Our Little Thanksgiving

Due to my work schedule, Hubs and I ended up tied to Nashville for the Thanksgiving holiday.  While we were obviously sad to miss out on the time with our families, we were excited to cook our first Thanksgiving meal.  I collected a bunch of recipes for the classics (mostly from Pioneer Woman) and bought an absurd number of groceries for two.  We had so much fun making all of the food together and enjoyed every bite.

I wanted to share a few pictures of the "fall" decorations I made for our house.

fall mantle

felt flowers on the wreath

give thanks banner

yarn wrapped H

front door wreath

The decorations were a bit of work but kept me busy while M was out of town for his job training.  I love the way they all turned out!

Two more random pics... 

our thanksgiving spread- yum!

tired from their turkey scraps ;)

Murfreesboro Middle Half Marathon Recap

As you might recall from my recap of the Country Music Marathon, I signed up to run my third half marathon on October 15th.  After the last race kicked my butt, I was looking for a little redemption.

The date of the race promised beautiful weather, but training in the summer was less than ideal and resulted in a very abbreviated training plan of about 8 weeks.  I ran only 2-3 days a week and completed just two 9-mile runs in the weeks leading up to the race.  I was nervous about my lack of preparation but encouraged by the forecast and the promise of a flat course.

Race morning arrived without my normal pre-race/pre-long run jitters.  We made it to Murfreesboro without too much trouble (after ditching the traffic line to the parking lot and walking the rest of the way).  Mike took a pre-race picture right as the sun rose and wished me good luck and I headed to the start line.  There were no wave starts or corrals so I found the 2 hour pace sign and smooshed myself into the crowd. 

The singing of the national anthem brought tears to my eyes as usual.  Nerves kicked in at the realization that I was on my own for this 13.1-  No husband to lean on if I got to the "omg please someone shoot me" stage.

The start horn came pretty quickly and I was off to weave through all the crazy people who lined up with the 9 min/mile pace but were actually running a 15 minute pace (why does this always happen?).  Eventually, I got in a groove at a comfortable pace and was happy to see my Garmin reading around 8:45.

One setback occurred in the first 2 miles of the race.  We were running down a neighborhood road when a whole bunch of runners came at us from a side street and informed everyone we'd gone the wrong way.  Police had accidentally blocked the correct path and sent us all down a few more streets.  This explained why I didn't see Mike cheering at the spot we'd planned.  It was pretty disheartening for me as I had a goal of breaking 2 hours and the half mile detour would be enough to put this out of reach.  I quickly made up my mind to just take my Garmin time for 13.1 and kept on running.

The first half of the course was really neat consisting of lots of neighborhood roads, out and backs along college campuses and by town landmarks, and a loop through their historic downtown complete with an amazing pumpkin display.  I saw Mike around miles 3 and 6 and was always happy to report to him that my pace was on track to break 2:00 and that I was still feeling great!

little kid high-fives are my favorite

The last 6 or so miles were less than exciting (though still perfectly flat) as we followed a pretty major highway for forever.  It was long and straight and had a lot less spectators than earlier portions.  Luckily, I was still feeling great and focused on seeing Mike at mile 10 and then on making it to the finish line. 

I had a mini celebration dance (in my mind, don't worry) when my watch signaled 13.1 at 1:58.  I would have happily stopped there but I could see the turn coming up for the finish and just kept running. 

Finishing on the track

I was beyond thrilled just to have completed the race on my own and never to have hit the "wall" I've encountered in the past.  It was even more exciting when the official (adjusted) chip time was posted at 1:58:48, right at a 9 minute mile. 

fruit tastes so good after a long run

Can't believe one month from today I'll be back at it... this time with three of my best friends!!  yay!

Hoover Hope Ride

Ever since M fell in love with road biking 2 years ago, he has been trying to convince me to join him.  I was never crazy about the thought of riding a bike on the road as I don't trust myself or drivers, so I resisted.  Recently, however, he began doing his tri training rides at Natchez Trace which is a 444-mile scenic drive that is super popular for bikers and has very limited traffic (the few cars you see are usually toting road bikes themselves).  We rented a bike one weekend for me to try out and after my first ride, I was hooked.  It was a better workout than I expected, not as scary as I feared, and had the beautiful benefit of being impact free (my shins and hips thanked me). After driving all over Nashville and testing out lots of bikes, we found one we both agreed on and I became the newest owner of a road bike!

 

 

site: http://www.hooverhope.org/home.cfm

Not long after my purchase, I discovered a road bike race a little south of us and set my goal on doing the 20 mile portion.  I convinced Mike and two of the guys I work with to do the 40 mile option.  I was a little nervous as it was only my third time on my bike and definitely my first time with that distance. 

The morning arrived and was absolutely beautiful: zero clouds, blue skies, and crisp temperatures.  The race took place near Arrington vineyards (those of you who have been will probably remember how gorgeous the scenery out there is).  I was super scared getting started in such a big group and trying to get my feet into the cage pedals but, once we got going, it was great.  M and I stayed together for the first 3.5 miles before splitting off on our respective courses. 

There weren't too many people on the 20 mile course and I was usually by myself.  I learned two things about rural Tennessee: it's super pretty and contains super hills.  Some of the hills were crazy but it was overall pretty reasonable.  {I'm not sure that M would say his course was reasonable- he equated his to the Swiss Alps.}

I finished up the ride fairly painlessly and waited around for the boys to get done.  I met some of the organizers of the event as well as the mom of the boy who the foundation is in honor of.  The foundation was created to raise money for pediatric cancer research after Liam Hoover lost his battle with brain cancer.  They have hosted a 5k run for 7 years and this was the first year for the bike ride.  It was a great event for a great cause and I'll definitely be marking my calendar for next years... maybe even for a longer distance!

What I've been up to: Residency, first rotation

Last week marked the end of the twelve weeks I spent in my first rotation as a resident.  Because radiation therapy is not something you would necessarily have any knowledge of without having actually experienced it yourself, I get a number of questions like "what exactly do you do?"  It's been a long time since I last posted about what goes on in grad school (and things have changed quite a bit) so I figured I'd give it a whirl.  As is true with any person's specialty, it's hard to adequately explain the ins and outs with a brief description (without boring you completely) but I can attempt to elaborate on the questions I typically get from Mike. 

Radiation therapy is used predominately to treat cancer and usually in some combination with chemo and/or surgery.  The two major ways of delivering radiation are through external beam (ie. with a linear accelerator) or brachytherapy (implanting tiny radioactive seeds directly to the site of the tumor).  In our clinic, we have four linear accelerators (linac for short).

this is one of the linacs we have- radiation shoots out of the yellow circle source

The best way to think of these how these machines deliver radiation is to equate it to getting a diagnostic x-ray (ie. for a broken leg)- the difference being the energy of the beam in a typical x-ray is around 100 kilo(=thousand)volts while our machines deliver x-rays between 6 and 18 mega(=million)volts.  Our linacs treat with either high energy x-rays (referred to as photons) or electrons of various energies.  The machine can rotate 360 degrees and the table rotates around as well.  This allows us to shoot the beam of radiation through the patient at pretty much any angle.

rotating

The normal course of events is as follows:  The patient comes to the clinic and undergoes a CT scan.  The physicist will "fuse" any other scans the patient has had such as a PET scan or MRI.   This allows us to combine or overlay the two scans so we can determine the location of the tumor that might not be visible on a CT scan.

first image: PET scan, second: CT scan, third: PET-CT fusion- Bright area indicates location of disease source

The physicist and/or MD will contour (basically color in 3-D) the major organs in the treatment area.

organ contours source

The radiation oncologist will contour the tumor volumes and supply us with a prescription dose of radiation to deliver to the site.  Along with this, we have a list of radiation dose limits that the healthy tissues and organs can tolerate.

At this time, the physicist takes over and does the bulk of our work: treatment planning.  The idea is to use our treatment planning software to experiment with different radiation beam angles, energies, and techniques to design a plan that delivers the maximum amount of dose to the tumor while limiting the dose to all of the healthy tissues.

one of my treatment plans for a brain cancer case

Radiation effects from treating healthy organs can be acute (ie. radiating the bowel causing GI symptoms) or long term (possibly inducing secondary cancers) so limiting their dose is extremely important.  Using multiple beams at different angles is the most obvious way to make this happen.  By intersecting the beams at the tumor site, low radiation doses are spread out over more normal tissue and the cumulative dose in the tumor is greater.

six beams to treat the prostate at center source

Once the treatment plan meets the goals (or gets as close as possible), we present the plan to the radiation oncologist for approval.  Finally, the plans are exported to the linac consoles so that the radiation therapists can treat the patients.

plan for treating a lung cancer

Patients are generally treated once a day for several days (traditionally ranging from 10 to 44 treatments).  The idea behind this is to allow the normal tissue some time to recover between each treatment.  Normal tissue recovers more quickly from radiation and will partially heal itself between treatments while the cancerous tissues do not experience this same recovery.

The rotation I just completed was IMRT/Rapid Arc.  These are two special techniques used to allow us to better spare dose to normal tissue.  A conventional treatment can treat with any size box or rectangle.  The IMRT technique makes use of the set of 120 "leaves" inside the linac.  These leaves are 5 mm wide lead blocks that each move independently (and very quickly) across the radiation field while the beam is on to selectively block out and treat desired areas. 

this is a snapshot of the treatment- blue lines indicate the leaf position at this point in time, yellow box jagged outline indicates the starting and ending position of the leaves

Rapid Arc is similar to IMRT except that instead of treating several angles, the radiation remains on while the machine rotates and the leaves move.

two 180-degree rapid arc fields

If there's any chance you haven't given up on this blog post yet and are still reading (haha), hopefully that gave you some insight into what I do without boring you to tears!

ellie's opinion of this post

Currahee Challenge

Last weekend we made a trip to my bro's (Alex and T) in Georgia for a little running and a lot of visiting.  A had told us about a run in nearby Toccoa, GA at Currahee Mountain.  Mt. Currahee was used as a training ground for paratroopers in WWII and was the setting for the popular HBO series Band of Brothers. The peak stands at 1735 feet which makes for some pretty challenging climbs.  The paratroopers motto became "3 miles up, 3 miles down" and stands as the race motto today.

We arrived at the mountain early, checked in and fought the cold, upper-40s temperatures as we waited for the race to start.  A&T are the experts at this mountain as they've been running it on weekends and they warned us of steep inclines making up the third mile.

check out my ridiculous trail running shoes. briiight.

The race began with a quick out and back on the road (added to make the distance a full 10k) before starting UP the mountain.  The first two miles were pretty steep rolling hills with plenty of ups and downs.  As warned, mile three was suuuper intense and rounding each curve just gave sight to another crazy hill.  I often felt as though I were running in place and glances at my Garmin confirmed these feelings.

up

really up

almost there

I was beyond thrilled to make it to the peak.  The views up top were amazing!

gorgeous

Coming back down was awesome.  I felt like I was flying on the steep declines (which is rare feeling for me as I'm usually a "slow and steady" runner).  Unfortunately, those pretty rolling hills on the way up made for some challenging moments on my tired legs on the way back.  Crossing the finish line was a great feeling, especially because I was only 3 minutes behind my speedy husband!  The time for my 10K was 1:03 which placed me fourth in my age group and seventh female overall. 

A finishing- he never stopped to walk- ridiculous!

I absolutely loved my first experience with trail running.  The gorgeous scenes, relaxed atmosphere and new type of challenge all appealed to me.  I'm already finding new trail races to sign up for! 

Mike's First Tri

After hearing Hubs talk about wanting to do a triathlon for what seemed like months, we finally found a weekend with a good race option and no plans and I forced encouraged him to sign up.  He followed a pretty action filled training plan with swim, run, bike, and combo workouts. 

The event included a half-ironman distance, olympic distance, and sprint distance.   M was competing in the sprint distance (400 meter swim, 14 mile bike, 3.5 mile run) so his start time wasn't until 11:30 am.  The weather that day was absolutely gorgeous so we arrived a little early to watch some of the other races and get set up.

laying out the gear

marked with race numbers

by the Cumberland river

Swimming was the event he was most worried about.  He'd heard your first open-water swim was an experience in itself as far as not being able to see, being surrounded by flailing arms and legs and attempting to swim in the right direction despite a pretty significant current. 

cute hat ;)

getting ready

his corral was up first

they're off

all the swimmers

made it!

It was impossible to tell who was who in the swim with everyone in their sweet blue hats so I was super excited when he emerged from the water.  He said this was absolutely the hardest part.  The water was cold (for Floridians) and he swallowed his share of it. 

At this point, I sprinted across the grounds to where I'd be able to see him starting the bike course.  He was riding by in no time at all and was surprised to see me already there with the camera. 

the only smile i got on the boy all day!

During the 45 minutes he was off on the bike, I got to see tons of runners and bikers from the other events.  Seeing the half ironman-ers was such a cool experience.  {In case you don't know, half-iron = 1.2 mile swim, 56 mile bike, and 13.1 mile run.}  These people were competing in an event my body could never dream of completing and I loved being able to cheer them on.  I remembered being frustrated in our races when people would only cheer for their own friends and just stare blankly as others went by.  I know how far a simple word of encouragement can push you when you are struggling along. 

almost done

M finished the bike pretty quickly and I knew it was just a few minutes till he would be coming back by on foot. 

he's so speedy

At this point, I headed over to the finish line and a few minutes later, he was done! 

don't worry, not his time ;)

see what I said about the smile?

One of the first things he said (after asking what his time was) was "that was so much fun!" Apparently, he loved every minute of it and can't wait to do more triathlons.  I was so proud of him for meeting his time goal in each event and doing so awesome in his first race. 

The excitement that day was a little infectious so we may both be counting down to the start of tri season next year.