Category Archives: medicine

Week in Review: 3.6.17 to 3.12.17

Monday: I didn’t have high expectations for this run. I’d been sick and expected to basically survive this. Instead, I had a darn good run! Warmed up then 2 by 2 mile at tempo pace on the track. First set was 6:32 pace, second set was 6:23 pace. Both felt totally in control.

Tuesday: Surgery Day. Didn’t do much besides sleep in the OR, sleep in PACU and sleep on my couch.

Wednesday: Back to class. Short walk with the dogs.

Thursday: Light arm lift with resistance band workout from here.

Friday: Hour walk in the woods with the dogs.

Saturday: 20 minute uphill (10% grade) walk on the treadmill and at-home Barre routine from here. 

Sunday: 20 minute jog on treadmill. Light arms and legs.

Total Miles: 10.3

I had no expectations that this week would be a big one for running. My hope was that I could get a little physical activity in for sanity and heal up so I can get back running soon. I attempted to run on Saturday but a few steps in, knew that it was too soon and settled for an uphill treadmill walk. Today, I was able to do an easy jog.

My restrictions are 1) no strenuous activity and 2) no lifting anything heavier than a milk carton. The latter is pretty objective, the former not so much. What is strenuous? For me, a jog isn’t technically strenuous but perhaps it is on a new scar. I chose (and this is NOT medical advice) to let pain or discomfort be my guide. If anything felt off, I had to stop doing it. I’ll continue that plan through this week. Suffice to say that New Bedford looks to be out of the question. I’m adding some other local races, however, in hopes that I’ll heal quickly enough for those.

There have been two major upsides from this week, however, besides the obvious of a safe, successful surgery. The first is that since I haven’t been running, I’ve had a ton of time to deal with my to-do list. I’m psyched to say that today, I finished a first draft of my manuscript and that by Tuesday at noon, my goal is to have a completely.empty.to do list. Can you imagine?!?

The second upside is that I’ve had to be creative about lifting options and came across some really fun (but really hard) low weight ones. If you think you’re in shape, I encourage you to try to resistance band one. In full disclosure, there was no way I could do 100 of the lying pullovers. I did 50 and literally couldn’t do another one.

The other exciting news for the week is that it’s MATCH WEEK!!!! Tomorrow at 11 am, we find out if we matched via a cryptic email that just says yes or no. On Friday at noon, we have a big ceremony at school (as do all 4th year medical students) where we open envelopes and find out where we’ll be going for Residency. I think I’ll breathe a sign of relief tomorrow at 11 but I have a feeling it’s going to be a long week.

Week in Review: 2.27.17 to 3.5.17

Monday: 10 K of skate skiing at the second part of the State Championships. Kids did AWESOME. Boys ended up third overall and girls were second. Such a fun day and an amazing end (sob) to my coaching career (for now).

Tuesday: Back to reality. 4.5 mile run before work. Legs totally exhausted from skiing. 300 abs at night.

Wednesday: 7 mile fartlek workout with 5 by 30 second hills hard then 4 by 2 minutes at tempo pace.

Thursday: The post call day that just wasn’t. Didn’t leave the hospital until 5 pm and then had to pretend to study for my national shelf exam that was happening Friday morning.

Friday: The niggle of a cold on Thursday turned into a full-blown cold by Friday morning and it.was.gross. I brought a roll of toilet paper to my exam and apologized profusely to my classmates for the 2.5 hours of sneezing, sniffling and nose blowing. 5 miles on the trails behind my house, however, between components of the exam.

Saturday: Down for the count. Couldn’t breathe, think or move. Since Will is gone for the next month, we attempted to have a nice day together but all I could manage was a coffee shop and then sneezing my way through the rest of our errands.

Sunday: Still sick but decided to move (slowly) to try to feel better. 5 miles on the trails again. Didn’t feel great but didn’t feel awful and I’m glad I got out there. Arms afterward.

Total Miles: 27.2

Total February Miles: 137

I am the poster child for burning the candle at both ends right now. I had a few threats of sickness over the past few weeks but was lucky and never fully crashed until Thursday, just in time for my first full weekend off in a while. Compounding this is the fact that tomorrow (Monday) will be my last run for a week because of my Tuesday morning surgery. As I said to Erin Lopez yesterday, this winter has been a total bust for training and only some of it has been in my control. I’m obviously going to play it by ear this week and let pain be my guide but my hope is to be doing light cardio by Thursday with hopes that I can be back to running for next Monday. After that, it’s scramble as best as I can until Unplugged and hope for the best!

Week in Review 1.23.17 to 1.29.17

Monday am: Thanks to odd January weather, actually made it to the outdoor track for 5 by 800 at interval pace. Enormously humbling to be struggling along just a bit faster than what I consider my usual tempo pace but felt great to get it done. Legs after.

Monday pm: 45 minute skate ski with the team.

Tuesday: 4.7 mile run in the snow/sleet/ice storm. Stayed upright, which is all a girl can ask for.

Wednesday: 5.65 miles while the car was getting inspected. Sidewalks still a little hairy but trail shoes did the trick. Skied with the team in the afternoon, probably 20 minutes or so of real skiing and a lot of coach standing.

Thursday: No run. Had I known how busy the end of the week would get, I would have run on Thursday instead of taking it as a scheduled rest day but I was trying to be good. I downhill skied all day and the conditions were INCREDIBLE.

Friday: 7 mile progression run on the treadmill. Massage in the afternoon.

Saturday: All of the activities day. 3 mile recovery run, 30 minutes of nordic skiing plus coaching then 5 hours of downhill skiing then three rounds of bowling.

Sunday: Got slammed by my schedule (and my own bad planning) and didn’t get any run in, let alone my long run. Disappointed but trying to view my accessory activities as deposits into the fitness bank.

Total Miles: 33.1

The good? I got two solid workouts in, lifted a lot and got a massage which did wonders for my glutes, hamstrings and back. The not so good? I didn’t do a good job managing my schedule and messed up my long run. My senior research abstract is due on Friday and I’m still scrambling to review charts. Interview season and HIPAA made it impossible to do this project on the road so I’ve been working hard to get through it since my travel wrapped up.

I still didn’t manage to get 20 minutes of yoga in this week, which is more a reflection of my prioritization than schedule. I need to make this investment, period. My DQS was > 15 on 5/7 days and even the days it wasn’t, I was making good food choices. Planning meals on Sunday makes a huge difference for me and surrounding myself with good choices for fueling makes it easy to get to 15.

This week brings my LAST interview. Wahooo!!! I’m headed to the Windy City where I’ll get my long run in on Friday, hopefully along the Lakefront Trail if there’s not too much snow. Will has shoulder surgery on Thursday and will be out of commission for 12 weeks so I’ll also be trying to pick up more of our household stuff that he usually manages. Finally, this is my last weekend before I go back on service on Monday for my Medicine Acting Internship. My AI will be a great test for my workout plan during Residency and my goal is to just get my workouts in (including that long run!!) and be at least at 40 miles a week. Everything else is gravy!

Goals for 2017

The only guarantee in 2017 for me is change. In March, I’ll find out where I matched. In May, I’ll move and graduate. In mid-June, I become a surgical intern. As I’ve been ruminating on goals for 2017, one of the biggest challenges is that I don’t know exactly what my life will look like and past June, I don’t know what my call schedule will be which makes planning races or training difficult. Thus, my biggest goal for early 2017 is to lay down the habits that will allow me to continue to train during Residency. My secondary goal is to build a foundation to chase the Trials Standard for the 2020 Olympics and continue to represent Skechers Performance at local, regional and national races.

To do this, I’ve had to think about what works for me in terms of training, what is a reasonable training load that will allow me to race well AND be sane and what I’ve continued to struggle with during the past few years. I don’t know the specifics of any program yet but I do know that I can plan on working 80 hours a week with approximately one day off a week.

  1. 40 to 45 miles a week. Such a bitter pill to swallow but I have to be realistic about what I can really get in throughout the year. At this point, my plan is to do 30 minutes on most mornings with an early wakeup two days a week for an interval effort and a steady state effort plus a long run on my off day. This obviously won’t prepare me for a marathon length event but should allow me to do a half marathon or shorter with minimal notice. It will also let me scale up to the marathon once I have my schedule.
  2. Daily strength training or core. One of the things that I’ve been reminded of during my run break is that I feel so much better when I’m doing strength training and core on a regular basis. Although I am well aware of the benefits of strength training, I always struggle to fit this “extra” in. To better do this, I’ll plan to do my strength or core work at the end of the day. It’s so tempting to hammer through my to-do list but I need to make strength a real priority and setting a time for it both eliminates the need to get up at 3:30 am every day and gives me a mental break at the end of the work day.
  3. Diet Quality Score > 15. Despite my best efforts, interview season continues to wreck havoc on my nutrition. When I have a choice, I’m making high DQS choices but on interview days, all bets are off. There will be plenty of temptation to eat quick, easy food but residency is just as much of an endurance sport as running and fueling with good food will make both running and learning to be a surgeon a little less painful.
  4. Flexibility. Trying this one again! Yoga practice at least once a week, both to center my mind and work on my ever worsening flexibility. Daily foam rolling routine (8 passes over each major muscle group) to follow my daily strength/core.
  5. Morning runs!! The only constant for me is that if my run doesn’t happen in the morning, the likelihood that something comes up skyrockets. When I come back to running on Monday, my first order of business is to get my run done. My hope is that by June, it’s such a a habit that I don’t think anything of it.

As I always tell my girls, it’s one thing to set goals. It’s another to figure out the processes that set you up for success in reaching them. I’m highly motivated by checklists so I’m going to make a weekly checklist that sits on my bulletin board and includes all of these items as checkmarks. I also went back to a paper weekly/monthly planner for 2017 (I need the broad overview to feel in control) and will write in my daily workout as well as my week goal on the week page. Finally, I’m putting a bulleted version of this goal list on my bathroom mirror and on my desk.

What are your goals for 2017? How are you setting yourself up to meet them?

It Ain’t About How Hard You Hit (Olympic Trials 2020)

It ain’t about how hard you can hit, it’s about how hard you can get hit and keep moving forward, how much you can take and keep moving forward. That’s how winning is done. 

I’ve talked about it here before although not in great detail, but Philly 2015 and my failure to make the Olympic Trials or even break 1:20 did significant damage to my running soul. I’m still not sure I’ve recovered as evidenced by my lack of…caring during races but I’m starting to feel a bit more life since the 2020 Standards were released this past weekend. The full standard will be 2:45 and opens September 1, 2017, which is what it was relaxed to at the end of the window this past year. The half standard was lowered to 1:13 and doesn’t open til 2018. Aka, I’ll be going for the full standard.

When I asked Will on Sunday if I had a chance, he didn’t miss a beat and said, “without a doubt.” He’s generally pretty honest, so I allowed myself a little hope and even decided that I’ll run the New Bedford Half Marathon this spring as part of an extended build-up. My goal isn’t to PR but to start getting some long distance specificity back. I can’t pick a goal race or even a window yet until I know 1) where I’m doing residency and 2) what my schedule looks like for PGY 1 and 2 but I’m officially putting it out there as a big, scary goal.

Sometimes I forget how far I’ve come in the marathon amidst some disappointments, but here’s my trajectory AND what I’ll need to qualify.

  • City of Oaks 2008 3:17:35 (7:32)
  • Rock’nRoll 2009 Las Vegas 3:15:51 (7:28)
  • Boston Marathon 2011 3:11:18 (7:18)
  • Vermont City Marathon 2012 3:05:33 (7:04)
  • Vermont City Marathon 2013 2:58:28 (6:48)
  • Mohawk Hudson River Marathon 2014 2:54:38 (6:39)
  • Olympic Trials 2020 Standard 2:45 (6:17)

6 marathons, 23 minutes off and a drop in pace of 57 seconds. For a 2:44:30, I’ll need to drop 10 more minutes and 23 seconds per mile. It seems wholly insurmountable now, but we all have to start somewhere, right? I don’t anticipate doing it all in one bite; it seems more realistic to aim to get under 2:50 first and then take the final stab after that.

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.