Hope Everyone is SAFELY Getting Exercise - COVID-19 Potpourri

Coronavirus tips, plus trivia, from a physician who loves being outside:

1) Now is not the time for intense exercise regimens. Keep up a gentle routine. But anything that really stresses you (long runs, lots of sprinting) can wait - it immunocompromises you, increases inflammation, and very likely will make your course more dangerous when you get coronovirus. (It's a matter of when, not if.) Look at it this way - pressure's off! Everything is canceled! Just relax!

2) STAY HOME.

3) It turns out that hanging around in your hood is not so bad. We're all trying to find silver linings and that's one of them for me! Here is a list of California superlatives. Pennsylvania is the most underrated state on the East Coast so wherever you are, make your own list. (Sort of like a combination of bucket list-making and gratitude exercise.) Check out uncoveringpa.com. Check out u/moxy79's southeastern PA hiking/exploring videos, and Scott's Odyssey for Central PA, on Reddit.

4) STAY HOME.

5) Get outside in a way that stays AWAY FROM OTHER PEOPLE, not these selfish idiots who endangered themselves and everyone else in Northern California.

6) I thought this was a really interesting story. Native heritage on the East Coast is not as culturally central, which is a big lose-lose for everyone. We can fix this. "These Native American Women Came to Philadelphia To See Their Ancestral Land."

7) Let's all be adults and not belly-ache too much about our missed trips. So far I have two trips, including one that was a planned mountain climb with other people, canceled. Know what's more important than that? My family and my health. Another silver lining: priorities become very clear when something REAL like this pandemic is happening.

8) I think our ideas of what animals can survive at what altitude are probably off. Here's the new world record for world's highest dwelling mammal, a mouse found at the summit of one of the highest mountains in Chile, Lluillaillaco, over 22,000 feet. Yes humans have summited Everest without oxygen but no one lives there - the highest permanent settlement with any self-sustaining economic activity (not research stations that would die quickly without outside support) is La Rinconada in Peru at 16,830'. In California at least in the Sierras from Yosemite to Tahoe or so, the received wisdom is that there are no rattlesnakes above 7,000'. This report (linked here) of a rattlesnake at the summit of San Jacinto (yes a bit further south) at 10,000' would take issue with that.

9) Some social distancing photos (Sonoma Coast and Sugarloaf State Park - snowcapped ridge in the distance in the last photo probably Snow Mountain in Mendocino NF.) All taken before parks closure, which I am obeying, and not joking about that. WEAR A MASK! WASH YOUR HANDS! STAY HOME! STAY ALIVE!

Running and Depression or Anxiety

A patch of eucalyptus above Rodeo Beach in the Marin Headlands on an August afternoon

Great Runners World article on the benefits of running on depression and anxiety here; also see this article on forest bathing, or shinrin-yoku. I've been staying inside due to the forest fire smoke hanging over the northern half of the state, and no wonder I feel like I'm in withdrawal!


Above: picture of current air quality in northern California

High Altitude Psychosis: A New Medical Entity?

Cross-posted at Cognition and Evolution.

A new paper breaks down cases of acute mountain sickness into several categories, including isolated psychosis with no evidence of cerebral edema (a quarter of cases!) Psychosis was more associated with accidents than the other subgroups, not surprising in retrospect. These cases were all taken from above 3500m/11,700'. It's always interesting that humans, and life on Earth generally, can tolerate some amazing extremes, but when the partial pressure of O2 drops a little bit, everything breaks.

Hüfner K, Brugger H, Kuster E, Dünsser F, Stawinoga AE, Turner R, Tomazin I, Sperner-Unterweger B. Isolated psychosis during exposure to very high and extreme altitude – characterisation of a new medical entity. Psychol Med. 2017 Dec 5:1-8. doi: 10.1017/S0033291717003397

Nothing is More Boring Than Reading Someone Else's Diet Log

Except maybe writing one. Still doing reasonably well. After my cheat day I did have a little bit of a GI disturbance, but since then have been doing mostly fine. I did notice that when I wander into the kitchen, I'm often not hungry, just bored. Amazing what happens when you actually pay attention to your eating habits. Instead I'll leave you with a self-motivation game I play, called "time machine".

Ever get frustrated at something you did in the past (or more likely, didn't do) and wish you had a time machine so you could go back and change it? Try this instead: think of what you will be frustrated about five years, ten years from now and wish you had a time machine to fix. Guess what? You do. You just traveled back in time from the future, and you're here. Fix it. Related: when you think of how stupid you were five or ten years ago, that's a good sign that you've gotten smarter.

Consequently, I worry if ever I'm not frustrated with how stupid I used to be.

Very Low Carb Day 9 - CHEAT DAY

Day 9:

• Whole milk with protein powder
• 2 protein bars
• 1 piece of bread
• half a bag of chips
• 1 quesarito from Taco Bell
• 1 chalupa from Taco Bell
• 1 ultimate cheeseburger from Jack in the Box
• 1 root beer float with Tilenti sea salt and caramel ice cream
• 2 chicken wings
• several crackers with much brie

Workout: very hilly 7 miler in Auburn (1000'ish of gain and loss, pretty much all at once)

Effects: In my previous terrible diet, I would get 4-5 items at Taco Bell and put them away with no problem. Now? I had to force the second one down. The Jack in the Box burger was not fun either. The boiled lettuce and shrimp dish my wife put together for herself actually looked pretty good! (Again, this is my *cheat day.*)

Very Low Carb Day 8

Day 8:

• Whole milk with protein powder
• One hard boiled egg
• One can of tuna
• Whole milk with protein powder
• Six slices of turkey
• Ahi tuna with sesame
• (and then cheat day began (at sunset, as the sabbath.)
• ~10 horse derbs contained crackers and cheese but also meat)
• glass of wine
• 2 pieces of bread
• 10 crackers
• brie and parmesan cheese

Workout: none

Effects: none noted. Also, reading about Atkins (which basically this diet is), I saw that there's not a lot of good data on weight loss compared to other diets. It seems to me that many diets converge on weight loss via the same mechanism, which is that suddenly you're paying attention to intake and eating more filling foods (i.e. not crap from McDonald's and 7-11.) I don't know if that study has been done. In any event after cheat day, I will keep my carb intake lower than standard American diet, but I'm not going to strive for zero as I have been.

Very Low Carb Day 7

Day 7:

• 3 slices of turkey
• 3 slices of bacon
• 3 sunny-side up eggs with 1 chile
• 1 packet of teriyaki beef jerky (stupid me, after I ate it I read the label and learned that there are 17g of sugar in this)
• 2 hard-boiled eggs
• Flaked Romano cheese mixed with pound of beef and one fried egg with fat poured off

Workout: none. Very sleep-deprived.

Effects: Felt a little more hungry today than other days. Terrible sleep the night before so I think my lethargy is related to that, but still feel okay all things considered. Tomorrow is the last day before cheat day - will be interesting to see how my body reacts.

Very Low Carb Day 6

Day 6:

• glass of milk with whey protein powder
• 3 slices of bacon
• 1.3 lbs of pain fried ground beef, fat poured off, scooped into lettuce "sandwiches"
• 1 chile
• 2 protein-style burgers from In-N-Out
• 1 glass of milk with protein powder

Workout: None.

Effects: no cravings, although I spend most of the day inside the house with my wife and newborn, and when I went out to get the In-N-Out, exposure to all the convenience store and fast food logos did trip my circuits a bit (but not THAT much. Really didn't have to exercise that much willpower.) Oddly sore in triceps and platysmus and don't know why.

Very Low Carb Day 5

Day 5:

• 2 tilapia fillets with tartar sauce
• 3 slices of bacon
• 1/2 venti Americano with half & half
• 3 tilapia fillets with tartar sauce, tabasco, and serrano chiles
• 4 scrambled eggs

Workout: sprints x 4. They were bad - peak velocity lowered ~20%, long recovery afterwards with shallow puffing indicative of just trying to blow off CO2, just no good in general.

Effects: After the filets, bacon and coffee, and sprints, my blood glucose was 74. A little hungrier after eating than I had been. I'm thinking of instituting a cheat day on Saturdays after I've gone over a week (yes I know I won't enter ketosis.) While I'm being gross, I had a loose stool but that may have been from undercooked fish. No cramps today.

Very Low Carb Day 4

Day 4:

• 4 slices of turkey
• 1 hardboiled egg
• half a bell pepper
• crystal light (40 sugar calories)
• 1 tall pumpkin spice latte (an indulgence, the most carby thing I've had for 3.5 days)
• 1/2 venti Americano with half & half
• 1 can tuna in water
• ~1.8 pounds ground beef (some for lunch, some for dinner) with lettuce and serrano chiles

Workout: None.

Effects: Okay, now the cravings have begun. I dreamed about chocolate, and I've never before dreamed about food. I felt terrible (weak, grouchy) on waking, but not sure I can distinguish that from infant sleep deprivation. Some cramps (when bending awkwardly) but not severe. Overall, still feel full after I eat a meal.

Very Low Carb Day 3

Day 3:

• 1 cup of coffee with half and half
• burrito bowl with carne asada, lettuce, beans, guac and sour cream (guy at pick-up window: "Are you doing paleo?")
• 2 black pepper-crusted tilapia fillets
• 1 Crystal Light pitcher with caffeine (40 sugar calories)
• 8 slices cotto salami with 2 chili peppers

Workout: flat 7.7 mile run which was MUCH MUCH harder than it otherwise would have been. Needed many breaks, couldn't sustain my normal pace for more than a couple hundred yards. I hadn't done weights for a long time and when I got back, decided to do bench presses and had to give up after 2 of my normal 3 sets, with a weak second set. Definitely feeling the effect here. Solution: more cardio! "Ve have vays of making you more insulin sensitive."

Effects: besides the crash and burn on my exercise as above, I was very hungry when I woke up and didn't eat until 1pm, but not still not dying. No incredible cravings like some people report. I continue feeling full after I eat.

I have terrible dietary discipline, so I'm a combination of ashamed and proud to admit that this may be the longest I've stuck to a major dietary change. Being in a heightened state of awareness and self-control due to my daughter's birth (and wanting to be healthy for her) likely has a lot to do with that.

Very Low Carb Day 2

Day 1 here, Day 3 forthcoming.

Day 2:

• 3 hard-boiled chicken eggs
• 8 oz of lentils with Japanese curry
• 8 slices of cotto salami
• 6 slices of turkey wrapped in lettuce with barbecue sauce
• 1 package smoked salmon

Workout: no workout. Fell asleep when I was intending to run. Babies mess up your schedule. Well, at least everything will return to normal soon!

Effects: I may have urinated more than usual overnight. Slightly hungry when I woke up but not dying for a candy bar. After the eggs and lentils in the morning I was full, which surprised me.

Diet Experiment - Very Low Carb, Day 1

I've read enough about the benefits of this and been wanting to try it for a long time. Also, my wife had gestational diabetes, and went low carb, and she actually lost (fat) weight relative to her pre-pregnancy for the first five months - so it works! (That's without ANY additional exercise.) My intention is to get as close to zero carb, and zero fat as possible. I will be providing gory details so if you don't want to hear about blood chemistry, poop consistency, the whole nine yards, this is not the post series for you.

Zero carb!?!? you say? Yes I know about rabbit starvation, but partly I'm trying to induce ketosis, and I doubt I'll actually eliminate all carbs or fat so I will keep that as the goal knowing I may fall short. If I start rabbit-starving because I'm so committed, then it's easier to relax a bit than to wonder why it's not working when I'm aiming at x milligrams of carbs, and overshooting it.

So begins my experiment. I'll be posting my diet here partly to commit myself in public (embarrassing if I don't stick with it) and partly in case it's useful to others. I didn't have any kind of ease-in, just went from my crappy junk food diet day zero to this on...

Day 1:

• 1 can of tuna fish in water
• 5 swallows of heavy whipping cream (forgot about the diet for two seconds. See the crap I eat?)
• 8 oz of lentils (with portions experimentally spiced with Japanese curry, turmeric, cumin, garlic, black pepper, oregano and basil. Japanese curry and black pepper were best.)
• 1 tilapia fillet
• 1/2 bell pepper

Effects: by the end of the day I had a very mild headache. Unusual for me, as I've had probably ten headaches in my life. I'm mildly more hungry, with occasional but not out-of-the ordinary carb cravings; i.e., while thinking I would make a sandwich for dinner, I had to catch myself to remind myself that that wouldn't be happening. No workouts today.


Comments:

- Some question the wisdom of making such a profound change in diet when I'm already sleep-deprived with a newborn at home. But waiting for the ideal time to try something is often just a way of avoiding ever trying it. Another way to look at it: if ultra-low carb makes me feel terrible, well I'm already miserable, so why not?

- I also started taking a probiotic today. While I'm starving my high-carb flora, if I really want to give them the old 1-2, I could either take high-dose antibiotics (not responsible and carries risk) or load in a bunch of new competition just as the old ones are weak. And so far, the only effect is maybe a mildly softer stool. I've tried them before and it smelled like a wet cattle ranch, so this isn't nearly as bad.

- This diet is of course washed down with an ungodly amount of Diet Mountain Dew, which I'm also considering cutting out. People have actually warned me that switching over to all protein and vegetables AND stopping soda could leave me hyponatremic, when suddenly my body that's used to getting of salt is getting NO salt.

- I will be checking my lipids and A1c after 6 weeks and comparing to my most recent values.

Mercury Concentration in Lower American River Safe for Swimming, Most Fish

Mercury is a concern in California waters. There was a lot of gold mining here in the central and northern Sierras, and lots of mercury was used to get the gold out of the ground. So what? Because mercury can cause neuropsychiatric problems, even at what might seem to be low concentrations, especially in developing fetuses that are exposed to it.

Because there were so many gold mines in the American River's watershed, there has been concern about mercury pollution in the river, including in the lower American River. "Lower" is the part below Lake Folsom, all the way down to the confluence with the Sacramento River at Discovery Park.

I looked this up because I was told it was unsafe to raft or swim in the river. And it turns out that despite these (not unreasonable) concerns, the lower American River's mercury concentration is well within EPA standards.[1] In another source,[2], even taking the upper range outliers, at five sites along the lower American River the highest reading was 18.51 ng/L, well within EPA freshwater standards of 50 ng/L. (By the way, if you look in those documents - American River, okay. Cache Creek? Not so good.)

Again, this means it's safe to swim. But fish have to live in that water all day long and some of them tend to concentrate any mercury that's there. Consequently, if you're planning on eating them, here's how the California Office of Environmental health Hazard Assessment bottom-lines it about how much you should eat, not just in terms of mercury but also PCBs:





(Broken down that way to decrease fetal or childhood exposure. Adult men's brains are a lost cause, having already been damaged beyond repair by prolonged exposure to testosterone.) So swim all you want, and eat according to these guidelines.


REFERENCES

1. Domagalski J. Mercury and methylmercury in water and sediment of the Sacramento River Basin, California. Applied Geochemsitry 16 (2001) 1677-1691.

2. Lower American River and Lake Natoma Mercury Control Program, Straw Proposal. State Water Resources Control Board, 3 Sept 2010.

Is There Such a Thing as Too Much Running?

Everyone who's not a numbskull accepts that some exercise is good. The question here is, is there such a thing as too much running, and if so, how much is too much?

Well, too much by what standards? There are two flaws you should look out for when you see these kinds of studies. First of all, the best studies are the ones that look at the association between [some exposure, in this case running] and all-cause mortality. If you're reading this post, I imagine it's more likely because you want to know if running will make you live longer, rather than you suddenly worried if your troponins went up after a 5-miler. Studies which use other endpoints (like cardiac markers or signs of inflammation as Thompson et al 2011, or imaging like Wilson et al 2011) might actually be overstating the risks because they're assuming that these things translate into the outcomes that we care about, like longevity, and they might be wrong. (That is to say: yes, Wilson convinces you that lifelong endurance athletes have more fibrotic hearts. Unless we're fairly certain this means they'll die sooner, who cares?) On the other hand, they might not be stating the risks strongly enough - because what if running is bad, and damaging the heart isn't the only way it hurts you? Unlikely though it is, if running is bad for you, and it (at least partly) kills you by messing up your spleen and you're just looking at the heart, you're not going to capture all the carnage.

Second, some studies are limited by non-generalizeable results. That is to say, they look at hardcore ultramarathoners, or they look at the effect of marathons on un-fit people. You might look at these papers and say, "Well, before they told me that, I figured it wasn't a good idea to show up to a marathon without reasonable training, and I also don't run an ultra every month." In other words, how much can any of it be applied to the rest of us?

So that's why I like this paper. In the Journal of the American College of Cardiology Schnohr et al provide all-cause mortality evidence that frequent, strenuous jogging is the same as no exercise at all in terms of mortality benefit. The optimal time and frequency: 1 to 2.4 hours per week; 2 to 3 times per week, at a slow to average pace. The downside is that for many of us traily types, that's very much on the low side. The upside is that those weeks when you only get out 2-3 times? They're just fine for extending your life. I thought this sounded familiar, and looked back over my previous posts, and sure enough Schnohr presented the same conclusion in 2012 at the European Society for Cardiology from data gathered in the Copenhagen City Heart Study. Encouragingly, the mortality benefit he reported in 2012 was on the order of 6 years of extra life!

REFERENCES

Tomas G. Neilan, MD; James L. Januzzi, MD; Elizabeth Lee-Lewandrowski, PhD; Thanh-Thao Ton-Nu, MD; Danita M. Yoerger, MD; Davinder S. Jassal, MD; Kent B. Lewandrowski, MD; Arthur J. Siegel, MD; Jane E. Marshall, RDCS; Pamela S. Douglas, MD; David Lawlor, MD; Michael H. Picard, MD; Malissa J. Wood, MD. Myocardial Injury and Ventricular Dysfunction Related to Training Levels Among Nonelite Participants in the Boston Marathon. Circulation. 2006; 114: 2325-2333

M. Wilson, R. O'Hanlon, S. Prasad, A. Deighan, P. MacMillan, D. Oxborough, R. Godfrey, G. Smith, A. Maceira, S. Sharma, K. George, and G. Whyte. Diverse patterns of myocardial fibrosis in lifelong, veteran endurance athletes. J Appl Physiol (1985). 2011 Jun; 110(6): 1622–1626. Published online 2011 Feb 17. doi: 10.1152/japplphysiol.01280.2010PMCID: PMC3119133

Eric Larose, Canadian Cardiovascular Congress 2010.

Peter Schnohr, MD, DMSc; James H. O'Keefe, MD; Jacob L. Marott, MSc; Peter Lange, MD, DMSc; Gorm B. Jensen, MD, DMSc. Dose of Jogging and Long-Term Mortality: The Copenhagen City Heart Study. J Am Coll Cardiol. 2015;65(5):411-419. doi:10.1016/j.jacc.2014.11.023

European Society of Cardiology 2012 EuroPRevent2012 Meeting (Press Release).

Dr. Caton's Totally Serious Strength Training Advice

I normally write about running, not strength training, but there's one thing I'm all about, in life and training: balance. So here are some basic truths about resistance training, as I understand them from my life and strength coach, Tom C.


1) Too much, too soon, too fast, is the starting point of any serious training regimen. Look up an advanced training plan for whatever it is you're trying to accomplish, and then do just a little bit more. It won't be fun at first, but you'll get there eventually.

2) Is it okay to work out while sore? Let me rephrase this. Is it okay to work out while NOT sore? No. If working out doesn't hurt REAL BAD, you're wasting your time. There's no way around it: you can't get fit and healthy without being disabled and in pain.

3) If you're not overtraining, you're not training.

4) Always make lots of extreme changes at one time. Especially diet and exercise together. For example: right as you start strength training, switch from a high-carb to a zero-carb diet. You'll find that after your meals of raw tuna, if you clench your teeth tightly enough, you can usually keep yourself from vomiting. After all, if your body doesn't want to go along with it - then it deserves to be punished anyway.

5) Consider yoga. Again, it's important to balance.

6) Serious training is always and only motivated by spite. Only anger will help you, young Jedi: against yourself and the world. Let the hate flow through you!


Next time: child-rearing advice! And if you have any problems with this, hey, take it up with the UCLA School of Medicine.

Your Vibrams Don't Work, Now You Can Get a Refund

Vibram has settled a class-action suit and will now put money in a trust for people who want a refund. They will also stop making claims that their shoes are good for you.

There's a very non-zero chance that if you've run across this, you're a barefoot/minimalist type, so I'm writing this for you, knowing full well you'll be pissed off about this. Of course legal outcomes are not stone-cold scientific evidence, but they should at least inch your dial toward "B.S." and away from "true". (If you think that's an outrageous thing to say: what would you have said had the outcome here been the opposite? "Good, the legal system works"?) But there's just nothing like the evidence in favor of running barefoot that I've heard and read minimalist runners claim.

There IS evidence that Vibrams imitate the form running barefoot pretty well. But, unless that's better for you, who cares? Because there is NOT (much) evidence that running barefoot is any better for you. (Despite the many otherwise evidence-minded types in the tech and rationalist communities who were carried along by this trend, couched as it was in sciencey-sounding claims; that's the most interesting part of this.) I suspect most of our opinions on this, outside of the professional sports science and medicine communities and their respective peer-reviewed journals, are based on our own N=1 experiments. (I'm waiting for the first claims of conspiracy against science from minimalists. Don't be the first one!) Barefoot running is awkward and unpleasant for me personally. If it works for other people, great - although I've been told repeatedly by fanatics that barefoot running is clearly better for everyone, and based on my own N=1, I can disprove that. If it's not clear to you how a single case can be much more disconfirmatory to a theory than it can support a theory, your issue is with science in general, not just footwear.

Heads-Up: Infected Ticks Around Los Penasquitos Canyon

With the bacterium that causes tularemia. Straight from SD County: "Symptoms in humans include lymph node swelling, headache and fever. Other symptoms include a skin ulcer at the site of the bite, fatigue, body aches and nausea."


Bad. Not good. Get seen, even if you're not aware that's from a tick.

Does this mean every tick carries the bacteria? No, but it does mean that, as always, if you pull a tick off of yourself, you should be vigilant for any illness that follows. It's not unusual to find this bug in CA although it's usually further north; it's commonly found in rabbits and in fact is named after Tulare County, where it was first discovered. But the point is a) you don't want it, so if you get a tick bite or these symptoms even without one, see a doctor, and b) the good news, it's very treatable with antibiotics.

Santiago Peak For Real

Done. Didn't start in time for the side trip to Modjeska. The saddle of Saddleback doesn't look as pretty from the top as the pre-Divide Road portion of the route Santiago was, with lots of wooded areas and some of the biggest damn ferns you'll ever see. The view from the type is a nice look straight across to San Jacinto, Banning Pass and San Gorgonio. Baldy was there too, really the only snow yesterday in the San Gabriels, with the smog pouring east from LA still considerable. As for many SoCal hikes, Nobody Hikes in LA is a great resource to plan your hike. Just keep in mind how annoyingly indirect that Divide Road around the summit is. Since it's for cars that need a level surface, that road is pretty much the opposite of the shortest route.

If you've had any of the bugs going around this year - one of several* viral flus, or a nasty strain of Strep pneumo that I was lucky enough to host for two weeks - you know how hard it is coming back from this. Very frustrating! The up-side is that when you're coming back from an illness, those parts of your training you hate and neglect have a more obvious impact. For many people it's hills; for me (and also many people) it's sprints. See you at the track!

There must be several viral strains going around this season because there are many people who got their flu shots, your blogger among them, and still got sick. That's no excuse not to get immunized!

Backbone/Bulldog Loop in Malibu, and Not a Lat Injury

Despite a current injury, I relied on my low levels of common sense and did an awesome 15 miler (this trail with side spurs) in the I-can't-believe-I-haven't-run-here-before Malibu Creek State Park, in the Santa Monica Mountains. Some of the views would not be out of place in Colorado, except for the Pacific being below your feet of course.



From photographyontherun.com



There sure am be some green stuff back there, and the rock formations and sea views from the top of the ridge can't be beat.  Plus along the way I saw the MASH filming site.  It's only right now that I laugh out loud and realize I ran the aptly-named Backbone loop (and Bulldog).

Why is that funny?  Two posts ago I mentioned a possible injury to my lats that I got (I think) from bicep curls.  Despite knowing that something didn't fit, i.e. the location of the pain wasn't really where your lats are, I didn't update my belief.  Saying the same thing in medical language, I should have moved "lat tear/sprain" down my differential and thought about what to move up.

Long story short, there are many reasons to think that my current (and previous) pain are a disc herniation, rather than a lat injury.  I have contralateral pain at a different level that also fits the bill for herniated disc that's stayed with me for a year but I can tolerate it; this one has gone from comparatively much worse to almost resolved in a few days, and it's moved downward a little too (n.b., muscle injuries don't do that).

Fortunately, scary though it sounds, disc herniation is usually self-resolving or only causes mild discomfort, and can be managed conservatively with NSAIDs, heat, and activity restriction.  15 miles up and down hills didn't bother me too much; I guess I just need to find a bicep exercise that doesn't involve shock-loading my spinal column.