A Personal Peek into My Life: Living with Ciguatera
photo by Erik Aeder
Aloha friends. Before the holidays really begin I wanted to send this to you; my supporters, clients, sponsors, friends, my Ohana in sincere gratitude for giving me the drive and strength to forge ahead.
I am so very thankful that I’ve lived on the beautiful island of Maui for almost 14 years. Living the island lifestyle and having the most amazing circle of friends is a real blessing. As a personal trainer, water sports enthusiast and SUP athlete and one whose passion is being on the water helping and coaching others; this is literally my way of life.
But what if you discovered that you had a health condition where it was contraindicated and/or suggested not to exercise too hard or possibly the notion of being in the sun, or ever eating fish again may not be the best thing to do and trigger your nervous system to release a toxin, so painful and disabling with no way to escape?
What if you were in a career that required you to do all the above and it was your life-long dream and passion? And what if you were paddling on a downwinder and your skin, your eyes, your mouth, your feet, felt afire like a vat of acid being poured on your body the entire way because your nerves have reversed your normal sensation of temperature? How would you navigate?
I feel compelled to share this with all of you, although I felt for some time it may be career suicide. As I pondered now for two years, I decided that maybe I could help others by informing them to take note of a condition that is becoming more recognized and common throughout the world. This is especially true for those of us living in Hawaii and other subtropical areas.
Before I go on, I don’t want to alarm you, have you feel sorry for me or treat me any differently if you see me next to you at the next downwind race or out catching waves. I am training, I am paddling and I am on this planet to help others in many ways through the water sports I enjoy. So chalk this one up to one more way I want to help you become more aware or maybe help someone you know who may be or have had experienced similar symptoms.
You may be surprised to learn that this is how I’ve had to roll and cope since June of 2011 to be exact. This condition is often misdiagnosed as multiple sclerosis and is one that I will have for the rest of my life. It is called ciguatera. (ci·gua·te·ra) Pronunciation: see-gwuh-ter-uh ( Reference links at end of article )
Some of the facts: As referenced by the The National Center for Biotechnology, they identify it as: “Ciguatera Fish Poisoning (CFP) is the most frequently reported seafood-toxin illness in the world, and it causes substantial physical and functional impact. It produces a myriad of gastrointestinal, neurologic and/or cardiovascular symptoms which last days to weeks, or even months.
They also state: Ciguatera fish poisoning (CFP) is a foodborne illness affecting humans worldwide. Humans acquire this illness by eating reef fish containing the naturally occurring toxins, ciguatoxins. Multiple ciguatoxins have been identified, but in this paper ciguatoxins will be referred to collectively as “CTX.” CTX is derived from benthic dinoflagellates of the genus Gambierdiscus, growing predominantly in association with macroalgae in coral reefs in tropical and subtropical climates. The toxin is transferred through the food web as the algae is consumed by herbivorous fish, which are consumed by carnivorous fish, which are in turn consumed by humans.” ( more references below )
WebMd: “Ciguatera poisoning is most common in Florida and Hawaii. Red snapper, barracuda, parrotfish, jacks, and grouper are most commonly contaminated, but over 400 normally safe fish species may contain the poison. There are no good “rules of thumb” for detecting tainted fish. They look, taste, and smell normal. Testing for ciguatera is available in some areas.”
New York Times, January 2013: “Fish Toxin Cited as Cause of Poisonings in ’10 and ’11 …” He was one of 28 New Yorkers to fall ill from ciguatera between August 2010 and July 2011 — more cases than had been reported in the entire preceding decade in the city..” ( see more of this article below )
The symptoms are vast but the most notable are the ones I have like the constant burning (dysaesthesia), with varying intensities that migrates all throughout my body with no warning. Sometimes I will itch incessantly around my nose, face and arms, but the most unusual one for sure is the feeling or sensation like my teeth are falling out. This is a noted symptom with severe cases. Don’t worry, I still have my own teeth but I’ll tell you it is not fun.
Currently there is still no 100% test or markers on a blood test that will confirm ciguatera. Collaborative efforts of rewinding the two years back of my record keeping, training journals and daily pain level journal; we concluded, I probably contracted the toxin while visiting my mother in the Bay Area in June of 2011 and eating fish the night before I returned to Maui.
How the first episode was revealed was upon my return to Maui that next day, June 11, 2011. I decided to paddle 10 miles the next day from Maliko to the harbor, along with my good friends Bill and Simone. I came into the harbor feeling like I was on fire!
At that time it was just on my left arm and then my lips swelled up so strangely I made jokes that I finally had lips like Angolina Jolie. I headed to Kaiser immediately, where unfortunately my amazing and supportive internist Rick Sands, MD was out and I was put through a round of tests for allergies. The usual Benadryl tabs routine, etc.
When I was able to see Rick about 2 weeks later he was very concerned and perplexed. We tested for everything and I mean everything. There was also some concern that some of the symptoms I was experiencing was similar to that of as I mentioned early, multiple sclerosis.
This was very upsetting but I knew Rick was looking out for me as he always does, so we ordered a brain scan. From that time until I had to wait for the results, my life flashed before my eyes in many different scenarios and I started thinking about what my life we be like with that disease. What in the world would or could I do for a living? It was a very tough time. But luckily the scan was clear for that.
A month had gone by and it was July 2011 and the Naish SUP race was soon approaching. I did my best to paddle and train through the burn. I was determined and so baffled how I could burn all the time like this? It was in my mouth, behind my eyes, my upper back, thighs at times, under my feet and always my left arm. Some days I would actually turn red as the toxin would move through my body.
Aloha everyone! Here is my list of some of my “favorite things” that are sure to excite and motivate the fitness fanatics or those who are re-entering fitness, or simply want to change up their routine. Tune in here and listen to my radio segment from my weekly health and fitness radio segment on the Maui Breakfast Club, December 10, 2012 and find the perfect healthy gift.
Click Here to Hear Suzie Live
The training equipment I suggest here is appropriate for all ages and all levels of fitness. I like to keep things simple and functional as not to overwhelm people but to allow them to get the results they desire in a very easy and efficient way so they don’t get bored nor does there body. Click here to listen now.
My Favorite Health & Fitness Gifts:
Gift Certificate for a Personal Trainer: Having someone in your corner is so helpful. Whether your trying to shed 5 or few more pounds, prepare for an event or race, or simply want to have a personal program designed to keep you on track and mix it up, a well qualified personal trainer can help. Check for certification such as NASM, make sure they are insured and have a good reputation in the community.
Indo Board Balance Trainer:FREE SHIPPING UNTIL DEC 17thOrder here Everyone knows that I am a huge fan of this equipment. It not only helps the surfers and standup paddlers in your life, but if your’e just coming off a knee, ankle or hip injury this functional training equipment can do wonders and help strengthen the weakest core muscles, improve your balance and leg, hip and knee strength.
“Sometimes fate seems to send a subtle message in ordinary observations. This time it came from a name and the resulting initials – Suzie Cooney, SC. Ed and I are in week 8 of our “Eddie Will Go on the Olukai Ho’olaule’a” race – comeback from extensive shoulder surgery. Week 8 is the best one yet. We are actually in Maui and are SUP surfing and doing sweet down-winders every day on our Naish 14? Glide GX. Last night we had dinner with our trainer-from-a-distance, Suzie Cooney, CPT of Suzie Trains Maui.
There’s nothing like a face-to-face conversation over ono burgers at the Fish Market Restaurant in Paia, especially after all the support we’ve gained from Suzie over the past months. How did two 63 year olds from Oregon come to be trained by Suzie Cooney on Maui? That’s quite a story.
We were casually playing at down-wind riding while on vacation in Maui in May 2011. Hearing that the Olukai Ho’olaule’a offered a “fun race” of just 4 miles we grabbed our rental surfboards and registered. The day of the race we were all butterflies and doubt. Ed was having shoulder surgery 4 days later and we were second-guessing everything. Then the announcer gathered us all for a pre-race warm-up, and we met Suzie.
With a warm smile and ultimate encouragement she talked and moved the nervous group through breathing, stretching and a warm-up. Surprisingly, by the time we were done the group had a relaxed and solidified feel. Then we were off for one of the most exhilarating fun-runs ever. We decided that when Ed was able to train after his surgery, just seven weeks ago, we would start training with Suzie. We set a goal to do the 8-mile run from Maliko Gulch to Kanaha. Suzie’s regimine has been just what Ed needed.
Meeting up with Suzie last night confirmed it, she has the absolute best initials for her spirit and talent:
1. SC – Sincere compassion: Ed is coming back from an injury and Suzie’s compassion for the struggle is obvious. It takes quite a bit of digging to gain the information that might attribute to that. Suzie is no stranger to injury, rehab, set-backs and the value of dedication and solid training. She has walked the talk, and then some.
2. SC – Social commitment: Much like Olukai, the sponsor of the Ho’olaule’a, Suzie has always had a strong commitment to her community and sharing her expertise and talent. We love that and it sets the same tone that we go for at Elder SUP
By Suzie Cooney, CPT owner of Suzie Trains Maui, LLC
It’s no doubt that Hunter Joslin, Indo Board Balance Trainer’s Founder and developer of the popular Gigante Flo Cushion, entertains and trains with me at this year’s Battle of the Paddle at Dana Point. Hunter was wowing the crowd with some tricks this weekend as Chip Martoccia, VP of Operations and I cheered on.
Hunter Joslin and Suzie Cooney having Gigante fun at 2012 BOP, Dana Point
I’ve been a team rider and ambassador for Indo Board Balance Trainer for some time, and thoroughly enjoy my time with Hunter and crew. We never miss an opportunity to play around and challenge one another. He’s quite the surfer and in very good shape. We’ve shared a few waves together on Maui, and I can say he is just a little competitive!
Hunter asked if I’d do this photo shoot and share some new tricks I’ve been working on in my studio here at SUZIE TRAINS MAUI. Of course! Turns out he had never tried or seen any of these so I was stoked, but under the gun to give him my best.
These exercises are THE ultimate core challenge and require good form, good posture and good overall anatomical health. Remember the core is where all movement begins and is everything excluding your extremities.
This type of training, I also refer to as proprioception training to encourage cat-like reflexes for your lifestyle, prevent injury and to provide the opportunity for your brain to command each finite muscle, tendon and ligament that supports all joints.
UPDATE: Nov 2, 2012: Thank you everyone for helping me reach my goal of 3100 squats with 20lbs. I am continuing on with new found strength and am wondering why I took so long to do this. See, even trainers need a little help now and than. My legs are super strong AND my butt and legs got more toned!
I am writing this blog entry today, October 9th, 2012 with 900 squats completed in my own training log. Today was proof, with a high surf advisory here on the N. shore of Maui, my legs held me up and helped me stick 2 head high waves at Kanaha. It was closing out all the way across and at first, I simply could not get out, then finally a small lull. I felt confident and strong. YES!
Why in the world you may ask am I challenging myself to perform 100 squats a day with 10lb (20 total) dumbbells? Did you know that this is my LEAST favorite exercise to do? I absolutely with my heart and soul detest doing squats. You’d never bet that would you?
Well guess what, I need to be motivated and challenged too. As a trainer I tell my clients that if you make a commitment and goal to yourself, then tell someone publicly; your trainer, spouse, friend or whatever, you will more likely make that goal. Write it down, post it, let the world know. You don’t want to let them down do you?
Have you heard of the 21day rule? If you do something for 21 days in a row it becomes habit. I will admit I think things are not only taking shape but it’s shaping my thought and my brain.
So, the main reason for me sharing this on Facebook the month of October 2012, is that I need your help. You see, after busting my legs in April of 2009 (Maui Weekly Story) that 3 month wheelchair stint did a number on me. I mean, my legs turned to mush in two weeks. My lower half atrophied in ways I’ve never ever experienced and even with all the training they are not quite the same legs they used to be and yes, I do run like a girl!-
That freak accident changed my life in so many amazing ways and here I am professing and confessing to you my weakest link! Three years later I’m still trying. My left ankle is bigger than the left but you won’t notice at first, my strength is ( to me ) about 75% and I really want to be extra strong for surfing, stand up paddling, and long distance crossings.
I still have to wear a compression stalking on the left leg once in a while and it still swells up once in a while. It feels great and maybe I’ll start a new trend!
Now I am accountable to you. I don’t want to let you down and simply by posting this blog, I have assigned accountability. That is one of the many reasons people hire me is to hold them accountable and help them reach their goals. I get it. But did you know that even trainers come to me to get motivated, get a jump start and ask me to hold them accountable? It is true.
I know that some of you are doing it with me and I really appreciate that. It helps more than you can know. I will occasionally jump in here or on FB to keep you updated and please feel free to do the same.
I want to thank straight away Tracy Lynn Penny and son from Sunset Beach, Hawaii , sales person for freesurfmagazine. Way to go Tracy! Also to Jennifer Gladwin, Jacqueline Tan-Barclay, Amie Engerbreston, Jenny Ryan, Suzi Tucker, Joel Edwards, Brian Coppedge, John Smalley, Carlita T., Marty Melum, Salma Ansari, Elder SUP, Brianna Castillo, Mary Lynn Hershey, Nick De Meyer, Kimberly Sutton, Casey Gotcher, Blen Hinton, Jeffrey Zerkle, and many more.
There’s a tremendous amount of SUP and surf talent on this island that is inspirational, charging, and leaves people in awe, but there is one person who is all that and more.
Kody Lake Tahoe July 2012
Most of you probably already know Kody Kerbox; Naish Team Rider and young gun born to shred and yes the son of legendary big wave surfer Buzzy Kerbox. But did you know this strong champion has had such a winning streak these past few months, you’ve got to wonder if his legs are sore from stepping up on the podium every weekend?
From Lake Tahoe to Dana Point and now back on Maui for the 7th Annual Naish International Race, he is humble and fierce and it’s an honor to have him in the studio.
Observing his explosive, controlled strength combined with a laser focus, these are just a few of the superior qualities he already possess. I’ve been watching Kody over the past few years increase his strength, power and overall body endurance, and wow it’s paying off.
See photos of Kody’s first day with me in the studio below. I made a deal I wouldn’t kill him but would on the second day!
I’m super stoked to have Kody in the studio to help him learn more about how to capture and harness his acceleration and power from flat water paddling, downwinders and wave riding. He’s already pretty fit, so I was able to advance him quickly on his first day. We’ll also focus on fast forms of recovery in between races, eating for energy and other important things he’ll need while out on tour.
The field of competitors this year is thick but you can be sure you’ll be seeing Kody leading the pack. It’s awesome to have him on board!
In preparation for the 4th Annual OluKai Ho’olaule’a and anytime you venture into the ocean, open ocean endurance is not something to take for granted and it is a required physical and mental element that all water sport enthusiasts must have, especially when faced with huge walls of water moving and changing conditions. Besides navigating current changes, surface wind speeds, waves or deep troughs, often experienced and non-experienced folks can get into serious trouble or lose critical momentum needed to paddle over, in and through some of the roughest patches that can form underneath you, near you, in front of you or behind you.
This article is helpful if you’re a prone paddler, surfer, kayak paddler, canoe paddler or stand up paddler. Are you ready if your canoe hulis and you lose your paddle? How to you react if you fall of your down wind board on a big day on Maliko? How prepared are you? Do you carry a waterproof pouch with your cell phone or better yet, a GPS unit? Do you have a regular cardio routine that includes intense bouts of intervals? Do you cross-train? If you’re pausing to think about anything of these questions, then it’s time you take good inventory and learn all you can and implement now. ( See tips below ) Also contributing, is Stacie Thorlakson, MCKC Maui Canoe & Kayak Club board president.
1.Equipment Check: Check integrity of leash, tighten all fins, repair any major dings, tighten drain plugs, charge and take cell phone, fill Camelback, pack extra energy gel, waterproof whistle, wear sun protection, if a one man canoe, strap on an extra paddle.
2. Fuel: Charging the ocean requires food in your belly and hydration to reduce cramping. I like to suggest oatmeal or any complex carb at least an hour before departure. What’s great are two pieces of a nutty whole grain bread with a protein spread like almond butter or low salt peanut butter. Coconut water is a favorite of mine that offers lots of potassium which allows you to hydrate more quickly. I also squirt a full pack of an energy gel before a Maliko run. I avoid caffeine or super charged sugary drinks as these can actually dehydrate you and cause your energy to crash hard.
3. Body: Strength, stamina and cardio, and more intense cardio. The biggest thing I notice when training my sport specific athletes or weekend water warriors is the lack of cardio and cross-training. It’s a common component that get’s overlooked but it’s so important. Strength and body stamina takes time to build but is necessary too. There are many formulas on the how to and it’s based on your sport, your goals and your current level of fitness so I can’t write one program to fit you all. You’ll have to come train with me for your specialized program. Continue reading Open Ocean Endurance Radio Segment with Suzie Cooney of Suzie Trains Maui
Whether you’re just learning to surf or pulling into a nice hollow Honolua Bay wave, the thrill of surfing or dreaming of a wave like this is definitely good for your health. Here, Maui photographer, Simone Reddingius captures this surfer dropping in. His muscles are ripped, he’s focused and you can bet his heart rate is high. The endorphins that make you feel so good are exploding as he carves that gun into the blue room for that magical moment. This, you can be sure is good for your health!
CLICK here to see more of Simone’s fine surf photographer and other talents.
Also, check out all the photos from recent Suzie Trains Maui ENews Highlights of Naish & Suzie Trains Maui SUP Fun Beach Fitness & Paddle Challenge special guest Kai Lenny, as 55 participants finished FREE event. See the famous “taco rolls in the sand”. See photos and event highlights.
Gear & Board Reviews: The Alana Series featured here is oh so lovely. Don’t let the frills or flowers fool you. These two high performance boards are delivering waves of fun and miles of exlporations!Follow @SuzieTrainsMaui
Please feel free to post a comment and tell us how you love to surf to keep healthy! Also, any tips you want to share about how you approach the New Year to make good lifestyle choices, feel free! Mahalo!
Happy New Year! Suzie Cooney, CPT owner of Suzie Trains Maui
Stand up paddling is no doubt taking the world by storm, and while you don’t need to be in the greatest shape to paddle, you’ll soon discover the benefits. As you begin to improve your technique, experiment with new gear and maybe decide to enter a race or wave competition, it’s a good idea to learn how to train in a balanced way to prevent injury so that you can enjoy paddling even more and stay on the water.
As the sport continues to evolve, and as a trainer who specializes in educating people how to paddle stronger and better improve their performance, I’d like to share with you first an overview of some of the known complaints and injuries that I’m seeing and helping people manage. I’ll also share with you many training strategies designed to help you better approach your SUP training in a balanced manor as a way to avoid injuries.
This article is part one of a two-part series that will illustrate a more in-depth review of the anatomy and how your muscles function while you paddle and how injuries might occur. Part two will be the actual exercises and training approach I recommend to help recover from some of these injuries and/or avoid them.
I’ve also gathered some helpful insight from one of our Naish Team Riders, Karen Wrenn, on how she trains to help her better perform. In addition, I’ll be highlighting another paddler, Kevin Vangritis from North Carolina and new racing competitor and long distance paddler, with his personal story and struggle with a unique injury and how he’s managed to come back on the water.
Common SUP Injuries
Overuse injuries and strains from SUP are common and include mostly the muscles of the shoulder and/or rotator cuff muscles, the knee joint, foot and ankle and low back. It’s good to have a knowledge base of the anatomy and function of each group so you can better adapt your SUP training to avoid these injuries. There may be more to mention, but in my practice and I too have experienced things such as a nagging bicep tendonitis issue in my right arm and on occasion after long distances over 20 miles, my traps (trapezius) have cramped a bit and my feet have fallen asleep.
Injuries that are more common where there are waves are fin lacerations to the extremities and face, paddle handles giving bloody noses (mine), and leash wrap-arounds I call them, that can cause sprains to fingers and other body parts from wrapping around you after a heavy wave wipe out. Also, as these boards are much heavier than surfboards for example, if you get hit in the head you could suffer a good blow or even a concussion. In addition, some super heavy hold downs at some of the bigger breaks can wreck havoc on your back and lower extremities.
Shoulder and Rotator Cuff Injuries:
Stand up paddling works a lot of muscles and is well known for being a great core workout. It also requires a lot of work from the stabilizers of the shoulder girdle. The paddle stroke is a combination of medial rotation and abduction (of the top hand). The deeper rotator cuff muscles included are the supraspinatus, subscapularis, infraspinatus and the teres minor. This requires the work of the subscapularis, latissimus dorsi, pec. minor, pec. major, and teres major along with deltoid and supraspinatus to lift the arm up. The bottom hand is mostly stabilizing to transfer the rotation of the trunk to the paddle the muscles used to stabilize are mainly latissimus dorsi rhomboids, triceps, and middle fibers of the traps.
One client complaint was that of a burning sensation radiating from his elbow up to his shoulder and down to his hand, and another, with numbness radiating down from his shoulder through his pinky finger. These can be common nerve entrapment injuries with chronic tension and overuse of certain muscle groups.
Rhomboid & Trapeziums Strains:
The rhomboid muscles interact with and help support the shoulder blade. Your trapezius (also referred to as your “traps”) are the connective muscles from the neck to the head of the humerus or top of the shoulder, and are responsible for stabilizing your neck and shoulder while you paddle. These muscles require a great deal of endurance. This is also where we tend to hold our stress and the area that can fatigue and cramp up on long distance races. I often hear of muscle fatigue and recently of a tear of the rhomboid as described by Kevin Vangritis. Read more of his experience and how he recovered:
Kevin Vangritis is a friend of mine from North Carolina and is just getting into SUP racing. Over the summer, Kevin was training for a big 50+mile-long distance SUP crossing in Chicago (with Windy City Waterman and Matt Lennert). Prior to the race, he was helping a friend with an exercise and felt a pop near his right scapulae or shoulder blade. At the time, he thought that to simply take an anti-inflammatory and ice should do the trick.
I should note that Kevin is in amazing shape and has a very consistent, well planned and executed training and paddling routine, so this was a bit of a surprise. Kevin is also well versed in the field of sports orthopedics as he assists surgeons and medical teams and knows the anatomy which is also helpful when recovering from an injury.
He writes, “Over the next couple of days, I began to develop a large knot in my trap as well as radicular pain down my right arm into my hand, which was my major concern. This is a classic sign of a herniated cervical disc. The knot began to limit mobility in my neck. Our endurance paddle of crossing Lake Michigan was fast approaching, and I had to come up with a plan to get better. Continue reading Balanced SUP Training to Help Prevent Injury Part One by Suzie Cooney for Naish