Travel Medical Adventures (Warning, Dog Bite Photos)

Hello from the other side of the longest I've gone without blogging since 2003.  I didn't miss it at all, which surprised me.

Tulips on the way into AMS (before our quick hop to CDG)

Given that I've habitually blogged at least once a week for 16 years, I spent some time trying to understand why it was so easy to let it go:

1. I have Instagram and Twitter if I really feel the need to project my words/pictures, and they are faster and easier to use.

2. Over the years, I've gotten less and less dedicated to the actual craft of writing on this blog, *and* I've gotten less and less specific with the details I share. This means the blog has really shrunk down from a general purpose somewhat redacted diary with intermittent writing exercises to more of a running, fitness, travel, food, and reading tracker -- e.g. useful, but not a particularly creative pursuit.

3. I was preparing for and enjoying a 19-day trip, with at least half of it completely off work.  During our Sabbatical year, I blogged about our experiences and observations as part of the fun of the travel.  I built in time to prepare blog posts after each new location, to help me process and record my thoughts while they were fresh before I went to another place. On this vacation, I believe the longest one I've ever taken while working, I really wanted to just focus on enjoying the trip in the moment and minimizing the activities that could feel like work.

Chefchauoen, Morocco -- the blue city

Our original plan had been to fly round trip to Paris (because any chance I can build in a France visit, I will, and also because we weren't sure what might happen with Brexit at the time we booked our flights, so we wanted an option to bail out of England if necessary).  After one night in Paris to manage jet lag, we planned to fly to Morocco and visit Chefchaouen and do some hiking there, followed by a visit to Marrakech and hiking in the Atlas Mountains.  From Marrakech, we had flights to London, where we'd cheer on Jen at the London Marathon, visit London friends, possibly do some hiking in Wales, and then close out the trip with an awesome weekend full of Wiltshire adventures with Jen & Gypsy Runner as guests of Cat and her family and cats.

Roughly our route, except we flew from Fes to Marrakesh

How did we pick Morocco?  Well, I wanted to visit a country we'd never been to, and we wanted to do some hiking.  E had never been to Africa, and we knew we wanted to start in France, which made Morocco an easier option due to its history as a French protectorate and popularity with French-speaking tourists.  Once we decided to go, E's dad decided to come along as well, which made for a fun family trip.

Day 1 hiking, Chefchauoen in the background

Unfortunately, on the first day of hiking, despite having a local guide, I got bit by a dog.  We were on public hiking trails, but the dog's owner had a marijuana farm near the trail and the dog was a bit too territorial.  There were two dogs, actually, a black one that came running at our group towards the guide in the front of our single file line, and a yellow one that came at the back of our line (me).  The dog was loudly and angrily barking and I was oddly calm in the certainty that I was going to get bit.  I chose to keep my back to it, and sure enough, it did quickly nip at my heel, slicing through my wool socks and leggings and then it ran away.  It was a quick sharp slice, and it didn't actually hurt that much.  I was surprised when I pulled my sock down and saw how deep it actually was.  Later, I felt very grateful when I saw the other scrapes on the outside of my calf from the teeth that didn't puncture. Any deeper in the lower part and it would have injured my achilles.  Any deeper up above and it could have seriously injured my calf muscles.  I was very lucky and extremely thankful.

Within 30 seconds of me explaining that I'd been bitten, our guide rinsed it with saline, applied betadine, and wrapped it with gauze.  He then called a jeep to come get us and we went to the hospital, where they cleaned the wound, gave me a tetanus shot in my stomach, prescribed antibiotics, and sent me to the municipality for 2 doses of the rabies vaccine and a card instructing me to get another dose in 7 days and another dose 14 days after that.

I'd already been taking it relatively easy, athletically, on this trip, in the hopes of calming down my pesky left hamstring/glute, but now it appeared that I'd be taking it *very* easy.

2 days post injury

On day 7, I got myself in to see a travel doctor in London, and they informed me that Public Health England disagreed with the regimen that Morocco had prescribed.  They wanted Immunoglobulin injected into the bite site (actually the most painful part of this whole process) as well as vaccinations on day 7, day 10, and day 21.  So, E and I took the train all the way out to Colindale and back to pick up Immunoglobulin and vaccine doses, which we took back to the clinic for evening treatment.  (Side note -- if you ever need treatment for travel-related medical issues in London, Dr. Dawood and the team at the Fleet Street Clinic is for you.  The first travel-clinic I tried shrunk in horror at the idea of post-exposure rabies treatment and sent me to them. They were wonderful.)

Monday's London vacation activities were:

laundry, Dishoom, 

and several hours of medical stuff with lots of public transit

Day 10, instead of staying in the lovely English countryside, we spent about 2 hours going from the adorably named Castle Combe back to Fleet Street Clinic for another vaccination (the vaccines had to be kept refrigerated and administered by someone PHE trusted) and then another 2 hours or so heading back to Wiltshire, where we met up with our friends.

Castle Combe -- does it get any more quaint?

Once back in the US, I called my local travel clinic and learned that the US doesn't agree with either the UK or Morocco about the treatment regime.  So, tomorrow, I'm headed in for my last and final vaccine dose (day 17 instead of 21).

I did do a little bit of hiking and jogging in the last couple of weeks, and it didn't really hurt, but the wound is actually fairly deep and most of those activities seemed to open up the most recently healed areas. So, I'm going to hold off any "training" until it's fully closed up and healed over.  Wish me luck.

2019: Goals

Last year, I didn't have many explicit year-long goals.

The only fitness goal I openly stated was that I wanted to try to improve my fitness to the point where I could run "very good" on the Cooper Test. I didn't even come close (it requires running 8:23/mile for 12 minutes).  My first cooper test of the year was at a 9:34/mile pace.  Over the course of the year, I dropped it down to a 9:16/mile pace.  But, I also decreased my 5K pace over the year down to 9:34 (so my 12 minute best became my almost 30 minute best pace) and I ran an 8:52 minute mile at the end of the year.  Both of these made me happy, as my fitness obviously improved.  Any year where you end the year better than where you started is a good one!

I bought myself Lauren Fleshman's Believe

Training Journal for Christmas

This year, I decided to set some concrete running goals:

1. A sub 1 hour 10K (looking for a good late fall option as the target race, with a few races over the course of the year to inch towards that time)

2. A sub 29 minute 5K (I'm hopeful I can do this sometime this Spring)

3. A sub 8 minute mile (this one is a stretch, so in the meantime I'll be happy with sub 8:30 as a stepping stone by June)

4. Very Good on the Cooper Test (probably not doable unless I can get close to the sub 8 minute mile, but I'll chip away at it)

I'm still scheduling my workout and target race schedule for the first few months of the year, and I'm looking forward to having a few racing opportunities to ratchet down towards these goals and hopefully also see and catch up with some of my running friends.

Example weeks from my food log

(can you spot the two weeks with travel & visitors?)

Another thing I did last year was I labeled my days as red (ate red meat), beige (ate poultry), blue (ate fish/seafood), or white (ate ovo-lacto vegetarian).  If I ate two of the categories, I used the color that was higher in the unhealthy/environmentally damaging order.

Due to the negative health associations and negative environmental impact of red meat, I started last year with a goal of keeping my red days below 1/3 of the total and just observing the other days. About halfway through the year, I realized that achieving this goal would be harder than I assumed.

The story I tell myself is that I eat vegetarian about 75% of the time.  And, when left to my own devices (E & I, eating alone, at home), I definitely did eat vegetarian about 75% of the time, with about 5% of my meals containing poultry and approximately 10% containing red meat, while 10% contained fish.

But, any time we have visitors, or we travel, I end up splurging.  Because I don't really enjoy most poultry, splurging for me generally results in red meat.  It was very easy to see the weeks where we had visitors, or were traveling simply by looking at the color patterns on the spreadsheet.

All in all, I finished out the year with 40% of my days being red (145 days), 8% beige (28 days), 15% blue (54 days), and 36% white (133 days). I definitely eat red meat more often than I thought I did.

Logging by day instead of meal does not give me a great insight into the actual percentage of my meals that contain the various protein sources.  I was insistent on logging any day where I had a piece of bacon or 2 ounces of charcuterie as red, for the sake of honesty.  Also, occasionally, I'd opt for a second serving of red meat on a day when I knew it was already marked red -- the day was blown, so why not indulge even more?  So, this year, I'll continue with the color coding for the frequency imagery, but I'm going to do the actual logging by servings (4 oz), with a half serving for small things like a piece of bacon.

In the interest of my health and the environment, my 2019 food goals are: less than 100 servings of red meat & at least 100 servings of fish/seafood (with a focus on sustainable sources) while maintaining my relatively low poultry intake (and thus getting a majority of my protein and other nutrients from plants, dairy, and eggs).  And, of course, I'll continue to try to eat locally sourced and produced food wherever possible (with the *most* local source, of course, being my garden).

Winter lettuces and veggies -- ready to go into the garden.

If you are interested in learning more about the environmental impacts of food production, I highly recommend this fascinating study.

 

Intermittent Fasting: A Toe In the Water

Forgive me with the title, but I couldn't resist. As my last post showed in the last photo, I have an unexpected toe injury.

It's healing, but I've restricted my physical activity this week in an effort to heal as much as possible (in hopes that I can do the trail 10K I'm already registered for this weekend).

In non-toe-news, I've been thinking of trying a 24-hour water fast for a while now.  I've studied enough Buddhism to find fasting a very fascinating discipline.  Of course, I've toyed with the idea of trying it over the years, but I'd never done so.

However, you may have noticed that intermittent fasting is all over the nutrition/health news these days.

Intrigued by the recent hype, I'd looked a little deeper, and the science around intermittent fasting looked relatively solid (to my oh-so-brief-scan-of-the-most-recent-published-study-abstracts). At a minimum, I figured that it if it turned out water fasting wasn't a huge burden, then it might benefit me, or worst case, it would just give me the same benefits of an equal decrease in calories on a constant calorically restricted diet.  Either way, I knew a short mid-week fast wouldn't hurt me.

Based on everything I'd read and heard about fasting over the years, I knew I didn't want my first attempt to be during any sort of heavy physical activity.

So, enter the busted toe.  Clearly, I needed to take advantage of the situation and try one of the intermittent fast options and see how it treated me.

Bonus: E and I needed to detox from our Alaska trip (surprisingly, despite a diet full of fried things, the cold shivering metabolic demands were such that we were both shocked to arrive home without either of us gaining weight -- Clearly this is a miracle, as we were there for less than a week and I alone consumed many things I wouldn't ordinarily including a cheesesteak, brunch with hollandaise, mac and cheese, fried mozzarella sticks, nachos a few times, chili, and more.)

Did I mention E and I needed to detox?  So, when we arrived home Tuesday evening, I made a vegetable soup of puréed roast cauliflower, broccoli, onions, garlic, broth and some spices.  (Of course we added cheese.)  It was delicious, but also light and healthy.

Wednesday, still on good behavior, we both ate light lunches and the remainder of the soup for dinner, followed by bed with herbal tea and reading.  My last bite of soup was at 8:20 PM and thanks to the inactivity required by my toe, I decided it was a good time to attempt a 24-hour water (tea/coffee/lemon) fast.

I don't eat breakfast, so I regularly hit 15-16 hours between calories (hence, one of the reasons I've been intrigued by the intermittent fast trend -- it's in sync with the eating patterns I've found work best for me).

Cut to last night -- I was committed to 24 hours, but frankly, I was a little scared. Mainly, my concerns were around how I tend to get HANGRY.

Turns out, for me, a 24-hour water fast was relatively easy (sort of).  I sincerely enjoyed it on a few levels.

For the last several weeks, I've been trying to work in at least 1-2 sets of 7 minutes+ of 30 seconds on/ 10 second off high intensity intervals of body-weight strength work.  Since the toe injury, this is one of the only work-outs I can do, other than stretching.  So, Wednesday, I did the HIIT 2X7 minutes, showered, ate dinner and started the fast.

I slept relatively well.  I woke this AM, had my coffee, and before I knew it I was already 12-hours in (50% done!) I worked, edited documents, took calls, and didn't really even think about hunger 'til my Junior Attorney brought back spare chips and salsa for me from her lunch run since she saw that it looked like I was skipping lunch (so kind, and yet... so cruel). 

At this point, I'll admit, I started keeping score.  12:20 was 16 hours.  1:30 was 17+.  3 PM was almost 19 hours and time for another coffee.  Leaving the last client's office at 5:25 was less than 3 hours to go and I knew I had it in the bag.  (With 2 hours to go, I fit in a 2X7 min HIIT workout followed by 30 minutes of easy yoga stretching, knowing it would kill my appetite from experience.)

I never got lightheaded, a headache, pains or anything debilitating.  A few times I got mild hunger pains but coffee, herbal tea, water, and life seemed to make those disappear relatively easily.

Overall, while the break-fast meal was ready to go and I took my first bite at 8:21 on the dot, I was surprised at how easy this was for me.

In fact, I ate much less for dinner than I expected.  I made myself a huge bowl of miso soup with an entire box of silken tofu and tons of seaweed, chili oil, and more.  I fully expected to eat the whole pot.  Instead, I had a nice big bowl, a glass of wine, and I was satiated.

The reason I say it was (sort of) easy for me is that a funny thing happened this morning.  I woke up.  I made my coffee.  I poured myself some sparkling water with lemon.  And then I opened the pickle jar.  I remember thinking, "I can drink pickle juice, it doesn't have calories.  In fact, it's got electrolytes that I probably need since I'll be diluting all day with water and diuretics like tea and coffee."

Except somewhere in that analysis my brain shut off.  And I ate a pickle out of the jar.  When I finished the pickle, I closed the jar, looking for a kitchen towel for my hands before realizing I'd blown my 24 hour fast about 12.5 hours in.  I laughed.

I realized I probably eat a pickle every AM without realizing it.  I tell myself I don't eat breakfast, but truly, my breakfast is actually usually made up of coffee (with sugar and milk/cream if we have it), sparkling water (with lemon) and a pickle.

And that, my friends, may be the biggest most important take home from my 24-hour water fast.  If nothing else, if you do one, you will realize things about your eating patterns and hunger patterns and relationship to food and those around you that you've never considered.

So for that reason (regardless of the other benefits you may accrue) I recommend it.  Given that it wasn't as difficult as I expected, I suspect I may deploy it more frequently over the coming months (or years/decades, as some studies cite it as a useful tool vs. menopause) as a compensatory measure whenever I find I need to detox from some serious gorging or when I'm in a situation where I'm unable to workout as much as I like.  

Lunar Eclipse

How cool is this?

Lunar Eclipse from our yard.

It was overcast at the start but cleared up towards the end.  So cool