i freakin’ did it! :) 480!

In this blog

  • i freakin’ did it! – 480
  • humble pie
  • future plans

i freakin’ did it!

I guess there’s a story here but there also is much I’d rather not admit to.  The number of times it took me to finally pass my Part III board exam is one thing I’d rather not advertise.  I wish I could say “third times a charm!”  but … it was more like 5 times and possibly 6.

I hone in on my brother who didn’t even attempt Part III until after he graduated because he failed it on his first attempt but passed it on his second attempt.  So, if you don’t count all the attempts prior to graduation then, at least, I was able to emulate him.

Age is another matter I don’t really want to own up to so….hypothetically speaking ….it’s like I started this new adventure when I was still 41 years old and, after I get results for my Part IV exam which I’ll be taking in May of 2015 I …could be ,,,49.

Then things become a little surreal.  Have I actually spent a decade of my life in this pursuit? 20-25% …  and this is all post college.   As my brother described it before I started my attempt to become a DC, he said it was “balls to the wall” and, that may even be an understatement.

Humble Pie – sort of fits in with all this since I just finished up a week of reviews in preparation for my May 2015 exam.  Within minutes of the first day of reviews you realize you’re eating humble pie – within the first hour, you realize it’s more like a humble buffet that’s being forced down your throat.

The questions are rapid fire, like a machine gun.  Is body temperature increased or decreased with Graves disease?  Temperature?  Don’t we have a lab panel to look at?  I never thought of a simple vital sign pointing me in the direction of Graves disease, I think of exophthalmos – eyes bulging out, increased T3, 4, TSH …oh, OK, hyperthyroidism, I guess it would make sense that we’d have an increased temp but, by the time my 10-speed brain figures all that out I’m 3 questions behind and we’re talking about Thalassemia – …I just studied some anemias the other day, maybe I can feel a bit smug as opposed to stupid …not a chance.  I’m confusing Coombs (a test for Rh factor with Cooley’s Anemia which is a subset of Thalassemia.  Now I’m falling farther behind, feeling stupid, wondering if I even belong there.  It’s a trip – that much is certain.

That’s pretty much how the days go, from 9 a.m. to 6 p.m. save an hour for lunch.  We covered 2 years worth of radiology in a day and a half this past weekend.  At which point, I’m thinking the words ‘self torture’ and really don’t want to go back for any more.

Mock exams are Monday, the 27th of October – gotta show up for that.  These upcoming Part IV exams – one day is all radiology, the other consist of 25 different rooms filled with actors pretending to be patients with certain diseases.  We get a whole 5 minutes per room to ask questions and test accordingly after which time we move to another room and have 90 seconds to look over x-rays and lab results then need to come up with a diagnosis, differential dx, and appropriate case management & treatment.  I guess it’s not so bad but, this goes on for 3 hours straight.

The DC program is kind of like signing up for a slow death and you just need to graduate before it kills you.  And, other than the 20% or so that don’t make it to graduation after 15 semesters a few do die.  I remember one guy died from a heart attack one weekend when I was at school because, you know, 8 hours of classes along with clinic during the weekdays is never enough and the stress is very real.

The most self induced stressful times I’ve had this year have been at those reviews.  That’s when I’m reminded that we actually have three autonomic nervous systems.  Most everyone knows about the good old, fight or flight – that’s the sympathetic nervous system and is sort of like the bodies gas pedal.  Somewhat lesser known would be our parasympathetic nervous system which would be like our brakes or some say ‘wine & dine’ or even …poop & relax.  Probably the least well known autonomic nervous system would be our enteric nervous system which is made up of two subsets known as Aurebach’s and Meissner’s plexuses.  This system basically has to do with our gut.  and – without exception that’s where I feel a great deal of stress making itself known but, it also helps me make greater sense of various ailments such as enteropathic arthropathies and remembering to ask patients about various work and social aspects of their life to help gauge levels of stress in their lives.

March of this year was my first post graduation attempt at Part III and I failed it worse than any other time I attempted the exam with a very dismal score of 340.   A score of 375 is needed to pass Part III.  I did learn that we needed to have everything from Part II down cold and wholly memorized as a prerequisite for getting through Part III so I scheduled review sessions for Parts II, III and even a few PT reviews this past August.  Essentially 23 solid days of reviews in 3 different states – Iowa, Kansas and Missouri and averaged about 12 hours a day of worthwhile study.

Well – it freakin’ paid off!  A few days ago I checked to see when the scores might be available and to my surprise the website said results would be available Monday morning, 8 a.m. MST.

I crushed it!  Bested my previous score by 140 points and ended up getting a 480!

2014-10-27 14.11.43

There was a week between my last review session and that exam and that week was probably unduly stressful because I had to work every day leading up tot he exam – my fault,  for not requesting more days off but, I had already taken off nearly a month – still, I’d done enough to pass with flying colors! :)

In order to finally get though school, I had to break things up by first finishing all my classes then I focused exclusively on completing my clinics.  That strategy did work and got me to graduation.  However, a lot of the kids I talked with during this past week shared with me that they were in the process of finishing up their 2nd year of radiology with me – I have to go back about 3 years to when I finished and I realize, every day that passes between when all these classes ended and now all tends to make that humble buffet a little bigger every single day.

On the other hand, maybe it’s a bit like that Leitner method of memorization with spaced repetition and perhaps I can at least say I’m on my way to eventually consuming, digesting and assimilating that humble buffet.

I’ve got about 6 months before that exam.  I just need to up my game.

oh yeah – one of the last hotels I stayed at when prepping for my Part III retake didn’t have a desk, it barely had room for the bed so I spent a lot of time outside with a book and leaning on the balcony.  I spent so much time with my elbows on that balcony holding my books that I eventually wore the skin away on my elbows to the point of bleeding.  Study battle scares!  Good for the male ego and kind of funny.  About a week later my brother took a picture

2014-08-28 01.15.46 - Copy

well, not overly dramatic but, if you look closely you can still see the study scars ;)

Honestly, it was pretty emotional to see that score.  Anyway, I suppose that’s enough musing.

Time to look forward – There is one state in the country that allows you to get a license with Part III and that state is Illinois where I happen to live :)

and, with that license I can finally apply to test and become an NRCME! – Nationally Registered Certified Medical Examiner.

How long does it take to get a license…. (had to Google this)  looks like once I tic off 15 or so items the state requires and get everything sent in then I should have it within about 2 and a half months.  ….hmmmm, maybe by Valentines Day :)

Pondering 2015 – real possibilities include that license and a black belt in karate.  I think I’m signed up for 3 half marathons – 2 in April and one Rock n Roll in October.

I did play it a little smart and allocated some post-review time at my parents condo so I’ll have some time to get some plans in motion and figure out more for 2015 and, ideally not end up as sick and strung out on stress like I was after my last bout of reviews.

I did learn on that site I Googled that only 150 hours of CMEs (Continuing Medical Education) is needed each year, I thought it was 200 hours.  This will afford me some great opportunities.  I think one of the first things I’d like to go after is a diplomat (specialty) in Neurology.  A first step there will be searching out a former teacher by the name of Dr Bub!  :)

 

 

 

 

KC Monster Dash 5K

In this blog:

  • KC 5k Monster Dash
  • .

KC 5k Monster Dash

This was an evening 5k run held along a couple roads that run adjacent to the Missouri River in Northern Downtown Kansas City.  This was a well run, simple event with a preview email sent out which included pdf files showing several areas of free parking as well as the race course.  Being a Halloween event, at least half of the 1,000+ runners that showed up were in costume.

2014-10-26 05.42.39 2014-10-25 21.15.29 2014-10-25 16.13.07 2014-10-25 17.36.49 2014-10-25 18.42.04 2014-10-25 19.50.35 2014-10-25 21.39.12 2014-10-25 18.41.48 2014-10-25 18.41.14

After the 5K Monster Dash, I learned from my phone that I was only a few blocks North of the Power & Light District so, I thought that might be a fun place to watch the World Series from.  The outdoor portion of the P&L District was barricaded off because only so many people were allowed to be down there at any given time for safety reasons.

2014-10-25 21.22.49 2014-10-25 21.17.32 2014-10-25 21.15.44 2014-10-25 21.15.05 2014-10-25 20.49.15 2014-10-25 20.46.27 2014-10-25 20.44.03 2014-10-25 20.41.20 2014-10-25 22.28.52

 

 

Week 40 Weigh-In

On Jan 13th of this year I went on a 12 week program to lose weight – lost a bunch, then have kept it off for an additional 28 weeks now.    Still holding today onto 56 of those lost pounds with a weigh in today of 261.0

Week n - 2nd 12 Week Session Weeks 40-28 - Copy

I have learned it doesn’t take much effort to maintain that weight loss but, it does take something – a couple jogs here or there, a karate workout or two.  Maybe 3 or 4 days with some physical activity.  without that activity the weight starts creeping up.

I’ll need to use this 261.0 weigh in as the start of a new wallpaper – might be next week before I get to that.

Week 1 Day 2 jogging training is in the books with a mile run last night.  That little bit of exercise I mentioned is the absolute BEST sleep medication I could take.  during the couple weeks when I did nothing or maybe only 1 day of running, my sleep was pretty bad and I’d wake up every couple of hours.  Since the Rock n Roll runs this past weekend and every day since I’ve slept like a rock straight through every night :)

Day 20: Excellence Always

In this blog:

  • Mindless Meandering…
  • Day 20: Excellence Always – a video recap
  • Week 1 Day 1 – 1.5 Miles
  • 2015 – Future Runs

Mindless Meandering…

Lately, I have found that when I take things from my mind and write them down – say, in an email to my brother, for example, that I can add greater life to those thoughts and somehow, that simple act of writing those things down brings me a step closer to taking action.

Getting Serious is still fresh in my mind as is the daily list of 10 prioritized items we write down and send out each day from the 100 Day Challenge.  I mentioned Karate & Piano previously but, Career Goals & Objectives would probably be of a greater pragmatic importance.  I’ve got about 7 months until the Part IV Board Exam which, in most people’s eyes would make it seem as absolutely Not Urgent but, I can’t think like that.  There’s too much to know and it’s too important relative to the rest of my life.  We need a score of 375 to pass but I’m thinking a goal of scoring a 475 would be fantastic and allow me to be eligible to practice in any state and get paid by all insurance companies.  Passing the first time is important because it’s such a ridiculously expensive exam.

just remembered, I need to follow up on a great job I applied for a couple weeks ago….

Scheduled, consistent action/study is necessary to get through Part IV and, if by chance Part III doesn’t go through I’ll also be totally ready for that again.


Day 20:  Excellence Always

Video definition of Excellence

Video definition of Excellence

is what i'm doing

Excellence

Some people perpetually create for themselves a condition for their own dissatisfaction.

 


Week 1 Day 1 – 1.5 Miles

2014-10-20 13.43.342014-10-20 19.19.05

Went to the park in the morning to get in either 20 minutes or 1 lap (1.5 miles) to start off my training program again.   I also ended up having to walk around a neighborhood for work so I kept track of that also ;)  All told, 3.5 miles for the day.

I’ll be repeating the original 26 week program, at least as far as the basic weekly sequence of 2 short, 1 medium, 1 long run per week is concerned and will probably be sticking with the 6 week buildup built into the program as well.

There is far less excitement for this second round – during the first round I could tell myself – and others, I was training for a marathon and, quite frankly, I believed I was but, the results didn’t pan out to that level of achievement but ….there were results and some very positive changes.  I’d say I’m a pretty solid 5k runner right now in that I can go out and actually run that distance pretty much whenever I want.  …probably 80% of the time anyway.

I’ll have to ponder over this program.  I have three full days vacation scheduled after KC and will devote more time to the specifics of the program then.


2015 – Future Runs

For right now – I’m already signed up for the St Louis Rock n Roll 1/2 marathon on October 18, 2015.

I was also looking at two 1/2 marathons in April of 2015 – the Go! St Louis and the Lincoln Presidential 1/2 marathon in Springfield, IL.  I would like a giant lincoln penny as a medal… :)

OK – now I’m signed up for the Go! 1/2 in April as well….

OK – I’m signed up for the Lincoln Half Marathon which is a week before the Go! 1/2 in April – very cool – productive blog today :)  I got some of that excitement back :) :) :)

My training thinking here is that I’ve got 6 months until April (for my 2nd training bout) and then another 6 months until October (and a 3rd bout of training)  :)

 

 

 

 

Success Requires Inconvenience

In this blog:

  • 100 Day Challenge recap to date
  • Success Requires Inconvenience
  • Sacrifices

100 Day Challenge recap to date

Today is the 19th day of the 100 Day Challenge and today’s video is Success Requires Inconvenience.  There are a few things which are sticking out in my mind as perhaps being key to greater success in my own life.  The very first video was Grow Up, Get Serious.  The grow up part doesn’t resonate too much in my life but, the Get Serious part does.  Karate and Piano are two areas in my life that could benefit from being more serious.  With karate, I know simply attending the classes can only do so much in helping me advance and I have to practice and review my katas & yakusoku’s outside of class, i.e., get more serious.  Piano is one of those things which tends to cross my mind on a daily basis but absolutely nothing is being done in regard to playing at a level I could appreciate.  Again, this is another area where I either need to eradicate further thinking about it in my head which will never happen or, instead of random fleeting thoughts, simply do it.  Practice.  Play.

I’m sure if I dwell on other areas of my life I’ll be able to come up with more ways to get more serious and thus get better results in any of those areas.

There was a list of things the other day about how to help empower one’s life and among that list was something along the notion of being uncomfortable and striving for more discomfort.  I know this is a simply adage about getting out of your comfort zone but, really applying that in day to day situations and everyday life on a consistent basis can be a little different since it can mean cutting into time normally spent engaging in behavior patterns which may simply be coping mechanisms for ones life.

I guess some coping mechanisms can be better than others.  Some may be downright destructive while others may be more benign and simply a waste of time.  I suppose mine would be more in the benign, time wasting camp.  I recall in another blog that I’d mentioned it being very easy for me to be content – A cup of coffee and an internet connection can easily turn into a pot of coffee and mindless tangential Internet surfing.  This leads me into thinking about Steven Covey’s book, The 7 Habits of Highly Effective People where he illustrates a Cartesian coordinate system with Importance on one axis and Urgency on the other.  Things in a person’s life are either important or not important and they are either urgent or not urgent.  This is how the four sections of the graph are filled out and in order to spend more time on things that are Important but not necessarily Urgent, we take time away from those things which are Not Important and Not Urgent …which, as one example, could be my coffee & Internet Surfing.


Success Requires Inconvenience

Success Requires Inconvenience

 

High performers understand that the road to success is filled with acts of discomfort and sacrifice.  They choose what needs to be done regardless of the inconvenience.  But, if they don’t like to be inconvenienced then why do some people embrace it?

Successful people are influenced by the desire for pleasing results.  While the overwhelming majority of people are influenced by the desire for pleasing methods.  That is the distinction, successful people are driven by pleasing results while the majority of people are interested in pleasing methods.  That’s where the excuse of convenience comes into the equation.  The vast majority of people are inclined to be satisfied by such results as can be obtained by doing things that they like to do or simply that they find to be convenient.

appetite

 


My first notable sacrifices while trying to adhere to this program would have to be skipping going out to watch the Cardinals baseball game to take care of other more important matters.  Listening to the game on the radio while taking care of business was the substitution.

The biggest inconvenience was similar for both me and my brother this past weekend.  I have to admit – on Saturday morning, physically, the last thing in the world I wanted to do was get up at 5 a.m. after having so little sleep the previous two nights.  The thought of skipping both the 5k and karate testing crossed my mind.

Our testing was a little premature due to an upcoming trip to Okinawa for many of our dojo members.  One person never showed up for their testing and another couldn’t get through the testing.  I talked with people afterwards and without exception, everyone of them had considered skipping.

I know over Thur, Fri & Sat night, my brother had only 10 hours of sleep himself which was about the same as me but still managed a trip to New York for a talk and a flight back and then a totally butt kicking 2:07 time in the half marathon on Sunday morning.

So, there’s definitely effort going out – just looking to further tweak situations for greater productivity – looking to embrace more inconvenience for greater results and, i would think, a happier life.

 

 

St Louis Rock n Roll Half Marathon

This race was a total blast.   Partly because it was so close and mainly because I ran it with my brother.  The race started at 7 a.m. and we hooked up and left around 6:10 a.m. and still had plenty of time to get there, park and get to the starting line on time.

Originally, I had requested off work for today but since I’m heading out of town again this week I thought I’d pick up some extra hours …as I sit here and my legs tighten up, I’m not sure how smart of an idea that was.

The spinning medal was totally cool and looked much better in person.

My brother & I being a little goofy before the run.  He was a little chilly

My brother & I being a little goofy before the run. He was a little chilly

less goofy ...i think i liked the goofy one better :)

less goofy …i think i liked the goofy one better :)

Our view during the first mile - really awesome! :)

Our view during the first mile – really awesome! :)

We ran by the YMCA ...apparently it stands for Young Men's Christian Association.  I didn't know that....

We ran by the YMCA …apparently it stands for Young Men’s Christian Association. I didn’t know that….

My brother getting prepped for the run - mental focus is very important ;)

My brother getting prepped for the run – mental focus is very important ;)

SPINNING MEDAL! – The *real* motivation for getting out this weekend!

2014-10-19 13.52.222014-10-19 13.52.44

The guitar pick in the middle of the medal spins! – and I’m easily amused so – this did it for me :)  We got that medal for running on both days of the St Louis Rock n Roll Marathon Weekend (5k yesterday morning and 1/2 marathon today)

unnamed

5k medals handed out yesterday :)

5k medals handed out yesterday :)

 

Karate Promotion & Rock n Roll Weekend!

In this blog

  • Karate Promotion
  • St Louis Rock n Roll Expo
  • St Louis Rock n Roll 5k Race

I think Wednesday morning was the last full night’s sleep I had.  A post karate Thursday night trip to the ER unit at Children’s Hospital for one of my little nephews didn’t end until 4 a.m. Friday morning which normally wouldn’t be so bad except I had to meet some guys at the gym early Friday morning to practice our katas for Saturday testing!  :)

After I finally got home from the Expo on Friday I slept 6 to 9 p.m. Friday and again from 3 a.m to 5 a.m. Saturday morning….then had a nifty little 5k Rock n Roll run in downtown st louis at 8 a.m. and karate testing starting at 10 a.m. :)

Karate Promotion

That test went well :)  Out of the 10 people slated for testing today  – I was among the 8 that passed :)

From left to right - Sensei Bob Seibert (7th Dan), myself, Sensei Xian (8th Dan), Marty (5th Dan)

From left to right – Sensei Bob Seibert (7th Dan), myself, Sensei Xian (8th Dan), Marty (5th Dan)

The three black belts pictured above made up our testing board.  As a group, many members of the dojo are going to Okinawa, Japan next week.  Usually we’ll get about 3 years advanced notice so everyone has time to save up, this year was a little compressed with only about 8 months notice.  Anyway, I’m pretty happy about this.  I’ve been at this for so long – first promotion May 5th, 1982 so, to look down at that certificate and see 2-kyu was kind of emotional.  One of the higher ranking black belts that tested ended up showing a fair amount of emotion towards the end of her testing as well.  I think she may have been going for her 4th degree which, is the highest that can be tested for outside of Okinawa.

2014-10-18 13.27.13 - Copy (2)

5K – Rock n Roll preview – might just toss some pictures up here – really tired….

St Louis 2014 Rock n Roll Expo

inside the expo, at the entrance

inside the expo, at the entrance

We were allowed to sign up for next years race for $55 and they threw in this extra t-shirt ....can't have too many of those... ;)

We were allowed to sign up for next years race for $55 and they threw in this extra t-shirt ….can’t have too many of those… ;)

the date for next years run is actually 10.18.15 and the shirt says 10.20.15 but, it’s still pretty cool

5K t-shirt & bib

5K t-shirt & bib

1/2 mary t-shirt & bib.  The black band is worn during the 1/2 so, after the run we go to a special tent to pick up our Extra Spinning Guitar pick medal for running Sat & Sun :)

1/2 mary t-shirt & bib. The black band is worn during the 1/2 so, after the run we go to a special tent to pick up our Extra Spinning Guitar pick medal for running Sat & Sun :)

back of the 1/2 mary t-shirt

back of the 1/2 mary t-shirt

common logo on the backs of all three t-shirts

common logo on the backs of all three t-shirts

Saturday 5K Race Pics

The Ribbon was really nice on this medal and I've never had one before that said 5K on it like this before :)

The Ribbon was really nice on this medal and I’ve never had one before that said 5K on it like this before :)

5k Start Line - I think I heard the announcer say there were over 1,500 people in this race

5k Start Line – I think I heard the announcer say there were over 1,500 people in this race

Looking back at the finish line :)

Looking back at the finish line :)

Had to get my picture taken with Captain America!  :D

Had to get my picture taken with Captain America! :D

and now ….6 full hours of sleep await until tomorrow’s 1/2 :)  my brother will also be doing the half which is pretty cool  :)  My goal is to finish within an hour after he finishes :)