Category Archives: medicine

Week in Review 8.29.16 to 9.4.16

Monday: 7 miles while running around after the girls doing their tempo run.

Tuesday: 11.3 mile long run. First long run in a while, felt good to be out there!

Wednesday: 4.5 mile recovery run.

Thursday: Interval workout on the treadmill in Chicago. 2 mile warmup then 5 by (.25 at regular pace, .25 at tempo pace, .25 at interval pace, .25 at recovery pace) and 2 mile cooldown for 8 miles. Legs after.

Friday: Step 2 Clinical Skills Board, so I took this as a scheduled off day. 7 miles prorated.

Saturday: 7 miles easy on the Essex Invitational Course. A few sprints across the course to cheer.

Sunday: 8 miles on the rail trail in Cambridge.

Total Miles: 52.8

Total August Miles: 176

Happy with the way this week went and enjoying the slight increase in flexibility offered by the 9 day schedule. I knew I had to travel (back) to Chicago to take my last set of Boards on Friday (yay!!!!) and had the option of doing my interval workout on Thursday or Saturday. Since Race Days are always crazy and I feel strongly that the team should get 100% of me, I opted to do it on Thursday on slightly less recovered legs. Totally the right choice!

One of the things I’m currently working through is what shape I want my running to take this fall. I had initially had a thought that I’d start working towards a winter marathon but I’m starting to back track on that. Residency applications are due this week and this fall will be full of travel for interviews. Although I am happy to run in lots of places, it might not be the best set up for a good performance when I’m trying to balance all of that. On top of that, this will (sob) be my last year coaching and honestly, I’m happiest when I can give all my attention to coaching and not be distracted by my own running. I’ll keep chewing on this over the next few weeks but stay tuned!

Week in Review 8.1.16 to 8.7.16

When your Sunday run starts at 5000 feet, your legs are gonna burn...

Where my run on Sunday started. 

July Stats: 174 miles, 1 race (for which I still haven’t written a Race Report…)

Monday: 6 miles easy bright and early. Well, not bright because it was pitch black but certainly early.

Tuesday: 8 miles early.

Wednesday: In the OR until almost 10 so no run for me.

Thursday: 7 miles on the French Broad Greenway. Nice break from the hills and it wasn’t even hot.

Friday: My first real failed adventure. Headed to Warren Wilson College to run the trails but clearly didn’t get connected to the right trail network because I ended up doing 3 miles on deer paths until I gave up.

Saturday: 7.5 miles including Riverside Cemetery. Odd to run in a cemetery but Asheville maintains it as a park.

Sunday: 3 miles up Mount Pisgah.

Clouds caught on the top.

Clouds caught on the top.

Total Miles: 34.5

Not the best training week. I got off my schedule of running in the morning early and then had a couple late nights in the OR and a misfire on an adventure run. It’s tough to get workouts in here because I’m running in the dark and there aren’t a lot of flat options for interval work so I’m going to go with intervals and hills for the next two weeks and regroup once I get back to Vermont. I did decide that I’ll be switching to a 9 day cycle for my upcoming races and am excited to share what that will look like soon!

Not running related, but a beautiful piece that captures a huge amount of what I see and feel on a daily basis. It both captures what draws me to surgery and what sometimes brings me to tears after the immediacy of a situation is handled. I run for many, many reasons but finding a way to process stories like that is one of the big ones.

Looking towards Tennessee from the observation deck at ~5900 feet.

Looking towards Tennessee from the observation deck at ~5900 feet.

 

Week in Review 6.20.16 to 6.26.16

Finally, a solid week of training!!

Monday: 7.2 miles around my new neighborhood in blistering heat.

Tuesday: Back in Vermont. Didn’t have an inhaler so kind of a fake workout. Did 7 minutes at tempo pace then a mile of striders on the track. 8.5 total.

Wednesday: 8 miles at Palos Woods. What an incredible place to run!

Thursday: 11.5 miles on the Cal-Sag trail.

Friday: 10 by (1 minute hard, 1 minute easy) for a total of 9.25 miles. Focused and strong for all the hard sections. Really happy with how this went. Legs after.

Saturday: 7.1 super hot miles around the neighborhood.

Sunday: 10 miles at Palos Woods. Didn’t mean to do that much but got a little lost on the back loop. Much needed after a really rough night in the House of God. 

Total Miles: 61.6

Really happy with this week of training, especially since it was a big transition week for me in a new place on a new rotation. The running options in Chicago are amazing and I’m grateful for it because the rotation is definitely one that requires some…decompression. I also have my full schedule for the next three weeks so was able to plan all my training out. Such a luxury!

I start the coming week off with 5 by tempo miles on the Prairie Path tomorrow then speed later in the week and a long run next Saturday. I’m toying with jumping in a 4th of July 5K as well just to shake things up and check my fitness going into the half.

Never A Dull Moment

The fourth year of medical school is a magical time. After three years of almost no control over our schedules, fourth year arrives and for 365 short days, the world is ours. Our requirements are more like guidelines and what we do with our time is dictated by our interests, our passions and our level of motivation to get things organized. For me, building a strong foundation for residency is a priority. This means that over the next year, I’ll be challenging myself to build skills in and out of the OR and getting out of my comfort zone while I’m still buffered by the title of student doctor. I didn’t intend to include getting out of Burlington as part of getting out of my comfort zone but as it turns out, it’s important to “audition” at programs where you think you might want to be for the next 4 to 7 years. As such, I’ll be a wandering runner for the next 8 weeks (and again in January)…

In mid June, I’m off to the Windy City for four weeks of Emergency Medicine. I’ve never been to Chicago besides stopping through the airport but am excited to run along Lake Michigan and closer to where I’ll be working, along the John Husar Canal Trail. Because it’s an Emergency Medicine elective, it’s shifted work so I should have plenty of time to get good training in and am excited to work on my summer base in a new place.

In mid July, I’m headed up…to 2000 feet in Asheville, North Carolina for an elective in Acute Care Surgery. I am beyond excited for this opportunity as it is a brand new residency program and may well be where I land for the next 5 years. Running will be more difficult to fit in here around the OR schedule but I’m hoping to enjoy the trails around Asheville (and hopefully even Boone) on my days off.

Despite the fact that it takes a huge amount of logistical energy to pull this off, I’m so excited to check out programs in new places and get the opportunity to run on some of the most beautiful bike paths, trails and roads that the US has to offer.

Race Report: Plattsburgh Half Marathon 2016

Short Version: 2nd Woman, 1:26:44. Got to hang out with the Skechers crew and had a BLAST at the Expo and post-race party.

Doing our best Kara at the post-race party.

Doing our best Kara at the post-race party.

Long Version: 

I went into this race with relatively low expectations. I’ve been lucky to run consistently this Spring but as I remarked in my recent post on this cycle’s inventory, I have been low mileage (for me) and only doing maintenance workouts. On top of this, I did a lot of driving (and not a lot of sleeping) going into this race.

The morning started in an entertaining fashion. As I pulled up to the Ferry Dock to cross the lake, the 6:30 ferry was pulling away. Plattsburgh is actually only about 6 miles from my house but there’s a big lake in the middle with no local bridge so you have to take a ferry to get there. I texted Dave to tell him I might be cutting it close and he responded “Ha! I’m on the ferry that just left you!!” Needless to say, I had to wait for the 6:45 ferry and decided to change into my racing flats (GoMeb Speed 3) and take my inhaler on the boat. As it turned out, I arrived by 7:15, found a porto-potty on my way to the Rec Center and found Erin Lopez for our warmup all by 7:30. We did 20 minutes of easy jogging then stripped down and headed for the start. It was PERFECT racing weather at 40 degrees and overcast. I wish I’d been in amazing shape because it was a PR day for sure.

At the start line, Erin and I had to get a little aggressive to get a spot as a few misplaced souls found themselves on the line. We did a strider, got our spot and we were off. Although we’d both planned to run around 1:25, Erin took off from the start and I opted to hang back and stay comfortable for me. Erin went on to win overall AND post a new PR!! We made our way around the Oval and I was happy to find that I felt smooth and effortless. I only had a stopwatch on but when we went through what I presume to be mile 1 based on the Garmins beeping around me, my watch said 6:15 pace. I put the brakes on a bit here because optimism is great, but I doubted that I was in 1:22 shape. At around 10 minutes in, we went by the mile 1 marker. Two and a half minutes later, we went by the 2 mile marker. So much for using my watch to track splits. As such, I have almost no data points from the race other than that my first mile was a 6:15 and I finished in 1:26. Since it was obvious that I couldn’t rely on mile markers, I just ran on effort through the first half of the race and was happy to feel like my effort was about 7/10. I crossed the halfway point around 41 minutes. We would later learn that it was not exactly halfway but the 10K instead…

During the second half, the turns began. Although it made it hard to hold momentum, I was in a bit of a funk at this point and appreciated the opportunity to refocus every few hundred meters as we turned. I was running alone and had quite the pity party between 7 and 9, cranky that I felt like I could hold my pace all day but couldn’t click up as I’d planned. I was also cranky that the mile markers were 100% unreliable. I had no idea if I was running 6:15 pace or 7:15 pace or if I was at mile 7 or mile 8.5.

At mile 10, we went over a little bridge and into a 2 mile flat neighborhood loop. I was able to click up in effort for a few minutes but by mile 11, felt like I was running out of fitness and found myself back at tempo effort. Mile 12 was an insidious uphill and I was just ready to return to the Oval and finish. Mile 13 is around the Oval and taunts you, as you can see the finish but you’re minutes away. I just tried to finish strong but really didn’t have much in the way of gears.

As it turns out, the race course had to undergo some changes and 13.1 miles came…a bit before the finish line did. According to one of the local ladies who runs for Skechers as well, it is actually in the middle of the final turn before the straightaway where we finished, so probably over a quarter mile long. I’m not sure why they couldn’t have adjusted the start or the finish since it was on an oval, but regardless, it’s questionable how far we actually ran. The first and second half splits are hysterical too; all of us had 4 minute “positive” splits since the second half was more like 7 miles.

The 1-2 punch!

The 1-2 punch!

Despite some course snafus, it’s actually an awesome course that I would readily race again. It has a nice combination of flats, small hills, and some cruising downhills, it winds through a lot of Plattsburgh and had great course support for a small race on Sunday morning. The weather was also PERFECTION. The vibe before and after the race was fun too; people who just enjoy running and community events. If it gets re-certified, I would definitely consider going back to aim for a PR since it’s my kind of course.

Now that I’ve had time to reflect a bit, I find myself slightly frustrated with my race. It was one of my slowest half marathons ever (1:33, 1:29, 1:28 all come to mind as slower…). The logical part of my brain knows that it’s great that I got a 13+ mile effort in and that it wasn’t a race I could expect to knock out of the park. The emotional part of my brain is frustrated that I feel so…flat right now. I feel like I have one gear and although I know that I haven’t done workouts to develop my other gears lately, I have an illogical fear that this is just the beginning of slowing down as I hid my mid 30s.

You Can Have It All

You can have it all, just not at once. 

I’ve been in a hurry since conception. I arrived on a warm September day when I was supposed to arrive in late November and besides needing some time under the bili lights, I was surprisingly healthy for a preemie. Thanks to my September birthday, I went to kindergarten when I was 4. When I was 7, I wanted to go to sleepaway camp even though you had to be 8, so somehow convinced my parents and the camp director to let me go. It’s practically in my DNA to want everything all at once and I generally do a good job of juggling 100 priorities at once.

The process of scheduling my fourth year, however, is challenging this lifelong balancing act. Without going into the specifics, trying to schedule audition rotations, interview months, study for another set of boards and prepare to move our entire life plus attempt to continue to train and coach plus maintain a marriage and friendships is almost paralyzing. Unlike the first three years where UVM is essentially the only institution with whom we have to coordinate, fourth year requires coordination with 30+ programs who all run on their own schedules and time frames. This process is not one to half ass; what you choose for a specialty and where you choose to train is arguably a bigger life choice than choosing a spouse and significantly more difficult to dissolve if you make the wrong choice.

Over the past few weeks, I’ve worked myself into my share of tizzies over how to make this all work. I love medicine and feel so honored to have the opportunity to work with patients every day but I also love running, coaching my garden and my family. The thought of not having time to train or at least run regularly is unfathomable to me after almost ten years of consistent mileage and running. Not coaching my “girls” this fall isn’t an option. Will and I would also like to expand our family in the future, which raises a whole other host of issues in a field that is still not particularly welcoming to pregnant or parenting women.

Although this isn’t particularly running related although thinking about giving up high level running is part of my stress, this is certainly what’s kicking around in my head while I’m running lately.

What are you worrying about while you run lately? How have you achieved work-life-running balance?

Walk It Out

Screenshot_2016-01-31-16-35-54

I’ve never been one to wear a pedometer; after all, I run almost every day and never have trouble getting to 10,000 steps. I was curious, however, just how much I move on a daily basis while I’m in the hospital. My phone comes with a built in pedometer (S Health, for those on Android) that I don’t have to think about so I turned it on a couple of weeks ago. What I learned is pretty interesting. On any given day, I get about 2000 steps in during the first hour of my day. Between walking to the hospital and rounds, I get the day off right with lots of motion. Then my day diverges depending on the plan for the day. If I have clinic, I end the day around 5000 steps. If I’m in the OR, however, I end up at least near 10,000 and sometimes higher. My highest last week was 13,561 steps!

What I’ve learned from my little experiment is that especially after OR days, doing a workout and expecting a good result is ridiculous. 10,000 steps is something like 6 miles walked on top of my regular run and isn’t a good setup for a speed workout. I was also interested, however, to see how few steps I take during clinic even though I feel fairly active because I’m up and down a lot to see patients.

Do you use a pedometer? How active is your daily life?

 

Paddle Your Own Canoe

paddlecanoe

There are plenty of things about being a third year medical student that are hard. You’re never entirely sure of your responsibilities, you’re almost always in the way and most of the time, you get your feet on the ground just to switch services again. It is the definition of in flux. Despite this, third year is also the time when you are supposed to pick your specialty. Picking your specialty is somewhat like picking a spouse. In fact for some people, their specialty will last longer than their spouse.

For whatever it says about me, classmates who don’t know me particularly well always assumed I would do Surgery. I wasn’t so convinced; after all, it’s a notoriously difficult residency and lifestyle and I like my dogs, my husband and my running. I loved my OBGyn clerkship and was fairly convinced that was the way to go for me. Until General Surgery. I absolutely fell head over heels in love with Surgery, not unlike falling in love with your spouse. As Abbey once said, when you know you know. As soon as I admitted it to Will and to my closest friends (and switched my Advisor and my entire 4th year schedule…), I just felt at peace. I was excited again about the next phase, invigorated by the challenge of tinkering with the human body.

As word spread, however, that I ditched OB to General Surgery (we get a little cliquey about such things), I started to get reactions from friends that included, “Well, do anesthesia before you really commit” and “Are you sure? Don’t you want kids?” As sure and as happy as I was (and am), doubt started to creep in.

While I was walking the dogs late this afternoon, I realized that choosing General Surgery as a 30 something female is par for the course for me. I’ve never been one for the easy path. I’ve never been one who avoids an experience because it might be arduous or difficult. People ask me the same thing about marathons/my running life: “Aren’t they hard?” or “I could NEVER run that many miles.” Ultimately what works for me (and ignites the spark in me) doesn’t have to work for everyone else. I love running and I embrace the challenges and disappointments that come with it. Some days it’s easy and I don’t have to think before heading out the door and some days it takes sheer force of will to get out there. But it’s always worth it. I am approaching General Surgery in the same way. I know it is an exhausting road, but I can tolerate exhaustion if it’s something I’m passionate about. That is a lesson gleaned from life as a long distance runner…

Paddle your own canoe. 

 

How Many Things Do You Want to Be Good At?

My experience in medical school is generally on the periphery of this blog, in part because it’s a blog about running and in part because I like having a section of my life that isn’t consumed by medicine and the torture that is becoming a doctor. That last statement is a bit tongue in cheek, especially over the past year. Anyone who was around me during the first year of medical school knows that I was miserable. I love people and being around patients and getting ripped away from the real world to study biochemistry was painful. Last night, however, as I was walking out of the hospital some 13 hours after I walked in, I found myself almost bouncing home and realized whoa, I am in love with my job. That’s not to say that I didn’t come home and almost cry when I realized I had 10 hours of work to do but only 9 hours til my alarm went off again and a strong desire to get a little sleep, but in general, what I get to do every day is fucking incredible.

In that vein, this week has been nuts. Will is back in Connecticut so I’m on my own with the dogs, the house and everything that goes into being a 32 year old with a life outside the hospital. Despite the fact that my alarm went off at 3:45 every morning this week, I still found myself running out of time to get my full planned run in and was so frustrated with myself on Wednesday when my planned 8 mile workout turned into a 4 mile workout. By the time I got home, I had convinced myself that I could never do a surgical residency because my house would be messy and I wouldn’t be able to get my runs in and would never see my family. Then I opened the door and the dogs were there, as happy as ever to see me and Joe made dinner (best friend ever) so I could get the 4 miles in and I just took.a.breath.

After I calmed down, we were talking about the limits of what you can be good at at one time. This topic is actually a big source of conflict for Will and I because it is one of the few areas in which we view the world entirely differently. I throw myself into things and my brain never shuts off, even when a commitment is done. Will walks out of the hospital and switches gears, leaving work at work until he goes back the next day. When he’s running, he’s running. When he’s watching tv, he’s just watching tv. In contrast, if I happen to be sitting on the couch, I’m practicing suturing, answering coaching emails, looking up articles for my next great research paper and thinking through all the unsolved questions of my day.

I don’t know which approach is best (probably somewhere between the two), but I do know that it’s definitely a place where I need to improve going forward. I will have plenty of time to be a runner; in fact, surgery ends in three weeks and I start a rotation with more time to train. I will get more time back to help coach the Nordic team. I will get a moment to call my mom.

The running related piece of this is that for the next few weeks, I’ve accepted that what I have time for is what I have time for and am working on being fully grateful for whatever that looks like. I’m so excited for some outdoor runs this weekend (even if the weather forecast is for rain, which will make our snowy sidewalks a mess). I’m grateful that I was able to run every day this week.

Week in Review 12/14/15 to 12/20/15

Monday: 3.7 mile run plus 300 abs. All done by 5:30 am!

Tuesday: 6.3 mile with 2K at tempo effort on the New Years Day 5K course. Rainy but felt pretty good to move fast-ish.

Wednesday: 5.2 mile with the dogs plus a tryout of a new circuit. Accidentally did 3 times through each rather than two. Wouldn’t recommend that!! Definitely want to add the Bridge with Chest Press and Woodchop to my regular routines.

Thursday: 5.5 mile run home from dropping Justin’s truck off.

Friday: 4.3 mile run with striders in the Sheraton Parking lot.

Saturday: Off day. Ran errands and finished Christmas shopping with Will. Total abs at night.

Sunday: It snowed!!!!!! 10.8 mile long run with some dicey footing, but otherwise a lovely run. Arms after.

Total Miles: 35.8

Not a bad week! I wish I’d gotten in a little more running but felt like it was better to have all my Christmas errands done so that I can just rest and relax this week. Decided to run the RunVermont First Run again this year and hoping for a fast time! I also talked Will into joining me, so I’m excited to have a chance to run together.

Francesca shared this with me after my post on strength training and I’m passing it on because I had no idea this website existed. There are hundreds of workouts to try on there and I like that they are adaptable for different levels. I’m definitely going to be trying the Sprinter one and the Ironclad abs. 

We’re on vacation this week (yayyyyyyy) so I’ll have a little more time to run. It will be hard to resist the urge to run 70 miles because I can but I know that’s a recipe for injury. Instead, I’ll be aiming for about 50 with 1 to 2 workouts and a long run plus lots of new strength routine trials.