Ultrarunners understand RFMs- relentless forward motion. We often use our determination and mental strength to carry us forward through discomfort and difficult situations in our personal lives and work lives in addition to our athletic pursuits.
I had a conversation with my friend Lisbeth Overton yesterday in a podcast for Nurses' Week (listen here). We talked about the difference between moving forward one foot in front of the other in a way that breaks you down, versus moving forward intentionally with progress. I want to say more about that because right now, between healthcare and the crazy shit happening in our country, it can be easy to go to a place of despair.
I've found myself over the past month deteriorating into that place of despair and realized I need to get out and move more. I have been so bad about allowing myself to not go outdoors to run in the bad weather this winter. I need the fresh air and the brain break it gives me. Being a bit of a political news junkie and overthinker has not been working in my favor lately.
Lisbeth and I talked about how so many nurses are struggling and frustrated with the opportunities and working conditions their profession affords. They want to use their knowledge, talents, and skills to truly make a difference in patients’ lives, but often there is no place for that in the task-oriented, rushed and understaffed workplaces of healthcare facilities and hospitals.
Many nurses wish they could break out of the grind, find a better job that allows them to practice patient care they way they’d like to. They can feel stuck, which leads to despair, low morale, burnout, and health problems, none of which are good for taking care of sick people.
There are two ways you can move forward: one is to grind through, trudging with dread because you feel like you have no choice. The other way to move forward is by taking small steps, still moving forward, not any faster, but with intention and action, no matter how small those actions are, but doing something to move yourself toward better days.
The lesson, I think, that ultrarunners have learned, that sedentary people need, is that active leisure is such an important and undervalued part of our lives. It seems that so many people have forgotten how to play. Too busy chasing material objects, or buried in our electronic gadgets and devices, we end up sitting down as time flies past us.
The time focused on a screen takes away from the time we’re aware of our environment, using all our senses, learning, and appreciating what is in our world at arm’s length. Unaware of our surroundings, we could be moving and breathing, paying attention, burning calories, reducing our fatigue, circulating our blood, and boosting our mood and energy.
People who have not pushed themselves toward physical goals, who are not athletes, often miss out on the rich lessons that athletes learn, of pushing beyond prior achievements, and refusing to accept outwardly-imposed limits. We're always looking to go further, in distance, time, space, or experience.
Working with cancer patients, acutely ill people, and those with chronic disease, I've observed what being an athlete can do for a person in terms of mental and physical strength. Athletes who do get sick are at a big advantage, not just in terms of likelihood of recovery and regaining function and quality of life after an illness, but in coping with the physical and mental demands of an illness, even when there is a discouraging prognosis.
I used to say to my co-workers in the hospital, that it was easier to run a fifty miler than work a twelve hour shift. None of them believed me, but for me it was true. If you're going to be on your feet for 12 hours, you might as well be outside without crazy demands on you every second. Plus you can eat, drink, and pee whenever you want!
When it comes down to it, nursing is about public health, helping people (the public) get healthier, function more effectively, and live better lives. All of the major issues facing our country right now are connected to public health. Here is an incomplete list:
1. Income inequality- the greed, sociopathy and lack of empathy that leads us to a place where a few people have the overwhelming majority of wealth so that large numbers of people are unable to meet their own basic needs or access adequate services that allow them a decent opportunity at a decent standard of living and level of health. People who have to work two or more jobs to pay their bills are unable to take care of their own health.
2. The lack of mental health services, proper care and treatment of addiction, unaffordability of health insurance and prescription drugs, and near-monopolies that destroy competition and drive up prices, make decent healthcare out of reach even for those with health insurance.
3. Our stressful lifestyle- too many people are working too hard for too little compensation for things that are too expensive and often unnecessary. Poor community planning leads to overreliance on vehicles and commutes that are detrimental to our environment, people's health, and financial well-being. We don't have enough mental health services available and people don't demand them because of stigma associated with mental illness.
4. Obesity and metabolic disease are an epidemic, for many of the reasons cited above- community planning, mental health, low incomes, working several jobs, lack of education, feeling powerless, cycles of abuse...
5. The opioid crisis, a result of greed, poverty, lack of mental health services, lack of education, unemployment, family and social cycles of stress and despair.
6. The gun violence epidemic- children and teachers shouldn't be traumatized by the idea of being shot at school, and parents shouldn't be traumatized by dropping their kids off at school to get an education. We had another shooting this week in Colorado in Highlands Ranch. Our U.S. Senator Cory Gardner, big NRA money recipient, has blood on his hands. AGAIN. And again, nothing is being done legislatively to stop this.
I think if we could solve one of these problems I think income inequality and the factors that lead to it are the key. I think nurses need to make it our business to push for social change. And I don't think we've done nearly enough on that front, at least not in a publically vocal and visible way. Nurses care for other people regardless of who they are, their background, what they look like, or other characteristics. No matter how much the current sociopathic executive in chief wants to erode this.
Nurses could teach the public a lot about how to truly care for others and to see the humanity in everyone. I think it is something we've lost in our country- the idea of caring for others and considering others' needs before asserting one's privilege and "rights". If we cared for and about each other, we would be caring for ourselves, too.
I needed to get some miles in this week, but I didn't have a lot of time to plan something. Decided I wanted to get a long run in, but it was easier to split it up into two days. I settled on 50 miles broken up into 30 and 20. That way I didn't have to rest so much or plan- both days could be low key, just a little longer than my normal run.
I woke up super early for some reason on Wednesday and got out the door by 4:45 am to start my 30 miles. I ran for about three hours and watched the sun rise, then came back to the house, got Velcro and Gypsy, and took them for about an hour run, then brought them home so I could finish my miles. All went well, I felt good, and kept a decent pace all morning.
I ran into two people I know at the lake, one is a runner I see often over there since he lives by the lake, and the other was a surgeon who is now retired, but I used to work with him when I worked in ICU. We stopped and talked briefly looking at the lake. He said something about next time there being snow. I'm not quite ready for that, but it will happen soon enough. It sort of feels like an early fall, it's been cool in the mornings and the trees seem to be changing colors earlier than usual. The sky was so clear today, I could see the Indian Peaks south of Longs Peak, which I haven't been able to see all summer, with all the smoke from the fires everywhere.
I got done with the run feeling like it was no different than my usual 10 to 12 miles, got some things done in the afternoon, pulled 40 pounds of grapes from our vines off the stems, ate dinner and went to bed.
This morning I woke up later and took the girls for the first 6 miles of my 20. As we rounded the lake I saw two people walking, a man and a woman, and the man looked somewhat familiar. I saw him look in my direction too, but we ran by and he didn't say anything. I wracked my brain to try to figure out who he was and how I knew him, then it hit me like a lightning bolt- he worked at the hospital too. I remember talking with him as he was often working part of his day in the ICU.
As we turned around to run back toward the lake, they had turned around and were heading toward us. This time we looked at each other and stopped- and yes, it was him. We hugged each other and he introduced me to his friend, who also worked at the hospital. Now they are both retired. He introduced me as "used to be an oncology nurse" and I told him that I still am, briefly told him what I'd been doing since I left the hospital. He's been gone from there about as long as I have been. He said he was glad to see me and also said he's always happy to see people who thrive after leaving that place, and his friend nodded. He said he was really glad to leave such a toxic work environment.
It's funny because now I clearly remember the day I was so pissed off at my boss, who had terrible management skills, and I was ready to tell her to shove it up her ass. I left the hospital crying that day and that night I wrote my letter of resignation. As I was leaving work, I ran into this same person I saw at the lake today, and he gave me a hug then and wished me well. He knew at the time that there was so much bullshit going on in the hospital. I'm glad he got out, too.
I brought the girls back to the house and went out again, first stopping at the donut shop because I was hungry and it was conveniently located. I didn't plan for much running food, so I ate what was easy to find. After that I went south of where I usually run, and made a stop about three miles from home for an ice cream sandwich and cold water, as it was getting hot and my water bottle were getting warm. I felt fine, like I did any old run. I can definitely feel my fitness and endurance have improved since the beginning of the year.
After my treat, I finished my 20 miles, and spent the afternoon making tomato bisque soup from our tomatoes and putting the de-stemmed grapes into plastic bags to freeze so I can make jam in a few weeks when I have time. I'll be doing a little traveling for a while, and then There Goes the Sun 12 hour run is on the day of the Fall Equinox. After that I'll have 3 more months to get ready for Across the Years!
One of my pet peeves is the strain of armchair oncologists who seem to proliferate unchecked, spreading their genetic pollution and bullshit among the human species.
Those are the people who have no education, training, license, degree, board certification, or experience in the practice of the medical specialty of oncology, but possess the unabashed confidence that they know what will cure and/or prevent cancer better than anyone. Especially anyone who promotes the conspiratorial discipline of western medicine that is surely out to irradiate, poison, and depilate us all so they can laugh all the way to the bank. (Please, I’m being sarcastic here).
At the risk of sounding like JP Sears I need to release my frustration and exasperation. (I think JP Sears is hysterical and I wish he would do a video on curing cancer, it would be hilarious. And it would benefit me immensely- he could be the one offending people, allowing me a safe harbor for avoidance)
Since I rarely avoid confrontation anymore, I frequently set up a table or booth at health fairs and public events where I can promote my services and interact with people to discuss cancer. My cancer literacy booth contains information about why it’s important to think about cancer even if you’ve never had it, and has a list of common myths vs facts, basic information, and resources.
In these events I find out what people are thinking, seeing, experiencing, and perceiving about cancer. It helps me direct my information more effectively in meeting their needs. I often deliver educational presentations to dispel myths and misinformation about cancer. While I soft sell my book and my services as a survivorship health coach, speaker, educator and writer, one thing I do not do is hard sell products or services. Especially not products.
I frequently get cold calls from hucksters hard selling the latest in nutritional products or supplements who think I’d be willing to spread their crap to my own clients. They find out quickly how mistaken they were in contacting me.
When I set up my booth, it’s always hard at first to get people to come to my table- they see something about cancer and they avoid eye contact, the ambivalence is palpable from across the room. There’s some fear, but they are curious- it’s that morbid curiosity, yet they tend to stay away unless I can make eye contact with them and draw them in.
And there is always one person, who thinks they know what to do about cancer better than anyone else. They’ve never had cancer themselves, of course, but they know. And they come right up, without hesitation, complete with chest-puffing bully bravado and steam coming out of every orifice.
As it was with Kombucha lady.
She ambushed me before I even saw her come up to the table.
“Do you use Kombucha to cure cancer?” were her first words to me, before I could even greet her.
Her question took me by surprise at first- maybe half a second- and then of course I knew what was coming. I said, “No, I don’t.”
She shot back, “DO you know what Kombucha is?” As if I surely didn’t know.
In a covertly snarky but fake validating tone I said, “Yes I do know.”
First, there is nothing in my booth that says I cure cancer. I am not a doctor and I’m not even providing nursing care- what I do is called education. I even have a disclaimer that says all of that.
She gave me the side-eye like she didn’t believe a word I was saying. “Kombucha is better than any of that chemotherapy or radiation or those other cures that just poison you. People who drink Kombucha are completely cured- but the medical profession doesn’t want people to know that. There’s been research too. It’s all been hidden and it’s done in Russia. There’s this one place in Russia where everybody drinks Kombucha and nobody has cancer. You should look it up.”
She almost stopped but before I could reply, she continued, ”I know this goes against your western medicine point of view, but it’s true. You need to look it up. And I know, because I’m a PhD candidate.”
Oh, Lord.
I don’t think she saw my business card that says I have a PhD. I know she didn’t read anything in my display. I didn’t say anything to her that would convince her that my point of view was entirely driven by Western medicine. I scrambled for something to say that would either make her shut up and go away, or disappear. I didn’t have any water to throw on her.
“Well that’s great, with a Ph.D. you will be able to research that and when you have the evidence you can shout it from the rooftops.”
“Oh, it’s already there. They just don’t want you to know.” And she whirled out of there as fast as she arrived.
So...I hope she enjoys her doctoral program at Trump University.
No Ph.D. program can possibly fix stupidity or social ineptitude.
Debriefing for the masses
1.If she were truly a legitimate Ph.D candidate, she would:
• have an understanding of the scientific method. I can only imagine her professors hazing her when it came time to take her comprehensive exams. • know better than to make assumptions, • realize that we learn more through observation and listening than we do by asserting our opinion loudly and forcefully with a complete absence of self-awareness, • have humility instead of arrogance- the more you learn, the less you know. I would have to say if you take nothing else away from a doctoral program, this is it.
2. I didn’t even get a chance to ask her if they did randomized controlled trials. Not that she would have understood what that means. You can do any kind of research you want, but you can’t try to pass it off as more than it actually is. You have to state the limitations. If there was no control group, then you must state that. If subjects are assigned other than randomly to the study groups, or if it is subject to bias or being contaminated by other variables in any way, you must also state that.
3. I did in fact look it up, for my own amusement. I was curious as to where she got this information and what she was reading that made her such an expert.(I didn’t even get a chance to ask her if she’s ever had cancer or anyone close to her has.)
As it turns out, most of the studies done on Kombucha that have been documented in peer reviewed journals are from 10- 20 years ago. Most of them were on green tea, not specifically on Kombucha, and the tea demonstrated certain activities in rats, mice, or in test tubes, but not in humans. It’s quite a stretch to take findings from animal or in vitro (test tube) studies and assume those findings will be duplicated in humans.
There have been more recent studies of the effects of Kombucha tea, but there has been no body of evidence based on repeated studies and similar or consistent findings. Anyone who cites “a study” and tries to generalize from that study’s findings also does not understand science. I’m not saying that they never will find evidence of benefits in the future, but the necessary body of research to draw conclusions has not been done.
The antimicrobial and antiproliferative findings of the tea were in test tubes, not in live subjects, and in Japan, where their culture, diet and just about everything, is different from the U.S.-you can’t generalize across cultures when there are so many confounding variables.
I could not find any human clinical trials of kombucha tea. And also, it’s a fungus- if you are suffering from a cancer that weakens your immune system- such as some blood cancers like leukemia- you might be hurting yourself more than helping by drinking that swill.
4. You can fix ignorant, but, as I said above, you can’t fix stupid, or social ineptitude.
So, like JP Sears would likely say, in his wisdom, yes, you have the right to be offended and to remain ignorant. You have a right to your own beliefs, but remember they are beliefs, not facts until shown to be real with scientific evidence. Furthermore, don’t even try to pass your beliefs off as facts and don’t spew and proselytize them as fact. By sharing your beliefs as facts, that’s deception, and with cancer, it could get someone killed.
5. Videos, documentaries, and advertisements that sell products making claims to cure or prevent cancer that fan the flames of ignorance, paranoia, and conspiracy theories is deception. When you make assumptions that you know better than years of scientific research that has millions of cases of demonstrated benefits and successes, you are acting without compassion, and certainly without empathy, unless you ask someone who has had cancer and been treated for it and find out what their experience and outcome has been after 5, 10, or 20 years.
6. People need to understand the difference between what they know and what they believe.
What's Missing
Most misconceptions behind the misinformation about cancer stem from a few misunderstandings.
We can fix ignorance. We can get people to think more critically and raise their level of understanding and awareness of the world around them. They need to be willing to do some work. They also need to be willing to be challenged in some of their ingrained beliefs.
The most common misconceptions about cancer that I hear from the lay public are:
1. Cancer is one disease that behaves predictably and each person’s cancer is like every other person’s cancer, so there must be one cure. There is no thought given to the differences between individual people, their environment, experiences, or their immune systems.
This is a holdover from the old, old days when we thought cancer was just one disease and we had much less knowledge and understanding about cancer. The lay public has not caught up in their knowledge, so we need to improve cancer literacy and bring it up to date.
What we know is that cancer is a disease of the cells’ genetic material that results in uncontrolled growth of those cells. It manifests in hundreds of different ways and cannot be completely predicted or generalized from one case to the next. It can arise in different organs or parts of the body and be triggered by different chemical signals, proteins, and alterations in genes that cause cells to behave differently than normal.
2. Mistaking “genetic” for “hereditary” and thinking that when we are talking about genetic mutations we mean hereditary mutations that are passed along from one generation to the next. What we know now is that most cancers are caused by somatic mutations in a person’s body- in your DNA- that affects the way your cells in your body function-not anyone else’s- that have nothing to do with the germline passed down through families.
3. They think cancer is caused by something definable outside of our bodies, and that it’s a matter of simply avoiding that thing and you can avoid cancer.
4. They think we can cure cancer with one thing- we just haven’t discovered that thing yet, and when we do, it will be the end for cancer. (See conspiracy theories below)
5. They think that cancer can be cured now. It depends on how you look at it. Since we can eradicate detectable cancer cells in the body, but there could always be a stray cell or more somewhere, we don’t know that for sure even with our most advanced technology, PET scans or blood tests. If the cancer is treated and never comes back, we tend to think that’s a cure. But we use the term “remission” because we never know if it will come charging back one day. We also know that if the person doesn’t have a trace of the cancer for many years, likely they are in permanent remission (or cure, if you wish to call it that). But you can never assume completely. And that is why people who have had cancer always have anxiety about it coming back.
6. This is the thing that peeves me the most: They want nutrition to be the holy grail of health. Because they can control what they put in their mouths, they get this false sense of security and arrogance that they can keep from developing cancer. Some people are like that with exercise. They think that stringent exercise programs will prevent it. They will not.
What we do know, through bodies of evidence, is that the healthier and fitter you are, the less likely you are to die from most chronic diseases. And if you do have cancer, and need treatment, the healthier and fitter you are, the better the outcome is likely to be. Less loss of muscle mass, less fatigue, fewer side effects from medication and treatment, and faster recovery after treatment.
7. Some people think cancer is contagious. It is not. They think death is contagious too, even when the word is spoken. that’s why they are so scared of having the conversations about cancer and advance directives and end of life planning and all of the other things we could do to make our lives so much more comfortable, meaningful, and enjoyable all the way to the end.
8. Medicine has the answers, so if we do get sick someday, we can rely on medicine to cure us, like antibiotics for a cold (being sarcastic, again: What we know is that antibiotics will not help a cold caused by a virus. Antibiotics work to kill bacterial infections.)
The problem with this mentality- thinking medicine will cure it- is that it ignores the responsibility of the person for staying healthy. Too many people live unhealthy lifestyles and have bad habits that lead to chronic disease such as diabetes, cardiovascular disease, obesity and metabolic syndrome, and chronic lung disease. They think medicine will save them. And they think the same way about cancer medicine, but when they are diagnosed with a very aggressive cancer or a very advanced cancer, they expect medicine to save them, when it often cannot.
Yes, we do a good job of advancing medicine and medical interventions, but not on building supportive social skills and services. We follow the money, not the quality of life. You might be able to get the medicine, but you can’t get your life back. So you need to take responsibility for that too. You can’t act like a victim when medical interventions don’t do what you wish they would.
I think we could combat this victim mentality by giving people the skills, tools and knowledge to take better care of themselves, of course that would require they were self-disciplined and motivated enough to use it. It's not that simple of course, but if people would take more responsibility for their own health it would help.
I’m not saying there is no greed or deception in mainstream medicine, quite the contrary. I think the healthcare industry is polluted through and through with greed in this world of mergers and administrative growth on steroids. People with fewer resources, who don’t have access to healthcare, education, income, and opportunities are at a great disadvantage and we should be fixing those inequalities now. The current status of the healthcare industry in our country is shameful and self-serving.
Conspiracy Theories
To the people who say there is a conspiracy around cancer- that “they” already have the cure but “they” won’t tell us because then the pharmaceutical and healthcare industry would stop making money- how is making money on drugs any different than making money on the untested supplements and natural products you are pushing with claims of better health?
While the healthcare industry is far from innocent when it comes to greed, and I think think they are even more subject to political influence than they were in the past- there is no difference in my mind between medical industry greed and the greed of the multi-billion dollar natural medicine/food/supplement industry.
The only difference is that in mainstream western medicine, the science is better established. It adheres more closely to the scientific method, does randomized trials, has far larger numbers of subjects, and has more regulatory oversight and safeguards than the supplement industry. Like anything else, this could change. But show me the bodies of evidence so I know you’re not just selling me what you believe.
Solutions
I think educating the public is one of the best solutions. We need to get people to understand the importance of having the tools, skills, and knowledge to be able to survive encounters with the healthcare industry.
I wrote a book with lots of solutions in it, for people at all levels of involvement in healthcare. The prevent-prepare-prehab section in the appendix is a rough description of what I'd like to pursue- building cancer literacy among the public. People tend to push the idea of cancer aside, which is understandable. It’s scary, but it’s even scarier when you have no idea what’s ahead of you.
Having a little knowledge and preparation beforehand is not that difficult, and could make a big difference especially for those who have no family members or close social connections who are healthcare professionals. Having someone to advocate for and/or with you when you confront a serious illness is essential. The industry is too complex to go it alone, even if you are a healthcare professional.
The moral of the story is, drink all the Kombucha you want, I harbor no grievance against you. Bathe in it, mainline it, dry it and snort it, just don't tell me to use it to cure cancer.
I'm home, looking at the cool fall colors, after a week in Arizona. I managed to catch a nasty cold, probably on the flight down there, so I'm sniffling, hacking and snorting my way through the day, surrounded by piles of tissue and tea cups.
This blogpost isn't much about running, although I'm proud to announce that I have now been consistent with running most days of the week for the past 6 weeks. This coming week I'm sure I will cut back in order to get over this crud, but I feel like I've finally reached a point where the running is habitual again. I was up to nearly an hour and a half of running 4 or 5 days a week with some 2 hour runs thrown in there. Still no interest in ending my current hiatus from doing any running events, but we'll see how that goes...
I went down to Scottsdale to visit my dad and stepmom, and speak at an event in Tucson. Wednesday October 21 was BRA Day, Breast Reconstruction Awareness Day. It's intended to educate women about a full range of options for breast reconstruction following mastectomy.
Most women don't find out that they have a range of procedures to choose from that include using their own tissue to reconstruct breasts after a mastectomy, often they rush into immediate reconstruction with expanders and then implants, without being informed about all the possibilities because of microsurgical techniques that allow the patient's own fat and skin to be harvested and a blood supply established to create a more natural appearing breast.
More about that in a few... I flew down and the weather was un-Arizona-like. It rained like hell two nights in a row, a deluge of rain and hail in different parts of the valley. I ran early Monday morning with my running friend Chris and another friend of his on the canal, before the sun came up. It felt more Florida than Arizona with the humidity.
I hung out with my dad and stepmom, my dad is doing somewhat better and it appears that chemo is working. We won't go into the details of the possibility of relapse, which is fairly high, but he's feeling better and things are going well overall. Things are looking up now. It's great to see him getting his old energy back. Not quite himself, but he's improved dramatically.
I met with a social media expert while I was down there and will be using his services as I move forward with my business endeavors. I finished a big chunk of work before I left and now I'm switching gears from developing content to marketing.
Then it was time to go to Tucson for BRA Day. I met Terri online, now I can't even remember the exact circumstances of our connection but we started corresponding last summer and Terri wanted to make a BRA Day event happen in Tucson and she perservered along with the help of some nurses and social workers in Tucson who convinced the powers-that-be that it would be a worthwhile event to host.
Terri assembled a panel of speakers and the backing of local businesses to support the event and it came together despite many hiccups and speedbumps along the way. I agreed to help in any way I could despite being out of town.
We set it all up in the lobby of the U of A Cancer Center, which looks and feels remarkably similar to the Cancer Center we have here in Fort Collins. It was dumping rain as we carried all the supplies and donated gifts from Terri's car to the lobby of the Cancer Center.
We didn't have a room, podium, or formal presentation set-up, just some lobby furniture and a screen, and a microphone. But we did it, and it worked. One of the nursing staff members bought the refreshments herself. Local businesses donated prizes. Terri's son recorded all he could on the Periscope app on my phone. Of course my phone battery died even with the extra battery pack, so we didn't get to record most of the speakers. We have a learning curve with Periscope, which has some glitches itself.
I spoke on "Reconstructing Well-Being", about some of the overall wellness, prehabilitation and lifelong habits to adopt regardless of where a person might be with regards to cancer treatment and reconstruction decisions. Terri talked about her experience as a patient, there were nurses, social workers, tattoo artists, a plastic surgeon's PA and a breast surgeon there. Topics ranged from sexuality to surgical options to cosmetic appearance to more personal experiences from a patient who is also a nurse.
We had no idea how many people might show up for the event but we hoped it would be at least a couple of dozen. As it turned out we had a good 40-50 people in attendance. Afterwards we cleaned up and moved the furniture back to where it was, and it was time to party!
Afterwards four of us, the three nurses and Terri, went out to a Mexican restaurant for food and margaritas and got serenaded by a mariachi band, and decompressed. It is so amazing how every health system, nurses, cancer centers, and administration work the same everywhere.
This event only happened because of the work of Terri, a patient advocate, and her backing by a nurse and social worker who wanted to do something needed, useful, important, and meaningful for patients. It wouldn't have happened otherwise.
This is what it takes, people need to speak up and be vocal. Advocating for yourself as a patient, and for others who face similar experiences, as Terri does, and health care workers advocating for patients' needs and filling the gaps in information and care, all of that only happens at the grassroots level. With the corporatization of health care, the people up high are running a business. To use an overused term, there is a disconnect yes- I hate cliches too - between the business of health care and the service of health care. Service is what it needs to be about, otherwise we won't be serving anyone's best interest except the people who stand to profit.
The only way to make things work for the people who need the services is to do the footwork, be vocal, don't back down, and persist. It takes effort to make worthwhile things happen, and if at first it doesn't fit, make it fit.
Just like you have to move and make some effort to improve your health, changing the way the system works will take real effort toward movement. Sedentary habits won't create change.
Today I ran a little over 20 miles. I started out the day running with Emma. We did about 7 miles and then I was meeting Cat below the dam for more miles, and we did about 11. Then I came home and took Iris for a couple of miles. Three of my favorite girls to run with, what an easy and fun way to get 20 miles in.
It was a busy day, I had some work to do, and the Cancer Center ribbon cutting was this evening. It's always an interesting experience going back... I saw several of my former patients, and a few others I know from other cancer-related groups in the community. It was so great to see them. Especially the ones who are still going and living the best they can, despite some pretty rough odds. It is a beautiful facility. And it was truly built by the community because there was so much contribution from so many people.
It will serve it's purpose better than what was there before. And walking through the upstairs infusion center I remember writing on the beam "bless the nurses" and that is underneath on the south wall. It's going to be so nice for both the patients and the staff to be there instead of in a dingy little cramped windowless cave like the one I worked in at the hospital. Patients can look out the window at the mountains and they can even go out on the deck and sit outside as they get their infusions.
I do hope that the brighter environment will contribute to better overall patient care and outcomes, and I really believe that it will. When I think of all those days that I was working and feeling so bad for the patients having to sit in those little spaces with ugly old curtains for hours on end, with no privacy, no view except for a roomful of other sick people under fluorescent lighting, and I know how I felt just having to spend 12 hours a day in there and I wasn't even sick!
Since I know so many people where I used to work, it's always nice to catch up with people socially, and I did have fun. Of course there were the long-winded speeches from administrators and others, including the mayor, because it was a huge public community event. When I listen to those speeches I know that despite the good intentions of many people, there's the reality of today's health care systems that will mandate as little staffing and budgeting as possible, so it will be interesting to see if the lofty ambitions that everyone started with can be met.
I am skeptical, of course, because of what I've seen. It's very hard for people in health care, who went in because of good intentions and wanting to make people's lives better, but then having to juggle the profit motive that trumps everything else.
It's always interesting to hear the comments from people who don't realize I left the place, and so often I get the comment that it takes a lot of guts and they ask me if it's scary to be on my own. Well of course it is but for me, I'd rather not be stuck in a box because I'm too afraid to peek outside of it.
Even though I am not directly involved in the Cancer Center anymore I am glad it was completed and there is that small spark of pride in seeing what all of our efforts built. Some of my blog readers contributed too, and I want to thank you for that.
Tomorrow I have a photo shoot for a magazine I'm being interviewed in, thanks to Wheaties Boy. I am really happy about the opportunity, more about that later. The only drawback is that I really don't like putting makeup on for the studio photography but I'll come home and decontaminate myself afterwards!
After 45 miles in the last 3 days, my legs are a bit sore and tired. I might even take tomorrow off, definitely won't do more than 5 miles. Between Friday and Sunday I have some intense workouts planned.
I had divine intervention this morning, the universe prevented me from being able to sign up for Umstead. I wrestled with it all morning, knowing that when I'm injured I should never sign up for a race that predetermines when I will have to be un-injured. Fortunately, when I got on the website, I sat there for a few minutes refreshing the page with no luck and then decided it wasn't worth it.
So, no trip to North Carolina next spring. I'll figure something out. I might even go back to run Cornbelt again in May since that was so fun and low-key. But right now, there's no plan.
I did my first run this morning, in two weeks. I ran 32 minutes, about a 5K loop in my neighborhood, with one hill, and not a peep out the hamstring. It was already hot and humid. It did feel good to get moving again but I wasn't overly motivated to go out first thing this morning. Iris dragged me on a walk first, then I had to wait around for the big nothing of Umstead registration, so it was 10:30 before I went out the door.
Yesterday I had an interesting conversation with someone who knows the business of health care a lot better than I do. It occurs to me daily that the people who work directly with the patients and provide the direct care speak a completely different language than the people who make the decisions about how to run things.
They don't speak to each other. But when the decision-makers start throwing terms around like "value stream" and "evidence-based" and pick and choose how they want to apply those concepts without considering the hard, tangible reality of how their decisions affect the real live people providing the daily services, and consequently, the recipients of those services, it's a big mess. Ignoring evidence that is right there screaming in your face is not evidence-based practice.
Whenever you complicate a concept or task, adding steps and analysis to it, you get further away from the simple process of just doing it. You add all sorts of unnecessary in-between costs because you have all these overpaid bodies who get in on analyzing and tearing it apart, but actually make it much harder and more expensive to deliver the product. They accidentally forget to include the people who do the work of delivering it, who would most likely tell the analysts to put that in their pipes and smoke it.
Each day I'm feeling a little more positive about my future, less trashed, and more determined to move forward. I'm still very much trashed, though. If I can salvage my health before something seriously goes wrong with my body I'll be in good shape. Being a nurse, especially an oncology nurse makes you a little paranoid at times.
The eerie light on the tree trunks this evening and the hazy sky are a reminder of last spring's High Park fire, but this is March, and it's a different fire. The Soldier Canyon (now named Galena) fire broke out near Lory State Park this morning, first a small fire, then grew to 40, then 200, then 800 acres as of now, 6 pm.
Today when I went outside to walk the girls, I thought it smelled smoky, but thought maybe someone was grilling in their backyard. And my eyes have been burning all afternoon. It's been windy and gusty, but rain or snow are in the forecast for the weekend. Let's hope we get the moisture.
Already there are evacuation orders for everyone living west of the reservoir near Horsetooth Mountain and Lory State parks. Having to do this again, so soon after last year, has to be extra traumatic for all those people, and anyone who lives in those fire-prone areas. Looks like it will be a repeat of last year's fire season. Not fun.
Looking out the window and seeing the hazy sky is depressing, I'm not looking forward to dealing with the smoke. Also, if the fire doesn't get controlled soon and does a lot of damage in the park, that could mean problems for the Quad Rock races that will be held May 11th this year.
My intention was not to write a depressing blogpost but this sure is going that way. I apologize. This week has been a rough one.
Recovering from Delano Park has been harder than I expected. I think it was because of the traveling and so much jammed into a short weekend. I went to work on Tuesday and I was so tired. Wednesday I was completely worthless. I had terrible brain fog, couldn't think clearly at all. I walked 5 miles on Monday, then all I did Wednesday was walk the girls for a short one, I had no energy.
Thursday I ran 8.5 miles easy and that was better after some good sleep Wednesday night. I toook long naps both Thursday and today, and those have helped. I'll try to get a few miles in over the weekend, but I'm pretty much blowing this week off. My legs are still slightly sore and tired in places, too.
Today I got word that a particularly young patient I took care of over the past 2 years, died this morning at home. I really liked him, he was so smart, talented, athletic, and had a great spirit about him. His parents are my age. I feel terrible for them. Some deaths hit you hard, and this is one of them for me.
The Buffaloes went for their annual vet appointment today, both are doing well, approaching 12 years old. It's hard to believe my babies are almost 12. They've slowed down a bit, but they still have plenty of energy and Iris especially loves to run. Isabelle is not so sure about the running, but she loves to get out for a good fence fight.
Having several friends who have lost their dogs or cats lately to old age, it's a sad thought of what's ahead, but I try to focus on each day and what they can do. We try to have some Buffalo adventures every day, and those work days really put the guilt trip on me. It's beyond a blogpost to describe how much the presence of these two girls has enriched our lives. Dogs just don't live long enough.
Today Iris kept the vet and his tech entertained while Isabelle trembled. The girls have such opposite personalities. Iris was obsessed with the thermometer, once the tech whipped that out, she kept her eye on it until he put it away, then she watched his hands to make sure that nasty thing wasn't coming at her again. You can't get away with anything when Iris is around.
And I finally got around to getting my labs drawn before I left for Alabama, so I got the results this week. My thyroid results are right where things should be, so I don't think the anxiety I've been experiencing is due to that. I'm sure it is those other hormones, the dang girl hormones, or lack thereof. Everything looks great except for my cholesterol, thanks to my genes I have high total cholesterol and my LDL is high, too. But my HDL so high it's off the charts.
I know I could make a few dietary modifications but not much, I really don't consume all that much crap, my one bad daily habit is having half and half in my coffee, so maybe I need to go back to Silk. And on my work days I can do better. I can probably add more beans or oatmeal to my diet, but I don't really like oatmeal and I don't really like what beans do to me all that much, either. Beano, I know.
I will not be sold on statins, I still need to go through menopause completely and see where the dust settles. As far as cardiovascular risk I don't have any other risk factors except for family history on my mom's side, the men in her family all had early heart attacks. They were also overweight sedentary smokers. I was a little surprised when my doctor suggested I might try dietary modification first but then was really sort of pushing for statins as a backup plan. That's not like her.
As an athlete, statins can cause a lot of problems with myopathies- muscle aches, muscle breakdown. Repair of muscle tissue and recovery from hard workouts are a problem, also statins have been associated with elevated blood glucose. Really, do we need any more help inducing diabetes in people?
There are other risks with statins and I'm not really convinced that any drug that is so widely marketed to the public with so-called results is good for people. By results I mean lowering actual numbers in lab tests. The numbers might be pretty, but what does it do to the person long-term and what are the realistic and practical effects of taking the drug itself on other body systems and overall health?
Also, athletes have special needs to consider when getting on a drug that can affect how they feel when training, how they perform, and whether those impacts will have a detrimental effect on quality of life for that person. For example, putting an athlete who is hypertensive on a beta blocker, that is not going to be the right drug for them.
Also, my feeling, for myself, is that I'm going to die of something. If that something is a sudden heart attack or stroke at age 80, well, good for me. I'll make damn sure they don't try to rescusitate me. If nothing else gets me by then, and lots of things could: cancer, accidents, meteor strike, gunshot, getting hit by a car while running, eaten by a gator on a run in Florida, whatever...then it will be my time to go.
Really, the way the world is going, I don't really care to live to be very old. I see what happens to people as they age and it doesn't look like fun. As long as I'm able to run and take care of myself independently, I'll stick around. Once I need to have my butt wiped, forget it. Paging Dr. Kevorkian...please, put me out of my misery and everyone else's too.
I'm hoping that this weekend will recharge my batteries. Some rain or snow would be a nice thing at this point. I might have to drive to Loveland or Windsor, depending on the wind direction, to do my runs to avoid the smoke.
Sorry to end on sort of a down note, but this is where I am today.
Goose Poop, Hula Hoop...sounds like a Jimmy Buffett song.
The past few days have been awesome. Really great. Ever since the pressure of having to pass the OCN exam is lifted off me, I feel so much better. I feel like this pedestrian dude in the sign with no neck and no feet, with his hula hoop. My head is floating somewhere on top of my body, which is suspended in air, off the ground.
I'm enjoying my runs, especially in the mornings with the girls, despite the constant search for goose poop that challenges my hamstrings as they pull me and I try to put the brakes on...
I took several days off from running, after two 90 mile weeks followed by a few days off, I did another 100 miles in 7 days. So then last week I had 5 days off in a row, which is an unusually long break for not having just run a race, but I didn't want to be tired or brain fogged for the test, and then I worked all weekend.
It was a nice weekend at work, for some reason, we were miraculously staffed adequately. Not sure what happened there, but it was so nice for a change. I actually got my charting done each time before the next patient rolled in. Sunday I got off a little early so I could go to my friend Troy's birthday party.
After going to a bowling alley we went over to Coopersmiths and the guys shot pool and the girls mostly hung out at a table and talked. It was a group of my former coworkers from ICU, the people I really liked, and it was great to catch up under happier circumstances than earlier this year. I drank more beer than I realized I was capable of drinking, but it didn't seem to affect me.
I stayed out extra late for me, didn't get home until 10:30, and was amazed that I was able to stay awake that long after two days of work. I made up for it Monday by taking a 3 hour nap.
Monday I ran 11 miles and change in the morning and did some strides. I felt good after all that time off. This morning I did 12 easy miles and tonight is tempo night with Wheaties Boy. I'm shooting for 100 miles this week, or at least 90. I don't want to taper much for Across the Years, I will take an easy week during the week before the race, but I want to keep my training mileage up.
I've been taking the girls running each morning and it's been cold, but I got some new Pearl Izumi tights and a jacket that are windproof, warm and lightweight, so I've been able to only wear one or two layers instead of 5 or 6. The girls love the cold weather. Iris is putting in a lot more miles, Isabelle sticks to one or 2 miles and she's done.
The Buffaloes demonstrate the use of their GPS (goose poop sniffing). The leashes are perfectly lined up with the most direct route to the goose poop. All you have to do is let them pull you to it and you'll never get lost. No batteries required.
Not a gallstone or a kidney stone, not chicked or sharpei'd, but the OCN exam.
That's the certification exam for oncology nursing. I started studying for this at the beginning of the year. I had several months where I didn't study much at all, but I needed to get it done. And now it's done.
I haven't had much running news to post this week, I only ran 40 miles and from the looks of it, that will be it for the week, as I go back for my work weekend tomorrow.
But I am so relieved, I studied so long for this test, I don't remember studying for anything this long except for my Ph.D. comps twenty years ago.
Woke up early this morning, and stopped off to get something to eat, and was on my way out of town and saw Wheaties Boy out on his morning run. He's always out before dawn. I didn't honk because he looked like he was in the zone and I didn't want to startle him, I hate it when people do that to me when I'm running if I'm totally lost in my own world.
Driving down I thought about how I could compare this to any race for which I'd trained hard. I had a job to do, I needed to focus and get it done.
I was nervous about this one because I've heard horror stories of nurses having to take it two or three times before they passed. The amount of material I had to study was crazy. It made my critical care certification test look like kindergarten. Cancer is a BIG topic.
The sunrise this morning was amazing over Denver and the foothills. I got there early and got checked in to the exam. It took me two hours, but about halfway through I realized I was doing better than I thought, seemed like I was confident about most of my answers.
When I finished the test and reviewed all the answers I wasn't sure of, I had about 40 minutes to spare, but I wasn't going to overthink it, so I finished the exam and a screen came up and said "Result: Pass" and I let out this huge sigh of relief.
After I got out of there, I had to sit in the car for a few minutes before I was ready to drive home. I was drained! I got on the road and when I got home, Dennis had taken the day off and we went out for sushi to celebrate. Then we came home and I took a nap.
I took a few days off running this week, after running long on Monday and just 10 on Tuesday. I didn't want to be tired going into this exam, I needed to have a clear brain, no brain fog. I have enough trouble these days between waking up hot flashing and the hormonal brain fog I get, plus topping that off with workday fatigue and being tired from running.
It worked out well, as this week is my work weekend and I don't have as many days to run as I usually do. So I'll call it my back off week, and the next two weeks I can hit it hard again, and then back off a little before Across the Years. I'm not going to taper much, just get a little extra rest the week before.
I am actually looking forward to the work weekend, I like our weekend crew, we usually have fun, and it feels good to have that huge weight lifted off me. And after the weekend, I can have more of my life back instead of always having to study. I look forward to getting in some good miles over the next few weeks. And we're due for snow and cold...but on December 31, I have another fun job to do!
Signed, sealed, delivered. Not that I had any question about who I would vote for. I don't expect any magic solutions to society's ills in the next 4 years as a result of this president or any other, but I vote with my conscience, and I can only vote in the direction I'd rather see us moving. Now if I could just get the phone calls to stop, it would be delightful.
Tomorrow I'm headed to Denver to hang out, not run, with a group of ultrarunners I've known for many years. We're all old fart ultrarunners, except me of course, most have been in the ultraworld for at least the past 20 years, and the premise is "No Goblin Gas".
There usually is a race in Utah that is a day's drive away for most of us, called the Goblin Valley 50K, and it has been cancelled indefinitely, so this year they are staying home and doing a 50K training run in southwest Denver. And what would an ultra be without a party, food and beer afterwards?
I'm going to walk with Steph for a couple of hours, then we'll set up for the post-run BBQ. I plan to do a lot more of the goblin than the no goblin. I will also get to meet Sylvia, who is my friend Ed's new girlfriend. That's Ed who ran with me in the Black Hills this summer. He was just starting to date Sylvia when we were there in June, and things seem to be working out.
I survived another two days of work. Thought I would never make it through the first 12 hour shift, but I got 9 hours of sleep afterwards, a rare event for me on a work night, because I didn't have to go in until noon on Thursday. Then I only worked 9 hours because I had the closing shift. It was nice to not feel exhausted at work for a change.
Lately I've talked a lot about work and work hangovers and I vent because I do get tired, 12 hour shifts are hard, especially with the psychosocial components of the work I do. That's why nursing is a profession in which it is so easy to burn out.
It's easy to hang a bag of chemo or a liter of fluids, but taking care of the patient's needs demands not only attention to their physical condition, but also to everything they need in their lives when living with a serious illness.
One of the things you see in nursing, that is more the norm than the exception, is the propensity for people's past life issues to come out when suddenly they are faced with a life-threatening illness and the rigorous treatments that go along with that.
So many people have not worked through their past traumas to the point where they can consciously identify them, and have the awareness that something they are experiencing in their body during cancer or other treatment is a result of their past psychological history, and not the current physical condition.
When they experience the trauma of cancer treatment, all the unresolved issues come charging to the surface and it can be a huge obstacle for them as they struggle through the intensity of staying on track with medications, appointments, procedures, follow-ups, treatments, side effects, and dealing with the issues that come up in their own families surrounding their illness.
I'm not even going to delve into it here, but who knows how much the trauma of past experience affects the immune system to the degree that genetic mutations that happen at the cellular level are allowed to flourish unchecked and become cancer.
I had my review at work yesterday. It went well, there's always an element of anxiety before you go in to find out what they think of you and what your peers have to say. I am so thankful that I work in a place where I can get useful, valuable input and support to go along with it, that truly helps me professionally and personally. I think I work in one of those rare workplaces, which I attribute to careful, consistent, and conscientious management for many years. That is rare these days in the workplace.
Which is the exact opposite of what I experienced in my previous workplace. How fitting then, that Patricia Singleton posted this post on her blog yesterday.
If you feel like reading her blog, there is a link at the bottom under "blogs I read" on the right hand side of this blog as you scroll down. A blog about sexual abuse doesn't really fit in to a running blog, but I find Patricia's blog applicable to everything in life, because of the theme that underlies her writing. It's about ending violence and abuse, and shedding light on the forces that perpetuate abuse. And that applies to all kinds of violence, not just sexual abuse.
The way I found Patricia, was way back in the days when I was a new nurse working in ICU, I was having one of my sleepless nights and dealing with a lot of the workplace violence that nurses often experience, called "eating their young".
When I worked there, there was a culture of abuse, not only directed at new nurses, but at anyone who failed to kiss the narcissistic boss's ass along with her minions. Almost everyone was intimidated into silence, except for a few of us who spoke our minds, and we became the targets.
Eventually, after a large percentage of the staff turned over within a year, the administration got wise and got rid of that boss. The reason it was allowed to go on so long was that there was a person in a high level administrative position who was protecting her and looking the other way, and until that person left the organization, nothing happened.
Justice was served in that case, but not before many of us experienced a lot of physical and mental stress that was costly not only to us as individuals, but to the organization.
I stumbled on Patricia's blog with a Google search on some topic related to violence or abuse in the workplace. I found Patricia's insights to be enlightening and perceptive, and since someone important in my life is a sexual abuse survivor I also found the insights on sexual abuse and its consequences to be valuable and eye-opening for me.
I think this blogpost from Patricia and the links she includes within the post are excellent and thought-provoking reading material, they are short and easy to read, but worthwhile. The violence associated with silence affects everyone, in some way. There is no person who is immune to any type of abuse. Perpetrators of abuse don't just become that way by themselves, they have experienced abuse in order to learn how it's done.
I think it's important to bring silence to everyone's attention because we are all indoctrinated with compliance at an early age, don't make waves, don't speak up, keep a low profile. It's easier to ignore injustice than to act on it.
There's much work to do, it's a political issue as much as a personal issue, that could be a whole blog in itself. I think it's a good idea to check ourselves every so often. Am I speaking up about issues that I care about? Am I serving someone's best interest, or am I hurting them by being silent? Silence that allows violence to continue, is violence itself.
I thank Patricia for the reminder, and the inspiration. She's an amazing woman and if you're interested in these issues, I highly recommend her blog.
I can't really write much about work because of patient privacy, but I can tell you about the emotions. Most days pass with little blips on the radar screen, small tremors, nothing earthshattering. Today was one of those days that registered big on the Richter scale, up and down, all day long. None of the things that happened were new to me, it's just that they all converged on this one paticular day and happened together.
My coworkers and I were commenting to each other about how insignificant our little problems are, something that we do a lot, given the patients we see.
It's hard to watch when people don't do well, and they have few options, and life becomes boxed into a narrow time frame and they have no control over their decline. Meanwhile, someone else, similar age, similar type of cancer, does well, is cured, and goes on with their life. Then a family member of the person not doing well interacts with the person who is doing well. I found myself wiping tears after listening to my patient talk about her feelings of guilt over being the one who got the lucky break. The tears were mine.
I also watched someone experience joy of finishing their first chemo treatment, because they are so thrilled they made it through a quarter of their treatment, and they have no idea how rough things are about to become, but they are so happy to have made it through the first day with no nausea, no adverse effects. So excited that they give you a big hug before going home for the night, after a 10 hour day of chemo. Give them a couple of weeks, and they might think something different, or maybe not, but for now, they feel like they can do this, they can make it through chemo.
Sometimes people you never expect to make it very far surprise you. Some of it is luck, some of it is attitude, some is determination and stubbornness, support and love. I find myself blown away by seeing them smile because they just found out there is another option that will keep them comfortable longer, when other people faced with the same options would have said long ago, forget it, it's not worth it to live like that.
Sometimes people you love have to deal with very difficult situations and there is nothing you can do for them, all you can do is watch from a distance, and be there, and let them know that you are there.
I got to experience all of this today in one day.
One thing I have learned is don't hesitate to go see someone if there is ever a doubt that you might get another chance. If someone is important to you, make sure they know it. That was what I said to my patient who felt guilty about her good outcome when the other patient her age was facing a short time to say goodbye.
Sometimes, I can't believe I'm doing this. Sometimes I can't believe they're paying me to do this. Sometimes I can't believe it took me almost 50 years to begin.
Sometimes at the end of the day, when I leave work at 9 pm after a 13 hour day and walk toward the parking garage, I take a deep breath. That breath speaks a language of prayer and thanks and gratitude and love.
And I know I will be back there at 8:00 tomorrow ready to do it again, and be better, for what I experienced today.
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