Deer Run

I went out for a run in our neighborhood this morning. It was a beautiful summer day.

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As usual, I spotted many deer along the way. But unlike before, where they were too fast and scurried away before I get close, this time they seem to stand still and let me take their photo.

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There’s even two in one shot.

IMG_5206Also a mother and her fawn.

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Even the rabbits were not bounding away, as I was approaching.

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I even stopped to smell the flowers.

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Or maybe taking photos was just my excuse to stop and take a breather, in completing my 5-mile run.

And here’s one deer that even crossed my path. I was able to capture it in action.

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Just like the slogan of John Deere: nothing runs like a deer. Have a good day!

(*photos taken with an iPhone)

Out of Shape

The other day, one of my partners requested me to supervise a cardiopulmonary exercise test (CPET) that he ordered on a patient that he saw in our clinic. Since I would be in the hospital all day that particular day, and the exercise test would be done in a lab in the hospital anyway, so I obliged.

CPET is usually a test that we request if the cause of shortness of breath remains unclear even after initial evaluation. Most of the time when we request a CPET, we have already done lung imaging (like a chest x-ray), a pulmonary function test, and basic heart evaluation to rule out gross cardiac problems. Definitely we don’t want a patient having a heart attack and keeling over while we are performing the test.

During CPET, a patients walks/runs on a treadmill or pedals on a stationary bike, while having all these body monitors to measure the heart rate, blood pressure, and oxygen saturation level. Then they also wear a mask, like the super villain Bane in the Batman movie, that is attached to a breath analyzer where we measure not alcohol content, but the volume and gas content (oxygen and carbon dioxide) of the air they inhale and exhale. At the peak of the exercise, we also draw a blood sample to measure the level of oxygen, carbon dioxide, and lactic acid. We may not be experimenting on Captain America, but it is an intense test regardless.

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cardiopulmonary exercise test (image from BMJ journal)

By the way, lactic acid is a byproduct of “overstressed” metabolism. It is produced when there’s not enough oxygen supply to the contracting muscles, so the muscle switched from aerobic to anaerobic metabolism. The build up of lactic acid in the muscles is one of the cause of having pain in your muscles few hours or few days after a viogorous exercise. I hope I am not bringing back bad memories from your high school physiology teacher.

The exercise test is usually ended in several possible ways: a patient cannot exercise anymore due to exhaustion, or we have achieved the maximum target heart rate (which is: 220 minus patient’s age), or we have reached the end of the designed exercise protocol, or the patient developed an alarming symptom, like severe chest pain.

The information we gather in this test help us delineate what is the limiting factor causing the shortness of breath, whether it is a heart problem, a lung problem, a muscle problem, or plain deconditioning. Sometimes elite athletes undergo this test to gain data on how they can improve their performance. I’m sure Gatorade lab performs lots of this.

Perhaps the most common diagnosis we reach considering the group of patients we deal with, is deconditioning, or in simple term, being out of shape. Definitely this is a scientific way, albeit expensive, to say to a patient that he is too lazy or is too fat.

The duration of the CPET is mostly less than 15 minutes, and with our patient population, it rarely last more than 10 minutes. Not a big deal for me to supervise the test, as it is short and quick.

I was busy that day so I was not able to look beforehand at the chart of the patient whose CPET I would supervise. What I just know was the time I needed to show up in the lab, the name of the patient, and his age.

I knew that the patient was in his early 50’s, a couple of years older than me. Even before meeting the patient, I already have a diagnosis in mind, as I was expecting a middle-aged man who is overweight, maybe a couch potato, and perhaps cannot accept the fact that he is way out of shape, and instead blames something is wrong with him, thus we are doing this CPET. Since I have a few half-marathons under my belt, I thought I could show him how to “exercise.”

When I came to the lab, I met our patient who was already sitting on the stationary bike. He looked fairly trim, and to be honest, he looks younger than his age. I introduced myself and explained the test that we will administer.

To get some idea of his condition, I asked him about his symptoms. He told me that he felt this “disproportionate” shortness of breath when he is running.

Sensing that he is a “runner” like me, I asked if the shortness of breath happens early, or during the latter part of his run. He answered that he experienced this shortness of breath relatively “early” in his run. I asked him then to be more specific, like how many minutes after he started his run.

Then he said, “I have this ‘unusual’ shortness of breath after running 20 to 25 miles.”

What?! Who considers 25 miles as early? Most people are not short of breath, but may not be even breathing at that point!

That’s when I learned that he was an ultra-marathoner, and runs 50 to 100 miles or more when he competes. He said that after 25 miles of running, he usually catches his “second wind” and feels good the rest of the way through.

All my preconceived notion flew out the window. Life is never short of surprises. Another lesson learned. Never assume.

I just told the lab staff to commence the exercise, and brace for a long, long test.

Slow Run

It’s summer here in our place. Well, not quite officially, as the summer solstice is not until June 21 which marks the official start of summer in the northern hemisphere. Yet the mercury is rising, as our high temperature for the past few days and the coming week will be in the 90’s to even reaching 100 º F.

But this morning, it was a comfortable 74 º F, so I went out for a run. It is also about this time of year that I should start preparing for the half marathon, if I should decide to join again this coming fall.

As I was approaching the small pond in my running route, I have to stop and let the family of geese get off the road before I could pass. The mother goose was already hissing at me as I was approaching them. They can be very territorial you know. But that’s fine, I can share the road with them, and I have no plans on swimming in their pond.


When I came to the wooded areas, I also saw a deer. But it bounded quickly away before I could take out my phone out of my pocket to take a photo. It might be sneering at me that I am too slow.

Same thing happened when I came to an area where a couple of wild rabbits were on the side of the road foraging for food. They also scurried away at the sound of my slow feet, before I can get near them. They may also laughing at me for being slow.

I admit, I am getting slower. Maybe my age is catching up on me. I have no match for the swiftness of the deer and the hare. They seem to dash so effortlessly and yet so gracefully. While me, I push for every step of my way to get to a pace that runners would even consider “running.”

Maybe all of us can relate in one way or another, and in different endeavors, that we feel we are no match to the “competition” we are going against. Whether it be in sports, or in school, or in our work, and in life in general.

Then as I was fighting my way uphill, I saw this guy.


Yes, that is a snapping turtle. And I was “quick” enough to take a photo of him.

They are called snapping turtles not because they snap their fingers as they go, rather they have the ability to snap, as in bite an attacker. That’s why I kept my distance.

The pond, or any body of water that I know in this area, was hundreds of meters away. I don’t know how long it would take him to get there, if that was where he was heading. But I’m sure his slow pace does not stop him from continuing, for that’s who he is.

It gave me a good insight for the day.  Life they say could be like a race. But it is not always for the swift, but to those who kept on running.

 

Hagibis

Ako’y tumakbo kaninang umaga,

Sa amin dito sa Iowa,

Habang humahangos sa daan,

Ay aking pinakikinggan,

Maiingay na halakhak,

Ng mga ibong taratitat,

At sa aking paghingal,

Aking namang nalalanghap,

Ang mabangong halimuyak,

Ng mga bulaklak ng lilac.

Pero miss na miss ko na,

Mag-jogging sa Maynila,

Kung saan naghaharana,

Mga traysikel na umaarangkada,

At aking muling masasanghap,

Usok ng tambutsong kay sarap,

At takbo ko’y lalong bumibilis,

Parang anak ni Hagibis,

Dahil ako’y hinahabol,

Ng mga asong nauulol.

(*Hagibis means speed in Tagalog, it is also a Filipino comics hero, and the name of an all-male pop group.)

 

A Gray Day to Run a Marathon

It was time for my annual participation for the half marathon. As always, I can’t run without taking photos. I could have played Pokemon Go and capture Pokemon creatures too, but I settled in just capturing pictures.

It was a foggy and an overcast morning. Though for runners, there’s no “bad” day to run. As you can see, hundreds of runners showed up on race day. Here we are waiting for the run to start.

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And here we go! Crossing the official Starting Line.

img_3577Weaving our way through downtown Des Moines.

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Passing the Pappajohn’s Sculpture Park.

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We’re away from the downtown buildings now. The visibility remained a few hundred yards due to the fog, as shown below.

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Circling around a lake. Where’s the lake you may ask? I know you can’t see it, but just believe me, that’s a lake.

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Crossing a foot bridge in Gray’s Lake. It was really gray indeed!

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Even if it’s foggy and cool, we need to keep hydrated. Below are the paper cups thrown aside by the runners just past the water station.

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Running around the Capitol building. The golden dome is barely visible due to the fog. It was about this time that I felt my legs starting to cramp. So I started to intermittently walk and run.

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I almost crawled the last (13th) mile. But to look good for the spectators at the finish line, I ran fast for the final 0.2 to 0.3 miles to the Finish Line. As they always say, finish strong! Even if it just for a show.

Finally, me approaching the Finish Line! Look, a medical personnel is waiting.

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(*all photos were taken by me, except for the last photo which was taken by my wife)

Harvest Time

This morning I went for a long run, in preparation for the half-marathon that I would be participating in. The event would be in 2 weeks.

My long runs have been getting longer, and sometimes it can be tedious and boring. Maybe I should play Pokemon Go while I run to make it more exciting, and capture those fleeting critters.

I did not capture a Pokemon, but I captured these photos while I was running:

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Yes, it is harvest time in this part of the world I’m living in. The fields are golden brown, the days are getting shorter, and the wind is getting colder.

In this particular field, they were harvesting corn.

Why are they harvesting corn? Because they sow corn! Shouldn’t it be that way, we harvest what we sow?

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Maybe some cynics out there may disagree with me, for I know we are living in a world where so much injustice abound. People seems to reap what they did not sow, or have been harvesting in fields that are not theirs.

In my home country, we even have a proverb for that: Ako ang nagtanim, ako ang nagbayo, ako ang nagsaing, pero iba ang kumain.

Loosely translated, it says, I was the one who planted, I pounded, and I cooked, but somebody else ate it.

Yet I still believe in justice.

Lady Justice may seems to be blindfolded (I don’t know why it is portrayed that way) to the unjustness and repression happening all around us. And I’m not blind to that. But I know it as a fact that in the end, justice will be served.

That day of reckoning will come to all of us, when we will harvest what we sow.

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(*photos taken with an iPhone)

Purple Crown and Thorns

(I know Prince’s untimely death has hugged the news in the past several weeks and many people wrote articles with “purple” theme, but this post has nothing to do with Prince.)

There are things in this world that are unwanted.

When I went out for my morning run today, I came near a pond and a large mother goose was standing at the middle of the road. Nearby is her family. The protective mother goose stared and hissed at me. I was an unwanted guest.

I went slowly and timidly, as far as I can on the other side of the road, so not to agitate the goose further. After I passed them, they quietly slipped into the water and swam away.

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Not long thereafter, another bird, an aggressive red-winged blackbird hovered wildly above me. It made repeated dives on my head while chirping loudly. I think she has a nest nearby, and she’s telling me to go away. Definitely I was unwelcome there.

I probably would do that too, if an intruder whose intention I am not sure, would go near my family.

But there are other things that are unwanted and unwelcome, which we try to get rid of. Like weeds and thistles from our lawn and garden.

Back to this morning run, after my confrontation with the goose and the blackbird, I went out to the lonely gravel road to continue on my run, where I have not been for a while. There I noticed this purple thistle at the side of the road.

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I did not know that this weed, can grow this tall, as the moment we see it in our garden, we pull them out immediately. I did not know as well that it can produce beautiful purple flowers. Thorny yet exquisite.

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thorny crowns

This weed is known as the milk thistle (scientific name: Sylibum marianum). It was named such due to the milky sap that the plant produce when cut. It is native to the Mediterranean, but is now found throughout the world.

It is not just in the manicured lawns and gardens that it is unwanted. Even in prairies and pasture land where cattle roam and graze, farmers try to eradicate them, as they are considered noxious weed. The reason is it can be toxic to cattle, sheep and other livestocks, if they eat them.

So most of the time, this purple weed is left to grow only on the side of lonesome roads, or in wild, forsaken places. An outcast, if you will.

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But I will argue that despite being unwanted by most of the world, it survives. Defiantly existing to show its beauty for anyone who would stop and appreciate. It has spiny-edged leaves, prickly stems, thorny crowns, yet colorful blooms.

My little research also tells me that this thistle even though it is toxic to cattle and other ruminants, it is perfectly edible and safe to humans, provided we don’t eat the thorns. There’s even studies to suggest that it has medicinal property, like treatment for liver diseases, and also been looked at to treat cancer.

An unwanted and lowly prickly thistle. Yet there’s beauty and purpose for its existence. Just like many other things in our lives.

I know you have an annoying classmate or officemate that you wish would migrate to the moon. Or you have unwanted daily tasks that you wish you don’t have to deal with. Or you experience thorn-on-the-side everyday challenges that you hope to live without. And the list of “unwanted” things go on and on.

Yet they exist for a reason. We just have to look a little closer.

(*photos taken with an iPhone)

 

Zen Moment

In our breakneck-pace, sink-or-swim busy schedule, we badly need some time to exhale and relax. We need to find our zen moment.

Different people have different ways to unwind and rejuvenate. There are some who would spend some time in a spa and be pampered. There are some who would go for a hike in the woods or climb a mountain. There are some who would watch a movie. There are some who will go to a mall. Zen shopping? While some would just sit and do nothing. And I mean nothing, as if staring blankly in space, like a frozen computer screen. I know, I do that sometimes.

Another favorite way of unwinding for me is my Sunday easy morning run of 2-3 miles where I just go on a slower pace than my usual, and commune with the wind, the lonely road, and nature. I would say that many of my creative thoughts come during this runs. I guess mild brain hypoxia can generate a stroke of genius.

Then there’s my wife. She will put on comfy clothes. She will go outside to be alone with the elements. She has her portable speaker playing her zen-type of music softly in the background. While she is on her hands and knees……….pulling weeds.

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(*photo taken with an iPhone)

Turkey Run

Here in the US, there are two occasions in a year, that people are strongly compelled to exercise. During these times there is a considerable spike in gym attendance. This is based at least in my observation and purely my opinion only.

The first one is during early January, when everybody is jumping on the band wagon for the New Year’s resolution to exercise, lose weight, and join the gym. However by the end of January, some if not most of them, have already fallen off the wagon.

The second occasion is right after Thanksgiving, when many are feeling guilty they over ate during the holiday. According to one study, an average American will gobble 3000 calories during Thanksgiving dinner. But with all the snacking throughout the day, it can easily amount to 4500 calories in that day alone.

Some will reason that they can burn all those calories when they go shopping on Black Friday. However, unless you go jumping rope while shopping or you’re hauling or carrying a piano, the amount of calories burned is not even close.

One exercise physiologist estimated that in order for a 160-pound person to burn 3000 calories, he has to walk 30 miles. Or if you want to burn them faster, you can run. For 4 hours!

So this weekend, I avoided the gym altogether since I know it will jam-packed. This morning, I decided to run outside instead.

The problem is during this season, in this part of the world, it is already pretty cold. In fact, we already had snow and freezing rain this past week. Today is no different, the temperature was subfreezing.

Good thing is that I have invested on nifty cold-weather running apparel that I can be warm and toasty even if the temperature is below freezing. So I layered up, summon the spirit of the Black Ninja runner  (see previous post), and ran.

I was a little chilly when I started but by the second mile, I was already feeling warm that I took off the hood from my head. By the third mile, I already unzipped my outer layer. I ended my run after 4 miles, and I was all sweaty and hot that I even took off my jacket, at least temporarily, as I was walking to cool down.

I checked on my smart phone, and the temperature was a nippy 29º F (-2º C).

I believe my run will partly burn off all the turkey I ate. Though I still have to burn all the kare-kare* and krema de fruta*, which were what I really feasted on during the Thanksgiving dinner.

Now I’m feeling hungry. Where’s the left over kare-kare?

(*traditional Filipino dishes)

Not Running

The annual Des Moines Marathon is less than 3 weeks away. And I am in no close form to run it.

For the past 5 years, I participated in this yearly event, running the half-marathon (13.1 miles). This year I learned that a classmate of mine from medical school who is also now living in the US, but in another state, is participating in this run. Even out-of-towners are joining this event, not to mention some elite runners as well.

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(photo taken during Des Moines Marathon 2013)

Participating in this annual race keeps me committed on my running and hopefully this keeps me fit and healthy, which is the ultimate goal anyway.

I know it is not hard to find a hundred reasons to stop running and it is so easy to fall off the wagon, and stop exercising at all. Doing this half-marathon at least once a year keeps me motivated. Or unable to button my pants, or an innocent yet honest remark from my kids about my bulging belly, will also do the same.

If I follow the running gurus’ advice, like the Hal Higdon’s training schedule (click here) on how to prepare for the half marathon, my long runs should be at least 8 to 10 miles by this time. Adhering to these recommended training schedules assure you that you cross the finish line on race day without killing yourself. But I loosely follow those schedules anyway.

Yet, even if I am not on track in my training for the half-marathon, there’s no urgency for me to train hard. The truth is I was not even training at all. I have not run a distance of more than 3 miles for the past couple of months. I am indeed slacking.

Why? Have I lost the motivation? Have I resigned and accept my bulging midsection? Not at all!

About 3 months ago, I learned that on the weekend of the scheduled Des Moines Marathon is the date that my kids will have their piano competition. And I will not miss the world for that. So we will be out-of-town at that time, and thus I cannot do the run.

So I forgo on my training.

However last Sunday, just to challenge myself, I push to run 5 miles in less than an hour, and I felt good about it. Next weekend, if I can run 7 or 8 miles, then it is as if I am ready to run the half marathon, even if I am not doing it.

Just because.