My Leadbaby

I embrace the Leadville mentality to “dig deep-you’re tougher than you think you are, you can do more than you think you can!” However, finding out I was pregnant four months into my training for the Leadwoman race series made the mental tenacity needed to complete such a challenge seem like an unlikely goal. While I am already a “geriatric pregnancy” by OB standards and don’t have a lot of fresh eggs left to create my beautiful 4-year old a baby sister, the timing frustrated me somewhat since I had already put so much work into training. I already felt the satisfaction of doing back to back long runs easily without pain or week-long recoveries. I felt ready to begin the series. Though I could no longer push myself to the extreme physically, I could participate at a lower-than-max intensity and do the best I could.

Judgment from virtual strangers and friends alike slammed me over and over when mentioning the Leadwoman venture I was continuing to contemplate doing while pregnant. As any mother knows, unsolicited parenting advice abounds about everything that you are clearly doing incorrectly. While most didn’t have any actual medical knowledge, they insisted I was going to cause a miscarriage and would never forgive myself. I stopped telling people I was pregnant because I didn’t want to deal with the judgment. And kept running.

As an Emergency Department physician, avid rock climber, trail runner, ski mountaineer and Wilderness Medicine aficionado, I consider myself more comfortable with calculated risk than many others. Guidelines for pregnancy are very conservative, often based on nothing but opinion. I read every scientific article on exercise during pregnancy. Historical recommendations to limit exercise during pregnancy based on the theoretical risk of preterm labor have proven unfounded. Current recommendations support that continuing pre-pregnancy exercise levels throughout pregnancy is not only safe, but decreases your risk for back pain, diabetes and preeclampsia. The altitude studies are likewise reassuring; for short-term exposures to high altitude during pregnancies, there does not appear to be any increased risk of complications. Basically, the baby is a parasite, taking what it needs before you get what you need. So, if you feel good, your baby is probably fine.

I completed the marathon, the first event in the Leadwoman series at 9 weeks of pregnancy. I kept my heart rate below 140 the whole time, eating and hydrating much more carefully than my typical haphazard style. My training had been suffering a bit with fatigue and morning sickness, but exercise consistently made me feel better, not worse. I listened to my body and kept training, just not to the intensity I had hoped. I quit my training program with Travis Macy, Leadman 2013 winner because I couldn’t keep up such a defined regimen. I just went with how I was feeling on that day.

I was fully prepared to drop out of the Silver Rush 50-mile race, which is not a very good mental state to be in at the start of a such long race. But I again felt good. I had to slow down from what I had hoped, to keep my heart rate below 140 and my effort moderate. And I was much hungrier than normal-I ate sandwiches at every aid station. And I peed about 20 times. But, I still finished in just under 11 hours and was still leading the Leadwoman competition.

The Leadville 100 mountain bike race proved more of a challenge. I had just started mountain biking in March since I wanted to do the event. The race was my first bike race ever, and am not quite comfortable descending such steep rocky terrain. I certainly was more cautious than I otherwise would have been, since I didn’t want to fall for fear of hurting my baby, though she is still only turnip-sized and would probably be just fine. While I passed many people on the uphills, they passed me right back on the downs while I played it safe. That combined with several more than normal pee breaks likely cost me the finish-I missed the 12-hour cutoff by 4 minutes.

I’m ready for the 100-mile run this weekend. I don’t know if I will make it. I know I won’t be psychologically willing to push through those walls I will likely hit for the safety of my baby. At 17 weeks, I am 12 pounds up from my pre-pregnancy weight and getting slower by the day. But I will do my best. And either way, my little Leadbaby will have done this crazy mountain adventure with me before she is even born.

swine flu

I'd been complaining for weeks about the peds ED. I love kids but, damn. How can one not get frustrated when your board says cough, tos, cough, no come nada, fiebre and on and on. So, I decided I didn't care that we had our lovely DG Holiday Party the night before I had to work at 7. I stayed late and allowed the 4th years to accomplish the waste-the-interns mission. And then, of course, I showed up to work to get the sickest patient I have ever seen.

The only history was that she'd had a fever and muscle aches for a few days. That morning, she had had some vomiting and diarrhea. And at around noon, her stepdad found her passed out on the bathroom floor. By the time she arrived at the hospital, she was breathing agonally and vomiting blood. We intubated her, started giving her blood for her hemoglobin of 5, started antibiotics, started lines all within a few minutes of her arrival. By the time her parents arrived, she was coding. There was nothing we could have done to save her.

This case doesn't bother me because I wish we had done something different, because I fully believe that there was nothing we could have done; she was too sick when she arrived. However, this case bothers me because I really want to know what she had and I can't wait for the autopsy results to come back. Some of her blood culture results came back, which were positive for e. coli. I just think that this is bizarre. She was a young, healthy girl. Why would she get a gram negative sepsis without any preceding symptoms of UTI? I think that maybe she had H1N1 and that she got ARDS and DIC from the H1N1 and then seeded her blood from her gut, which was obviously bleeding by the time she got to the ER and by the time we took the cultures. I want to be able to explain this, and I think that this is a plausible explanation.

H1N1 has taken quite a few young, healthy people this year. It is much more virulent than the typical seasonal influenza. In fact, young healthy people don't have immunity to it because the last time a similar strain was seen was around 30 years ago. People under 30 don't have immunity.

I also think this case is interesting because it is completely parallel to Brittany Murphy's case, who also recently died after a few days of flu-like illness. The cause of her death is, as well, unknown. People are trying to pin it down to drugs, but the only hard facts are that she had a flu-like syndrome and that she went into cardiopulmonary failure and shock and died very quickly.

I will have to leave it as a theory at this point.

Bishop Christmas Crush

We planned to avoid the snowy weather by driving South and avoiding the high elevation passes that were sure to delay us as we headed cross-country on a time limit. We left immediately after Joel's final and had to make it to my interview in Las Vegas less than 2 days later. Murphy's law held true, and just about everything possible went wrong. The giant red pickle van lost power only about 100 miles south of the cities. Was it broken? Was it out of gas? Was something frozen? We didn't know. The gas gauge was broken and it was -20; our calculated mileage was around 8mpg. We gambled optimistically and kept going. We then hit snow and ice storms through Kansas, Oklahoma, New Mexico and Arizona, stressing a bit as we saw about 30 cars in the ditch. We stopped at a truck stop to shower, I changed into my suit in the van, Joel de-Rocco-haired me with a tape roller as I rolled into my interview only 5 minutes late and on a few hours of quality van sleep. Maybe in retrospect, we might have planned it a bit differently. But, we made it, safe and happy, to Bishop, CA. We joined Team Minnesota in the Bishop Christmas Crush!!

Danette on "The Hulk," a super-classic 4 star boulder problem at the Happies that is really sweet. But hard.




Mike on Red Rum, his proj.











Lynn at the optimal angle to photograph Joel in the silly furry hat Danielle gave him on the problem next to Red Rum. I forgot what its called.











Trinh on The Cave Problem, V6. I loved this problem, and worked on it my entire time in Bishop, but never sent it. I've got some unfinished business; all the more reason to make a return trip to this beautiful place.

Joel, getting the butt spot on Kyle as he tries The Mandala, V12, his proj.















Alex flashing High Plains Drifter, V7, on her first day in Bishop.

Interview Trips

I heard someone refer to residency interview trips as our victory lap around the country for doing well in medical school. I suppose you could say that . . . the interviews were mostly relaxed and low-key and I did get to visit some really cool places and mix a bit of business and pleasure. Here is Lisa, one of the British girls I climbed with during my one-day stop in Hueco. She is proving that short people can indeed do the first move on Babyface, though maybe not the second.

This is Hueco, the cutie pie little pup that George, one of the guys staying at the Rock Ranch this season, adopted. He has the exact same shape, pencil tail and giant bat ears as Rocco when he was a baby. Awww.

My first look at the amazingly majestic Yosemite Valley. Someday, someday, I will climb these granite behemoths. First, I've got some work to do on my weak sauce crack climbing skills.










The boulders, too, were awesome. I didn't actually see anybody bouldering at the Camp Four boulders, which kind of surprised me because there were a lot of tents. So, I had to boulder sans-pad on the short ones so as not to re-break myself. But, I'll be back . . . mwahaha.







I think this may be the first time ever in my life that I've taken a picture of a rainbow and it has actually showed up in the picture. This is Yosemite Falls, which I hiked up to when I got bored of bouldering by myself with no crash pad. It is absolutely beautiful and gives you some amazing views of the valley, especially Half Dome.



Portland, Maine is a really, really cute and picturesque little city. Really, with all the cobbles and tranquility, its hard to imagine a crime being committed there. Which makes it probably not the ideal place to train for Emergency Medicine. However, I think it would be a fun place to live. The residents all have Maine Medical Center biking jerseys and go on long rides twice a week. They pride themselves on being the happiest residents in the nation. It would be a fun group of people to train with.

I mean, really, is this even real? It looks like a painting. Or a postcard. I think my mom would paint a lot more if she lived in Maine.

Winter at Sandstone

It was a sunny, snowy November day at Sandstone. About 25 degrees. Climbing weather, right? I did boulder with my socks on and my wingers were just a bit chilly, but we had a great time. I was afraid the little Rocco man would fall through the thin ice, though. He really did not understand about the ice, even when it was cracking.



Shirtless on the river boulder, Joel tries voraciously to prove that Minnesota really is seasonless in its incredible climbability.











Me, with my 4 toplayer, two bottom layers and socks in my climbing shoes. A little more of a freeze baby. Or a seasonal realist, see it as you will.

The Amazing Case

The Amazing Case is a sweet urban treasure hunt/pub crawl sponsored by Summit brewing company. Janet and I did it two years ago with her brother and sister in law and had a ton of fun. This time, we were back in business with our team, the "Cheesy Poofs." My bro, Derek, Janet, Mitch and I ran from bar to bar and did various challenges ranging from pole dancing to pin the tap on the keg. There was also a photo scavenger hunt where the boys got a Hooters girl while Janet and I coaxed the valet at a fancy hotel to let us in to photograph some fancy cars.

We had a great day and made it successfully to the finish line. I should have stopped drinking a little bit earlier, though, because I was hurting the next morning at work. Also, I hadn't thought about the fact that it was night and I had biked there, leaving my car at my brother's house. Which I was far too drunk to drive. Luckily, Joel went to get my car and pick me up!

Tracy came out to meet us at the finish line and celebrate.

Halloween Comp

Lynn as "Dot" in the first annual Halloween Costume Comp at Lynn and Kris's wall. Kris set a ton of awesome problems for the comp and we had an absolutely perfect day for it.












Jess and Trinh (the Asian beetle).

















Rocco as the cutest little dinosaur monster ever.






The wall may not have won the "best woody" contest in Urban Climber, but it is surely way cooler than most of the ones I have ever seen. Or the ones that won for that matter, although apparently painting clouds on it makes it better.

"Hula Joel" did win best costume with my bikini top on.














And my M&M costume was awfully hard to climb in. But the day was super fun!! If I'm not in MN next year, I'll have to try to come back for the tradition . . .