Archive for October, 2019

I’ve Got Hospitals Sussed

Wednesday, October 30th, 2019


I’m becoming a bit of an expert on Auckland hospitals. I’ve done time in Auckland Hospital, North Shore Hospital, Waitakere Hospital and, as an outpatient only, Green Lane Hospital. And I think I’ve got the average hospital stay sussed. Each visit is divided into two portions. First there is the admittance and repair and second the consolidation and release.

To be fair the first portion is not all that pleasant. You’re usually not feeling the best and a hundred dedicated people are devoted to fixing whatever has gone wrong. Life is busier than Queens Street on Christmas Eve. Each day moves from breakfast, to blood test, to weight, to blood pressure, to sugar levels, to oxygen absorption, to morning tea, to ECG, to specialist rounds, to time for a wash, to blood pressure and sugar levels again, to lunch, to a visit to the surgical team, to can “I clean your room”, to another blood pressure and sugar test, to another visit from the consultant, to dinner, to a dressing on that wound and ends at 3.00am with the days final blood pressure and sugar test. The Longest Day movie has nothing on the first part of a hospital stay.

When you just want to do nothing the first portion of a hospital visit involves an activity level unmatched anywhere in the civilized world. It’s difficult but I don’t mind the organised chaos. I’m not well and an army of skilled and caring people are doing their friendly best to fix the problem. Occasionally I irrationally ask myself whether the cure is worse than the disease. But that disappears when another friendly nurse appears asking, “Hello Mr Wright, how are we feeling?”

You have to give credit to the army of people devoted to keeping you busy all day. Without exception they are positive, up-beat, caring and polite. Their days must be pretty busy too, looking after dozens of people like me. But it never shows. From surgeon to cleaner – training and skill are different but their generous concern is remarkably similar. I know I could not keep it up day after day, year after year. But these guys in Auckland hospitals are made of sterner stuff.

A remarkable example is the team that looks after vascular surgery at North Shore Hospital. If you ever need anyone to care for your pipes this group of plumbers are the people to contact. Good people doing skilled things is always a pleasure to observe. Whether it is Michael Phelps swimming a 400IM, or John Walker running 1500 meters or a North Shore vascular surgeon drilling out an artery there is a common quality. Some people, it seems, are born to do difficult stuff easily. Just visit the North Shore vascular surgery. You’ll see what I mean.

Eventually all the activity begins to work. You begin to get better. And so begins the second portion of your stay – consolidation and release. Now make the most of this period. It won’t last long. Veteran nurses like North Shore’s Margo, Kathryn, Hannah and Sarah know when you are ready to go. Getting back on the horse is important. And they are going to make sure that is what happens. But for a couple of days things are going to be good.

I’ve got used to the routine, I’m feeling better, the view out my window is stunning, I order breakfast, lunch and dinner and have it delivered. I’ve stayed at worse hotels that Auckland’s hospitals. For as long as you can get away with it, this part of the journey is like a well-run health spa. Some people say they hate being in hospital but for these few days there is no truth in that. Full service, twenty four hours a day, spectacular care, what is there not to like? And don’t believe the stories you hear about hospital food. Of course it’s basic – this is not Sails Restaurant, but it is good wholesome stuff.

And I always remember, these journeys are provided by my caring country free of charge. Compared to Donald Trump and his capitalist health care we are indeed in a fortunate place.

So thank you again – North Shore, Waitakere and Auckland – you have fixed me up again and I’m on my way, the better for it.

But before I go Nurse Margo tells me her son is interested in a career as a pilot. I wish him well. He may even learn at my old training airport, Palmerston North. Lifting an airplane off the ground and heading out over Auckland Harbour takes a pile of beating; even better perhaps than the last couple of days in his mum’s hospital.

It Took Jacinda To Get Me Into Pyjamas

Monday, October 28th, 2019

What I put on or take off to go to bed is not something to discuss on Swimwatch. Swimwatch is about sport. My night time uniform falls outside the description of sport. Or at least it should. What happens in my or anyone else’s bedroom is better filed in the drawer named “Private”.

However something so significant happened this week that normal good manners may need to be compromised. I have told you about the operation I had on my arm that required a visit to Auckland Hospital. Sadly they found I also needed a second procedure at North Shore Hospital. When I’m done with all this I plan to start a tourist guide business visiting Auckland medical facilities.

It is off the subject but in the two weeks I have been in two Auckland Hospitals you would not believe the stunning views. Some rich Remuera toffs would pay millions to look out at the scenes I’ve had in the past two weeks. In Auckland Hospital my window looked over the Hauraki Gulf out to Rangitoto Island. Small boats snapped at the ankles of huge container vessels. Cruise ships full of Americas slid into port, credit cards poised to boost Queen Street shops. I could only hope Uncle Sam’s finest were unaware that Sky Tower fumes could well damage the benefits of that expensive deep-sea air.

In North Shore Hospital my window looked out at Lake Pupuke. For readers unaware of Lake Pupuke – I was until this week – it is a most attractive sight. Wikipedia tells me it “is a heart-shaped freshwater lake occupying a volcanic crater (or maar) between the suburbs of Takapuna and Milford on the North Shore of Auckland, New Zealand. Separated from the sea by less than 200 m at one point, it has a circumference of about 4.5 km and reaches a depth of 57 meters.

Aquatic recreation of every sort seems to go on there. Sailboats, canoeing, rowing, those guys who incredibly paddle surfboards standing up and one lone swimmer. I’ve seen them all this week. In fact the physical activity gave me an idea. At 4.5 kilometres around perhaps Alison could do her Monday run around the lake. And at 57 meters deep perhaps Eyad could do his Waitakeres swim for this week as four laps across and back. Generously I offered to sit at my hospital window and time them both. I was certain that Arch Jelley and Arthur Lydiard would think the idea had considerable merit. Sadly wives and young people are not what they used to be. Both declined my princely offer. One retreated to the comfort of the Millennium Pool to swim a set of 10x500s while the other ran 5 kilometres in 33.38 minutes on a treadmill in our local gym. Things are not what they were in my day.

But back to my night-time attire. Since I was twelve years old my eight hours in bed have been spent in either togs (swim suits for non-New Zealanders) and a t-shirt (but only in winter) or a pair of Jockeys (underpants) and a t-shirt. Freedom is what I called the uniform. No masses of cloth and buttons to get tangled up in the sheets. No additional heat to sweat through the night. For sixty years togs, underpants and a t-shirt have served me well.

But this week, North Shore Hospital changed all that. No, they said, my underpants and t-shirt would not do. Jacinda Ardern, the New Zealand Prime Minister, required pyjamas in her hospitals. So here I am in a light blue top and trouser suit bottoms number. The designer label is cool. It is underlined in a soft pastel green. Along with iconic names like Burberry, Valentino, Off-White, Givenchy, Balenciaga, Yves Saint Laurent and Prada I have a pair of labeled “Hospital Property” pyjamas. In fact the label is so famous it appears 56 times on the top and about 70 times on the trousers. I can understand that. We don’t want people running away with state sponsored pjs.

So thank you Jacinda. The pjs are great and (seriously this time) the medical care is first class. Now back to my window. Let’s see what’s happening on Lake Pupuke.

One More Look At The National Health Service

Wednesday, October 23rd, 2019

This week I spent another three days as a guest of the National Health Service (NHS). I won’t bore you with details of what and how, except to say Swimming New Zealand (SNZ), in the view of health professionals, is responsible for the what and the how. More of that in the coming months.

What I do want to discuss is something way more positive. New Zealand is a most fortunate country. Why? Because of the standard of its health service. The reason for my visit was to have a problem with an artery and vein in my arm addressed. The procedure involved going into Auckland Hospital on Monday, having the operation on Tuesday and being discharged on Wednesday. The operation is not huge; certainly no heart/lung transplant. But it is more serious than having a mole removed. Until very recently it always involved a general anaesthetic. Today that is still usually the case, but not always. Evidently advances in ultrasound scanning have meant that for selected patients the nerves of just the arm can be selectively blocked and the operation conducted as a local anaesthetic procedure.

Two types of the procedure are available AVF and AVG. The more recent AVF is made by connecting a vein, most often in a patient’s arm, to a nearby artery. In contrast, the AVG uses an artificial device, a plastic tube, to make the artery-vein connection. In the USA 25% of operations still involve the older and less efficient AVG procedure. In New Zealand, what I had done this week and what is always done in New Zealand is the new AVF operation. Additionally, in the USA, the average annual cost for creating and maintaining an AVF is, an incredible, $US60,000. That’s 93,000 downtown Auckland dollars.

Just consider that fact for a moment. I walked into Auckland Hospital on Monday. I had the most modern procedure under local anaesthetic on Tuesday and walked out on Wednesday at no direct cost. In Florida I’d be searching for $NZ93,000 before I was allowed in any hospital door. And even then there is a 25% chance I’d have to accept the old plastic tube treatment. We are indeed a lucky, caring and generous nation.

But it does not stop there. Everyone always says this, but it does not make it any less true. The staff in New Zealand hospitals are bloody incredible. From the cleaners, to the porters, to the nurse who checks your blood pressure at two in the morning, to the theatre nurses and the surgeons; without exception they are kind, they are caring and they are courteous. I don’t know how they do it day after day – but they do.

But more than that they innovate. I was pleased enough that my operation only involved a local anesthetic. As I was being prepared in the operating theatre the anesthetist asked if I’d like to watch the operation on TV. “Of course,” I said. Seconds later a wide screen TV was found and for an hour I lay and watched two incredibly skilled people cut me open, fix me up and sew me back together. Bloody amazing. The detail is stunning. Tiny little blood vessels and nerves are manipulated and repaired. The skill is beyond belief. There is a surprising lack of blood. The commentary explaining what’s happening to a medical novice is first class. It’s an hour of riveting TV with no ad-breaks.

Even when a major fire broke out within view of the theatre windows I’m delighted to report that the two surgeons appeared to be far more interested in my arm than the drama outside. And so thank-you National Health Service. Thank-you for looking after me again. As Mohammed Ali once said, “You done splendid.”

I have found that most trips to a hospital have their lighter moments. Not every patient is as lucky as me. For some their procedure involves a general anaesthetic. The chap in the bed next to mine was recovering from a “general”. He was still very confused.

He asked his nurse, “Where am I?”

“In Ward 71,” she replied.

“Where is that?” he asked.

“In Auckland Hospital,” she patiently explained.

 “Where is that?” he said again.

Calm and without any sarcasm whatsoever the nurse gently replied, “In Auckland.”

Take What These Two Say Seriously

Sunday, October 20th, 2019

Today I saw Coach Rhi Jeffrey posted an article from “The Telegraph” newspaper on her Facebook page. The long title tells you most of what it’s about – “Children should not stop playing sport in run up to exams as it has no impact on results, study suggests”.

It is well worth a read and comes at a time when, here in New Zealand, we are about to begin the exam season. Here is the link.

I also saw that Rhi’s post had been supported by Jane Copland. Here is her comment – “100km (swimming) Exam: School Certificate English Grade: 96%. To be fair, I wouldn’t recommend quite that degree of insanity but yeah, I did fine that week. It made college (university) an absolute breeze.”

We should pay attention to what these two say. I know both of them pretty well and they know what they are talking about. Both of them swam for their countries, both held national records and both have brains. Jane swam through four years in a Division One American University program and Rhi won an Olympic Gold Medal. When it comes to matters swimming it’s tough to fault these two.

Coaching Rhi was an exciting challenge. You see she is intelligent and knows the subject very well. You don’t want to make too many coaching mistakes when Rhi is around. She will catch you out every time. Loyal, talented and tough. It is easy to see the qualities that made her an Olympic Champion.

I also remember the week Jane achieved one of New Zealand’s highest marks in the School Certificate English exam and swam 100 km in the same week. In fact I’ve always felt a little guilty about that week. Jane calls it insanity and she is probably right. There are few swimmers around who can swim 100kms a week, let alone get 96% in a national English exam at the same time.

Like Rhi and Jane, the swimmer I’m helping now, Eyad, is as bright as all can be. He is sitting his university engineering exams next week so I’ve reduced training to 40 km – easy street. Rhi and Jane probably think I’m getting soft. But you should see the sort of things those engineering students are asked to do. For example build a horizontal car park for 300 cars built directly out from the face of a cliff. It makes my study of Aristotle and John Stewart Mill look positively junior high school.

But back to the “The Telegraph” article. I agree with the benefit of a balance between study and sport. Over the years I’ve had dozens of parents come to me with the story that their children are having a month off training to prepare and sit school exams. Occasionally I’ve tried to convince them the importance of leading a balanced life, of how some physical activity will benefit their mental preparation. I’ve used the example of athletes I’ve known who have successfully mixed academics and sport – Dr Roger Bannister, Dr Thomas Wessinghager, Dr Jenny Thompson and, of course, Dr Peter Snell. But it never works. These parents seem obsessed with the idea that a couple of hours in the pool would be better spent reading another chapter of their geography text book.

What they simply refuse to acknowledge is that their fanaticism won’t work. It doesn’t work in academics. It doesn’t work in sport either. OAPs (over anxious parents) have never been a benefit to their offspring.

All that pressure must transmit itself to the children. If a horse can detect a frightened rider and swimmers can recognise an emotional wreck of a coach then children must know when their parents are over-the-top pushing too hard. I decided to investigate and went to the American Journal of Psychiatry for help.

Here is what I found.

A study looked at almost 900 families with adult twins to determine the effect of environmental influence on anxiety. Results showed strong support of environmental transmission of anxiety from parent to child, independent of genetics. In essence, this study showed that anxious behaviours can be learned and that a child’s anxious behavior can also increase the anxious behaviour of the parent. The good news from this research is that parents can take an active role in reducing their child’s anxiety by changing their own behaviour and modelling effective coping skills.

 So there you have it. Your behaviour could well be making your child’s academic results and their swimming training worse. With every nervous demand, the success you want most is getting less and less likely. Through this New Zealand exam season, parents need to relax and let their children enjoy the exams and their sport.

Accept the advice of some pretty knowledgeable sportswomen, Rhi and Jane. Study hard and swim well and enjoy both.

The Gospel According To Peter Snell

Friday, October 18th, 2019


Earlier this week I wrote a story on coaching rules I had learned from Arch Jelley and Arthur Lydiard. The story ended with a confession that I could not find a training interview with Peter Snell. A few minutes after my confession was posted I received a message from Arch Jelley telling me where to go to find Snell’s post. What Snell says is well worth a read.

Mind you, it should. I would think three Olympic track Gold Medals and a PhD in exercise physiology qualifies Snell as a knowledgeable source. Let’s look at some of the things he has to say. And as you read ponder for a moment the average training schedules handed out to swimming squads around New Zealand. If they break Snell’s rules, go find another coach.

Quote One – “Many coaches think that runners don’t have a kick due to lack of speed when it is due to lack of endurance.”

Isn’t that the truth? Even 50 meters is an endurance event. Toni Jeffs won 50 meter races all over New Zealand for 10 years because she could swim the second 25 better than anyone else. So often world class 50 meter races are won, not by the fastest swimmer, but by the person who slows down the least. And that’s endurance, not speed.

Quote Two – “All you need is a decent base, some leg turnover work and a lot of the scientific stuff is bullshit. At some stage after distance training you have to do high volume intervals and then as you approach your racing you have to do a bit of speed.”

So here is the simplicity of Snell’s coach coming through in the words of the student. Just consider the irony of a man who has three Olympic Gold Medals and a PhD in exercise physiology saying “a lot of the scientific stuff is bullshit”. I often listen to coaches talking about their training and don’t understand a word they are saying. A1 effort this and A4 effort that. As Snell says it’s scientific bullshit. Duncan Laing once told me a story of standing in for a local junior rugby coach. The coach asked Duncan to teach the team technical line-out calls. But when the ball was thrown in to the line-out no one could catch it. So Duncan dropped the line-out calls and took the team for an hour of catching practice. Just Duncan’s way of saying scientific bullshit.

Quote Three – “As a scientist I learned that the benefits of distance running are achieved after muscle glycogen depletion. So if you run for two hours a lot of the slow-twitch muscle fibers which were initially recruited run out of glycogen and cannot contract any more. Eventually you use the fast twitch muscle fibers which you normally only use when running fast, so that was a stunning revelation for me.”

So to all those people out there who say, “You don’t need to swim 100 kilometres a week if you only race 50 meters” or call distance training “garbage yardage” or like Dave Salo in his book, “Sprint Salo”, ask the question, “How does swimming slow for thousands and thousands of yards make them fast for a couple hundred?” Well now you have your answer – for all you doubters out there Snell has provided the reason. Long distance training makes you faster by exercising your fast twitch fibres.

Quote Four – “I tried to run everything evenly so we didn’t do those sessions where a runner gets faster as he progresses. I also didn’t do sessions where I went from 200 meters to 400 meters to 600 meters and back down. I think those are little tricks that coaches use to justify their existence. It’s all bullshit. The ideal training is the maximum amount of race related pace running you can do without overtraining.”

I could not agree more. Those fancy schedules are all tricks coaches write on white boards to impress parents with the complications of their trade. And it is all bullshit. One coach I see most Saturday mornings is a classic of confusion. He charges around the pool, stopwatches at the ready, screaming instructions on how to do his stunningly complicated sets and none of it works. Some parents love it. They can’t understand a word he says – It must be good. If your child is being subjected to all that stuff, find another coach. You would never see an Arch Jelley or Arthur Lydiard session look like that.

Quote Five – “There are some sport scientists in New Zealand who think it’s crazy to be doing lots of distance and I feel that they haven’t a clue.”

There you have it. “Miles make champions”. I was talking to Arch Jelley on the phone a few nights ago. We were discussing coach’s education. Remember, both of us have a university education so we are not against education. In fact Arch has spent a huge portion of his life in education. But Arch laughed and asked me if I knew of two people who never had a formal coaching education certificate? The answer is Arch and Arthur. That is not a comment against a coaching education – not at all. That is a warning that coaching certificates require the addition of experience and common sense.

Quote Six – The key finding is the understanding of why distance running works in terms of muscle fiber recruitment and glycogen depletion that occurs over time allowing a different population of muscle fibers to be activated when you run long enough and at a sufficient intensity. Finally, there is the idea of the relationship between endurance fitness and tolerance of high intensity training.

Back to the same idea. Distance training works because it exercises the slow twitch and the fast twitch muscle fibers. It contributes to a simple, clear, no nonsense balanced program. And those are the qualities that work best. I think Eyad is going to swim a better 50 meters freestyle at the 2020 Long Course Nationals than he has ever swum before. Why? Two reasons – He’s going to swim the Taupo Open Water 5K Championship and his 1500 swims are so much better. Just ask Peter Snell.