still running

Since I started running (jogging? or whatever you can call this slow shuffling gait) I've hit several road blocks.

Being overweight and unfit I could not even run for 5 minutes straight in the beginning. I searched for a newbie running program and decided to aim for a 5 km (The Couch-to-5k Running Plan). Getting to 3 km was easy enough. But after that I hit my first wall.

I mixed it up a bit. I run to the beach, not minding if I made several stops on the way. I run on a treadmill. Pretty soon I was running my 5 km. It was like sweet victory since it was something I never thought I could do.

Then I hit another wall. I could not get past 5 km this time. For a month I was only running 5 km/run. I took a tiny break, a vacation, then suddenly I ran a 6 km without even knowing it.

Then I hit yet another wall. After 2 weeks of doing short quick runs (to the point of feeling nauseous at times) and running out of safe roads to run on I was afraid I would never run more than 6 km.

Then I run 8 km. It took me totally by surprise!

All in all, progress may be slow but I can't say I'm not doing good. Except for a few misses I'm pretty much on schedule. Even the weight loss (which was never the primary reason for my taking up running) was surprising. As it is, it seems that I will be running a 10 km sooner than I expected.

* * *

Last night I run my last 2 km under pouring rain. I thought it was just going to be a light drizzle so I kept on running. Then it started pouring really hard. I kept blinking as water dripped from my brow into my eyes. Since I was already wet I decided to finish my run. And finish it I did - with my fastest km (mile) to date =D

It's good to know that even with road blocks I'm not running out of motivation yet. I still think it would be great if I could run with someone else, though.

I do need someone to run with. It would make all this running even more enjoyable.

Is there any one in Batangas looking for a running partner? I'm a slow and plodding newbie who refuses to believe her hyperactive (asthmatic) lungs and airways are not suited for mid-distance runs.

all in a day's work

Nights on duty:

A year-old baby arrives at the hospital - a referral from another hospital. She is febrile and weak-looking. She is severely dehydrated and is breathing with difficulty. Pneumonia. Within the minute she arrives she goes into a seizure. Right away you consider meningitis and then cerebral malaria. You admit the patient immediately slightly piqued that the referring hospital did not call or send an SMS about transferring the patient. After admitting the patient and sending the ambulance away an SMS arrives regarding the referral. You conveniently forget to reply as you go on with your other admissions.

Two patients arrive almost at the same time. Both hypertensive with systolic blood pressures over 220 (normal systolic BP is 120 and below). Motor intact, sensory intact, no change in sensorium, oriented to person, place and time. Not stroke. One is congested, you start diuresis to rid of the fluid overload and bring down the blood pressure. One is diabetic and on insulin, blood sugar is in the high 200's. You give another shot of insulin. You monitor each patient closely the whole night.

A pregnant woman arrives complaining of lumbosacral pains. She has just gone into labor. A check reveals her baby is okay, fetal heart tones are okay. The woman's blood pressure, however, isn't. At 230/160 she is in preeclampsia. You start her on Hydralazine, load Magnesium Sulfate and inform her OB-Gyne. Her blood pressure goes down a little. In two hours time you are holding her baby. She had undergone an emergency Cesarian Section. They were okay.

Another pregnant woman arrives. She has been having uterine contractions since that morning. It was her sixth pregnancy. You do an internal examination which reveals that her cervix is fully dilated. You admit her directly to the delivery room. She delivers her baby within 15 minutes. The NA stands beside you to catch the baby. Both of you cringe as you notice a pinkish round noodle-like thing come out of her anus after the baby is delivered. A worm - Ascaris by the looks of it. You put a side note on the chart beside your post delivery orders and remind yourself to inform the OB resident to give the patient a purgative on follow-up.

You finally get some rest before 3 in the morning. You lie down and try to fall asleep knowing full well that the adrenaline coursing through your veins is going to keep you awake. Twenty minutes later just as your were about to doze off a knock on the call room door jolts you back into wakefulness. There is another patient in the ER. A mother has just brought her eight year old son. He has been vomiting and having loose bowel movement since the night before. He looks on innocently and smiles at me as he stands straight in his blue and white striped pajamas. You advise the mother to have labs done in the morning (the med tech had gone home for the day). Even though febrile, the patient showed no signs of dehydration. His clinical picture was that of a urinary tract infection - not viral gastroenteritis, not intestinal amoebiaisis*. You prescribed an oral rehydration solution, an antipyretic and an antibiotic, said goodbye to the kid and went back to sleep.

Two hours later you are awoken by another patient for admission.



*Labs done the following day did reveal a urinary tract infection.

back to work

I went on the trip alone. A colleague I usually go with had passed on work this month and was going home for a vacation.

I took an earlier trip. It was windy but the sea was flat and the sky was a clear blue. Another boat run almost parallel to the Baleno Otso before it veered a little to the left to head for Calapan. As the boat grew smaller in the distance I shifted in my seat and started reading.

"There is nothing nicer than doing nothing all day, then having a rest afterwards."

I agree. Take me away from the city any time. Take me away from the noise, the pollution, the congestion and anxiety. Give me space. Give me green trees and blue sky every day.

The boat docked at Abra in under two hours. I was lucky enough to get a ride on a passenger van that had gotten on the boat from Batangas.

I never get tired of the ride to the hospital. It is still a vision to see the clean green of rice paddies in the light of the setting sun. The coconuts frame the paddies in the distance. Only white cows and birds (egrets?) break the green sea.

Small towns always give me a warm and fuzzy feeling as I enter them. I always hope that this feeling of "home" is not replaced by a feeling of stalker creepiness. Small town people can be intrusive. They always know when somebody is new in town. In such a small place everyone knows what you've been up to.

After settling in and giving my dorm room a little clean-up I headed out to the hospital to chat up with the previous group of doctors. I had arrived just in time for a bon voyage party for two of them. After an unhealthy dinner of liempo and crispy pata we spent the rest of the night drinking and howling at each others videoke miscues.

I've never been much of a drinker. Occasions to drink don't come too often either. Recent R&R trips had me drinking more in a month than what I usually drink in a year.

At 2:30 in the morning I turned in earlier than the others. They would all be off in the morning while I was just going to start my work week. I made sure to hydrate and went straight to bed after I washed up.


I woke up early in the morning and run a 6k.



Reading:
Underwater To Get Out of the Rain: A Love Affair With The Sea (Trevor Norton)

reality check

A few days after coming back from Cebu I am still experiencing what one can only call travel-withdrawal. I still feel the sun on my skin and the salty spray on my face as I rushed to welcome oncoming waves. I can still picture running at the beach. I can still hear the loud churning of the motor boat and the soft lull of the sea as we went island-hopping.

{I smile at strangers with beach-hangover as evidenced by the flip flops and board shorts they are still wearing in the city.}


I keep thinking I need a few more days of R&R after my week-long vacation to help ease me from vacation mode to work mode.

Tomorrow I will be traveling by sea again. The 2-hour ride to Mindoro will be my wake-up call.

Reality beckons. I shall welcome it.

motivation

Maundy Thursday.

At midday, I was at Loyola Memorial Cemetery laying to rest my aunt’s sister-in-law. She had passed away due to complications of diabetes. At the funeral service I couldn’t help but shed a tear for the passing of a strong woman at such a young age of 53. Her own mother is the picture of health at 80. I cried as her 17-year old daughter said goodbye to her, describing her as their “home” – a place (person) where they were safe, provided for, comfortable and loved. With her passing the remaining family members needed to come together to rebuild a new home.

With each death in the family (there has been three for this month alone) my mortality haunts me.

I have enough motivation to keep me striving for health and fitness with my family history of hypertension, diabetes, coronary artery disease and cancer. I am glad that I’ve quit smoking and that I only drink occasionally. I suppose I’m also glad that even as I grow a year older in a couple of weeks my age cannot be considered a risk factor yet.

I’m lucky that I also have the added motivation of being a physician. If I want to continue to advise my patients to increase physical activity, reduce weight and eat right it would be hypocritical if I don’t do the same. I need to practice what I preach. I need to be the picture of health. My patients need to know and see the benefits of the advice that I offer.

By the age of 30 I’d like to be at my fittest, with a normal BMI, able to run a half marathon, able to swim a mile (or more), with updated immunizations, normal blood pressure and normal blood chemistry.

At this point I am confident it is not too hard to achieve.

R&R

Cebu City and Bantayan Island
April 1 - 7, 2009

My last trip to Cebu was in August last year. For this trip I decided to stay longer.


After a nice dinner at STK (baked clams, grilled tangigue, mixed seafood and crab curry) a ride around the city revealed a very active bunch of graffiti artists.


In the morning, as the best friend headed for work I headed to McDonald's for breakfast. I sat in the roadside veranda trying to soak up the energy of the city. I read the local paper and calmly waited for things to happen Cebu-style.


On the weekend we started the trip to Bantayan Island.


On the early bus to Hagnaya: Thorntree discussions at Lonely Planet has called this ride as one of the craziest bus rides. I am almost grateful of the darkness before sunrise as I am spared of the scary cliffside view. The bus careens up and down the mountain road not even slowing down for blind curves. [Ceres bus ride: P80 - regular fare, ~3.5 hours]


First look at Sta. Fe: I was apprehensive at first about going to Bantayan Island just before the Holy Week. I was expecting a beach full of tourists on their holiday. I couldn't be more wrong. [Boat to Sta. Fe: P130 - ~1.5 hours]


Bantayan was wonderful. We stayed at Sta. Fe Beach Resort [aircon room for 3: P2000 - a really big room that could easily fit 5 or 6 persons, hot and cold shower]. After brunch we took a dip in Ogtong Cave, jumped the waves back at Sta. Fe and basically just soaked in the salty water. We had dinner at the D' Jungle [all you can eat for P300 with over 50 dishes to choose from]. After a long walk at the beach and divulging secrets over SMB we called it a night.


Sunrise at Sta. Fe looked like sunset everywhere else. We heard mass first thing the next morning (it was Palm Sunday), then took a habal-habal to Bantayan to buy seafood. We had chartered a boat to take us islandhopping.

We had earlier planned to go to Virgin Island but I'm glad we changed our plans and headed to Hilantaga-an (I think) instead. There were too many people at Virgin Island we wouldn't have enjoyed it.


Harry was our able cook and guide. We had an overabundance of scallops, shrimp, squid and tilapia for lunch all washed down with buko juice. [Islandhopping: P800; Snorkeling gear can be rented for another P100]


It was like we had the whole island cove to ourselves. The sand was white hot, the water was clear, it was so quiet you could speak at your normal voice and be heard a kilometer away.


Back at Sta. Fe I took a quick run around town. I couldn't help laughing when a sikad driver offered to give me a ride back to the resort in the middle of my run.


More pictures from Bantayan:

Flip Flops!

Late afternoon, taking a breather

Another sunrise at Sta. Fe.

Last look before we leave.

I don't think I would mind if I never went back to Boracay again. But I certainly would love to go back to Bantayan.