Fight of ideas

Death Cab for Cutie

-excerpt from Soul Meets Body

I want to live where soul meets body
And let the sun rap its arms around me
And bathe my skin in water cool and cleansing
And feel, feel what it's like to be new

Cause in my head there is a Greyhound station
Where I've sent my thoughts to far off destinations
So they may have a chance of finding a place where
They're far more suited then here

-excerpt from The New Year

so this is the new year.
and i don't feel any different.
the clanking of crystal
explosions off in the distance (in the distance).

so this is the new year
and I have no resolutions
for self assigned penance
for problems with easy solutions

so everybody put your best suit or dress on
let's make believe that we are wealthy for just this once
lighting firecrackers off on the front lawn
as thirty dialogues bleed into one

i wish the world was flat like the old days
then i could travel just by folding a map
no more airplanes, or speedtrains, or freeways
there'd be no distance that can hold us back.

Steps and Hoops

I am finished. Done with being in the hell hole of America. Done with being in a classroom. Done with not seeing patients for 2 years, but learning about diseases. Done with Step 1! Just another hoop to jump through. Just another step in the process of medical school. Just another step in the process of life.

So, with all that being said and me sobering up from last night, I will be moving to Indianapolis. Leaving all the smells and (train) bells behind. (If you have ever been to TH, you know about the smells and trains.) I'm just trying not to gloat in front of my friends, but after 2 years of class, when you finish, you have to gloat a little just to blow off some steam.

So, look forward to posts about patients. (No, I'm not going to violate HIPAA and give names and/or other identifying information.) Well, unless it's one of my friends. Look forward to happier posts, since being holed up in a shit-hole town studying like mad for 2 years doesn't exactly make me happy. New town (but not really new to me), new apt, new roommate, new tasks, new friends, new responsibilities, new opportunities. (I know this post is lame, but it helps me, so don't read if you don't want to.)

I'm taking some time off after I move tomorrow and going to a friend's wedding, going riding with a couple of my friends, going to see about a girl, going to spend some time in Michigan horsing around. Posts will be scant for the next month until I get settled in my rotation. I'm not sure what my call schedule is going to be like. Also, this is the last 3 weeks of my life that I won't have a pager attached to my hip. In 3 weeks, I will be "available" pretty much at all times. Sometimes I feel like I need to "unplug," even now, when I'm not that hooked in.

For the next 3 weeks I have no responsibility. I'm going riding and running as much as possible. I might do a couple brick workouts, (if you don't know what a brick is, in regards to cycling and running, look it up) hit the pool, and look for a sprint or an olympic tri to do. I'm going golfing as much as possible, going out as much as possible, avoiding my exes as much as possible. (There are just some people that you don't want to see out at the bar... several names come to mind... quite a few actually)

The next 3 weeks are the last summer break that I will ever have. The next 3 weeks are the last break that I get until Christmas. (After that until I take time off to interview.) I finally get to hang out with my friends from college again. I have been in exile for 21 months. Although 2 of my friends are getting married this summer/fall. Idiots. I'm glad they are elated about it, 'cause I'm certainly not.

Farewell to blogging from TH. Farewell to living on a highway with constant traffic, no matter the time of day. Farewell to people I don't care to see again in my life. And... I'm out.

Magnet for Rain

I'm not really sure what the problem is. I went for a ride on Sunday. It was supposed to be a decent paced 40 miler. Of course when we were about 14-15 miles out it starts raining. No, not raining, it was monsoon season. I felt like I should have been looking for an ark out there. I though Noah was going to pull up beside us and as us if we needed a lift. Cycling on roads with at least an inch of water... not the greatest of times. So, we cut it short and only went 30 miles.

Yesterday:
I went for a biweekly ride with some guys in town. They are just some guys that like to get out and hammer it. 10 miles in, it starts raining on us. Cool. At least it only lasted for about 5-10 minutes. Then the sun came out again and it was off to the races, which is partly why I got lost, but that is another story all together.

Today:
I was out running some trails. I went out for a nice and easy run to get my legs some blood flow. I saw some either National Guard or Army soldiers in the woods running in formation early on in my run. I got about another 10 or 15 minutes further into my run and heard a couple loud noises. Over my iPod mix, I assumed they were the troops firing some blanks at something. Nope... It started to sprinkle a bit. Then it started raining a little harder. I looked around at the woods and said, "Is, is that hail?" Sure as shit it was. It started hailing on me. Not big enough to hurt, just enough to piss a guy off. Then as soon as it started it stopped and the sun came out. F-ing Midwest weather.

Tomorrow:
God only knows what it will do. Hitting up the group to ride again. So, who knows. Will I plan ahead and bring some arm warmers or rain jacket? Probably not. I'm stubborn and bull-headed. I'll just hammer through it.

Lactic Acid = Fuel

Lactic acid, the stuff that makes your muscles burn is a good thing. It is not a waste byproduct that makes your muscles sore and ache. It is a good thing that your muscles produce through glycolysis to generate more energy. It comes down to how your muscles utilize that energy to determine how you will perform. Lactic Acid Is Not Muscles' Foe, It's Fuel details the continued findings of George A. Brooks, Ph.D.

Lactic acid is produced from the glycolytic pathway through the action lactate dehydrogenase converting pyruvate to lactate under anaerobic conditions, which oxidizes NADH to NAD+ and H+. The generation of NAD+ allows glycolysis to continue, because it is a substrate for glyceraldehyde-3-phosphate dehydrogenase. For a review of glycolysis and lactate metabolism visit: THE Medical Biochemistry Page (It's a great site for all of Biochem)

What does that all mean? It means that through the lactic acid shunt, muscles can continue to burn glucose. More than that, lactate is burned in the mitochondria of your skeletal muscle cells to generate more ATP(ie. ENERGY!!). For more information read the following site: Muscles burn lactic acid as well as carbos

Further reading:
Lactate doesn't necessarily cause fatigue

Endurance training increased gluconeogenesis during rest and exercise in men

Endurance training has little effect on active muscle free fatty acid, lipoprotein cholesterol or triglyceride net balances

Glycemic Index

An article entitled Are You High? on runnersworld.com helps to explain the concept of Glycemic index and what types of food to eat before, during, and after workouts. For those of you unfamiliar with the concept of glycemic index, it goes something like this: Food is ranked from 0-100 depending the rate at which carbohydrates enter your bloodstream. Most fruit has a low glycemic index (in the 30-40 range) while something like Gatorade is high (89). The fiber from the fruit slows digestion and absorption of the carbs. Similarly, adding protein or fat can alter the way that food is digested. For instance, pretzels have a high glycemic index, but if you dip them into 3 tablespoons of low-fat yogurt, they have a low GI. Spaghetti weighs in at 60, brown rice at 55 on the chart. Okay, so that's great, now how does that help?

Without going into the detailed workouts and scheduling of meals, know that runners, cyclist, and other endurance athletes benefit from a low GI meal about 2 hours before a workout. During the workout, a high GI food is needed for rapid entrance into the bloodstream, hence gels, gu, honey, jelly beans, whatever you can get your hands on. The main idea is that you need energy and quick. By the way, that pre-race bagel you always maw on... it has a GI value of about 72. Good for right before the race, but it will let you hit the wall, bonk, die, lose your legs, (I could keep going) during the race (especially if it is longer than say... 5K).

Eating foods with lower GI values may help you stave off Diabetes, Heart disease, and even types of Cancer. See: some of this information is actually useful in daily life. Eating foods with lower GI values will lessen the chances that you will have a sugar and corresponding insulin spike after a meal. Lowering cholesterol intake as well as a diet that lowers LDL will aid in staving off heart disease. Eating more fiber is a proven method to stave off colon cancer. Now, problems come into play with genetics. Family History is one of the strongest predictors. So... If your family gets colon cancer at age 35, you can eat all the Metamucil and prunes that you want. You will still probably get colon cancer and at a young age.

To look up the glycemic index of various foods go to: glycemicindex.com

Mother's Day

Did you know that there is an entire website dedicated to the celebration of Mother's Day? Wonder what they do during the "off-season"... Mother's Day on the Net It has the history of Mother's Day, dating back to Greek times, honoring Rhea, the Mother of the Gods. It also has the American beginnings of the holiday. Contrary to popular belief that it is just another Hallmark generated Holiday, President Woodrow Wilson declared the second Sunday in May to be Mother's Day back in 1914, although, technically Joyce Clyde Hall, the founder of Hallmark, stepped off a train in Kansas City, MO in 1910, so the possibility still exists that it is a 90+ year conspiracy.

Anyways, Mother's Day is not celebrated around the globe on the same day. It differs from country to country due to theories of the origins of Mother's Day in the respective countries. In Costa Rica and Antwerp, it is actually celebrated on the day that Mary was believed to be assumed into heaven, Assumption Day. For those of you not Catholic, or not acquainted with the concept of Assumption, I encourage you to check out the link. Essentially, it means she didn't die, but was taken straight into heaven.

The Mother's Day Proclamation can be read at: The Mother's Day Proclamation For more information on why your mom is so great, and the origins of the holiday, visit Wikipedia: Mother's Day

Go, celebrate, call you mom. Tell her how much she is worth and what she has done for you. Don't neglect the fact that she "brought you into this world, and by God [she] will take you out if you don't shape up."

apathetic relationships

Apathy, disregard, general withdrawal. Not from a handful of relationships, but from all. Supposed goals of studying have fallen by the wayside only to be replaced with a quest for something. What? What is it? I'm not sure. Cycling, running, studying: these are the things around which my days revolve. Food is an after-thought. I delve into the pantry only to be disappointed. What am I looking for? CNN, FoxNews, MSNBC: have become the center of my universe. Why? What is it? Searching, Journeying, Questing, but for what? For whom? For what purpose? I'm lost in my own apartment without a map, without a compass, without direction at all. Am I avoiding? Ignoring? Where am I???

Traffic and Ailment (T&A if you will)

As I arose at 5:15 AM on the morning of the half marathon I noted that I still had some lingering flu, as signified by the sore throat and massive headache. So, I took a gram of Acetaminophen and went on with it. Weather report: supposed to be 46 at gun-time warming up to 65ish. (aka good running weather) I got to the starting of the race only to discover that I got hosed on my starting corral. Somehow I was with the walkers?? Seriously? Seriously? Someone was going to get hurt. So, I waited until all the corrals closed and hoped into one that had a few runners. Runners that were poking at about 10 min/mi, but runners nonetheless. (My race pace, when I'm on my game is about 7:30) So, I swerved and juked my way through a couple miles of traffic only to have to stop and pee at about the 5K. (Rookie mistake. I know better than that.) As I exited the lovely port-a-potty, I ran into the traffic I had just passed. So, like Ali, I was moving like a butterfly and stinging like a bee. Although, the stinging consisted of bursts of acceleration to get past people.

As I rounded the 10 mile mark I was still feeling not too bad. My feet felt like they were bleeding, but that's normal at that distance and in a half marathon. I was still passing people at this point, but there weren't walkers around me. I sped up a bit for the last 5K and finished a disgruntled 1:49:09, 4281 overall. (The winner, a Kenyan, finished in like 1:03.) Faster than last year's, but much slower than I wanted. So, I'm going to find another half within the next couple months and do that. Hopefully one with less people. The 35,000+ people was a cluster f at times.

On a side note: how do people drink beer after a race? All I want is water and one half cup of gatorade. I don't get it. I understand that beer has sodium in it, but... honestly you are drinking a diuretic after sweating for 13.1 miles. That just doesn't make medical sense to me.

Also, there was a firefighter from Bloomington, IN that wore full gear. (walking) I saw the guy at the race and shook my head in disbelief. He had on the mask, helmet, everything. I said to myself as I passed, "holy shnikes he must be hot." Awesome job on his part.

That's about all the update that I have. I will never have to take another class again. That's cool. I have also been in school for 2 decades continuously. Depressing, I know...

Obesity Reaches new Height (I mean Weight)

Before I delve into this matter, let me just say that I am not a fat person, by any stretch of the imagination, nor does obesity run in my family. My family is from Denmark: tall fishermen with lanky builds. So, I might be a little biased when it comes to this issue. But, let me assure you if I ever enter the category of "overweight" (from a BMI standpoint) I will restrict myself to a 1000 calorie diet and exercise for over an hour a day until the weight comes off. That being said:

Imagine that you were overweight. Okay, obese. Now, what would you do to correct the issue? Anything? What if you weighed as much as 5 baby elephants? Would you do something then? And let me ask you: how did you let yourself get that fat? It certainly didn't happen overnight. Well, Manuel Uribe is such a man. He weighs approx 1,200 lbs. (Actually, they aren't sure how much he weighs. They can't find a scale that would work for him. Well that and he can't walk.) Yep, Sr. Uribe can't walk. What does he do all day you ask? Uh, I don't know contemplate life and eat? Apparently his mom sows his clothes and cooks for him. Sr. Uribe went on Mexican television and pleading with the govt. of Mexico to give him a gastric bypass to help him lose weight. "Uribe made an impassioned plea for help earlier this year on Mexican television, saying he weighed a more normal 290 pounds until age 22 and did not know what happened to him." More normal 290 huh? Well I guess that is normal-esque these days. Normal has shifted from the 75 kilo man to the 100 kilo man now. (290 is actually 131.5 kilos) Uribe is now 40. His wife left him 10 years ago because she was disgusted with him and thought he was dying. (my sentiments exactly) So now Uribe has attracted the attention of some Italian surgeon who is going to do the bypass for free. Dr. Giancarlo De Bernardinis said that his largest patient to date was 770 lbs.

Now, obviously there are interesting issues in this case: political, medical, social. Lets hit up the political first. Why do people insist on getting themselves up shit creek without a paddle and then start begging for help? How about I have 20 kids and then ask welfare to take care of them for me because I'm too busy turning tricks to buy meth? Or, I won't go to a physician for years and then just show up with malignant HTN, Diabetes, and a fungating mass on my testicle. "Oh and by the way, I'm on Medicaid." People, seriously. If you don't take care of yourself, why do you expect others to take care of you FOR you? I actually found a blog about this fatty. It was pretty good: Blogthecoast.com

Medically this guy is a surgeon's, an anesthesiologist's, a RT's, and a nurse's worst nightmare. First, lets talk about how they are going to get Fatty McFatterson out of his house and over to Italy. Uh... whale lift? Are they going to float him in a tank over to Italy? The CNN story quotes the fattest person in history: Jon Brower Minnoch. He was a fat POS as well. And yes, he weighted 1399.935 pounds at his fattest.

Moral of the story: go exercise. I saw a news article last night on CNNHN that kids in school are reaching obesity at alarming rates. Something needs to be done and fast.

Running Delirium

Today was my first day back to real running. I ran yesterday, sort of. It was more like jogging for a couple miles and then calling it a day. Not "running." So, today I decided to do my speed work for the week. I did 4 x 800 at race pace, which turned out to be oddly comfortable. In fact, I was giddy during my run. It is very hard to describe the feeling. It was a mix of: having my legs feel like they were just bouncing along of their own accord, feeling a tingle in my legs for a few strides on the back stretch, being completely detached from my body all at the same time. My interior monologue went something like this (imagine Derek Zoolander saying it): "Yippee, HOOORAY. I'm running. Ha Ha Ha." (Orange Mocha Frappucino!!!) Needless to say, this is not my normal demeanor while running. I'm usually all business or thinking about something else going on in my life (usually school, as awful as that sounds, sometimes girls, but that is few and far between). I equate this experience to running drunk. As I have done this before, I have personal experience. While running drunk, all you want to do is throw up, after that you have a moment of complete clarity. It's as if you have just ascended to another plane of existence. So, in a sense running drunk can be compared to a religious experience. Think about that...

Background: I have had a mild case of the flu for the past couple of days. Frontal HA, night sweats, malaise, myalgias, a touch of photophobia, and some orthostatic hypotension just for good measure. Actually I'm on a taper for a half marathon this saturday. It always seems like you get sick while you are tapering and not while running your hardest. It's like your body just says "enough," and that happens right after your hardest workouts. So, now I feel about 70%, but I'm on a protein loading right now, which also drains your strength. I'll follow the protein loading by carbo loading in the days leading up to the half.

In the mean time, tomorrow is my last day of running until the half. I'm only going 2 or 3 miles easy. Rest for two days and then it's on like Donkey Kong.