistance from by now less hardened  arteries. That despite my genetic predisposition I have some control over my genes expressions.  That my arteries  were still not flexible enough to absorb the sudden  burst  of the blood from the left ventricle. I began to tolerate  more and more crossing my legs before  the numbness and discomfort  were  felt.   
More info next posting.





  

Tuesday, January 3, 2017

 It is an understatement  to say that humans are habit forming creatures.
If anyone of us were to log down every act or thought on a daily basis for just a week; we would find, surprisingly, that all of it is nothing but repetitious. No real new thought or action. Most of us, realizing it or not, are going on autopilot. " Most, if not all the time." " Same old same old" as they say.  Yet everyone of us has the cognitive ability to formulate  new thought processes, learn new languages and come with an awe inspiring cancer cure, if put in the right state of mind and the right environment.

From our brain's perspective anything we keep repeating  becomes encoded indelibly and relegated to parts of the brain that deals with  automatic activities.  The more we repeat anything,  an act or a thought, our brain cells, that we call neurons, get organized and create a pathway. Initially the pathway is weak, easily reversible, but after a while it becomes hard wired and structured. At that point  it is relegated to the lower parts of the brain (cerebellum and brain stem) that deal with the automated functions. We no longer have to think about every minute detail of the desired activity. In an absent minded manner once we get in our car in the morning we find ourselves parking our cars in our assigned spot at work. The same could be said of  just like standing, walking or speaking.

Once I became a runner I discovered  a new world.   A new world that deals with many things; running shoes, clothing, nutrition, electrolytes, and tips on how to maximize our efforts. We get exposed to running organizations, training programs, books and manuals and so on.
During one of those days I happened to meet and befriended Michael Smith, an astronaut living along the water front road in the  Timber Cove subdivision. I knew him socially  and his wife  was a client  of mine.
Having a running mate makes it  easier  to keep training. It helps to take our minds off of the running and the spirit of competitiveness infuses both of us to be better, and above all it soothes the passing time.
Over time our relationship strengthened and he invited me to witness the Challenger launch out of Cap Canaveral in Florida. I was unable to make it  because the launch kept being postponed due to the  weather. So along with a disbelieving heartbroken nation, we  witnessed  on January 28, 1986 the destruction of the  Challenger. This was a national tragic event and  I lost a dear friend and  my running mate.
After a year of improving my fitness and my running skills, I decided to check my progress by going back to my cardiologist to have another full physical with stress test.
The results were very good. My weight and waist went down, as well as my heart rate and systolic  blood pressure. The only unchanged factor was my diastolic blood pressure, it was still hovering around mid eighty.
It was a disappointment to say the least.
I decided that I needed to do more running. Yet I knew without a running mate this was not going to be easy.
One day while I was running in Houston at Memorial Park I saw a sign inviting runners to train for the Houston marathon. I stopped to enquire about it since I didn't  know what a marathon was. Promptly I joined " The Runners High Club"  and before long I finished my first marathon in four hours and ten minutes. Crossing the finish line was an exhilarating unimaginable fulfilling feeling. Like many first timers,  the immediate thought process is I am going to do better next time.
Having accomplished that lofty goal I thought for sure my diastolic blood pressure would now be in the seventies or even in the sixties.
Back to the cardiologist. Except now I thought of changing my doctor.  Maybe the problem resides  with my cardiologist or his equipment. So I sought another heart doctor friend.
Again all of my results had drastically improved with the exception of the diastolic blood pressure which by now was in the low eighties.
That is when I started questioning my nutrition.
An exploration of the world of nutrition began and have not stopped since then.
In my next blog I will explore that world and share my continuous quest.
   

Friday, November 18, 2016

At the time we were living in the city of  Seabrook near Nasa, in a subdivision ( Timber Cove) that was originally created by astronauts. Many of them lived there while working and training  in the nearby space center.
It is a very nice closed quiet safe middle to upper class  neighborhood with only one access road that was an  entrance and exit off the old Kirby road.
 Most people knew each other if not they knew about each other. A none resident was easily spotted.
 We had a waterfront property overlooking Taylor Lack, an extension of Clear Lake. The backyards of the houses on the water were unfenced.
It was  common to stroll, late in the afternoon or early evening, from one neighbor  to another socializing and sharing  drinks, even  in the middle of the hot summer, the  cool  breeze coming from the lake made it very pleasant.
Over the following few months my daily walks, along with  my son's biking,  progressed from just walks to brisk walks to walk and jog. Increasing the distance slowly.
within six months it was up to three miles a day seven days a week.
Progressively both  my pipe smoking and  my TV time went down because by the time we finish and shower  my son and I were exhausted and ready to sleep.
Having lost some weight, I was feeling better and  looking better, I thought it was time to have another stress test expecting better outcome than the first time. I will share the results in my next posting.

        

Wednesday, November 9, 2016

This past August the 21,  I was competing in my last and number 15 Ironman. This event was held  in Coeur D'Alene ( Idaho).
 For those of you who are unfamiliar with this sport, it is a triathlon that includes 2.4 miles swimming, 112 miles biking and a 26.2 miles run. Usually  the starting time is  7 am and it ends at  midnight.
The day before, on the 20th, my office manager in Houston called to ask if I'd mind being interviewed by one of the local TV channels in Coeur D'Alene.
 It was a surprise. Here I was far away from home where I assumed no one knew me, being asked for a TV interview!
Before long I was in front of the camera answering questions.
My seniority was what prompted the inquiry.  At the age of seventy six  I was  the oldest participant. The day before they had interviewed the youngest participant  who was only eighteen.

Later  that day ( Saturday the 20th)  as  my wife and I  were strolling around town  we  began  to notice  that some  people were nodding their heads and smiling, while others volunteered words of encouragements and appreciations. All of which made me feel good about my ephemeral celebrity.

During the flight back to Houston my memories took me back to the early eighties and how it all started.
 Back in July  1983 I had just started my practice as a plastic surgeon for about one year.
I was very busy building a reputation,  going from one ER ( emergency room)  to another, taking care of  facial and hands injuries,  in addition to whatever  elective cosmetic surgery a young , little known, plastic surgeon can get.
My daily routine back then,  after finishing my work, was to  head   back home, eat dinner, smoke a pipe and watch any sport event before  going  to bed.
The routine was interrupted one day. I had applied for a life insurance policy that required a complete physical examination, extensive lab work and a stress test. All of them turned out to be satisfactory for the insurance policy but not to me. The reason is that I knew  my  father died from heart attack at the age of seventy.   He went to sleep one day and did not wake up. My mother said that earlier that day he complained of heart burn following a heavy meal. Prior to his death and for years he was treated off and on for high blood pressure.
My physical exam revealed elevated diastolic blood pressure 125 over 86. We call the high number "systolic" meaning when the heart is contracting and the lower number "diastolic" it measures the pressure when the heart is resting. What concerned me is the lower number; It is close to" ninety" and by definition it means high blood pressure.
The  heart contracts to push  the blood into the arterial vascular system. The more resistance it faces the higher the blood pressure would be.
Some of the increased resistance is due to loss of softness  of the arterial tree, often due to what we call atherosclerosis ( hardening of the arteries).
At the time my  cardiologist  was not concerned about it at all. To him it is what he sees every day as normal. Yet, seeing my worry, he suggested he would put me on medication if I wanted but recommended   to start working out. I had no desire to be on medication that is why I preferred the later.

Even before my consult a  warning symptom was already manifest,   that I could not keep my legs crossed other than  for a short time before the crossed leg  goes painfully  numb. That meant that the artery behind my knee was not flexible or pliable ,  and the pressure from the weight of my leg compressed it reducing the flow of blood down  my leg.
My journey, to the triathlons and the Iron man competition,  began  with  walking around the neighborhood while my ten years old son followed  me  on his bike. It felt very good spending quality time with  him.

That was a modest beginning for a lifelong never ending  journey of learning , experimenting and  self discovery.  It transformed me from a coach potatoe to an athlete ranked third in the world in my age group.
I am fully conscious that my  unique knowledge and expertise can be useful and helpful for many. I share it with colleagues, patients, Rotarians and hospital staff.
Recently my daughter and her husband pressed me to  start a blog telling my story and share what I learned.
Not being a digital person this  medium of communication is intimidating.
 I prefer public speaking or direct person to person exchange.
 Yet  I am willing  to try. Ralph Waldo Emerson wrote and I am paraphrasing " If you only  helped one person breath better you have succeeded in life".
 In the next few days I  will share with you what I learned and what worked for me.

A.K.F