Blogging "every day" amirite?

[Day 95]

Tired right now. Break was great. Too lazy to go into all the details. Here just have the summaries.

Monday's Workout: Gym sesh w/ Henry
Summary:

• Back squats: WU 12 @ 75#, 3 x 8 @ 115#, last set drop set for 12 @ 95#
• Pulldowns: 3 x 12 @ 90#
• Flat bench: 12 @ 55#, 3 x 12/8/6-2 @ 85#
• Trap bar deadlifts: 3 x 8 @ 165# (split 6-2 or 5-3 just sort of depending...) - we just googled it and found out how much the bar weighs, turns out that's why those were sort of rough lol
• Legs superset: 3 x 
• 15 goblet squats @ 45#
• 15 split squats @ 15#/side (DBs)
• 15 reverse lunges @ 15#/side (DBs)
• Dips: 3 x 12 @ 50 lbs of assist
• Seated cable rows: 3 x 12 @ 70#

Hit Rate: 87/95 (91.5%)

Tuesday's Workout: Run

Summary: 8.66 mi, 1:23:24, 9:37 pace, 171 spm average

Pace splits by mile: 9:11, 9:31, 9:43, 9:43, 9:47, 9:38, 9:42, 10:13, 8:57

Things worth noting: I had really bad period cramps that started about a mile in, I ended up stopping at 1.5 mi and thinking that I would just have to walk home and call it a day, but the cramps faded and I ended up deciding that I should try and get through it anyways and if I had to, I would just walk when the cramps acted up. They didn't come back, so I got the rest of my workout in nice and smooth. Was glad I decided to stick it out. (:

Hit Rate: 88/96 (91.6%)

Wednesday's Workout: Indoor brick at the hotel gym

Summary: (continuous)

• 20 mins biking as 10 mins @ 6-8 warm up, 5 mins @ 9, 5 mins @ 10, all at 95 rpm
• 10 mins running @ 2% incline, 6.2-6.4 mph speed
• 20 mins biking as 5 mins @ 10, 5 mins @ 11, 5 mins @ 12, 5 mins @ 11
• 10 mins running @ 2% incline, 6.5 mph speed
• Summed totals:
• Biking: 11.50 mi, 40:06
• Running: 2.19 mi, 20:42

Things worth noting: So sore from the gym sesh...but you gotta do what you gotta do.

Hit Rate: 89/97 (91.7%)

Thursday's Workout: Stadiums at Princeton w/ Henry

Summary: 2 rounds of stadiums with rest between rounds, lower level only, alternating singles/doubles by staircase

Hit Rate: 90/98 (91.8%)

Friday's Workout: Indoor biking at the hotel gym

Summary: 17.68 mi, 1:01:03

• All at 90-95+ rpm
• WU: 10 mins @ 6-8
• Main Set: 9 x 5 mins @ 9/10/11/12/13/12/11/11/10
• WD: 5 mins working down from 10 to 6

Things worth noting: Henry had to kick me out of bed so I would do this. I really didn't wanna do it, but I'm glad I did. Stadiums were really bad to my ankles so I stuck with non-impact work.

Hit Rate: 91/99 (91.9%)

Saturday's Workout: Gym sesh w/ Henry, upper body only

Summary:

• Flat bench: WU 12 @ 55#, 3 x 12/8/8 @ 85#
• Pulldowns: 4 x 12/12/12/10-2 @ 90#
• Incline bench: 3 x 12 @ 65#
• Single arm DB rows: 3 x 12 @ 40#
• Shoulder press: 3 x 8-12 @ 25#-15#
• Bicep curls: 3 x 12 @ 20#
• Dips: 3 x 12/12/10 @ 40# of assist
• Superset: 3 x
• 12 lateral raises @ 12.5#
• 12 front plate raises @ 25#
• Leaning lateral raises, one set of 12/side @ 7.5#
• Skull crushers: 3 x 12/12/6-4 @ 15#/15#/15#-10#
• Machine flyes and reverse flyes: 3 sets of each, 12 reps, the weight was whatever Henry set the machine to (I think I did the same for normal and reverse flyes, which I guess says something ridiculous about my front/back strength ratios), alternating exercises

Hit Rate: 92/100 (92%)

Sunday: Rest day! Ah glorious rest days.

Today's AM Workout: Base run, 5 mi

Summary: 5.04 mi, 46:20, 9:12 pace, 175 spm

Pace splits by mile: 9:09, 9:18, 9:18, 9:09, 9:06

Notes: Felt sluggish, but got through it. Probs b/c I hadn't run fasted in a while and last week is catching up to me fatigue wise, but it's fine. I'm happy with this for a normal run of the mill run.

Hit Rate: 93/101 (92%)

Today's PM Workout: Outdoor ride w/ Hoang (who puuuuuushed me, it was awesome)

Summary: 28.87 mi, 1:43:33, 16.7 mph

Speed splits by mile: 16.2, 16.9, 16.3, 20.9, 16.5, 14.2

Notes: New 40k PR today, 1:25:44, kinda cool.

Hit Rate: 94/102 (92.1%)

Yayyyyyy. Swim tomorrow. Sleep now.

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