I have been feeling a sense of anxiety over the past few days, and I can’t quite put my finger on the source. Granted, we are moving to our new city this week, and for the first time ever, have MOVERS! To pack and load and move our stuff! All I have to do is sit here and work on stuff (other stuff). This blows my mind, and I think it is a luxury which I’ll never do without again. Also, we are leaving our home for the past 4 years, leaving the very first house we ever bought together (well, our very first house, period). It was a tough 4 years, being away from so many friends and family, going through residency with its associated stressors, exams, etc….but at the same time we met some amazing people. We made some wonderful memories of our own here. Cooking Thanksgiving dinner for just ourselves (and maybe a new resident) started here, and I cherish it. Our next door neighbors have become great friends, and I will miss them dearly. My running girls, with whom I accomplished something I never would have thought possible (half-marathon), and got to spend Saturdays first running our hearts out and then stuffing ourselves with well-deserved breakfast afterwards. I think I’ve said it before, but something about forging friendships in the extremes of weather and physical performance bonds them more quickly and more solidly than others. I can’t forget all the people I’ve worked with and for throughout my training at the cancer center either. I know with every July 1st, new residents start, people take on new roles and those of us who’ve finished are quickly put aside, if not forgotten. But I can say without doubt that everyone there, in some capacity, has mentored me, taught me, and been great to work with. I wish them the best.

I have spent much time and energy the past few months on getting things ready for my new job (licensing and such), studying for board exams, finding a place to live when it looked like we wouldn’t be selling our house in time to buy one…I haven’t given much of a thought to saying goodbye to our home of the past four years. I sit here today, feeling sad that we are moving on from all that we have here, but also very excited about what’s to come. I hope everyone here knows how much they have meant to us, and everyone in our “new” town knows how happy we are to be coming back to them.

I have to take a moment to plug my sister’s upcoming mission trip to Padibe, Uganda. She is going through her parish, Three Holy Women in Milwaukee, WI, and will be blogging about the trip at http://www.padibe.org. I am so very proud of her, and my thoughts will be with her for the entire two weeks of her trip (she leaves Friday). Read

Erin and her boyfriend Shawn at their blessing prior to their Uganda trip.

along to learn about the great work that she’s doing.

I was inspired today to start posting here again, as I was talking to my fellow residents (GT and Lauren) about their blogs. I think it’s kind of cool that we all keep them, and as I face the end of my residency and start of my actual career, keeping in touch with the people I care about and friends I’ve made is something I’ve reflected on recently.

For anyone that read the last post, I ended up not having a stress fracture (an argument for NOT healing thyself, or at least not diagnosing thyself), going through physical therapy and completing the half-marathon. It was slower than I’d hoped, but I’m pretty proud that I did it, and hope to do another this fall with my sister. Training for that to start soon.

In other news, everything in my life is in limbo. Our house has not yet sold, we had thoughts of moving to an apartment but can’t find one, and have no solid date as to when we will move to Wisconsin. Being the planner type that I am, this is making me certifiable. We do have a showing today, so I’m pinning all my hopes and dreams on that. (Not really.) (Maybe.) Due to this generalized stress, I have been studying for board exams a LOT less than I’d like to be, which is my own damn fault. However, yesterday one of my attendings who recently passed the last section of his boards reminded me that the pass rate is well over 90% and that “you’re not 90% dumb!” Much appreciated, seriously. Perspective is good at times like this.

And in truth, perspective in general is what I need right now. Things could be so much worse in so many ways. I have a great husband, we have our health, our families, our jobs, and the future looks bright (off in the distance). If worse comes to worst, we can hang out under a cardboard box for a few months. ;)

Check out my sister’s fabulous shopbop giveaway – $100 giftcard for all sorts of amazingness on http://www.shopbop.com. It’s right here: http://bit.ly/hAANNh and open until April 30th!!

I haven’t updated this blog a whole lot with running updates because I post on dailymile, too, and for essentially the past two months my updates have vacillated wildly between “I feel great!” and “OMGMYLEGSTHEYHURT” and I feel like there are only so many ways I can complain about my shins. (Co-workers, friends and family members may disagree with me on this.) But as the right leg got better, the left leg got worse. Significantly worse. I have pain at rest, and it’s been nearly a week since I’ve last run – or done anything fitness-related. I tried the “hop test” today – can you hop on it without pain? – an anecdotal diagnostic test at best, but I’m grasping here as my MRI isn’t for two more days. The answer is no, hopping on it causes A LOT OF PAIN. I have seen a podiatrist (back when this was shin splints) and now my doctor, who is getting the MRI and possibly sending me to an orthopod. I go back and forth on whether to take NSAIDS to help the pain because I’ve read some data that they delay healing of fractures. I’ve been icing it daily, and wearing my compression sleeves which are the two things that actually seem to make it better.

And I’m hoping, really hoping that the MRI shows no fracture.

But deep down inside, I know that’s what this is. It’s just….too much to be anything else at this point. And I am pretty sure that will take me out of running the half marathon on May1st. Even if I’m up to snuff in 6 weeks, what could be more injury-inducing than jumping back in and trying to complete a half in two weeks (especially because my training group will be in taper-mode by then).

I’m sad because I was accomplishing things that I had never accomplished before, physically. I was able to take the concept of “fitness” outside of my old obsession and make it about what things my body could do next, what distances I could conquer, what pace I could accomplish. But I’m also sad because there is a very social aspect to training. I met some wonderful people in my training group whose company I really enjoyed, and there’s something about slogging out 5 miles in freezing rain that bonds you with someone faster than your average bear. (And then going to get breakfast afterwards.) I will truly, truly miss that if I have to sit it out.

My rational, doctor brain keeps saying that it’s better to let it heal now than to be come a chronic problem, and that there will be other races. But I’m still sad. I’m still trying to hold out come hope for my MRI results. I guess time (and the radiologist) will tell.

This is something that I’ve been thinking about for awhile and it hit me like a punch to the gut this week while I was working on a retrospective research project. Let me give a little background.

When I started residency, I started a research project tracking the toxicities of treatment in patients with cancers of the head and neck. They got surveys about their symptoms at particular time points and the we analyzed that data based on their tumor type, stage, location and other risk factors. It took awhile to enroll enough patients, and each of those patients had to be follow for about 14 months, so I’m just now completing the project, nearly four years later. There were a few pieces of data that we thought would be useful to have before submitting the paper to a journal for review, so recently I’ve been going back through all the patients’ charts to gather this data regarding treatment details.

I can’t believe how many of them have died.

I know that cancer kills people; believe me, I’ve got numbers and data memorized and coming out of my ears. But somehow when you’ve seen a patient – I mean I JUST saw her a few months ago, she looked like she was doing pretty well! – and then their name comes up in the computer in red! I can’t describe it as anything other than a punch to the gut when I found out that patient had died days after I saw her in clinic.

Maybe it’s different as an attending. I would hope that someone would tell you these things. As residents, we rotate services every 2 months, and get immersed in a different set of patients, and it’s impossible to keep up. But when I take care of these patients they are my patients. I see them at least once a week while they are getting their treatments, I get to know their families and their lives and then suddenly *poof* I’m on to the next group until I come across it in the EMR and all I really wanted to know was whether she had a g-tube.

And then I start to get existential about it and feel like I’m running on a hamster wheel. If I get too hung up on the ones that died or the ones I couldn’t help, I can’t get through the day. When people ask me about how I can work in oncology, in casual conversation, I say that it’ s the patients (and it is). That when I can’t cure them, often I can make their pain better and help them decrease the dosage of narcotics they’re taking (often, I can). But the truth is, at the end of the day, cancer still kills people and sometimes it happens out of left field. Sometimes it happens even when I did everything right and the medical oncologist did everything right and the patient did everything right….sometimes it just happens.

That out of control feeling, that question of why am I doing this again? doesn’t creep up until I stop to think. I need to take active steps to work against it. I need to remind myself that this is why I go home and study every night. This is why I go to Washington every year with radiation oncologists from all over the country and ask our representatives to fund cancer research, stop letting other specialties devalue our services via loopholes, stop cutting reimbursements so that cancer centers in rural areas close down. That soon, soon I will get to see all MY patients in follow up and know what’s going on with their care all the time.

 

I think it will still feel like a punch to the gut to find out that one of them died.

I had another snowy run today, in my new shoes and felt great. Finally. I’m not sure what finally clued me into the fact that maybe my lightweight, wanna-be minimalist shoes were not providing enough support, and therefore the impact on my legs may be contributing to the nagging shin pain, but the more I thought about it, the more sense it made. I’ve been doing everything else…stretches, icing, resting (no, I really don’t need anymore excuses to rest on my couch, thanks!). Why not try the shoes? So I went off to my local running store, Bob Roncker’s Running Spot (about which I can’t say enough good things) where I was measured, made to stand and run, and then fitted in a variety of shoes. Like I should have been months ago. *facepalm*

And although it was snowy and slippery and coooooold tonight, I was really excited to get out and run with the group. AND  I felt good. I felt fast. I liked it. I think I’m starting to understand what John Bingham means when he talks about this as a lifestyle change. It’s not a lifestyle change like a diet or something. It means that I will get my ass out the door in 20 degree weather and snow to go run for three miles in the dark like a fool and enjoy it. If you would have told me that a year or even six months ago I would have told you there was a snowball’s chance in hell (pardon the pun).

I almost don’t want to do crosstraining tomorrow, even thought I know I should and why it will help. It just feels so nice to feel good; in the words of Baron Baptiste and others, to try easy (rather than trying hard all the time).

 

Last night I had an amazing run; it was an “easy 20-30 minutes” as a prep run before the half marathon training group starts Saturday. My last run on Saturday had been long, slow and painful, so I wasn’t expecting much. I wore my Garmin, but looked at it only on and off throughout because it was under my jacket – too damn cold! – and I think that helped me relax and enjoy the run. It had started snowing, and I tried to focus on that, and to just keep going and listen to my body. I took two short walk breaks, but not a strict 3:1 like I had been, and I think that made it better, too.

It was an infinitely better run…so much so that I don’t think I can adequately express it. I ran all the way up the hill on Madison, I ran all the way back down my street, and I stopped my watch and was quite pleased with the much better time and pace than I had seen last week! But even better than that was the feeling I had, the snow coming down in the twilight, and being the only one out on the street. I felt what one might convey as a runner’s high.

I got back in the house, and my husband told me he was starting to get worried about me running in “this mess” – and I couldn’t stop talking about how beautiful it was. I’m pretty sure he thinks I’m crazy. I’m also certain I want to do it again the next time it snows!

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