Life, Running, & Medicine.
Notes on life as I see it.

Wednesday, February 27, 2008

Six in the COLD

Well yesterday brought some wicked rain and storms to the area, culmonating in a snow dusting last night.
Today I managed to knock off around 4pm and head out for a little recovery run from my 10miler monday.  I wound of doing six at a reasonable pace, but in the brutal windy cold.  In all felt great at the end but also glad was time to come in and get warmed up.

Monday, February 25, 2008

Good Ten

Didn't get a chance to do any running this weekend really.  A little let down but did get in 9 holes of golf yesterday (and just to be nerdy I hooked my Forerunner up to my golf bag to track our progress).  In all my driving and mid game have improved but I'm totally incapable of finishing it on the green.  Interestingly my golf partner took a direct hit to the shoulder with an aberrant drive at the exact instant the golfer yelled "FORE!".  Why do I pick these sports that take years and years of practice and have too many variables to adequately EVER account for?!
Today was a great day for Hillary Care.  Our first case got started late.  Our second case had to cancel because he was "sippin' on some coffee" this morning instead of showing up for surgery (a shame because he's got what looks like cancer and needs a biopsy).  Score one for cancer, and score one for me getting done early I guess.
Was a beautiful 65-degrees and sunny.  A great day for a run.
I first got to take off running around 4pm but called back at 1/2 mile point to deal with some nose bleeding problems (of someone else), so I had an hour intermission.  Starting again, I extended my Candler Lake/Lullwater loop today and ran through the Emory campus, making a long leg out to the IM fields.  For a mile or so ran right by a beautiful little stretch of creek, which since the recent rains is a little like whitewater.
I finished relatively strong at mile 9.4 (not including my 1 mile false-start).  I was starting to notice some tension at my right IT band though.  I've never had the IT band problem, so don't really know what it feels like.  Hopefully it won't turn out to be a worsening problem...
Rains are coming back tomorrow, so this is probably it until the end of week.  Cheerio.

Sunday, February 24, 2008

Blog Site Stats

Well, in the interest of full disclosure and perhaps some blogucation for others wanting to run or optimize thier blog, I am giving some site stat summaries from my first 5 months in real existence.  Note this only includes the web site, not the Feedburner Feed, which is a real limitation.  FYI right now I have about 10-12 "subscribers" to the feed, a third of which are some kind of search engine or aggregator.  All stats here were generated by Google Analytics:

Date of first post: October 20, 2007
Total posts to date: 45
Total pageviews to date: 1,516
Total Unique views to date: 1,099 (much more important, unique views disregards multiple same-page loads by the same visitor)
Visitor Trends:
Late October an initial bump with 50 unique visits the first week
Second Week: 39 visits
Third through Seventh weeks: about 13-15 visits/week
Slow increase in visits through late December
Week of Jan 21st had 89 visits
Week of Jan 27 - 148 visits
Week of Feb 4 - 144 visits
Week of Feb 11 - 123 visits
Week of Feb 18 - 193 visits so far!
Popular Content:
Although this is primarily a running blog, the most attention by far has been from two articles on non-running subjects.  I guess that goes to show us runners are still in a miniscule minority on the web, and even a runner blogging about John McCain or medical software will still get more hits than a runner blogging about running.  Interesting philosophically but also a good tool if you're interested in getting your site some new visitors.  I never really meant the blog to be only about running, it's just what I mostly interested in spending my free time writing about.  Notice nearly 2/3 of visits come for two articles that are not running related.  All of the top pages reference other things or people.  One is a semi-scientific article with a reference to a full text scientific report.  Bottom line is if you want to get hits then reference things.  People are more interested in your thoughts about things than just your thoughts.
Visitor Loyalty:
  • 76% visited once and never returned
  • 11% visited 2-8 times
  • 3% visited 9-25 times
  • 3% visited 26-50 times
  • 4% visited >50 times
Traffic Sources:
I was added to the CRN running blog network,, and in late October, so it's tough to see an impact those made.  Jan 27th I was listed to BlogCatalog and MyBlogLog.  I have since dropped MyBlogLog.  I also added and dropped Romlet in late January.

Sorry for the long one!  Hope this provides some insight into starting a blog.  Despite trying to gain readership probably the most fun part is reading the comments from other runners.  So it's not all about the numbers...

Saturday, February 23, 2008

Threemilers and bird watching

I know many of my readers might find these topics equally exciting.  The weather and certain extracurricular obligations have kept me from putting in more miles this week.  I did another "quick" three miles on the road last night, trying to get a start-finished-showered-and-ready-to-go-to-dinner time under 40 minutes.  I did make it.  It's still amazing to me how I can go out and run 8 miles at a 10 minute pace and feel great but doing 3 miles at an 8:45 pace is killer (granted its hills).  I guess there's something to this interval training thing I need to be doing more of.
In other news the past few weeks have brought much avian attention to my birdfeeder.  I put up a nice birdfeeder last year behind my house.  Seems like the first few months it was slow to catch on with the birds.  Now, however, they will go through a pound of food in 2 days (black oil sunflower).  I had to buy a 40-lb bag.  Every week there is the cycle of it being empty, me filling it, no activty for about 2 days then BAM an assault and its gone over about 3 days time, then it usually sits empty 2-3 days before I refill it.  This morning was the first time I saw a bird fly up to it to eat right as I was walking away from filling it.  I guess they are getting used to me.  BTW I have yet to see a squirrel in it, so I think its all birds.  Also BTW I am not a bird freak or anything, just thought it added to the landscape, kinda like watching a fish tank.

Thursday, February 21, 2008

The Rain Came

Just when i was all ready for a nice medium distance run today the sky fell.  They are predicting 3 inches over the next 24 hours in Atlanta - that's about two inches higher than our reservoir given the drought.
Rather than head out into the muddy abyss I borrowed by neighbor's basement and ran on his Horizon Treadmill.  I must just be too used to gym-quality equipment, this thing was under-impressive honestly.  He said he spent around $800 on it (he actually does A LOT of running, several marathons, etc and only uses it for the occasional bad weather).  It has an air cushion under the running platform that was just too awkward - when running at about 7mph my weight coming down on the platform slightly deforms the platform (the "cushion"), causing the belt to "pinch" and slow down.  This makes for an awkward "trip" and almost fall every time this happens.
Anywho, I finally adopted an odd run pattern to keep from tripping, but my boredom and perceived treadmill exhaustion finally caught up at 3 miles and I stopped.  Oh well, a good cool down coming off the 12 miler this past weekend I guess.  Too bad tomorrow will bring more rain.
Till next time...

Monday, February 18, 2008

New Personal Distance Best: 12 miles

Run Data Here

I knew I felt about 90% over the cold - all I had left was a stuffy nose and the occasional sneezing fit. Sunday morning I decided I would head out see how far I could go to try and make up for lost training this past week. I figured this would be 6 or 7 miles then call it day.

About halfway through I was feeling good enough to try and do 10. I did 10 last week, but that was flat and on the treadmill, much different. At about mile 8 or so I realized I could do a little extra. Should I try for 12? One time in high school I completed a 20K, which is about 12.6 miles, but I've never run that far again. I hardly even count it anymore because it was so long ago and my training/build-up recently really has nothing to do with back then.

So I set the mark for 12 miles. The last 3 miles my pace really dipped... also I was entering a very hilly stretch (right near my house) so was little worried about hurting myself. I came into my neighborhood at about 11.5 miles and wound up having to do a few silly laps down the road to get it up to 12 miles.

But I finished. I was very tired and a little disoriented. There was no one there cheering me on. Just me. I had to waddle (very slowly) back up the hill to my house.

The hot shower never felt so good.

1771 kcals! (1 pound of fat = 3600kcals)

Wednesday, February 13, 2008

The 'Epizootie

Sorry all.  Running not happening this week.  Got knocked down yesterday with the cold, which may as well be plague.  I trudged through four cases today and a full 40-some-odd clinic tomorrow.  To top it off I've got an oral exam Saturday and somehow have to figure out how to put in a cochlear implant by Friday.
I did get all dressed up after work, insisting that running would make me "shake this thing", but the second I got outside and saw the car in the distance the thought of home, a fireplace, and an early night was just too tempting.

Sunday, February 10, 2008

10 miles on the 'mill with a negative split

Wow today I put in a 10 miler on the treadmill!  Was a beautiful day outside but being on call makes it hard to run outdoors (although as my wife tells me I could just do a "lot of small laps" around the house).  I decided to do a long run on the treadmill at the hospital.
All said I ran 10.12 miles in 89:08 (8:47 pace) at a 0.2 incline.  Not bad pace.  Ran the first 5 miles at 9:11 pace, the second 5 miles at 8:24 pace.  After the first three miles I thought I would die of boredom, as always when I run on a treadmill.  I watched the same Headline News cast repeat 3 1/2 times.
I usually put the incline up to at least 1.0 but unfortunately the machine in front of the TV had the incline broken.
I also figured out how I can log these treadmill & elliptical runs on MotionBased: I just record a very short "workout", a few seconds or whatever, then upload that as a workout to MB.  The data fields for distance and time are not changeable but I just indicate the real workout info in the workout "name" or comments area.  Of course this method is pretty featureless but its something.
As a cool down I tried on of those Gatorade G2 drinks - the "diet" energy drink.  It has far less sugar but supposedly the same electrolytes as regular Gatorade.  I got it on promo for 3 for $2 at Kroger.  I must say it sounds like a good idea for a post-workout drink; I've always wondered why pumping yourself with extra sugar calories at the end of a workout is a good idea.  Anyway, the lowdown is it fairly tasty but does have a bit more salty or acidic taste than a full-sugar drink.  I think I will continue to buy these (or the Powerade version) in the future.

Chicago Marathon Registration Open

The Chicago Marathon is back with a new namesake sponser - Bank Of America.  Registration opened Feb 1 for the nation's most popular beginning marathoner's marathon.  Price is a steep $110 but the loot includes a technical running shirt, I'm sure a goodie bag, and a ChampionChip to borrow.
I don't know what the demand is exactly, but it its only open to the first 45,000 registrants - I'm pretty sure they fill up every year.  I just registered minutes ago.  In case you want to find me, I'll be in the "Hopefully 4:30" pace group.  :)
It will be my first marathon.  My first half marathon is coming up in March (The ING Georgia).  Right now I'm up to long runs of about 8 miles, but I feel like that can be bumped up to 10 or 11 whenever time allows.  I should be in the position to run a 12 or 13 miler BEFORE the ING Half Marathon March 30.  Then my hope is a slow build up to around 22 miles before Chicago - so the marathon will have about 4 miles of "uncharted territory" as far as my running expectations.  I am not doing a plan really.  I've found I have too unreliable a schedule; often going a week or two without being able to run.  So far the slow and steady has worked without injury.
Hope to see you there!  Get your registrations in early!

Wednesday, February 6, 2008

McCain's Darn Parotid Gland

Being an ENT I can't help but notice that the recent photos of Senator John McCain shows his left parotid gland to be enlarged.  I first noticed it a few weeks ago during a news interview; I  was shocked because I thought he had a tobacco chew in...
I did a quick Dr. Google search and found that he seems to have had a melanoma of the left shoulder around 1999 or 2000 that was removed.  At that time he also had what sounds like a left neck dissection and superficial parotidectomy to remove any lymph nodes that might be involved.  He is apparently pretty hush-hush about this so there's not a lot of news out there on it.
So diagnosing through the television I hope someone is on top of that gland...  The most worrisome possibility of just what the heck that could be is recurrent melanoma.  Other more friendly things might include a second new parotid tumor (usually benign), an inflammation of the remaining parotid gland (parotitis), or possibly some "post surgical change" / scarring.
Included here are a series of photos snagged from the internet of McCain from 2004 to 2008.  It's hard to deny the left parotid is bigger now than it ever has been.  The 2006 image demonstrates the classic sunken retromandibular space where the parotid was previously removed.  Also clear here is that long up-and-down scar, that is particularly odd because it is the wrong scar for a parotidectomy.  The fatty, enlarged area in 2006 seems to be over the cheek region, not really in that retromandibular area.  There is usually some parotid tissue in that area, but not that much.  You can also see where he has a good deal of swelling below his jaw on the left.  That looks like his submandibular gland has just "slipped" or become ptotic; that happens with aging.
Hmmm.... so does anyone have the scoop?  Is someone looking into this?  Has McCain said anything that hasn't yet made it to the net?

Tuesday, February 5, 2008

The twisted ankle

Last week I ran upon a college-aged kid holding his leg rolling around on the ground, obviously in great agony.  "Great," I thought.  Being a doctor can be a huge inconvenience at times.  Like at thanksgiving when Aunt Elda asks about her incontinence, or at my grandfather-in-law's funeral when I'm getting the third degree about the hospital that "killed him".
I say "Great" sarcastically.  Anyone in medicine knows that all docs don't know all things.  Furthermore, aanyone gone to med school knows that orthopedics and orthopedic injuries (those involving the bones/ligaments/tendons/muscles) are only known to those appropriate specialties.  LITERALLY, my formal education of the foot consisted of a 50 minute anatomy lecture followed by a 2 hour cadaver dissection that was to include everything below the knee.  And that's not to say I am dumb or went to a dumb school (my board scores are about 95th percentile).
Anyway, I kinda know the pathology of an incontinent bladder and can visualize a sprained ankle.  But treatment?  What I say might as well be voodoo.  Most of my education about orthopedic injuries has come from the web, looking at exercise websites, blogs, and the occasional expert opinion.
So between breaths I asked the kid if he was ok (a good starting point I thought.  In advanced life support they teach you really obvious things like "if the person can talk then they are doing better than if they can't").  "Yeah, I just have a cramp".  Oh thank God.  "Sorry, there's nothing I can do about that..."  I ran on.  From the looks of things his pride was a little hurt that another male only a few years older was offering him help.
It got me thinking that I really don't know how to treat the common athletic ailments any better than the average athlete.  I find myself telling people things like "alternate cold and hot compresses, take advil, elevate it, rest it but keep it active".  What does that mean?  Where did I learn that?  It's all just made up based on hearsay and what may be common sense.
So tonight I read a little about ankle sprain, a very common complaint, especially for runners.
To not be too redundant, there is a complete review article published in the American Family Practice Journal last year that takes a scientific look at treatment.  It is available free here:
In summary:
1. There is something called the Ottawa Ankle Rules that is simple way to diagnose severe sprain or ligament tear with reasonable accuracy.  It was designed to sort out who needs xrays and who doesn't, to save the health care system money.  Basically, if you have swelling, bruising, pain, and an "anterior drawer test" (looks at the abnormal laxity of motion around the heel joint) there is 96% risk of a serious tendon/joint injury.  Without all 4 of these things, risk is 14% and declines with declining severity.
2. ICE is the treatment.  Not heat.  There is some (limited) scientific studies that icing ankle injuries not only improves pain but speeds recovery.  HEAT IS NOT RECOMMENDED.
3. Taping a sprained ankle seems to help some, but not greatly.
4. Using compression taping or a brace seems to help.  Lace-up semirigid braces are best.
5. Taping/bracing or icing seems to help EVEN WHEN YOU DON'T HAVE AN INJURY.  You can reduce your risk of injury if you use braces on joints that have old inactive injuries, maybe even to be totally preventative.
6. There is even some evidence that icing non-injured muscles and joints (after workouts) can reduce the risk of injury.
7. Meds: the use of NSAIDS (ie ibuprofen and the like) seem to speed recovery.  Take it not just for pain but for swelling.
8. Research supports avoiding immobilization, ie you don't want to just rest your ankle totally.  Some function is important to recovery.  Of course act within reason; probably walking is enough early on.
9. Surgery, even for severely sprained ankle, is not the first line of therapy.  First try physical therapy / exercise.  Many studies show no long term difference between surgery and physical therapy.

Monday, February 4, 2008

Nice 8mile

I hit the pavement tonight at 5pm thinking I would just run for another four miles or so (given that my last two runs have been pretty, errr, crappy).  The weather was nice and warm and the sun made it out by the afternoon.
At mile four I realized I was actually feeling pretty limber and thought I should take the opportunity to push a little further.
At mile six I still felt solid, though slowing some by now but decided to do another lap around the lake.
All said I finished 8 miles in a reasonable time and felt very solid afterward.  I could've definitely gone 10.
I think this distance running thing depends a lot more on physical exertion over the past several days than I realized... recovery runs and days off are a must (limited alcohol and poor diet while out of town a close second).

Sunday, February 3, 2008

Dallas / Las Colinas

The past two days were beautiful but rushed; we left home Friday morning around 6am to arrive in Dallas-Ft. Worth by 9am and to the resort thirty minutes later.  We checked in early and did an hour in the gym prior to our noon luncheon.  I wound up doing 3 "miles" on the elliptical plus a one mile 'sprint' on the treadmill, along with some nautilus machine work.  The luncheon was followed by an afternoon of meetings / lectures until around 6:45pm.  At this point the evening activities got underway, which included a tequila bar and heavy hors devours.
Unfortunately stayed up too late to be able to get my 5am run in...  wound up stumbling back down to the conference at 7am to sit through another 5 hours.
Immediately following a box lunch Saturday (maybe this was a mistake) I headed out for a Colinas neighborhood run.  As you see from the map, not exactly the most scenic path, but I was a little pressed for time to catch my flight.  Las Colinas seems like it was originally a middle class suburb that got overrun with 3 or 4 large resort and country clubs.  Interesting mix of small ranch homes, average apartments and very large golf course houses.
I was pretty exhausted after this one.  Again, must attribute it to my eating, sleeping, and exercising the day before.
Best part was I was already checked out by this point so I used the spa to shower, shave, get dressed, and relax in the spa lounge.  I think definitely I could start everyday in a spa facility.  Sorry no pictures!