Fragility and Resilience

Ever injure yourself in a really dumb way? Come on, yes you have. Recent stories I’ve heard from other early-30’s women at my gym: 1. I stepped on a lime and sprained my ankle. 2. I sprained my toe putting on underwear. I mean, this is kind of funny, we joke about getting old and hurting ourselves by like, getting out of bed. But are we really fragile enough that something like that can put us down for the count?


Relatedly: Ever had your day completely ruined by something completely stupid? The restaurant was out of the thing you wanted. Someone forgot your meeting. Someone said something mean. And then suddenly you’re a mess, and you can’t get your mojo back (guilty!).  How can we cope with this? How can we be come resilient, to the physical and the emotional?

Resilience: from Merriam-Webster online:

  • 1: the capability of a strained body to recover its size and shape after deformation caused especially by compressive stress.
  • 2: an ability to recover from or adjust easily to misfortune or change.

Ok, yeah. This sounds awesome. Sign me up! Advice for cultivating psychological resilience is generally broad— really broad. Keep a positive attitude! Maintian perspective! Practice self-care! Great, Ok, but how to I put this into practice?

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Delicious, yet malicious: Reading Salt, Sugar, Fat

No one, as far as I know, will be surprised to find out that highly processed, manufactured food isn’t the healthiest option. No, what’s compelling about Michael Moss’s Sugar, Salt, Fat isn’t some surprising revelation. Rather, it’s the breadth and depth of an issue we kind of already knew about, laid bare. And it ain’t pretty. Here are the take aways, in the cliff’s notes version:

  • Food companies are not interested in your well being. They’re interested in their bottom line. They will make things healthier if and only if it helps them sell more. They are for-profit companies in a cutthroat competitive market. Capitalism, folks!
  • The executives and scientists who make processed food and drinks generally don’t partake of the products they design and sell. Make of that what you will.
  • The copy on food packages is disingenuous. The only information about a food’s

    keeping fly.

    nutritional value is on the actual nutrition facts and ingredients labeling.

  • The history of the government’s dietary guidelines is apalling— this isn’t a conspiracy theory, it’s pretty blatent. The department of agriculture steers the ship— and this department’s primary mission is not, in fact, health. RBG knows— Moss wrote of Ginsberg’s opnion in a 2005 case about the checkoff program for beef marketing that the USDA was simultaneusly promoting beef (advertising paid for by the government program) and telling people to eat less meat (in the USDA guidelines). She couldn’t square that circle, and neither can I: these folks have a texas-sized conflict of interest.

Bottom line: if you want to eat healthy, you have to pay attention, and it’s up to you because neither the food industry nor the government has your back. Bon appetit!

What has CBD ever done for you?

Suddenly, CBD (cannabidiol, which is a cannabinoid found in cannibis plants but which lacks the psychoactive punch of its cousin, THC), is everywhere. You can buy it online. It’s less illegal than plain old marijuana (as far as anyone really knows— You can buy it on the internet, but it’s maybe still classified as schedule 1, if it’s marijuana-derived and not hemp-derrived? But if you live in Indiana, maybe not so much?  Guilt by association? Hey, I’m a nurse, not a lawyer).

girls are no substitute for weed. . . but maybe CBD is?

It’s  touted for relaxation, sleep, pain, inflammation. . . you name it. You can get it in a tincture. You can get it in a gummie. You can get it in a salve. According to GQ, you can rub it all over your body! I’ve seen creams, balms, and salves for topical application recently on friend’s bathroom counters and in fellow-gym-goer’s bags. It’s great for pain, they say! For muscle relaxation! For inflammation! So I had to dig in to the state of CBD and ask: is topical CBD a safe and effective remedy for musculoskeletal aches and pains? Here’s what I found:

First, what the heck is this stuff? Scientifically, CBD is a non-euphoriant, anti-inflammatory analgesic with CB1 receptor antagonist and endocannabinoid modulating effects. It’s considered a minor phytocannabinoid. It can be sourced from hemp or other cannibis-family plants (like the classic marijuana plants you probably think of).

  • CBD a miracle drug! At least. . . if you’re a rodent, or maybe a child with epilepsy. A scientific literature search using PubMed turned up a few studies in animals (it seems to help rats with lab-induced arthritis), and a few looking at some specific medical conditions (MS, IBD, a few rare genetic syndromes). A regular old google search, though, was an embarassment of riches, with top hits from sites “ministry of hemp”, “leafly”, and “”— all touting the miracle effects of products for sale. Ruh roh, this sets off a few alarm bells.
  • Now, to be fair, some of the reason research is sparse is that it’s legally complicated. NIDA restricts federal funding and also access to cannibis in clinical research. I mention this because the “absence of evidence” is a barrier here, and one that’s propped up by the guvmint. There are a total of 138 studies registered in (that’s not a lot— for reference, there are over 10,000 on insulin). The most common indication studied is childhood epilepsy. Some of these were for cannabis which included both THC and CBD. Delivery forms were oils/tinctures, vaporizers, and a spray used in the mouth. There were zero studies on topical or transdermal CBD.

OK, there’s not a lot of evidence, we get it. So, is it safe??

  • Overall, the evidence suggests that the safety profile of CBD is well established. But there are still things we don’t know!
  • In-vitro and rat studies suggest possible hormonal effects, but whether this translates to humans or to doses used is not known.
  • There is the potential for  drug interactions, particularly for drugs cleared by the liver.
  • There is no long-term data.

The next question: topical application of CBD-containing products actually help with pain or inflammation?

CBD topical

i mean, the label says it’s legit.

  • I repeat: there are no clinical studies about this. Zero, zilch, goose-egg. So what follows is mostly theoretical.
  • NIDA reports that CBD in general has neuroprotective, alalgesic, anxiolytic, and anti-inflammatory effects.
  • Research also demonstrates that CBD is absorbed transdermally, meaning that if you apply it to the skin, it is detectable in the bloodstream. However, there are lots of parameters that could impact absorption! It’s not known what effect the carrier, temperature, concentration, or other parameters might have. It also isn’t know whether there is a local effect (the area you apply it) vs. a systemic effect (throughout the body). Since it isn’t absorbred very well orally, transdermal administration is a good option.
  • The rat study I mentioned above suggested that in rats (this is important, since you are not a rat),  transermal application of CBD lead to pain relief— but they did not apply the medication to the affected joint. They just used the skin as a way to get the drug into the body. So they were not studying the local effect on the painful area, as some people assume they were.

So the answer is: CBD is likely safe, it’s in a legal gray area, and there’s no science about whether or not topical application has clinical benefit, and if so, through what mechanism.

welcome– you’ve got FEMALE!

International Women’s Day– yesterday– was a cool day on the internet. NYT published obits of women they had failed to memorialize in the past. Male friends honored their women friends on insta. Everyone wore purple. It was hip to listen to women! Cool. But I didn’t publish this post yesterday, and here’s why: women’s voices matter every. single. day. Put that in your pipe and smoke it! So without further ado, here are some thoughts on women and adventure in the media:
A few years ago, I read a copy of Outside Magazine on a plane. I like Outside— because I like adventure, and I like fitness, and it’s more interesting than Shape or whatever (which let’s face it, you’ve read one, you’ve read them all). But boy, did I get mad that day. The cover touted a story about some awesome women athletes (didn’t manage to get one in the cover shot, though!)— and I flipped to the article. I was dismayed to find it was actually more like a photo spread, with full-page photos of women in tiny clothing, and the text was mostly about like, what they ate for breakfast. Sad trombone, Outside. So, I looked back to ask myself if my magazine-reading habits were silently minimizing women, and guess what?

  • 2016 was 0 for 11 on women gracing the cover (yet they somehow managed to get noted outdoorsman Tim Ferriss in there?). Oh, and the Tim Ferriss issue contained the story that started it all— “these seven women will crush you”. Like that should be somehow surprising or notable that women might “crush” you? Anyway.
  • 2015 was 1/12— and she’s wearing a bathing suit (but at least she’s an athlete!). It doesn’t get better as you keep going back (you can look at their archives.)

I think, to their credit, Outside has recognized this and is trying to rectify it. I’m waiting to see whether they can walk the walk. So far, 2018 has had Amelia Boone on a cover. 2017 had Mikaela Shiffren as cover athlete, plus a special women’s-themed issue (XX factor-branded, co-sponsored by REI, where they put their men on hiatus for the month. I have mixed feelings about this*). I’m not counting the anonyous bikini-clad ass on the April issue.

But, there’s a silver lining! My fed-up female athlete ass went on a mission to find some better content for adventerous females, and lo and behold, Misadventures was there for me. You guys. Have you seen this? They have it at Barnes and Noble, and REI. But get a subscription!

Spread from Misadventures 1

tucson represent! from a glorious Misadventures story on BICAS.

They have  incredible articles and no sexy pictures. They write about conservation! And urban cycling! And surfing, and skating, and kayaking, and camping! The photos are gorgeous— and they’re of natural elements, and women athletes— including, frequently, women of color. They review gear for women— and not just by adding a pink one to the list. They review books by women. But what mostly makes me happy is the fierce, fresh female voice that runs through it. My experience of the first issue of Misadventures was kind of like when I watched Wonder Woman— IT ME!! I’ve been doing it all wrong letting men run the show! My tribe has arrived!

*Is this kind of like the thing fashion magazines do where they do a “size themed issue” or have a column about plus sized clothing, but don’t do anything to alter the rest of their content about dieting and featuring models with unrealistic bodies? Maybe. I guess we’ll have to see. I’ll be happier about it if, instead of putting their male writers, editorial staff, and photogs on furlough for a month, they start hiring more women into high-level jobs, and using more women freelancers, every month.

Kinesio taping: yea nor nay?

I’ve had a minor niggling calf pain for a week or so. Should I kinesio tape that sucker? Kinesio tape (also called KT tape, though technically that’s a brand name): it was a hot ticket at the olympics a few years ago (London, maybe?). I’ve used it before, for minor tweaks and sore spots. I see others at the gym doing it. Patients of mine ask about it. Professionals (hi PTs!) do it. Theoretically, kinesio taping is supposted to increase blood and lymph flow by lifting the skin— this isn’t the same as traditional athletic taping, which is meant to create stability. Because I’m a science person, I’m immediately skeptical of a claim without evidence, even if it seems generally sane.

So, let’s ask: Kinesio tape. Is it safe? Does it do anything? Should I cover myself in multi-colored tape before my next workout?
taped up and ready to run.

why yes, my KT tape does match my skoras, than you for noticing.

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Running, Thrills, and Awesome

It’s THRILLING to accomplish something you weren’t certain you could do. For all the babble out there and instagram quotes about comfort zones and breakthroughs and whatnot, that central truth remains. And to accomplish something you aren’t certain you can do, you have to, well, do something you aren’t sure you can do. For people who are risk-averse creatures of habit, this can be a huge leap— but so, so worth it. There are roller-coaster thrills, and then there are life-changing thrills. On the roller coaster, you know you’re on there for five minutes and everything’s been safety-checked. For the other kind, there’s no net— you don’t know what will happen.

Last weekend, I ran a Ragnar Relay with my sister and a bunch of other lawyers.

the van

what could go wrong?

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