It’s January. Are you running?

It’s January, and I just moved from Tucson to Portland, OR. Winter is peak running weather in Tucson— sunny in the daytime, and cool in the mornings and evenings. In Portland, it’s. . . dark. From 4:30 PM until 7:30 AM. And wet. I’ll treadmill it if necessary, but it sucks the joy from my life. So what’s a girl to do? Adapt. Here’s what I’ve tried so far:

  1. Gear. Since Ragnar last year, I haven’t had much use for my reflective vest  but now I do. I also needed a better headlamp. Now I’m visible, and I can see. Safety? Check. Add that to toasty tops and tights and something to keep my ears warm, and I’m feeling pretty good. I’m still figuring out which shoes are best for slick sidewalks (any advice??), but I’ve got muddy trails covered. 
  2. Adjust expectations. Yes, I can run in the dark. In the rain. I won’t melt. The rain is often kind of misty and drizzly— almost pleasant, in a way. Portlanders aren’t phased the way Tucsonans are— I used to joke that people stayed home if it looked a little cloudy. Here? Bring it on. People are out there. I also thought it would suck running before it’s light out, remembering pre-dawn runs of yore before early hospital shifts. But 6 AM is way better than 4:45, even if it’s dark. 
  3. Learn to love the mud. Pippi, Max and I ran on some Forrest Park trails last weekend and we had a blast— it was sloppy, but who cares? There’s a distinct joy in getting dirty. Own it.
  4. Back up plans and cross-training. Some days it’s too nasty. A gym membership was in order— so I got one. I can use the treadmill, sure, but maybe a functional training class (kettlebells! boxes! bodyweight!), a rowing workout, or some cycling, too. Cross-training has its own set of benefits that I’m starting to enjoy, like feeling stronger on hills.
when you gotta, you gotta.

What other tips to you have for me to help me run all winter long?

E.N.E.R.G.Y., 7 ways

Last night was both the winter solstice— the darkest night of the year— and a magnificent full moon. As if the sky wanted to remind us that the light returns, starting now!

Lots of folks, myself included, find it hard to keep our energy levels up at this time of year. Exactly when there seem to be extra demands on us. Funny how that goes, isn’t it? If we just accept the defaults, we’ll probably crash at some point (who hasn’t had a December meltdown?). So what can we do? How can we turn this strain into a teachable moment for ourselves?

Stress can point out to us exactly where the inflection points are.  Then it’s up to us to pay attention.

So, ENERGY: each night, experience rest, gratitude, and yoga? even night-owl extroverts require gentle years? eggplants! nectarines! endive! radishes! ginger! yams!

OR. . .

Here’s some low-hanging fruit— things that are easy to blow off in the moment, but that add up to exhaustion:

  1. Go to bed! It’s OK to lean into the hibernation instinct a little bit. When you have a lot to do, don’t knock sleep off the back. Set an alarm for bedtime, use the function on your iphone, and stick to it. If you don’t have a true reason to be up too late, don’t be. I don’t mean skip out on being present for important events, but I do mean maybe turn off the Hallmark channel and get some quality pillow time. (I’ve given the sleep rundown before, but I’ll give you the short version again: make your room cool and your bed warm, no screens in bed, make it dark and unplug stuff with little glowing lights, use do not disturb mode on your phone).
  2. Eat your veggies. Of course there’s lots to indulge in around the holidays, and I’d never tell you not to do so. Just don’t crowd out all the nutrition your body needs to function. Remember to eat green stuff every day. If you know you’re going to a party, maybe start your day with a smoothie or have a big salad for lunch. Order a side salad. Bring a veggie dish to the potluck. Whatever works.
  3. Pay attention to energy vampires— sugar and alcohol. It would be easy to drink wine and eat dessert every single day between Thanksgiving and New Year’s. This will probably make your energy levels tank. Both will disrupt your sleep, in addition to taxing your system, dehydrating you, and giving you that fuzziness (you know). So just pay attention. You could think about skipping either or both few days. While we often think there’s social pressure to indulge, the fact is, most people don’t really care what you do or don’t eat and drink. You can say no thanks. You can have a seltzer with lime or a kombucha or an apple cider at a party. You can say those look delicious but you’re totally full and would love one for later. If you do take a day off, note how you feel in the morning. 
  4. Get some sunlight. It’s in short supply in December, so get creative. If before and after work are dark try midday (a walk, at least?). . Go out in nature on the weekends. If you live somewhere dark, maybe light therapy lamp is for you. Using a bright light (look for “10,000 lux)  for 30 minutes per day has been shown to combat depression
  5. Relatedly, get some exercise. Maybe you can organize a family hike? Or run a 5k? If you’re a gym person, carve out the time. Even if it’s less time than you’d like, make time.  This will feel easier if you do 1, 2, and 3. And everyone feels better after a sweat. Promise. 
  6. Don’t burn yourself out. You don’t have to say yes to everything and everyone. You can put in an appearance and go on to the next event. It’s OK if that event is a date with a good book and your dog.  
  7. Finally, don’t lean too heavily on artificial sources of energy to pull you through. I love coffee, I really do, but it doesn’t replace the things I suggested above. If you’re too tired, maybe you should listen, honor that, and cool your jets.

Which one of these fall off first for you? Can put it back?

Work travel. . . again.

I’m a health-consious person (but you knew that). I set up my daily life to make it easy— walk/bike/public transit. High-quality food in my kitchen, healthy snacks in my backpack, veggies with everything. Breaks for a stretch/walk. Standing and fidgeting as I work. Runs, yoga classes, gym classes surrounding and sometimes interrupting my work day. It’s easy for me when I have control.

But what happens when, suddenly, I’m stuck in an airport, on a plane, in another airport, in a hotel, in a conference center? No vitamix, no yoga studio, no time to seek out a grocery store even. I’ll tell you how I make it work, but I also have a wishlist for the hotels and conference organizers (I’m looking at you, Hyatt Bethesda).

Let’s start with the stuff I can do, no matter where I wind up:

  1. Pack workout clothes. No one can take this from you, even if your schedule is tight. If the weather’s OK and the location is safe, an outdoor run is the best— gets you oriented, helps your body clock, just plain feels good. This might mean packing something warm. If not, there’s almost always a gym. You can find out what they’ve got (pool? bikes? kettlebells?) before you go— website or phone call will usually do it.  Yes, a hotel gym can be a sad place, but I’m like my border collie mix (hi Pippi!)

    black and white dog with wagging tail

    we’re going for a run now, right? RIGHT??

    and if I don’t get at least 30 minutes of exercise in the morning, I’m a nightmare for the rest of the day. I’m not a treadmill person, but I’ll use one in a pinch. I’ve found I’m better off with a little structure for an indoor workout so I don’t quit out of boredom. I tried Aaptiv this trip, which lets you stream or download audio workouts for treadmill, bike, rower, strength training, etc. It got the job done (meaning, I got a good workout in on the treadmill and didn’t die of boredom). I’d do it again.

  2. pink hydro flask bottle

    keeping hydration cute.

    Bring your water bottle. Yes, you have to bring it empty through security. But you can find bottle fillers everywhere now, or at least water fountains. If you have access to it, you’re more likely to drink it (plus my pink hydroflask is just plain cute). And if you didn’t pay $6 for the water, you won’t ration it. Planes (and plane wine, let’s be honest) are dehydrating. Indoor air is dehydrating. Packaged, processed food is dehydrating. Too much coffee (guilty), even, could be dehydrating. Let’s keep things from getting too desiccated, shall we? Your skin, digestion, and brain will thank you.

  3. You can move around, even if the structure of the day doesn’t include it. Stand up at every break and walk outside, upstairs, to the bathroom, around in circles. Go out at lunch time instead of staying in the conference center. Walk to the restaurant for dinner (you can meet them there if you’re the only one braving it).
  4. Take a routine from home with you. I like to meditate, journal and plan in the morning, so I bring Headspace and my planner with me. It helps me keep some normalcy.

 

So, what could the hotels do better?

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moving boxes

ch-ch-ch-changes. . .

So, I’m moving. Moving from Arizona to Oregon. Moving from one job to a new one.

Transitions engender reflection, and I’m thinking about what I really value.

This effect shows up as I sort my possessions. I’ve thought about this before, but now it’s inescapable. Do I like this? Do I use it? Do I need it? Do I want it? Or, did it just slip into my life somehow and attach itself, without my deliberate attention? Or was it once valuable and is no longer? Is it beautiful? Or, am I keeping it out of some sort of guilt at the idea of selling it, donating it, or throwing it away? I’ve been answering these questions a lot lately, and it’s very revealing.

It also shows up as I visit people and places here. I have beloved teachers and communities at my yoga studio (where I’ve taken over 2,000 classes) and my krav maga gym (where I learned that I can, and should, fight when threatened). I have favorite trails and coffee shops. I have coworkers who’ve taught me and learned from me. Of course I’ve valued these things over the years, but the thought of moving away from them brings my appreciation into sharper focus. Each visit feels significant.

I also think about myself and my life in the ten years I’ve been here. I moved here with Max and took my first job as a nurse. I took my habits of yoga and running from occasional to nearly daily. I went to graduate school and became a nurse practitioner, then a researcher, then a teacher. Max went to graduate school and cycled through jobs. I hosted weekly dinners with Max for years, sharing a love of vegetarian food and socially progressive conversation with smart and loveable friends. I cooked a lot of vegan food, and learned to love eating that way, even when I haven’t made it a firm rule in my life. I’ve travelled from here, to Europe, to Asia, to Mexico, to Montana, to New York, to California, to the Midwest. And then I cam home, to the home I made here in this funny desert city. And now, I’m going.  New beginnings are exciting! But still, leaving is sad. What would you miss if you moved?

Book Club: An American Sickness

The U.S. healthcare system is a hot mess. Even people who know things are convoluted and expensive might not realize the extent: we pay far more for just about all aspects of healthcare here than anywhere else, and our outcomes are worse pretty much across the board (see this article from the Commonwealth Fund for details).  As tempting as it is to implicitly trust that you’ll get the best care in the world right here, the facts would suggest otherwise. Every other major developed economny in the world as some form of universal access. So why do Americans cling to the idea that our healthcare market is somehow sacred, and that a market-based approach is the answer? I’ve talked about why healthcare is not just another commodity before, but it’s still true.

Elisabeth Rosenthal, a physician turned journalist who has worked for the NYT and Kaiser Health News, wrote a book last year. In it, she exposes a lot of the causes and effects of the major malfunctions in our healthcare system. Much of this is illuminating— examples about hospital conglomerates and pharmaceutical pricing are spot-on. But what seems to lack punch is the explanation for why this upside-down, losing system persists. When healthcare is treated like every other business, greed drives, incentives are bonkers, and lobbyists shape policy. When healthcare is considered as a public service, things are different. But once powerful people are making obscene amounts of money, it’s nigh impossible to unring that bell. Are there market failures? Big time. Can the people affected muster enough influence to combat the big-money lobbying of professions and industry that have become accustomed to fat-cat money? Fat chance.

Aother quibble: Rosenthal is mercelessly physician-centric. She doesn’t consider the unique added value of team-based healthcare or other professional expertise, choosing instead to lump unique professions like NPs and PAs together as “extenders”. Barf. Dr. Rosenthal, I wish you’d take a broader view of health.

That said, give it a read. It’s interesting/depressing. And you might pick up some useful tips for your nex hospital visit, knock on wood.

What we talk about when we talk about research findings in the news

What happens when journalists report the findings of a scientific study to the general public? Often, the findings are stated out of context, broadly interpreted, and stripped of the nuance and uncertainty that characterize much of scientific research.  Should this scare us back from publicizing findings to a wider audience than you might typically find in a scientific journal? Or is publicity critical to uptake?

What is our responsibility as scientists to communicate our findings, not only through dedicated dissemination and implementation planning, but also through the popular press?

Here’s a recent example. JAMA published the findings of a study by Mandager et al.  on the association of cardiorespiratory fitness (CRF) with long-term mortality. CRF was measured by exercise treadmill testing in a sample of over 120,000 patients who were having this test done anyway as part of their care (that means these people were mostly being evaluated for symptoms potentially related to cardiovascular disease). The investigators quantified CRF as peak estimated METs. They separated by sex and age to calculate percentiles and then stratified CRF based on those percentiles. They used public and hospital records to determine mortality. Median follow-up was 8.4 years. The investigators concluded that CRF was significantly inversely associated with all-cause mortality (i.e., the fitter you are, the less likely you are to die). They went on to state that low CRF was as risky as or riskier than diabetes, CAD, or smoking. They also noted, importantly, that “there does not appear to be an upper limit of aerobic fitness above which a survival benefit is no longer observed”, but “there continues to be uncertainty regarding the relative benefit or potential risk of extreme levels of exercise and fitness”. They go on to offer several other sensible caveats, including that the study population may not be representative of the general population, and there are potentially significant unmeasured factors in this retrospective study. All things considered, though, this seems to represent very good news: a modifiable factor is strongly associated with increased longevity in a large sample with a long follow-up.  Bravo!

So how did this get reported in the popular press? Gizmodo’s headline reads “No Such Thing As Too Much Exercise, Study Finds”.

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