weighing in.

Quick, how much do you weigh? How many calories have you consumed today? What do you see when you look in the mirror?

If you're a woman, you likely know the answersto the first two questions. As for the third, that's between you and your reflection. But as someone who has paid particular attention to the first two for years, I feel the need to comment. I realized how far I'd come when my roommate was talking about how she's gained 5 lbs and is upset, etc. I asked her how her clothes fit, and said that numbers mean nothing, that how your clothes fit and how you feel is a much better barometer of health.

I wasnt always like this, believe me. In college I was part of a sorority that was known for its "pretty" girls - although we also had the highest GPA year after year, but somehow that paled when compared to our looks. Was there pressure to look good? Of course, but I think that was prevalent on the whole campus. I will say, though, that I went from a size 10/12 to a size 2 in less than a year, and hollowed out my bagels for the remainder of college. It was years before I ate a full bagel, with the insides NOT scooped out. I never met the criteria for an eating disorder, but I definitely had disordered eating. But then again, so did every one of my friends. Unfortunately, this continued for years, although to a lesser degree as time went on.

The past few years have been great for me. I love North Carolina, I feel like I am finally finding my way (most of the time), and I feel healthy. But the 8 or so months has been the most transformative.

When I made the choice to train for the triathlon, I knew that I would have to give up much of my restrictions on various foods. I knew that I would have to eat more to sustain that level of activity. But in my heart, I knew it was the right choice for me. And so I ate. I ate peanut butter, nuts and grains, fats, carbs -- and started training. And lo and behold, my weight has evened out and I honestly, honestly, honestly, don't think about what I eat to the degree that I did. My main focus is getting the nutrients I need for my workout and training schedule. And since I have started training, have I gained weight? I honestly don't know the answer. I make the conscious choice not to weigh myself; I don't even have a scale. I know that muscle weighs more than fat, and I have been lifting weights and training and building muscle. I know that I look leaner. But I also look powerful and athletic. At least, I think I do. I wear tight yoga pants and crops to the gym because I know that I'll bust out with a 20 mile bike ride there and feel good about my body as I walk back to the locker room. Standing in front of the mirror in the weight area, my focus isn't on my hips; it's on my biceps as I curl the weights, seeing visible muscles contracting.

And if someone doesn't like what they see? Too bad for them. I'll kick their butt at the finish line.

Is this simply a product of getting older and maturing? Maybe. Is this a product of training for an endurance sport that I never dreamed I would do? Maybe. Or maybe it was simply time to stop wasting brain power and energy on fitting into a number, on fitting into what the beauty myth dictated I should be. Seriously. How much energy are women putting into getting thinner, when they could be thinking of ways to cure ALS? Or help little kids? Or succeed at their schoolwork?

It's not easy. I know this. But I also know that the rewards are sweeter than any number on the scale or size jeans you fit into.

oh, Manhattan...here we are again.

I was looking through some old writing of mine, and found an entry from October 2007, right after I found out I would be interning at MSKCC that coming summer. It took my breath away, because reading it, I could feel how excited I was to return to Manhattan. And if I really thought about it and admitted it, as much as I love Chapel Hill, I do miss Manhattan. If I were offered the right job, I would move back. Here's what I wrote:

....I just got an internship in nyc for the summer, which I am SO psyched about, but now I am wondering where I will live...maybe I just need to chill about that for now, and simply enjoy the fact that I got my dream internship at my dream job place, and I will be in the city I love for 8 weeks, doing what I love. I can go to Crumbs and Magnolia and Bloomingdales and Scoop and Searle, and Barnes & Noble in Lincoln Center and walk down Central Park West and people-watch at Columbus Circle and walk around the village and eat falafel and subway hop and go to Dylan's Candy Bar and The Ginger Man. I can complain about how crowded the 6 is and how sweaty NY summers are. I can walk around Soho on a Sunday and play in the Apple store and try perfumes at Sephora and browse for things for my nephew at the Scholastic store. I can peruse the magazines at the awesome newsstand near my old place in Morningside Heights and go to Duane Reade at 2am if I want to. I can order groceries from Fresh Direct and get bubble tea on the Upper West Side. I can walk around amongst the noises of the city and traffic and people and life and feel like I am in the heart of the world, the blood flowing through my veins so loud I can hear it, like there's no other place that matters. I can't wait.

Reading that, can't you just feel how much I love that city? How much that place also feels like home? I never had to "get used" to New York. When I first moved there to go to Columbia, it felt like home. I was never nervous about wandering the city or subways, and it felt filled with endless possibilities. I still feel that way about it. I thrive on the anonymity there. Funny, because here in Chapel Hill, especially in my neighborhood, it's impossible to be anonymous. I guess there are some places that will always feel like home to us. For me, it's Manhattan, Chapel Hill and Israel. When I left Israel, I was - and still am - homesick, on a visceral and spiritual level.

Anyway. I guess what also triggered this was I found some old papers from Teachers College (Columbia) about Nursing Education/Exercise Physiology/Health Education programs there. I don't know why I kept them....but I did. hmmm.....

Bondi Bands and other stuff.

So....I've been hearing a lot about Bondi Bands. They're lycra bands that soak up sweat and keep your hair out of your face. They're relatively cheap ($8) and come in lots of colors, patterns, and sayings.

These are some of the Bondi Bands I am in love with! And the cupcake one is so true.

I volunteered today with race registration for the "Four on the Fourth" race tomorrow, and for maybe the first time in my life, I wished I was running those 4 miles. I cannot wait to get back running. The elliptical machine is NOT the same. You have no idea how much you use your feet until something happens. I haven't walked without discomfort or thinking about it since March. Sometimes I feel like Bambi, when he starts to stand for the first time and is all wobbly. I feel like I still walk very gingerly and with intention; I overthink it in order to not hurt myself. It gets frustrating and discouraging. How on earth did I think I would be running by June? It's now July and....I tried jogging a few steps in my kitchen to try out my new Asics, and yeah, it's not happening. Pain stopped me real quick. *sigh*.

I do like going to the gym though. It makes me feel like an athlete still. Sometimes the gym feels like the only place that makes any sense lately. The one place where I feel good at something. School is still difficult; I am wondering if I can successfully make the switch from social sciences to the hard sciences. These aren't things I can rationally think through and come to an answer; it's a lot of memorization and facts. I can't feel my way through it. It's fascinating and intriguing, but hard as hell. And like I've said before, for someone who has been good at school her whole life, to suddenly have this be a place where I struggle, is hard. I like being a part of Team UNC Wellness, though, and getting all the member emails, volunteer opportunities and monthly meetings. Who knows, maybe sports will enter my life in a bigger way in the future.

orthopedic blues.

So...the rehab journey continues. I saw the orthopedic surgeon on Friday, a week and a half earlier than I was supposed to, because I thought I had a stress fracture in my 5th metatarsal. It hurt alongside the lateral portion of my foot when I walked, and since I've been supinating on that foot since the surgery, I thought I overdid it and stressed the bone. According to x-rays done yesterday, I did not. While that is good news, I also know that stress fractures may not show up on x-rays for a few weeks. But he doesn't seem to think it's a fracture. He thinks that tendons along the bottom of my foot are overcompensating for the way I'm walking and pulling the 4th and 5th metatarsals and causing strain and pain. So he wanted me to go to Fleet Feet, a specialty running store here in Carrboro, and get fitted for a shoe that has a wide toe box, adequate support on my arch to take the pressure off my metatarsals, and cushioning. Well, they were awesome. They measured my foot, took notice where my arches fell, watched me walk barefoot up and down, and brought out a bunch of shoes for me to try. I ended up with a pair of Asics Gel-Nimbus 12s. These babies are sweet. Stable, cushiony, just excellent. I haven't worn Asics since middle school. But these might change me.

However. And there is a big however......my surgeon also told me that I cannot run for at least another 6 weeks, until my next visit with him. Again, my eyes started tearing up. He said it won't be until well into the fall that I will be running seriously. I asked if he thought I'd be able to do the triathlon in October, and at first he said he didn't know. But then he asked the distance, and thought about it, and said maybe. I will crawl across that finish line if I have to. He told me not to forget I am still in the recovery phase, and will be for a while. After all, in addition to breaking the first metatarsal, they rearranged tendons, ligaments and moved a joint. Soft tissue takes longer to heal, with the nerves, etc. *sigh*. Now I know why my rehab from the last bunion surgery wasn't as long or involved. I don't think I was expecting this. He did say I can still swim, bike, and do the elliptical. He also said I can start walking more. But not power walking on the treadmill. Again, *sigh*.

umm....fact check.

So, I was reading people.com and stumbled across Elizabeth Edwards' interview. Apparently her cancer has metastasized more, with tumors in her legs, spine and skull. Breast cancer most often metastasizes to the bones, brain, lungs or liver. But what got me was what she said...."It's less frightening than you think; it can't migrate to your brain." I am hoping she meant literally move from the skull to the brain, because breast cancer can certainly metastasize to your brain. I have had the good fortune to meet this woman, and she is really lovely. She is an amazing woman, and I am sad to hear that she has more bone mets. I actually think she gets treatment here at UNC.

treated to death.

I have talked ad nauseum about hospice, end-of-life care and death with my friend Carolyn, and today I came across an article that was so wonderful. And it talked about many of the things she and I have discussed. Namely, Americans are being treated for incurable cancers til right before they die, rather than having those hard conversations with their doctors and urged to pursue hospice or palliative care. And many of those patients suffer and experience pain, and do not get to live their days out like they would have liked. They cited that 12 percent of patients who died from cancer in 1999 received chemo in the 2 weeks before they died. The article mentioned that Americans use sports and war metaphors in dealing with disease and cancer, instead of talking about death and how it is a natural part of life.

I have seen this myself. I saw how my grandfather was treated, time and time again for his mesothelioma and lung cancer, though we knew it wasn't making much of a difference. He got his chemo treatments, his Procrit, lost a ton of weight, lost his bowels and bladder in public, and in the process, lost his dignity and enjoyment of life. I was living in Florida at the time, and had a feeling he wasn't going to live til Thanksgiving, when I was slated to come up to NJ next, so I flew up Halloween weekend, after not seeing him since July. He was a shell of who he had been. He was just put on hospice, after years of treatment. He could barely eat, could barely drink, could barely breathe. He had moments of lucidity and moments of....well, it wasn't delirium, but it definitely was some sort of supernatural end-of-life thing. We talked about how he was "watching the wind" because he "couldn't go" until it was a certain way. Make of that what you will. It wasn't until he was on hospice that he finally got permission to relax and let go. I left that Sunday to fly back to FL; he died the following Saturday. He was on hospice for little more than a week. This isn't too far from the national average for hospice stays.

He missed so much because he was sick. He was too sick to go to my college graduation. He was in and out of care facilities. The day before I moved to FL, we had to take him to the hospital because his lungs were filling up with fluid. In my heart, I know it could have gone down a totally different way.

So when do doctors, nurses and nurse practitioners talk to their patients? How do we get the point across that palliative and hospice care isn't "giving up"? How do we convey that it's a way for the person to enjoy their life and the time they have left, rather than missing out on family gatherings, Christmas dinners and seeing their grandchildren? How do we admit that the treatment they are on might not be working, or may be of minimal value when compared to the painful side effects? There is no easy way. I know this as someone who has provided counseling to cancer patients, some of whom really needed help talking to their family about death. I know this as a health researcher, a patient advocate and a family member. It is not an easy set of conversations to have, and each person has to make a personal choice that is right for them at that time.

People may see it as "giving up hope", but I don't think it is. I think it is merely a shift in what we are hoping for. Let's hope for days free of crippling fatigue and vomiting. Let's hope for being healthy enough for holidays, or trips to places you've always wanted to go. Let's hope for quality time with loved ones and friends, days where honesty is spoken and we say everything we need to. We can hope for living life, not just prolonging survival.

KT Tape, where have you been all my life?

Some uses of KT tape.

Different colors of KT Tape. I'm partial to pink, myself.

I recently came across this kinesiology tape called KT Tape, and I love it. Kinesiology tape is flexible tape that can be used to support and stabilize tendons, muscles and ligaments. It can help prevent injury and speed recovery, and can be worn during any activity, even swimming, for days at a time. I've gotten back into tri training, biking, swimming and doing the elliptical, as well as lifting upper body weights, and maybe it's my nearly-30-year-old body, but my knees are a little achy. Although, my orthopedic surgeon also said that foot problems can throw off the alignment of the knees and hips.....so maybe my foot problems are why I wear the patellar tendonitis bands when I run. Or, uh, ran.

Anyway, this KT Tape is magic. Seriously. And it comes in pink! I apply it to my knee in the prescribed pattern, and it really does alleviate soreness and provide support. I love it.

learning to walk.

I finally got my air cast off on Monday! I had a feeling I would, and I was planning on going to the gym afterward. At my appointment, the surgeon told me that I was NOT to get on the treadmill and run -- or even walk -- because I could snap the metatarsal, as it is still healing and building bone. Daily activities are fine, but prolonged, excessive walking is not. He said I'll be running by fall, and like a little child, I could feel my eyes tearing up and exclaimed, "But you said I'd be running by July!" He said that in 4 weeks, after my next appointment, we could re-evaluate after looking at new X-rays. So needless to say, I've been continuing swimming, and added biking and the elliptical, as well as upper body weight lifting to my routine.

But there's the little problem of walking. I cannot flex my toes so much; this is normal due to the realigning of the tendons and ligaments. Soft tissue heals much slower than bones, and the nerves are rebuilding themselves. So walking is interesting. I cannot flex my foot and push off the ball of my foot with my left foot. So I end up walking/somewhat limping sort of slowly and overcompensating on my right side. Sometimes it's more pronounced than others, and I get self-conscious about it, because it's not apparent to everyone that I had foot surgery; I just look like I'm walking weird. So I am, essentially, learning to walk all over again. Talk about a metaphor, huh?

In the locker room today, there was a little girl changing next to her mom, and the little girl's locker was next to mine. I had just finished my workout, and the girl started talking to me. She was probably 5 or 6 years old, maybe 7, and she had Down syndrome. She reached into my locker and started playing with the lock, while her mother admonished her and I reassured the mom it was okay for her to touch it. The little girl started telling me about how she's changing back into her clothes because they're going out to dinner, and how much she loves pizza and cookies. I agreed that pizza and cookies sounded pretty good, and I love pizza. I bent down to take my shoes off, and the little girl leaned over so our faces were level and she said to me, smiling, "It's a beautiful day today." The sweetness with which she said it brought tears to my eyes and I said, "Yes, it is." As I was leaving, she called after me, "Have a wonderful summer!" That simple exchange made my day.

Delivering Happiness

Hsieh's Book

I received an advance copy of Tony Hsieh's new book, "Delivering Happiness", for me to review on this blog. Hsieh is the CEO of the website Zappos.com, which sells shoes, clothes and accessories. Anyone who's ordered from Zappos knows their exceptional commitment to excellence, the free upgrades to overnight shipping, and their sense of humor. This book tells the story of how Hsieh got involved with Zappos and built it to where it is today, including how he developed the workplace culture there. Initially, I wasn't sure if I would like the book, but Hsieh is so down to earth and unassuming, plus he's funny. He's developed a culture that people love to be a part of, and whose employees take pride in their work and learn more about themselves than they could imagine. Zappos is truly a unique and special place to work, and this book tells the story of the business from the beginning. Even if you're not into business, or never heard of Zappos, pick this book up - it goes on sale today, and it's well worth it! The lessons Hsieh outlines in developing a brand can be applied to life and how you treat others....which may explain the success Zappos has achieved.

Here is a link to the book's website where you can learn more about it, and here is Amazon's website where you can buy the book.

getting in the zone.

Last night was my first UNC Team Wellness multisport club meeting, and the speaker was a sports psychologist. It was a REALLY great meeting, I met new people, and the speaker was amazing. One of the things we talked about was positive self-talk. He said, "There are plenty of people in the world who are willing to beat you up. Don't be one of those people to yourself." And when it came down to it, all of us have doubts. All of us reach that point that our stomachs are churning and we're nervous. Personally, I am nervous every day, with my science classes and training for this thing called a triathlon. I think to myself every single day, in the pool or studying physiology, what the hell am I doing? Why am I doing this? I am terrified. But he said that being scared means you are accepting a challenge, something you've never done before, and that's AWESOME. Give yourself props for accepting a challenge and doing something new. That alone is something to be proud of. Amen, dude.

Granted, this is just a sprint-tri. I'm signing up for the indoor tri in November, and I'd really like to, years down the road, do a half-Ironman or Ironman. I mean, think about it - how amazing is that, to push yourself to the ultimate? Here's a video about it. I thought that everyone would want to do this, but apparently not! I don't know why I'm so intrigued by it, but I am.