Runner’s Knee

Last December, I started training for my first triathlon, which for me primarily involved running. I’d never done any sort of regular running, but I soon found that I really loved doing it (far more than, say, swimming). In March, I successfully entered and completed the Pasadena Sprint Triathlon — what a high point! I’d worked up to 3-mile runs without any trouble. After the triathlon, I continued running, and kept increasing the distance until I made it to 5 miles. That run actually wasn’t so much fun, so I backed off from there to ~3.5-mile runs again.

By June, however, I started experiencing knee pain. Not while running, but at other times, like just walking around, and especially when going downstairs. The final straw was when I was hiking in Scotland and had to cut a hike short (one I’d done two years before with no trouble!) because it was just too painful. I took a couple of weeks off of running but still was feeling achiness in my knees. That’s right, knees plural — not just the one I’d injured skiing last year.

Today I visited my doctor and learned that I’ve developed runner’s knee, also known as “patellofemoral pain,” which often manifests as aching below the kneecap, most strongly when going downhill or downstairs. This can be caused by a variety of things including imbalance in musculature or mechanical problems with how your patella (kneecap) slides over the knee, but it’s very common in runners who increase their distance or speed too aggressively, and also twice as common in women as in men. Argh! I was being cautious, but I hadn’t really abided to the suggested “only increase by 10% each week” rule because I was feeling fine. In fact, my knees don’t hurt much or at all while I’m running. It’s afterwards (for days?) that I notice it. So this all points to the running aggravating the joint, and it means I need to back off, take it easy, and be more gradual in my efforts. As my doctor said, “Run for enjoyment, not for achievement,” and then chuckled self-deprecatingly before he segued into a story of his own over-ambition and series of injuries in his determination to run a half-marathon even if it killed him (or his knees). There are also some strengthening exercises for the quad muscles that can help, and I can go to a running shoe store to get an assessment and their recommendation for shoe styles (many friends have advised this). His other advice was to avoid running downhill (here I’d thought downhill bits were my chance to improve my average speed!) and online I’ve read that I should be running on a track or something softer than sidewalks/roads.

I hope to improve soon! I am really, really missing my running. The good news is that the doctor said there’s no reason someone my age shouldn’t be able to run 3 miles 3-4 times a week, so I should be able to build up to that pain-free. It was good to hear this confirmation of my own expectations, rather than a dim outlook and some dire words about the effects of aging. Bah!

What is it like to live on Mars time?

Stressful, according to “Choosing Mars Time: Analysis of the Mars Exploration Rover Experience” by Deborah S. Bass, Roxana C. Wales, and Valerie L. Shalin. Almost certainly, one would adjust quite easily to a Mars-length day (24 hours + 39 minutes) if it were synchronized to the rest of the planet. But as the Mars Exploration Rover scientists and mission operators discovered, keeping Mars time on Earth plunges you perpetually into jet lag limbo.

The decision was made to run MER mission operations on Mars time so that personnel could be synchronized with the rovers’ wake/sleep cycles. They slept while the rovers were awake, and they were awake in turn to receive the latest data and make plans for the next sol’s commands to send back, while the rovers slept. This meant that for those on Mars time, each “day” rotated 39 minutes forward relative to local Earth time — as if they were gradually sliding westward almost (but not quite) one time zone per day. To help with the time-shifting, the buildings were outfitted with black-out curtains and cots and irregular (to Earthlings) meal service. My favorite touch: personnel were given special watches designed to tick off 24:37 per day instead of 24:00.

However, the bizarre schedule was challenging not just due to fatigue and physiological issues but, as the authors discuss, sociological ones, like maintaining connections to friends or family members, or figuring out how to pick up your child from school when (by your calendar) that pick-up time moves 37 minutes earlier each day! An extra complexity arose from the fact that the two rovers, Spirit and Opportunity, were on opposite sides of Mars — so there were actually two different Mars times observed during the mission, depending which rover you were supporting.

Although efforts were made to provide reasonable meal service, it wasn’t perfect:

“Operations staff occasionally were confused about whether the [food] cart would be present when they had a break as they were tracking multiple clocks simultaneously as well as working a schedule that did not follow the normal workday/weekend cycle.”

But there was one reliable source of calories: ice cream.

“Free ice cream, provided as a reward for a successful mission, was also available to the team at all hours. Because the ice cream was easily available, operations personnel ate more of it than they would have normally (3-5 ice cream bars/day was not unusual). Some people gained weight. There is anecdotal evidence that team members relied on the ice cream as both a reward and a pick-me-up to push through the harder parts of their shift work.”

I’ve been told that personnel also wore biometric devices, to track blood pressure, heart rate, and so on. This was a grand experiment from the human physiology perspective: 250 people living with an altered clock, for 90 days, and not in isolation but instead while trying to perform their jobs and live their regular lives as much as possible. I haven’t yet identified a paper analyzing that data or reporting on the conclusions, but I’d love to find such a thing!

Short-term health insurance

On sabbatical from my job, and no longer a student, I’m for the first time in a position where I need to find my own health insurance. I started seeking out options to provide at least catastrophic coverage in case anything should happen during this period. Happily, it turns out that there are some providers that offer exactly what I need: short-term coverage for otherwise healthy people while between jobs (or for students who’ve just graduated, etc.).

Previously I knew about PPOs and HMOs, but short-term insurance is a third kind: indemnity. This means that you’re not restricted to any particular network, but can instead go wherever you want. You simply specify the deductible you’re willing to absorb, and how many days you want coverage for (usually up to 180), and pay the specified amount. After the deductible is met, these plans generally cover either 50% (or 80% for a higher rate) of additional expenses. The nice thing is that you can get your policy activated almost immediately, since there is no underwriting or health exam involved. Essentially, insurance is reduced to its bare essentials: protection against a major event. Pre-existing conditions are *not* covered.

The two main options I identified for coverage in Oregon are Regence and PacificSource. The rates were almost identical (about $1.75/day for a $1000 deductible). Regence was a little better about providing details on what was and was not covered up front, so they got my business.

I’m pleased to have learned that there is a niche type of insurance that provides just what I needed. If I’d had to sign up for a “regular” individual policy, the rates would have been a lot higher, and I was told it would take weeks to get it set up. The coverage probably would be a little more extensive (e.g., copays for prescriptions and doctor visits rather than having to use up your deductible first), but for a short-term solution, I think this is just right.

Health care jackpot!

I approached my doctor’s office’s “Patient Online Portal” with curiosity but some skepticism: would it be yet another website and login, with only generic advice about drinking more water and exercising more often?

I was therefore delighted to discover that the HealthCare Partners site is a goldmine of exactly the data you’d hope to be able to access. It reports all of the data they’ve collected about me from every visit, including “vital signs” like weight, blood pressure, and pulse, as well as every immunization and lab test I’ve received.

The lab tests are particularly interesting and useful. I have a file folder at home with all of the printout results I’ve received over time, but having them all organized together electronically makes them much easier to browse, and any changes over time to be highlighted. Not only that, but each test is linked to an *extensive* online description of what the test is, how it is conducted, what gets measured, and what the result means. This is far more information than I ever got from mailed results, and especially handy when you go in for a generic “checkup” and come out with a battery of results from tests you didn’t specifically order. For example, apparently the albumin test detects kidney or liver disease.

Kudos to HCP for creating a well designed, informative website!

Wash your hair without any water

One of the challenges to be met and conquered during my upcoming mission to Mars is the limitation on showers. We have a very limited supply of water for our mission, just 39 gallons per day to support six crew members. We anticipate this supporting only one shower per day, so we’ll have to rotate through and wait six days between our individual showers. I don’t think I’ve gone more than three days between showers since reaching my teens, and those gaps have been few and far between (camping trips). The crew briefing documents recommend bringing baby wipes to facilitate sponge baths between showers. But now I’m stuck wondering: what about my hair?

It’s not the appearance that I’m particularly worried about, and my hair is actually rather short, which probably makes this easier than it would be otherwise. It’s just that I’ve observed that going even 1.5 days between showers leaves my hair greasy enough (to me) that I don’t want it touching me. I don’t like the hair oil smell. (Does this mean I’m over-civilized? Or is it true that daily showers make your hair produce more grease than “normal”?) I have no idea, but eventually I confessed my worries to my hairdresser and asked her advice.

“Take a dry shampoo with you,” she said.

A dry shampoo? What? I’d never heard of such a thing. It turns out that dry shampoos are powdered substances that perform the same function as the liquid shampoo you’re currently using: they bond to the sebum (oils) in your hair, and can then be brushed out, carrying the oil (and any dirt or other particles stuck to the oil) away. The efficacy is generally lower than that of a wet shampoo (probably due to easier distribution and bonding in liquid form), but apparently still can provide a good between-shower cleaning. Just the ticket for a restricted water environment!

The dry shampoos available commercially seem to be rather expensive ($20-25), but the web is teeming with advice about making your own from corn meal or cornstarch or salt or clay or what have you (plus baking powder, to absorb odors). I think it’s worth a test run prior to the mission. If it works, I’ll be set! Nothing like low tech solutions to save the high-tech day.

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