Friday, June 29, 2012

Guns, Gold, Girls: Epic running songs pt 1

This is one of my favorite running songs right now. The song starts at 1:30 and it is well worth watching the link as I think of this as I run. As one kayaker says "I would be proud to say that I did this, but I'm racing it" a philosophy that is HUGE in running:

What does it mean to say that "it's never going to be enough?" To me it means that I'm never going to give up on life, it's how I feel about life, I "will not go gently into the night" (Dylan Thomas). To me it means what I tell myself and patients every day, that what feels impossible emotionally and physically is something that is worth striving for, because without having worked towards that goal day in and day out, you still don't know if you can attain it. It means that you can survive a lot worse circumstances than you expected because it takes so much more to break your body.

No surprise, I think of my mom and how when we were in the hospital for those three weeks following her first seizure she could finally walk to the end of the hall and part of the way back (with a walker and the support of her two physical therapists). Then the next day when she got her diagnosis of brain cancer she couldn't even stand much less walk. It all felt impossible. She was diagnosed with a rare form of brain cancer that meant she would live for 3-9 more months. Over that time she would have several seizures, lose all capabilities, walking, feeding her self, bowel/bladder fundtion, until she could only move her eyes. At this point her organs would slowly shut down and then she would die. So walking felt pretty f-ing impossible for her at that moment.

I brought her to the end of the hall in her wheelchair, where she could see sunlight, and sat and talked to her. I had prepared for this moment and had expected the diagnosis. I had read every last paper on her form of brain cancer, about what treatments could possibly give her a chance to survive. I told her we had a plan, and kept talking, and don't remember what else I said but finally something worked. She reached for/grabbed for my espresso, a sign of her still wanting something!

My dad intervened. No stimulants... no caffeine. Your mother had a seizure. DAD! Mom is smiling, mom is excited about something, give her what she wants she just got a death sentence... And caffeine is NOT potent enough to cause a seizure, especially with all the anti-seizure meds. So I gave it to her and he took it away and complained of sharing germs. I asked her if she wanted one, she said yes. My dad protested, so I said oh dad, it will be decaf, and winked at my mom.

I sprinted down the stairs, got her an espresso, fully caffeinated, and ran it back to her and assured my dad with many more winks in my mom's direction that it was decaf. My mom, with a shit-eating grin and mischievousness in her eyes guzzled it down, a little drop running down her chin.

Then I knew I had to move back home. My mom and dad were fully in love but someone had to develop the desire to live in my mom and make sure she enjoyed what she had left so she would fight for the ability to walk or eat or anything and my dad was just much too blinded by his misery to be able to do that.

Every day I bought my mom the most expensive, foofiest caramel-latte-whip cream drink on the menu at Starbucks and every day my mom drank it as fast as she could while I reassured my dad that it was decaf (sometimes it actually was, when I felt really guilty about disobeying my dad for months on end). And afterwords she would beam and sparkle. Eventually she lost much of her short term memory and no longer remembered drinking the foofy latte afterwords, which was hard, as the only external proof of my daily effort was an empty bank account.

But when I hear this song, I think of that sparkle in my mom's eye and knowing oh, she has some life in her. Like in One Flew Over The Cuckoo's Nest, where tapping into your inner rapscallion is intrinsic to healing and health and will to live. No, it's never going to be enough and I hope all my patients feel the same.

Then, thinking of this, I pick up my feet, improve my cadence, and enjoy the freedom of running.

An image of my mom and I at christmas about a month before her first seizure, toasting wine glasses after having spent 4 hours making tortelini from scratch (i.e. making the pasta dough from flour, etc)

Thursday, June 28, 2012

Never Enough.

So after this last half marathon that felt horrible, I have really contemplated what the heck I am doing with my running. I'm just an average runner who has run a couple marathons in the 3:30-3:40 range, then ran one under emotional duress at 3:12 and decided hey, I can run a marathon at six minute miles and now, a year and a half later, am solidly categorized as an elite runner.

So I looked over pictures... how are these two pictures different? What is different about my stride and what is broken down?

The left one is from Grandma's.... Haha, so after contemplating what was wrong, I finally went to see an MD; a physiatrist who specializes in sports medicine and was a competitive gymnast through college.

Turns out that my IT band is tight and my gluteus medius is weak and I gained five pounds with the stress of moving and I have dural tightness, etc, etc.

So I'll work on that and post stuff up here, but I think the biggest problem is that I was too stressed out and stopped enjoying running for a short period of time. It's hard to move to a new city where you don't know anyone and start a new job where you want to do really well and train to be an elite athlete. It was too much and I put too much stock into performance and taking it seriously. I needed to loosen up and enjoy myself while running. That's the way to fix my stride... to focus on running, not plodding.

So I made a mix music of songs that I enjoy running to and have thought about my cadence and thought about why I love to run and what I get from running.

To me, running is freedom. To run means I am alive, strong, and persevering. Below are pictures Ross peak in the Bridger mountain range in montana. A friend and I ran up there on a saturday for shits and giggles. That is what it means to be a runner. And I'm going to focus on just loving it. Then I'll see where running takes me next.

Thursday, June 21, 2012

Strength in life

The most profound experience happened the other day. I have been working on a stroke ward and in stroke urinary incontinence (inability to urinate) is a very poor prognostic factor (i.e. much greater percentage of people dying and much fewer regaining strength and independence).

Well, I have been holding back emotionally from the patients for reasons of being objective, professional, not knowing what to do or say, and just trying to mimic other highly effective physicians. But then the other day in the afternoon before going on my run, I went into a patient's room for a routine procedure. For some reason, I felt like I was entering my mom's hospital room and I treated the patient similarly to how I treated my mother. It wasn't that I said anything different, I just looked at her differently, like I loved her and I responded to her in a more personal fashion. Upon leaving, I saw her look at me differently, smiling with wide open eyes instead of sullenly and tired and miserable like every other time I have left her room. I know I opened myself up as that night I dreamed about visiting my mother in rehab, indicating that I had tapped into old emotions that I had kept walled off. 

With my mother, she knew she was going to live her worst nightmare. She had specific orders that if her mental capabilities were compromised, she did not want to live. She was DNR and my sister and I were fully aware of this well before the seventh grade. Then the way she died (and normal progression of her particular form of brain cancer) is that a tumor progressively ate out her brain from the top down, destroying her ability to think and focus, giving her seizures, and finally sending her into a coma for 2-4 weeks before taking her life. So what do you do when every day you see your mother in a wheelchair and know she is living her greatest nightmare and will be until the second she dies?

I saw the person I loved and I sucked up my pain and drew on her strength. When I entered her room it was about getting her to smile, laugh, draw out whatever fight or mischievousness possible so that she would try to walk or laugh or live another day. It is about seeing life and beauty and happiness wherever you can find it and that is what you develop and that is what you interact with and accept. I needed to be aware of the rest of her symptoms, but I needed to be her cheerleader and comrade.

I entered medicine with the belief that I can help people the way I helped my mom. Apparently after I left the patients room, she urinated on her own during a bowel movement, and did the next day as well. When she told me this I was so excited, which then got her excited. Normally when the attending MD and I round to all the patients rooms, she would be trying to sleep, complaining of the sun, and telling us she doesn't want her friends to visit because she wants to just rest. Instead she asked the nurse to find the attending to come and see her (she was so excited to tell the attending herself) and when we found her she was in the common room where it is even sunnier than her room.

So is this what it means to have a healing touch? Does it mean to open yourself up to loving a patient? Does feeling loved allow you to be strong? Might my being able to open up to a patient the way I did with my mom just have saved another person's life? I'll never know, but it is worth thinking about.

Sunday, June 17, 2012

Grandma's Half Marathon

So yesterday, I ran Grandma's Half Marathon. It was a special run because the USA Track & Field finals were held 20 minutes before our gun time. It was also my first time traveling for a race, which was quite a nerve-wracking experience! I forgot both my phone charger and one of my two running socks. But before I say anything else, It was BEAUTIFUL! Minnesota is just covered with trees and rolling hills and watching the sun rise over Lake Superior is an amazing experience. I would recommend this race to anyone who enjoys a breath-taking course near fishermen's boats and pine trees in a charming area with extremely kind people. And the taxi drivers are the greatest. I haven't ridden in many taxis, but one taught me all about the gems found around Duluth, which he shines himself and sells. And another was an avid follower of Miss Patti Labelle who moved back to Duluth once retired after having lived in cities including San Francisco and LA for his working life. Wonderful people!

With only a carry on bag stacked with race clothes and books to study, I traveled all day Friday. Starting from my summer apartment in Chicago at 8am and arriving at the convention center in Duluth at 5pm. Not knowing anyone, I went to eat at an irish pub, hoping for some good beef stew, my favorite. However, there was no stew so I went with a salad. There I discovered I had left behind my charger, rolled up on my table. The staff at the Dublin restaurant were FABULOUS wrangling one up. So friendly and really living up to Minnesota expectations.

The day of the race I got up at 4:30 from my dorm room at University of Minnesota, Duluth and ran downstairs for a complimentary banana, lots of peanut butter, coffee, and toast with an apple and powerade (bought the night before) for the road. I waited in line and hopped on the bus with a new friend, Elisha Engelen (aiming for sub-1:50 and got 1:44!!!), who was also running alone though she had many friends and her husband along the course.

Upon arriving at the race, I met up with a running partner from dc who I had never met or run with before, Elizabeth Young, who runs at about my pace. It was GREAT getting to share the experience with her! We did a short warm up and made our way to the front. It was difficult as we wove between many people frustrated who said things like "we are all running the same race" which is true, but we can't win the race unless we start at the front. However, as we neared the front it was not nearly so packed and we were able to get up to run some striders and make another pit stop before beginning.

The race itself was incredibly difficult for me.  I was incredibly sick the week before the race. I think with new allergies due to Chicago for the summer. I woke up Friday morning with a nose bleed for the first time since early childhood (first time I can remember) I think due to the fact it wouldn't stop running for the previous week. I thought I wouldn't run the race....  But there I was and I was going to try my hardest!

I was told the whole race was downhill. Well, coming from flat Norfolk and Chicago, let me say there is a significant amount of uphill the first 10k. One needs to take this into account when planning how to best run the race, which I did not. I ran my pr for the first 5k (5:57/mi, 18:22), meaning I was on track to run my goal speed of ~6min/mi. However, my breathing started getting really bad and my back and neck started cramping. I felt horrible. At the 10k mark I almost dropped out. The only thing that kept me going was remembering one time back in montana. I fell at the top of a mountain range during a race and broke my tailbone. I had to finish the race because there was no other way off the mountain (maybe a helicopter rescue). So I got down by a very slow-pace jog that minimized the bouncing but was faster than walking. So thinking of that I kept going but stopped 'racing'. I didn't look at my garmin and I didn't care who passed me. My goal was to just make it to the finish despite the fact I could barely breathe. I do not encourage other people with asthma or breathing difficulties to do this.

In the end, I got good miles on my legs and built strength. I finished a solid fourth with a 6:16 pace in 1:22. I hope to never run another race that feels so terrible and probably will sit out next time I feel so sick. But the times it is hardest characterizes how much you can do when it feels easy. Well, off to start cross training! I will post soon on Chicago & its running scene & what I am learning working in the top rehabilitation facility in the nation (Rehabilitation Institute of Chicago)... Which is A LOT to make me a MUCH better doctor in the future! YAY! And yes, I spent the morning looking up what my next races will be...