walking around in tap shoes and pyjamas since 2010 - my cycling log (opens in new window)

Wednesday, July 13, 2011

Goals, and Some Complex Thoughts About Medical Stuff

I've been putzing around with my goals all year, and I don't think I've achieved any of them yet.  The fact that some of them can't be achieved until at least September, anyway, may have something to do with that -- but that doesn't mean that thinking about them a bit more doesn't make at least some sense.

Thus, here I am, thinking about my goals.

What it boils down to is this: I'm not actually all that good at setting goals.  My goals tend to be either too vague, too specific, too pessimistic, or too optimistic.

My non-racing goals, at least, make sense: going out on more sociable group rides is a great idea, and I've actually been following through on that one and enjoying it.  My racing goals, however, could use a little work.

Last year, I set exactly one goal for 'cross season: finish at least one race.  I achieved that goal.

This year, I started by setting the rather vague goal of 'finish better.'

The thing about that goal is that it doesn't give me anything really specific to go on.  Goals, in this context, are useful insofar as they help you design a program to achieve them.  'Finish better' isn't very helpful.

As such, I'm updating my 'cross season goal.  Here it is:
  1. Finish Cat 4 races within time constraints (preferably less 5 minutes).
This seems like a feasible goal: I can look at my various races, say to myself, for example, 'Okay, at Applecross, I will need to complete my race in 40 minutes.  This means I will need to be able to ride hard for 40 minutes on varied terrain.'  I can build a training strategy to help me meet that goal.

 I thought about using 'Finish in the last 1/3 of the pack or better,' but to do so would present two problems:
  1. It would require me to know how fast my group is likely to be.  In all honesty, I haven't the foggiest.
  2. It's based on comparing myself to other racers, which isn't really the approach I want to take.
Likewise, I'm updating my road racing goals as follows:
  1. Hang with the pack in the 5-Spot Crit Series (Cat 5) or some other Criterium series
  2. Ride a sub-12 hour 200k.
  3. Climb like a bad-- err, a like goat ;)
Again, these are pretty specific goals that I can break down into workable steps.

Road Racing Goal #1 only appears comparison-based on first analysis.  It actually breaks down into two more specific goals:
  • Maintain 25 MPH average for 30+ minutes.
  • Get really comfortable riding fast in a pack.
The only potential problem with the 5-Spot series is that it takes place in the summer, and I have pretty much decided summer shouldn't, ideally, be a racing season for me.

The second of my 5-Spot sub-goals, I've already made headway towards -- in a tight pack, I tend to fall into 'flocking mode.'  This startled the heck out of me on the first fast club ride I did this year.  I was afraid I would find myself boxed into a tight pack and freak out, but instead I just kind of relaxed and went with the flow.  Weird, eh?  Of course, we weren't descending at 45 MPH on a wet, curvy road, either.

The first ... well, we'll see in the next couple of weeks how much more work I need to achieve that sub-goal.

None of my goals, you might notice, are at all results-oriented -- which is to say, none of them has anything to do with where I finish in a given race.  I don't care if I finish DFL in 'cross; finishing at all is enough.  I did it once last year; if I can keep that up, and focus my training on improving my time a little each race, I'll be pretty happy.

Technically, riding a sub-12 hour 200k isn't a racing goal at all -- it's a randonneuring goal -- but it also supports my road-racing goals for next year by requiring improved endurance.  You know, just in case we should actually succeed in having an actual road race around here, let alone in the spring (or, really, any time between the End of the Ice and mid-June).  I was thinking about the Tour of Red River Gorge, but while the non-competitive ride went off this year, the races were cancelled due to insufficient sponsor support, so I 'm concerned that they may be cancelled next year as well.

The whole purpose behind the third goal is basically to not suck at climbing during the summer.  If I climb really, really well during the reasonable seasons (spring and fall), it follows that I should climb at least decently well in the summer, when my respiratory system goes on vacation without me.  This year, I was climbing decently well during the spring, and am now climbing abysmally.

I suppose I should also add one more goal:
  1. Take a more organized approach to treating my medical issues.
I don't like say that I have 'medical issues.'  It sounds like a cop-out.

I'm trying to change how I think about my health -- to think of my asthma not as a barrier, but as a challenge that can be managed.  That said, it has officially crossed the line into 'poorly managed' as of the past week -- which is to say, I'm experiencing significant symptoms pretty much every day -- so I may need to see about getting back on a preventive medication like Advair or Singulair (only cheaper, I hope, because there's no way I can afford either of those) for the rest of the summer.  I would rather bite the bullet, take the meds now, and be able to wean back off them in the fall than try to avoid taking the meds, let the underlying inflammatory process get really out of hand, get really sick, and find myself off the bike for several months again.

Likewise, I have a condition that keeps my androgen levels well below normal, and I'm trying to determine whether or not I should pursue treatment for that. 

On one hand, I want to say it isn't hurting anything, but on the other hand, it is.  I was skeptical about hormone replacement therapy, but when I tried it for about a year, I did feel better, both physically and emotionally.  I have struggled with depression since high school, and I can count the one year that I consented to do something about my hormones as the least-depressed year I've ever had, pretty much.

I stopped hormone therapy for a number of reasons -- first, I wasn't convinced it was entirely necessary.  My feelings about that are much less definite right now: it does seem to help, and as my body has wandered back to its native state (which takes about six to seven months, from what I understand), I have begun to think it helped more than I realized, both physically and emotionally.

Second, my old doctor had prescribed way too high a dose, and even when I trimmed it back my levels tended to be higher-than-typical, which also isn't good.  I wanted to taper back to my own base level, then start over at a very low dose and see how it goes. 

Third, part of me feels really weird about taking testosterone (even though it's prescribed to me) and competing in bike races.  Technically, it's not doping if you have a valid medical reason to be doing so -- which I do, since low sex hormone levels can lead to osteoporosis, among other things -- but as I mentioned, my old doc seemed to have a hard time finding a dose that didn't shoot me above the typical range, and that seems potentially unfair.  Likewise, if HRT always bumps my testosterone level higher than the typical range, I don't know that I'd be able to view any potential success in racing as real.  I fear I'd feel like I cheated.

I'm also concerned about the possibility of testicular cancer, which is -- for someone like me, with atypical sex differentiation including undescended testicular tissue -- much higher when HRT is employed.

I feel a little weird discussing something this personal in this particular blog.  I haven't really discussed this topic here because it never seemed relevant or useful before.  Likewise, there's a part of me that A) would like, for once in my life, simply to be regarded as 'normal' and B) fears that people will be uncomfortable around me if they know I'm 'different' in such a fundamental way.  Also, I get tired of explaining myself: even if most of the population of the United States had any clue what I mean when I say "I have an intersex condition," intersex is such a broad category that it still wouldn't tell anyone anything useful about my anatomical and physiological nature, or why that nature has any meaning for me outside of the most private domains of life.

In light of racing and formal training, though, it does seem relevant and useful, especially because I can't possibly be the only person with an intersex condition who wants to race bikes.  We're simply not that rare (okay, my particular condition is extremely rare; but other types of intersexuality are surprisingly common).  The incidence of Klinefelter's syndrome, for example, is generally stated at around one in 500 males (I'm not sure if that figure counts people who have the 47XXY karyotype and ambiguous primary sex differentiation, or if that population is counted under the headings of their various atypicalities) and KS frequently involves hypogonadism -- that is, low sex hormone levels -- which might benefit from HRT.

It is probably true that in test of strength and power, like sprinting and (to an extent) criteriums and 'cross, my hormonal status, unaltered, could be a liability.  HRT would ameliorate that effect.

However, I'm more interested in endurance and long-distance speed, and I don't know how much of an impact low serum testosterone levels should have -- if any -- on endurance and speed over distance.  My testosterone level, for example, generally falls at the lower end of the window between the typical female range and the typical male range, and there are certainly women who hold their own with the men in road racing at levels much higher than I ever hope to attain.  Therefore, it stands to reason that I shouldn't need HRT to compete as a Cat 5 road racer.  Likewise, I am genetically predisposed to hypertrophy in my leg muscles -- people at work comment on the size of my legs all the time, but the truth is I could do absolutely nothing at all cycling-wise and they would stay the way they are.  My Mom's legs, in fact, look a lot like mine, and I don't think she's even sat on a bike in the past several years.  My Dad's family, meanwhile, is made up of strong people with long, sleek muscles -- so I have exactly no genetic predisposition to much in the way of upper-body development. HRT didn't really do much of anything for me, upper-body wise.

The real stumbling block, for me, is the emotional effect of my hormonal issues.  Everyone is subject to some degree of hormonal fluctuation; my fluctuations impact my mood profoundly.  I can tell when my testosterone level is at ebb tide because I generally feel emotionally cooked.  It's like I just 'bonk' emotionally.  My mood drops through the floor, my motivation goes to pieces, and I just want to crawl into a dark hole somewhere.  The depressions sometimes torpedo my training plans.  They definitely torpedo my ability to keep up with housework.

Right now -- that is, on this particular afternoon -- I would rate my depression level as roughly 7/10, if 0 is the best and 10 the worst I could possibly feel.  7/10 is pretty rough. 

This depression is definitely not situational -- my life is in pretty good shape right now, especially relative to previous years.  Yet still I have these episodes, and they really interfere with my life, and especially with my cycling life.  Yesterday, I had to push myself out the door; today, I have not succeeded in doing so.  I have accomplished exactly nothing today, and I really just want to go back to bed.

I have a lot more of these days right now than I let on.  Usually I manage them by main force -- I force myself to get outside and ride the bike; I force myself to put on a happy face (on the 'fake it 'til you make it' principal) -- but sometimes that method doesn't work.

When I was on HRT, I had far fewer of these days.

For some, the question of whether or not to pursue HRT is a simple one: a lot of people like me aren't comfortable with their own ambiguity.  Personally, I am comfortable being an androgynous pretty boy (the fact that I'm gay and that DD likes me the way I am probably makes that easier for me) -- so it becomes a complex analysis of risks versus benefits.

Right now, the benefits are winning, and thus part of me feels a bit like a traitor to the cause.

Basically, I want people like me to be able to be who and what we are, without feeling like we have to conform to some culturally-approved sense of what it means to be 'male' or 'female' or 'human.'  My reasons for considering HRT have nothing to do with that culturally-approved sense, but I still can't help but feel like I'm weakening my own argument -- that it's okay to be what I am -- if I pursue something that effectively makes me more 'normal.'

I intend to think this thing through very thoroughly.  DD and I have been talking about it: he tends to lean towards the non-interventionist side of things, because he worries A) that medical intervention might lead to unforeseen consequences and B) that I should be allowed to be who I am in all senses of the word, and that I might be more subject than I realize to the pressures of 'normalization.'

As for me, I would simply like to stop having these days on which I just want to crawl into a hole.  The lack of motivation is, in and of itself, destructive, since I tend to judge myself rather harshly when I don't get things done.

Today I have done nothing but write this blog, and I am pretty unhappy about that.

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