10

10 years today and so thankful.

I'm Still Here!

So, if you're still reading this (there may be a few of you), I have not dropped off the face of the planet! Actually, I have in some ways, but as usual, I have an excellent excuse. Third year began in full force a month ago and...WOW. Needless to say, I hadn't fully appreciated how busy I would be on this first rotation.

I suppose many things this year haven't gone the way I expected them to go, for better or worse. I started this blog with the intention of meeting a personal goal and marking an occasion, but things change. It has been an interesting transition to seeing this blog less as a means to an end than as an exercise in self-reflection, but that's what it has become, and I've been grateful for the outlet. That said, life moves quickly and unfortunately, updating this blog always falls at the bottom of my "to do" list.

So, it is with great appreciation to my readers that I sign off, at least for now. Thank you for making this a meaningful endeavor, however unexpected the endpoint turned out to be. One thing is for sure: over $10,000 has been raised for transplant research and meds by way of, well, you, my generous family and friends. Incredible, no?

xxoo, Sarah

No Way You're Never Gonna Shake Me

The past week has been a reminder of what summer feels like--especially what it's like to be surrounded by the very same friends my six year-old self (and in one special case, my twelve year-old self) met in the classrooms, on the playgrounds and in the lunchrooms of Willard Elementary and George Washington Middle School. I'm still amazed at my foresight--and my luck (see the video below for exhibit A).



Yeah. Incriminating, but somehow necessary--and that was just a teensy portion of the ride home from our weekend getaway. I couldn't have asked for a better two days.

I love you girls. There's so much to say, but my words come up embarrassingly short. As the wise Mariah Carey once said, you're never gonna shake me. We'll be friends 'til we're dancing around with our walkers.

So...clearly, this post has nothing to do with swimming or running or anything of the sort. Plenty of time for that. Back to Boston tomorrow and onto the next thing: third year. Yikes.

In the Meantime...

http://www.nytimes.com/2011/05/17/health/17organ.html?hp

T-7 days to freedom. Hallelujah.

Lessons

Here are some things I've learned since I started swimming:

1. Only amateurs use the ladder. [Same goes for the swimsuit dryer thinger, but use it anyway, because it's awesome.]
2. Just because you're not sweating doesn't mean you won't want to eat the entire contents of your refrigerator when you get home.
3. Bob the Ridiculously Energetic Spinning Teacher swims. And goes out to lunch. And teaches spin class...all while wearing the same two-piece spandex suit!

Jumping In!

Actually, climbing in...very slowly (it is only 4 feet deep, after all).

I must admit, besides spending much of last week doing all too much thinking about fears and worst-case-scenarios and torturing myself and everyone who dared cross my path, I also wondered why I ever started this little blog in the first place. I wished I hadn't. I am feeling much more optimistic now, especially since I started swimming.

Rather than dwell on possibilities which likely (if I have any say) won't come to fruition, these days I'm more occupied with noticing the copious gym perks seemingly meant exclusively for swimmers. How had I not realized that all this time, I have been being treated as a second class citizen to the swimming elite? I'll start with the steam room. Who in their right mind would sit in a 105 degree room after a non-aquatic aerobic workout? Also, there's the issue of the showers. The shower room is directly connected to the pool area, so as to facilitate swimmers' access. Anyone coming from elsewhere in the gym must peel off and deposit their workout gear in a locker, then traverse the entire locker room clad in a towel to potentially wait for a shower to become free--not the worst fate but obviously not acceptable to swimmers, who have first dibs on hopping in. Did I mention the bathing suit dryer thinga-miggiger? Yup, you read right. But, whadda you know? No regular washer/dryer to be found.

Then there's the pool itself, quiet and peaceful and well-maintained--without the pumped-in music that permeates through the rest of the gym. Though only four lanes, it's plenty large to cater to the gym's small swimming population. So far, I've only had to share my lane once (then, the serious swimmer there before I arrived switched to a newly unoccupied lane of her own). Unlike the rules that apply to treadmills, ellipticals and the like, there's no limit to the amount of time one can occupy a swimming lane during peak hours.

You can imagine that to a newbie like me, these newly-discovered benefits are especially exciting. All in all, an auspicious start to my new activity.

Just Keep Swimming

Last Thursday, I got off the train at Penn Station and went straight to the Hospital for Special Surgery. For the past month or so, I have been feeling a mysterious pain in my right leg, which I could no longer ignore. Roughly 24 hours after I arrived in New York, I was having an MRI. Days later, I got the call from my doctor.

I can't run anymore. Not now, not ever, or so I'm told. Years of high-dose steroids and low vitamin D during a period of crucial bone-building took its toll. For anyone who ever doubted the power of steroids to deliver life-saving treatment and life-altering side effects, let my situation be exhibit A. I have known for years my bones were weak, but never anticipated that at the age of 25, I'd already be forced to make adjustments to my activity and to my expectations. The impact of this news really hit me yesterday, as anyone in close proximity or phone contact with me could tell you. But as Natalie reminded me, the sun rises every day. Things are starting to look a little less dim.

I will not be marking this 10 year anniversary with a 10k. However, I have every intention of finding a suitable alternative to mark the occasion, even if it takes longer to reach my goal. Some of you have had the pleasure of hearing about the one summer that I was in the most advanced swim group at Camp Ramah. For four weeks, I looked out on the commanding view from the dock in the deepest water and sauntered around the lake like I owned the place, superior to the masses of others treading in shallower water. Nevermind that I was demoted several groups the next summer. I always knew that was a mistake, some cruel misunderstanding or test of character. It has been years since I've ventured voluntarily into a pool for anything more than lazing in an inner tube with a book, but now I intend to recapture my former glory as a swimmer.

This new chapter will be different and potentially more difficult. Soon I'll emerge from this current fog. When I do, I'm looking forward to the challenge.

Ocean's Poem

Once again, I find myself behind (my own, self-imposed) schedule--no time to write an original post re: running, etc. Instead, in true nerd form, I will share this, my favorite passage from Leaves of Grass. I like it so much that it commands a sought-after spot on what some have come to call my "study wall." Call it cliche, but I think you may enjoy it.

Here are our thoughts, voyagers' thoughts,
Here not the land, firm land, alone appears, may then by them be said,
The sky o'erarches here, we feel the undulating deck beneath our feet,
We feel the long pulsation, ebb and flow of endless motion,
The tones of unseen mystery, the vague and vast suggestions of the briny world,
the liquid-flowing syllables,
The perfume, the faint creaking of the cordage, the melancholy rhythm,
The boundless vista and the horizon far and dim are all here,
And this is ocean's poem.

Walt Whitman

Off the Wagon, On the Road

Ok, so I may have fallen off the blogging wagon just a bit this last couple of weeks. That said, I'm pretty sure my select readership can appreciate and relate to the legitimate reasons this has occurred. Also, just because I haven't been blogging doesn't mean I haven't been training, however loose a term that seems to be these days.

I returned to running refreshed after my not-so-epic foray into spinning. I was overjoyed to have the chance to run outside last week for the first time this season. It was a balmy 60-something degrees here in Boston last Friday, and sunny--a welcome (but alas, brief) respite from the cold. Two days ago, the weather gods had the nerve to make it snow. Again. I was back on the treadmill later in the week, feigning ignorance to the 30-minute limit during peak gym hours. I made it 3.75 mi. before I was found out. Foiled again. And yes, it definitely did take me more than 30 minutes to run that distance. I'll work on it.

Soon, the only thing holding me back from running to my heart's content will be my guilt about neglecting my relationship with Qbank. Spring is coming, with all its fresh smells and awkward ankle sunburns and big events and yes, new beginnings.

It may be a couple of weeks or more before I write again, hopefully with a more robust report regarding my running progress. In the meantime, rest assured I'll keep myself busy.

Why am I posting the accompanying photos, you ask? Because looking at them and remembering the days they were taken make me happy. That's the only reason and right now, it's good enough for me.

Spring Forward (Fall Back)

Happy Daylight Savings Time!
My, how time has flown. This past Friday at around 4pm, members of the class of 2013 received their third year clerkship rotations. Responses to this development varied. There were the inevitable announcements on Facebook, the anti-announcement announcements ("I will not be sharing my schedule. I am far too original for that, but I still feel compelled to update you on my 'status.'"), the flurry of panicked texts ("NOOOO!!! I'm DOOMED!" Then, 5min later "Phew-I switched."), the quietly content group who got one of their top choices and those few people still desperately pleading for a schedule change, to no avail. Guess which group I'm in?

Things aren't so bad. We're all pretty excited to depart the 5th circle of hell that is the end of second year. I, for one, am more than ready to embrace the feelings of perpetual ignorance and inferiority that third year will bring.

Another piece of good news is that unless my schedule miraculously changes, I can now begin to think more seriously about races. Kate suggested this one, for the Boston contingent: http://www.lonegull10k.com/about/. Or this one: http://www.runtotherock.webs.com/. Or this one, should only women decide to participate: http://www.tuftshealthplan.com/tufts10k/eventdetails/. All look good to me right now, so tell me what you think.

For those running in New York, I think it could be really fun to do the Merrell Down and Dirty Mud Run (http://www.downanddirtymudrun.com/ny.cfm), though it's admittedly not a conventional 10k. I'm open to suggestions, so please send them along!

Running this week was...meh. Even though I'm on spring break and should have energy to spare, for some reason, I haven't been able to match the level of endurance I had reached a week ago. The regression put me a sort of funk, fueled also by the fact that I haven't been feeling all that great for the past few days. What is it about having time off that makes the body automatically poop out? In an attempt to get my aerobic groove back, I decided to try a couple of spinning classes.

Normally, I actively avoid spinning. Sitting on a stationary bike in a dark room for upwards of 45 minutes, watching myself struggling in a mirror while being instructed to vary the bike's resistance to simulate a scenic, hilly ride never held much appeal. But, bolstered by the encouragement of my friend/chaperone/handler Nicole, I took the leap. The verdict: shockingly, it's not so bad, after all. I don't think I will ever favor spinning over other forms of exercise, but sometimes it's nice to switch it up. This week, I will be back on my feet, though, hoping for the best.

In case you didn't see them, here are links to a couple of relevant editorials from last Sunday's New York Times' "Week in Review."

http://www.nytimes.com/2011/03/06/opinion/06ross.html?scp=9&sq=organ%20donation&st=cse
http://www.nytimes.com/2011/03/06/opinion/06longo.html?scp=5&sq=organ%20donation&st=cse

The first piece, written by a transplant nephrologist and a clinical ethics professor, offers one viewpoint on the new proposal to change the way kidneys are divvied up.
The second is written by Christian Longo, a prisoner on death row in Oregon who started an organization to promote organ donation among prisoners sentenced to death.

From Blah to Boo-ya

Oscars were horrendous--Anne Hathaway even more annoying than usual. Hated dermatology ("A 26 year-old man presents with an intensely pruritic, erythematous, papular rash. What is the next step in evaluation?" An HIV test? What?!). Apartment search fruitless. Cat close to death.

All in all, this week sucked. Turns out, it's amazing what a bad week can do for one's motivation to RUN. Tonight, I hopped on the treadmill and stayed on there for 4.5 miles at a pace of 6 miles/hour. And I could have kept going. Woot. Suddenly, my day was looking up. Dermatology is over (hooray! hooray!). The apartment search continues, with some promising leads. The cat lives!

As if that were not enough, some happy revelations came to me as I was walking home from the gym. First, that there's suddenly, finally almost no snow on the streets of Boston. Second, despite all of my complaints, the South End is a pretty beautiful place to live. Also, by this time tomorrow, I will be hanging with my family.

Yes, I'm off to New York, where my pseudo-athleticism will be officially put to shame by 12 year-old whipper-snappers performing in "Billy Elliot." I can't wait.

Some words.

A second post within three days? And a title without alliteration? Whatever would possess me?

Well, here's the thing: all weekend I've been back and forth on my decision to share the URL for this blog on my Facebook profile, which I did this past Friday. The choice was made in light of much good-natured badgering by a certain sister, along with rational conversation with wise friends, the same friends who generously remind me to see the forest among the trees on an essentially daily basis.

I was so touched by the kind messages from classmates that followed my post, yet I still find myself awake, at almost 2am on a Sunday night, contemplating the choice. It's not that I don't see the benefit of encouraging visitors to the site. All along, the whole point of this project wasn't to share "my story." Rather, the purpose was always to raise awareness about the issue, which grows in magnitude every day, to generate conversation and incite progress, in some small way.

I suppose I think of myself as a somewhat private person. I never thought of my transplant as a big deal or as a big secret, but before recently, my medical history was never something I planned on sharing with anyone other than my good friends. This blog changed all that, to a certain extent. However self-centered it is, my fear is that friends, classmates, or anyone who happens upon this blog as a result of my public announcement of its existence will think I'm seeking attention or recognition. The long and short of it is that I do not wish to be lionized for living through circumstances I did not choose and for feeling compelled to do something about a matter that is pervasive in my life and in the lives of many, many others.

Phew. I feel much better now that I've said that.

In other news, you might be wondering what your donation could do right now for renal transplant research at Columbia-Presbyterian. I'm so glad you asked! According to Dr. Lloyd Ratner, director of renal transplantation at the medical center, the money you give will help fund studies investigating transplant from "incompatible" donors and the development of alternative sources of organs for transplant (not just renal), such as stem cells and xenografts. On the more immediate horizon, donations will also go into programs that aim to increase access to transplant by pairing patients with living, unrelated donors. If you're thinking about giving, no amount of money is too small.

I will leave you with these statistics, from the U.S. Department of Health and Human Services Organ Donor Initiative website (http://www.organdonor.gov/Default.asp):

-Every 11 minutes, someone is added to the waiting list for an organ.
-On average, 20 people a day die while awaiting an organ transplant.
-According to 2009 statistics, 75% heart transplant recipients, 73% liver recipients, 69% kidney recipients and 54% lung recipients were living 5 years after their transplants.
-One organ donor can save up to eight lives. Wow!

A Pertinent Pause

This week, I was poised to write another lighthearted post about my training exploits. I had a gym anecdote to share (one involving the apparent performance of a fellow gym-goer, blasting show tunes from his iPod and making interesting use of the body balls in one exercise studio, to the delight of those who had gathered there for a class). I had a cryptic/inspiring yoga instructor quote to share. But alas, those things will have to wait.

Yesterday, it was widely reported by popular and medical news outlets that a panel of healthcare experts from the United Network for Organ Sharing made public a new proposal for ranking those in line for organ transplant. If adopted, the proposal will replace the current "first come, first served" policy for with one that makes kidneys preferentially available for younger patients who are expected to live longer.

My initial response to the proposal was positive; after all, it seems logical that those who are "graded" highly according to the new algorithm will get the most--in terms of longevity and productivity--out of the distressingly limited number of organs available. I still believe that to be true. However, the lifespan of a kidney need not be so simple as the one it is presumed to have by the new proposal.

Consider this: a 20 year-old dies tragically in a motorcycle accident. His family chooses to donate his organs. Two patients are medically qualified to receive the donor's kidneys. One is 52 years-old, diagnosed with stage I hypertension two years ago, the father of four children ranging in age from 13 to 24 and currently covered by private health insurance. The other is 25 years-old with seemingly no other co-morbid conditions, no children, and is unemployed with no insurance coverage. It seems obvious that the 25 year-old would live the longest if he receives the newly available organ. Or is it? It is my firm belief that before measures are adopted that will make it more difficult for the 52 year-old hypertensive father of four to receive a life-saving transplant, legislators should take a good, long look at the programs in place to ensure that the kidney gifted to the equally worthy, uninsured 25 year-old will live out its full potential.

It's still taboo to talk about decisions like this one. No one wants to make the judgment that denies someone new life. But sadly, these are the kinds of choices we're left with when demand so obviously overwhelms supply. Proposals like the one put forward by the panel sound logical and fair, until you're the one shunted from the top of the list to receive an organ. Disease doesn't strike in a systematic fashion. Not everything happens for a reason. It is my sincere hope that the same concentrated effort that went into writing the current proposal will be applied to coordinate new, inventive ways to expand the supply and long-term viability of organs.

Slow but Steady

Today was one of those days I was ready to break out the jazz hands and "dance face" to "Party in the USA" while bouncing along on the treadmill. Oh come on, don't pretend you haven't had those days. I don't know what it was--the fact that I was pressed for time, that I hadn't left my couch...err...apartment all morning or that I was simply motivated by the scintillating coverage of Red Sox spring training on the gym TVs, but I ran super fast--for me, anyway. I'm pretty certain edamame (I swear by the soy!) and Girl Talk (http://illegal-art.net/allday/) also deserve credit. Oh, and the fact that there was no wind. In any case, the tide of endorphins carried me through the rest of the evening. Clearly.

It felt great to jump into a running routine this week. On Tuesday, I ran a respectable 3.1 miles, albeit at a snail's pace. I decided to up the ante today, but my general strategy is to start with easy runs so that I don't set myself up to feel like I'm failing to meet the small goals I make for myself. For now, I'm building up distance, not speed, and I trying not to get distracted by my treadmill "neighbors," inevitably barreling along, roadrunner-style, at over 8 miles an hour. So far, depending on my mood and schedule, I've been alternating runs with some interval training. I'm confident I'll be able to sustain a faster clip once my endurance improves.

I promised you news. Thank goodness for subtitled television! So...a porpoise was recently rescued off the New England coastline. Crazy, right? That's all I know.

Have I mentioned how overwhelmed I've been by the enthusiasm that followed my first post? Frankly, it's humbling.

So, I had this idea...

It came to me...at the gym, of all places. I was on the treadmill trying to ward off boredom when it dawned on me. Eureka! What better way to celebrate turning (gulp) 25 than to mark the 10 year anniversary of my kidney transplant? And how better to do that than by raising awareness and money for the thousands of others who haven't yet been as lucky?

With some trepidation, I hatched the plan to start this blog. The main purpose isn't to wax poetic on my views (although I'm sure there will be plenty of the usual self-indulgent commentary), but to get word out about my goal to run a 10k (or several, potentially) next fall in honor of the past ten years and to kick off the next decade during which my Dad's kidney will hopefully continue to be its rockstar self.

I intend to use this blog as a means of keeping myself accountable. Though for some of you, a 10k is a walk in the park, let's face it, med school has taken quite a significant toll on my exercise routine. There will be times--an upcoming chunk of time, in particular--when I will be noticeably absent. However, I hope to post every week or so with my progress and any recent, relevant news. Ultimately, I hope to raise money for organ transplant research and to subsidize the exhorbinant cost of immunosuppressive medications for people who can't cover it themselves.

My efforts will focus specifically on the work being done at New York Presbyterian-Columbia University Medical Center, where I underwent my transplant surgery on July 26, 2001, but there are plenty of centers in need of help. At any given time, about 800 people are waiting for kidneys at CUMC alone; one can only imagine the numbers if those in line for other transplantable organs were tallied. Within Region 9 of the United Network for Organ Sharing, which covers only the state of New York and Western Vermont, this past month more than 7,500 people were awaiting kidneys.

There are countless worthy organizations to which one can give. Regardless of your religious or moral beliefs, I hope you will join me in acknowledging these people and in celebrating the modern miracle of organ transplant. To be completely honest, it feels odd and uncomfortable to be sharing this information about myself in such a public forum and, most of all, to be soliciting my friends for donations. However, I believe it's worth this feeling of exposure even if only a single person is helped by this campaign.

So I guess you're wondering how you factor into all of this. Well, here's what you can do:
1. Nothing! I will never know and promise to love you anyway. Maybe.
2. Read and feel inspired to do something--anything.
3. Send me song suggestions or, better yet, make me a 10k playlist.
4. Cheer me on!
5. Pass on word to friends, family, co-workers, whoever.
6. Join me! Run yourself and get friends and family to sponsor you for this cause.
7. Support transplant research and add to the fund for people struggling with healthcare costs, now or in the future.

Send your donation, payable to Columbia University and designated for renal transplant (or any other organ of your liking) to:
New York Presbyterian Hospital
Attn: Elena Manuel
622 West 168th St., PH-14-407
New York, NY 10032

May this be the start of an interesting and exciting adventure!
All my love,
Sarah