Sleep to Dream

Last weekend was spent visiting Aunt Ruth. I had wondered why the flight to Indianapolis was so pricey. As it turned out, it was the same weekend as the Indy 500. I perplexed more than a few race fans on the plane when I said I was planning on spending a nice, quiet weekend in a retirement home rather than watching the race.

Last fall, Aunt Ruth suffered a hip fracture from a nasty fall. She made it through surgery, and finally rehab, but she's definitely slowed down quite a bit from my visit two years ago. Since the fracture, she's had three more falls, but luckily hasn't broken any more bones. For me, the weekend was an opportunity to see her at her baseline. With my grandparents, there was always that expectation of an upcoming visit that was canceled abruptly by death. At least for me, visiting Aunt Ruth is somewhat awkward as in my head, I am always expecting it to be our last meeting. Happily, so far she's proved me wrong.

As it turned out, she had full-blown hip replacement last fall, which is kind of shocking given the high mortality rate (up to 35% in the first year following surgery) and her age (105 this past February!). I am sure that she made the decision as she would have hated to be bed-ridden, but it seems like most orthopedic surgeons wouldn't touch someone her age. Now she is clearly having balance issues and the long walk to the dining room now has to be interrupted by rest breaks.

Her remote memory is now being affected. She introduced me to a lot of other residents. Sometimes I was a doctor, sometimes I was a nurse. Sometimes I was from Washington, sometimes I was from Arizona, or Louisiana... it's a good thing we sat with different people at each meal, so nobody caught on!

Our days were full-- with meals at 8 am, 11 am, and 4 pm. In between there were 3 or 4 naps a day. It was a good visit and she reminisced often, sticking to the same memories that she felt comfortable talking about. We talked of Appersons and life on the farm.

Like my grandparents before her, Aunt Ruth is withdrawing from the world around her. The woman who used to read three newspapers a day still has a picture of Ronald Reagan at Camp David from 1984 on her desk.

Luckily, although she never had any children, one of my uncles checks on her several times a week. The staff at the assisted living center also seem to be pretty good about checking up on her several times a day. The day is soon coming when she will have to move to the nursing home wing, and she seems to be all too aware of that, but is putting it off for now.

I prefer to think that her mind works better when she drifts off to sleep, returning to a time of antiquated behaviors and expectations, a world where she makes decisions rather than having them be made more and more for her.

An Update, but Not Really

I have been neglectful about updating this thing as of late. Lately, I just seem to be content at doing nothing. Free time abounds, and instead I am content to waste it all. The running has continued, in spite of the "unseasonably" cold weather lately. My motivation has off and left once again. Tomorrow I am heading out to visit my Aunt Ruth, if I can get myself packed and on the plane! Let's hope I gain some inspiration from talks with a centenarian.

Puddle Jumping

Yesterday, I ran in a 5K race. I had participated in the same race last year, but this year I did much better, coming in over 3 minutes faster than last year's time. The first mile I ran in 8:34, which is flying for me (I am typically a 10 min+ distance runner)! For me, the highlight of the race was passing by this guy doing Beatles karaoke by himself dressed in a Sgt. Pepper-style costume, complete with mustache!


Today, I went for a 12-mile run. It was raining most of the time that I was out there. Unfortunately, I stepped in a puddle right around mile 6, so that changed my stride to step-splat-step-splat with rain dripping off the right side of the bill of my hat. The sprinkling finally stopped for the last 3 miles, and that was when the wind picked up. A rain/sweat-soaked fleece shirt does not make for good insulation. On the drive home, I was still sweating and shivering at the same time.

My legs are already telling me that tomorrow is going to be a day of rest. The good thing about getting the run done today is that was the longest run according to the training plan. The rest of the weeks before the half marathon taper off. It does make me nervous to be running 13 miles on race day when I haven't run that far in practice runs, but there seem to be two theories in training: either build up to 90% of the race distance and back off, or run 110% of the distance and back off. I guess the main thing is to not fall into my usual pattern of taking weeks off entirely and avoid injury.


I did finally pick out some new shoes, but I haven't worn them yet because I figured today was not the time to break them in.


Here's the old stand-by's:

They will probably be reserved for nasty weather until the end of softball season, when they'll make their debut in the ED. (Hospital shoes stay in the hospital, given the nasty things that can be found on our floors.)


And the new pair:

The fancy running store I went to measured me, analyzed my stride on a treadmill, and pored over the soles of my old shoes. I received a look of disapproval when I said I had been wearing my old shoes for over a year. Then an engineer-type dude sat down next to me with his 9 year-old Nikes! These ones have a lot more arch support, so we'll see if I still end up with sore feet. (Either way, I don't imagine I will stop taking advantage of Army Guy's foot massage skills.)

Into the Wild

One of the things that I have discovered that I like most about running is the ability to clear my head. After a certain point, it is just one foot in front of the other, with breaths rising and falling as part of the pattern. I think that I must be somewhat unbalanced, as after I get going, I inevitably develop an ache in one shin, which melts away as an ache in the opposite knee develops, which recedes in kind as a groin or butt muscle begins to whine. (How is it even possible for only one side of your butt to be sore?)

The other thing that I like is being outside. Now that Spring has finally arrived, there are all sorts of distractions... dandelion seedlings taking flight.

• The other day, my friend and I had to slow down to pass a group of geese and their downy goslings. As we approached, the mother started hissing, just like a cat, in our direction! Luckily, we were able to make a wide enough arc from her path that no sprints were necessary. I have a feeling I can't outrun an angered goose in flight!

• Earlier this week, as I rounded a corner, a beaver quickly scuttled into some reeds.

• Today, during my run, I was pretty much a blank slate, when suddenly a hawk swooped in for a quick attack on an unsuspecting small animal, soaring just feet from my face!

Currently, I am on an elective block, which lately has meant fluttering about from room to room in the ED looking for pathology on ultrasound. Basically, I pop in, introduce myself, and slop some cold gel on a stomach, leg or chest, and then disappear, leaving a slimy snail trail in my wake. It's been interesting to kind of be on observer status in our department. No dictations to do, only minimal paperwork. Sometimes there is an attending around to provide on-the-spot teaching, but often I am left to my own resources... which typically involves getting coffee and chatting with coworkers. Not bad at all.

April Showers Bring...

I was more than a little surprised when I opened the curtains today to look outside and found this guy staring back in at me! The storm window on that window is broken, so he had flown up and gotten caught in between the layers of glass.

Slow and Steady

On Sunday, I lined up behind the starting line with a bunch of serious runners. For 10 miles we ran up and down the streets of this city... through downtown, bad neighborhoods, exclusive neighborhoods, the university campus, and past "Hospital Row". I surprised myself, and was able to do the whole thing without walking! Granted I have been building up to this run for months, but up until now, my longest run had been 8 miles continuously on a treadmill, and just shy of 7 miles on the flat trails by the lake.

One of my friends decided the run sounded like fun, and signed up at the last minute. She hadn't trained at all, so I tried to discourage her from it, but she attempted anyway. For the first 5 miles, I plodded along with her at a 12-minute pace, but ultimately ended up parting ways when she needed to stop. I think she was a bit upset at me for not stopping to walk with her. I am glad I didn't though, because the race organizers were pretty serious about only keeping the streets in town shut down for as little as possible. I finished at 1:57. As I stood at the finish line waiting for my friend, they started re-opening the streets and rolling up the finish line at 2 hours and 15 minutes. As it turned out, my friend had her husband pick her up at mile 7. I'm pretty sure if I had gone at my own pace, I would have completed the race at least 10 minutes faster.

The race was a lot of fun though, and I saw several parts of the city that I had never seen before. One of the highlights was a small park with lots of small hills and twisting paths around a pond. Best of all, I beat my own distance record! There's a half-marathon (13.1 miles) that Army Guy and I are planning on running with another couple in about a month, so I think I am well on my way to being prepared for that. As for the new running shoes, I'm planning on going to a running store in a couple of days to get custom-fitted.

After the race, I felt pretty good, and worked a full shift that night. Yesterday, I just felt kind of tired, so I limited myself to walking the hills around my neighborhood. Today, my shins are kind of angry, but I am nowhere near as sore as I had expected to be. Perhaps that slow start was a good thing after all!

Mama's New Shoes

The other night, a couple of my friends and I went for a nice dinner at the local casino. Afterwards, we decided to hit the gambling floor. It made for some interesting people-watching. Despite being in the middle-of-nowhere, there were a few women who were dressed up in mini-skirts and heels. However, there were no well-dressed men to be found-- mostly biker-types, seniors, and scruffy-looking young adults with questionable hygeine. I don't know who or what these young women were expecting to find, but clearly there weren't many options.

Anyway, my friend and her husband proceeded to argue about exactly how much money he should be allowed to "throw away down the toilet." I had brought a set amount to mess around with, but as the situation was somewhat tense between the two of them, I settled for putting down $20 at the roulette table. After nearly losing it, I was up to $40. My friends were still bickering, so we walked around a bit. I was about ready to get out of there, but my friend's husband decided he was going to play some poker, no matter how much she scrunched up her face at him. (Isn't going out with married couples fun?)

I shrugged it off, and sat down next to him. I ended up getting dealt two jacks, and as I had paid for a "bonus", I was already sure to win something just off the deal. My friend's husband unfortuately didn't get much of anything, but I ended up with a full house and up $100. I decided there wasn't any way I could beat that, so after one hand of poker, I called it quits, having just won enough to buy a new pair of running shoes I had been trying to justify. It made for a short night, but I figured it was best to quit while I was ahead.

Amateur Transplants - YouTube Fun

One of my friends was sharing this clip the other day at work. (Beware of office-inappropriate language!)

My friends give me a hard time about not liking Billy Joel, but here's a more tolerable version of one of his songs:



And finally, I think this one's the funniest:

Treinta

Yesterday I turned the big 3-0. I think it is safe to say that a sure sign that one is getting on in years is the feeling of being younger than your actual age.

Sigh.

The morning I spent sleeping in (there were snow flurries!). Although I had the day off, I went in to work in the afternoon because we were having pig lab. Pig lab, like cadaver lab, involves performing as many surgical procedures as possible in order to help residents gain hands-on experience on rare procedures, so that in the event we do have to perform them on patients, we will at least have some exposure to the procedure rather than learning on a live patient.

The pigs are heavily anesthetized and then euthanized towards the end of the lab. We only do the lab a couple of times a year, and there are only a few animals available for the resident class to work on together, so it was too important of an opportunity to miss.

I am certain that some people would be horrified by this type of learning. However, doing a thoracotomy on a living animal is completely different than on a cadaver. There's no substitute for working with real blood vessels and beating hearts. At our program, we utilize mannequins and simulate different scenarios, but again, it's nothing like the visceral experience of a real patient.

Yesterday was our second session at the pig lab. As luck would have it, just a few days prior, a cricothyrotomy was performed in the department on a difficult airway patient. While I am sure that the situation was very stressful, I can't imagine the resident having had to perform it without having had the lab training first. And I am certain that the patient and their family are glad that they weren't on-the-job training! Although animal labs can certainly make you squeamish, I think that our program does a good job about being as humane as possible and maximizing the learning opportunities from each lab animal, while minimizing the number of deaths.

----------

After lab, I met Army Guy for a nice dinner. Throughout the day, I caught up with friends and family via email/phone. It was maybe not the most traditional of birthdays, but still a good one.