Work Hangover Wednesday: And Your Little Dog, Too!

This Valentine's Day is shaping up to be very appropriate to the theme. I have my ACLS renewal class on Thursday, so I'll be pounding on mannequin chests doing CPR.

I'm a little stressed about the class. I don't use ACLS very often in my current job, or look at EKGs very often. The guidelines have changed since I last renewed in 2011, so there is some new material, the drug doses have changed, and I've never taken the one day class before, always did it in two days. So I'll be really glad when it's over.

This morning I read about this. All I can say is, glorifying gluttony is hazardous to your health. And the nurse waitress uniforms, well...I could try to laugh, but I'd rather cry. Obesification again, and nurses as waitresses. Doesn't sit well with me, and my sense of humor is non-existent today.

It's also Ash Wednesday. I would say there are a lot of people out there who should consider giving up gluttony for Lent. But then, who am I to judge. I am the last person in the world to be proclaiming what Jesus would eat. The Pope retired, so maybe there is no Lent this year. Let's all eat quadruple bypass burgers.

I am in a mood today. I already had a suckfest of a work week. I ended up going into overtime on Monday night because one of my patients had a mild reaction to a platelet transfusion, fortunately they were okay, but I had to make a trip down to the ER with the patient. I was the only nurse there, it was the last patient of the day, and I couldn't get a hold of the doctor after hours.

The doctor on call was a neurologist from a hospital in Denver, who had no clue about how to manage a blood transfusion reaction, which we do all the time. So that was no help to me. I needed an order for medication. Our secretary was trying to go home for the day, and she got stuck making phone calls for me, and we didn't even have the right number to call.

It was all I could do to be civil to the doctor on the phone, even though it wasn't her fault. Not enough thought had gone into the process of scheduling this patient, and it relates to staffing and changes going on in the system, among other things. Long story. What happens? The patient suffers, and the nurse caring for the patient does, too.

I had steam coming out of my ears by the time I got a hold of the patient's primary care physician and they were no help either. So I took the patient to the ER and that was that. I spent nearly two hours charting and doing paperwork related to the event.

Then Tuesday I had a long day of chemo plus other patients. I was so tired by the afternoon, starting at 2 pm I was looking at the clock every half hour and thinking, 6 more hours....5 1/2 more hours...

The general mood at work has been rather sour lately, it's hard to keep my spirits up when everyone around me is grouchy and fed up. We've had so many changes at work and it's chipping away at morale. The summer vacation scheduling part is only a small issue.

On the positive side, I did find out that it's likely that I will be able to get time off for the Cornbelt 24 Hour run. On the really sucky side, looks like working medical at Badwater may be out of the question this year, unless a miracle happens in July.

I've decided that this week I am not going to stress myself out by trying to get a million miles of running in. I'll get my quality workouts and run a hard 20 miles with Wheaties Boy on Sunday, but I need to keep my brain from spinning inside my skull again. I can't be wasting energy perseverating on stupid things.

Tonight I will run with the Wednesday night group and take the girls for a short run this morning, or what's left of it. Hoping for a nap so I can feel human again, and have a brain for my class tomorrow.

I really feel like telling everybody to F-Off today. It's a good thing I don't have to work again until Monday.

I have no heart, and no brain. Stay away from me, or you'll regret it...and your little dog, too!

Obesification: Killing Our Kids

I found this fascinating.

Yesterday we saw a young family, the parents and two little girls probably 8 to 10 years old. The parents were noticeably overweight but not what I'd call obviously obese. I'd say average based on the majority of people I see these days. But the little girls were both fat, in my opinion, at least working on obese.

I wonder, what are these kids eating, how much are they eating and what, and what are they doing all the time?

Allow me to rant for a while.

Obesity is one of the most pressing issues we have to deal with not only here in this country but worldwide, as it's spreading. Pun not intended.

This video caught my eye not only because I'm interested in the topic, but I used to work for this organization, Scottsdale Healthcare, it's a good hospital system and good place to work, doing some cutting edge work in certain areas like bariatrics.

I first saw this in one of the e-mail medical newsletters I read daily.

Diabetes is an extremely costly disease. The complications: cardiovascular disease, neuropathies, infections, organ dysfunction especially of the kidneys and eyes. Limb loss. Sepsis. Dialysis. Premature death.

We also need to attempt to stop it before it happens, like not letting people get to a BMI of 30 in the first place, even though some people are more likely to go there due to genetic influences. The video doesn't talk about changing behavior early on, intervening before a person starts to become obese and the metabolic signaling results in diabetes.

Years ago people were not so fat. They were more active. They didn't have the range of sedentary activities to keep them mesmerized. There wasn't the range of bad food, and the ingredients, and the portion sizes.

There is a huge genetic influence on obesity. But that doesn't mean we throw up our hands and say, wait until the person is diabetic then give them a sleeve gastrectomy.
We need thinkers like Dr. Blackstone to manage the medical approach to this disease, but we also need more action on the prevention end of things. We certainly aren't doing enough lifestyle interventions to help solve the problem.

Bad workplace habits, poor city planning, commuting time, work schedules, stress, availability of healthy foods, poor food choices, lack of leisure time, poor leisure time choices, lack of physical education that truly teaches kids how to develop healthy lifestyles, all of these things and more add up to what? Sleeve gastrectomies?

No!

Simple things! Behavioral, exercise and nutritional screening, screening for tobacco and alcohol consumption, electronics use and TV watching. Intervening in each of these areas through real, solid active approaches. Doctors aren't necessarily good examples at all.

I'd like to see total screening in preventive care as an ongoing intervention, with education and practice throughout the lifespan. It doesn't belong primarily in the domain of preventive health care in a doctors' offices. The schools could play a huge role, along with the community organizations that sponsor youth activities. What to eat, how to cook, what to buy, what to avoid. How to increase activity, emphasizing less sedentary time. Adults and children need it.

As people get older, include thyroid screening. You wouldn't believe how many patients I see, they tell me they're tired all the time. When I look at their labs, I see elevated TSH and they're not on thyroid meds. When I ask about it, they look perplexed. Many cancer treatments can affect thyroid function but many of these patients are not getting treatment for cancer.

The thing is, we already know all this stuff. We know what would work. But there's a lack of organized, coordinated societal effort. In the video, Dr. Blackstone acknowledges that some of the other medical disciplines such as oncology and cardiology have had a lot of success with combination therapies, including behavioral interventions and medications, in addition to surgery. It is a multifaceted problem and needs to be treated accordingly.

But when I see little kids who are well on their way to becoming obese adults, it makes me cringe, and I know we are setting them up for failure early on, before they ever get a chance to learn to make healthy choices for themselves.

And I think that's a major failure on the part of the adults in this country. We know better, and it's outright negligence to continue to allow this to happen.

end of rant, for now.

(cross posted at ultrahypo)

Work Hangover Wednesday: Towanda! vs. the Zombie Apocalypse

What a week. The Zombie Apocalypse is making news headlines. It's an election year and we're more interested in reading about people eating each others' faces than we are about the issues facing the nation and how to solve them intelligently. The Merikins continue to drink the zombie kool-aid (pictured here).

I'm feeling pretty snarky today. In fact, I feel extremely, dangerously, over the top snarky, and really bitchy too. I'm starting to wonder if these face-eating zombies might be perimenopausal women.

Just this morning in the grocery store parking lot, I was having a Towanda! moment. It was all I could do to keep myself from verbalizing the thoughts going through my head. "The world is being taken over by f***ing idiots!" People are completely OBLIVIOUS to what's going on around them.

I wanted to back up and smash into the driving school car that stopped behind me, basically, parked, just as I was trying to pull out of my parking space. It looked like the teacher and the kid were planning to park right there, at a 90 degree angle to me, just having a conversation, OBLIVIOUS to my reverse lights.

I'm older and I have more insurance. And furthermore, don't teach the kid to do stupid things in the parking lot. I was really tempted to Towanda! them. Instead I got out and walked toward the instructor's side of the car, finally she realized what they were doing and looked apologetic and made the kid move. Hel-lo?

By the time I got to back out of my parking space, then I had to deal with the clueless mom jabbering on her cell phone, walking with her two kids down the middle between the parking spaces, OBLIVIOUS to the cars that were trying to get in and out.

The past week or so I've been in a funk and it's most likely hormones, but I feel like I'm about to become someone else. Like somebody who walks the street downtown ranting and raving about whatever the voices are saying to them at the moment.

By the time I get home Tuesday nights, after two busy days at work and listening to a lot of people who need more than just IV therapy, there are times when I start to feel like I need therapy myself. I'm not even being sarcastic about that, there are some sad stories out there. Sometimes I can barely get away before the tears start rolling down my face.

What brings out the snark in me are the people who create their own problems and refuse to own their own crap, and try to blame everyone else for their victim attitude.

In the midst of the national paranoia about government taking action on something that might actually help us, someone is finally stepping up to take action. I'm glad to see it. Long overdue.

Our zombies who continue to eat recreationally with their own faces stuffed full of bad food, and allow the manufacture, advertising, and sales of bad food, in the face of an epidemic of fat kids who are growing into even fatter adults and soon will be getting IV antibiotics for their non-healing diabetic foot ulcers and having amputations at age 30, continue to lead sedentary lives hypnotized in front of the TV where they can be sold the next sugary excuse for food.

Someone is doing something about childhood obesity, and who ever would think it would be a huge entertainment corporation, but Disney is taking action. Soon there will be "Mickey Checks"- meaning if the product is mouse-approved, then it gets the thumbs up for advertising on Disney.

Recently I had an opportunity to try GoGurt. It's sold as a healthy snack for kids, but it's full of sugar. It's enough to gag anybody. That's why they call it Gogurt- because the kid goes on sugar until he crashes.

We'll see if this anti-obesity effort catches on, but good for Disney for being willing to make the first corporate move.

Time to stop bitching and talk about what I'm excited about. Number one, I just made all my reservations for my trip to Death Valley in July to be on the Badwater medical team again. I can't wait!

And next week we start the Double Mick.

Time to get busy packing, and maybe later I'll actually get my butt out the door and go running...

Obeseification

Lately I've been avoiding King Soopers, the big store close to my house where I used to shop for a lot of our groceries. It's part of a national chain, Kroger. Instead I shop mostly at Sunflower Market, which is within walking distance of our house and is smaller.

King Soopers used to be a nice store as far as supermarkets go, but then they expanded it. As a result of the expansion, the aisles seem longer, narrower, taller, and more cluttered. You can't see where you're going, because the shelves are so high they impede the view of the directory that tells you what you can find in the next several aisles. And of course it's just what our expanding population needs- more choices of more bad food.

It's also very expensive. Things that are packaged are expensive. They are colorful and are wrapped in materials to make them more visually appealing. I find the supermarkets overwhelming. I feel bombarded with color, clutter, and noise. It's too much input for me, and you get distracted by all kinds of things that seem to jump in your face, which is no accident. You end up spending more money as a result.

Big box stores take a long time to get through if you just need a few items, usually you end up covering the entire store because things are spread out in different aisles. I also find it irritating when you have more than a few customers per aisle with grocery carts, because you have to maneuver around each other and it's hard to focus on finding the thing you want in the multitude of choices.

When I go shopping, for anything, I know what I want and I like to go in, get it, and leave. I find that big supermarkets are a huge waste of time and energy, so if I can't find it at Sunflower, I either don't need it or I plan one trip to the big box, preferably early in the morning before the crowds show up.

Now it's Christmas and every end cap, and all the big aisles, are full of glitzy plasticized garbage, and you have to listen to Christmas music, interrupted by advertisements. The store is crowded, even though they expanded, the aisles are not wider- just more numerous, so it gets to be really annoying when more than two or three people are shopping in the same part of the aisle.

So last night, as I was trying to get to the dairy case and having to navigate through freezer cases in the middle of the aisles, and huge cardboard displays of red, green and gold Christmas crap, I moved my cart to get out of another customer's way, and nearly knocked over a pyramid of chocolate covered Ritz crackers.

I have no idea how long these have been around, but it's new to me. It sounds disgusting, but I don't like Ritz crackers, and they fall into the category of things I would never buy unless I were running a really long ultra and needed salt, fat, and variety. And even then, I'd choose some other crackers.

Seeing this product struck me as so disgusting, I pictured people as wide as the aisles buying them, huge rolls of fat flopping off their waists, shirts that barely covered the bottom of their hanging pannus.

That people will buy this crap is what really bothers me. The food corporations are profiting off the destruction of our health. People spend money on a package of air, surrounded by cardboard and cellophane, with contents of so little nutritional value. I don't know what they cost, I didn't notice the price, but I imagine it's probably 3 or 4 dollars a box. And for that you could buy a gallon of milk, some yogurt, beans and rice, or some vegetables instead.

I'm sure the Nabisco corporation is planning to put a portion of their profits toward national health care and diabetes prevention.

It's apathy. Most people who shop at these stores do know better, but they fall into the traps of marketing. Someone is getting very wealthy off your failure to think. And it's not the people in the factories making the crackers, either.

If the store continues to sell things like this, they will have to expand again because no more than one person at a time will be able to walk down the aisle, they'll be so fat!

Come on people, use some part of your head besides your mouth! Quit supporting the gluttony!

How lucky we runners are...

In my life outside of running, I am an oncology nurse. I see some parallels between training, racing, and going through cancer treatment, but when my races are over, I can go home and rest. For someone with cancer, there is no finish line.

I see patients running their own personal ultramarathons every day, propelled by their inner drive, perseverance, courage, and will to live. They don’t know where the finish line is, but they give everything they have to the race.

Yet every day at work, a common theme I hear from patients who are in for the battle of their lives, and are as sick as they've ever been, is how much they have to be thankful for.

I see them for weeks or months, until they finish their chemotherapy. Often they have already had some type of surgery that alters their bodies, and they might have radiation too. It’s more than a full-time job for them. Not only do they average eighty medical appointments in the year after diagnosis, but the treatments leave them fatigued, sometimes nauseated, or with nerve damage to hands or feet making it difficult to walk or do fine motor tasks like buttoning their shirts. They can be vulnerable to falls, infection, or bleeding, and unable to concentrate.

No one can manage cancer alone, and not without community support. There are many other equally important needs that go along with cancer treatment, such as having to negotiate family responsibilities, employment and financial issues, and social relationships. None of these things go away when a person has cancer. And not everyone the person with cancer has to interact with is understanding or informed.

Even their families can fail to become educated, sometimes willfully. Sometimes it's because of fear, or sometimes a low educational level. Or they just don't want to know. They expect the person to come home from their treatment and go back to being themselves, to keep doing all the usual tasks at home, or at work, such as taking care of sick kids, doing the cooking, cleaning, and activities that can expose them to life-threatening complications. Imagine knowing your immune system is very weak and having to go into public places where people cough in your face, or don't wash their hands after using the bathroom.

For the cancer patient, all of this is like being on a treadmill that has no “off” switch. After treatment, if the cancer is gone, they can't just pick up where they left off. It’s not like coming back from a running injury. Cancer changes everything. Relationships and family dynamics are affected. The person needs to adjust to changes in a body altered from surgery or radiation damage. If there are lasting effects of the chemotherapy, like nerve damage, the person might not be able to drive. Repeat checkups and scans must be done for years to ensure the cancer has not come back. Nothing is guaranteed but hope.

I'm not writing this as a scare story to dramatize the effects of cancer treatment. This is reality. Some people have these side effects I've mentioned, some don't, and some have it worse than others. This is not all-inclusive, either. There are lots of things that happen along the way in treatment. One in three of us will be diagnosed with cancer, and the older we get, the more likely that is to happen. If cancer hasn't touched you or your family, or anyone you know, then you are in a rare category. Inform yourself, because eventually you will be touched by cancer, indirectly, or otherwise.

Restoring quality of life for the whole person who has been diagnosed with cancer is a challenge. The road back to wellness is a lot longer than the treatment itself. The support of this community in the form of a cancer center will ultimately shorten the distance back to wellness for those with cancer.

The greatest gift you can give is to do the best you can every day with what you have. If you can do something that has meaning for you, and helps someone else, you win the race. If you have your health now, then you already have a head start. Use it to your advantage, and reach beyond your own fitness, competitiveness, vanity, or whatever else is driving your running.

I look around and see so many overweight people everywhere. Even here in Colorado, where we have the optimal conditions for a variety of outdoor activities year-round, we have a growing problem. So many health problems stem from obesity and other unhealthy behaviors like sedentary lifestyles, smoking, overconsumption of alcohol, overexposure to the sun, unhealthy diets. Cardiovascular disease, diabetes, and cancer are costly and a huge burden to all of us.

What is even worse is that so many children are overweight. They are getting a bad start in life when it comes to their health. They aren't active enough, they are exposed to TV advertising of sedentary games and junk food. Not enough of them ride their bikes or walk to school, and they don't play outside the way we did when we were kids.

Schools in our community did something extraordinary this past year to raise funds for the PVHS Cancer Center. Three elementary schools each held a wellness day where the kids ran and walked laps and played soccer. They were doing their best, being active, and turning their activity into a meaningful gift to their community, raising nearly $13,000 through pledges. One of these schools is in a neighborhood that has the lowest income in the city.

This holiday season, when many people are struggling to meet their basic needs, shopping for gifts is overwhelming, stressful, and financially challenging. One great gift idea is to give to a charity in someone else's name. Even a small gift makes a powerful statement.

My gift is my health and ability to run ultramarathons, when I use it to give something back to my community. I'm supporting the Cancer Center here, and making the Survivorship Center within it a reality for those in our community who will need it. Make running your gift this year, wrap it into something meaningful to you, to help people in your community.

If you are fortunate enough to know where your finish line is this year, find your own gift of activity, live it, and give it. Let your finish line be the start of your next adventure.