09 November 2009

notes at five in the morning

i got to leave work early tonight because my patient died.

that sounds too chipper, but i am tired and don't know how to write it with a more negative spin.

honestly, i was a bit bummed because he was a candidate for organ donation, but the family did not want to donate. i do not know their reasons. i understand it is a very personal decision, but i've always been a big supporter of organ donation. just like those stickers say, heaven (or whatever you consider the afterlife to be) doesn't need your organs; thousands of people die every year while they wait for a transplant. when my father died, his heart, corneas and skin were donated. i can't fathom not donating--it is something i've wanted to do since i was a young teenager.

in addition, the whole process would have been an awesome learning experience. i was really excited the charge nurse had given me that patient since we don't frequently have organ donation candidates.

i feel for my patient's family this morning. despite the situation (the patient was essentially brain dead on arrival), a loss is still a loss. knowing his history, i do think my patient is in a better place now, as cliche as that may be.

if you want to make a difference in somebody else's life, please consider donating and indicate your desire to be an organ donor on your license. all sorts of body parts are used nowadays--bone, blood vessels, even intestines. why not give somebody the ultimate gift--the gift of life?

18 October 2009

Playa Del Rey Sprint Triathlon race report

short report:
overall time 1:32:33.7 (placings: overall 189/280, sex 39/91, age group 5/17)

swim (600m) 18:42, 14/17AG
T1: 4:12.2, 14/17AG
bike (20k) 45:56, 11/17AG
T2: 1:08.5, 7/14AG
run (5k): 22:33.7, 2/17AG

(gosh, i wonder where i need work?)

all in all, a success.


long report (and i mean long):

although i signed up for this race several months ago after my tibial stress fracture, it's actually been much longer in the making. many moons ago, when i lived in the DC area (prior to nursing school), i decided i wanted to do a triathlon. but, i couldn't really swim. i took some lessons before moving from DC, and again a few summers ago, but i hadn't continued swimming on a consistent basis. to give you an idea of where i was coming from when i signed up for the race, the first time i swam 50m continously was earlier this year. yes, this year, as in 2009.

i also hadn't really ridden a bike in about two years when i purchased my road bike this summer. my last bike was a mountain bike with the seat low enough to comfortably touch the ground; my road bike's saddle is much higher, meaning i can't touch the ground while in the seat. i'd also never gotten very proficient on the mountain bike (understatement of the decade), so cycling was another obstacle in training for this race.

i had a lot of work to do when i committed myself to the 600m ocean swim, 20k bike ride and 5k run.

due to my sporadic work schedule, i quickly abandoned the training program i'd found online and winged it. i tried to ride my bike 2-3x a week, run 3x a week (once i was allowed to), and swim 3x a week. needless to say, guilt about not swimming or cycling was a frequent motivator. my ocean swimming consisted of two practice swims with a friend of mine and my transition practice consisted of two brick-ish workouts (cycle 12 miles, bring bike back upstairs into my apartment, go back out and run 3 miles). i had worn my wetsuit a total of four times before today.

my goals for today's race, by increasing difficulty, were:
  1. not to die (between seeing these shark photos and dealing with patients with head traumas, i thought i should set the bar low)
  2. to finish
  3. not to be last
  4. finish smiling (this one was suggested to me by a nice lady at the packet pick up yesterday)

the race began bright and early at 7, so my wonderful boyfriend Billy picked me up around 5:30. unfortunately, he's spent the last few months sidelined from running by a cuboid stress fracture and a cuneiform stress reaction, but has continued with his amazing support of my athletic endeavors. i honestly don't think i could have accomplished any of personal records this year without him.

anyway, upon arriving at the race site, we heard overhead that the race start was going to be delayed 25-30 minutes. while it would have been nice to sleep an extra 30 minutes, i appreciated the extra time to calm the pre-race jitters. the kind lady at the packet pickup had given me a crash course in transitions yesterday, and i gingerly picked a spot away from the other competitors to avoid some agro crazy woman yelling at me for taking up too much space. to my luck, however, a few other newbies ended up nearby and we made small talk. i organized my transition stuff and used the restroom before wriggling into my wetsuit.
body glide'ng up my neck, as to avoid wetsuit burn.

about ten minutes before race start, the other newbs and i headed towards the beach. painlessly maneuvering past the breakers, i took a quick dip in the ocean, to acclimate myself and help calm my nerves. i was in the second wave of four, and the waves were set to go off every 7 minutes. unfortunately, the first wave to go out took longer than the race officials had intended, so my wave had to wait a few extra minutes before we could go out, adding to the anxiety.

the horn went off and into the water we went. i didn't want to get kicked or climbed over in the water, so i hung back rather than dashing into the water. unfortunately, my second entry into the water wasn't quite as smooth as my first one and i immediately got knocked onto my butt by a wave. another woman was kind enough to stop and ask me if i was okay. my goggles had been knocked about a bit, but fortunately they stayed on my head.

on my second try, i managed to get past the breakers and started swimming. honestly, despite my hours spent in the pool, i am still not a strong swimmer. i don't know if it is my lack of practice in open water, my hesitation to open my eyes underwater in the ocean (not that i can see much) or my limited practice "sighting" the buoys, but i definitely struggled out there today. 600m is not far in the pool, but in the ocean it felt like miles. i did a combination of regular front crawl, modified front crawl with my head sticking out of water, and a little bit of backstroke. one woman who was in the water nearby did the backstroke the entire way. awesome. i kept looking back to make sure i wasn't the last pink cap in the water (each wave was designated by a different color cap). if i could survive the swim and not be the last person out of the water, goals 1, 2 and 3 were all highly likely.

the swim ended fairly uneventfully. Billy hooted and hollered as i dragged my tired body onto the shore. my legs felt like jello, something i hadn't felt when i'd done my ocean swims.
heading into T1. i jogged for a bit and then gave up and walked.

heading into the first transition, i knew i'd be stuck there for a little bit struggling to get my wetsuit off (still haven't figured out how to do that quickly) and getting dressed again. while more experienced triathletes wear specific tri clothing, i'd gone the budget friendly route of wearing a bikini and then throwing on some shorts and a shirt afterwards. yes, putting on all that clothing was very time consuming. and clumsy. i also hadn't practiced rinsing off my feet and putting on shoes and socks quickly. i'm slower than average at things like using the restroom in restaurants, so it came as no surprise that my transition was lengthy. since i'm still rather inept on the bike (i haven't graduated to clipless pedals), i wore running shoes for the bike portion but figured it'd be beneficial during the second transition since i wouldn't have to change footwear.

after the swim, the second thing i was nervous about was getting started on the bike. i'm still a bit wobbly with my starts and stops and i had been concerned about having trouble getting my bike going. fortunately, i was able to hop on and get it moving without any problems.

how nice of the volunteer to look away.

the bike course was a mostly flat 20k with some small, rollingish hills. it began with an ascent away from the beach and within the first quarter mile i was able to pass a woman on a mountain bike. the competitive juices started flowing and i started picking off women on the bike course.

i'm not 100% certain about this, but i think at some point during my transition or maybe before the race Billy had something to me about channeling Chrissie Wellington. as ridiculous as it may seem, that thought popped into my head while i was on the bike and i just went with it. i think it helped me get into a groove and whenever i lost focus, the thought "channel Chrissie Wellington" would pop into my mind.

over the 20k i must have passed about 8 or 10 women. i was extra excited when i passed somebody on a road bike with the clipless pedals. quite a few men passed me, but only one woman passed me, and that was after i'd passed her first. not bad, Sara, not bad at all.

i cruised back into the transition area, racked my bike, took off my helmet and gloves and put on my visor. it's been years since i ran a race without my visor and even though the sun hadn't emerged from the clouds, i didn't want to run without it.

one decision i had made was to bike and run with my Garmin. the only problem in doing this was that it was another thing to deal with during transitions. putting it on before the bike was fine, but after the bike section i had forgotten to switch it to running mode so i had to fiddle with it while i was running. once i got the settings correct, i realized i was running way too fast. like, sub-7 pace. (i'm now doubting the Garmin's accuracy.) my legs felt like they were at a standstill, however.

Billy yelled for me to start picking women off and i did my best, although i was unable to pick as many off as i had during the bike section. i was also successful in picking off a few men, although several seemed unappreciative of getting chicked and passed me in return.

my return to running after my injury hasn't been the smoothest. my longest run since my injury has been 7 miles, max weekly mileage about 20 miles, and i haven't done any speedwork--not even strides. i really had no idea what pace to run the 5k at, and that's not even taking into consideration the fact that i'd just swam 600m in the ocean and biked 20k. needless to say, i pleasantly surprised myself with a new 5k PR of 22:33 (i'd only run two 5ks prior to today, and never really raced one).

yeah, i passed all those people. and i smiled while doing it too.

i crossed the finish line and had no idea how i had done, but was just soooooo happy and excited just to have finished. a goal set several years ago, finally accomplished.

i didn't die, i finished the race, i wasn't last, and i finished with a smile on my face. not much more i can ask for than that.

will there be another triathlon for me? most definitely. to be honest, i was incredibly anxious about today's race since there were so many unexplored variables (the ocean swim, transtions, nutrition) but i had such a good time i can't imagine not doing another one. however, my main priority right now is getting back into running shape and building up my mileage safely so i can train for Boston. the swimming and cycling will remain part of my conditioning as two awesome ways of crosstraining and hopefully i will improve a little in both. i'd like to get more comfortable swimming in open water and refine my stroke a bit, and on the bike i'd like to get to the point where i can take a hand off the handlebars to grab my water bottle (yes, i'm that bad on the bike).

today's race was a good first step back into racing. i anticipate it will be several months or possibly even a year before i am able to set any new running PRs, but this race served as a great reminder that these events should be fun, and completion of the event can be a goal in itself. there are also wonderful byproducts of training, something i've forgotten after a disappointing footrace more than once. a few months ago i panicked swimming across a 50m pool--who knew i'd be able to swim 600m in the ocean today?

a few months ago i was really upset about my injury, but i'm now happy it forced me to focus on a goal i set long ago. one goal met ... now, what's next?

21 August 2009

downed by a two year old

a few weeks ago, i sang my immune system's praises for supporting my night shift duties for months on end with nary a concern. little did i know that my immune system would be toppled by none other than a two year old.

i spent the past week visiting friends and family on the east coast. the latter portion of my trip included a few days on the Jersey shore* with my family, including my brother and his two kids. unfortunately, my two year old niece was sick with a fever, runny nose and cough.

she's so cute its hard not to play with her or give into her requests to read Humpty Dumpty 10 times straight. little did i know she would infect me with all her germs!

wednesday night--my last night on the east coast--i had a scratchy, sore throat. i attributed it to the ocean water i'd inadvertently swallowed while playing in the surf. then the runny nose started. no worries, maybe i got a lot of sea water in my sinuses.

hours later, my nose was still running and my throat still hurt. not good.

armed with Halls cough drops and lots of water, i made my journey back across the country yesterday. in LA i found i had also developed a mild fever. time to start pounding the ibuprofen.

looks like i'll be playing nurse to myself over the next few days. hopefully i can kick this bug quickly--i hate to think Humpty Dumpty has put me out of commission!

* yes, i live three miles from the beach in LA, but i flew across the country and spent another three hours in the car to go to the Jersey shore. i don't get it either.

09 August 2009

quickly now ...

as i am supposed to be getting ready for work.

1. i finally broke down and bought an iPhone. this meant ending my 7 year relationship with Verizon. sorry, Verizon, i will miss you. but man, i love my iPhone.

2. this means i will be [re-]joining the Twitter world.

3. did the same workout today as i did on january 1. as many rounds as possible (AMRAP) of 5 push ups, 10 sit ups and 15 squats in 20 minutes. did 20 rounds plus 5 push ups and 4 sit ups. booya! the only thing was that my laundry basket is out of commission (i.e., very full) so i had no target for my squats. which is fine.

4. i also ran today--almost 3.5 miles, with no walk breaks. granted, i had to stop for some traffic lights, but still, this is very exciting.

5. unfortunately i have a tweaky spot at the end of one of my toes. really hoping this is not a stress fracture and instead a neuroma or something like that. i've had enough with the stress fractures!

04 August 2009

you never forget your first time ...

and now i've had another first i won't forget!

last night i had my first swanned patient. i'd never even had one while i was on orientation so this was a big deal for me. honestly, i was nervous but ready for the challenge. it was pretty awesome because we don't frequently have swanned patients (one or two at a time, at most) and they're usually given to the senior nurses. i'd taken care of this patient the previous night and she'd gone downhill during the day, necessitating the catheter insertion just before shift change. good for me, not so good for my patient.

the day shift charge nurse came by before she left and asked, "do you think you can handle this?" gosh, thanks for the vote of confidence. i had little to worry about, though. the night shift charge nurse and resource nurse* were quick to answer my questions and checked in on me periodically throughout the night. there were no episodes of panic, just some bouts of cluelessness when talking the medical team.

unfortunately my experience was not complete as we could not wedge the patient; the catheter must have been positioned incorrectly or something. i don't know. the idea of inflating a balloon inside somebody's heart is still pretty trippy if you ask me.

my patient was also on three pressors and an insulin drip. i've never had so many pumps in my room before. it was awesome. fortunately there wasn't too much titration going on; otherwise i would have been completely overwhelmed.

unfortunately, i'm not sure when i will get my next experience with Mr. Swan and Mr. Ganz. i'm off from work tonight, and the likelihood of me getting the same patient back tomorrow night is next to nil. but i'm happy i finally had a swan. guess i'm finally growing out of my ICU ugly duckling stage.

* we're really fortunate in our ICU to have a resource-out-of-ratio or "helper nurse," in addition to the charge nurse, who circulates and assists in patient care as needed. extremely helpful when one patient is going downhill and you still have another to manage.

30 July 2009

breaking my silence

it has been a while since my last post. it's not that i haven't had anything to write about; certainly i could have blogged about how a visitor thought my patient's facial twitching (a result of her status epilepticus) resembled talking, or i could blog about my pitiful efforts to train for my upcoming triathlon.

honestly, though, i just haven't really felt like writing and putting myself out there.

when i first began my blog several years ago, readership was pretty limited and i personally knew everybody who read my blog. i also tried to maintain a shroud of secrecy if somebody who knew me somehow stumbled upon my blog without my knowledge.

over the past year or so i've given up maintaining that secrecy, and my readership has grown (although it remains pretty pitiful), but that means this blog no longer serves it purpose as a place for me to write some of my innermost thoughts. honestly, not knowing who's reading my blog sometimes makes me uncomfortable.

i've thought of changing my blog to be invite-only. i've thought of changing the topic material and sticking to just running, for example. i've thought of abandoning this blog completely and starting over somewhere new, where i can be secretive again.

there hasn't been a precipitating event for these thoughts, besides a small resurgence of the dysthymia i've struggled with in years past. truth be told, i am lonely more often than i would like to be, and disappearing into the virtual world, where it is so easy to disappear into, does not seem to be the best longterm solution. at the same time, with the increasing activity on Facebook, Twitter, and the like, i'm not really sure what to do. how to balance all this?

obviously i haven't come to a conclusion about what i'll do. maybe some insight will be gained over the next few weeks ... or maybe not. maybe this weird anti-blogging funk will pass and i'll get back to my tales of running and tending to poop. who knows.

until then ...

24 June 2009

i believe the technical term is "wogging"

yesterday afternoon before work i had trouble sleeping so i decided it would be my big day to return to running, courtesy of Pfitzinger's recovery plan. after programming my Garmin, i walked a quarter mile to a road that has a large grassy median and started running.

if you look at the plan, you'll notice the first workout is: walk 10 minutes, run 5 minutes, walk 5 minutes, run 5 minutes.

that's all fine and dandy unless you're like me and have a serious blonde* moment and switch the running and walking segments. yup, my first time running in over three months and i ran for 10 minutes straight. definitely not what the doctor ordered.

fortunately so far there have been no major negative consequences, but gosh do i feel like an idiot.

i ended up walking/running almost 3 miles, if i include the walk to and from the grassy median. the running (a.k.a., jogging) sections were pathetically slow and i could tell i was overanalyzing every step for fear of reinjury. in addition, i've thought of switching from being a heel-striker to a midfoot-striker, so i attempted to land more midfoot during the running segments yesterday, adding to my uber conscious run. there's some debate as to whether or not it's advantageous to be a midfoot-striker and honestly i don't even know if i am a heel-striker in the first place ... maybe i should figure that out first.

needless to say, the banner on the right side of my blog is going to stay up for a bit longer, at least until i feel like i can run a few steps without thinking about every ... single ... footfall.

* i am not a natural blonde. but when i do things like this, i definitely think i should be. it would certainly save me some money.

22 June 2009

taking the plunge

... and going for a ride and a brief jog.

my bike arrived at REI the other day, and with my boyfriend's help, i picked it up on friday night. i took her out for a spin saturday morning and covered about 25 miles on the scary roads of Los Angeles. it was terrifying at times because my old bike was a clunky slow mountain bike, and this bike is much faster with skinny tires and lighter frame. the clerk at the store even fitted the bike for me, which means i am now riding more efficiently with my butt up in the air, as opposed to how i rode on my mountain bike, where i could comfortably touch the ground. i haven't yet graduated to the clips and special shoes--i had enough near falls using the regular pedals on saturday. hopefully in due time.

in other news (or, where the title of this post comes from), i registered for my first triathlon! i feel a bit silly because i'm not officially running yet, but, whatever--its been too long since i trained for something. it's a sprint triathlon and is on october 18, which gives me just under 17 weeks to train. 600m swim, 20k bike, 5k run. seems doable. nice flat course and a small field. now, time to learn everything i need to know about transitioning, swimming in open water, wetsuits! simple, right?

18 June 2009

the little immune system that could

really--i must say i am impressed with my immune system. it's carried me through the past few months of working nights with nary an issue. most recently, it helped me survive working 9 night shifts in 13 nights without getting sick.

for my recent slew of nights i decided to switch it up. my old stand-bys at avoiding illness are sleep and Emergen-C, but i couldn't rely on sleep since i usually only get five or six hours between night shifts. Emergen-C consumption remained about the same--approximately one packet every two days, but more if i remembered it.

my new strategy:
  • Kombucha--yes, i've bought into the hype. Kombucha contains probiotics, live active enzymes, and antioxidants. much of our immune system is actually found in our gut, so i figured if i supported my gut, maybe my immune system would follow. anyway, i drank a bottle of this stuff every other day while working. its an acquired taste--i imagine this is what watered down vinegar with some additional flavoring would taste like. unfortunately, its pricey, but you can sometimes find it on sale at Whole Foods or other similar stores. i wish Trader Joes would come out with a version already!
  • Amazing Grass Superfood--this was something i had wanted to try after reading about it on other blogs, but the price tag was a major deterrent. i found a 30 serving container on sale at the Santa Monica Co-Op (a good place to shop if you are rich and vegan, not that i am either) and decided to splurge. again, this is an acquired taste--its kind of like drinking grass. finely chopped organic grass. i suppose it would taste better if you mixed it with juice, but i am not a big juice person. the website touts that one serving provides you with the antioxidant equivalent of 7 servings of fruits and veggies. i'm not good about eating fruits and veggies while working, admittedly, so i had one serving every day before heading into work.
  • Phiten--my boyfriend recently gave me a Phiten necklace. Phiten claims that their products improve energy flow by stabilizing ions. i don't really understand the technology, but i did manage to survive quite a few nights of work without any caffeine at all. if its good enough for Kara Goucher and Paula Radcliffe, its good enough for me.
  • exercise--i exercised in some fashion 9 out of the 13 days, including between all of the back-to-back shifts. my exercised varied from 45 minutes on the stationary bike to 2000m of swimming and drills in the pool. maybe its all the chlorinated water that flushed through my sinuses that kept the germs at bay, ha.
there you have it. i doubt i'll work as many shifts in such a short period again, unless i pick up a second job. but, its nice to have a strategy to keep myself healthy if such a marathon stretch is required.

15 June 2009

liberation

after months of captivity, first in the walking boot and then in the air splint, my right leg was set free today. yup, that's right--my sports medicine doctor told me the last MRI showed my tibial stress fracture had resolved and gave me the go ahead to ease back into running. he also encouraged me to chuck my splint (his words, not mine), although i packed it in my bag before leaving his office. maybe i'll bronze it--i'm not sure i'm ready to part ways with it.

admittedly, i am a bit terrified. i really really really don't want to re-injure myself. this week and next will be devoted to the ellipti-hell, and then i will slowly return to running based on Pfitzinger's plan. or maybe i'll start with walking. i'll start with something. my brain is still too fried from the last week of work to know exactly what i'll do (one more night of work tomorrow which i forgot about when i wrote my last post--fun fun).

this also means i can more seriously consider a triathlon.

this also means i can return to wearing matching socks. i always wore a tall sock under my walking boot or splint, which meant i wore mismatched socks for the past few months. seriously, one of my "things" is wearing mismatched socks ... i just hate doing it, even if the only difference is the color of the logo on the bottom of the sock. yes, i'm weird, i know, but everybody has their "thing" and mine is mismatched socks.

the freedom to wear matching socks! who knew it would be so great?