Scatter my ashes here...

Scatter my ashes here...
scatter my ashes in the desert...

Monday, January 26, 2015

Mental Paws

Feeling like I'm stuck in quicksand both mentally and physically has gotten old already, so I made an appointment with my primary care P.A., to discuss this downhill slide and how to turn it around. I needed to get labs done anyway since I haven't had my thyroid checked in a while. We did a CBC with diff, thyroid labs, and a vitamin D.

I am super deficient in vitamin D, which doesn't surprise me, so I will begin taking a supplement. That alone should help boost my mood and possibly make me less achy. Everything was fine with the thyroid, so it's not that. My CBC with diff was perfect. Not anemic, no blood issues whatsoever.

After we talked about all that's going on, we arrived at the same conclusion, that it's hormones and menopause and I'm right there in the thick of it, so this is how it's affecting me. I'm up 11 pounds, and I can't run right now because my back is still not quite right. I am able to walk and get on the bike though the motivation is the problem with the bike. My brain is out to a two margarita lunch, and I have no idea when it will be back.

I feel like I'm 90, but I'm about 7 weeks away from 51. It's nearly 70 degrees here today, and I can't even get out running to take advantage of it. I took Iris for a walk and she was dragging her butt. It hurts my butt and back with every step. Isabelle didn't even want to go. We're all feeling old today.

Speaking of old, there are lots of fossils and dinosaurs in the world, and they need to move on. We have a lot of them in our government, and in positions of power in our institutions such as health care. Even if they aren't old in years, sticking to the old way of doing things in a world that has changed, and fighting for dominance to continue the old ways, not only looks kind of silly but is unproductive and wasteful.

Spoiler alert: You'll be hearing more about Fighting Dinosaurs in the near future. When you see dinosaurs fighting each other and bashing each others' skulls in, you have to wonder why they are trying to hasten their mutual extinction, and killing everyone else off with their counterproductivity. I would have to describe the nursing profession as a bunch of dinosaurs. They are still trying to train people, in the 19th century image of Florence Nightingale, with a 20th century mindset, in the 21st century of the health care reform corporatocracy. To borrow a dinosaur term from last century, Stay tuned...

Sunday, January 25, 2015

Stuck in the Starting Blocks

It's only a week from February and I have not moved, I am still stuck in the funk that I've been in for the past four months. No progress on fitness or losing the blob around my midsection and hips, soon I'll be giving Kim Kardashian some real competition.

To top it off I did something to my back a few days ago, I can't figure out what I did because I didn't work out, didn't lift anything, nothing out of the ordinary happened in my activities all week, but Friday morning I woke up with a sore low lack, and it stretched from my sacrum all the way through my lumbar area. And all the muscles in my glutes, around my hips, and hamstrings are tight and sore. Every small movement is painful.

Friday I drove to Denver to hang out with Steph for the day. It was a mental health break for both of us. We mostly just sat and talked, took her dog for a walk at the park since it was a decent day, and caught up on what's happening in our lives. We still have to carry out our mutual bucket list trip to Death Valley to see all the sights we never got to see during the race.

Getting out of the car when I got home from her house was excruciating. I iced, took ibuprofen, and slept on the floor Friday night. Saturday was hell, and I had to sit in a chair for much of the day finishing up my chemo class. Thankfully I got it done, one less thing to deal with right now. But my back hurts! Can't bend over to do laundry, pick up dog poop, empty the trash, feed the girls, or anything I need or want to do. Getting in and out of the car seat is an ordeal.

Today I went for a walk with Iris for a couple of miles and that felt okay. It wasn't comfortable, but it wasn't painful and it helped to loosen things up.

I'm not thinking very clearly or being efficient at getting any work done. My brain is not firing properly. Executive function is seriously impaired. When you get dressed you have to think about the steps in order to complete the task, like putting your underwear on first, then putting your pants on, then your shoes. It's very difficult to get through those steps. I was trying to describe it to Wheaties Boy on the phone. We've been trying to figure out when we can meet to run, and I am in no shape to get my butt out the door.

I have too many stray thoughts, my brain is unfocused and unsettled. Chalk it up to hormones, the weather, isolation, depression, who knows. It's a combination of things, I'm sure. I need to sort out the tangles. Not running at all for the past week hasn't helped. And now I can't run at all due to my back. I'm hoping things will improve this week.

I'm tempted to get in the car, drive south and west, until the sun stays out and there's no more white or gray in the landscape. Some bougainvillea flowers would be nice to see. Palm trees, oleanders and cactus. But it hurts to sit...

I'm hoping this coming week will bring me some forward progress, I can scrape the gum out of my brain and unstick the parts.

Wednesday, January 21, 2015

DON'T LOOK DOWN!

This is a story of a love affair with a running bra.

Except it's more of a love-hate story. Like a bad ex, the nightmare stays with you, even though it's all over now.

Last night, before I got out of my clothes to take a shower and relax before bedtime, I was wearing a running bra, a black camo thing, it just happened to be my favorite one, underneath a shirt that has a sort of low-cut scoop neck. I was just hanging out at the house, otherwise I would have been more modest in my dress. I bent over the sink to begin brushing my teeth and I screamed.

Not a loud, bloodcurdling scream, but a subdued, dismayed, dramatic noise that was more than a gasp of horror and less than a shriek.

I noticed something for the first time...from the skin above the top seam of the bra, extending down into the bra about a half-inch, there was something different.

It's the moment where you realize, it's all going downhill.

Turkey cleavage.

That tiny fold of skin that used to be perfectly smooth and blemish-free, now is wrinkled, the lack of estrogen to keep the skin poofed out, the undeniable quiet sign of menopause and aging.

Was I dehydrated? Was it a tight bra holding things too close together? Are my eyes going bad?

I looked again.

Dennis was downstairs on the futon, watching a movie on the laptop. He heard me scream but wasn't concerned. Now I was standing on the stairs, looking down at him.

He looked up at me, over his glasses, his headphones on like Mickey Mouse ears. "What happened?"

I shut my toothbrush off. "I have turkey cleavage!" For a split second I thought he might say, "You just figured that out?"

Lucky for him, he didn't. He shook his head. "You don't have turkey anything."

"Good answer." I turned the toothbrush back on and went back up the stairs.

I looked again. It was only there if I bent over far enough. When I stood up, it disappeared. Smooth. No wrinkles.

When I took off my bra there was no more sign of the turkey skin. I checked my neck too, smooth. No trace of turkey skin.

Dammit. That's what a running bra does to you at my age.

After all these years of trying to find the perfect running bra, one that won't chafe, won't rub your nipples raw, won't give you road rash, heat rash, scars, bloody shoulders, back and chest, wicks moisture, doesn't leave a permanent imprint on your skin, doesn't ride up, isn't too tight or too loose. It hasn't been easy. It's funny how out of all these expensive running bras I've had over the years, the most comfortable ones have been the cheap ones from Walmart.

Except now it betrayed me, showed me my latest flaw. I think I'll need a mental health day...

There's only one solution. Like I always say to women who complain about seeing the wrinkles on the front of their thighs when they run, I'll use the expression I learned from my friend Keith:

DON'T LOOK DOWN!!!!

Sunday, January 18, 2015

Spring in January, Told Ya So...

Sunny and 57 degrees, right now, going on 4 pm. It is spring, and the Great Antarctic Ice Sheet is retreating from our neighborhood streets. I no longer have to drive put of the neighborhood to start running, to avoid risking my life.

This afternoon I am kicking back after a nice long run. Long in time, not in distance. It was warm, almost 50 degrees when I woke up this morning, and windy. I needed to get at least two and a half hours in, preferably more. I decided to do a run on the Spring Creek and Poudre Trail bike paths, then followed it up with a half hour with the tire east of town.

I wore shorts! My legs are about as white as they ever get, they never get quite pale enough to blind anyone, but they haven't seen the sun in months. I got more than 15 miles including the tire pulling, in 3 hours. Slow overall pace but fighting the wind for half my run and then the tire, with the hill, so that was pretty good. Longest run since October for me.

Now I'm in the woman cave drinking a Stranger Pale Ale from Left Hand Brewing, in Longmont. They make good beer there, even if they're not in Fort Collins. The other day I made a huge pot of green chile and some refried beans, we've been living on that with tortillas all weekend.

The sun came back on Wednesday morning, Cat called me and we met up at Horsetooth for a late morning run. It was the best thing I could have done. Just seeing the sky and the scenery, instead of cold, gray ice in town, was enough to pick my mood up out of the winter depression that was setting in. I have been in a major hole this winter.

Interesting thing I found out this past week. Last year's U.S. performances in the 24 hour were posted for men and women. I managed to miss the top 25 list by just a hair. The 25th place performance was 112.9 miles. I am not sure if there's anyone else between me and her, but I ran 112.29 at Cornbelt. Damn. Not that it matters, but I guess I could feel pretty good about it given that there were not that many other women 50 or older on the list. There were a few, but most were much younger. Not bad for an old fart. I think I can still do better, but I'm not sure when or where I might do my next 24 hour. My buddy Hung Ng ended up just out of the top 25 too. We met when we suffered together at North Coast in 2013.

Here in Colorado we are spoiled, we are used to having sunshine most days, and when the sun doesn't shine for more than two days in a row, we get GRUMPY.
The girls got grumpy, too. It was cold and so icy that I didn't want to walk them, because I was afraid they would hurt themselves. Old dogs don't need soft tissue injuries. So they went without walks for a couple of days and by Wednesday Iris was bouncing off the walls, and Isabelle was ready to go first thing in the morning.

The Great Antarctic Ice Sheet has been worse this year than most, we got all that snow, it started to melt, and then we got the deep freeze. The water was higher than the sidewalks and spilling over the curbs. When it froze, the sidewalks were skating rinks. The usual ice dam at the end of our street is deep enough that if a car without much clearance tries to go over it, it scrapes the bottom and makes an awful noise. The city hasn't figured it out that every year they end up having to bring the big equipment in to chip the ice away from that same spot.

We've had some nice sunrises with all the clouds, but it's hard to not see the mountains for days on end. Grumpy. Finally today from the bike paths and the east side of town, I got some good views.

The geese were hanging out along the Poudre River, which is almost free of ice.


After the first 2 and a half hours I was starving. I stopped by the hosue and grabbed a snack, then quickly got into the car and drove over to Strauss Cabin, where I did a quick little jog to re-warm up, then I got the tire and did 35 minutes with it.

West of the cabin, off the paved roads of Horsetooth and Ziegler, there is a nice little hill where the road isn't paved, perfect for the tire.



Nice day for a tire. I hope the sunshine lasts a while...it is spring.

Sunday, January 11, 2015

Winterscape

It's been another week of low motivation, cold, and ice. Yesterday I made it out for 10 miles only because there was group from the running club going, and I didn't have to wake up too early. It turned out to be a pleasant run even though there were so treacherously icy sections.

I ran with Jacob and Dan for the first 4 miles, and it was a little bit of a challenge to keep up with them, though I did it. After a potty break at the ELC, I ended up running with Valerie and Sheila for the last 6 miles. Valerie knows all the birds, and she pointed out a kingfisher perched on a powerline overhead, so I learned a new bird.

In the afternoon I did yoga with Lauren at our class and I can tell how tight I am. My quads especially, but I think running on ice has made things even tighter because I can feel all these muscles: my groin and hamstrings and calves, from bracing on the ice. I can even feel it in my upper back.

The lack of sunshine has been the hardest part. We're spoiled here, we are used to most days being sunny. I can tell how badly it's all affected me, I've been uniformly unmotivated in all aspects of my life lately.

Yesterday in yoga I realized how uncomfortable I feel carrying the extra winter weight, and it's two months to my birthday so I am going to try to back off on the bad habits and make it a goal to drop the bike tire and hips by then. I have to start working out regularly, though, two days of running a week just won't cut it. Marissa's 12 hour event is after my birthday, and I know by then I could drop most of what I gained since the fall, maybe all of it.

This morning the sky is gray, I woke up early but I have no desire to run this early, even though 24 degrees feels warm to me now. I can run in a single pair of tights. Crossing the Great Antarctic Ice Sheet to get to Lemay Avenue, the first plowed street near our house, is the big deterrent for me. Trying not to injure myself in the four blocks to there is the challenge. It's a full mile and a quarter to the Power Trail, and I just have to get from here to there, and then it's almost ice-free.

Yesterday there was an article on the front page of the Coloradoan about the ice problem in town. Our street is one of the worst areas because of the lack of drainage and we don't have much traffic, so it doesn't ever get plowed. Our ice rink is up over the curb in some places, spilling over onto the sidewalk. It gets warm during the day and melts the snow but it doesn't stay warm enough or long enough to evaporate much of the moisture, so it pools and freezes. The small streets in town are really bad. The sidewalks are death traps.

The bike paths are mostly clear except for occasional underpasses that get slick. So there isn't much choice of where to run these days. The trails are not in any shape for running unless you want to wear spikes, or you enjoy going one mile an hour over uneven patches, chunks, and icy spots. I want to go up to Horsetooth Reservoir eventually, but the past week it was too slick.

From the warmth of the woman cave I can entertain myself watching the girls on the Buffcam in the house. Here, Iris does her leap onto the couch.
It's a good thing I'm easily entertained. Whatever it takes to keep cabin fever under control...

Friday, January 9, 2015

Spring, Hook, Line & Sinker

So far this spring sucks! We're already 9 days into it, and I am going to absolutely lose my mind if we don't start getting some consistent sunshine, enough to at least melt the ice off the sidewalks.

It's slicker than snot out there, and the Great Antarctic Ice Sheet is back, thicker than ever, filling the street up over the curb, with big fat chunks that have solidified to the point of making the sidewalk ice rinks ankle twisting hazards too. It's crazy. I can handle the cold, I can handle the snow, but ice and continued gray skies drive me bonkers!! I can't go out to run or even walk. That's how bad it is.

Yesterday was the most halfway decent day we've had so far, we did get sunshine, with a cold wind, but it was just enough to melt things to the point where they didn't evaporate and overnight it froze again and a light dusting of snow fell, just enough to coat everything in a fine layer of ice.

Then this morning I tried to step out the door to the woman cave, just to go out and turn the heat on before I started working, and two steps out the door I almost fell on my ass on the patio- the entire surfaces outside-concrete patio, gravel path, snow-covered yard, and flagstone leading to the steps of the woman cave- were an ice skating rink.

I went back in and had to put on my Yak Trax just to walk across the freaking yard!

Plus it's cold, and gray. No sunshine. The sun did seem to be trying to come through the clouds for a brief time today, but never quite happened. It hit maybe 25 degrees.

And of course the girls don't understand that I can't walk them in these conditions. I would be okay if I had my Yak Trax or Microspikes on, but the girls wouldn't be safe. They are older and it would be too easy for them to twist something or fall on the ice. Not worth it. So Iris has been pouting on the couch all day, in between brief games of hedgehog toss.

Wednesday was the only day I went out all week to run, so far. I might get out this weekend, but honestly, I don't care right now. I met Cat at the fire station on Wednesday morning and we ran 9 miles on the icy bike path, in the freezing cold. I wouldn't have gone if she hadn't called me. I have been an absolute slug all week. The weather is definitely affecting my moods and motivation.

I texted Wheaties Boy to see if he could go for a run this weekend, but he's off to Florida to run the 2/3 Goofy Challenge, as a pacer in the Disney Marathon, Maybe next week we can do a few miles.

Meanwhile, my fitness takes another slide. I am just not in the mental place to sit on the bike and pedal. That's just where I am. I don't care.


This past week I had an interesting conversation with someone I used to work with, about healthcare and nursing leadership. He quit and moved on about a year after I did, and it was excellent validation to hear that the same things really do occur at all levels of an organization and hear echoes of the same sentiments I've had, about the need for professional nursing reform, about the profession dropping the ball when it came to health care reform, the failure of any overarching organization to support nurses, the higher education scam in nursing, and the inability of different players in the organization to communicate with each other at all, in any language, of business, medicine, nursing, or whatever.

It also reinforced the point that I needed to hear, which was, that good, strong leaders help to nurture people and their ideas and bring them along, but if you're in an organization that has leadership who fail to recognize or value the potential of their people, you are sunk, and you might as well get out.

I've been working on an idea recently that has to do with blogging, and this blog will not change much from what it does now, but I am seriously considering taking my health care vents and rants to a separate blog with a completely separate agenda. That blog would have a different character from this blog. When I do it I will announce it, and I hope that readers will check out the new one.

After over a year away from the corporate world, I'm still so passionate about changing the nursing profession, and I hear it from so many other people, the same thing, from nurses all over the world, and nurses need an outlet for their voices to be heard, because they aren't being heard in the workplace or by any organization that even slightly supports nursing. For all my snarling and bitching, I do have some ideas on how things could be changed. Lots of other people do too, and those ideas need to get out there in a visible way.

Otherwise it's just like being at work, everyone puts on a happy face for the powers-that-be and for the patients, but behind the nurses' station they're bitching and moaning and miserable. You can't make change within these entrenched institutions so it needs to be done from outside. So it's time to get the ball rolling. Stay tuned.

And stay warm.

Monday, January 5, 2015

Wrong Way

Physical activity needs to come first.

That's just one of a few of my thoughts on health care as we enter this new year under our still-newly implemented health care reform system. I think we're headed in the wrong direction, even though we do desperately need to reform the way we do health care in this country. As a nurse and health coach I see firsthand what's wrong with our approaches, in people's everyday lives.

I just spent some time writing a chapter in a book on nurse empowerment, and the topic of my chapter had much to say about nursing leadership in the current climate of health care. Then I read a couple of articles this morning, both of which echo what I have been saying and observing for so long, that we are going about things the wrong way by trying to do "health care reform" by approaching health care the same old ways, by the top-down, paternalistic, medically-reliant model.

The opinion piece I read this morning asks who really is pushing health care reform along in this country, but the author asks it from a physician's viewpoint, steeped in the medical model. I have a different take on it from a nurse's perspective. Here is my reply so you don't have to wade through the comments:

"Coming from a nursing perspective I see many of the same problems in the health care system. RNs are currently being used as waitstaff and should instead be utilized to the fullest extent of their skills and training. If the entire health care system would rely on a less hierarchical system and use a care-based model, holistic in nature much like nurses are trained, with medicine as a part of the approach but not the guiding approach, we could make great strides in health outcomes. The medical model has a blind spot and physicians do not usually see or understand the value that nurses bring to health and care. We could make your lives so much easier if we would all work together to provide education, coaching, and reinforcement for patients, especially in regards to education in the community and from a very young age in the public schools (huge political and legislative hurdles notwithstanding). The current corporate model of profit should not be directing health care as it is unsustainable, and the current top-down model of medicine guiding health care is also unsustainable if we ever hope to put a dent in the growing costs of early onset chronic disease, or health care waste and costs throughout the lifespan."


And then I was doing some further reading, and stumbled across this blogpost, which really spoke to me, not just because exercise and oncology are my primary areas of professional interest, but also, because of the problems with our health care system, namely the way in which health care reform has been implemented to benefit the profit margin of certain segments of the industry which do not directly serve public health or care.

If you haven't been around the running scene for several decades, you might not remember former U.S. marathon champion Ken Martin, but he ran a 2:09 back in the day. Now he is an exercise-oncology research advocate and post-stem cell transplant cancer survivor. He writes an excellent blog on physical activity and cancer. Here is a quote from the blogpost.

"If patients are willing to have their bodies ravaged by surgery, radiation, and chemotherapy, all of which can decrease physical function, then it shouldn’t be too much to do 30 minutes of walking a day, however one wants to carve that time up, as a part of cancer treatment plans or at least as a part of survivorship care planning. With better planning prior to first treatment maybe exercise can improve cancer treatments and reduce treatment side effects, including cancer related fatigue, which appears to be more debilitating than we thought." -Ken Martin

If you don't know how to plan an exercise program, and you make it either too challenging or not challenging enough, you will not get the benefits, because you either will give up, or you won't be working hard enough to be effective. Current guidelines on exercise state that you should do at least the effort level of a brisk walk for 150 minutes a week, or 30 minutes a day 5 days a week, it doesn't really matter how you split that up as long as you do it.

There is ample evidence of the health benefits of this type of exercise, however, in order to improve fitness beyond basic health maintenance, it is necessary to do more than this, in terms of how hard, how often, and how long. When a client comes to me frustrated because they have been able to do 150 minutes a week but feel they haven't accomplished the fit, hard body like they hoped, I explain it takes much more than that to achieve the fit, hard body.

Evidence suggests that certain types of cancer, such as colon cancer, are better addressed by at least 6 hours of this level of exercise weekly. That may be because the health of the GI tract depends on adequate motility, and exercise helps to "keep things moving", but there are lots of other reasons this could be the case, I won't even attempt to make assumptions.

The point is, if you want to exercise but know very little about how to plan an exercise program, and especially if you've had some sort of chronic disease or cancer diagnosis, it's important to work with a coach who can help you determine what you need, what is appropriate for you and a realistic starting point for you. It takes time, patience, and persistence to achieve the benefits, but you will.

When you think about how much health care costs and how much pain and suffering you go through as a result of chronic disease, why wouldn't you want to make the investment in yourself before these things occur? Either you will prevent the illness from occurring altogether, or if you happen to be unfortunate enough to be diagnosed with cancer or another illness, by being physically fit you will likely reduce the overall amount and length of medical interventions such as medications, chemo, surgeries, tests, labs, and imaging that will you need, which reduces the cost, too.

Nursing takes a holistic approach to health, and that's where I'm coming from as a health coach with a nursing background. I look at all of the things that affect our overall well-being. Physical activity is one of them, and I believe a huge part. It's not everything, but it is an essential piece of the puzzle, linked to all of the other pieces holding us together. It takes time and a little money to incorporate health behavior changes and reap the fitness benefits, but it takes a lot less time and only a tiny fraction of the cost, for example, of complications of diabetes, or cancer treatment and associated recovery.

The other point is, we are going about things the wrong way. The corporate profit and power approach is killing us. There is nothing wrong with making a profit, or with being in business, but it cannot come at the expense of public health and our fellow human beings. That is simply unsustainable.