Here’s to 2 years and another half marathon in the books

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Two years ago today, I wrote my first blog post. It was on running a half marathon in my hometown. It was my third half marathon. Writing about the experience and it’s reflection on my past was a great way to start blogging, something I had been contemplating for at least a year by that point. You see, my zeal to run was borne from following the musings of others who felt similarly challenged with regards to their personal wellness.

And so, Hot Heels, Cool Kicks, & a Scalpel came to be. It’s a blog about what a traumamama does to get through the days and still be whole–a whole surgeon to her patients and their families, a whole researcher to the university and funding agencies, a whole teacher to her trainees and students, a whole peer to her colleagues, a whole friend, a whole sibling, a whole daughter, a whole spouse, a whole parent, a whole person who takes care of herself.

I was lucky to have hoodwinked my fabulously witty and sarcastic fellow traumamama @surgeoninkicks into this whole blogging thing soon after this first post. Our original connection was that we were both trying to make running part of our lives at a time when life and work was overwhelming and causing us to neglect ourselves. I had no idea how compelling her writing would be but I knew I needed to do this with her lacking the time to keep the content flowing on my own. Working on the blog together (it’s our form of joint therapy) has help our friendship grow in ways that I don’t think either of us imagined and we have also run together on many an occasion since then.

Finding time to run is still the hardest thing I do and running is my biggest physical challenge. Since my first real run without stopping at a whopping 15min/mi pace in August 2011, I have logged just about 1100 outdoor miles (and very few on treadmills). But I consistently run at an 11-11:45 pace these days (depending on hills and whether or not I have done a recent barre class!) and have finished 4 half marathons and a Ragnar Relay just this past year alone. Four days ago I ran that same hometown half marathon again. It was my third time. I posted this photo at the corrals with the caption “Suck it high school self-esteem issues.” It was a hit with my Facebook friends. (PS. if you hit Old Navy’s clearance rack in the summer you will have lots of $5 throw away fleece that comes in handy when the temperature at the start line is 29F)


With the 2 year anniversary of this blog, I want to say a continued suck it to self-neglect and thank you for continuing to read the random, somewhat disjointed, musings of two traumamamas who engage daily in the push and pull between their families, their patients, and their own well-being (fueled through food, fashion, fitness, humor, and sentimentality). Together we have written 195 blogs that have been viewed more than 1.2 million times and we now have 787 followers.

I hope you will continue to read, and subscribe, and share and I will continue trying to run as much as a I can.

 

Organized Surgery Begins to Battle Burnout

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General Surgeon Lifestyles -- Linking to Burnout: Medscape Survey by Carol Peckham March 28, 2013

General Surgeon Lifestyles — Linking to Burnout: Medscape Survey
by Carol Peckham
March 28, 2013

US surgeons are burned out and the numbers are staggering. Whether experiencing emotional exhaustion, depersonalization, or a low sense of personal achievement, 4 in 10 US surgeons exhibit signs and symptoms of burnout. Among neurosurgeons that number jumps to nearly 60%. Burned out surgeons are more likely to report substance abuse, clinical depression, and suicidal ideation. They are more prone to medical errors.

Interestingly, academic practice, trauma sub-specialty, increased nights of call, longer hours worked, younger age, female gender, and small children at home were all risk factors for burnout. For those of you who are new to this blog, I am a female academic trauma surgeon who routinely works long hours and takes in-house call while my small children are at home.

To be clear, these data prove associations and associations do not equal causation; but still, it is sobering to think that so many who entered a profession to fundamentally improve the lives of others are themselves leading such troubled lives due to their chosen occupation.

The occupational hazards of surgical careers are multiple. We suffer moral distress when our patients experience complications or die whether or not an error occurred. We develop compassion fatigue by bearing witness to our patients’ collective and continuous suffering no matter how successful any individual’s outcome may be. Due to our long and often erratic hours, we suffer from chronic fatigue and sleep deprivation. The physical plight caused by fatigue is complicated by many hours on our feet and maintaining awkward postures in the operating room. By routinely putting our patients before ourselves, we often exhibit illness presenteeism. Not infreqeuently, we face the double bind of choosing between being there for our patients or being there for our family. Meanwhile, whether it’s catching up with billing and coding one day, keeping up with meaningful use another day, or spending days studying subjects totally irrelevant to one’s daily practice for maintenance of certification, delivering care in the modern error mandates many a frustrating task that ultimately does nothing to benefit our patients. Furthermore, there is constant fear of litigation that might ruin us in financially or reputationally. And so, it is not surprising that so many of us are burned out.

Emotional awareness (how are you feeling, how does what you are feeling impact your behavior, and how does what you are feeling impact those around you)

All is not dark, however. There are ways for us to be well and resilient. They require both individual effort and culture change. Importantly, they demand emotional awareness. When we understand how we are feeling impacts both our perceptions and our actions, we can act in a way that props us up rather than gets us down.

I was heartened this past week that the American College of Surgeons chose to put surgeon wellness and resiliency on equal footing with the likes of “what’s new in hernia repair” or “ethical challenges in geriatric surgery.” There were a number of educational panel sessions tackling burnout head on. Whether is was about bouncing back in the face of personal loss, gender discrimination, pathways to help surgeons recovering from alcohol abuse back into clinical practice, or managing fatigue, the program was replete with informative sessions on burnout avoidance. Mindfulness, time management, kinship, and down time were emphasized as was physical fitness.

And for the first time ever, the College had a fitness program. As that youngish female academic trauma surgeon with two kids who has struggled with tending to herself after spending her youth, college, medical school, residency, fellowship training, and early years on faculty essentially ignoring personal wellness, I was delighted that this change was happening at my profession’s annual meeting. It was something of a pilot test offering only a very early morning Zumba and a Yoga class, but it was a start. Sure many surgeons at this meeting probably went to the hotel gym or hit the lakefront running path but these efforts happened without the largest surgical professional organization’s imprimatur (hey I even got an American College of Surgeons yoga mat!) or beckoning. These surgeons are likely the 6 in 10 of us who aren’t burned out. But that doesn’t mean we should ignore the self-neglect of our brothers and sisters in the occupation. So this simple step of organizing these fitness events indicated to all attendees that the College both encourages and supports surgeons taking care of themselves. 

Making time for fitness has been shown to reduce burnout so I hope the College expands their offerings this time next year. I invite the College to challenge us surgeons to find time for wellness within the already overwhelming conference that offers 5 days of educational sessions geared at making us better surgeons technically and intellectually. The annual Clinical Congress of the American College of Surgeons has essentially had this format the entire time that I have been attending (every year for the past 12 years). With the pilot fitness program the College chose hours and days specifically to not interfere with this typical format. However, given that all the data shows that prioritizing wellness is a key factor in combatting burnout and that wellness takes on many forms, the College should offer multiple offerings–whether it is meditation, or high intensity interval training, or barre, or a knitting circle, or Zumba, or TRX, kick boxing, or spinning, or running– at different times throughout the conference thereby forcing us to prioritize just as I was forced to prioritize between “surgical jeopardy” and “what’s new in body contouring.”

Slide1It will be hard for us to make these choices but we need the practice. I figure its easier to choose wellness when there are no cases to be done or patients waiting in the ER or clinics to be staffed, when there are no lives at risk other than our own.

10 thoughts from a really hard barre class

I am a huge fan of barre. Tonight’s class was one of the hardest I have ever done and this I what I was thinking. 

1) I wonder if anyone has ever cried in class before. 

2)  I suspect I might be having a seizure there’s so much shaking.

3) I hope that defibrillator is charged. 

F@$&!

4) I am pretty sure my hamstrings don’t do that.

5) I didn’t know I had muscles down there but I guess I do. 

6) I guess I do have abs under this mommy belly after all.

Oh F@$&!

7) I could go all Xenia from Goldeneye  and choke a man with my thighs. 

8) I should be ready to start my second career as an ass model tomorrow. 

9) I hope I won’t have to use these arms to operate, or drive, or even hold a pen tomorrow. 

Holy F@$&!

10) I should have bought a ranch style home. 

Damn, that was a good class

Summer Fun Calls for Summer Flavors

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Today ended up being an unexpectedly unscheduled day with welcoming dewey morning sunshine bubbling into a sweltering midday heat. I started with a run alongside my husband to a barre class (he ran back and then picked me up later … Continue reading

Assigning Blame for My Crappy Summer Run

Remember my summer goal? I haven’t exactly kept up. During a recent summer run I did, however, manage to assign a lot of blame.

1) The humidity

Running through soup is the worst. I almost died a little while back running in Park City; but honestly, I much prefer the cardiovascular agony of that experience to the feeling of swimming through hot, thick fluid while pounding the pavement. I would like the only tackiness on my skin during and post-run to be my very own sweat and not the atmosphere building up on my pores. Gross! Humidity ruins running for me.

2) My thighs

I know the blogosphere is rich with those who argue that thigh gap is an unnatural and unreasonable body goal. But when it’s hot and humid (see #1 above) running capris or layering shorts over compression garments is really not feasible due to the substantial overheating they cause. However, the absence of thigh gap in running shorts results in a burning from chafe that escalates throughout the run. And the thought of the tackiness of body glide to prevent it in the soup (see #1, again!)….ugh I can’t even imagine despite the fact that rubbing thighs make for a less than awesome run.

3) That barre class that I took

Speaking of thigh gap (see #2 above), the effort to make the hammies and the quads along with the sartorius, tensor fascia lata, and gracilis (that’s right these baby muscles I didn’t even know could hurt until I started barre) lean, long, and strong might eventually abate the kissing inner thighs. But, in current practice, running too soon after a barre class leads to quite of bit of muscular agony with each step. Don’t get me wrong, the muscle strengthening I have gained from barre has made me a better and stronger runner (and led to a wider set of summer beach wear options) but, ouch!, the soreness does distract from being able to enjoy the run.

4) The sun

Typically it’s bright sunshine that lures me out to run. I have dark skin. I don’t burn. But on a sunny summer day the sun is my enemy (perhaps not as much the humidity but still). Constantly looking up for a cloud, or tree, or building to cast a shadow and alleviate the fire raging in your skin definitely ruins a run.

5) My hate of mornings

I know I could have avoided some of this bitterness at the weather ruining my run had a simply gotten out there before the sun (see #4 above) became such a foe, lingering mid-sky cockily, an while the refreshing dew was still cooling the early dawn air.  But I suck at mornings and, despite my best efforts, runs after 7am are easier for me than runs before 7am. This time of year, though, the conditions are oppressive soon after 7 and I spend my run cursing myself for having slept in. Calling yourself bad names makes you feel like less of a badass runner.

 

6) My running partner

My husband is my go to running partner. Typically he keeps up with me or I keep up with him; we make a good pair with our matched 29 inch inseams. But evidently the humidity is less of a battle for him. He runs ahead of me and then waits, patiently, for me to catch up. This waiting part seems so smug to me. Maybe it’s just the humidity getting into my head but a this moment I want to both stop running immediately and divorce him and thinking about divorce tends to take away from the joy of running with your life mate.

 

On Spring Running and 3 Races in 30 Days

The first day of summer has finally arrived. I am making plans to stay fit for the coming months so that I can head into fall half marathon season both motivated and rested. 

You see, after a long, hard winter it ended up being a glorious spring for this aspiring runner.

Between Christmas Day and April 4th I never stepped foot outside in my running gear near my home base. A total of 120 inches of snow had accumulated out side my front door. The roads were too narrowed by eyeball height piles of white fluff that lingered into the early days of April. Thankfully, a few work trips to Vegas, Chicago, and Orlando allowed me to squeeze in 7 short runs. That was it. I ran the Disney half on January 10th and only ran seven more times during the rest of Jan, Feb, and Mar. 

It was a long, hard winter.

When the roads and sidewalks finally emerged in early April the pressure was on. I had signed up for a Ragnar Relay months before and it was less than 5 weeks away. I didn’t feel pressure to train for distances (my 3 relay legs were supposed to range in distance from 3.2 miles to 7.6 miles and I was confident that my untrained body could pull that off based on past experience) but I did feel urgency to become comfortable running in the dark (something that I had tried once and it had freaked me out) and running on little or no sleep (I had previously never run post call; it turns out that the post-call runs are perfect for Ragnar training).

And so it began. Random runs of random distances at random hours. #RagnarPrep

Meanwhile, there was Ironhorse half marathon on the horizon. The event that had become an annual tradition for me and my best friend from residency. She moved just two hours south of me and a really lovely half course was just an hour between each of us in Simsbury CT; and, it did not occur on a prime weekend thus making it easy for me to get the time off to run. In years past, we (I run with my husband too) had loosely adhered to a 8-10 week half training plan on the Runner’s World app. Loosely because until recently getting my act together to get in the weekday runs was impossible; it would have required waking up sufficiently early enough to actually run. (Thankfully, I have pretty much turned that around with my detox.) This year, we had to get through Ragnar before before we could wrap our heads around training for a half.

And then the May call schedule came out. I cannot remember the last time since graduating medical school 15 years ago that I had all 3 days of the Memorial Day long weekend off. Since my first half a few years ago (the half that started this blog and the half which I did on a crazy whim with just 3 weeks to go having never run more than 6 miles in a row), I was always envious of my running friends who ran the Boston Run to Remember that weekend. I never could. I was either on call, pre-call (and thus needed to be available as back-up), or post-call (there’s no way to get to a 7am gun let alone run 13.1 miles after being up all night). So, when the May schedule gave me the gift of the weekend off, I was delirious to find out that the race was not sold out.

And there it was. My 30 Day Race Plan. From May 8th, the day the vans pulled up for Ragnar, to June 7th I ran an overnight relay with 3 legs that ended up ranging from 3.2 to 9.0 and two half marathons–one urban with a huge field with thousands of runners and the other through the Connecticut countryside along with just over 1500 other runners. 
And now my plan for the summer. 

  
I am in no hurry to pack in the miles. I am ready for a break from distances for a few weeks but I do want to keep up the running momentum. This is something I have struggled to do in the past with our humid summers. But I am a different person now, capable of getting in run in the wee hours before it warms up if needed. I have trained my body to do distances on very little prep. Now, I want to get a little faster (and hopefully drop the 7lbs I gained during the sedentary winter–one craves comfort food when snowed in and please don’t ask about the high quality cardio equipment I house in my basement gym). 

My goal is to run 3 miles 3 times a week no matter what. There are lots of hills in my area. Though I managed to run my first leg of 3.2 miles at Ragnar at a 9:59 pace running a 10 min/mile has never been within my capacity. I hope to turn that around too by the end of the summer. While running for has never been about speed for me, I do feel that I will be much more consistent getting in quick running workouts in the future if in can do three miles in 30 minutes. Along with the weekly running goal, I also plan to hit my local studio for Pilates, Barre, Zumba, or HIIT at least three times per week for additional strength building, core work, toning, and cardio (with different muscle groups than running) that will all make me a better runner. 

I am honestly relieved not to have a high pressure race goal this summer. Instead of focusing on a date and location I am focusing on myself and looking forward to a fun running summer which will leave me well rested but fit and energized for a couple of fall half marathons that I am eying depending on the call schedule. 

Happy Summer Solstice running friends. 

Dear Friend, It is Zumba

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Dear Friend,

I can relate. You have made it to middle age (Gasp! Yes it is true, we are more than half way to 80) and you have spent a quarter of that lifetime (Yes, the past twenty years! My god, have we really known each other that long?!) neglecting yourself.

I get it. You were busy training for a lifetime of work in one of the most demanding careers around. You trained and you studIMG_3940ied and then you trained and you studied more (Do you really have three degrees after college?!? Was being valedictorian of your elite college not over-achievement enough for you?!) Alas, none of that training was of the “personal trainer” or “training for an Ironman” kind. No. You didn’t have time for that (Okay, neither did I; yes, I confess that’s my office wall).

I know why. There were the 120 hour work weeks, then there were the babies, and now there is life with a busy career and growing kids (They really have to have sooooooo many needs! Darn food and shelter! But, why so many school events? And for the love of god, why so many extracurriculars that eat up every weekend that we are lucky enough to be off?) I know there is a spouse involved (I mean how else would those kids get clothed and fed everyday while you work from dusk to dawn, or frequently from dawn to dawn or dawn to the dusk 40 hours later?). In the midst of all this working and raising babies you are busy doing your best to be a good wife too.

So I can totally see why putting you on the bottom of the list was easy. You would feel too guilty to do to otherwise (You know that guilt trip is totally in your head, right?  Everyone around you, who you feel you don’t give enough time to, would really rather you put some time into yourself.) You deserve it. You need it. It will make you a better wife, a better mother, and a better doctor. But it needs to be something that gives you pure joy so you don’t beat yourself up about not writing that grant instead, or missing bedtime, or skipping that after dinner glass of wine with your husband. I too used to struggle choosing it on the precious few nights I home from work and not in a post-call coma. But I am so glad I found it.

Solid_gold_dancers_mediumAnd, I am writing to tell you that it is Zumba. You see, I remember the days when if it was a Friday night you were spritzing on the Aquanet and heading to Sh-booms to dance the night away (In retrospect both the hairspray and the venue was questionable but you were young). I have a vivid picture in my mind of you rockin’ out to It’s Raining Men at your wedding (Why you would be delirious about it raining men having just married the man of your dreams is also somewhat questionable but it is a great song). And, I know your childhood dream was to become a Solid Gold Dancer (Okay, in retrospect the hairspray and the venue totally make sense even though it was no longer the 80s by then!)

I love Zumba and so will you (Zumba’s motto is “ditch the workout, join the party.” Doesn’t everyone want to party more as they age and trick the body into feeling younger, hipper, and cooler?). Zumba burns calories and builds core strength through super fun dance moves. Many are Latin inspired but there is a range so you can salsa, or charleston, or plain old old-school aerobics style grapevine your way to an effective workout (Come on. Surely you have seen the infomercial? Yes, it’s true you really do have that much fun doing Zumba. Not everyone there is as hot as on the infomercial but that’s fake TV and not real life). There are some variations like Zumba toning that focus more on muscle definition (In Zumba toning you use a double sided maraca thingy and who doesn’t love that–like shaking a martini without the alcohol and calories but the dancing leaves you buzzed in a calorie deficit.) Also, as if channeling your childhood aspirations there are cool Retro 80s Zumba parties (Seriously, if this isn’t s sign what is?!?).  You can see how the Core Connection‘s clients danced “Like a Maniac” here.

So instead of trying to coordinate our schedules to meet up over a cosmo let shake at Zumba together.  You love to dance; getting a groove on is in your biologic makeup (I know because I am a doctor) so I guarantee that Zumba will bring the pure joy that it seems you need to justify being able to find some way to squeeze physical fitness into your life in a way that reading journal articles on a recumbent bike decidedly cannot.

It may be the answer to your mid-life fitness woes my dear, dear friend and former aspiring Solid Gold Dancer.

Love,

Your ungraceful, uncoordinated, booty does not dissociate from her spine but still gets her ass to Zumba friend,

@surgeoninheels

zumbalogo

Reasons I Loved Ragnar

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It’s been a busy week back to work after Ragnar Cape Cod so I have been a bit delayed in my promised glut of #Bragnar posts. Find a recap of my actual legs here. More than a week after Ragnar Eve, I am still giddy from what a great experience I had. Here’s why.

1) The views

I haven’t run any other Ragnar Relay races before but this particular one came with some killer views.

ragnarview1 ragnarview2

2) Letting out your inner kid out

Evidently it’s a thing to decorate vans for the race. Doing this as an adult tends to make one giddy.

vanwrite3vanwrite2 vanwrite1

3) Speaking of acting like a kid

Again, sticking magnets on vans is a bit of silliness that we tend not to manifest in our grown-up lives and some of the team names were hysterical.

magnet2 magnet1

4) The crazy night gear

Overnight runs call for gear that will make you stand out in the dark and I love things that sparkle and glow!

nightgear1 nightgear2nightgear3

5) The other crazy gear

Typical road races have water stations ever couple of miles or offer little other the backs (if you’re as slow as me) of other runs to view but we supplied our own water and got to take a movie over the Bourne Bridge.

watergear3 watergear1 watergear2

6) People acting crazy

Let’s face it, being up all night in a hot sweaty van in between running a lot will lead to some insanity. Who doesn’t love some insane behavior among friends. (Okay, it was mostly just this one chick who was crazy but I love her!)

helenecrazy

7) The cheering

I loved people rooting for me and I love rooting for them.

cheer2 cheer1

8) Sharing the starts and the finishes

In most races, you run from start to finish but in a relay you get to hand off to your buddies at each exchange and this camaraderie is special.

Exchange1exchange2exchange3

9) The friendships

Even if you find yourself in a van full of strangers, it doesn’t take long to get to know each other really, really well.

sleeping friends

10) The Swagnar

You get cool Ragnar stuff to commemorate your effort.

swagnar2 swagnar1swagnartatoo