Week 22 Day 2 – 1.2 Miles

My running weeks run Monday through Sunday so I still had a chance, as of yesterday, to still fit in 4 runs for this week.  Unfortunately an unexpected rain shower and my gym being closed put an end to that idea.

I did head out tonight and squeezed in a quick 1.2 miles.

2014-09-07 03.17.13

I’ll probably have a similar run tomorrow before work to give me three runs for the week then I’ll look to maintain the frequency for the final days leading up to my Part III exam.

I did 100 miles last month and in the last 8 days of the month I only ran twice so, tomorrow is the 7th day of Sept and I’ll be able to get in a third run.  I did have a 13.1 mile training run last month and a double run day for a total of 11.5 miles and one 8 mile day.  Other than those three runs there wasn’t anything much beyond a 10k.

It looks like Sports Tracker has upgraded it’s online website.  I like the new format.  It’s URL is listed as beta.sports-tracker.com  At the top of the dashboard is a chart showing my last 30 days worth of running with a total of 19 hours 44 minutes spent running and a distance of 82 miles.  Apparently, that’s down 9% from the previous 90 days.

Since it was raining last night I went grocery shopping and found an amazing deal on bottled water – only $1.99 for a 24 pack so I got 6 cases.  That should help put me back on track.

Basically, making sure to get in my runs, regardless of how short and shooting up a blog of each one will be about the extent of my running involvement for the rest of this week.  My mind is pretty well focused on that upcoming exam.

I’m pretty sure I’ll do much better than my previous attempts but don’t know for sure if I’ll pass.  If I don’t pass then I would think there would only be one or two areas out of the 9 areas we get tested on which would need more work.  I know I could maintain 7 or 8 areas and beef up whatever area might be left to pass for certain in March but, there is still a decent chance next week.  We’ll see.

Pass or fail, I still want to get through Part IV next May.  I’ll be darned – just checked the NBCE website and there’s only three major areas to be tested and one of them is actually (finally) chiropractic.

  • x-ray interpretation and diagnosis
  • chiropractic technique
  • case management

I was talking with an MD friend of mine about all these exams and he said his part four was for his specialty so, that would make sense that we finally have some actual chiropractic in this last exam.

I was looking at some Instagram running post and one person mentioned that “this shit sure takes a long time”  I would have to agree.  It certainly does with the running and I’m also thinking it sure takes a long time with the doctor road as well.

I got some literature again from St George’s University School of Medicine while I was away on my travels.  This is the medical school down in Grenada and, if anyone reading this is old enough to remember it’s a country the US invaded back in the early 80’s when Reagan was president.  From what I’ve learned that medical school in Grenada and the great many US students there played a factor in our invasion.  About all I really remember was seeing a picture of a long line of US helicopters making their way into the country and wondering how terrifying that must be if you’re someone on the ground.

It sure would be a beautiful place to stay for 4 years while getting a degree but I have no idea how the financial aspects of it would work.

That mailer prompted me to look into the situation a bit more.  Back in the 1970s there were three medical schools in the caribbean and as of 2011 there are now 60.

hmmmm – here is a picture of the beach at St George

1280px-Grand_Anse_Beach_Grenada

that’s a picture probably worth clicking on to make bigger ….it’s very alluring.

but – for now, I have to focus myself on getting this:

engraved_cert

 

I have a plaque just like that for completing the physiotherapy requirements for the NBCE.  With the plaque above I’ll be good to go for practice in any state in the Union and, a few other countries as well.

6 years post college – 1.5 years to finish up licensing – at least 1 year understudy working w/ someone else then after 5 years with my own office things should be looking pretty sweet.  At least, that’s the standard pattern I’ve seen many of my colleagues take.

 

Week 33 Weigh-In – Wooosh! Massive Weight Gains

I weighed myself yesterday morning, Thursday as I normally do and saw 260.8 lbs but, what really got my attention was stepping on the scale today – Week 33 plus 1 day and saw an all time high for the past 21 weeks of 267.4!  Hmmm.  Well, I added not only the official Thursday weight to my desktop wallpaper but also added  that 267.4 weight.

Week n - 2nd 12 Week Session Week 33

Basically in 3 weeks and 1 day I managed to gain over 20 pounds.  Of course, yesterday just ended 24 days of 9-5 board reviews so things may not be as bad as it first appears.  Perhaps more importantly, are the cars I’ve added to my Week 33 weigh in so, maybe we should address those first ;)   (it’s a guy thing)

968 Porsche
In the lower right hand corner we have the 968 Porsche which is a front engine, 4 cylinder car which was only produced from 1992 to 1995.  There were a little over 12,000 of them made and only about 2,400 which were convertibles.  This little car started it’s life as a 924 in the mid to late 70s, then grew up into the popular 944 model then ended with this amazingly refined 968.  Well ….I guess you could say the 914 may have been the oldest predecessor in this line of front engine Porsche cars.

I always have to wonder why any car enthusiast, especially a Porsche enthusiast would ever bother with a 944.  Those cars are a dime a dozen and have to wonder if they just don’t know the lineage of the car or maybe just want the cheapest option available and still be able to tout the Porsche name.

In a 500 mile search on cars.com of Porsches there’s 38 944s available with prices starting below $2,000 while the 968 yields only 2 for sale with a low price of $13k.

When I was 19 I bought a 924 and still remember quite a bit about it.   It was Alpine White, about 4.5 inches off the ground and had a 016z transmission which meant the transmission was in the back of the car and not directly mated to the engine.  This provided a nearly perfect 50/50 weight distribution.  The ergonomics of that car were still the best of any car I’ve ever owned or driven for that matter.

Had to check wikipedia for info on these models – sure enough – about 171,000 of the 944s were produced.  The much nicer 968 however only had 12,776 total produced and only 4,665 of them were distributed between the US and Canada.  Of those, 2,248 were convertibles that made it to the US.  Definitely not a dime a dozen car like the 944.

I have never owned a convertible before and the 968 cabriolet was going to be my first.  I was in the market for one prior to heading back to school and even had a spreadsheet where I kept track of the 968 cabriolets for sale, along with their VIN numbers since there were only so many of those cars in play.

2015 Corvette
My brother is on his 3rd ‘vette so I wanted to check them out.  $54,000 baseline coupe and $59,000 baseline price on the convertible.  I’m not sure if I’ll ever be buying one of these new – probably not but, it was fun to go through the Chevy “build your own” website.  0-60 in 3.8 seconds – that’s kind of like my motorcycle fast.

2015 Camaro
These start at $24,700 for the 1LS but, I would have to get a 1LT model (baseline $27,000) in order to get the optional 245 watt, 9 speaker Boston audio system.

Before I headed out on my 24 day board reviews trek I watched a number of car videos on YouTube including one that was about 1.5 hours long on the history of cars starting back with the steam driven vehicles up to current models and a glimpse into the future.

Another great thing about the 968 Porsche was that as early back as 1992 when it first came out it had variable cam timing – who else had that?  It was maybe 10 or 15 years later when I noticed the Honda Civic incorporated variable cam timing in their cars.

I’m not sure what the 968’s cost new but back in 2007 the resale value had dipped below $20k for most of them with lower mileage models going for just under $30k.   According to wiki, in April 2012 a 968 got auctioned off for $346,000.

What about running?  Week 33 Weigh-In and getting fatter??!
Yesterday concluded my 24 day marathon of reviews during which time I had only 2 days off and a ton of travelling.  I got home a bit early yesterday at 5:30 and around ….oh, 5:31 I was fast asleep.  Totally exhausted but, nothing 14 hours of sleep couldn’t fix :)  However, as much as weighing 260.8 caught my attention yesterday it was the 267.4 this morning which really caught my attention.

Pragmatically speaking, this new high weight has me a little concerned because I’m signed up for a 50 mile bike ride tomorrow – huh.

So, what happened?  I overlayed my weight for the past 4 weeks on my calendar.  Then I realized that these past 3+ weeks were much like when I was in clinic and school last year and watched my weight climb and climb week by week.

Basically, it seems anytime I’m sitting on my but for 9 or more hours per day with little or no days off that my weight goes up.

Things started easy in Davenport – almost ideal actually.  School was still in session in Iowa so my first four days of reviews were only from 5 to 11 p.m., just 6 hours of reviews each day and plenty of time to study and run and swim and I hit my low weight of 245.  But, after those four days, every day became 9 a.m. to 6 p.m. – everyday including weekends.

In Iowa and Kansas, I was at least able to stay in hotels that were close to the schools.  My final week in Chesterfield, MO meant staying at home and commuting every day so, in addition to the 9-6 schedule there was another 2 hours of driving each day so the schedule was more like 8 am. to 7 p.m.  Bedtime hovered around 9 p.m. so, that’s 11 hours per day on my butt and another 8 or so sleeping.  It’s an ideal situation for packing on the pounds fast and very stressful.

It’s either ironic or funny depending on how you look at this but, one of my 26 reasons for leaving SAVVIS to go back to school to become a chiropractor had to do with my health and health was probably a top 5 reason for making the change.  I grew to loathe the drive to SAVVIS everyday and figured I would move close to school and not make that drive everyday anymore.  I never did more and simply added 5 miles per day each way to my commute.

2007 was a big running year for me because I was trying to offset 5 years of sitting on my butt for 11 hours per day and the ensuing weight gain.

Well – I have to figure a few things out here -

It’s Friday and I went jogging Wednesday for 4 miles.  It was pretty rough.  I remembered way back in high school a book I read – it may have been a tape of the book called, “You can’t afford the Luxury of a negative thought”  A part of that book had you imagine that you were some kind of master achiever, that you could work towards anything you thought of and accomplish it then, achievement got too easy, lost it’s luster and you wanted a greater challenge so you created a button called “Greater Challenge” – pressed it and found yourself exactly where you are now.

For me, I realized that the extra hours of commuting along w/ the 9 hours of reviews and only 2 days off over the past 24 days was representing a greater challenge so I simply went to a park near the school and was able to get in 4 miles.  I had two days off before that and 3 days away from running before that.

But – my running weeks are Mon through Sunday so, I still have 3 days left for this 22nd week of my program and can get in 4 days of running this week as long as I go today, tomorrow and Sunday -

easy enough.  I don’t see myself doing 18 miles on Sat as scheduled, nor do I care a whole lot right now.  I’m not overly concerned about that 50 mile bike ride tomorrow either – and, it just occurred to me that bike ride did not have any online payment options so, I’m only registered and have not paid for it.  Cool.  I might just enjoy my 2nd day off and blow that off.

I had 3 other half marathons I was looking at for October – I passed / missed the Aug 31st deadline to register at cheaper rates but had other things going on.

The race in Valmier, IL is probably going to be along back roads – country roads and is on Sept 27th and I could probably live without that one.  The other two are bigger events  and all held on Sundays – Missouri Cowbell half in St Charles – a really good place to run, I’ve done the Lewis & Clark half marathon there before.  The other two would be the Go! St Louis Half (Halloween edition) the the Rock n Roll St Louis half the following week which I’m already signed up for.

I think I’ll put off any future registration for at least another week, until my Part III exam is over.  I’m sure I’ll do at least one extra half so I can join Half Fanatics.  And, somewhere between now and the end of the year, I need to get a sub 2:30 half marathon to (re)qualify for the Pikes Peak Ascent.  I would like another Platinum trophy so, maybe this month can end the way last month started, we’ll see.  It’s not the end of the world of I don’t get it but I do need to keep running.

October 18th, I test for my next belt in karate – maybe I’ll check that out again tomorrow since I’m blowing off the 50 mile bike race.   Those 4 miles I did this past Wed were kind of sad in terms of performance.  It was my 22nd week in the program but felt more like week 1.  I’ll probably keep my mileage down this week, maybe no more than 3 miles at a time unless I happen to be feeling it and want to run longer.

Part III is the main focus this week.

I have talked with NBS about Part IV reviews already and will be taking that exam in May of 2015.  ….reminds me I have to sign up for the 2015 Lincoln Presidential half yet as well as the Go! which should be taking place the next day – back to back halfs – i like that challenge idea.  :)

I did get a chance to talk with two other chiropractors who told me they passed part 4 before they passed part 3.  So, however I end up doing next Saturday, I will be giving Part IV a shot next May.  I know I’ve got a really decent shot at getting through this next exam – I know a lot and just need to make sure I don’t have any weaknesses that could hold me back.

It’s odd but, with Part III – one person could score a 70% and pass while another might score a 90% and fail because all 9 sections have to be adequately passed and those sections aren’t fully determined until after the exam is analyzed.

We had a bit over 200 pages of review material in each review session but only a single page for Chiropractic Technique.  It’s almost overlooked but, it does make up a lightly weighted section of the 9 total sections.

Ideally, this will be the plan

  1. Pass Part III (results by Dec)
  2. Obtain License for Illinois
  3. Become Nationally Registered Certified Medical Examiner
  4. Pass Part IV

Somewhere in the midst of #’s 2 & 3 up there I will be eligible to get a job somewhere with someone, at least in the state of Illinois – after passing Part IV – I’ll be able to work anywhere in the country!  :)   My eyes are wide open at that thought :)

 

 

August Running Recap – Went PLATINUM! :)

2014-09-01 05.01.35 - Copy

That platinum trophy and covering the 100 miles in August in order to obtain it was probably the biggest thing I accomplished this month in terms of running & physical training.

I was away on business for over half the month so I got to run in four different states to help make that platinum trophy a reality.  I ran in Illinois, Missouri, Iowa and Kansas.

My Average weight is probably the next biggest thing accomplished since it’s the lowest it’s been all year at 251 lbs.  I had a single weigh in this past April at the end of my 12 week contest which was 242.6 and two weeks ago I revisited the 240’s with a weigh in around 245.

I got to swap a few comments earlier this month with the author of a blog named Fat to Fit.  This person  lost 140 pounds since April 30, 2013 with healthy eating and daily exercise.  I solidly realized and began to more fully appreciate the immense value of being able to keep excess weight off once it is lost.

This last weight loss contest I won in 2014 was my fifth time doing that contest.  Prior, I had completed the contest twice and placed 4th and 3rd respectively (each contest has been with 1,000 to 1,200 other contestants)  The other two times I entered, I did not finish.  I know, however, that in each of the contest I finished – including this one that I kept starting out and a higher and higher starting weight.  So, what’s the point of dropping weight if you’re just going to end up heavier than you started six months later?

Tracking my Average Monthly Weight is something new I started.  I weigh in every Thursday and blog that each which but now, at the end of the month I enter the average of my Thursday weigh ins and put that down in my Running Log tab in the Ave Weight column.

Well, September is a new month :)  I want another Platinum Trophy :)

2014-08-30 05.03.57

Got G.A.S.? and What you might not know about Michael Jackson

Hans Selye 1907-1982

Hans Selye 1907-1982

…and, of course, by GAS, we’re talking about the General Adaptation Syndrome discovered by endocrinologist Dr. Hans Sylye.  To me, this guy comes across as almost a prodigy and certainly a cerebral powerhouse.  Hans Selye entered a German Medical School in Prague at the age of 17 where he graduated first in his class.  Later he earned a doctorate in organic chemistry.

Bust of Hans Selye at Selye János University, Komárno, Slovakia

Bust of Hans Selye at Selye János University, Komárno, Slovakia

The clinician teaching board reviews, Dr James, had a fun way to describe the GAS and it’s effect on the body by using a somewhat benign example involving a couple who had broken up but are currently at odds and fighting over their DVD collection.   There may be a knock at the door, a fight ensues and the fighting may bring a person from say a calm baseline of zero to an exacerbated 10 on the stress scale.  The thing is, when the fight is over for that day and people go their separate ways, the persons stress level doesn’t necessarily go back down to zero but rather, stays elevated at maybe a 4 or a 5 – kind of ready to jump back into action should the need arise.

"Stress plays a factor or role in any disease"

“Stress plays a factor or role in any disease”

As with many things in life, the stress Dr Selye talks about doesn’t have to be real so, any perception of chronic stress would constitute a state of Alarm which can eventually cause a neuroendocrine response, often from the pituitary which suppresses the thymicolymphaticus system and reduce the resistance of the body to disease.  Other contributing mechanisms would include lymph involution, decrease in WBC, increase in eosinophils, increases in (adrenocorticotropic hormone) and increases in cortisol.

Essentially, with regards to survival, it’s more important to be able to fight off a lion than to fight off a cold which is why immunity decreases in patients with chronic stress.  Dr Selye’s work goes a little beyond the basic flight or fight notion.  As a chiropractor, we learn about Selye because he shows a direct link between the immune system and the nervous system.

I think most people are aware  that we have a brain and a spinal cord.

The brain and spinal cord make up the Central Nervous System

The brain and spinal cord make up the Central Nervous System

once nerves leave the Central Nervous System (CNS) they become part of what’s known as the peripheral nervous system (PNS) and innervate with every organ and muscle in the body.

Peripheral Nervous System (PNS)

Peripheral Nervous System (PNS)

But, there’s also another set of nerves that run parallel to the spinal cord known as the sympathetic chain ganglion which are also known as the intermediolateral cell columns.   I was trying to find a simple picture of the sympathetic chain ganglion.  This was the best I could do for now -

Sympathetic Chain Ganglion with organ innervation

Sympathetic Chain Ganglion with organ innervation

Admittedly, this model is a bit more confusing than the CNS and PNS but it does give a little better idea of how our nervous system controls so many functions and organs of the human body.  The Sympathetic Chain Ganglion in this picture is shown running from T1 to L1 – or from the first thoracic vertebrae to the 2nd Lumbar vertebrae, about the middle portion of your back.    That ganglion of sympathetic nerves and the whole fight or flight system is to the human body what nitrous oxide is to a car.  In a fraction of a second heart rate & blood pressure increase, pupils dilate, sphincter muscles in arterioles that precede capillaries can constrict to shunt blood away from lower priority areas of the body (we don’t care about digesting your food when mama bear jumps out of the woods and attacks you)  smooth muscles in the lungs relax to allow more oxygen into the lungs and so much more – it’s quite a well orchestrated and impressive chain of events.

By the way – that spinal cord is rather small.  Take two of your favorite #2 pencils and put them together, look at the two eraser heads side by side.  That’s about the size of the spinal cord.  It is bigger in some places and smaller in other places but still much smaller than one might imagine.  I never realized the size until I saw it for myself along with transverse sections of the cord during gross anatomy.

I can’t find any pictures online which show with any relativity the transverse size of the spinal cord so, you’ll have to take my word for it.  It’s absolutely mind boggling – the degree to which scientist have dissected that little cord to learn what every little column & tract does and what everything is connected to.

Cross Section of the Spinal Cord

Cross Section of the Spinal Cord

I have absolutely no idea how all of that was figured out but I’m sure it would make fascinating reading :)

If you think of a fuse box in your house, it has wires that go from the fuse box to your air conditioner, stove, washer & dryer, the bathrooms, etc.  This is much like the spinal cord which has wires in the form of nerves which go to your arms, legs, fingers, toes and also (as we have seen above) to your heart, lung, kidneys, bladder and reproductive organs.

So, if you come into my office and we want to check the wiring in the posterior columns of your spinal cord we might strike a 512 Mhz tuning fork and press the handle against your big toe since the sensation of vibration is conducted through the wiring of the posterior column.  We may also check two point discrimination and position sense to further evaluate those posterior columns.  Elderly people often lose the sense to vibration first and that has been what I’ve found with geriatric patients I have tested.  It’s all pretty amazing.

Michael Jackson’s Birthday!
michael-jackson-mus-jy-0182_61285906

While I was escaping the realities of my life via blogging it came to my attention that today would have been Michael Jackson’s 56th birthday.  Back in 1982 MJ’s Thriller album was the only album by any artist that I had to buy twice.  At that time the music medium I used was cassette and I played his Thriller cassette so many times that the tape eventually wore out and broke which is why I had to buy a second Thriller cassette.

MJ had a form of Lupus called Discoid Lupus Erythematosus (DLS).  The more common variant people are usually referring to when they mention Lupus is Systemic Lupus Erythematosus (SLE).  The DLS and vitiligo give some insight into some of the changes the public would witness over his lifetime and judge without really known what the heck they were talking about.

Week 32 Weigh-In, First 100 Mile Month

I was coming home from Kansas along highway 70 and had been driving for about an hour and a half when I got to Columbia, MO and noticed on my GPS that I still had 3 hours to go before I would get home.  Then I checked my GPS again to find that I was only 1 hour away from the Lake of the Ozarks where my parents have a condo and quickly concluded that I would head South for the shorter trip to a place to sleep for the night.  It was still early enough that I knew I could get there, maybe see a nice sunset over the lake and still get in a jog before the night was over.

I thought the reviews on Wednesday night would last until about 6 or 6:30 so I had bought a ticket to see the Royals play the Twins at Kauffman Stadium.  I’d seen both these teams play before …  ….  huh …..well, as a St Louis Cardinals fan, there are some rough memories of the Cardinals playing both of these teams back in the 80’s.

1985 – The I-70 Series when both the Cardinals and Royals went to the World Series.  After the first four games of the series the Cardinals were up 3 games to 1 and only needed one more win to clinch the series then dropped the last three games of the series to the Royals. :(

1987 – The Cardinals played the Minnesota Twins in the world series …..ugh again…. After 5 games the Cardinals were up 3 games to 2 but lost the final 2 games.

Still – getting to the World Series is a heck of an accomplishment and both of those series went 7 games.  AND – I was at Busch Stadium in 1982 when the Cardinals did win the World Series against the Milwaukee Brewers!  :)  HA!  :)

Cardinals Win World Series in 1982!

Cardinals Win World Series in 1982!

Earlier in the week I was checking out different things to do in the Kansas City area and found they had a pretty cool looking King Tut exhibit in town through September but the times conflicted with my board reviews but not the baseball game.  :)  I’d never been to Kauffman stadium and guess I wanted something fun to look forward to to help get me through the remaining days of board reviews – StubHub to the rescue!

I figured ticket prices would be comparable to St Louis with some less expensive seats available on Tuesday and Wednesday and, sure enough, I found a Field Box seat at Section 141 for only $15!  These same seats were going for $200 on Monday night when the Yankees were in town.

2014-08-24 00.53.25 2014-08-27 21.28.03

I did learn something pretty cool since I didn’t have a printer to print off tickets like I normally would – there is an app for StubHub that can be downloaded and a section of the app allows you to pull up your tickets and just show your phone and a picture of your ticket to get into the game.

The last day of board reviews finished up around 3:30 that day and I’d already checked out of my hotel that morning so I went straight to the ballpark.  I learned the gates didn’t open until 5:30 and didn’t want to hang around outside in the hot sun for an hour an a half to see the inside of the ballpark or 3.5 hours for the game to start, especially since I knew I could be almost all the way home if I were to leave so, I took some pics of the two stadiums and headed out.  I didn’t know that both Arrowhead Stadium and Kauffman stadium were located in the same area.

Arrowhead Stadium

Arrowhead Stadium

Kauffman Stadium on the left and Arrowhead Stadium on the right.

Kauffman Stadium on the left and Arrowhead Stadium on the right.

So, I never stuck around for the game but it made me realize again that there are a lot of things to see and places to go not too far from St Louis.  Iowa was only 4 hours North and they had a pretty big festival going on up there over the weekend when I was there.  I know one event was trying to set a new world record for the most number of Kayaks (or maybe just rowboats in general) for being on the river at the same time along with some concerts, fair activities and a few concerts.

Memphis and Nashville are within 4.5 hours to the South and KC was just under 4.5 hours to the West and with my gas sipping car less than two tanks are needed for any round trip.

Week 32 Weigh-In
Anyway – I was wearing my shoes during Thursday morning’s Week 32 Weigh-In since I needed to leave by 6:30 a.m. to get to Chesterfield, MO for another round of board reviews and was running a bit late so I just stepped on the scale fully dressed to get my weight for that week.

2014-08-28 06.35.15

Week n - 2nd 12 Week Session Week 32 - Copy

 

I was bummed that I lost my one little square with my fantasy car so I just added a whole new strip.  The marketing folks at Chevy did a great job when they named the color of that car Metallic Rock Red.   Very nice guy appeal :)

For the next two weeks I’ll probably be a little liberal with my diet – and for me the word diet simply refers to what I happen to be eating as opposed to any caloric deficit or fad type of plan pertaining to my eating.  When I was up in Iowa and had that 13.1 mile training run I had plenty of energy to get me through that run and I was simply eating normal meals – That day I believe I had a breakfast (homemade waffles from the hotel) then ate during my first break during reviews, then had an actual lunch a few hours later then a protein shake, grits and some naturally organic nutrition bar I’d gotten from my brother.  Just ample and fairly good eating but, what a difference it made on my run.  After so many talks about hyperinsulemia or hypoglycemia I tried a simple candy bar prior during our reviews and it did make a difference and NO, I did not experience any crash later on during the day but I was more alert and didn’t fall asleep at all during the reviews.  I just need to maintain being sharp and alert mentally these next couple weeks and keep up my study intensity to have the best chance possible at passing this Part III exam.

Another interesting thing I learned about that exam is that someone who say, scores a 65% might pass the exam while another person who gets 80 or even 90% of the answers correct might fail the exam.  That’s because after the exam is taken and all the exams world wide have been submitted, the governing body who puts out the exam (NBCE) then decides exactly which categories each question falls into.  Then, each section will have a minimum number of questions that have to be answered correctly.

This exam also varies the most from year to year.  Heart, Lungs and kidneys are kind of staples in the exam but, one year the eyes might get asked about a lot and maybe not at all the next exam.  Neurogenic diseases might be hot one exam but not so much on the next so, one kind of has to know everything just in case.

I am feeling more confident in my ability to pass this exam, time will tell.  But, confident enough that I’ve started checking out Part IV which is actually still given this year in November but, I had my sights more on taking it in May of next year since that exam runs close to $1,500 now which has to be paid in cash …no credit cards accepted.  I’ve got an extra couple hours this morning so I think I’ll email Dr Laura and start inquiring about taking Part IV reviews a couple times.  There are some reviews in November.  Currently, I’m taking reviews for Parts II, III and PT because all that has to be known for Part IV and 8 days is usually enough time for all three of those reviews but, with Part IV it takes an entire week for just that one exam …and …of course, we’re still expected to know everything from the previous reviews which, isn’t exactly unreasonable to get licensed as a doctor.

I’ve also been looking into the NRCME – Nationally Registered Certified Medical Examiners which is something I’ll be eligible for once I have a licence.  There’s some good videos on YouTube about the NRCME and I did a search for the Illinois and Missouri areas and learned the range of prices charged for giving a DOT physical are ranging from $50 to $280.  I was hoping to be able to travel to various areas where over the road truck drivers get their own license for driving and maybe offering a service where I would drive to them to administer these physicals and perhaps be able to get 10 or 20 physicals completed in a few days time.  Maybe I could work out a deal with some of these truck driving schools where they can include the physical as part of their tuition then offer a price break.  Maybe $120 for a regular physical and offer a special deal of $80 or $90 for having the quantity.

There’s still things to look into but, here is a great thing – the exam to become a NRCME is only 80 bucks!  :)

Eat Your Veggies?
I was looking at an article in the HuffingtonPost called “6 Vegetables That Might Save Your Life” and the first line starts out, “If there’s one food that no one — not your doctor, your nutritionist or even your mother — will tell you to eat less of, it’s leafy greens.”

uh – I don’t think so -

The average standard of care would indicate that the types of leafy greens advocated in the article are actually contraindicated for people taking blood thinners.  Also, these leafy greens, especially the super healthy looking dark green ones are contraindicated for people prone to kidney stones since the majority of those stones are calcium oxylate and foods containing high quantities of those substances should be avoided.  Unless, of course, you like getting kidney stones.

First 100 Mile Month
I’m at 96 miles for the month and perhaps, could be getting a bit lazy since I had three straight days earlier this week without running.  The focus on studying has been rather intense so running hasn’t been on my mind quite as much but, there’s also pure exhaustion which has kicked in a couple of times and had me passed out and sleeping by 8:30 some nights.

Still, there are 3 days left in this month so, hitting 100 miles with only 4 miles left to do will be pretty easy – basically one more run and I’m there.

Upcoming Events & Marathon Ponderings – 
A week from tomorrow I have my first Half Century (50 mile) bike ride.  That should be interesting and it will be a new distance record for me.  Right now, my longest distance would be the 35 mile bike ride from the Tour de Donut.  I’m hopeful :)

The week after that is Part III boards ….then a week off from any races then….

could or should I do 4 straight weeks of half marathons?  idk.

I already have one in the books (the 4th one) but, dare I add three more in the preceding weeks?

I know I’ve had a running fantasy/strategy in my head before of running a half marathon distance a week – maybe for a year straight or something like that.  That distance seems to have a pretty favorable effect on me physically and maybe it’s the kind of thing that needs to be done in order to push/force my weight down into the 220’s(?)

I also know that I don’t have much in the way of long runs that exceed the 10 mile mark – maybe 2 right now?  I’ve done a double session of running which put me over 10 one day but that isn’t quite the same in my mind.

Cost is a bit of a factor but, I would be using a credit card for the additional 3 events so registration is attainable.

My scheduled long runs would be cut short since most are over that 13 mile mark in the weeks leading up to the full marathon but, as stated, I’m not hitting those distances much.  I know I’m getting closer and I am improving but that improvement does take time.

I do have a couple days to decide – I think rates for most those runs won’t be going up until after the end of this month.

Kansas Review, running, shin splints, fascia, etc…

I’ve had a plethora of different things I’ve wanted to blog about over the past few weeks but hardly anything has been inked.  I was quite impressed with Overland Park, Kansas which was one of the nicest cities I’ve ever been in.  My hotel in Davenport, Iowa was considerably nicer but there was basically a highway on one side of the hotel and modest residential housing on the other side of the hotel which lead to my running path.

Davenport Iowa has a population a little over 100,000 people and is one of the quad cities.  I noticed Kansas City had a population of around 496,000.  Highway 435 is the bypass around Kansas City much like hwy 270 is the bypass around St Louis.

I do believe everything I could have needed for living the next year in Overland Park could be found within a 5 mile radius of the hotel where I was staying.  Even the two stadiums, Arrowhead and Kauffman Stadium were only 20 minutes away.  The sheer quantity and diversity of places to eat was rather impressive also.  Multiples of every kind of restaurant you can imagine.  Not just one BBQ place but maybe 1/2 a dozen including Korean BBQ.  I’m not even exactly sure what that is. Thai, Mediterranean, Chinese, Italian, Indian – you name it, it was bound to be close by.

Recalling …I indulged in Chinese, Pizza, Mexican, another Pizza place, Denny’s and Subway …..got a feeling I’ll be weighing in tomorrow in the mid 250’s ;)

The running path took a little more to figure out than in Davenport but, I believe the one I was on in Kansas was about 26 miles long.  In a few areas it would come up to a street then you had to know which way to go down the street in order to hook back up to the path.  I went West on the path my second time out and that direction was nicely contiguous.

I’m still having a bit of a tough time with my differentials.  A diagnosis (dx) is one thing – it’s just flat out what a person may be suffering from or what disease (dz) they have but a differential (ddx) is what you think an ailment is along with what you think it’s not.

I’m looking at x-rays and it’s pretty obvious that it’s not a case of Multiple Myeloma the same way it’s obvious that 2 plus 2 does not equal 5 but …in some cases I have to pick MM as one of the differentials.  I thought I was getting the hand of it but, in other cases we may skip cancer as a differential all together.

I did get one of my case studies 100% correct today so that was pretty cool.

idk – I’ve got a friend who is a pediatrician at a local air force base and he hated his Part 3 as well.

Shin Splits is kind of a bug-a-boo of mine – almost a nemesis.  I’ve actually heard it best described by the clinician who is teaching the board reviews I’m taking as minor compartment syndrome while inflammation in the posterior compartment or, more commonly, the calf would be a major compartment syndrome and could require emergency surgery.

calf-musculature

In the picture above you can see an axial view with the tibia and fibula, this is around midcalf but, as we go distal, those two bones are going to approximate.  The thing with the anterior tibialis muscle in the anterior compartment is that those bones will limit where that muscle can expand.  Anybody who has ever lifted weights or tried their hand at bodybuilding knows that when a muscle is worked intensely enough that the muscle can be engorged with blood and become measurably larger.  That muscle gets worked a lot when a person runs and especially with new runners, when it does get worked, it will become engorged with blood and become larger – but, it’s only got so much room to expand, the bones and other compartments limit it’s posterior expansion so it’s going to press outward (anteriorly) and cause strain against the fascia of that compartment.   It’s my contention that the strain and pressure against the fascia of the AT muscle is what causes most of the pain in most beginning runners and, those do tend to be the ones who are often afflicted with this temporary condition.

The National Institute of Health (NIH) has stated in some of the articles I’ve read that fascia does not stretch.  Well …with all due respect to the NIH, that is wrong.  And, it’s easy to prove.  If fascia wasn’t able to stretch or expand then bodybuilders would not exist.  Bodybuilders do exist, ergo – fascia can expand, stretch and accommodate musculature of various sizes.  It’s probably more accurate to state that fascia is not elastic but, over time it can accommodate.  This is probably an area where Graston or a good massage therapist can help combat the pain and help a patient/runner adapt to the pain of “shin splints” as quickly as possible.

I’m currently sitting at 96 miles for the month of August and should be getting my first Platinum trophy from Nike Plus in the next day or so.

I’m still pondering over my back to back to back to back ideas of running a half marathon each weekend for 4 weeks straight – then having almost two weeks off before the full marathon in Wynne, Arkansas.

There’s only 9 weeks and change left before that run.  I’m having a bit of a challenging time believing that I’ll be ready to run that marathon the way I want to run it.  I still have a long weight to go but …. 9+ weeks is still a bit over two months of training.

Some Great Runs
There have been a few times in the past month were I’ve had some really great runs.  I guess it was about a week before I left for Iowa when I had a trio of runs on Tue, Wed and Thursday.  The Tuesday and Wednesday runs were 4 and 6.2 miles respectively and they were my very worst runs in terms of time that I’ve had all year.  However, on Thursday night after Karate I headed out and did a 4 mile run that I practically fell in love with.  I just ran and ran and ran …I didn’t have any need to walk any parts of it, just a nice constant running.  I think more of my runs lately are becoming more pain free which is helping a lot.  I usually put two bandaids on each foot then a strip of athletic tape around them and that helps with chaffing in the areas around the lateral malleolus and just proximal to the calcaneus.   There is a chance that my shoes might be a little too big since fat feet at a bodyweight north of 300 probably are a bit different than those same feet at 250.

The other night in Kansas I had a 6.2 mile run and however long that took, there were only about 3 minutes of the entire run where I was walking, maybe a few minutes longer.  Once was towards the beginning of my run because my path was pitch black and I had to use my phone to help light the way.  I walked that part since I didn’t want to hit a tree.  Then after about an hour, I walked and checked my phone to figure out where i was and how to get back to my hotel.  Then one final time when I found myself running by Cleveland College of Chiropractic to take some pictures.

Without even realizing it, when the run was over and I looked at my splits I saw a 10:04 mile pace for mile number 4 :)  There was a long stretch of path that ran adjacent to the highway and I could tell that I was moving faster but it seemed like with less effort than normal.  The form and everything just kind of flowed and felt great.  I think there was a slight decline to the path so that probably helped as well but I seem to be a sucker for nice, long straight paths :)

My running is coming along but it really takes a long time to reap significant improvements. That’s what it’s seeming like to me anyway.

Sometimes, it feels like when I got my first motorcycle and even though I barely knew how to ride it I would go out maybe 8 or 10 times a day just to ride it around the neighborhood because it was something new and kind of exciting for me.  It’s almost getting that way with the running again.  It’s like i’m developing a new toy or something …but, it’s an ability that I haven’t had for quite a long time so it’s very welcomed back into my life.

Just have to keep at it.

Biomechanics of Fat Runners
That kind of sounds like it could be the name of a magazine article, doesn’t it?  It is something I’ve been becoming more aware of over time.

The Japanese have a very advanced robot they have been working on for quite some time called Asimo.

Asimo Running

Asimo Running

I was watching some videos of Asimo running and realized I do about the same thing when I run.  In the picture above you can see that Asimo’s lead leg ends up striking the ground with the leg still flexed, that is, it’s bent when it strikes the ground.  With running humans, the front leg is more extended and the front leg, with the heel strike phase of running is where you have maximum pressure and force on the cushioning elements of the knee, things like meniscus and articular cartilage.  I don’t have a huge gait when I run and often the lead leg will strike the ground like Asimo and still have a fair amount of flexion when it hits the ground.

I’ve talked to a few other runners who were a bit larger and heavier than your typical runner and found out that it is common for them to also have a faster pace walking than running.

well ….looks like my two little nephews have joined me here at the Ozarks so I’ll have to finish this up at another time :)

Week 31 Weigh-In – 251.6

Week 31 Weigh-In
My brother sent me a link the other day about a guy who got up early for an entire year.  The blog was called I’ve been waking up early for a yar.  Here’s how my life has changed.  I liked the idea of maintaining a habit or any worthwhile endeavor for a long period of time then seeing what positive effects take place as a result.  Below is a copied except of the life improvements that guy got from getting up early for a year.

Some Life Improvements

  • I see the world through a much broader perspective
  • I have a drastically more open mind and heart toward all beings
  • Meditation is the number one habit of all, it’s the foundation
  • Reading and journaling have been huge for me
  • I’m no longer depressed, in fact I’m more inspired and driven than ever
  • I appreciate a slow walk through nature without rushing
  • I have read a ton of books, podcasts, documentaries, and YouTube videos
  • I feel more inner peace and less anxiety and fear
  • I am thrilled about my upcoming life and getting older
  • I’ve had dozens of lucid dreams and out of body experiences
  • I am learning to follow my joy despite my fears and doubts

Anyway, I’ve been weighing in every Thursday for 31 weeks now and I’m at the tail end of 20 straight weeks of my running program so I figured I could keep those things up and eventually post about the changes in my life as a result of a few positive endeavors.

This week I weighed in at 251.6 which is up a bit from last weeks 245.4 but, I’m not really concerned about it one way or another.

Week n - 2nd 12 Week Session Week 31 - Copy