night shift

The ER has been interesting. Lately I have been doing the night shifts, which haven't been all bad. I have managed to make it through most nights without disasters and staying awake to boot. There are no call rooms for the ER, so you're up all night seeing all the kids that come in at whatever time. The nights are funny. The volume and types of patients can depend on the weather, and the holiday, as it were. Thanksgiving night was pretty quiet, and it was not so cold out, but two nights before that the asthma room was busting at the seams, because it was cold and wet out. So things run like that.

Of course there are the requisite non-ER necessary visits (cough, cold, routine stuff) that people deem necessary because they don't bother to go their regular doctor, or it's the middle of the night and the kid is cranky so they don't want to wait until the next morning to see what the pediatrician thinks. We see some pretty good abuse of the medical system in this setting, up to and including EMS-ambulance services for things that are not emergenct or even urgent sometimes. This is what happens when you serve a population that is somewhat indigent; many people do not have their own cars, and MARTA, the supposed public transportation system in Atlanta, is not terrific.

It also amazes me how many people come in to the ER, especially into the ER but also sometimes in my weekly clinic, who answer the question "does anyone around your child smoke cigarettes?" with a No, when the kid himself smells like stale smoke. Or, if it's a yes to that question, it's always a qualified, "But only outside." When a kid who does not smoke himself comes in with his own clothes stinking of cigarette smoke, then you must be smoking around that kid. I don't know how many parents I have told that they have to quit (yeah, like it's gonna happen), especially in the instances of asthma. Regardless of asthma, it's important to me to encourage all parents to quit smoking, or at the very least be darn sure they are smoking away from the kid. Oh, I could go on and on.

Anyway, I have been muddling through my nights. I have one pseudo-night (1pm to 11pm) and two more bonafide nights (5pm-3am) left, then I am done with nights! I haven't had any trouble sleeping during the day, which is good. I have been going to sleep in the morning when I get home from the ER for about 3 hours or so, then getting up and doing my daytime things. Then I have been going back to bed about four hours or so before I have to get up to get ready for work. I pretend that the time I go to work is like the morning, and I do the morning getting-ready ritual of showering, etc. It has worked out pretty well, except that I feel like a hermit.

On Thanksgiving Day I ended up running the Atlanta half marathon. Originally I thought I wasn't going to do it because of my overnight shifts, but I talked myself into doing it by reasoning that it was just like running after work, with the caveat that work happened to be overnight. Two days before the race I went to the race expo and registered for the race. The morning of the race I left the ER at 7:30am. My plan was to go home, sleep for an hour or two, then do the race. The race officially started at 7am, and of course I knew I would miss that. I got permission from the race directors to start the race late. Really you can run whenever you want to but they do close the course after a certain time, after which you don't have the support like water stations and police & volunteers blocking the intersections, etc. In my case, I knew I could get to the race and finish it before they closed the course because the full marathon was also going on. The half marathon race course was the second half of the full marathon race course.

When I left the ER that morning I decided that I would just go run the race without sleeping because there was a good chance that I wouldn't get up in due time if I slept, and I felt pretty awake and psyched to go ahead and do it. I started the race about two hours and 15 minutes after the half start time, and I finished the race ahead of my usual finish time. I set a personal record for myself for the half marathon, 1:54:23. I'm pretty stoked about that because it's a full five minutes (and then some) faster than my other two half marathons. I must be doing something right in my training. I think it does help that more than half of the half marathon course is regular training ground for me, not on purpose for this race but because of where I live. When I started to run, many full marathoners had already reached the halfway point, so it was funny that I was running my entire race with marathoners. At the beginning I was being lapped by marathoners, but by the end I was lapping the marathoners. I realize it's no great feat however because I was at, say, mile 13, when they were at mile 26. No comparison!

I think I've hit my quota of half marathons this year, so I'll not go do another one during my vacation in a couple of weeks. We'll see when the next one comes along, maybe in January when it's good and cold.

from day into night

I started my ER rotation this week. I'm not terribly excited about it, but the first couple of days haven't been too bad. I'd been really digging my work in the hospital the last month, so I was not looking forward to the new rotation. The nice thing about it is the 10 hours shifts, but the flip side is I have a lot overnight shifts scheduled. So I'm going to be living the night life, so to speak, for the next two weeks. I am looking forward to having some daylight hours to myself to conduct some of the normal business of life, but I will also have to sleep during the day part of the time. Then, at the end of the rotation, I have my second vacation of the year. I am looking forward to it, though I don't have any exciting going away plans, except perhaps another half marathon. Doing a half marathon would require that I get some more runs in the next few weeks, so we'll see if the night life/daylight business arrangement lets me run. I'd like it to.

I did a 10k race a couple weeks back, the Strong Legs Run to benefit Children's Healthcare of Atlanta (CHOA), the hospitals where I work. I've run only twice since then, but actually I was kind of ready for a break. The day before the race I didn't feel like going, which is really not like me. It was my first real day off in about four weeks. The night before I decided to go to run but not race. Then when I got there and started running, I ended up racing. I ran 52 minutes and change. It's not my PR, but still pretty good. I can reliably run less than 9 minute miles. Cool. I'll pick it up again next week.

This past weekend I went back up north to go to my friend Robert's wedding. He is my best friend in medical school. He got married on Sunday, so when I was able to travel on Friday (after being on call Thursday night), I flew into Philadelphia and drove to northern Maryland to visit my cousins. I stayed with them til I went up to where I used to live in south Jersey to go to Robert's wedding. It was a very sophisticated Jewish wedding. Because I had to fly back to Atlanta Sunday night for work on Monday morning, I didn't get to stay for the whole party, barely made it through the main course. It was fun though, saw some friends from medical school. I can't believe it's been 5 1/2 months since I moved from there. It's also been 5 1/2 months since I went to the airport and/or got on an airplane. I haven't missed air travel in the least.

I got the flu shot yesterday. One of my ER attendings called me on it. I have admittedly put off getting it. I've never had the flu shot before, but before last winter I never had the flu before either. In the course of our conversation in the ER yesterday morning, I said I would never wish the flu on anyone. So she asked if I had my flu shot, and I said no. Long story short, I went up to the hospital's Occupational & Employee Health office and got my flu shot. Not long after that I started feeling like I had a cold. By the time I got home, I had a runny nose and conjunctivitis (pink eye) in both eyes. We're supposed to say that getting sick when you get a flu shot is a coincidence, but my belief now is that yes, I was injected with a virus, so my body is going to react like I had a virus, thus my symptoms last night. On the other hand it could be a coincidence, because I am constantly exposed to sick children. Good news is I do feel better today, but still with some mild pink eye and a little drippy nose. It'll go away. And I'll eventually get another cold. But hopefully I won't get the flu.

Tonight I walked into St. Cecelia rehearsal at church (the one orchestra I get to play in these days), and found that the concertmaster seat had been reserved for me. I think I might be there through Christmas. We've rotated concertmasters this fall, so it's not definitive how long I'll sit there. The director Charlie surprised me today, but my feeling is that I will be there through our next performances, which are Dec. 21 and Christmas eve. I was concertmaster for St. Cecelia for five years before I left Atlanta five years ago. I was concertmaster during our two European concert tours. When I left my friend Steve took over as concertmaster, but he's had some rehearsal and performance conflicts this fall, so another lady who has been around the last few years has been sitting in. Now it's apparently my turn. =) I just feel badly because I got there right when rehearsal was about to start and I wasn't properly tuned myself before I had to tune the orchestra. I kept having to ask the first cello for her note before I gave it to the orchestra. Anyway it was fun to sit there again.

the way it is

So the dude I spoke about before informed me that he was going for a
long run this weekend on Sunday, if I was interested. Being that I'm
me, and happy to run with a friend (though his friend status sounds
right questionable at this point, we can probably all agree), I gave
him the benefit of the doubt again. I let him know I was interested in
going running. Wrong answer. I again have not heard word one from him
about going running today. Why on earth do you invite someone to do
something when you have no intention of following through? In the
least he could let me know he's no longer doing this today. Today is
an absolutely gorgeous day for running and in my training plan I
included a long run because somebody invited me to go for a long run.
Minus points for him for being inconsiderate in the first degree ad
throwing off my training schedule in the second degree. Weekends for
long training runs are at a premium around here, and should not be
wasted.

It's my fault really, because my expectations of the human beings
around me to stick to their word is just too high, apparently. And I
gave the benefit of the doubt. Now I have every doubt. Guess I'll have
to stick to running on my own or running with someone else who's
willing to make a plan and stick to it.

and I digress

I don't know why I'm so surprised my life has turned out this way. As I stated in my status update on Facebook today: I was tremendously disappointed to have slept all afternoon, therefore missing a gorgeous day and the opportunity to go for a long run with a friend. The run itself was never set in stone, and in fact my friend was on call with me last night, so there might have been a pretty good reason why one or both of us didn't run today. I worked more than 28 hours and slept 1.5. Sleeping the afternoon away is no great shock. We didn't plan the run specifically but didn't competely blow off the idea either. I woke up at 5:40pm after sleeping for over five hours, and was saddened to realize the time, knowing that daylight savings time brings darkness sooner. No 8 mile run, or any run of consequence, was going to be accomplished before dark. A lot of words to say, I was disappointed that I couldn't run with my friend, who told me to call whenever but probably in the end went running without me and didn't bother to call me when he wanted to go. True, I don't really know for sure yet that he did go running.

Friday was Halloween, and I was my (maybe-not-so) trusty alter-ego, the glam vamp. Not really my alter ego, just a costume I came up with ten years ago and have now worn three times. I probably won't wear it any more. I was happy that I got most of my team at the hospital to dress up for Halloween. It was great fun, and we were the most spirited residents that day. My MO for the day was to be someone unlike myself for the day. Well I was mostly myself, just dressed up in those red pleather pants and feathery long black shirt-coat, and lipstick to boot. One of my (female) friends told me I looked hot, but not necessarily the friend I was hoping to impress. Who am I kidding. I got bold and asked this person if he wanted to go for beer Friday night. He said no. I was okay with the explanation he gave, because generally on Friday nights I'm kinda pooped myself and probably have my evening planned from the beginning of the week. But without going into details I realized that this person gave me a false reason for not going out. My reaction to being told no was two-fold, initially disappointed that the one time I go out on a limb I'm turned down, and finally kinda pissed off (and ultimately, disappointed again) that the reason turned out to be false. Enter the friend I was hoping to go running with today. He's one and the same. He has even told me he's been feeling lonely lately, would like to go out with somebody. I guess that somebody isn't me.

It's multi-faceted. I feel largely acclimated and accustomed to this life and being on call, but some days I still want to believe I can live a normal life. And then there's hoping I can come across someone who wants to go out with me, spend some time getting to know me, and end up liking me, instead of bugging out after they get to know me a little. I guess I choose poorly.

I'm going to run on the treadmill during the Colts game.

follow up

I thought I'd share an article that I read a few weeks back regarding organic foods, since I posted something before about organic milk. I thought it was a good, informative article. I thought there was more to it when I read it, but maybe there were a couple of separate articles clumped together in the magazine and I just can't find the others on the internet. Then again maybe not. In any case, it's from Atlanta Sports & Fitness magazine.

The Whole Foods MovementOrganic foods may be green, but do they make you healthier?
You exercise daily and you watch what you eat, making a habit of following the U.S. Department of Agriculture’s recommended food pyramid and dining mainly on fruits and vegetables. It’s healthy, right? But could it be healthier? As an increasing number of organic grocery stores pop up in Atlanta, our fruits and vegetables, as well as our whole grains, dairy and meats, have gone green. Everyone’s going organic, but is organic actually better for your body?
“Organic foods are not necessarily more nutritional,” says registered dietitian and nutritionist Page Love of Nutrifit, Sport, Therapy Inc. in Atlanta. “But what you get when you eat organic foods are foods grown without toxins, pesticides, herbicides or fertilizers.”
Making Organic
In order to be deemed organic by the USDA, foods must be grown and processed in a manner that conserves water and soil, reduces pollution, and restricts chemicals such as insecticides and fertilizers. For poultry, dairy and meat, organic standards prevent the use of growth hormones, antibiotics and medications, and animals must be allowed to roam outdoors instead of remaining caged or penned.
Organic methods may not have much of an effect on the nutritional value of foods, although some research indicates vitamin C may be more prevalent in organic produce and farmed fish may contain less nutrients than wild fish (see sidebar), so what’s all the fuss about? Science is beginning to taut organics’ lack of chemicals and additives as a benefit to our bodies.
In fact, research is examining the rise of cancer, autism and other diseases since pesticides, insecticides and growth hormones were first introduced. In milk, for example, farmers may use biosynthetic growth hormones to increase milk production in cows. Some claim that these same hormones are the reason behind a rise in early puberty in girls. Others say the hormone increases the risk of cancer, including breast, colon and prostate cancers. Europe and the United Nations have even banned American milk due to early findings that suggest the same.
The Organic Center, a nonprofit research center based in Colorado, has been researching the effects of chemicals in foods, and while the number of variables involved make it difficult to link certain illnesses to pesticides, its scientists have found American children are exposed to six or seven different pesticides each day from food and beverages. Because of their small size, the exposure puts them at greater risk of negative effects, which is also why researchers are crying foul play on toxic chemicals in a pregnant woman’s bloodstream that can affect a fetus, especially as more and more children are developing ADHD and autism, both conditions that are neurological. A 2006 study published in Pediatrics agreed, linking chlorpyrifos, an insecticide, with attention problems, ADHD and pervasive developmental disorder in children.
However, the Environmental Protection Agency, which regulates pesticides farmers use, has set limits on pesticides and insecticides, with its own research finding the low levels allowed have no effect on adults or children.
With a lack of conclusive evidence proving organic is the way to go, many nutritionists like Love are saying chemicals and additives should be cut out of a diet just in case.
“I suggest my clients refer to the ‘Dirty Dozen,’ a list of foods with the highest level of pesticides, which was compiled from research from the Environmental Working Group in Washington, D.C.,” she says.
The EWG found 12 fruits and vegetables exposed a person to an average of 14 pesticides per day. Its “Dirty Dozen” includes peaches, apples, sweet bell peppers, celery, nectarines, strawberries, cherries, lettuce, grapes, pears, spinach and potatoes. It recommends if there is ever a time to choose organic versus non-organic, pick organic when selecting these items in the produce department. The good news is that the cleanest produce–avocados, onions, frozen sweet corn and peas, pineapples, mangoes, asparagus, kiwis, bananas, cabbage, broccoli and eggplant–only expose a person to a few chemicals a day, and that washing fruits and vegetables under running water can remove 99 percent of any pesticide residue, so there’s no need to go totally green.
Still, when working hard to make sure your body is as healthy as it can be, it certainly cannot hurt to choose organic foods.
Reading the Label
When selecting organic foods, including pre-packaged foods containing produce, dairy or meats, labels can be a bit tricky to decipher. Here’s a cheat sheet:
• USDA Organic. The USDA Organic green seal is not a mandatory stamp, although, in order to meet the USDA’s standards, products with this seal are “100-percent organic” or “organic.”
• 100-Percent Organic. Contains only organically produced ingredients, but also may contain added salt and water.
• Organic. Contains 95-percent organically produced ingredients.
• Made with Organic Ingredients. Contains 70-percent organic ingredients and lists up to three of the organic ingredients on the primary display panel. The USDA seal may not be used on this package.
• Free Range/Free Roaming. Poultry with this seal must have received outdoor access, although some farmers restrict the space animals can roam in what is called “yarding,” so the label can be deceiving.
• No Hormones. Hormones may never have been used in the lifetime of an animal (beef), with documentation submitted as proof. This label is misleading if marked on pork or poultry, as hormones are not federally permitted on these animals.
• No Antibiotics. Again, documented proof that no antibiotics were used in the lifetime of beef or poultry is required to receive this label.
• Natural. Products without artificial ingredients or added color, and
are minimally processed.

old time rock & roll

I attended an organ concert at church a couple of weeks ago, and there is a somewhat interesting back story to this particular performance. The church puts on a concert series every year, and this summer I looked at the concert series schedule to determine if I would be playing in any of the concerts (perhaps one in the spring, if my work schedule allows). The first concert of the year was an organ concert by an organist that I know. It is indeed a small world.

This organist attended Westminter Choir College in Princeton, NJ with Charlie and Diane, who are my music directors at church. I have been playing music with and for them for ten years. I happen to know this organist (I'm not going to name him because of reasons) because he was the organist and music director at my church in Carmel, IN when I first moved there at the age of five. This man is an amazing organist and wonderful church musician, and my mother has always held him in highest esteem and largely credits his him with her love of and devotion to sacred music. This man's wife at the time was my very first piano teacher, and their first daughter was the first kid that I ever babysat (rather, I was a mother's helper), even at whatever young age I was when she was born (I might have been six or seven, I can't remember exactly how many years older I am than she is).

This family moved from Carmel several years after we got there, and we kept in touch with them for awhile. Then their family changed by going through a divorce, and we kept in touch with the wife and her kids, but lost touch with the man. He has since gone on to play concert tours all over Europe and record organ DVD's, and has landed various university teaching jobs in the US. When I read that he was a giving a concert at my church, I was amazed that he would be here in Atlanta. Turns out, like I said before, Charlie and Diane know him. They were equally amazed when I told them that I know him too. He is currently serving in a church right up the road in Gainesville, GA.

I immediately told my mother about the organ concert and invited her to come to Atlanta that weekend. As she was making plan to come down, she looked him up on the internet and sent him an email. His reply was less than desirable, saying he didn't want to be in contact with her, that the period of his life which she represented to him he did not want to remember, and basically he wants to be left alone. He doesn't have contact with his children, apparently. He dislikes being in the US. So I feel bad for the guy, but the time that he knew my mother, even though it was apparently horrible for him, was so uplifting and defining for my mother, and likely could have been for many other people. I know that what my mother holds pure and sacred about church music she has passed on to me. It's too bad.

I debated about going to the concert myself because I didn't want to make him uncomfortable. I could easily sit there and not shake his hand afterwards, make myself anonymous. The week before the concert Charlie and Diane asked me to go to dinner with the three of them, and unfortunately I had to decline because of what my mother told me about his email message back to her. My mother actually did not want me to tell Charlie and Diane the circumstances, but since they invited me to dinner I felt I owed it to be honest with them. They're fully aware that this man certainly has his quirks, that he is divorced and doesn't know his children, and truthfully, he is a recovering alcoholic. They know this, so I felt comfortable in telling them why I had to decline the dinner invitation, as wonderful as it would have been to spend an evening with my mother's previous musical mentor and my current musical mentors.

I decided to attend the concert. I sat with Diane, as Charlie was sitting up at the organ turning pages during the concert (and because my other church/music friends didn't show up even though I told them this would be an amazing performance, the bums). She introduced me to him after the concert, he said he remembered me, I congratulated him on the performance, and that was that. He was eager to turn away and speak to the next person behind me, so I did not linger. Maybe I should not have been introduced, but in the grand scheme of things, it's amazing how small the world is, even though inside the realm of music maybe it isn't so small. It is indeed a curious world, however.

let's run the list

1. Tonight I went to the Atlanta Opera's preview concert where they performed excerpts of this season's operas. It was informal, there was a narrator who was describing the opera, the scene being presented, the particulars of the musical style of the particular opera, and some anecdotes here and there. It was an enjoyable performance, short and sweet. I was more impressed with the male performers than the female, but all in all, very well performed.

2. This morning I played at church with my orchestra there, the St. Cecilia Consort. It was nothing short of amazing. I love playing there and always have. I'm so at home there, and I feel fulfilled. I wish though I could have devoted a little more time to practicing the music in preparation for the service today. I try to practice an hour a week outside of the one hour per week rehearsal that we have. Some familiarity with the music outside of Wednesday night rehearsal is ideal. It's hard to believe that I can only carve out one hour per week (maybe if I run less I could find a better balance), and alternately it's hard to believe that just one additional hour can make a difference (but it does). Ideally though, for me, I need to spend more time on the violin strengthening my fundamentals that have regressed while I was going for months at a time without playing in medical school.

3. Yesterday afternoon I went for a mani-pedi with my friend Christine who I went to Carmel High School with. Long story short, her parents have been living here in Atlanta since I moved here for college, and Christine finished med school/residency/business school and moved to Atlanta with her husband to work here three years ago. We caught up with each other and got our nails did. It was fun.

4. Yesterday morning I ran a 10k race here in town. It was called the Buckhead Sizzler, as it is supposed to be a fast race. Indeed it was fast for me, for I quite shockingly achieved a time of 50:42. Maybe the official time will be a little different but that's what I recall the clock saying when I crossed the finish line. Wowsa! I'm so excited. I qualified for the Peachtree Road Race for next year, so maybe I can take a break now! =) (hardly...) I was shooting for 54:59, because you have to have less than 55 minutes to get a time group placement, and I thought given my last two timed 10k times, that's as good as I could hope for. I don't know exactly why this is a fast race, because it's not all downhill like people say. There are some uphills to it. I guess being on the wide open Peachtree Road, not being a crowded race, and not really having any twists and turns in the course to deal with, that might have something to do with it being fast. I'm pretty psyched.

5. This week I was a bit under the weather. It's kind of a long story, and I never felt really terribly sick, but it did have some consequences. I got a sore throat one night when I was on call about 12 days ago. I got a mild cold, and thought it was going away. However, whenever I get a cold, I also get really bad (EVIL) post-nasal drip that goes on for awhile and leads to tickles in the throat and subsequent coughing. This is what I thought was going on this week, when mid-week I had repeated bouts of coughing that took me out of my patients' rooms and disturbed my team's work flow. I had taken cough medicine for one night, because the previous nights I had been awake coughing. One of my supervising doctors suggested that I might need some albuterol given the spasmodic nature of my coughing fits. Actually, they were teasing me that I had pertussis. It is true that the two times I went running early last week I felt tight in the chest after running and considered whether I was having bronchospasm, which I attributed to being exercised-induced and a consequence of having a cold. I'd experienced this exercise-induced bronchospasm/chest tightness one other time, after I had the flu in February of this year, but at the time I never had coughing that was unrelated to running, and I got over it very easily. This time I'm not so lucky. My attending wrote me a prescription for albuterol, so I tried it. It has helped my coughing, so there's a chance that I have a touch of asthma. Saying 'a touch of asthma' is really a misnomer; I shouldn't say it. You either got it or you don't. I could be in denial. There's a number of ways to categorize my case. In terms of its cause, it's induced by the cold illness that I had, creating a level of reactivity in my airways. In terms of its triggers, it's exercise-induced (and it doesn't stop me from running, just when I stop running I start coughing and getting tight), and I can't say what induces the coughing fits when I'm not running but talking certainly has had something to do with it. I could say that I have cough-variant asthma, because my main symptom is cough, and I really do not wheeze. The official categories that we place people into with asthma that guide treatment are mild intermittent, mild persistent, moderate, severe...I do not fit those categories right now because although this is technically the second time it's happened (although I fit the bill in that illness is a trigger for many having asthma attacks and especially being admitted to the hospital for a severe attack--status asthmaticus), it's the first time it's been brought to medical attention. I have to see over time how it acts before I can fit it in to a category. I wouldn't say I feel crippled by having to take this medication, but it's a life-changing view of my healthy self as far as I'm concerned. I'll still do everything I've ever done but I guess I gotta remember that I might have an asthma attack and keep some albuterol around. Maybe if it only happens when I get colds (which I'm going to get a lot of as a resident!), I can remember that fact and take albuterol at regularly scheduled intervals starting right when I get the cold to prevent the spasmodic coughing that hampered my work this week.

6. That's it for now.

oops I did it again

So, I ran another half marathon. I went to Asheville, NC this weekend for the half marathon on Saturday morning. Way back when I started residency, I asked to have this weekend off as my "golden weekend," which means you are not on call Friday, Saturday, or Sunday. Technically we should automatically receive one golden weekend per month, but once every three rotations we get to individually request which weekend we would like to have as the golden weekend.

I chose this weekend because there were two half marathons from which to choose: Asheville, NC and Chicago, IL. I chose Asheville because it's closer and would be less expensive for me overall, and I had not been there before. I can drive to Asheville, whereas I'd have to fly to Chicago, and turns out I really didn't have the resources for that. Asheville proved to be a challenge for me, I knew going into it that it would be, because it's a rather hilly town, in the mountains of western North Carolina.

I've been training for the race since my last 10k on the fourth of July, but by virtue of my work schedule (excuses, excuses!), I didn't achieve any great mileage until the last several weeks. I ran 8.5 miles twice a few weeks back, then ran 10 miles once two or three weeks ago, and then ran 14 miles last weekend. I'm not saying that's all I ran; all the other runs I do during the week are six miles or less. I do the long runs on weekends when I'm not on-call or post-call. You're not supposed to run 14 miles or anything resembling race distance one week before the race, but the way the weekends worked out with my schedule it's what I had to do. Plus, I did a similar thing the last time I ran a half marathon; I ran 13 miles one week before the race then two short runs during the week as my taper. That time I had to prove to myself that I could indeed do 13 miles prior to the race because I had been injured. This time, it was just the way the training plan worked out.

I admit that I ran too much the week of the race, but I was afraid of getting cold, so I did more instead of less. I ran 14 miles Sat then 2 miles Sun, then 3.5 miles Tues and 4.5 miles Wed. That was plenty. My right knee had something to say about it, so I started taking meloxicam (an anti-inflammatory) for two days leading up to the race. It did the trick, no pain. Not that I pill pop, I was stretching and icing adequately as well, but I was also up all night on-call two nights during the week and figured my body could use a little help so I could run a successful race. I haven't taken it since the morning of the race and haven't needed to.

I was on call Thursday night, so when I got home from the hospital about 9am on Friday I went to sleep for about 3.5 hours. Then I got up and got ready and then drove to Asheville, which is about 4 hours from Atlanta. I checked into my hotel, which was the cheapest one in town and also the closest to the start/finish line -- 1.5 blocks! Then I went to get microwave macaroni & cheese from the local grocery so I could eat in my room and go to bed. Post-call is a brutal feeling, so I was definitely ready to sleep after being up all night the night before and driving to Asheville by myself. Maybe someday I'll have a cheering section in the form of a significant other that wants to accompany me on these excursions.

I woke up a couple of hours before the race on Saturday and ate some peanut butter on a slice of bread and some fruit. I took my time showering, getting dressed and stretching, then it was time to walk over to the start/finish. I could not have planned it better! It was overcast but warm, and it turned out to be pretty muggy. The sun started to come out as the race was finishing, then it was a beautiful warm sunny day afterwards.

In terms of time, I didn't have any expectations that I would have a better time than my last half marathon, because this course is hilly compared to the last one. But after about 10 miles I realized that I might be close, so I tried to push. I didn't do too shabby and only missed my previous time by 5 seconds -- 1:59:38 was my chip time this race. I goofed at the beginning of the race and didn't start my watch properly, so my personal timing was off, but at least I was able to roughly keep track of each of my miles. My quickest mile was mile 11 which I did in 8 minutes, because it was downhill. =) Most of my other miles were in the 9 to 9:30 range. The very last 1.1 miles (or so they said, I think it was longer!) was all an uphill incline, and I swear it took me like 12 minutes to go that distance. That was a little frustrating, running that bloody hill right at the end.

After the race I got cleaned up and checked out of the hotel. I met my friend Jennifer (my twin brother's ex-girlfriend, actually) for lunch in Asheville. She happened to be in town with a couple of her co-residents in the Duke psychiatry program attending a conference. We couldn't have planned it, it just happened. It was nice to see somebody I knew in town, and we had an enjoyable lunch catching up. Then I left Asheville and drove to Spartanburg, SC to visit my friend Karen and her husband Karl and their 1 year old daughter (tomorrow!) Evie. We mainly watched football games -- Michigan on Sat night and the Colts on Sunday -- which was fine with me, I was ready to sit and do nothing. They're such good company and I'm so glad they're willing to host me from time to time.

I'm glad I did this race. I like the challenge. Prior to it I wanted to be able to do 10 miles once a month, and now I'd really like to be able to keep up a 13 miler every month instead of or in addition to. We'll see about that. It will probably even out to being one really long run every 5-6 weeks. I'd like to do another half marathon before the year is out. I don't get to do the home town favorite, the Atlanta half marathon (and marathon) that takes place every year on Thanksgiving day. I'm working in the ER that month, and that week in particular I am working nights, Wed-Fri, so working all night the night before Thanksgiving is not conducive to running a half marathon, unfortunately. I really got the shaft for this particular holiday, but somebody's gotta work!

These are the pics I found on the race website. The solo shot is just about at the finish line. The group shots are I don't remember when, but I do remember that I played cat & mouse with the dude in the black shirt and blue shorts, and eventually I passed him and finished before him.

milk experiment

I have started buying organic milk, mostly because I have decided I don't want to be exposed exogenous hormones, pesticides, and antibiotics that they are putting into commercial milk (commercial cows) these days. It's a personal decision, not necessarily one that is driven by hard facts about bad things, but relatively soft personal convictions. I'm not an expert on any one thing.

I believe one reason we are seeing an increase in breast cancer and other hormone-driven diseases is the rise of environmental estrogens. There is an incidence of breast cancer in my family, my maternal aunt died of it about two years ago, so anything I can do to minimize the risk for myself, I will do. Besides the now unavoidable fact that I am over thirty years of age and have not given birth (being pregnant especially before the age of 30 is highly protective), I shall do what I can to minimize the possibility, and exercise, diet, and healthy living play a big part in that. Seems serious, but that's not to say it's a daily worry of mine. Far from it.

Also, I believe that we are contributing to the development of supermicrobes that will become resistant to our medicines by the widespread unnecessary use of antibiotics, both in a medical setting and in the setting of agriculture.

I realize that my little teeny tiny convictions and little teeny tiny impact on the milk market won't change the world, but I'd like to try to change little things about how I shop. I buy one of two different brands of organic milk, one of which states outright that it doesn't use antibiotics, hormones, or pesticides. The other brand that I buy states that their philosophy is for the use of free range cattle, but they don't exactly specify their lack of hormone and antibiotic use. Have to look into that one. And it's probably also true that other things that I eat on a regular basis also fall into this antibiotic/hormone/pesticide treated category, but I'm trying to buy more organic products in the hopes that they are being truthful with me as the consumer of these products.

In any case, this organic milk is almost twice the cost of regular milk, so I've had to cut in half the amount of milk that I consume. I love milk, and it's hard for me to drink half a glass instead of a whole glass because I can't really afford all the milk I want to drink at this new higher price.

And now to the milk experiment. I am in the habit of taking milk and cereal to some of my morning academic lectures and for my overnights on call in order to have breakfast. I have found that one of the organic milk companies produces a milk that can be put on the shelf at room temperature, then refrigerated prior to use. I bought one of the convenient single-sized packages of this milk, skeptical of whether it would be good.

Might I mention that yes, I love milk, but I'm actually quite finicky about the milk that I ultimately drink. It has to taste just right!

I took the special room temperature milk container to work with me yesterday, put it in the fridge when I got there, and took it out of the fridge this morning after rounds and proceeded to eat my cereal. It was good, it wasn't bad! I might be sold on this shelf milk concept for the ease of convenience, especially in the situation where I don't have the luxury of storing milk all day before I go somewhere to be on call overnight. (Sometimes I'm on call overnight at a facility other than where I've been working all day, and I don't have time to go home to change clothes and collect food, so I have to prepare in advance and carry it with me that day.) This isn't the most cost effective way because these containers are more than a dollar apiece, but it easily replaces carting around milk in a sports water bottle and worrying that it will go bad before I get it to another refrigerator, and I can rely on having breakfast wherever I work overnight, whether or not there's a cafeteria. (Other note is that as a cost-saving measure, I rarely buy food outside of what I bring from home, and some places at which I work don't have food available or provided to us even though we work all day, all night.)

So I'm pleased to announce that my milk experiment worked. It must be said that it's anecdotal, and now my own personal dogma, which is not the best way to represent the true efficacy of research. The best level of evidence by a research study of an intervention or treatment is a randomized controlled double blind prospective study...this is certainly not that!

maybe I need a tooth fairy

Maybe I need to lose a tooth or something, 'cause there's really no other way I can earn extra money, not with my schedule! Okay, so maybe I can babysit on occasion. Anyway, I had a chuckle to myself today when I opened my accounts online, and found this:

credit card balance $285.72
bank account balance $284.45

Doh, so close! It's really only pertinent because tomorrow is payday (can't come soon enough!) and it just shows how close to the proverbial edge I live financially. (Actually the scenario is that all the bills are paid except this credit card balance so I'm not really behind on anything or borrowing from next month). Things are definitely better as a wage-earner now as opposed to before when I was a student, the ceiling is a tad higher, but things are still close. I have to budget carefully to do a lot of the things that I want to do (but by no means all) and to save for the future.

I guess I could make it a MasterCard commercial above and add the caption: Ability to pay it off and not worry about next month, Priceless! I'll admit and acknowedge that I am blessed to have a pretty good life.

I'm post-call, which means I'm tired, groggy, foggy, mildly GI-upset, and a little giddy. I should be asleep although I got decent sleep on call (four hours). The sun happens to be shining for the first time in a week and I'm seriously considering going to sleep at the pool.

fun day

Today was a fun day. By all counts I really should be in bed by now, but the Olympics has kept me up tonight, as it has most nights this week. I didn't watch the Olympics when it started, but then when I was on call Monday night, I started watching it, and I watched it every night since. I have been stunned by the amazing feats of the athletes and proud of the American representation. Need I say it? Swimming has been amazing. Then there was the 100m men's final tonight with that dude from Jamaica who hadn't even finished racing and was legs ahead of everybody else and celebrated pre-finish line. And the women's marathon, where the lady who won was far ahead from mile 16 or something ridiculous like that. Amazing. There was also a Georgia Army dude from Fort Benning, GA who won the gold in skeet shooting today.

This morning I had my own little event, which I'm proud to report afforded me my own PR (personal record). I ran a 5k race this morning, and achieved my fastest 5k time, 25:17. Pretty darn cool. It's much cooler to say my pace was 8:09 per mile, although in truth my first mile was 8 minutes, the second mile was 8:14, and the last 1.1 mile was about 9 minutes. So I slowed considerably after two miles. There was some uphill to it, and I did feel pooped out. I wanted to break 26:00 which is my previous 5k PR, from March of this year. I was glad I could do it even though I haven't really been training for speed (I'm still slow, see last post, but I did surprise myself). I think the cooler temperature (70 degrees) and lower humidity (maybe 40%?) played large roles, not to mention the race was first thing in the morning. Running is so much easier when it's the first activity of the day just after getting up from sleeping, not the 18th activity after 10 hours of work.

After racing today, I went to the North Georgia mountains with friends from residency for hiking and swimming. It wasn't serious hiking, mostly short jaunts, but it was really fun. We went to the highest point in GA, Brasstown Bald, and then we went to High Shoals and visited three waterfalls and played in the water. In all the time I've lived in Georgia I had only made it up to North Georgia to play some concerts and to go white water rafting. It was cool seeing this part of Georgia. Here's some pictures. (I'm glad my digital camera works even though the screen does not. Have to use the good old fashioned view finder instead of the digital screen!)

I'm on vacation! And oh by the way, Michael Phelps is a stud.

shameless self promotion

These pics are from my all-time favorite race, the Peachtree Road Race. It's a 10k on the Fourth of July in Atlanta. I was fortunate to have the day off from work, and I had signed up for a race number when the race applications became available back in March, even when I didn't know where I would be moving for residency. See, it all worked out!

I'm the girl in the yellow. The girl cheering in the light blue shirt next to me is my friend Heather. We ran the race together, all but the last quarter mile or so. She speeded up ahead of me right at the end right after this picture was taken. They changed the race course this year, so it ended uphill, so that kinda got me at the end so I wasn't as quick at the end as I would have liked. In fact, I wasn't the least bit fast for this race. I ran it in 57:45, whereas my best 10k is 54:39 (last November). We enjoyed our pace though and had a nice conversation through the whole race. Heather's husband Bill started out the race with us, but had to make a pit stop, so we left him behind. He rose to the challenge though and actually finished the race ahead of us and awaited us at the finishing area. I knew that Bill and Heather were starting in my time group for the race, but I didn't anticipate running with anybody, given the masses that run this race (total 55,000 people). It turned out that right before the starting gun I happened upon them in the crowd, along with my big brother Reid who was also standing a few people over, so we all started together. Reid suggested I run with him, but there was no way, he has such long legs and runs so much faster than me. So I ran with Bill and Heather, and then just Heather. It was great fun. We passed my friend Matthew on the way, actually at the top of cardiac hill, the hill in the race course that goes right in front of Piedmont Hospital, so you know, just in case... So normally I don't see anyone in this race but this year I saw a lot of people, except for the people behind me, namely my brother Kevin who started a couple of time groups back. It's such a great race.

So I'm planning on a few races this fall. It's been tough scheduling them with my work schedule. Around here most of the races are on Saturdays, and it seems as though I work more Saturdays than Sundays, and the schedule that I got for work didn't allow for some races I really wanted to do. But I found some backups, and a couple of races I can do out of town, for added fun.

I'm still working on maintaining distance, because I'd like to do some more half marathons. As I mentioned above, I have become notably slower. There's really two parts to that problem, and for the time being I think I have to be content with doing what I'm doing and worry about speed later, like in another life. It's been really hot here (hello, it's Atlanta, duh) and the heat and humidity can really take a toll on a run. The time I generally get to run is late in the afternoon, when it's hot and thick. Plus, I'm overall much more tired than I used to be, because of work (75 hour work weeks will do it to ya!), so my stamina and my energy reserves are not what they were. I do run 2-3 times a week about 30-45 minutes apiece (but sometimes I can only handle 25 minutes!) to maintain something resembling stamina, and every other weekend or so that I'm not working, I try to do a long-ish run so I can maintain distance. This weekend on Sunday it was gorgeous out and practically not-hot so I got a great run in the morning. I was hoping for 10 miles but it ended up being 8.6 miles. It's amazing how far around town I can go and still not go quite far enough.

back in the saddle

I am officially a resident, if I haven't said it before, I'll say it now. They weren't lying when they said it was hard. Emory Pediatrics in of itself is pretty hard because they give us a lot of call, and when we're on call there's a lot of patients to take care of and new ones to admit to the hospital. My first four weeks of residency was about as hard as it gets in terms of workload. I started out on one of the hardest intern (first year) rotations, a combination of Gastroenterology and Pulmonology. Complicated patients coupled with very busy services (i.e. long patient lists every day). I had trouble initially not only because they are busy services, but also getting the hang of the workflow. The actual workflow does not vary between hospitals, you kinda know that you see patients, write notes, write orders, round with the attending, communicate with parents, nurses, social workers, pharmacy, etc. from day one. But taking on a busy service and learning how to be an intern and feeling like you have a remote grasp of how to make medical decisions all involve a significant learning curve. I kinda got the hang of it, and the beauty of it is that although it's busy services to work for, that month they only give you two overnight calls to make up for the busy-ness. Call or no call, I still averaged over 72 hours of work per week, with one week that I worked 93 hours.

Now my new rotation this month is outpatient Nephrology (kidneys), so because it's clinic-based and not inpatient, the hours are much more reasonable. We don't even have any morning clinics, so I do attend rounds in the morning with the inpatient team, which is interesting, and there's not an intern on the service this month so I do help out the 2nd year resident with orders and such after rounds. I have clinics (see patients in the office) most afternoons. This rotation, however, since it's not as intense during the average working day, I am on call every fourth night in the hospital (and, rest assured, typically you go home by noon at the latest the after you are on call overnight, it's the law). The bonus to this rotation also is that it includes a one week (actually, 9 days, which is one five-day work week flanked by two weekends) vacation. So there's a give and take to scheduling. I'm just glad my hours are overall less this month and I can sleep a little. Then for my vacation I don't have anything exotic planned. I think my extensive travels over the last year have made me reticent and wanting to stick around home. I could be convinced otherwise.

Speaking of home, I moved into a condo right before my residency started. I didn't buy it, I'm renting it from a friend of my brother Kevin's in-laws. The place had been on the market and they were unable to sell it, so they cut me a deal and I moved in. My very first place by myself. I know they want to put it on the market again but I'd really like it if I could stay in this one place for three years. Would be a bargain, certainly. Anyhow it's turned out to be quiet, which is key for me, and the view ain't too shabby. I have an unobstructed view of the skyline of Midtown Atlanta. It doesn't get much better than that (unless you want an unobstructed view of mountains or something). I still have too much stuff though. And I keep getting things. My grandparents are moving into assisted living, so they're downsizing and are offering up things. I got the things I've had my eyes on: a beautiful corner curio cabinet, a rocking chair, my grandmother's Spode, as well as some pots and pans that I had been desparately needing (couldn't cook anything!). But, if I take too much more I won't have any place to put anything. I'm in this phase where I'd really just like to have everything put away and tidy all the time. I just need slightly more storage room that what I have with just two closets in the whole apartment. The thing about being tidy is, since I spend so little time at home, being untidy could just get to so unruly, that I might as well keep tidy from the get-go. And I don't want to appear to be a pack-rat, whereas in reality I do keep things around hoping for a bigger place in the future.

I'm actually at work now, on call on a Saturday night. I should go take a nap before the ER calls with a new admission! I can't wait til tomorrow morning when I get to go home. It'll be anywhere from 10am to 12pm by the time I go home.

That's the life. I don't know how anybody does it with significant relationships in their life, especially children. It takes a lot out of person, and I could see how it can take a lot out of people in that person's life. Just ask my brothers, anyhow. Every time I see them I fade around 9pm and have to go home. And right now I'm trying to sell a car (my grandparents gave me their pimped out Cadillac as a graduation present, I'm trying to sell it to buy a new car), and Kevin ends up doing most of the leg work, even though he's out of town half of the week every week. I don't know which is worse, his schedule or mine. I'm trying not to be a cranky person.

We did manage to go to a Braves game the other night. It was fun. It's such a relaxing sport. =) I decided a few weeks back that we needed to go to this game because it was Braves 1974 hat night. Kevin, my friend Elizabeth, and I went to the game to get our '74 hats because that was the year we were born. We almost didn't get hats because they were only giving away 10,000 hats (for a 35,000 people crowd). When we arrived we went through a main gate where they had already given away their allotment, so we walked around the stadium and found one of the lesser-utilized entrances where they still had hats, so we got ours! 1974 is the year that Hank Aaron set the home run record while playing for the Braves.

Signing off!

watching time

I have not been wearing my watch for a while now, and I have been terribly unconcerned about it. Last night I dug it out of the bottom of my purse last night with the inent to put it on today. I'm still attending orientation at Emory for the start of residency, not really working just yet. That comes on July 1. When I got my watch out last night, I saw that it was three hours behind, and my first thought was, oh no! Do I need a new battery? Then I thought, how am I going to fit that chore in before I start working? Then I remembered: three weeks ago, when I last wore my watch and summarily dumped it in my purse, I was in California in the Pacific time zone!

Being on vacation has been nice. It's not that I haven't had time tables to follow, I just was able to do the things I was doing without being so tied to my watch. I like that. I use my watch to keep me on time -- yeah, that's a chore! -- and for taking pulses.

I moved into my new resting place yesterday. Moving, as always, was not fun, but it's done. Currently I am happily living among the boxes. That will most certainly last only a couple of days. By the weekend they'll need to go away. Of course that will be my job!

new

Today is the first day of the rest of my life. Everybody can say this, but today it's exceedingly true for me. I started my residency today, started with orientation. I am in Pediatrics at Emory University School of Medicine in Atlanta. Our orientation program goes for about two weeks, and I start working in the hospital as a resident physician on Tuesday, July 1.

The month of May proved fun and interesting, and flew by all too fast. I ran the half marathon then went to Bermuda on the cruise the first week of May. The second week I spent in Atlanta just hanging out. The third week was graduation week in New Jersey, and over Memorial Day weekend I was in Indy for a graduation party and the Indy 500.

The last week in May I packed up my stuff and moved to Atlanta, arriving on June 1. On June 3 I went to San Diego, CA for a few days to visit some med school friends. San Diego was nice, but it actually rained while I was there. That's kind of unusual! We saw some of the sights there, including the Gaslamp District, the Padres, Coronado Island and La Jolla, and the San Diego Zoo at Balboa Park.

I came back to Atlanta and embarked on my two weeks of not working or doing anything remotely constructive. Actually I started running again, to get ready for the Peachtree Road Race 10K on the Fourth of July. I was immediately stunted by the heat & humidity, so I've been working through that and feel pretty prepared for the race already. Aside from running, I started doing laps in the pool here at the apartment complex to get some arm exercise, and I laid out at the pool to soak up the rays whenever I could.

I am more tan now than I have ever been! Maybe I shouldn't be proud of that, but I kinda like it.

I have been staying at my brothers' apartment with the objective of finding my own place to live. It turns out that I'm probably going to stay at the condo of a friend of Kevin's which they have been unable to sell. I'll be there at least six months while they consider whether they want the place on the market or not. It's a pretty good deal for me dollar-wise, although the possibility of it being temporary is somewhat less than ideal. I gotta decide if I want to buy a place anyway. Buys me time for that.

I had my first day of orientation today at Emory. So far I am pleased with my fellow interns (we are also called first year residents, it's interchangeable). It will be a difficult three years here, but should be very educational and rewarding at the same time.

I'm a doctor now!

last week

School's over!

I spent last week at sea on a cruise to Bermuda. We cruised out of Manhattan on Sunday May 4 and returned today. I took a cruise with four classmates: TJ, Melissa, Amy, and David. It was affectionately called the class cruise, because we planned it to be for us graduates, but only five people signed up. That's okay. We had fun. I went to Bermuda before when I was 15, so it was nice to go back again.


We sailed from NYC Sunday afternoon, but that same Sunday morning before the cruise I accomplished something I have been wanting to do for a long time: I ran my first half marathon. It was at the shore in Long Branch, New Jersey. I spent the night at the shore, ran the race, then my roommate picked me up and took me to meet my friends at the ship in the city. I actually signed up for this race way back in October, and started training for it in November. So seven months went by and I was able to run this race. If you've followed my blog, I have to admit that I've knowingly been training for this race but hadn't mentioned that I was going to do it, because I wanted to be able to succeed at it. I didn't want to make a big deal about getting ready for it and then not be able to succeed, although I did go on and on about increasing my running. I apologize for this sin of omission, but Surprise! I ran a Half Marathon!


When I was injured with distal IT band tendonitis three weeks before the race I was very upset, because I wanted so much to do this race. I wanted to accomplish a half marathon before graduating medical school, and I figured out early in the year that the timing would be good in the spring, with my relatively light schedule, to be able to train. It's not something I see being able to accomplish during first year of residency, so this spring was key. It's why I was pretty aggressive with physical therapy in the last weeks before the race, and kept training anyway. Actually, I had no pain in the race and was mostly pain-free after the race except for a little knee stiffness and a couple days of sore muscles. Physical therapy is amazing. I go back tomorrow to start to learn strength training.


Then, as per usual, my car decided to not cooperate last week when I needed it to drive to the shore to do the race and then drive to meet my friends to get the boat. I ended up taking the train from Philly to the shore on Saturday. It's not a direct route, it was a 4 1/2 hour train ride up to north Jersey and then back down the shore, for which a direct trip by car is 90 miles -- how annoying. Fortunately my roommate Anne was able to work me into her travel schedule on Sunday to pick me up after the race.


So, I ran the race in 1:59:33. It was about 3 minutes faster than my training times. I ran a little faster because I could, because being in a race around a lot of other runners kind of drives you to, and because I had to finish the race in two hours to get to the train (that only runs once an hour on Sunday) to meet my roommate picking me up after the race. I met my goal of finishing the race in two hours. I ran 13.1 miles, picked up my race bag, skipped all the food and beverages (darn it!) and then I ran one more mile to the train station. Fortunately I made it with time to spare and all was well. I made it to my destination and arrived at the ship on time! The whole weekend was a logistic challenge even without my car pooping out, and could have gone very wrong if something had happened to me at the race, but things worked out to the minute.


Bermuda was beautiful! The cruising weather on the way to Bermuda (2 1/2 days) and on the way back (1 1/2 days) was less than ideal, but Bermuda's weather was perfect. Our first day on the island we explored St. George's & Tobacco Bay on the eastern tip of the island and Hamilton, the main city in the center of the island. I met a friend for dinner in Hamilton that evening, and the others explored the Harbour Night festival. My brother Kevin has a fraternity brother from college, Mike, who now lives and works in Bermuda. Mike was gracious enough to take me to dinner after work and we had a nice time catching up, and he drove me back to the boat at Dockyard on the western tip of the island. It's the UK, so they drive on the left side of the road!


The next day was our bona fide beach day. We went to beautiful, calm Horseshoe Bay. Not only great for sun and swim, but also exploring. We climbed some rocks and explored the coves and even some caves (once the tide went down!). It's a good place for tourists, especially the cruising variety, because there's bathrooms and food available there. The next day we went to two beaches, both tremendously beautiful, but it was windier and they were essentially private beaches with no food and bathrooms. It was nice to go to less well-attended spots though. We were able to get around the island via the bus and ferry system. It was extremely easy to get around.


That was it for the Bermuda days. The ship, both going and returning, was less than ideal weather-wise, given that it's the north Atlantic! There were enough interesting things to do on the ship in the meantime, and we frequented the hot tub. Also, eating is a very common pasttime on the ship! It was actually pretty amazing to go on a 7-day vacation, with a bunch of friends, and I actually found it quite refreshing to be able to go somewhere nice without getting on an airplane.


About face -- I do go on airplanes this week and next week though. I go to Atlanta this week to start to get my life in order down there. Next week my family shows up here in New Jersey for graduation, after which I go to Indy for Memorial Day race weekend! Indy 500, baby!

back on the run

I am back on the run! Not back to any significant mileage yet, but back to running, at least. I rested last week, jogged a tad on the weekend, then went to PT on Tuesday, and started running again. It's amazing what rest can do, not only for the sake of an injury but for the body as a whole. Now I understand the concept of tapering before a race. You keep running up to the race but for two weeks or so prior to a big race you cut back on mileage and effort. When you get to the race, then your body is rested, your microtears have probably healed, your energy stores are back up, and you're ready to race. Not my MO necessarily for my week off, but I felt good and energetic for my first run in a week.

PT rocks, except for one thing. I love the assisted stretching, I love the attention to my thigh and knee with ultrasound with topical antiinflammatories. I do not love "the stick." It's like a rolling pin device that they roll up and down your outer thigh to loosen up the IT band. Man, that thing hurts!!! But I guess it's gotta get a little worse before it gets better. They're teaching me some stretching. I was pretty much on the right track with stretching before I got injured, but I wasn't doing it as many repetitions or as efficiently as I could have. So it's good lessons to learn here. I'm being pretty intense about PT, going twice this week, three times next week, and one time each week after that for the rest of the time I live in NJ. After the acute phase, probably in the next two to three weeks I'll start learning about some strengthening. Apparently the muscles in the back of my legs are not nearly as strong as the muscles at the front of my legs. It's well known that strength imbalances between antagonistic muscle groups can lead to injuries, including mine. So it's something to work on.

Gonna hit the road right now, and hopefully I can go for greater than 30 minutes!

the overdidits

I over-did it. I injured myself last Sunday when I ran 15 miles. My right knee stopped working properly. Monday it was painful and locked. Stairs weren't a problem but somehow walking on a regular flat surface proved difficult. I certainly couldn't run. By Tuesday it wasn't so painful, but it was still uncomfortable and locked up most of the day. I made an appointment with the orthopaedist at school and got xrays of my right knee. Wednesday I made it to the doctor, and while I was starting to be afraid that it was the meniscus of the knee, he assured me that it probably was not. It's probably IT band syndrome, an overuse injury, although how it manifested in me is not one of the more common presentations. The IT band goes from the top of the femur (thigh bone) to the top of the tibia (below the knee), on the outside of the leg. It comes from a muscle but continues as a fibrous band. Its distal attachment is on the anterior & lateral aspect of the tibia to the outside of and slightly below the knee. These are the spots where I was having pain, and this was the side of my leg that was feeling locked. As an overuse injury, the treatment is don't run so much (ha, I've haven't run at all since then), go to physical therapy, and take some anti-inflammatories for a while. At PT they will teach me to stretch and train properly to try to avoid overuse injury in the future, now that I'm prone to it. Recently I started a stretching regimen in addition to kicking up the cross-training a notch (stationary bike & eliptical at the gym, yoga & pilates at home, on days when I wasn't running), and was feeling particularly strong. Aside from this injury, I did feel strong during my run/s last week.

While I would much rather be running right now, especially since it's gorgeous outside!, but I'm glad to go to PT. I found a physical therapist who specializes in sports medicine therapy (who my insurance will pay for!). I didn't want to go to old people PT, I wanted to go to someone who understands that I want to run and what it requires. So we'll see how it goes. I haven't done any physical activity this week until today, because today was basically the first day I felt stable on my leg (but not stable enough to run yet). Today I took my bike out for a little while, which was great. Over the weekend I'll do stretching and yoga/pilates, and maybe try a little running on a treadmill. The important thing though is to do it right and not over-do it, so I can keep doing it for a long time.

On another note, I found out today that I passed the most recent installment of my board exams. It was a clinical skills exam that I took 10 weeks ago. I had to pass it to graduate, so guess what: I'm graduating! (not that there was a question...) =)

change the subject

I recognize the need to post about something other than medical school, something other than running ... just not yet. Last weekend I ran a 15k race that was aptly named the Indian Hills 15k. It was all hills, and it wound around the countryside near the Jersey shore in central Jersey. Usually in a race you can easily describe the terrain and the race atmosphere by what happened in what mile, break it down a bit. In this race, there was a hill in every mile from two through seven. After reaching mile 8 there was a big downhill (ouch, but in different way from uphill) then it was flat til the end at mile 9.3. At the crest of the hill at mile 8 you had a view across the water of the George Washington Bridge and Manhattan. It was pretty cool.

Those were some steep hills! I'm not a good hill-runner; hills kill me on a bike too. I think I'm just not built for it. If I trained exclusively on hills (which I can't fathom, yuck), maybe I'd be halfway decent at it. What I call my hill-training run around here doesn't nearly compare to what I encountered on this run. There were four very steep hills, three of which were on gravel, and I ended up walking by the time I reached the top. The rest were rolling and fairly continuous.

I reached the start of this race late because the roads in NJ tend to be poorly marked, true to form here as I exited the Garden State Parkway. So I started out as the last runner, which was fun as I got to falsely inflate my ego by passing people along the way. But I did finally find my pace and the group keeping that same pace and we grunted up the hills together. I was happy to have finished it, although technically I didn't run the whole way due to walking on the big hills.

Today, I completed another run. I went to an organized (well, somewhat) 10-mile training run on a half marathon course at the Jersey shore. The half marathon course is marked with spray paint in the road, but I think they forgot to mark where you should go off the course to complete 10 miles instead of 13, so I got lured into the full 13 miles in search of a turn-around point somewhere. The runners were fairly spread out, it wasn't a paced event where people ran in pacing groups, and I didn't find others at my pace, so as a solitary runner I made mistakes with the course. I actually did greater than 13, though I don't know how much more, not more than two miles I'm guessing, because I initially got off-course because I zoned out and missed a turn on the spray paint. Then I got back on course and was looking for the 10-mile training run turn-around that never materialized. So I Accidentally On-Purpose ran probably 15 miles. Needless to say I'm hurting today. Driving home 1 1/2 hours afterwards did not do me any good, but after hopefully enough stretching and alternating episodes of icing and heating my sore right leg (long story, it's a new, ongoing problem I have with distance running), I can recover nicely.

One last thing - I went swing dancing at UPenn last night when some school friends. It was really fun! I am a big fan of dancing though I almost never do it anymore, in any form. I took a ballroom class in college, but that's been the extent of my partner dancing experience. Here they gave a lesson at the beginning of the evening, where you stand in a circle and learn the moves and rotate around the room, so you don't have to go with a partner. Loved it! I found though that most of my partners, not all but most, had a little bit less experience in the dance realm than I, so I helped give tips where I could. There was this one older Indian (I say Indian, but he could have been Pakistani or other origin such as that) gentleman who really knew his stuff and was really fun to dance with one or two times during the free dance portion of the evening. I think my friends had a good time too, although they all went with their significant others and so didn't dance with other people in the room except during the lesson. I had to leave early though, per usual, so I could go home and go to bed, but also to save my feet for this run I did today. My feet hurt after dancing last night (actually I think it was the walk back to my car in my sandals afterwards that did it), so I actually had to ice the bottoms of my feet last night. I've never done that before, but it did the trick. I've been having some plantar fasciitis lately, not exclusively due to running but more the combination of running and being on my feet all day in the hospital, so ice turned out to be a nice thing last night. Usually I just get off my feet at the end of the day and put my legs up on pillows. I'm a mess! But I had more fun this weekend than I have in a while, with going swing dancing last night and then running at the shore today.

hmmmmmmmmm

Hi. It's been a while. I just spent a couple of days in Atlantic City at a conference. We have this conference every year, but I think I didn't attend the last two years. This time I stayed overnight in the conference hotel, which was Bally's casino. What I didn't know (maybe I knew but had forgotten), was that my class had three hotel rooms paid for by the school. I paid for my own room, which is best for me anyway because I can't sleep in a room with a bunch of other people. Also, there was a 5k run this morning that I decided to use as my short & fast run this week, so basically my training took precedence over partying. I did go out to dinner last night with some friends who were staying in the class's hotel rooms, and I hung out with them in one of the rooms for drinks and somebody's birthday cake, until about 11:30pm when they went out to meet other people at the bars. I showed my age and lack of stamina by going to my room instead of going out, but honestly I couldn't care less. I had fun while I was out, then it was time to turn in. My friends know this about me, and also the fact that I'm not likely to stay in a room that won't be quiet with a bunch of people coming and going at all hours.

At the 5k run today I ran a personal record of 25 min, 51 sec. Neither the time nor the distance are exact, but hopefully I can rely on it somewhat. My last 5k race was 26 minutes, so if it's true, maybe I've improved a little. I've managed to increase my distance beyond 10 miles per run, but my long runs are pretty slow. I don't foresee a time where I can maintain a quick pace such as the 5k pace for a long distance. I'm okay with that, as long as my short distances end up quicker. If I could get quicker at the 10k that would be good. I'd also like to still increase my long distance mileage.

I felt a little glossed over today with cigarette smoke. I completely forgot, until my drive to Atlantic City yesterday, that the casinos are smoky. About two years ago, the state of New Jersey instituted a smoking ban, but they did not ban smoking in the casinos, because it would likely affect the business which brings in what I can imagine to be a good deal of money for the state. However, they have limited some of the areas in which people can smoke inside of the casinos. But because there are few walls between the big casino spaces, smoke from any location wafts through to all the other locations throughout the casinos. I'm proud of myself though, because even though I detest cigarette smoke and can smell it a mile away, I didn't complain too much, although I do feel poisoned by the whole thing. Fortunately the hotel rooms, if they are non-smoking, are fine.

I learned how to play craps today. At Bally's or (Wild Wild West next door) a couple afternoons a week they have an expert teach a free craps lesson. I missed the first several minutes because I thought it was next door (thankfully my friends texted me to re-direct me), so I missed some of the first basics, but I learned what I could. I rarely gamble (I don't even buy lottery tickets) but I at least wanted to see what it was about. It can be complicated. A couple friends did win money on craps today. It's actually a game that's more favorable for a player than a lot of the other games.

I did manage to attend convention lectures and workshops! In fact, I was one of only a few students who went to the talks. Most students went for the free food, the pens (i.e. the exhibition hall goodies), the gambling, and the partying!

I have three weeks and one day left of my final medical school rotation (cardiology). I'm sticking around New Jersey for the next few weeks while I'm still on rotation. Then, on May 4 I go on a 7-day cruise from Manhattan to Bermuda and back with some classmates (mostly the same people I was with last night in AC). When I return from the cruise, I'm supposed to go to Atlanta to find a place to live. I originally intended to get a place for June 1, but I might put it off until the end of June to save on a month of rent. I'll still move to Atlanta at the end of May, but I can store my stuff and stay at my brothers' and others' homes in the meantime. Then I graduate on May 21, for which my immediate family is coming to New Jersey. Then I go to Indy for a graduation party there and to go the Indy 500, both on Memorial Day weekend. Then I finally head back to New Jersey the last week of May to pack and move. I gotta drive my car and a UHaul for my move, so hopefully there will be someone to help so I'm not making two separate road trips by myself or trailing my car from the truck. Moving is always a good time to have a boyfriend. I don't have one of those so I gotta improvise. I have enough people on either end to help pack and unpack, but it's the transit in between that might present a problem. We'll see how it works out.

the gods have spoken

Last Thursday, March 20, was match day for residency. I found out that I am going back to Emory for my pediatrics residency! It will be great to go back to Atlanta.

It's somewhat bittersweet, because although it's great to go back, Emory was technically my third choice of residency. But, residency being what it is, it should be nice to be in Atlanta where I know where to look for a place to live and know how to get around, and I have many family and friends already built in.

It's funny how when I was an undergrad at Emory with my brother and my pre-med friends, they never told us about the other options in medicine that we have outside of MD's, such as DO and podiatry (I have several friends who have become podiatrists). And, Emory wouldn't give me the time of day when I was applying for medical school, both as an undergraduate and employed there as a researcher. Now, I get to be the DO that does residency at Emory! I am the only DO in my residency program.

I can't help but wonder, and feel a little off about, what I did or didn't do to not get my first choice of residency. In the grand scheme of things Atlanta is where I want to be, but I thought I had found a better fit for my interests in a residency program in Greenville, South Carolina, a place that I really liked. I can't help but wonder why I worked so hard to be able to have as many doors open to me as possible, so I could have my pick of residencies; then it turns out I get one that wasn't my number one. Makes me wonder where along the way I didn't do the right thing or didn't meet the right people to get precisely where I wanted to go. I initially felt that having all the interviews that I did meant all the doors were open. I guess I read the program wrong, that not having tangible feedback (the annoying part of this process) did me a disservice. Not to mention the fact that very few pediatric residents go anywhere other than their first choice, or at least their second. I don't know what happened for me, but at least I'm be in an academic medical center with a reputation; it could help to take me anywhere in the future, so long as I continue to apply myself.

I am thrilled for and very proud of my classmates for their residency placements. About half my class matched into DO residency programs, while about half the class matched into MD programs. It's pretty common. Geography and specialities play a big role in that, because there are areas of the country where DO residencies are sparse (e.g. the southeast), and the available DO residencies don't cover all medical disciplines in which people would like to train. There aren't even that many pediatric residencies in the DO world, ironic given our inherent philosophy of primary care, notably including pediatrics.

Soon I get to go find a place to live! But not before I go on a cruise to Bermuda in six weeks when school is over! Until then I browse Craigslist...

update - I wish it were complete!

In my last post I mentioned that I had the flu. I was sick in bed for three days, and spent a fourth day at home that week. I worked in the ER for two days afterwards (which is probably where I contracted it in the first place), and then I managed to go to Utah with my roommate Stephanie to go skiing for two days. I had a bad bronchitis at the time, which made me a fun skiing partner (I'm really kidding!). Skiing was fun, a good way to spend a winter weekend, however I am ready for warmer weather! I'll try to get some pictures up, however my computer is dead so it's a matter of finding a compatible machine at school that will read my SD card to upload photos.



This past weekend I went to Atlanta for my friend Michelle's bat mitzvah. She's 13 today, so she had her service on Saturday. It was beautiful! She did a wonderful job chanting her Torah readings, in Hebrew with all the musical inflections. She gave an insightful speech about her mitzvah project experience of performing on violin and piano for the residents at area nursing homes (much more insightful than her assigned mitzvah partner did, who spoke about her favorite tv show, Gossip Girls; you can imagine the degree of insightfulness that derived), and the rabbi who blessed her spoke of her wonderful musical talents, kung fu training, and her willingness to try anything. Michelle is an exceptional young woman, and as a bat mitzvah she has stepped over the threshold out of childhood, but I will always remember her as the infant, toddler, and child that I knew her best as when I was her first babysitter from the age of 3 months. In this day and age of girls growing up way to fast to match their sisters, mothers, and Hollywood 'role' models actions and style of dress, I believe Michelle should hold onto to her childhood just a little bit longer, to cherish the joys and gifts of childhood. There are so many years ahead of wonderful adult experiences (and some not so wonderful, but educational none the less), that the spontaneity and naivete of childhood could rightly be prolonged just a few years for her. Fortunately she is not wrapped up in society, gossip, movie stars, or the like. She is much more down to earth than most teenagers. She is quite mature for her age, and a very dedicated, focused student of academics and music alike. But childhood is a special time. I am very happy for her achievements and accomplishment. Her bat mitzvah was simply joyous.



I am *patiently* awaiting March 20 when the allopathic match results come out and I finally find out where I'm going for residency! Then I can plan the next phase of my life, i.e. finding a place to live and actually moving there! I have eight more weeks of rotations here in NJ then I will be done, done, done with medical school!



I ranked four places for residency. That means I ranked four pediatrics programs which I liked the best and could see myself going to and having the best training and residency experience. I only ranked four places although I interviewed at greater than a dozen programs. The programs at which I interviewed in turn rank everyone whom they interviewed. Both parties submit their rank list to a centralized computer system that matches up the ranks, and spits out the result. Thus, the Match. If the program which I ranked as #1 also ranks me in their top number of available spots (number of spots vary per program), then I go to that place. Where it gets fuzzy is if my number one doesn't rank me so highly, then the computer goes to my rank list to see if my number two choice ranks me in their available spots, and so on.



Of course I'm hoping for my number one choice. However if I don't end up there, I will end up subsequently somewhere in the vicinity of Atlanta, which is how I designed my residency search and interviews (mostly, but not entirely). It turns out that the four programs that I ranked are in Atlanta or in the near vicinity (a couple hours' drive). Interestingly, although I did have a somewhat widespread search even with the focus being the southeast, ultimately my choices came down to being in the circumference of Atlanta. It's what I wanted all along from the day I started medical school. I really hope it works out that I get to come back South.



I posted a while back that I was invited for an interview at Stanford University (among many other reputable places!). I have to admit that I LOVED Stanford and the Pediatrics program there. The people were great, the hospital is substantial, the surroundings are beautiful (if not a little overcrowded), I interviewed with friends from the interview trail, and I stayed with friends while there. If I ranked programs solely for the programs' sake and not for anything peripheral to the program, I would have easily ranked Stanford number 2. I mean, I really want to be the DO that goes to Stanford. I would always have Stanford in my medical pedigree, and that could go a very long way. However, in my search for residency programs, I ultimately felt like I would be going against my own grain in several ways if I went to Stanford. First, because I always saw myself going back South, I would again be isolating myself in a region of the country where I didn't have family, and my family would be unlikely to visit me there. Second, because the cost of living is rather high, and I feel it necessary to begin to earn a productive living and create a nest egg, I would be hard-pressed to accomplish this in Northern California, especially as a single person. Third, and the most minor aspect although it did weigh on me a little, is my unfortunate personal history in that part of the country, that part of the state. I didn't want to be perceived as trying to regain or win back the thing that I lost over a year ago. Now, had this process been taking place 15-18 months ago, I would be all over going to Stanford! But my life did not work out that way.



I'm happy with the places I've chosen, and hope they in turn choose me (ideally that my number one chooses me!). The programs are pretty similar, and in fact in the Southeast the Pediatrics programs are relatively on par with each other in terms of educational benefit. It's a matter of finding your personal fit with the program first and with the peripherals second. My program needs are that I fit personally into the program and it meets my style and academic needs. My peripheral needs (needs that vary person to person) are that it not be in a place where the cost of living is huge, so I can make ends meet and not live quite as sparsely as I have as a medical student; that the climate is reasonable; that it is close to family; that there are enriching community activities that I can be involved with. I can only hope for the best at this point.

outgrown

I have outgrown my room. Everything I own, with the exception of my
kitchen table & chairs, kitchen items, bike, and car, lives in this
room. I've been in this place with two roommates, who also have their
own rooms, for three years. I can't wait to find out where I'm going
to residency, and then go there and find my own place to live. I found
out March 20, and it can't come soon enough. Meanwhile I have to get
over this nasty flu so I can go skiing next weekend, and I intend to
start thinning out some my belongings so I'm not so crowded here in my
room.

my dream car

Acura TSX. A 2008 model would be nice! I'm not a big fan of these wheels shown in the picture, it's just a representation of what I would like to get for a new car.

*****Update********

I drove this car (well, a black on black model with a manual transmission), and it was sweet!

every step you take you are one step closer to the finish ...

... unless you turn around and go the other way!

I did a 5k race in Carmel today, and after, I did the overachiever thing: I finished the race and kept going. I did the race course forwards with everybody, and then did the race course two more times in the opposite direction. My 5k time in the forward direction was 27:04 (not timed after that); not too shabby, but would have been quicker if the last 0.1-0.2 miles of the race were not uphill! My mom told me this church in Carmel where the race started & finished is on the highest point of elevation in Hamilton County. They made very good use of the at elevation (trust me, this place is pretty flat, but it was one steep hill) for the very end of the race. Phew. It was a nice, sunny 35 degrees. However, I suffered a little bit after running 9 miles with a GI discomfort common to some runners. I'd never had it before and I hope to not have it again. I think I have to acclimate to these longer distances. I was feeling kinda puny all day even though I went to my friend's bridal shower today and then to dinner at her parents' house tonight.

***Update*** I finished smack in the middle! I finished 99th out of 213. There were three dogs that finished in the runners ahead of me.

Back to NJ tomorrow. Car's all better, or at least back to baseline.