And there goes the dropped ball, but it's okay

[Day 139]

I go to med school. Sometimes I think I can suck it up and be exhausted and get on fine doing what I do but that's just not true. Opted to nap in the pm today because I was entirely non-functional. Chose to focus the rest of my time on school work rather than on squeezing in a workout. It was the right call. It's nice to not be training super seriously for something and have the ability to just axe workouts when I have to prioritize other stuff. I spent a lot of the past few months feeling torn between all of these different things that I wanted to accomplish. It's nice to have a single clear priority that I can put above other things and not constantly feel so conflicted about. Gonna try and run in the AM tomorrow if I can. No promises lol.

I'm tempted to drop the hit rate count because I know it's not gonna look good, but I'm also really curious about what the hit rate will turn out to be if I continue tracking it and choose to just live my life instead of constantly trying to work my life around training. I think it'll be an informative number honestly so I'm going to keep tracking it, even though I think there's a chance it might make me feel a little bad. The knowledge is worth that risk. Besides, I finished that last training block on a stellar 91.6% while still managing to do med school, so I'm allowed to drop the ball however much I want now. xD

Hit Rate: 11/13 (84.6%)

Send me good vibes for a good studying day tomorrow, I'm really needing it for the upcoming exam week. (:

Much love,
Jess

PS - Still going strong on that daily core/stretching! So proud! (:

...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

School comes first

[Day 54A]

Trying to convince myself to write blog posts on busy rest days is one of those things that works literally zero percent of the time. Third missed day now I guess? I'm not great at this resolution thing evidently...but you know what, I sort of see it like how I see training. It's not about being perfect, it's about being as consistent as possible.

That being said, I'm not at practice right now. I'm at home, doing some final review for genetics before I tackle a take home quiz this morning. I didn't have enough time to finish it yesterday (full morning of lectures and full afternoon of clinic hours mean that all my studying was relegated to the morning and the evening and it just wasn't enough time) so I'm here trying to get it done now (it's due at noon). School is the priority.

I've also been thinking a bit about next year and am realizing that I want to focus on being the best med student that I can be during second year, so I'm probably going to step down training intensity dramatically in the fall after my fall races and really just focus on doing well in my classes and doing well on Step 1. That's a ways off, but I think it'll take me some time to get used to the idea of letting one thing go to focus on the other, so I'm glad I'm making my own expectations for myself clear ahead of time.

The rest day was good, I haven't been sleeping well recently which is a bummer (though strictly speaking I have been hitting enough hours), but other than that things are going well. Afternoon run today if the rest of the day goes according to plan.

Hit Rate: 57/62 (91.9%)

Hit rate feels like it's getting precarious. Am gonna have to make a really serious effort to not be skipping more workouts from here on out. Might be tough though with exams coming up in a few weeks. We'll see how it goes. Wish me luck!

Much love,
Jess

Living room workouts are turning out to be pretty clutch

[Day 22B]

I just ate a lot of BBQ. Very happy about that.

Today's PM Workout: Trainer ride, endurance work
Summary:

• WU: 10 mins easy 
• Pre-set: 5 x :30/:30 spin ups 
• Main set: 4 x 
• 4 mins @ 90-95 rpm base 
• 4 mins @ 60 rpm climb (base +4)
• 4 mins @ 90-95 rpm base 
• 3 mins @ 90-95 rpm pick up (base +1) 
• 3 mins easy 
• Technique work: 10 x :45/:15 single leg drill 
• WD: ~5 mins easy 
• Totals: 22.66 mi, 1:33:12, 14.6 mph average

Hit Rate: 22/23 (95.6%)

Notes/thoughts:

• The point of this workout was to learn to recover from the pick ups without dropping the base effort. Just building nice long steady endurance. 60 mins without a full recovery, it was good. (Last round was tough but all in all I'm willing to step it up the next time I do an iteration of this. Haven't decided if I wanna change pace/resistance/total time yet, so we'll see.)
• The best thing about workouts like this one is that they calm the rest of my life freak outs. I was sort of losing it over how much work I have to do and how behind I feel but I conquered this thing so it makes me feel like I can handle whatever else there is that life wants to throw at me. Reminders that we're deeper than we think. 
• My brain definitely went offline in the latter parts of that workout. If I didn't have my timer (get the Seconds app if you haven't already!) running with what each interval was supposed to be written down on it, I would have totally lost my place. All I could really focus on was keeping the pedals turning at the right speed. 
• Worth noting that I had some pretty bad wrist pain in the first 30 or so minutes of the ride (right side). I just adjusted my position a bunch of times and eventually found something that eased it up, and then later on it just seemed to go away...Dunno what the deal is. Will keep an eye on it though.
• Was listening to Swimcerely again (love it sooooo soooooo much) and was thinking about team dynamics in swimming and how we're all super competitive people but at the end of the day we're all rooting for each other and working to lift each other up. It's funny because I'm in medical school now and I feel like applicants are always asking things like whether or not it's competitive and never in my life had I associated competitiveness with sabotage or other negatively connoted actions before so it's been weird to try and address those things. Honestly I feel like medical school much closer resembles a swim team. We're all trying to do something that is, at the end of the day, honestly really difficult. We all work really hard, we're all doing our best, and we all want to be successful. But just because we want to be successful doesn't mean that we don't want our peers to be successful too. We do a lot to help lift each other up, because it's wonderful to help others and it's wonderful to be helped by others. I sort of dislike that people pit competitiveness and genuine niceness against each other because that's not how I think it works. I'm extremely competitive. But I also have a lot of love for my teammates and classmates and I want them to succeed just as much as I want to succeed. And beyond that, I want to play a part in supporting them and helping them succeed whenever it's possible, and I'm 100% sure that they feel the same way about me. I think we really need to lose this notion that competitive people are just out to get you and want you to fail so they can look good. I honestly don't think that's how it works, at least not in my experience. Okay end random Jess musings. Check out Spin's podcast though, it's fantastic. 

So random last minute decision: I'm going to swim practice tomorrow morning! Because...why not? It's 6-7 am, I'll have time to come home and eat some food and get a tiny bit of rest before I go lift with a classmate at 9 am. That'll be okay right? Right? Lol I'm an addict. Someone help me. Anyways, after that it's a pretty busy day. I've got a health screening to work in the afternoon and a take home exam I haven't looked at yet that I really need to start on. But I believe! Gonna go home (I'm in lab right now, but it turns out I couldn't do any lab work because I'm still short a few accesses, which is annoying because I've requested like 7 accesses already and apparently I need even more) and stretch and do some more studying and then hit the sack. 5:25ish alarm tomorrow morning so 9ish bedtime? (Wow so much sleeping in.) That'll be the goal. 9:30 wouldn't be the end of the world either. Alright, that's all from me! (:

Much love,

Jess