Losing a Patient

I take care of patients with complicated medical illnesses.  Unfortunately, that means that occasionally my patients pass away.

One of my patients died a few mornings ago.

I met him in February.  He was an engineer and inventor, one of the brightest people I've ever met.  He had right heart failure, and was one of the few patients who knew why I look so closely at a patient's neck.

"How's my angle of Louis?" he would often ask as I looked at his neck veins to assess his right heart pressure.

He was one of my more talkative patients.  He would talk about science, research, often things that were a bit over my head.  He was dutifully compliant with his medications and kept meticulous records, though he occasionally indulged in foods higher in salt, which led to occasional decompensation of his heart failure.

He read my blog, because he'd ask me about my races and comment on my posts.  In particular, I remember him being very curious about my experience with supraventricular tachycardia and my ablation earlier this year.  I think he even posted an anonymous comment about my "ablative cardioversion".

I was also fortunate to have the connection of my medical school advisor being one of his closest friends.  He invited me to his home for lunch, which gave me the opportunity to reunite with my former advisor.  Seeing his home gave me more insight into who he was as a person and as an inventor.

But, it was ultimately other health issues that took their toll.  A compression fracture caused terrible back pain.  Cognitively, I could see him declining as he became less intellectual and less talkative at his more recent visits.  Most recently, swallowing became difficult for him and he was hospitalized due to aspiration into his lungs.

He was discharged home and passed away two days later.

He's a unique man who definitely left an impression.

Athlete Cookies

My friend Gail competed as part of a relay team for the San Diego Triathlon, to benefit the Challenged Athletes Foundation. She offered to make cookies for anyone who sponsored her $100. I took her up on the offer, and challenged her to make vegan cookies. Here they are, and they are very funny!!

From left to right, these are in honor of my best 5K race, my best marathon, and my most recent marathon which I ran in costume.

Clockwise from the top, these commemorate Santa Barbara Long Course triathlon with its chilly ocean swim, California International Marathon, and the New Moon Century ride.

These cookies are for Wildflower Long Course triathlon and Vineman 70.3, the two half-ironman distance races that I completed this year.

Running as Supergirl

I thought seriously about whether to post my marathon pictures on the blog. As a cardiologist, I have a certain image to maintain.

But, the more I thought about it, the more I thought that being Supergirl for a race was something I wanted to share. Fitness has to be fun, and I think that this experience reflects that. If exercise was always serious and always hard-core, we would burn out, a lesson that I've learned over the past few months of training.

So here are a few pictures from my race. Through the wind and cold, I had much more fun running as a superhero than I would have otherwise.

CIM Marathon

Today was the CIM Marathon in Sacramento.  I've been doing more cross training and a lot less running, and I wasn't sure what to expect from my legs or how long it would take me to finish.

I chose to run with the 4 hour and 15 minute goal time group.  My last marathon seven weeks ago, that I was far better trained for, was a 4:12 finishing time.

But, for the first time ever, I ran the marathon in costume, as Supergirl.  Complete with a cape.  The day was cold and windy, so the long sleeves of the costume and the cape worked well to keep me warm.

Self-portrait with my camera.  Better picture coming soon, hopefully.

At the start of the race, it was 29 degrees and maybe by the end the temperature was in the mid-40's. I started with the 4:15 pace group. Our leaders, Lisa and Mike, definitely made the running eperience unique. They had us shaking out our arms and fingers every couple of miles. It seemed silly, but they kept saying, "You'll thank us at mile 20", and yes they were right, it kept our upper body loose. They instructed us to take the tight turns on the course so that we limited the distance that we were running.

I felt good at mile 4, so I broke away from the group and went ahead. A few miles later, I stopped to use the restroom and the group caught up with me around mile 8.

The winds were strong and made running far more challenging. Our pace leaders told us to "tuck in" and run closer together to try to shield the wind. It helped a bit, but the cold and the wind definitely took their toll. With wind, there is more fluid loss, so I was mindful to drink as much as possible.

I pulled ahead of the pace group again at mile 12, and they caught me at mile 14. Lisa, one of the pace leaders said, "We caught up with Supergirl!" Part of me thought she was taunting me for thinking I could pull ahead.

I stayed with the group through mile 21 I needed that group support, positive energy, and shielding from the wind. It took everything in my being to keep up with them and not drop off.

At the water stop at mile 21, I choked on my cup of water, and as I choked, the group ran by. I tried to keep them in sight, but they kept getting farther and farther away.

Dressing as Supergirl definitely has its advantage in crowd support. Lots of people yelled, "Go Superwoman!" "Go Supergirl!" It really helped push me forward. But, my mile splits dropped below ten minutes. I felt tired. But I kept going. Three miles left. Two miles left. One mile. And then a strong finish. Even the announcer yelled for Supergirl!

My finish time:  4 hours, 16 minutes, thirty seconds.  That's about three and a half minutes slower than my time seven weeks ago at Long Beach, when I was training harder.  I'm proud of my time, and I had fun along the way.