Forced

That is the theme as of late for me, force myself to get up, force myself to go run, force myself to fall asleep, but it's very exciting nevertheless to be out in the big bad nursing world.

I received my first paycheck -- finally, after not having any income since January 26th.  It was a very welcome blessing.  I can't say how much it makes me happy to know that every two weeks I will get one of those puppies direct deposited into my account (heck yeah!!). 

I finally, started with one of my two regular preceptors this week and I felt much more comfortable and a lot less lost.  Medication administration makes me extremely nervous and it is taught to check the patient, dose, drug, route, time etc... three times before giving it to the patient.  I check about seven.  The idea of a medication error scares that crap out of me.  Last night, I worked a twelve (ended up a thirteen) and by the end of the night I was passing meds alone, no supervision or help.  I felt so insecure about giving insulin subcutaneously and pushing dilaudid into IVs I would swing by the nursing station and have another nurse confirm the right dose for me.  It's still my butt, if I give the wrong med and I can lose my license, so a million checks it is.  I ended up with about two hours of OT this week, which will only make my next check a little fatter (Woot!!)

On the running front, I am struggling with motivational issues right now.  I have had to force myself to go running as soon as I get home when I work an eight or I will just go into couch potato mode.  Thursday, I got home a little after 4:30p, changed and head out for an hour and a half only to come home, do laundry, eat dinner and have about 45 minutes before I had to go back to bed (very exciting life).  The days I work my twelves, I have yet to run.  It baffles me how to find the time to get a run in thus far.  I have yet to make it home on time and by the time I get home, I am freakin' exhausted.  I've gotten up at 4:30am a few times in an attempt to go out before I leave, but I just end up seeing the low temps and saying to hell with that and doing some yoga and stretching or going back to bed for another 30 minutes.  I had a good 11 mile run the other day with 5 miles at tempo pace, but I was really flat and felt horrible at the track Tuesday night.  The 'guestimated' paces for me were just too much and after only 1800 meters, I was suffering, by  2400, it was over and I ended up just jogging around the track for the remainder of the workout.  It was a little disheartening, but not the end of the world.  I haven't ran farther than 13.1 miles since the 1/2 marathon earlier in the month and with Boston only 3 weeks away, I really need to get in at least one more 18+ miler. 

I am hoping I can force myself to go here in a little bit.

The First Day

After nearly two full weeks of training and orientation I was finally scheduled to work on my unit.  It was a 12 hour shift (7a-7:30p), so when I got up at 5:00 am, I knew by the time I got home around 8:30 pm I was gonna be wiped.  It was so great to be back and see so many familiar faces.  It was a whirlwind of a day and of course, problems arose all at once rather than consecutively.  I spent a large part of the date observing IV drug administration and getting all my passwords set-up for the time clock, the computer, the pyxis machine (it's like a pop machine, but it dispenses drugs at no charge). 

I had my first up close and personal experience with an Indiana pouch.  I think those things are so cool!  Patients that have an ostomy bag on the outside of their body that can smell and must be emptied often suffer from self-image issues, but this internal pouch is pretty sweet for those who need new bladders.  The stoma itself just looked like a second belly button off to the left of my patient's abdomen.  The patient said catheterizing himself at regular intervals was pretty painless too.

We've added tele to our floor since I was there as an undergrad and reading EKG's has become more common.  I didn't care for them in my first undergrad and I still don't much enjoy counting the little boxes and trying not to go blind as I measure the PR interval or the QRS complex, but I am definitely better at it after spending two full eight hour days reviewing the material earlier in the week. 

Anyway, I was sitting at the nurse's station with about 45 minutes left of my day when I heard this strange noise that kind of sounded familiar to me, but I couldn't place it.  Out of the corner of my eye, around me, I saw a few nurses jump up quickly and call out a room number as they headed down the hall.  It registered at that point what it was.  "Oh sh*t!!"  A code blue really?  On my first freakin' day back, just when I was almost done!!!"  I jumped up and hauled ass down the hall to the patient's room.  It had been the tele monitor alarm indicating the patient's heart rythm was a flat line.  I was thinking two things, man I am not ready for this and if I was going to be in on this code, I definitely wanted to do compressions or bag the guy.  No way was I gonna put the central line in, if needed or push atropine, epinephrine, etc into said line. 

Luckily, when I got to the room, it turned out the patient was trying to get up to go the bathroom and had pulled a wire.  CHEESE AND RICE PEOPLE!!!  I was relieved, no code today for me.  I went back to my desk and prayed I would make it to 7:30 pm without any more codes or craziness.  The full moon was Saturday, not today.  I had a chance at normalcy and freedom still. 

Exhausted at 7:45pm I dropped off my time sheet and headed for the elevators.  I made it down to ground floor and had to get through the J building to get out by my car, but before I escaped I could see a couple looking a little confused.  I knew they were lost and I debated stopping.  I stopped.  They were lost and I ended up taking a ten minute detour into another building and up the elevators to escort them to the appropriate floor.  They told me their daughter was extremely sick and while I was exhausted, I wasn't sick and no one I loved was either.  The extra few minutes it took to help them were well spent. I left them in the waiting room of the unit their daughter was being transferred into and headed back out.  Finally, made it to my car a few minutes after 8:00 pm.  I was ready to head home.

Day 1: DONE

Youngstown 1/2 Marathon Race Recap

The course was either harder than I had imagined or I wasn't in as good of shape as I had hoped. I did not taper for this race, but I didn't run it as a training run either. The idea of paying money and not running the best I can, just seems silly to me. The idea was to re-enter the world of running/triathlon and guage my fitness level in hopes it would project a time for my upcoming marathon that would make me kind of happy.

It didn't quite go that way though. Ultimately, the course could have been 13.1 miles of uphill and I still would have been disappointed with my time (ridiculous, but true).

I had hoped to run as close to 1:45:00 as possible. I wore my watch as is standard for me with my less than reliable dinosaur Garmin 201. I didn't trust it to keep a signal through the park, the unit was being held on the band by electrical tape and after my wet 9 miler on Sunday, I couldn't even get it to turn on!! Not to worry though, there were mile markers and most other people had garmins (right?).

I started somewhere in the middle with Solar and JP, but they pulled away from me almost right away. I was running what I thought was 1/2 marathon effort for me and trying to get my focus on the "race" mindset. Everything seemed correct by my internal gauges (breathing, effort, stride frequency), but twenty minutes had gone by and I hadn't seen a mile marker yet. Some runners also sandbagged for over 1/2 the race and then hammered it or started off way too fast and with the hills position changes were occurring more than usual in a race of this size. Finally around 41:xx I saw a mile marker. I thought I would be relieved but it was number 4!!! It took me a split second to realize that was over a 10:00/mile. Frustration washed over me and I was angry. Angry, at the course, but mostly at myself for not running my goal pace (or anyhwere near it for that matter).

I spent a large part of the race trying to convince myself that the most important thing was to keep going and if this was Boston what would I do in the race, just give up on myself, slow down. -- No, I would keep going and that what I would do now. The topper to my race was the difficulty breathing throughout the race I was having. My airway felt narrow and I was wheezing on and off. I hadn't really had this problem since my iron levels had returned to normal, but today it was happening. I had been taking my iron pills regularlyl, so I was just dumbfounded as to the problem. I got to the race's 6th mile marker and my watch showed my split around 58:xx. I wasn't ignorant and accepting of the split, of course, but I had resolved not to let myself be swallowed by the negatives this race was pouring on me.

Somewhere, after that I saw the leaders coming back and was glad to see NC and e-speed running as the one and two females and in the top 10 overall. It was a nice distraction from my less than stellar performance. It occurred to me that maybe I was a little fuzzy as to what 5k, 1/2 marathon and marathon effort felt like after being away from racing for the last couple months. Perhaps, I had become a bit of a sissy...

But that seemed impossible to call yourself a sissy on a course such as this with it's 19 hills. Speaking of hills I hit one somewhere around eight or nine (I think that was nice and steep that gets your heart rate up and then sweeps to the right only to offer a second tier. As I passed a guy near the top he said "what a hill?" I laughed and asked him "which one?"

As I continued on, I saw a familiar figures almost trotting in front of me. It was GD. I knew something must be wrong because he is significantly faster than me and although he forgot his chip and started the race two minutes late, he still should have been way farther ahead of me. Just before another hill started I caught him and asked if he was ok. He said "yeah, I just can't breathe." Now, that is an oxymoron to me. If you can't breathe you are not okay!! He slowed to a walk and which made me even more worried. I asked if he wanted me to get some help or if he wanted me to stay with him. He said "no and waved me on." Before I became a nurse I always worried and stopped to check on people, but now I felt it my responsibility to always provide care if needed on or off the clock (like it or not I am an RN 24/7). I tentatively continued on and to think about him for a bit trying to ascertain if I had missed any signs that should have led me to believe something more serious was going on. I have had that "gut feeling" nurses refer to when something is really wrong before and I didn't have it now, so I pushed forward.

I was huffing and puffing on and off wondering how could I be so slow, what the hell is wrong with my breathing and thank goodness I was getting this all out today instead of at Boston in April. 

Towards the end of my race (not that I knew that then -- hehe) I started this tiered long climb that seemed to last for an hour.  I had seen e-speed and NC coming the other way for their cool downs and I hoped it was an indicator the end was near.  It was but not as near as I had hoped, those two had run out farther than I thought and dashed my hopes of a quicker and less painful death, errr, I mean finish.  My watch passed 1:45 and I thought if it takes me more than 30 minutes to finish this motherf*cker, I am quitting and getting a ride back!  I rounded a familiar corner to the right and there it was a few hundred meters in front of me up a nice little incline, the finish.  I was wheezing and according to GA, swerving all the way to the line.  I thought I heard him say "your all right" because I was wheezing uncontrollably, but apparently I am hard of hearing when running.  He really said "your almost there."  I finished in 1:50:01, another :01 finish.  Sheesh, what is it with me? 

My recap and confusion about the mile markers got a good laugh from everybody and while I was a bit disappointed I was glad to be back and it was awesome to get to spend the morning with my SERC pals and JP too.

Track Attack!!

Last night, I was fortunate enough to leave work by 3:00pm, so I could meet the girls (there were a few guys there too) at the track.  I was excited to see the sun while I sat in the lounge area of the health space building when I was taking a break from interpretting EKG's (I did it for 2 days, 8 hours each -- I know there is a lot of jealousy out there after reading this), but by the time I left it was raining.  Drat!!  Do we run in the rain? 

Of course, we do.  I got to the track and ran a lap before having to go to the bathroom and then we did a warm-up mile.  The workout prescribed for me was 4 x 1200 meters at 5:15 with 3:00 rest (and 1 by mile if I wasn't dead at 7:20).  That meant 1:45 for my 400's.  Whenever I've tried to run a 400 on the treadmill, that's the pace I set.  Hmmm, this could be a disaster I thought.  I was thinking more like a 5:30 pace, but the man with the plan disagreed.  I was fortunate enough to have somebody giving me the workout and the times tonight, all I had to do was run, no worrying or stressing needed, so I toed the line. 

The first lap was 1:43 and I felt stressed, but not too stressed, maybe the man with the plan was onto something.  Hit on 2 at 3:28 and dead nuts on 5:15.  I was breathing hard and my throat felt really dry, but I wan't wheezing or anything.  I grabbed some water and focused on getting my heart rate down and trying not to tighten up.  My "We Got the Runs" partner in crime and MG were also running these with me, but they were a few seconds ahead.  We were all supposed to hit on 5:15, but they were pushing it a bit.  I was content not to be an overachiever and try to keep up, so they usually gapped me by about 2-4 seconds each 1200.  It didn't bother me, but by the start of the third 1200, I could feel I had tightened up, especially in my gluteal area and that was a pain in the ass (double meaning).  I stayed focused on running even splits and doing my workout.  

The lacrosse kids were practicing on the track, so a few balls and players ended up in lane 1 at the same time as me, but I compensated for any swerving or slow downs I had to make to avoid being lacrossed to death.  There was a very loud bang behind me on the backside once that made me look back, only to see nothing.  NC was coming up on me hard and I was confused until she said "that ball almost took my f*cking face off."  Apparently, one of the players has made a really hard shot that no one managed to grab that passed oh so close to her face.  I had decided it would be best to look straight ahead the entire workout because I didn't wan to know if I was gonna take a lacrosse ball to the head.  I didn't want to see it coming.  I just wanted to be knocked right out!!

I managed to hit all my 1200's on 5:15 or 5:14 (there might have been one I hit on 5:13, which is better than 5:17, in my opinion).  It seemed no one was going to do the mile and the man with the plan said to do what you wanted.  That was the last straw that made me feel guilty.  I would step up and do an honest effort last mile.  Three others did to.  We started off the first lap with me leading, which was weird, I didn't lead but one time all night!  Lap 1 was 1:48 (2 seconds fast), but pretty close.  I had heard footsteps behind me the first lap, but when I turned around at the 100 meter marker after a dead quiet, there was nobody.  I looked over at the start/finish line.  Those (fill in blank with colorful name) had stopped!!  They ditched me. 

I kept going and hit lap 2 at 3:38 or 3:41 (can't remember now).  By lap 3, I could feel the fatigue and tightness setting in.  It felt like my feet weren't coming up as high and my arms were at chest height.  I kept running, thinking you don't know you can't hit the time until you finish, so keep going.  Lap 3 e-speed called out 5:30.  Now, by my math I had to run a 1:40 to get in on time and I swear I heard her say "come on Beth, pick it up."  I was confused and obviously senseless by that point.  I hurried down the track, like a turtle on meth and avoided a near crash with a lacrosse runner on my lap and kept trying to hold on.  The last stretch seemed longer than normal of course and I kept hoping it wouldn't be more than 7:25 when I hit.  It was 7:14.  I realized my math error and was glad it had been in my favor.  I was pooped, felt stiff and old, but I made it through.  Just like a turtle, I was slow, but steady.

Track workout: Success!!

Run From The Core

Well, after a distracting week of work my mileage dropped oh so close to the couch potato level, only running three times so far this week.  The good news is: it was a recovery week (my body does feel pretty rested) and I got in two quality workouts this week, one of those being my cut down/predator run (whatever you want to call it). 

I was pleasantly surprised that the weather had taken a turn for the better by Saturday morning after the white knuckle driving snowstorm yesterday (I am with the majority of Cleveland -- I'm done with this winter), so I happily dressed for a 50 degree run.  I overdressed with my arm warmers, but it took me less than a minute to strip them and tuck them in the waist of my capris around mile 2.  After 5 miles at a lazy pace, I started the cutdown with a good effort for the first mile.  I didn't look at the Garmin, but just ran somewhere around 10k to half marathon effort.  I could feel my legs adjusting to the intensity over the first mile and mile 2 went by with minimal discomfort.  The course I run has a lot of loops and turns as it goes through my 'hood, so often I found myself having to regroup (fixing my arm swing, not overstriding and keeping my core engaged, while exhaling deeply).  Surprisingly, the focus on my core really helped me relax.  Usually, I focus on my legs or arms, but today it was all about my core.  It was fantastic for me and while I was certain the fatigue was partially due to the continued effort I was putting out, I was hoping some of it was because I was pushing the pace a little too.  Hit the driveway just as mile 10 beeped on my Garmin.  I walked the cul de sac for a cool down and reviewed the splits (8:04, 7:52, 7:46, 7:46, 7:27).

Cut down run success!!!

My Vision

In the spring of 2008 I missed qualifying for the Boston marathon by a measly 8:44.  It had stung and it had shaken me deep down in my strong box, that box that puts up the never ending battle to persevere, to achieve, to not give up.  It made me wonder if the 3hr 40 min wall was impenetrable. 

I had taken the summer, to mentally regroup in hopes that I would want to try again in the fall.  I had blown up and suffered the last 8 miles.  The possibility of that happening again was a very loud and in my face thought whenever I seriously considered signing up for another one.  The idea of losing control of my race and stopping repeatedly, trying to get the cramps out of every muscle in my lower body as I played the role of the broken and defeated runner was horrifying. 

But sometimes fate steps in and it's impossible not to believe in signs...

I had been watching the olympics, specifically the women's gymnastics when I heard the back story to Nastia Liukin and her ambitions to win gold in Beijing.  She had made a vision board.  The board was a collage of  pictures and words that served as a vivid reminder of the "dream" at hand.  It had stirred something deep inside me.  I loved the idea.  It was a sign for me that it was time to try again. 

I set to work, thinking about what I wanted on the board.  The race itself was in Philadelphia.  I wanted to qualify for Boston.  My mom was a huge cheerleader, sherpa, supporter and inspiration.

The race was like a war, each mile being a 8 minute and 23 second battle.

I found a lot of "Runner's World" magazines I had laying around and started looking for pictures that would be appropriate for my collage.  Each picture, I selected became committed to memory over the course of the next 4 months as I prepared myself.  I spent time physically training, but also building up my mental walls to shut out the negative voice and remember all the reasons why I was meant to do this and why I wouldn't fail a second time.

The vision board itself has no magic of course, but putting it on paper made it "real."  It became that thing inside me that I all too often forget and lose sight of because it's overshadowed by doubts.  It became the belief inside me that I don't have to be afraid of failing that I can succeed and I will achieve my dream.

Oh and I did run sub-3:40 when the day came, just as I had forseen.