Someone will want to read this...

I just finished my first Marathon.

Wow.

I just finished a Marathon.

I've been training for this since I moved to Arkansas and today I finished it.

Pretty amazing.

I learned a lot of things.

Like how to run without bending either knee.

Woke up at 6am after a night of dreams in which I missed the race due to various unbelievable events. Ate a pita pocket stuffed with peanut butter, bananas and honey and some coffee.

7am arrived at the race and walked around in the freezing.

Miles 1-6 pretty good. Very cold however, felt like 32 degrees according to the weatherman.

Bathroom stop- this was a mistake. This is when my right knee seized up and I began the hobble.

Mile 13 tried to fix a wedgie in another portapotty, discovered my underwear had ripped and I was essentially commando the rest of the race. Oh yea, and my left knee decided to call it quits here.

Mile 14- learned to run without bending my knees.

Mile 15- met Ingrid from California, on her 7th Marathon. She has 2 children and 4 grandchildren, the youngest of which is 15.

Mile 17- borrowed some aspirin from Ingrid.

Mile 20- Finally.

Mile 23- Saw one of the race vehicles drive by with two racers I had recently passed. Were they picking up stragglers?! Better pick it up!

Mile 25- Cheered on by a man in a kilt.

Mile 25.2- got some free lipstick

Mile 26- I could see John and Sarah

Mile 26.2- They ran out of medals and will mail one to me. Rats.

I practically have no blisters though and my knees feel ok until I try to use them. Nothing 5 days of naproxen can't fix!

Now I can finally get that 26.2 sticker for my car!

Well, I almost wasn't going to post this...

But here goes.

Justifiable Homicide.

Reading through my own RSS feeds, seems several people have gotten their panties in a twist.

Good.

But I do want to point out that abortions are still legal medical procedures and so killing/harming someone for performing a legal procedure is still illegal.

Here's where it gets scary.

How many people are going to use this to feel justified? People already attack and kill physicians. Now there's a wordy bill that almost makes it seem...ok.

For those of you who read all that and heads are still spinning.

South Dakota is passing a bill that extends justifiable homicide (killing someone attacking someone else) to include those doing harm to a fetus/unborn child.

I do however like PZ Meyer's take on it.

They've still got to amend this thing, though. There's no mention of a season or of bag limits.

Do this right and we'll give you a cookie.

That's my assessment of Pay for Performance.

What's that you say? You normal, non-hospital person.

Weeeeelll, let's get into it. (Yes, I'm mixing homework and blog time.)

Pay for Performance.

Essentially, there are some "Quality Indicators" set up based on your presenting complaint. If the healthcare team hits these indicators the hospital gets "rewarded" for your visit. Sounds like a pretty good idea. I mean, everyone likes cookies. :D

Its purpose is to align payment incentives to encourage ongoing improvement in a way that will ensure high-quality care for all.

-http://books.nap.edu/openbook.php?record_id=11723&page=3#

For all. That would be nice. Unfortunately, an unintended effect has been the avoidance of "high-risk" patients. Those with multiple problems that would make meeting these "quality indicators" very difficult.

Then there's also fee for service. You basically get a bill for each test or procedure run, submit it to your insurance and hope they cover it. Also costs more, for you.

So it feels like this to me.

You can either order a #5 Cheeseburger that comes with lettuce, pickle tomato, fries, and a shake.

OR you can individually select what toppings and sides you want and pay the extra $0.50 per selection.

There's the argument that managed care, and care plans, and quality indicators are making medicine to be less of an art, more of a one size fits all. I hear grumblings that doctors can't make their own clinical judgement anymore. While I understand this frustration. I also like protocols. I feel they hit the high points. You cover the bases and check out all the reasonable possibilities.

I've heard the story one too many times about the 25 year old marathon runner presenting with chest pain and dying from an MI because no one thought it necessary to do an EKG on her.

Call me a freak, but zebras exist.

The problem is, as it always is, payment. How are we going to afford this mess?

Pay for Performance, doesn't make it cheaper.

Arg, so many problems, not enough solutions.

It's at this point in playing Sim City or Caesar I would generally quit and do something less stressful.

Now I have to reword all that in a professional sense and submit it as my assignment. Too bad I can't use hyperlinks...

Well, um oops.

Yea, it's me.

Not dead actually.

Just... busy...

Didn't realize more than a month had gone by since I posted anything... at all. Don't worry though, I haven't read my RSS feeds or called my mother.

But all that is going to change.

Eventually.

Maybe.

Meh.

So, what HAVE you been doing?!?

Truth is, I've got a roommate now and she's way more interesting to talk to than to surf the web first thing in the morning. So. HA.

Plus, this whole marathon training thing takes a LOT of time. Phew. I'll be glad when this is over and I can go back to simple hour long runs (instead of 4-5hours.)

Work is pretty intense with all the changes they're wanting to make and all the studies I want to do. I've been collecting, and compiling data, writing proposals and papers like a nut job.

I just hope I remember to document it all so I can get reimbursed with the whole Professional Advancement thingie they've got going on.

In addition to that crazy business, going back to class (even online class) takes quite a bit of time.

Good news is I'm progressing faster than a 90s video game character

Actually, at the rate I'm going I could be done by December.

Hm, fun.

Kelly visited again this weekend. No mudruns though. This time we played video games and attended a birthday party for Darwin. I know how to have a good time.

She's making me be a more social person. So I'm joining a club. We have a meeting tomorrow night. Kinda nervous. Geeks don't get out much. I haven't had to be social sans people I know in a very long time.

But, how can you call yourself an ENTJ you say?

ENTJs love to interact with people. As Extroverts, they're energized and stimulated primarily externally. There's nothing more enjoyable and satisfying to the ENTJ than having a lively, challenging conversation. They especially respect people who are able to stand up to the ENTJ, and argue persuasively for their point of view.

I am energized and like to be around people, but I don't necessarily want to talk to them. Tackett and I discovered this similar contrary trait we share. We like people, but we don't really like them.

I guess it's because I enjoy a good conversation and most people are (in my opinion) poor conversationalists.

I'm almost tempted to go purchase these, just so I'll know how to talk to people.

Meh, enough about this.

I'll get back on my blogging track and begin to provide details into all the fun and interesting things going on here.

Until then.

No science rage today.

Not enough time to catchup.

However,

I am listening to The Panic Virus on my long runs.

Well, I will be. Once I'm done with The Moral Landscape. (Book club meeting on Thursday if I do!)

I bet you can't wait for more Andrew Wakefield anger once I get into that!

Back in Class

Ah, back to school for me.

I'm in an online college now. Western Governor's University I did a lot of research and found out it's pretty good and not too expensive.

This was my main choice because it's all online and it's a "go at your own pace." I've discovered my pace can be pretty fast, so it felt like a good fit. I pay for my time, not credit hours.

Anyway. I completed my first class last week. I don't feel as though it should entirely count because it was an introductory class to online universities. How to set up classes, watch videos, access their library, things like that.

I've been playing around in my real first class today (Nursing Theories and Research) and I'm already 25% done. Whee!!

I do have a few frustrations though...

This textbook...

Sucks.

Understanding the Work of Nurse Theorists.

A Creative Beginning.

I guess the "Creative Beginning" should have clued me in. This is a load of fluffy---- well, it's very subjective.

My assignments are things like,

"Perform an Internet search using the phrase Hubble Space Telescope to find stunning photographs of outer space taken from the Hubble Space Telescope. Print your favorite photo to represent Roger's theory and paste it onto page 148 to share with classmates."

Excuse me? This is a MASTER'S program not 2nd grade. I stopped "pasting things to share with the class" when I learned how to open Microsoft Word.

You've got to be kidding me. When our graduate level classes have things like "paste to share with the class" as our assignments, no wonder so few people take nursing as a serious profession.

For another project I get to learn how to make a paper crane. Now, while I've always been interested in origami, I didn't expect to learn it in my Nursing Theories class.

Ugh. I'm thinking about posting about this aggravation to the "class community" but I don't want to be labeled as a troll this early on.

I guess I'm not much of one for the "Art" in the "Art & Science of Nursing."

Get your facts right!

More comments on Andrew Wakefield.

It's almost been a year since his paper has been retracted. I'm kinda glad and disappointed that we're still talking about this issue.

He was a fraud. He published a fraudulent paper. It was retracted and we're still feeling the effects of his fraudulence. (Look at pertussis for USA between years 2009 and 2010)

I'm glad it's still getting attention, because people need to know that vaccines do not cause autism!

I"m disappointed because it's been a LONG time since this started. It has caused a number of issues since it slipped through.

What is going on with the peer-review process?

It's a bit like this arsenic based life thing.

Things are getting out before they've been accurately checked. There's something wrong with the process if it's taking so long to be "reviewed and approved" but the "information" is still out for the general public to see. People made some very bad decisions based on the Wakefield incident.

Rebecca Watson made some interesting comments about this in the beginning-ish portion of this Skeptics Guide. (I had too, this is me with Rebecca Watson and some other weird-o...)

She was saying that now it's more the blog-o-sphere thats doing the fact checking and hand calling on bad science.

That's good in a way, but how can you tell who's a good blogger and a bad blogger. People go in search of blogs that reinforce their current beliefs and opinions. So, it seems that people are only going to get the data they want when they can search for it themselves.

It doesn't seem very objective.

On the other hand, it's good to get a lot of differing voices if you're presenting to a skeptical audience. Then they can discern for themselves.

Ugh, I feel it's time for a big overhaul in the peer-review process. When things like Butt-reflexology, fraudulent vaccine claims, and untested lifeforms keep on creeping in we've got problems.

It's no wonder the common man doesn't trust science.

Here's a Point of Inquiry that talks about why I think this is such a vast problem. Why Facts Fail.

After a while, once someone hears the initial data, it doesn't matter how much true data you can present them with. After they've formed their opinion, they're sticking with it, no matter how ridiculous it seems.

So, we really need to be sure we're getting the facts right. People just making stuff up so they'll get attention (AHEM, arsenic-based life) is not helpful. It's not a search for truth about our environment. It's not science.

*Steps off soapbox*

New Year!

Isn't everyone posting about New Years now?

I had a good 2010 and could regale you all with most of the stories about my life in 2010.

Biggest Event in 2010 for me Per Month

1. My cat was 1 year old.

2.John and I took a trip to KC and watched a free concert we learn about from google buzz 2 hours before it started. Good job social media.

3. John's Birthday, We learned about medschool acceptance.

4.I began applying for jobs in AR and we looked for houses

5.We bought a house

6.We moved to Arkansas and met Spencer (bad timing on that)

7.I began working in a new hospital, we hung out with some friends at the lake.

8.John started school

9.Met some medschool peeps.

10. I began marathon training in earnest, Kelly and I ran in the mud

11. Had a great Thanksgiving and Skepticon III

12.Traveled home for Christmas with family!

My life isn't that exciting according to this.

Maybe my New Year's Resolution should be to have more fun in life.

Things upcoming are the Little Rock Marathon and something else from my "list" that I haven't decided if I want to reveal...

According to WIRED, 2010 was a pretty dangerous year. I knew about the Russians and Wikileaks, but it seems I don't pay that much attention to the other things going on.

I guess it's time to compare and contrast Fail-Safe with Dr. Strangelove.

ACTUALLY.

It's Isaac Asimov's birthday. He'd be ninety one if he hadn't died of HIV complications. A bad blood transfusion killed a man that has been published in nine out of ten sections of the Dewey Decimal system.

Go hug a robot but, as Zog reminded me, make sure it follows the three laws of robotics first.