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The Triathlete in Pain, Opioid Avoidance/ Thank God I'm Not Racing Party


     A "Thank God I'm Not Racing!" Party in Kona?  

Site of one TGINR party
Although I'm lucky enough to go to Kona every October to work the event, I've missed the past couple TGINR parties as I'm usually still on the pier getting those last minute details finished so that come the starting cannon in the morning, those competing have the best shot at success.  Plus, I'm sunburned, been sweating all day, and everybody else is clean and smells nice. Bob Babbitt is not only a great guy, but a great host at this open bar buffet. We've both been part of the event for 30+ years, and although he doesn't really know me, he couldn't have been more gracious.  Thanks Bob.

So if you find yourself on the Big Island the night before this year's World Championship, see if you can't wrangle an invite to this fun event.  And don't forget to thank Bob!


Oh, and get one of the hats.  They're terrific.  Check out Facebook TGINR 2016 for a couple pics from last year.
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Might be you one day!

Ankle fracture weeks before "A" race Ironman
"Sickness will surely take the mind, where minds don't usually go.  Come on the amazing journey, and learn all you should know."
                                                             Tommy, The Who
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"At some point in your triathlon life, you may have some type of injury such that you're in enough pain that some sort of pain medication is offered/requested.  So many of us are resistant to the "there's a pill for that" mentality but we're addressing situations which are out of the ordinary and by using the suggested medication, perhaps other parts of life will benefit like amount of sleep, ability to exercise, spousal relations, etc. There are many options, and if you have a general idea of what might work best for you ahead of time, then you'll be neither over nor under medicated.  Let's look at some of your choices.

Aspirin

Anacin, Ascriptin, acetylsalicylic acid and other forms of this work horse medication have been around for decades and have found wide acceptance as an analgesic in the treatment of minor pain.  Either alone or in combination with or substances such as narcotics, it's proven most effective.  It also finds use as an antipyretic (lowers temperature,) an anti-inflammatory agent and most recently as an anti platelet drug in the prevention of myocardial infarction's, strokes and blood clots in low doses. The author takes a daily baby aspirin (81 mg) for just such an indication.  It's primary negative is the occasional formation of GI ulcers or stomach bleeding.  It's one of the most commonly used medications world wide.

Acetaminophen

Tylenol, like aspirin, is an analgesic (diminishes pain) that's available without a prescription and is useful in treating minor pain and flu like symptoms.  It also finds it's way into combination drugs like narcotics for more severe pain such as post operative, obstetric, or in those with cancer pain. It is not an anti inflammatory and does not share the same side effects as aspirin. But, if inflammation is part of the presenting symptoms, then acetaminophen may not be the best choice. In chronic use or larger doses, it can be potentially detrimental to liver function, and is a common cause of death in those who've taken a drug overdose.  It is quite safe when used appropriately.

Non-Steroidal Anti Inflammatory Medications

The NSAIDs, Motrin (ibuprofen), Naprosyn (naproxen),Clinoril (sulindac),Celebrex (celecoxib), etc. as they are called, can be quite useful in treating chronic or arthritic type pain as well as acute pain.  Like aspirin, NSAIDs also have the ability to lower temperature.  Their primary role is in the treatment of inflammatory conditions, the -itis's, as in tendinitis, bursitis, etc.  Once again, occasional GI distress is the major potential side effect. It is reported to be less with the family of drugs like Celebrex, a COX-2 inhibitor.  As with any medication, you should take it when needed but stop when you don't.

Corticosteroids (Do not confuse with anabolic steroids)

In select circumstances, these anti inflammatory agents like prednisone, Medrol Dose Packs, etc. can be quite effective over short durations.  They are not to be confused with anabolic steroids like the weight lifters/body builders have reportedly used.  You might be given these orally or as an injection into a joint or a tendon sheath.  Side effects can be elevated blood sugar in diabetics, weight gain, and adrenal suppression. Careful here. Often used short term for allergic reactions, poison ivy and the like.

Narcotics

Widely prescribed by the medical system, drugs like morphine, codeine, hydrocodone,etc. find a role in controlling more severe pain.  They require special licensing from the Drug Enforcement Agency to prescribe but help patients through surgery, migraines, deliveries, trauma, etc.  They should only be taken when the above options prove ineffective.  On the downside one finds the possibility of tolerance if taken for a long time, addiction, abuse, etc. The country in the middle of an opiod epidemic as you know, and hopefully, should you need pain relief with this class of drugs, specific uses and risks are discussed with you before you fill the prescription.

Alternatives

 In many instances, simply starting with ice and/or heat can make a big difference.  This list of medication categories is not meant to be exhaustive.  Electric stimulation, acupuncture, massage, physical therapy, etc. all may play a role in your care and return to health.

So, depending on your situation, if in pain, and asked to consider one or more of the above options, work with your health delivery team to determine which of the above agents might be best for you, remembering that a lot of pain is probably not OK, a little pain could be.

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