Top masters finishers after the 2009 Lake Anna Virginia Triathlon Series sprint race

When a cabbie cut into cyclist Rob Urbach’s path and was sent through the windshield, who would have thought that 3 years later he would be at the top of his game, winning awards at the Dextro ITU Olympic Triathlon and this weekend winning a Masters prize at the Lake Anna Acorn Sprint Triathlon held in Bumpass Virginia. Despite some windshield glass that still has not worked its way out of “Rocket Rob’s” arm, the talented mulisport athlete has had a consistent season, leaving his legal counsel in the dust at every venue.

There are “Ironmen” and then there are Ironmen. Rob Urbach is truly a man made of iron. Shown to the left are the Masters triathletes after the Virginia Triathlon race at Lake Anna, the same venue as the “Rumpass in Bumpass.” This event benefits Organization for Autism Research and Lake Anna Rescue Squad. They serve the Lake Anna region and many of them were on site race day. This weekend benefits both the Lake Anna Rescue Squad and the Organization for Autism Research. The Organization for Autism Research and it’s “Tri For Autism” program allows athletes to race and raise funds for Autism research. It’s better when you tri for a cause…

Dr. Dowling is shown giving ART treatment to competitor (& Maccabiah Gold Medal Winner after the ITU Dextro Triathlon in Washington, D.C.

“Active Release Technique” or “ART” is a patented, state of the art soft tissue system/movement based massage technique that treats problems with muscles, tendons, ligaments, fascia and nerves. Doug Landau has had ART treatment before and after races and found it to be beneficial, especially with regard to iliotibial band (“IT Band”) pain and hamstring tightness after hard multi sport training.

Headaches, back pain, carpal tunnel syndrome, shin splints, shoulder pain, sciatica, plantar fasciitis, knee problems, and tennis elbow are just a few of the many conditions that can be resolved quickly and permanently with ART. These conditions all have one important thing in common: they are often a result of overused muscles according to Dr. Steven Dowling of Ashburn Sport & Spine. This Ashburn area health care provider treats spinal pain as well as soft tissue injury. Dr. Dowell is a certified ART (Active Release Techniques) provider as well as a specialist in sports related injuries. He combines the latest techniques until he finds the right combination that works for you. This includes spinal and extremity adjustments, ultrasound, electrical stimulation, heat, ice, myofascial release, ART, stretching, rehab, and Kinesio Tape. Dr. Steven Dowling is also a member of the NSCA, whose publications Loudoun lawyer Landau has been reading for years.

Triathlon Trial Lawyer Doug Landau and 6 time Ironman World Champion Dave Scott

Even an experienced cyclist like Six time Ironman world champion Dave Scott can get struck by car while cycling.  While riding in his home town of Boulder, Colorado, Ironman Champion Dave Scott was hit by a car while on a training ride.  Witness at the scene of the accident report that Scott was conscious and talking after being struck, and that it looked to them like the car accident had potentially broken Scott’s collar bone or separated his shoulder with other multiple cuts on his legs and arms.  News reports indicate that the bike crash took place as he was riding down a hill and a car suddenly made a U-turn in his path.  The motorist was from out of town and was looking at real estate signs.

According to a biker who came on the scene shortly after the crash, the champion triathlete put two massive dents in the driver’s side door. he was taken to the hospital.  Witnesses at the scene also report that Scott was well taken care of by both emergency services and fellow cyclist.  Since 1999, Dave has served as head triathlon coach for Team In Training.  I have met and spoken to Scott at the Columbia and DC Nations Triathlons.  He is personable, with a ready sense of humor and an athlete who lives what he preaches.  I hope that he has a full and complete recovery from this bike crash.

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Check them out… DATE: RACE: COMMENTS:

2009 Events:

1/4/09 Freedom Fitness 5km at the Prince William County Campus of George Mason University, sponsored by Riptide Swim & Sport. Only 25 minutes, all highway from Worldgate Sport & Health. Get in the sauna or SUPER hot tub afterwards. Or, if you’re a French Ironman type, cycle, lift weights, swim a few laps and then hit the showers !

1/30/09* The 101st running of the Millrose Games at Madison Square Garden. Indoor Track & Field IS theater in the round. The Landau family made this an annual tradition, as Norman Landau ran as a high schooler in the handicap races that used to pit the best in the world against local teens. Some regards this night as the equivalent of the “Indoor Olympics.” With shot putting, pole vaulting and high jumping all going on at the same time as running events, there is something for everyone and nary a dull moment.

2/2/09 US Cross Country Championships, Derwood, MD (USATF.ORG)

3/20-22/09* USATF Masters Track & Field Championships, Prince Georges County Sports & Learning Complex, Landover (near the Redskins football stadium), MD. This superb, non-banked track with permanent grandstands has hosted meets for several years. See some of the best “experienced” runners, throwers and jumpers in the country.

3/28/09 Ukrops Monument Avenue 10km., Richmond, VA, registration opens 12/26/08. One of the largest and most fun 10ks in the country, the course is flat, scenic (taking in the historic statues), the Sportsbackers expo top notch, and the spectators showing the best of Southern Hospitality.

4/4/09 VTS Smithfield Sprint Triathlon, Smithfield, VA. A new date/venue for the increasingly popular Virginia Triathlon Series promoters at Set Up Events, Inc.

4/18-19/09 VTS “RumpAss in BumpAss” at Lake Anna in Spotsylvania State Park in Virginia, about an hour South of Washington, D.C. and an hour North of Richmond. There will be Olympic and Sprint Distance events and soon to be on eBay shirts. After all, with a race name like this, the Virginia Triathlon Series people should expect this race to sellout immediately, if not sooner ! If you’re as tough as Mary Delaney or Stephanie Colburn, you could do BOTH events !

4/25-26/09* USAT Duathlon Age Group Short Course Championships (Run 10km, Bike 40km, Run 5km), Browns Island, Richmond, VA. The runs go over a suspension bridge and involve some cross country trails. I watched the “off road” race on Saturday in 2008, and the bike was shorter, but the course safer, as we rode in the rain, and many wiped out on the hairpin turns. The race will be at this venue in 2010 as well. Great Transition area near the Civil War and Korean War Museums. Another Richmond SportsBackers event.

4/26/09 VTS Angels Sprint Triathlon, Lynchburg, VA. This is a fun race, indoor pool swim at the YMCA. Each competitor is supposed to claim an “Angel” before their first stroke, and the bike is hilly and challenging. The run goes down to the river, which means an uphill finish. The community turns out, and, in 2007, the Hokies won the College Team category (with lots of great prizes), only to be overshadowed by the tragic events that occurred on campus.

5/02/09 VTS Smith Mountain Lake Sprint Triathlon, Huddleston, VA. This Virginia Triathlon Series race is near Roanoke, and sees many members from the Virginia Tech Triathlon Club participating. It is a great “preview” for the September Olympic Distance Outback Big Lick Race at Smith Mountain Lake State Park. There are terrific Cabins, campsites around this gorgeous man-made lake. I have enjoyed every Smith Mountain Lake Race we have ever done, and I think it is one of Set Up Inc.’s best race venues.

5 /02/09 The Annual Shenandoah Apple Blossom Festival 10km.,

Everything's pink and green for the Winchester Apple Blossom Festival ! Triathlon Trial Lawyer Doug Landau is all smiles after the 2009 race.

Winchester, VA. The race course follows some of the Grand Feature Parade route that draws a half a million spectators after lunch. The Festival is actually several days long, with a carnival, circus, wine tasting, crafts selling and other events for the whole family. Have a picnic on the 5 acre lawn of the Handley High School at the Start/Finish line and then watch the biggest parade on the East Coast (bigger, better, cleaner, friendlier and more Norman Rockwellesque than the Macy’s Day Parade – I’ve been to both many times, and the Winchester Parade, 53 miles West of Dulles Airport is THE parade to attend).

5/9-10/09 VTS Kinetic Sprint & Half IronMan Triathlons, Lake Anna, Spotsylvania, VA. These races, located near the wonderful Sturgeon Creek Marina, have been the “early season wake up call” for many an area triathlete. The Bike and Run are both moderately rolling, but the swim can mean then end of your child-having abilities. Double capping with neoprene and using some of the “cold Weather Racing” strategies I have posted will help you in this one, otherwise “you will not have good fun.”

5/10/09 FinsWheelsFeet Centreville Sprint Triathlon, sponsored by RipTide Sport & Swim. This fun, fast event starts with a DOUBLE “Serpentine Swim” after which there is a multiloop bike and a wide open, relatively flat 5km. Great prizes, post-race celebration and photo-ops. Shandra Richardson and her crew do a fabulous job.

5/10/09 CBTF Dan Fiducia Spring Biathlon, the Madeira School, McLean, VA. This 525 yard indoor pool swim and 5km. multi-surfaced 5km. is one of the safest multisport sprint events I have ever participated in anywhere in the world. Race Directors Gib Smith and Rod Montrie do an amazing job with participants of all ages and abilities. Last year, there was a college swim team, members of the “SeaDevils” club and the top-ranked Madeira varsity swim team. You can participate as an individual, relay team and then relax and enjoy brunch and the awards ceremony while reading the Sunday paper on the warm bricks of the gated school’s pool patio. Perennially one of my favorite races.

5/17/09 Rocketts Landing Olympic Distance Triathlon, Richmond, VA. Laurie and the gang at RichmondMultisports are staging a new venue. They did a great job at Naylors Beach, the West End YMCA and other sites last year. If you got shut out of Columbia (like I did), this might be one to “tri.”

9/13/09 Reston Olympic Distance Triathlon, Reston, VA. While I will not be participating in the 26th annual event,I registered Mrs. Landau, who will hopefully uphold the family honor, and make up for my poor performance last year. This race sells out instantaneously. I will again be a volunteer on Saturday for registration, however I will be competing elsewhere on Sunday, as my worst Triathlon race ever was…

9/13/09* Nations Olympic Distance Triathlon, Washington, D.C. Becoming a “destiNation race,” Mayor Fenty has helped this event grow to several thousands. See my posts from 2007 and 2008. Amazing sightseeing, energy and inspiration. Warning, like Columbia, this race requires racking your bike after mandatory meetings, Friday night.

2008 Events:

MS Charity Spin RIde Leader Denise Morgan gets goosed by TheAthletesLawyer Doug Landau !

3/31 Virginia Duathlon, Virginia Beach (Run 5k, Bike 50k, Run 5k) kalerunning.com Kale running puts on terrific running and multi-sport events throughout Virginia.

4/5 MS SOCIETY CHARITY (SPIN) RIDE at Worldgate Sport & Health in Herndon, VA from 9:30-11:30 AM. Fun, great prizes and a Grand Prize for the highest fundraiser as well as bagels, fruit, coffee following this fundraising event that benefits the National Multiple Sclerosis Society. Reston Herndon injury & disability lawyer Doug Landau has taken classes from both Ed Smith and Denise Morgan, who will be leading this indoor ride (so it’s “RAIN OR SHINE”). Hurry, only 27 bikes available ! For more information, contact Ed Smith at: esmith1@aol.com or Denise Morgan at: denise1284@aol.com.

4/6 *Monument Avenue 10k is this year’s US National 10k Road Race Championships. Richmond Sports Backers (www.sportsbacker.org) Richmond’s principle non-profit sports advocate expects 30,000 runners to compete on this scenic, historic and relatively flat course. The Sports Backers also bid on, and won, the USAT National Age Group Short ourse DUathlon Championships for the next 3 years !
4/20 The 13th Annual “Run For Shelter” will take place at the Loudoun County Fairgrounds in Leesburg, Virginia. The Loudoun Abused Women’s Shelter (“LAWS”) is the beneficiary of this charitable sports fundraiser. The events take place 8:30 AM Sunday morning. Registration can be done at www.runfortheshelter.org and our friends at Potomac River Running are one of the sponsors. It is a great opportunity to get a quality “brick” by riding to, before or after this run !Triathlon Trial Lawyer Doug Landau has successfully raced in this event which raises money for the Loudoun Abused Women’s Shelter (”LAWS”). There will be a Half-Marathon, a 5km. and a “kids run for the shelter” for children 10 and under. There is an excellent staging area and there are participants of all ages, shapes and sizes. Landau will likely be lining up for the 5km. at 8:30, where he has medalled in the past. He also uses the W&OD Trail for training for Triathlon competition.Herndon injury lawyer Doug Landau hopes to see many familiar faces there walking, running and raising funds for this facility. Part of the race course has used the W&OD Trail, which passes right by the Abrams Landau, Ltd. office building in Herndon, at the 20 mile marker and caboose. It is possible to walk, run, skate, bike and roller blade on the W&OD trail to the staging area for this Northern Virginia sports event.

4/24 Run for Julia 5K A mid-week race! That’s right, Thursday, April 24, at 6:30 PM at Bluemont Park in Arlington this event will take place in honor of the memory of Julia Campbell, an avid runner, Peace Corps volunteer, and journalist who was killed in The Philippines in April 2007. Usually, the DCRRC has mid-week evening races after Memorial Day Weekend. So this is an excuse for some faster paced training with a bunch of other runners. To register, see www.jcmf.org/runforjulia.html or www.active.com/framed/event_detail.cfm?event_id=1539291

4/27*USAT National Age Group Short Course Duathlon Championships, Browns Island, Richmond, DUathlon SHourt COurse USAT richmond

4/27 Sport & Health Club Worldgate SuperSprint Triathlon, Herndon, VA Click here at the Worldgate Sport & Health Club Folks – this is agreat race thrown by Brian Crow that will field 600 people this year. It’s in Herndon, and will have a 300 yard pool swim (snake swim) a 17.8 mile bike and a 2 mile run. I do it yearly and highly recomend it! David Flynn 301-367-5201. The Athletes Lawyer notes that this race has GREAT PREEMS ! Don’t miss it !

5/3 VTS Smith Mountain Lake sprint triathlon. This Virginia Triathlon Series event is put on by SetUp Events and is not too far from Roanoke and the Virginia Tech campus. Set Up Inc

5/4 *CBTF Spring BIathlon at The Madeira School, McLean, VA, www.childhoodbraintumor.org/events.htm (525 yard pool swim, Run Cross Country 3.1 miles). A very safe course, 1/3 on pavement, then 1/3 on trail, then 1/3 on grass. It has one of the most spectator friendly layouts because the pool swim is indoors (with bleachers) and the run course is on a clover leaf pattern so that your “posse” and your “fan club” can see you SIX TIMES! Then you can enter the USAF Bike Races and get in all 3 Triathlon events !

5/11 *Centerville Sprint Triathlon, (Swim 250 meters, Bike 12 miles, Run 3.1 miles), put on by Chandra Richardson’s “Fins, Wheels & Feet.” According to Triathlon Trial Lawyer Doug Landau, this event had the best post-race feed around – cotton candy, ice cream bars, hot dogs – WOW ! www.finswheelsfeet.com

5/18 *Columbia, MD, Olympic Distance Triathlon, (Swim 1500 meters, Bike 25.5 miles, Run 6.2 miles). The Columbia Triathlon Association does an amazing job year after year. A very challenging bike course and the run is not “walk in the park” either. Race Director Bob Vigorito has a wonderful Expo the day before, and also puts on the Blackwater, Traverse and other top area events. www.tricolumbia.org

6/1 *VTS Reston Sprint Triathlon, (Swim 400 meters in outdoor pool, Bike 12 miles, Run 3.1 miles) Set-Up Events

6/14 Tim Harmon 5km., Fairfax County Government Center, 8:30 A.M. Register at www.RacePacket.com Race Director Tom Cook does an amazing job at a great weekend venue, complete with live music (the “Sock Monkeys” have serenaded the runners in the past) and a festival afterwards.

Pat Griskus Olympic Distance Triathlon, (Swim 1500 meters, Bike 24.9 miles, Run 6.2 miles). One of the “Best of the US” series races Triathlon Trial Lawyer Doug Landau did in 2006 when visiting Connecticut for his cases and Alumni Board service.

The annual Father’s Day SCSC (South Carroll Swim Club) sprint triathlon is an excellent event for first-timers and experienced racers to compete in a family friendly, enthusiastic and well-supported setting. The 400-meter swim occurs in an outdoor competition pool, while the 14-mile bike and 5K run showcase the scenic and rolling countryside of southern Carroll County, Maryland. Triathlon Trial Lawyer Doug Landau was 7th out of 239 finishers in 2005 with a time of 1:10:04, with a fixed gear bike (not on purpose). In 2004, The Herndon/Reston area injury lawyer won his age group by 4 minutes with a time of 1:12:09 for 3rd overall out of 150 competitors. www.southcarrollclub.com/news/triathlon/triathlon.htm

7/21 New York City Triathlon Olympic triathlon Swim 1500 meters, Bike 24.9 miles, Run 6.2 miles). You swim in the Hudson River, Bike through the toll booths on the Highway and then run cross town into Central Park. Like the D.C.Nations Triathlon, it’s a great tourist-Triathlete high !

7/26 2nd Annual Friends of the W&OD 10K — the Washington area’s race is Saturday, July 26, at 6:30 PM on the W&OD Trail west of Maple Avenue (Route 123) and west of Church Street. This race offers a unique flat fast course on a beautiful strip of urban environmental preservation. Multi-sport athletes can use this event as a “brick” by cycling to, from (or both) ! Register on-line Here.

7/27 Hagerstown Sprint Triathlon, MD, (Swim 300 meters, Bike 11.5 miles, Run 3.1 miles), Sunday, July 27, 2008 :: Hagerstown, Maryland: Martin L. Snook Memorial Park (Halfway Park) Start Time 07:00 am

Frederick, Maryland: Annual Cougar Biathlon, Run 3 miles, Bike 15 miles, Run 3 miles, Location: Frederick Community College

8/3 VTS Culpeper Sprint (Swim 750 meters, Bike 15 miles, Run 3.1 miles) set up inc.USAT Age Group Sprint Triathlon National Championship, Utica, NY USAT.org

8/12 Salisbury, Vermont: Lake Dunmore Triathlon, (Swim 0.9 miles, Bike 28 miles, Run 6.2 miles), Branbury State Park

8/19 ? Litchfield, CT Hills Olympic Triathlon, Brodie Park on West Hill Lake, New Hartford, CT. (1 mile swim, 23.8 mile bike, 6.2 mile run)

9/1 Winchester Valley sprint Triathlon (Swim ¼ mile, Bike 16 miles, Run 4 miles). If this is anything like the wonderful Winchester Triathlon Races Don Stinnette and Neil Reimenschneider put on at Summit Lake, it will be fantastic. These events finished at the War Memorial in Winchester, and were done in when the local governments demanded more than $10,000 for permitting. Their races featured a “point to point” course, unbeatable preems (flannel lined jackets, Ron Hill Sport Tights, “hoodies”, etc.). You still see triathletes wearing the “swag” they got from these unforgettable races.

9/7 *Reston, Virginia Triathlon. Olympic Distance, but the bike is short, it sells out in a nanosecond. Be a volunteer. It’s fun, you’ll see your friends, get some “shwag” and have fun.

9/14 D.C. Nations Triathlon, Olympic Distance. You cannot train on the coure, and you will swim in the Potomac (and then run through a “decon tent” BEFORE you get to T-1, but the sightseeing on the course is amazing and there’s a Race Expo the day before at the mandatory packet pick up. Bottom line: When the mayor is in the race, permits get done ! They even built a staircase to get over the Jersey wall on the elevated Whitestone Freeway in Georgetown. Since it’s “point-to-point” arrange for a ride back to your bike; the wait for busses may exceed your race time…

9/20 VTS Big Lick Outback Big Lick Smith Mountain Lake Triathlon. set up inc.USAT National Age Group Olympic Distance Triathlon National Championship is once again returning to Hagg Lake, OR, but this time in the Fall. The water may be cold, but at least the bike course is hilly, narrow and not closed to deadly traffic. USAT.org

9/21 Taylor Love Race, Worldgate Super Sprint Triathlon. This race is being held to raise funds to support Taylor Love. Taylor is a local resident who is fighting neuroblastoma. It is a reprise of the wonderful Sport & Health Club’s spring “Super Sprint Triathlon.” The race starts with a pool 300 yards pool “snake swim.” Swimmers start at 6:30 am sharp according to their estimated swim times. Swimmers will go off every 10 seconds until every swimmer has entered the water. The 17.8 mile bike course is: Worldgate Drive to Van Buren street where you will take a left, then to spring street where you will take a left, then accross Elden street to the W&OD trail where you will take a left onto the trail (this is a sharp turn), then out to the red barn (Partlows, sharp turn around) then back to the Herndon caboose. The run is a short out and back course on the streets and on the W&OD Trail. Total Distance 2 miles. Questions, go to Tri-Performance or contact Worldgate Sport & Health Club (703-709-9100), 13037 Worldgate Drive, Herndon, VA 20170

9/27 ITU WORLD DUATHLON Age Group Championships, Short Course, Rimini, Italy

10/4 VTS Acorn “BumpAss” sprint Triathlon, Spotsylvania, VA. set up inc. What a great name for a race! Stew is served after the race, though it’s not usually cold outside. Last year, Dr. Delaney and I went to another part of the Park to watch the triple Ironman Racers!

Osprey Sprint Triathlon, Public Landing, MD. Perfectly flat course after a shallow water swim, this is in an idyllic location at the end of Route 50.

10/31 GeezerJock Championship, Orlando, FL. While there are open and sprint races in conjunction with this event, the is MastersSports end of season finale. My bride was not thrilled with the prospect of my being a “GeezerJock” prizewinner at only 46!

Nov. Cape Henry sprint DUathlon, Va. Beach, VA. An end of season race on a flat course with serious competition. The Tidewater triathletes know how to race – hence their top placings at Colonial Beach and Virginia Triathlon Series events.

Enjoying a gorgeous, sunny day on the Maryland peninsula and raising money for several worthy causes, Herndon Reston area bicycle injury lawyer Doug Landau met up with several Northern Virginia lawyers after completing the 100 mile Sea Gull Century. Shown here at the finish at Salisbury State University is Triathlon Trial Lawyer Doug Landau, Alexandria lawyer Tom Curcio, Fairfax attorneys Steve Horvath and Fairfax General District Court Judge Tom Gallahue. While this was only Landau’s first Sea Gull Century, the other lawyers have all been riding in this bicycle tour for many years. While this was only Landau’s first Sea Gull Century, the other lawyers have all been riding in this bicycle tour for many years.

One of the reasons I went all the way down tot he tip of Maryland is that this was for a long-time client who re-broke his back.  he had had his spine put back together with rods and screws as the result of the first case I won for him.  One of the rods broke and was removed in the second Virginia claim I helped him with, and now, he had fallen and reinjured himself again.  Together with Maryland counsel, we had won before the comp judge, but the case had been appealed.  In Maryland, that means a jury trial in a workers compensation case !  After numerous depositions and motions, the case settled favorably for this Ocean City client, whom I had represented twice before in Virginia, on the eve of trial.

This beautiful part of the DelMarVa peninsula is very flat and undeveloped, and I had raced on the shores on both sides, but never explored the interior.  As an anniversary present, my bride signed us up for the 20th anniversary Sea Gull Century.  While it took me all day, we did manage to ride the entire 100 miles.  The event was well-supported, with friendly volunteers, mechanics and spectators.  The only hill was on the bridge approaching Assateague, and there were Sag wagons available.  Shown here is Doug Landau with Fairfax lawyer Dixon Young and Alexandria lawyer Tom Curcio at the Assateague Island State Park rest stop during the Sea Gull Century.  I have ridden and run with these Virginia Trial lawyers before, and it was nice to be surprised and see familiar faces in the crowd.

1. Obey all traffic signs, signals and other control devices.
2. Ride with vehicular traffic flow (as near to the right of the roadway as practical).
3. Use standard arm signals to alert others of the cyclist’s intentions.

Cyclists must NOT:

1. Wear headsets while riding on a public highway.
2. “Hitch a ride” by attaching to any other vehicle operating on a public highway.
3. Carry passengers unless the bicycle is equipped with seat securely attached to it for each passenger.
4. Operate the bicycle in a careless or negligent manner.
5. Conduct or participate in a bicycle racing event on a public highway that has not been approved by the State of Maryland and/or local agencies.

They have continuing headaches,

They have nystagamous (darting eye movements)

Dilated pupils, bruising, black eyes or “Racoon-like” eye bands

Inability to get restful sleep at night, which had not been an issue prior to the bike crash,

Difficulty with memory (long or short term), follow through or other mental tasks.

The TriathlonTrialLawyer Doug Landau notes that this list is by no means exhaustive. This Herndon-Reston area injury trial attorney adds that while most bike helmuts do a great job of absorbing the first impact, and the human skull likewise functions to protect the brain from injury and trauma, there can be injury from the brain impacting the inside of the skull. This injury can be subtle, with intracranial swelling taking time to show the extent of the damage caused by the bicycle crash. Get a referral from your family doctor, internist or general practitioner to someone qualified and experienced with closed head injury, concussions, traumatic brain injury and other neurological symptoms and treatments. Delay can be catastrophic !