Thoughts on the Long Run

I should do this later.
Hmm… legs feel good at 1 km.
Should I start taking some water now?
Is that a red light up ahead?
Yes!!! Thank goodness for traffic lights.
Wow, it’s hot.
That felt like a fast kilometer; oh, no it wasn’t.
What’s that sharp stingy feeling in my leg?
Is it time to walk yet?
Holy fuck it’s hot.
Wow. 10 more kilometers to go.
Wait, how was that only 4 km?
I should have stayed home.
This is stupid.
Why did I think I could ever finish a half marathon?
Oh look, half way!
Let’s try that gel now. I hope it’s not gross.
Ew.. that was gross.
I have to walk now.
I should stop to rest.
It’s like hell right now.
This sucks.
This is hell.
Who thought this was a good idea?
This isn’t healthy.
Only two more kilometers to go.
I can do this.
That runner ahead is fast.
Why can’t I run that fast?
I wish I could run faster, I’d be done by now.
I have to walk again.
I have to do 16 km next week.
I hope it’s not this hot.
Oh, thank god, I’m done.

The Lake Calls to Me.

Vacation starts in about an hour.

I am checking out of medicine for 19 days.

NINETEEN DAYS!!

The mental break is needed. I know it won’t be a particularly restful vacation – how is it possible with 3 children, the youngest of whom enjoys waking up at the crack of dawn?  But it will be a break from the daily grindhouse, of that I am sure.

It also means a small break from my half-marathon training.  Yes, that is going quite well, but the long runs will take a small backseat over the next two weeks or so.  I will aim to run 3-4 times a week regardless, they just won’t be more than 10k.  I worry about losing momentum but I think I have developed a good base which should carry me through.

I hope to return from the lake with a rested mind. My patients need it. I need it.

 

Revelations.

This summer marked 12 years since I became a family physician.  I have had my family practice, whereby I am primary care physician for close to a thousand patients, for the past 10 years.  I have learned a tremendous amount this past decade but over the past couple of years I have come to realize that I cannot be everything to everyone.

Let me state that again.

I cannot be everything to everyone.

In the early days of practice, I used to believe that if I couldn’t help a patient that must mean I failed them in some way.  After one patient yelled at me because I wasn’t helping them enough, I nearly broke down.  I was just back from my first maternity leave and struggling with my own post-partum depression.  To be yelled at in my own office and basically told that I was a shitty doctor, well it was the first time I came to tears while seeing a patient.  I had to excuse myself and take a breath.  Thank goodness for my colleagues present in the office that day.  After I composed myself and debriefed with one of them, I walked back into the exam room.  I listened to his concerns and formulated a plan for him.  The appointment ended.

I learned a valuable lesson that day.  I can’t fix people’s lives and while I believe that many patients don’t really expect me to, there is often an unspoken expectation that because I am a physician, I somehow have the answer to all that ails them.

Let me be perfectly clear on this….  I do not.

I can’t fix your life.

I can provide you advice, counsel and recommend options to you – all this in about 15 minutes, sometimes half an hour.  I just can’t delve into your life and pick the up the pieces for you. I can’t do that for one patient, let alone close to a thousand patients.

Having said that, I still do sometimes want to be able to be present for and participate in all aspects of a patient’s care –  to be there when their baby is born; to be there when the breast cancer is surgically removed; to be there when the chemotherapy is administered; to hold their hand as they take their last breath.

I want to do it all.  I want to be that all-encompassing physician who does it all.

But I can’t.

I need to come to terms with that.

 

To treat… or not.

My dad was diagnosed with prostate cancer on his 82nd birthday. I expected it when his PSA test started increasing. He had a biopsy.  I couldn’t attend the appointment for the results but asked my mom to make sure she found out his Gleason score. When she called me on his birthday, I heard it in her voice before she said the words.
Cancer.
It’s considered an intermediate- risk tumor.  There is no metastasis. But given his advanced age and other co-morbidities, namely the Alzheimer’s, surgery is not recommended.
At his age, hormone therapy and radiation is recommended. Without treatment, he has perhaps 10 years.  But that means the tumor will get larger, he’ll have more lower urinary tract symptoms of obstruction and likely bone pain from metastasis.   Radiation is not easy.  It involves daily trips to the hospital for weeks;  20-39 radiation visits. That’s 20-39 days that my mother has to drive him to and from hospital and pay exhorbitant fees in parking. My mom went through  radiation treatment for her own breast cancer 15 years ago. She still remembers how hard that was on her. How difficult now will this be on my dad? He asks her several times a day what the next doctor’s appointment is for. Because he forgets. How difficult will this be for my mom to take him to the hospital day in and day out,  in his already semi-frail and de-conditioned state?  Is it cruel to put him through treatment? Is it cruel not to?
After meeting with his radiation oncologist and learning about a new treatment protocol involving only 5 weekly visits for radiation therapy, it looks like we will be embarking on treatment for my dad.  He seems to understand the side effects of treatment and that it means weekly visits to the hospital.  Of course, he’ll ask many times why he’s going but that is okay for now.  Five weekly visits is going to be much easier for my mom.  If and when it gets to be too much, we’ll make a decision to stop.  But for now, he/we are going to fight this.

Let’s Talk

January 25 is Bell Let’s Talk Day.

One day a year the world comes together to help end the stigma of mental illness.

One day a year, a large corporation donates $0.05 for every tweet and hashtag that says “#BellLetsTalk” towards funding mental illness.

Meanwhile the province I live in is underfunding mental health across the board.  I can’t get a delusional/psychotic patient timely access to a psychiatrist without sending him to the ER or placing him on a Form 1 (ie involuntary 3 day hold).  I can’t get the chronically depressed and suicidal middle-aged woman a psychiatrist to follow her and manage her 3 psychotropic medications.

So yeah, let’s talk about mental illness.

Why don’t psychiatrists actually do what they are trained to do?  Why don’t they follow patients and see those that need weekly psychotherapy? Why doesn’t the Government adequately fund mental health?

How about we talk about mental illness every day of the year and not just one day?

Let’s talk.

Long Run – Week 3

I am a day late in reporting in, but Monday got away from me.

I found a funny mole on my husband’s back over the weekend so that meant I had to get him in to see the Dermatologist on Monday morning to have it removed.  Thankfully, the dermatologist didn’t think it was bad but took it off anyway.

But back to Sunday.  I finally got out for my long run in the mid-afternoon.  I headed east for the first time in forever and ran out 3.5 km and back.  7 km done! The wind was in my face on the way out and to my back on the way home and somehow I ended up with a few negative split kilometers by the end.

Overall pace was a bit faster than the last two weeks and I felt it in my legs a bit. I have to remember to try to keep these longer runs slower!

Long Run – Week 2

Yesterday’s long run almost didn’t happen.

After a wonderful evening with my best friend and her partner, after eating prime rib and Yorkshire pudding and 3.5 bottles of wine among us, I woke up Sunday morning with a slight hangover and a tummy that was not happy about all the food. I hate to get graphic but I had a very upset tummy that morning, well actually, more like in the middle of the night, reminiscent of the stomach flu but thankfully no vomiting.

Remember, hubby and I have been on a healthy eating kick.  We have small dinners of protein and veggies, no dessert and no booze.  My system clearly didn’t appreciate the high fat and alcohol all at the same time.  So Sunday morning came and I was like, “Long run? Not a chance.”

Instead we took the kids out and ended up at an aquarium store. A couple of hours later, we came home with a companion for our mama crayfish, a new aquarium for the two and a fire eel!!!!

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Mama crayfish is the red/orange one. Royal blue crayfish is her new companion.  The rainbow pebbles were chosen by our daughter. 

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We found the eel hiding under this rock a few hours after putting him in the tank. He is a bottom dweller and likes to hide.  I think his little snout sticking out is super cute.

So it was around 5:30pm when we were done setting up the homes of our new family members and I decided it was now or never to run. So I suited up and forced myself to go out. I’m so glad I did. Though it was super slow, it felt great to be back out there pounding the pavement.  I didn’t increase the distance too much, I had planned 6.7 km (10% increase from last week), but finished at 6.5 km due to general fatigue.  Still, it’s in the books and I feel good about it overall.

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Success!! 

Two months ago, I started tracking what I ate with My Fitness Pal.  My husband and I had both gained weight, or more accurately, were not losing weight, and he wanted to start eating better and exercising more to see if it would help his chronic kidney disease.  So together we decided to put an end to our big dinners and wine during the week.  We started eating more protein and veggies at dinner and minimized the carbs – ie. no pasta, no bread – and less deep fried foods.  We also stopped having dessert every night – no more Halloween chocolate, no cookies after dinner, etc.  Wine is only on Friday and Saturday night now.

After a few weeks husband started noticing a difference and with me tracking my calories and trying to adjust my macros, I started seeing subtle differences in the way my clothes fit.  He is running more during the week when the kids are at school and I am back on track with my running as well.

Now, I won’t lie, the nasty stomach flu I had over New Years’ certainly did help with the weight loss but surprisingly, the weight is staying off and well, I am pretty excited about that.

Since starting the healthy eating plan and tracking my diet, I have now lost 10 lbs.  I can’t remember the last time I was this weight – well, yes actually, it was before I got pregnant with my 3rd child.  My clothes fit better and I feel better.  We both do.

He says I don’t need to track my food intake anymore, but I can’t deny that it has become a habit for me now and the scientist in me is enjoying the process.   I can’t wait to see how the next few months shape up!

 

Monday Accountability

In an effort to blog more often I decided to make Mondays my accountability day, specifically in regards to the weekly long run. So, every Monday from now on, I will post about the long run I did the Sunday before.

Now, I am by no means a great runner but over the past two years I have seen the benefit of incorporating a weekly long run into my schedule.  One of my major goals for 2017 is to run more consistently (ideally injury free!) and maybe, just maybe run a spring half-marathon.

So yesterday was the first Sunday that I felt well enough to start the long runs again.  It was only 6 km but it was enough.  I started out slow and kept it slow – for me that’s a pace between 7:40-8:00 min/km. I was able to stick to my 1 km run: 100 m walk for most of run and only stopped to jog on the spot for a couple of traffic lights.

It was very cold, -9˚C without the wind, and with the wind, well if felt more like -15˚C. I bundled up with a balaclava, a toque and a fleece neck warmer.  I had winter running pants on underneath windbreaker track pants, a long sleeved winter running top with a short sleeve as well.  My fleece lined running jacket rounded out the outfit and I was off.

Overall it was a pretty decent run. I kept warm for the most part and the sun shining certainly helped.  I completed 6.1 km in 47:37 for an average pace of 7:43 min/km.  Not too bad for the first long run of 2017.


And best of all, the legs today feel great!

2017 – with a vengeance.

2017 came in with a vengeance, for me at least. New Years Eve day started out with my three-year-old up chucking his applesauce then spiking a fever for most of the afternoon. While the older two kids were on their way to my in-laws, it was touch and go whether the baby would be staying home and changing our NYE plans or going to my mom’s for the night. Thankfully with some Advil and Gravol, he perked up enough to be sent there for the night.

As my husband and I prepared to go to our friend’s place for the evening, I had a fleeting thought of “What if I’m the next one to get hit with the stomach flu?”  I forgot to mention that my eldest got hit with the stomach bug two days before.

The evening started out great. We brought all the fixings for a cheese fondue and it turned out great but shortly after starting to eat I felt the distinct uncomfortable rumblings in my lower stomach that signaled something wasn’t right.  Sure enough, an hour before midnight I was hugging the porcelain god and wishing I were dead.  The stomach virus that gently hit my children assaulted me with a vengeance.  Minutes after midnight I was lying in an upstairs spare bedroom shivering with chills. So much for my new year’s eve plans.

Why is it that the holidays bring on such horrible illnesses? This is the second year in a row that my family has been plagued with a stomach virus over the holidays. I myself have had more of these bouts of illness in the last 5 years than I can remember for most of my life. Is it the kids?  Are they the germ factories?

It’s downright awful.

Even after spending almost the entire day in bed yesterday and sleeping close to 14 hours I am still not 100% today and feel like I could be on the verge of intimacy with the porcelain gods again.  As I write this I’m lying in bed with three children arguing for my attention.

Time to sign off …