What is training fasted...

[Day 140]

It's been the first time in a while that I've literally gotten up, thrown clothes on, and went for a workout. When it was routine, it never felt as good as a fed afternoon workout, but it didn't feel terrible either. Now that it's not so routine, my body was rebelling against me as hard as it could this morning. I swear I was half asleep the entire run. Everything felt hard, my legs didn't feel like turning over, it was short and slow yet somehow still real rough. Glad I got out and did it though, another full day of just sitting around studying would've probably killed me. (My schedule didn't allow for an afternoon run break so I opted to just get something short in in the morning before things picked up for the day. Case in point: I'm writing this from lab at 9:30 pm. Yeah it's been one of those days.)

Today's Workout: AM easy run
Summary: 4.58 mi, 43:29, 9:30 pace, 174 spm average
Pace splits by mile: 9:26, 9:42, 9:35, 9:34, 8:56
Hit Rate: 12/14 (85.7%)

Officially speaking I think I'm gonna try and get that interval run in tomorrow afternoon. I also have a lot of studying to do though and some errands to run and I have to cook for lunch which may turn out to be a major time suck...we'll see how productive I am and play it by ear. If I don't have time or the mental energy for something hard and heavy, I'll just take another easy to moderate 4-6 miles and live with that because I'm in med school and exams are a thing and what are you gonna do right?

Gonna head home and do core work and stretch and hit the sack now. Happy Thursday! (:

Much love,
Jess

...And we're back

[Day 87]

I think I passed all my exams! I think we're in the clear! Lol I have so much I want to write about now that I'm back on the bandwagon. Let's get to it!

Life updates:

• I'm in Maine w/ Henry and his family. The rest of break will involve some mix of Boston and Princeton (for wedding planning). The training this week is pretty arbitrary - whatever I get in is whatever I get in. I'm trying to be consistent the whole week so I can put in a big 7-10 day push once I'm back in St. Louis before taper, but that's really the extent of goals.
• I basically opted to take the whole week away from training to focus on school. It was the right call. I have probably studied more this year alone than I have in my entire life prior and it's so amazing to feel like I'm learning things and getting this whole medicine thing figured out. Like by the time I got to the end of exam week and sort of looked back and took stock of everything I'd managed to shove in my brain during the week, it blew my mind. It's really nice to feel like working hard pays off in the end. It makes me feel a lot more reassured about this training too - I haven't given it a chance to show me what it's worth yet so of course I'm swimming in self-doubt but I think exam week made me feel like there are great things coming in the next few months. I've put good time and effort in, I trust that it'll pay of. It's nice to just feel steady and confident for once. 
• Taking time away really makes me appreciate swimming/running/biking/lifting/generally being active for the sake of loving the feeling of moving. I just missed being active. I didn't care about racing or getting faster or whatever, I just wanted to get out and do what I feel like bodies are made to do. Bodies are made to move. It made me really sad to feel like I didn't have time for that. It really puts things in perspective. Sometimes I put a lot of pressure on myself to work hard and to succeed and it makes me forget that I just genuinely love doing what I'm doing. Time away always puts that in perspective. I think I need that every once in a while.
• Being still is sort of a physically horrible thing. I had some back pain (lower and upper) and knee pain (left) that nagged me all week and it was just like, ugh why I haven't been doing anything but sitting all this time. But I guess that's what happens when you sit all the time. Yeah it's awful.

Anyways, I'm in Maine now and I took two runs, one yesterday and one today. Yesterday's was nice and quick and I really enjoyed that. Today's was a little bit slower. One of the things I really like about running here is that the terrain is nice and rolling, just gentle longer uphills and downhills which we don't really get in St. Louis. I'm enjoying playing with the effort on the slight terrain. I've also been running without keeping track of pace live as I run (time of day stays on my screen throughout and I get mile splits as they happen but that's it) which is nice. It's good just to focus on the feeling of running instead of worrying about how my running actually is and trying to compare perceived effort to what I think perceived effort should be based on pace. I'm just happier when I trust my instincts and don't feel the need to have the clock validate those instincts. And it tends to work out really well for me in terms of overall pace anyways, so I'm real happy with it. 

It's worth noting that I've had some naggy come and go foot pain (not soreness/achy-ness, actual pain) which worries me a little (which was also why I opted for a shorter slower run today). I think the plan of action is to continue with what I'm doing and just keep distances short (under 6-7 miles) so long as I can handle what that feels like during my runs without compromising stride form and hopefully with the consistency things will ease up day to day. I'm also hopefully gonna be back in the gym tomorrow. The weight work typically helps with my foot strength/balance so maybe that'll make a difference as well. I'll keep you updated. In the meantime, here are the workout numbers. I'm also going to include a fun little exercise at the end: I need practice with my H&P write ups, so I'm gonna do one for me and my foot! Hope you enjoy that little tidbit. Here we go:

Yesterday's Workout: Base run, 6.5ish miles

Summary: 6.74 mi, 58:44, 8:43 pace, 178 spm

Pace splits by mile: 8:56, 8:27, 8:22, 8:51, 9:00, 8:43, 8:42 

Hit Rate: 85/93 (91.3%)

Today's Workout: Base run, 5.5ish miles (w/ Henry for the first 3.5 miles)

Summary: 5.66 mi, 51:08, 9:02 pace, 176 spm

Pace splits by mile: 9:11, 9:19, 9:16, 8:54, 8:54, 8:26

Hit Rate: 86/94 (91.4%)

Jess's H&P: We're going to pretend I'm presenting to a walk-in clinic in Maine w/ foot pain.

• CC: foot/ankle pain (R)
• HPI: Miss H is an otherwise healthy 22 yo Asian female presenting with pain in her right foot/ankle. This began yesterday during a run in which she felt the pain come and go a few times throughout the run. She had a similar experience on a slightly shorter run today and states her pain today as worse than yesterday. Her pain is localized to the area under her medial malleolus and the arch of her foot and does not radiate to any other locations. She has no pain when the foot is resting but experiences pain when the ankle is bearing weight or with movement (e.g. rolling her ankle, pointing/flexing her foot). While she is running, she feels that the pain increases with uphill and downhill running, but tends to fade away on flat terrain. When she is not exercising, the pain is more mild than it is during her runs and does not interfere with her activities of daily living, although she does not limited range of motion in her right compared to left ankle, which concerns her. At the worst, she rates the pain a 5/10 and otherwise on average a 2/10. She denies any trauma precipitating the onset of the pain. It is worth noting that she is a triathlete and recently took a week away from training on account of exam week. She reports that her current training mileage/intensity is lower than what is typical for her training. These two recent runs are her first runs back from her break. She reports a history of MSK problems (previous ankle injuries/pain/weakness, knee injuries including a right ACL tear, ongoing lower back pain) that have largely been managed through PT. She has not tried NSAIDs or other pain medication. She has iced the ankle which does appear to help with the pain and slightly improves her range of motion. 
• ROS: Negative for symptoms outside of those reported in the HPI.
• PMH: No significant past medical history.
• PSH: Two major dental surgeries in distant past (8+ years ago). 
• Medications: None reported.
• Allergies: Tylenol (acetaminophen - hives reaction, unclear at the time if the true cause was Tylenol but avoids the medication anyways)
• FH: (redacted)
• SxH: Pt is from St. Louis, MO, lives alone in an apartment, attends medical school, is currently visiting fiance's family. Denies any history of tobacco or recreational drug use. Reports occasional alcohol use. (Sexual history redacted.) 
• Physical:
• VS: (not actually available, but let's assume they're normal because they probably are)
• General: Well-appearing young female in no apparent distress, sitting up and breathing comfortably on room air
• Mental status: A&O x4
• Cardiac: RRR, no S3 or S4, no murmurs/rubs/gallops
• Lungs: CTAB, no wheezes/rales/rhonchi
• Abd: Normoactive bowel sounds, soft, non-distended, non-tender to palpation, no hepatosplenomegaly
• Neuro:
• CN I-XII intact (symmetric where applicable)
• 5/5 strength in all four extremities, normal passive motion and tone
• +2 biceps, triceps, brachioradialis, quadriceps, and Achilles reflexes
• Soft touch and vibratory sensation intact and symmetric in all four extremities
• MSK: Pain with touch pressure on medial arch of right foot and below medial maleolus. Slight +1 edema on posterior aspect of right ankle joint surrounding both sides of Achilles tendon. Pain on active inversion of right foot reported, no pain reported with passive inversion. Marginally reduced range of motion on plantarflexion and inversion of right foot when compared to left. 
• Aw yeah, I did the thing. Without looking at a template. And you know what? I feel like I'm doing okay for myself given that I'm an M1 that really doesn't know what I'm doing. 

Okay I'm gonna go rejoin civilization and be a normal social person now. Yay! Happy Easter friends! (:

Much love,

Jess 

Sometimes the best plan is no plan at all

[Day 81]

I live a fairly regimented life, but there come times like exam week when I really just have to let go of some of that structure and listen to myself and what feels right when I'm studying. I had a really productive studying day yesterday, opted out of the run because I wanted to keep that streak up. After my microbes exam this morning I decided to take a short run because the weather was glorious and somehow did a destructively awesome job of it. I'm not a fast runner, so any time that I'm running at anything mildly resembling real speed it impresses me a lot. Today I opted not to pay attention to my watch and just run and that's exactly what I did. It felt HARD. My lungs felt like they were going to explode the whole time but I wanted to see if I cold hold that effort because it felt good in my legs so I stuck with it and this was what happened.

Today's Workout: AM run
Summary: 4.14 mi, 34:10, 8:15 average pace, 179 spm
Pace splits by mile: 8:17, 8:22, 8:14, 8:07
Hit Rate: 84/92 (91.3%) - Note that I'm opting not to dock for any "missed" workouts this week. I decided that every session I get in during exam week is icing on the cake because the priority really is passing, not training. So only positive credit this week, no negatives. (Same sort of goes for how well I do with logging. If I don't log again Friday night, it's fine, the priority is school.)

I did keep my eye on the splits so I knew I was going fast starting out, but I was expecting closer to 8:40ish for that second mile and when it came out 8:22, I knew I had to just keep pushing it out until the end. Am super super amazed at how that went. Am also feeling pretty good about my ability to sit in a really uncomfortable place and keep going, because running fast is way not comfortable. It was great though, so glad I went out and did that. Dunno when the next time my body will get to move from this chair is, so I'll be back whenever I'm back...Happy Monday! (:

Much love,
Jess

I don't understand mechanisms of heat/cold intolerance in thyroid disorders help me

[Day 77]

Today's Workout: AM CSP Practice, sprint free day
Summary:

• WU: 
• 200 swim
• 200 kick no fins
• 200 pull no paddles
• 100 swim (as written was a 200...idk what the lane decided)
• Pre-Set: straight through, breaks indicated, if I didn't put a pace time it's because I don't know what we did it on
• 8 x 50 stroke/free by 25 @ :55 (I did 4 fly, 4 back)
• 1 x 100 free
• 4 x 25 choice (back) descend 1-4
• (break)
• 4 x 50 kick w/ fins choice @ :50
• 1 x 100 swim w/ fins @ 1:30
• 4 x 25 kick w/ fins MAX @ :30
• (break)
• 2 x 50 free @ :45
• 1 x 100 swim @ 1:40
• 4 x 25 break outs free 
• Main Set: straight through, all free
• 1 x 50 @ :40
• 2 x 100 easy @ 1:40
• 2 x 50 @ :45/:40
• 2 x 100 easy @ 1:40
• 3 x 50 @ :50/:45/:40
• 2 x 100 easy @ 1:40
• 4 x 50 @ :55/:50/:45/:40
• 2 x 100 easy @ 1:40
• 5 x 50 @ 1:00/:55/:50/:45/:40
• 2 x 100 easy @ 1:40
• WD: lol no time
• Total Distance: 3750 SCY

Hit Rate: 82/90 (91.1%)

Already dreading the trainer ride tomorrow and I haven't even taken my exam yet yay. Back to studying.

Much love,

Jess