Saturday, September 29, 2007

Accidental bits of wit and wisdom

Today brought to you by the weird podiatry student (wps) on our medicine team that didn't have the common sense to put his phone on vibrate when we were on rounds/in conference/with patients.

wps: Do you like country music?

me: No, not particularly

wps: Oh... well what kind of music do you listen to?

me: I listen to pretty mellow stuff. Like Jack Johnson, Norah Jones, Nick Drake, Elliot Smith, Ben Folds, Josh Rouse...

wps: Oh, like Easy Listening?

I died a little inside

Am I that old already??

More randomness and a product review

First, a product review.

I always thought a tire was a tire. I bought cheap ones and used them until flats were a common feature of my rides. Then this year I thought I would be racing on my clinchers. So I went out an bought a really nice set of tires. And I will NEVER go back. I picked up my Michelin Pro2Race tires in March. I rode the same set of tires until this morning when I get my new set in the mail. I don't count miles, but lets say the mileage on those babies is measured in the 1000's. Including a lot of miles on my trainer. In all those miles, I got a total of 1 flat. And it wasn't a puncture. It was a result of me running into a pothole that even Clevelanders would consider massive. Any bigger and there would have been 48 hour live coverage on CNN of the poor little tri-girl stuck down a hole. Last week went I went on my ride I checked out my tires first, since I was going out by myself for a very long ride. What I saw concerned me more than a little. The tires were D-One done. Many slashes and a lot of rear heat damage starting to show from my trainer hours. I thought there was no way I was going to make it through the ride. But alas, no worries. And when I took them off today, they were totally clean on the inside. None of the gashes were full thickness. They have also been shown to be among the fastest clincher tires on the market, and they ride like a dream. They grip the road really, really well in the rain and are smooth like silk. And no, I'm not sponsored by Michelin (I wish- those suckers are expensive!)

On to randomness...

Went to the pool this morning. The plan was swimming in the morning with Lanny and a ride in the afternoon with whoever in the gang wanted to go. We got there this morning and had the entire pool to ourselves. A 9 lane olympic sized pool (the above pic is actually our pool). SWEET! So we started our set. I am totally unconditioned for swimming, so Lanny was nice enough to lead the sets. Soon more people showed up. And then at 7 we were invaded by the munchkins. It's bad enough when you feel out of shape and have to deal with a clock staring you in the face. But it's just too much to be passed like you're standing still by an 8 year old half pint doing the one armed breaststroke with a pull buoy. These kids are seriously fast.

Another random note... Any bloggers out there wonder sometimes who exactly is reading their blogs? I used to have a nice anonymous blog. About 5 months ago, I became Googleable. Not sure how I feel about that.... Thankfully there are very few people in this world that can successfully spell my full name correctly. So I guess I can keep a small amount of anonymity...

Ok, off to get ready to ride! I love days off!

Friday, September 28, 2007

Randomness.... and I'm tired!

- Only one week into inpatient internal medicine and I am so tired! I feel like I've been thrust from one TV show to another. Surgery was Grey's anatomy with interpersonal drama and dying patients, and now I'm in an episode of House. No, my attending isn't a crazy nutjob hooked on painkillers like in the show (she is actually a total sweetheart), but my patients are complete medical mysteries. Maybe I should take a cue from the show and start ordering rabies tests on my patients. Keeps me on my toes, though, and I'm learning a ton. It's hard not to learn a lot when you start at the level of comprehension and available medical knowledge that I have. Scary sometimes to think I'll have MD behind my name in 20 months. Yikes!

- Sad news... I put Mike Honcho on the trainer on Monday. What a sad moment! The plan was to ride and run on alternate days. Today ended up being an impromptu rest day since I decided to wake up, set my alarm for 1:15 later, and completely pass out. Ah, well! At least I haven't missed a run day yet this week!

- I have 3 days off this rotation (5 weeks) and one of them is tomorrow. I am very excited. My masters team meets on Saturdays now, so I'm going to swim in the morning and ride in the afternoon. Talk about a perfect day! But then I'm on call Sunday...

- You know what I miss most about racing? It's the smell of neoprene in the morning.

- I am going to have to admit I've become rather disillusioned in regards to relationships lately. But every once in awhile I meet someone that reminds me that true love still exists. The patient I admitted on Wednesday is the sweetest guy. He has been with his wife for 31 years. She is disabled and he helps her with activities that we all take for granted. Every time I go to see him, he talks about her and how special she is, how much strength he gets from her, how she is the greatest woman in the world. I got to spend a fair bit of time with them both in the ER before he was admitted and it was so touching how much they cared for each other. I called her today to let her know how he is doing and what we are planning for him. Even though it is incredibly difficult for her to manage alone without him, she made me promise that we would keep him until we knew exactly why he has been sick. I told her that we would keep him as long as we needed to, and not a minute longer. I guess at heart I'm a true romantic. I don't find young/new love that inspiring. But when people have been together for many, many years and still are 100% committed to each other and want nothing more than the health and happiness of the one they love... well I think that is just awesome

Sunday, September 23, 2007


I am Free! Free from the elliptical trainer, the stair climber, the couch. Yes, I am running again.

Ok, ok, so the amount I am running is laughable. Some bargaining with Coach Paulo, my official injury prevention manager, has brought me to my running plan of 2 miles, 3 times per week. But those 2 miles are pure bliss. Well, aside for the fact that I am in horrible running shape and am cruising along at about 10 minutes per mile in zone 3. But the important point is that the miles are pain free. I still don't know what was wrong with my knee, but honestly as long as it continues to get better, I don't really care. I know I fell on it, I very likely broke my patella (as evidenced by the ridge turned bone callus post injury), and did some soft tissue damage somewhere lateral to my left knee. Thankfully, it has vastly improved in the 3 months since I totally destroyed it by running a Marathon at CdA.

So what next? Well, as much as I'm dying to pick a race and to start training, I can't do it yet. I know that I am a hopelessly goal oriented person. If I set a running goal, I will meet that goal even if it means doing multi-hour training runs in intense pain and spending the rest of the day packed in ice (don't ask me how I know this...). So for now I will continue my 6 miles per week running schedule and only increase that as my body allows it. With no pain. And for God's sake try to keep my sneakers on the pavement this time! At least I now realize that a person with my coordination, balance, and grace cannot run and do anything else at the same time. No iPod, no thinking about that patient I saw that day, no chewing gum (ok, maybe I can chew gum....).

Although I have to say the thought of a spring half marathon and summer half Ironman are very appealing...

Saturday, September 22, 2007

Do you like Cleveland?

It's the question that I get asked at least once per week. It's usually from a native Clevelander when they find out that I'm from out of state. Well here's my answer...

I hated it at first. I still contend that Cleveland is one of the worst cities in the country to be single between the ages of 24-40. It being one of the poorest cities in the country dictates that people graduate from college and get the hell out to find a job. That being said, there is little for a young person to do around here.

But I did say that I hated it at first. What changed? I bought a bike and my life changed forever. Cleveland is an absolutely amazing place for cycling. Hundreds and hundreds of miles of roads that are just beautiful, have light traffic, and varied terrain. I always promised myself that when I was done with my Ironman I would go out for a few days on my old training routes with a camera. Today I went out on some of my favorite roads to share a piece of what my Ironman journey was like

Descending down into the valley on Berkshire road- the long, gradual descent:

After arriving in the valley you choose which way to start your ride. Every once in a great while, we start by crossing the bridge and going straight up out of the valley. That takes a lot of motivation because it's a killer hill. Today crossed the bridge and headed left....

I went left because I wanted to have some energy for the biggest hill of the day. My very favorite training hill, Sherman Rd. If you want a picture of the profile, it is the one I did here twice between hours 3-4

From the bottom:

Part 3 of the climb:

Part 4 of the climb:

View from the top:

Heading towards North Chagrin Reservation:

Washed Out Road. One of the only true bike paths we ride on:

This is a nice climb out of the valley

What goes up must come down!

Heading towards South Chagrin Reservation:

Time to climb out of the valley to go home:

Out of the valley heading towards the car

All of these pics were taken between North and South Chagrin Reservations, just a small fraction of the park system here. I feel so fortunate to have these roads every time I click into my pedals


Friday, September 21, 2007

What would you say?

If you knew you were going to die, and you had an hour to tell people all the lessons you learned about life, what would you say?

(8 parts... if you want to watch the whole thing, go to youtube or find #2 in the scrolling bar when this one ends)

Thursday, September 20, 2007

A whole different world

One week per year, each medical student from my school has to spend four days working with free health care clinics and homeless shelters in the community. My week ends tomorrow, and I think I learned more about people this week than I will for the next 18 months of medical school.

Cleveland has been ranked the poorest city in the nation 3 of the past 5 years. There is no denying that, even walking through my neighborhood and seeing the countless for sale signs, not to mention the half dozen or so houses in my neighborhood that have been vacated, foreclosed, and/or auctioned. But I'm still sheltered here in my community, without a doubt. I get a glimpse of the poverty when I take my morning route to school through East Cleveland, a city that was absolutely devastated by crack cocaine many many years ago and has yet to make the slightest recovery. But as I'm driving past the boarded up houses I'm still in a different world. Listening to music, paying attention to the road, thinking about the day ahead. But working in the clinics, there is no denying the world around me. The world where some of your questions are:

Where have you been getting your medical care?
Where did you sleep last night?
Do you feel safe?
When did you last use?
When was your last HIV test?

The thing that really made an impression on me was not the fact that there was so much poverty around. I knew that. It was the people. People who were nurses, administrative assistants, parents of kids in college, veterans. People who once were like me. They had a job, a family, money for food and clothing. And then something happened. For some it was tragedy- loss of a loved one, divorce, loss of their home. But for most, the thing that happened was drugs- usually the drug was crack. People lose everything because of this drug. Kids, homes, and most of all, they lose whatever it was that makes them who they are. And they are/were totally dependent on it. I asked one patient how much she used. She told me- I don't know. If I had a dollar I spent it on crack

But the nice thing about working at the Care Alliance and 2100 Lakeside is that you commonly work with people who have decided to finally try to make a change in their lives. The first thing people do when they decide to get clean is to take care of their health. So we are the first contact in their clean life. Sure, many people will try and fail to get clean in an endless cycle. Some aren't even trying to get clean. That is not for us to judge. But the fact that there are services like this in the community for people to go for free to seek help is really amazing. And there are plenty of people who have dedicated their lives to ensure that this happens.

And for the most part, it is a very rewarding job. You don't get to use the fanciest equipment, or prescribe the newest and best drug, but you get to practice really good medicine to a population that is in need. A population that is, for the most part, more grateful for the care they receive than you will see at any private clinic around. The patients at the clinics get education, monitoring and medications to keep their blood sugar in tight control and their blood pressure low. They get anti-depressants and anti-psychotic medications if they need them, and help finding a place to eat or sleep if necessary.

The shelter was just as impressive as the health clinics. Cleveland has one of the best and biggest men's shelters in the country. It runs on a several tiered system. The first tier is simply a place to sleep. You can check in at 4pm, but have to check out at 8am, taking with you anything you came in with. You can come in high on crack, pot, drunk, or psychotic as long as you are not too disruptive. No one is judged and there are people available if anyone wants to talk about change. But nothing is expected of the people in the first tier. It is free shelter and food.

People who graduate from that tier can move into the second tier. People have assigned beds and a locker. But more expectations are there. Classes need to be attended every day. Residents have to commit to getting clean and making a change.

Eventually people can move into the other side of the building. One community is made only of people with full time jobs who are actively saving and paying off debts necessary to get back on their feet. There are savings plans and personal case workers who ensure that everyone gets their license and deals with all outstanding tickets and warrants. There are weekly random drug tests. They have to pay a rent, per week which increases as time passes. When they move out, they get their rent back. Many of the workers at the facility were former residents who got clean and have their lives back because of the shelter. They understand what is going on with the residents- not because they read about it in a book. Because they were there.

The experience really made an impression on me. The only negative feeling I had was a sense of guilt. It was because I know that I can't possibly understand what these people are going through. I feel like- why should they listen to a 28 year old girl in preppy clinic clothes who has obviously never had a day in her life that could compare to a day on the streets. Never been addicted, never hungry. I know inside that I shouldn't feel guilty that I have lived a privileged life. But I felt like I was being judged for how easy my life is. But the irony of my feelings is that the people I am so afraid are judging me go through every day having people like me judge them. I guess it was then that I really felt like I understood a very small part of the battle they go through every day.

Monday, September 17, 2007

This is a test...

Just got my new computer... thought I would say...

Live from my new MacBookPro!

I'll write more later with pics of my weekend trip to Estes Park Colorado!

Monday, September 03, 2007

The Epic Ride Revisited

Another holiday, another tour of the Emerald Necklace. We are so lucky in Cleveland to be surrounded by a beautiful, interlocking park system that makes cycling such a pleasure. Here is a map of our parkway:

Every holiday, Shaker Cycling starts from the East side of Cleveland, rides straight through downtown to Rocky River, then takes the parkway through Mill Stream, to Brecksville and through Bedford Reservations. The brave souls continue on to do a century by going down into and through the South Chagrin Reservation, while the rest of us call it quits at 75 miles.

I was a bit worried about my fitness level and my ability to keep up with some of the uber studs that show up to hammer out this ride. I think there were about 15-20 of us in all and I was, once again, the token woman. Being the token woman I feel the need to not be the slowest member of the group so that people don't start rolling their eyes when I join them for their rides. So for the first 90 minutes (mostly warm up), Lanny and I took the lead. This is good because we get to control the pace, but it also means I don't get to draft off anyone, so it's not all that easy.

Then we arrived in the metroparks and the call was made:



All aboard the Shaker Train. Those not in the paceline will weep for your mommies in 30 minutes

I took a deep breath, put my butt 6-7th in line, and pedaled for dear life. Holy hell was that fun. Me without a spedometer could only guess how fast we were going, but when Lanny sped up to put a leash on the studs who were pulling, I got an idea.

"Can we keep it under 29 mph, guys?"

We had a long ways to go and had been holding 28-29mph on the flats for 20 minutes. I was in serious trouble.

I was able to keep up, but was anxiously awaiting our potty stop (and I will officially never live down This ride). Our one real stop happens after a big hill and my legs were screaming for mercy. My butt, which used to be rock hard, but is now flabby goo, was crying with every pedal stroke. To make matters worse, in order to keep up I need to forego that little thing that we like to call eating and drinking. So at mile 46 I had consumed a total of about 18 ounces of gatorade and 2 Gu packets (300 calories). So I quickly chugged 20 ounces of Accelerade and another Gu and was off.

In case you hadn't recoiled in horror at that last statement, it's a really, really bad idea to chug mass quantities of liquid and calories (including protein, no less) and immediately start riding. So now I needed to figure out how to pedal my fatigued muscles with a huge portion of my blood supply diverted to my gut. I would be lying if I said I hadn't considered the ole finger down the throat trick. But alas, I held my cookies.

At about mile 65 I was done. My body had given up the fight. Thankfully we were almost home and Lanny allowed me limp back home to a power shake.

What a fabulous way to end a long weekend! And a great week of training, no less
Mon- 3600 meter swim
Tue- 45 minutes elliptical
Wed- 3300 meter swim + 34 mile ride (hard)
Thur- off!
Fri- 3400 meter swim
Sat- 66 mile ride
Sun- 45 mile ride
Mon- 75 mile ride

10,300 meters in the water, 220 miles on the road

I love this stuff


Sunday, September 02, 2007

Cycling is my anti-depressant

I was telling someone the other day how amazed I was at the number of people that we see in clinic that are on anti-depressants. It's completely shocking. I got a very interesting comment back-

(this is probably not verbatim)

Do you ever think that depression is sometimes a sign that we are unhappy with things in our life and instead of changing things to make ourselves happy, we seek pills to cover it up?

I thought it was very insightful. I realize that many people have major depression and have chemical imbalances. And I think anti-depressants are amazing drugs for people like that. But I think this account for a small proportion of those that are medicated for depression.

So I got to thinking about times I have been very down. The last time I was really upset (as in, sitting in my room and crying- not eating for 2 weeks kind of thing) was the impetus that got me into triathlon. And I discovered the world's best natural antidepressant- cycling. I don't think that words can describe how much I love cycling and how much pure joy it brings me. I have met and cycled with probably 100 different people out on the roads in the past year (some of which are now my dearest friends), it gets me outside in the beautiful park system of Cleveland, and there is no denying the effects of endorphins. So this weekend I am the happiest girl in the world. I went out on Wednesday in the 90 degree humid heat for the best 34 miles I could have asked for followed by some amazing food and company. Then I hit the Summit county metroparks for 66 miles with a different group of remarkable and fun people. Then today I went out with my Wednesday buddies for 45 miles in the most beautiful weather Cleveland has ever seen. I will cap off my weekend with 76 hard miles with the Shaker Cycling roadie group tomorrow. This will be quite a challenge, but no less fun than the other rides. Could a girl ask for a better weekend?

As another note of anti-depressants... I think animals serve a good role for that too. Maddie has been particularly snuggly lately. I was sleeping like the dead the other night. I woke up feeling warm and really rested. When I came to I realized that I was spooning Maddie. The little sneak had managed to climb on the bed and was resting comfortably next to me, head on the pillow, sleeping as soundly as I was (she never sleeps on my bed!). Then the next morning when I woke up I had a black furry paw on my shoulder. She had done it again and was sleeping behind me, again with her head on the pillow. Funny stuff!


Happy 5th Birthday, Maddie bear!