‍TriDot Podcast .232

In Sickness and In Health: Training While You're Sick

‍

Intro: This is the TriDot podcast. TriDot uses yourtraining data and genetic profile, combined with predictive analytics andartificial intelligence to optimize your training, giving you better results inless time with fewer injuries. Our podcast is here to educate, inspire, andentertain. We’ll talk all things triathlon with expert coaches and specialguests. Join the conversation and let’s improve together.

Vanessa Ronksley: Well, hello there one and all! Welcome to theTriDot podcast. As endurance athletes who adore our training schedules, nothingcan be more annoying than getting a cold. Thankfully, on the show today we aregoing to talk about the ins and outs of what to do when you have caught a bugand how to handle your training. We have Dr. Jeff Krebs in the house to providesome insight for getting you back to your training as smoothly and quickly aspossible. Dr. Jeffrey Krebs is an internal medicine physician who has beenpracticing medicine for over 35 years in San Diego. He is a fellow of theAmerican College of Physicians, and an Associate Clinical Professor of Medicineat the University of California. He is a former competitive figure skater, a seven-timeIronman and multiple Half-Ironman finisher, an elite age-group runner who hasraced the Boston Marathon eight times, coming up on nine, and then hittingnumber ten in 2025, and will be competing in his third Age Group World MarathonChampionship later this year in Sydney, Australia. He is a TriDot CertifiedPool School Instructor, and a RunDot coach. Jeff, I am so pleased to have youon the podcast!

Jeff Krebs: Thank you so much, Vanessa. It's so great to be here discussing thisvery important topic, especially since there are so many bad bugs out theretrying to derail our training and our racing.

Vanessa:To round out the panel with a wealth of experience from his background as arespiratory therapist is TriDot Master Coach and the TriDot Pool School LeadInstructor, Ryan Tibball.  Ryan has a BSin Biomedical Sciences from Texas A&M University, and Respiratory Care fromUT Health Center in San Antonio. He serves as the head power cycle coach atLifetime Fitness. He is a certified CrossFit coach, and a certified Pose Methodrun coach. Ryan is a multiple Ironman finisher, has been coaching with TriDotsince 2015, and I am grateful that he is my very own coach. He also holds therole of TriDot Business Coach, and plays matchmaker as the Coach ConnectAdvisor for athletes who want the perfect coach for them. Welcome to the show,Ryan!

Ryan Tibball: Oh, thanks, Vanessa! Always excited to be here with you, and it's sucha pleasure to even talk here with Dr. Jeff Krebs as well. It's exciting toreally talk about something so important as what to do when you're sick, andwhat not to do is even the bigger thing. So thanks again, Vanessa.

Vanessa:And I'm Vanessa, your Average Triathlete with Elite-Level Enthusiasm! Let'sstart things off with our warmup question. We will then move into the main set,and then we'll cool down with our Coach Cooldown Tip. It's going to be a greatset everybody! Let's get to it!

Warm up theme: Time to warm up! Let’s get moving.

Vanessa:  For our warmup question, we are sticking withthe theme for the day. And the question is, what is the one thing that alwaysmakes you feel better when you're sick? Let's start with you, Jeff.

Jeff:Well fortunately, I rarely get sick. But when I do, all I want to do is sleep.And my favorite thing to do is to lay on the sofa with a nice warm blanket onme, and my labradoodle Walter right next to me. Seriously, his body heat givesme so much comfort.

Vanessa:This is incredible, so one of my favorite things as well is my heated blanket.That's pretty cool. And we have just been put on a wait list for a labradoodlepuppy, and I'm really excited. So I can't believe that you have one, and we'regoing to have one, and I'm really excited. So yay, that's awesome.

Jeff:I’ll have to show you pictures of Walter later, he is absolutely adorable. Andthey're really smart, so beware.

Vanessa:Okay, good to know. What about you, Ryan? What is your thing that makes youfeel better when you're sick?

Ryan:I'm going to go off-script here in such a way that it's going to blow people'sminds. A really good Margarita. No, I'm just kidding, I live in Texas, right?But really, I go old-school here, I actually love a great homemade chickensoup. And when I talk about this, I mean I put on a big pot, put the greenbeans, the carrots, potatoes, the rice, and loads of chicken. I like to say, inmany ways I feed my sickness, so I want to get that nutrition in. That is mybig go-to, and I did learn a little something as well about an addition I putto it, and I'm going to let you, Vanessa, elaborate on that here in just amoment. I have a feeling I know what you do.

Vanessa:Yes, you do have a feeling, because I may have sent you this recipe at onepoint in time.

Ryan:Yes you did.

Vanessa:So I'm very similar to you, Jeff, I rarely get sick. When my whole family isdown and out for the count, I am usually pretty fine. But when I do get sick, Imake a healing tea, and I have a pot of it going on the stove all day long, soI have this endless supply. It's made from rooibos tea, lemon slices, freshginger, fresh turmeric, pepper, and then if I'm feeling like I need a littlebit of antibacterial help, I'll put in some of that unpasteurized raw honey. Ittastes amazing, and I always make it for my friends and family when they getsick, and I'll do a little special delivery and bring a huge pot of it over forthem. Because it's legitimately magical.

Ryan:I agree. I did do this, and for our listeners out there, I can say you knowwhat, you could maybe even add a little bit of whiskey to that too, to justkind of take the edge off. Just saying.

Jeff:It does sound amazing, I'm going to have to get that recipe from you.

Vanessa:I will send it your way, absolutely.

Jeff:Thank you.

Vanessa:Yeah. Let's throw this out to the I AM TriDot Facebook community. Let us knowwhat makes you feel better when you're out for the count. I think we're goingto end up with a pretty good list of things to help us all out the next timewe're feeling a little under the weather.

Main set theme: On to the main set. Going in 3…2…1…

Vanessa:  Before we get too deep into the show today, Iwant to give a shout out to our good friends at UCAN. Here at TriDot, we arehuge believers in using UCAN to fuel our training and racing. In the crowdedfield of nutrition companies, what separates UCAN from the pack is the sciencebehind LIVSTEADY, the key ingredient in UCAN products. While most energypowders are filled with sugar or stimulants that cause a spike and crash, UCANenergy powders, powered by LIVSTEADY, deliver a steady release of complex carbsto give you stable blood sugar and provide long-lasting energy. I am so excitedto get my shipment of UCAN products. Their energy bars are out of this world.Between their energy mix, energy bars, almond butter, and more, there isdefinitely a LIVSTEADY product that you will love. So head over to theirwebsite, ucan.co, and use thecode TRIDOT to save 20% on your entire order. It used to be 10%, but the finefolks at UCAN have upped it to 20% off for TriDot Nation. Once again, that’s ucan.co, promo code TRIDOT.

Wehave all been there. Excited to smash the next training block, or lookingforward to an epic race that has been on our calendar for months or even years,and then we wake up with a little tickle in the throat, or sometimes even afull-blown cold. I don't know about you, but there's a lot of anxiety, sadness,anger, and all of the feelings that come after the realization of the impendingdiscomfort, forced rest – isn't that the worst thing ever is having to beforced to rest – and then potentially missing that special event? It could bereally discouraging. But is there something that we can do to potentially stopourselves from getting sick in the first place? Or if we do end up with themother of all colds, what steps can we take to get back to our training andracing that we love? Well, Jeff and Ryan are here to save the day. I'mabsolutely sure that they're going to shower us with knowledge and advice, andget us on the road to recovery as quickly as possible. So Jeff, let's jumpright in here. Can you tell us what is happening biologically in our bodieswhen we start to feel sick?

Jeff:First I want to distinguish between viral and bacterial illnesses. I think it'simportant, because bacterial illnesses for the most part require a doctor'svisit and antibiotics. But far and away the most prevalent of infections, andthe ones that we really experience the most, are viral. So when we talk aboutthe common cold – URIs or upper respiratory tract infections, the flu, all ofthose things – we're talking about viruses, and there are a lot of them outthere. Of course we all know influenza, RSV, COVID, but there's adenovirus,rhinovirus and a lot more. What happens as these viruses enter our bodies, ourimmune systems immediately go to work – well, hopefully anyway. Oftentimesthese viruses enter our cells, their main goal is to replicate. So they enterour cells, they start replicating, they get released from cells, they go intoour bloodstream, they infect other cells, and it just goes on and on and on.And a lot of what we're feeling is our immune system trying to destroy thevirus, and it also affects our normal tissues. As the immune system revs up, wedevelop fevers and chills. It raises our core temperature in an effort to fightoff the infection. So in this case the fever is good, even though we don'treally like to experience it. And as the viral infections continue, we startgetting sore throat, headaches, body aches, nasal congestion, cough, sneezing,watery eyes – most of them related to the effects of the virus, but a lot ofthe symptoms are related to our own immune systems trying to fight off thevirus. And with some viruses we also get nausea, vomiting, and diarrhea. A lotof what we feel is a release from our immune system of a lot of white bloodcells in our body, and white blood cells can actually cause inflammation. Sothat's sort of what biologically is going on.

Vanessa:Right, that was a really excellent synopsis of all of the things that happen.You've taken very complicated biological processes and made it very simple tounderstand, so thank you for doing that. I am a firm believer in preventativemeasures for all things that have to do with health and wellness. So what stepscan we take to prevent getting sick in the first place? Ryan, let's start withyou.

Ryan:I love this question, and I wish I could honestly follow exactly all of thethings I talk about with my athletes in particular. But generally speaking, agreat diet, a healthy diet can go a long way. But which one do you tag first?Is it the diet, is it the regular exercise, is it the sleep? In my opinion youjust put them all at the top of that list, and you make sure that youprioritize those three things, diet, sleep, and regular exercise. Those thingsare all going to help in any sort of preventative measures, and in fact, evenpotentially healing as well. But wash your hands too. That's another thing thatpeople often forget, washing your hands regularly. Don't go to the grocerystore, go shopping, and then immediately come in and start eating everything.Wash your hands, do those kinds of things. But let me go back to exercise.There are a ton of benefits from having a regular regimen of cardiovascular andstrength training. That does amazing wonders to our immune system. I know Idon't have to preach this too much, because our audience is primarily athletes.But again, keeping that consistency will benefit your immune system as well. Ialso add that regular exercise improves our body’s immune system and responsesto and defends our system. A little small caveat, now I know a lot of athletesare probably like, “Well, why am I getting sick after a marathon or a fullIronman, or in the middle of training for these big events?” Partially that isbecause some of these longer durations that we do, such as 3, 4, even 5-hourthings, can actually have a slightly opposite effect and make you a little moresusceptible. So what you have to do is be more diligent in protecting yourself,and eating and sleeping and recovering properly. I kind of got slightly deepinto the weeds on this, those are big preventative measures that can be done,and you can control every single one of those. I’d like to mention that as arespiratory therapist, I can speak directly to those with reactive airwaydisease and tell them, “Stick to your regimen that your doctor has prescribed.”That is something for your preventative measures, whether you're using inhalersof different sorts, the steroid inhalers or just plain bronchodilatorpreventative inhalers. Use those, continue to use those. That will also assistyou in being able to be more healthy and less susceptible to getting sick.

Vanessa:Yeah. Jeff, as a physician, I'm sure that most of your patients are coming into see you to get advice on how to relieve their symptoms. But do you sometimesget the opportunity to talk to them about prevention? And if so, what do yousay to them?

Jeff:Absolutely, I stress the importance of prevention all the time to my patients.And Ryan, I loved everything you said, I agree a hundred percent witheverything. One of the things, knowing that regular exercise strengthens theimmune system, I do advocate all of my patients to exercise regularly. Goodhand washing is really important, but going a step further, wiping down theequipment in the gym before using it, not just after. Because you can't trustthat the people who used the treadmill or the weights before you have done agood job of wiping it down. Also, common sense, just avoid people that you knoware sick. Get your appropriate vaccines for influenza, RSV, COVID, whatever isappropriate for your age group. And if you're immunocompromised, get thosevaccines that are recommended. Then the other thing that I always do is, Istill advocate these days to wear a mask in appropriate situations – airports,airplanes until you hit 10,000 feet. In certain large groups, you never knowwho's going to be sick, and it's better to be the only one in a mask than toget sick and to have your training compromised.

Vanessa:Absolutely. I'm very curious about something you just mentioned. So you onlyhave to wear your mask until you get to 10,000 feet?  Is that a thing?

Jeff:Yeah. That is a thing. Airplanes have these very elaborate airflow systems andHEPA filters. They don't kick in until they get up to the cruising altitude,and I'm pretty sure it's about 10,000 feet. That's because it takes so muchenergy, they can't invoke these systems early on when they're trying to takeoff, but once they get to about 10,000 feet, you can be pretty certain thatthose systems are all engaged, and it is a little bit safer. Now, obviously, ifyou're sitting next to someone who's hacking away or blowing their noseconstantly, I'd be a little bit wary of taking off the mask. But I always wearmy mask until I get up to that cruising altitude, and I feel pretty safe. Andwith the travel that we all do as athletes going to races, it’s so important,there's nothing worse than flying to a race, and the day before the race, youstart feeling ill.

Vanessa:Absolutely. Okay, you just saved a whole ton of people from hours of wearingmasks in the airplane. Thank you so much for that tip, that was absolutelygreat. So we know that there are measures that we can take in order to preventillness, which both of you have alluded to very wonderfully. But now, lo andbehold, we have come down with something. So Jeff, what are some of the signsand symptoms that it's time to actually consult a doctor, as opposed to justriding out the symptoms, or taking the cold and flu meds that we have access tofrom the pharmacy?

Jeff:Well, prolonged fever, or a very high fever, is one of the most importantthings to recognize and then seek medical care. If your temperature, as anadult I should say, is over 103°, you need to see a physician, because it maybe more than just a viral infection. Or if you've had a fever continuously forthree to four days. Shortness of breath is another one, and I’m sure Ryan willspeak to this as a respiratory therapist, especially if your oxygen saturationis dropping. The great thing – as endurance athletes, most of us have Garmindevices or other monitoring devices that actually nowadays can monitor ourpulse and our oxygen saturation. So if you're not feeling well, feeling shortof breath, toss on your Garmin, monitor the oxygen saturation, and if it startsdropping into the low 90s, that's probably a good time to start consideringseeing a physician for that. Also persistently elevated pulse. We all know whatour resting pulse rate is, and again our watches and other monitoring devicescan monitor that. And if you notice that your resting pulse is persistentlyelevated, that might be a good time to go see a physician. Certainly persistentnausea, vomiting, diarrhea, blood in your stool, vomiting blood, deep cough,especially with dark green brown or blood in the sputum. Doesn't sound great,but definitely a sign that you might need to see a physician. Then the otherthing that I will say, is that a lot of us now have these home COVID tests.When we start getting a little cold or flu symptom, we test. If you'repositive, I would definitely contact a physician, and the reason why is thatyou may be a candidate for some of the antiviral therapy that's out there.Although they're not perfect, they can help mitigate some of the symptoms, andthey can also decrease the duration of your symptoms.

Vanessa:As you were mentioning about taking note of your breathing rate, your elevatedpulse rate –I was in Peru with my husband at one point many years ago, and wewere walking around Machu Picchu, we had just done a massive hike up to 4,700meters elevation. We had come back down to Machu Picchu, and I noticed we werewalking up all these stairs and I was like, “Why is it so hard for me tobreathe on these stairs?” And I was like, “Oh, it just must be the elevation.”But then I started counting my respiration rate, and I was like, “Okay, this isnot normal. I'm at 50 breaths a minute.” So I went to our tour guide and I saidto him, “I think something's wrong.” So she said, “Well, we'll call the doctorand they'll be waiting for us when we get back down.” And sure enough, we gotback down to the hotel later on that day – this happened to be my birthday,actually – and the doctor came, and he took my oxygen saturation, and it was56.  At that time I didn't know that itshould be super high 90s, and I said to him, “Well, I just ordered dinner, canI just eat my dinner before we go to the hospital?” And he said, “Sure.” So Iate my dinner, and then they took me to the hospital in this ambulance thatwasn't really an ambulance, it was more like a van that was cleared out on theinside. Then I got hooked up to all sorts of things, and got to go in thehyperbaric chamber. It was great, I had high-altitude pulmonary edema. Funtimes.

Jeff:Exactly, yeah.

Vanessa:Well, leading up to Ironman California, I had just moved across the world fromAustralia back to North America. The kids had started school a few days afterwe got back, and needless to say, things were slightly chaotic in our house. Soof course, a couple of weeks later, less than one month before the big race, Igot COVID, and this was the first time that I had actually exhibited symptomsever before. Ryan, you helped me out big time navigating through this, so let'sdig into it right here. What do you tell your athletes about when and how muchto back off the training?

Ryan:Yeah unfortunately I've had to deal with this on more than one occasion too,even actually for myself. Let me begin with, regardless of the proximity of arace or a major event, this doesn't change the timeline, or how to treat. I'llgo even deeper here, this is a tough one for many to get through their heads toallow the healing process to do its work. We are all mostly type-Apersonalities. If you're not, you're just lying. We're all type-A’s. We all getanxious and we're like, “Oh my gosh, it's a few weeks, I've got a race.” Thehardest thing to do is be patient and let things run their course. But you cando things, as Jeff has mentioned, to help mitigate some of these things, andhopefully reduce the duration of those symptoms. Now in perspective of your racebeing a few weeks out, there was a bit of solace on my side and that Iexpressed to you – knowing your fitness had been built. You already had anenormous amount of fitness built for your Ironman. What was more important wasto get you healed and recovered and in turn get you ready for your race. Likemany athletes, you have invested so much time, blood, sweat, tears, etcetera,not to mention the money, that is like, “Hey, let me get to the start line.Let's get there.” COVID has been that most common thing as of the last severalyears, obviously, and that's been the biggest one that I've dealt withathletes. It's still a very finicky beast in my opinion. As an RT working inthe hospital, I observed it affected patients differently, both respiratory-wiseand cardiovascularly-wise. The biggest thing was to remain patient through therecovery process, and not to try to push through it. Some of the things that Ido with my athletes and coaching them, is regularly monitoring their heartrates, especially their resting and especially during any activity. I'll gothrough that a little bit more in regards to what you should and should not dowith what symptoms. As a good general rule, neck and above – no fever, no bodyaches – you can exercise, but keep it at a low effort, lower durations, andlower impact. When I say impact, I'm referring to our disciplines –specifically the swim, the bike, the run – I would opt for not necessarily tobe running, but maybe bike instead. That's a little bit lighter on the body, especiallyfrom the neck up. I want to make sure I really preface that – no fever, no bodyaches. Or easy swims – do those swim drills. Maybe this is an opportunity towork more on swim drills on dry land, an opportunity to work on run drills ondry land, do those kinds of things.  Dosome strength training, you can definitely still do that. But again, you don'twant to resume higher activity, higher durations, until those symptoms dosubside. Below the neck, this is that big thing – below the neck, chestcongestion, shortness of breath, anything like that, fever, body aches – thatdoes require serious attention to recovery, and definitely consulting aphysician. Again, keep in mind we're not telling you, “Just listen to ouradvice,” but rather, “Hey, this is the time you need to go talk to a physician,it's so important.” Those muscular body aches, let me talk about that for aquick moment. Those muscular body aches, the ones that you're feeling in thelegs, you feel in your arms, you're like, “I just can't lift my arms.” Guesswhat? Your heart is a muscle too. It's experiencing the same things. You wantto tax your body, you want to try to work out when you're feeling that way?Your heart is taking that beating too, and that is something you should not ignore.You should not be risking yourself in such a way that you're working out whenyou have illnesses that are affecting you that way. Trying to exercise withbody aches could lead to some serious, serious health issues, and rest isneeded with that fever and body aches. Jeff mentioned earlier about shortnessof breath, that is one of those things that can be classified as definitelyemergent. You need to go seek physician help, whether it's to a clinic or to anER. If you're short of breath, there's something else going on that you cannotsee or understand, and you need professional help at that point.

Vanessa:That was really great, thank you for sharing all of that. Jeff, is thereanything that you would like to add to what Ryan has said here about puttingthe training aside and catching up on rest?

Jeff:Ryan is absolutely right in all of those points. As endurance athletes, we’retrained to monitor our bodies, and we need to use that information to listenand act accordingly. It's hard, because we all love training. We all lovecompleting every workout and checking that box every day. But there aredefinite times when we're going to benefit more with rest than we do fromperforming a suboptimal workout that doesn't enhance our training at all.

Vanessa:I think you hit the nail right there with that one, absolutely. Now, this hasalso got me wondering if there are differences when adjusting training forswim, bike, and run. Ryan, you had mentioned maybe swapping in a swim or a bikeinstead of a run, but do we treat all of these different disciplines the same?Or are there differences in how much, or maybe the intensity that we engage infor the different sports? Let's go with you first, Jeff.

Jeff:Well, a lot has to do with what your symptoms are, and I might add what you'retaking for your symptoms. A lot of us take medications containing sedatingantihistamines, for example, and that's going to affect your reflexes andcognition. I would not swim, bike outside, or run outside under the influenceof these medications. It's hard enough, when we're riding with all of ourfaculties, to avoid cars and potholes and other obstacles. And taking any typeof sedating medication is going to really affect that adversely. The big one,of course, if you're having diarrhea as part of your viral illness, you’ve gotto stay out of the pool. Even after your diarrhea resolves, you need to stayout for 10 to 14 days. Many people have the false belief that exercising whileyou're sick will help your body fight off or kill the virus. That's just nottrue, and actually can be very dangerous, especially if you already have afever. Raising your core temperature even further with exercise can causetissue damage. In general, the adage that it's okay to keep training if yoursymptoms are really above the neck, as Ryan mentioned, is fine as long as youdon't have a fever. But anything below the neck, you definitely don't want todo it.

Vanessa:Yeah. I think the hardest part is that we know these things as athletes, andthen we struggle to actually execute on the resting portion of it. Like we justalways think, “Oh, maybe I'll just sweat it out.” How many times have you heardthat one? “I'm just going to sweat this cold out, maybe it'll make me feelbetter.” Then the next day you wake up ten times worse than you were the daybefore. Ryan, what are your thoughts on this?

Ryan:First off, Dr. Jeff, I hundred percent love the fact that you brought up,“Don't try to go sweat it out.” It's, like, innately built in many of us, “Oh,I’ve got to go sweat this out. I'm a triathlete. I'm a runner. I’ve got to godo these things.” No, no, no, no, you don’t. But I mentioned it earlier, of theswim, bike, and run, that the running does inherently have the highest trainingstress on the body, the pounding etcetera. So just adding to that, as we statedearlier, our stipulations as to when and when not to work out is to start withsome of the lighter sports, the lighter disciplines. Going back to doing swimdrills, doing running drills, you can bike, you can do strength training. Butagain, mind you, make sure you don't have fever, you don't have body aches.That's those big ones to really mention. Again, it's not to say you can't gorun, but it would not be my first discipline to go to when coming back off ofany sort of illnesses.

Vanessa:That all makes perfect sense, that's for sure. I do think that we have aquestion here that everyone has been waiting for. What can we do to get back totraining faster? Ryan, I know you have some tools for this in the toolkit. Whatdo you tell your athletes when they want to get back at it?

Ryan:Start off with “be patient”. Let's say you have an illness. Let’s say thetypical duration of that illness is seven days. If you're patient enough, andyou listen to your coach, or you listen to a professional physician, you mightget back in five days. Again, it's amazing, when you do the right things – andmost of the time, it’s not doing things to do the right things – the more youtry to fight the illness, trying to exercise as normal, the longer it actuallywill take to heal. Again, I go back to “fueling the machine”. I call everyone amachine. Fuel the machine, make healthy options, get adequate sleep.  Do those things, and actually you canpotentially get back faster, maybe cut off 24 to 36 hours to your healing. Asviral illnesses go, it has to run its course. That's just it. You can docertain things to reduce symptoms, and Jeff mentioned potentially gettingantiviral medications that can potentially reduce the durations of symptoms andget back into action sooner. And again, consulting your physician is alwaysgreat to do, instead of using Dr. Google. Dr. Google's not the source, allright? The other considerations are, as Jeff mentioned earlier on, are thedifferences between viral and bacterial infections. Bacterial infections willoften require antibiotics, and while using antibiotics it is recommended toreduce intensity and durations of exercises, or halt them completely to allowyour body time to heal. That is so, so important. Those are some of my toolsthat I use. And really, just being supportive of my athletes, giving them thatcommunication, and getting them equipped to do the right things.

Vanessa:Yeah, I think that's super important. The first aspect being patient issomething that we all struggle with. But knowing that if you put in the effortto reduce your training, which does take a lot of effort and consciousness,then you'll be better off and back at it faster than you would if you had justgone for that extra little Zone 2 even.

Jeff:Absolutely.

Vanessa:And Jeff, you absolutely must have had some experience with this consideringyour vast training and racing and professional experience. Do you have anysecrets to share?

Jeff:Well, definitely getting rest early on, as you've heard, will allow you to reapthe benefits later on and get you back to training sooner. We have tounderstand that when we're sick, our bodies are using important resources toget us better. At the same time, our appetites often decrease, so our caloricintake decreases. Our body needs every bit of the resources that we can give itto do its best to fight the infection. Ryan mentioned in the warmup questionthat his favorite thing to do when he's sick is have a big pot of chicken soup.That's really the right way to go about it, because he’s supplying hydrationand good nutrition to really help our bodies. The other thing to remember,because people just don't want to take time off from training – remember thatif you're training regularly, taking a week off will probably lead to a littleloss of endurance, especially the older you are. But you'll regain that within7 to 14 days of returning to training on average. So rest assured that takingthe time now is not going to set you back very far, and you'll regain thatwithin one to two weeks.

Ryan:I love what he just said, “rest assured”, he should have said “pun intended” onthat there.

Vanessa:Yeah, I didn't catch that one, that was good. But I think what both of you havesaid is that we all know, especially with TriDot, that we intentionally do theright training right. And I think that it's important when we get sick, we haveto do the right resting and recovery right. We have to make sure that we makethat a priority, so that the body can repair itself and get back to thattraining as quickly as possible. Now, the time has come when we've got throughthe worst symptoms, and we're actually ready to get back into that trainingprogram. So what I'm wondering is, if there is a “but” here. If athletes liketo attend spin class, go to the gym, hit the pools, is there a specific amountof time that we need to wait if we are training with others in order to avoidinfecting our training pals? Jeff, I know you had spoken about this about thepool, and not going back after having the viral diarrhea for 10 to 14 days.What are some other suggestions that you have?

Jeff:Well, the answer to your broad question is really not that straightforward.Many people want to get back to their training as soon as their fevers break.What you need to know is that in these viral illnesses, oftentimes fevers canbe cyclical. So you may break a fever for now, but it's going to return. So youdon't want to be too hasty returning to the training. It's also dependent, ofcourse, on what illness you have. For example, influenza may take 7 to 10 daysto run its course, so you're looking at seven to ten days of really taking iteasy. Other more minor viral illnesses, you'll feel better within a couple daysand you can go back sooner. As we heard, COVID is still prevalent. If you testpositive, you need to stop training for at least seven days, or until all thesymptoms have resolved. This also means, in the case of COVID, that you have tomonitor your heart rate. We don't really talk about that with other viralillnesses, but as Ryan was saying, COVID can definitely affect the heart muscle,and we need to be careful with that. Many illnesses are contagious, so bemindful when returning to a public gym, especially if you still have a runnynose or a cough. If at all possible, resume your training at home first. And asmentioned before, definitely stay out of the pool for 10 to 14 days afterhaving diarrhea. And that's not from the time the diarrhea starts, that's afterit has resolved, because there still can be transmission of bacteria andespecially parasites.

Vanessa:Yuck.

Ryan:Nobody wants that.

Vanessa:Oh my gosh, it just blows my mind, that obviously a lot of people probablyaren't that courteous, so to think that when you're swimming in the pool, andyou're just wondering what else is floating around in there – man, gross. Sofinally, the big A race is on the horizon, and I think that it's a hundredpercent normal for an athlete to feel nervous about a whole ton of things. Butone of those extra anxieties that a lot of people feel is about getting sickbefore that big race. So what can we do about this, Ryan? Let's start with you.

Ryan:Absolutely, there's a lot of things we can do. First, I do like my athletes togo ahead and go on Amazon, purchase a giant bubble, and live in it until raceday. And if any of y'all bought that, I have some oceanfront property inArizona as well to sell you.  To thisday, not a single one of my athletes has purchased this said bubble, so I'm notsure how well it works. But seriously, you've invested a lot of time, money,blood, sweat, tears in this major event. Doing your part in prevention can go along way. Again, we go back to proper rest, proper recovery, eating well,hydration, washing your hands, taking your vitamins. Doing those things,avoiding places like concerts a week or two weeks before your race – try not toschedule that concert, try not to schedule that family reunion, things likethat. That seems to be the common place for a lot of things. Avoid crowdedplaces. I know it's like, “Well, I want to do these things,” but think aboutthe investment and time that you've done. It's something that we do asathletes, we have to be very conscious of that. Avoid being around other sickpeople. That way it just gives you a lot more peace of mind, avoiding gettingsick before that big A race. Again, we love what we do, and as a coach, I'm init for my athletes. Just please take care of yourself guys. The best preventionis going to be the best thing for you in the first place.

Vanessa:I'm guessing, Jeff, you've had a ton of racing experience. Have you ever hadthese kinds of feelings before a big race, and if you did, what did you do toget through it?

Jeff:Before every single race. I'm always concerned that I'm going to get sickbefore a race. I start several weeks out making sure my nutrition is on point,and that I'm getting plenty of rest. Staying away from situations like Ryanmentioned is very important. But remember, we're going to races, and we have togo pick up our credentials at the race expo. For example, some of the marathonsI go to, we're talking about tens of thousands of people in an enclosed space.It is hard to completely avoid those environments, so I'm okay wearing an N95mask during that time, and I always do without fail. I'm okay if I'm the onlyone in the entire group, because I know it's for me, and I don't really carewhat anyone else thinks. I will give you a little true story. I raced theChicago Marathon this last October, and of course I show up at the expo and I’mone of the very few people wearing an N95 mask. I picked up my credentials atthe expo, I didn't stick around too much. I called an Uber to take me back tothe hotel, and I get into the Uber and the driver is hacking away this veryfruity, productive cough the entire time.

Vanessa:No. Oh no.

Jeff:Just non-stop, and it sounded horrible. I immediately rolled down the window,tightened my N95 mask on, and within about a mile and a half or so I asked herto pull over so I could get out. Fortunately, two days later I showed up to thestart line, I felt great, and had a good race, and I do think that the masksaved me, because those germs were just flying all over the place. Soyeah,  I worry about it, and I just tryto be sensible. You know, when we're racing, we're always talking about “raceyour own race”. For me, that goes with the prep before the race also. I don'treally care what other people are doing. I have to do what I need to do to beconfident that I'm going to show up in a healthy state.

Cool down theme: Great set everyone! Let’s cool down.

Vanessa:Well, it is my pleasure to bring you the cooldown today everybody. Chris Navinis here for our Coach Cooldown Tip. He is a metabolic specialist and endurancecoach, who opened his very own human performance lab. So to say that he has awealth of knowledge is a massive understatement. The most impressive part isthat his actions speak louder than his words. He has completed over 400endurance events, with podiums and age-group rankings that will knock yoursocks off. Chris considers himself to be a “Swiss army knife” kind of coach,who uses metabolic testing in addition to focusing on the technique side ofswim, bike, run. Welcome to the show, Chris!

Chris Navin: Hey, thanks for having me on.

Vanessa:So I was doing my warmup today for my run, and I was navigating the Lego citythat has overtaken my basement, because my kids are nuts about Lego. I heardthat this might be the case for you as well, so tell us about the massive buildthat you did in Tokyo.

Chris:Yeah, so growing up as a kid, I played with Legos a lot. I grew up inSwitzerland and had the toys there, and then came back to the US as well. Thenas I was growing up, my father was actually involved in working with Lego as acompany.  He got a grant from them, itwas at Brooklyn College in New York, using it as like an educational tool andwhatnot. So we ended up by going to conferences, we built computer-controlledLegos. It was when they first started adding the motors and things like that,and they had an interface called LegoDacta, that connected to a computer. So webuilt a display, and the Japanese Ministry on Trade and Technology was at aconference and they saw it and they're like, “Can you build this but bigger?”So they actually gave us a grant, commissioned us to come to Tokyo. We werethere for about a month, and I built this huge – they wanted it to be a futurecity. So I built this as essentially a teenager I think, I forget exactly howold I was at the time. We went over there for almost a month. We set it upright near the baseball stadium, actually, it was inside their offices, and itwas on display there for a year as a computer-controlled exhibit of the futureof technology and Legos.

Vanessa:That is incredible. When I tell my kids about this, they're going to be soexcited, and thinking that their dad does not have as cool of a job as your dadhad, that's for sure. So I am really pumped about the tip that you have for ustoday, because I think it's going to make a huge difference for our listeners.What do you have for us today?

Chris:Yes, it's a real simple one, but it can be applied in a couple different ways.Oftentimes some people get into training smarter, and they get a heart ratemonitor, and they focus a lot on being in the right zone and they focus a loton the beats per minute.  But if you justlook at your heart rate in terms of beats per minute, it doesn't correlate to alot. Like if I'm at 132 beats and you're at 147, it's hard to understand. Whatdoes that really mean? What does that feel like? So I encourage people, andpretty much all my athletes, to change the data field on their Garmin or theirbike computer to not just look at beats per minute, but look at it as apercentage of your max heart rate. Sometimes people percentage of your lactatethreshold, but max heart rate is the easiest and most common.  That way, when you're looking at your heartrate and you see like 132 beats, you'll also see it as a percentage, like 60%,70%. If I tell somebody, “Hey, go at a 90% effort,” you know what that feelslike roughly. So you can start to correlate the beats per minute into an actualrate of perceived exertion. It's also helpful, if you're ever training with afriend or whatnot, or as a coach working with an athlete, knowing wheresomebody is. If you just look at their heart rate, you might not know that 127beats is Zone 2 for somebody, and it's not comparable from one athlete to theother. So in terms of coaching groups, or if you go to a group spin class wherethey have heart rate on the screen, we try to do it as a percentage, soeveryone knows what effort you're going at, and it just gets you connected morewith understanding the data and the why behind using the heart rate data. Soyou can correlate it to a rate of perceived exertion, and that will correlateto understanding how your metabolism changes in the different zones. Butoftentimes too, the other issue I notice with a lot of people is if you'reusing TriDot, for example, and you have a Garmin watch, your heart rate zonesmight be set up differently in both of those. So in order to get your heartrate zones in sync, it's good to figure out what your Max heart rate should be.I like to call it your “metabolic max heart rate”, it doesn't have to be yourtrue max heart rate. But just a way to correlate the zones between systems,making sure that the heart rate settings on both systems are in sync. Becausehonestly that's what Garmin uses for all their training stress calculations,and you want your zones to be as accurate as possible. So I really encouragepeople to get that dialed in. Use a good heart rate monitor, ideally a cheststrap if you can, and that way you can really learn how to use heart rate dataa little bit more intelligently.

Vanessa:So you had mentioned RPE, which is rate of perceived effort, and I know thatpeople are actually pretty accurate at knowing their RPE and how it correlatesto the different zones. Do you find that the RPE correlates well to thepercentage of your max heart rate?

Chris:It should, but it all depends on if your heart rate zones are set properly.Like doing your assessments you know consistently, in the right way, and usinga good device to measure your heart rate. So if someone is really getting intobeing more precise, really using the data, you want good data coming in so thatyou can use the data. Oftentimes an optical wrist-based heart rate monitor, asgood as they are, they don't work as good across every individual type, likesomeone who has thicker arms, different color skin, you've got more bone aroundthe wrist. Things like that can affect the accuracy, so a big part of it ismaking sure you either use a chest strap, or the upper arm band opticals areusually a little bit better to have that good data going in. Then once you havethat, it will correlate very, very closely to rate of perceived exertion. Sowhen you put it in a percentage standpoint, that's how athletes, especiallybeginners, can really understand heart rate better. Like, sometimes people say,“Why is the app or device telling me I need to be at 132 beats? That feels tooeasy.” Or something like that. Once they see it as a percentage, then theybegin to understand, “Okay, I know I need to be in the 60 percents for Zone 2,the 70 percents for Zone 3, the 80 percents for Zone 4, generally speaking.”That way, they just understand heart rate data better, it kind of makes thatconnection. Once you've established that connection, it's a lot easier tofocus. You don't have to be like, “Oh, I need to be at 142 or 147.” You canfocus on the percentage scale, which just makes more sense. Especially ifyou're racing, your mind is distracted with a lot of things going on, andsometimes looking down and seeing like, 132, 137 – like, it doesn't make thatrate of perceived exertion connection very quickly. But if you see apercentage, you're like, “Oh shoot, I'm at 92% of my max heart rate, maybe I'mgoing a little bit too hard.” So I find it helps to get athletes to focus alittle bit more with more precision.

Vanessa:Yeah. I have one last question for you, how do you determine your max heartrate? I'm not sure if the 220 minus your age is still the standard or the go-tofor that. What do you suggest in that department?

Ryan:Yeah, do your assessments. Use RunDot, TriDot, do a field test essentially. Oneof the best field tests to do is a 5K run. If you really pace a 5K well, likeyou really give it your best effort – like sign up for a race and getcompetitive people around you –generally to truly assess someone’s max heartrate, the only consistent way is to really get someone to go for 15 minutes ormore above their anaerobic threshold, and then add on a ramp or a stressor atthe end. And usually with a 5K race, you come down that finish chute and yousee the finish line, that's enough of a stressor to get you, and you mightactually hit your true max heart rate at the end of a 5K. But at least gettingthe data where you see your average heart rate for that amount of time is whatour systems like RunDot and TriDot will use to get your heart rate zones dialedin properly. I am more biased, like I'll want people doing a metabolic test. Ihave a lot of lab equipment where we can really do some more high-precisionstuff. But for the general-purpose person, just doing a field test, doing yourassessments, is really the key. And you can learn a lot from that too, likeoftentimes people are still a little confused about heart rate. You might seethe average heart rate going higher or lower, but if you look over a longperiod of time and you notice, “Hey, I'm able to hold a higher heart rate for alonger period of time,” that actually usually correlates to improvements inperformance. It means your thresholds are moving up, it means you're fuelingbetter, it means you're hydrating better, you're becoming just a smarterathlete, and you'll be able to notice those improvements in your metabolism andyour health just by looking at the heart rate.

Outro:Thanks for joining us. Make sure to subscribe and share the TriDot podcast withyour triathlon crew. For more great tri content and community, connect with uson Facebook, YouTube, and Instagram. Ready to optimize your training? Head totridot.com and start your free trial today! TriDot – the obvious and automaticchoice for triathlon training.

‍