Marathon update

20 miles in the books – 1 month to go!

One of the benefits of long training runs has been exploring parts of the city I’ve never really seen before – especially on foot. In the past few weeks I’ve run over the 59th Street Bridge and the Triborough Bridge. I’ve run along the Hudson River to the Little Red Lighthouse. Today, we ran down the Hudson River to Battery Park and up the East River – essentially a partial loop of Manhattan!

As we ran past Chinatown, we saw a group practicing a fan dance – something so unique and definitely something I’d not have ever seen if I wasn’t training. It makes me look forward to race day when I get to see even more of my city!

Together we’ve raised over $4500 to support Breast Cancer research! Every dollar counts in the fight! Thank you to all who have donated so far, please consider donating during Breast Cancer Awareness month!

http://mskcc.convio.net/site/TR;jsessionid=00000000.app20101a?px=4073642&pg=personal&fr_id=3111&NONCE_TOKEN=91F3C2BDA6990E757955DF55C8CD3BE8

No Half Measures – I’m running the Full NYC Marathon

I’m running the NYC Marathon with Fred’s Team!

Running has been my passion since childhood. I started as a miler on the Middle School track team and although I was not always consistent with it, I’ve always found running to be an outlet for me. A way of clearing my head first thing in the morning. It didn’t hurt that it also helped me lose weight – 25 pounds in the past year!

As I got older running took on a new meaning – I started running for a cause. I did my first organized half marathon in honor of my wife, Lisa, who lives with Crohn’s Disease. I raised $25,000 at that race and was the third highest fundraiser in the country for the Crohn’s and Colitis Foundation of America. I ran several other half marathons for the CCFA and raised thousands more for them over the years. Which leads us to present day. Now I’m running the NYC Marathon for Fred’s Team with Memorial Sloan Kettering Cancer Center.

Longer course, different cause.

On May 19, 2017 Lisa was diagnosed with invasive lobular breast cancer. This type of breast cancer effects 10% of the breast cancer population. She’s never been one to take the common path, even with a breast cancer diagnosis. We went through a grueling year of mastectomies, chemotherapy, radiation and reconstruction. We’ve dealt with pain, vomiting, and hair loss. As sick as the chemo made her, she didn’t miss or delay a single dose. She needed 5 blood transfusions to get through chemo – including one on our anniversary – and never hesitated. Cancer picked the wrong woman to pick a fight with! Lisa dealt with all this with style, grace and humor – like the true warrior she is. Click for Lisa’s reflections on chemo. While the “heavy” lifting of treatment is in the rear view mirror, she’ll be on anti-hormone treatments for at least another 10 years.

No more half measures!

Just as Lisa’s treatment required aggressive therapy, I’m fulfilling a dream of mine – to run a full Marathon. So far, the longest I’ve run is 18 miles, and in 2 months I’ll be running 26.2 miles – hopefully under 4 hours. Please consider supporting me and this cause – while great strides have been made in this fight, there is so much more to do. 1 in 8 women are diagnosed with breast cancer – making it almost impossible for anyone reading this not to know someone affected.

To donate: http://mskcc.convio.net/site/TR/RunsWalks/FredsTeam?px=4073642&pg=personal&fr_id=3111

Thank you!

Remembering

17 years ago. My wife was almost 3 months pregnant, we hadn’t told anyone yet. In my office when she called to tell me about the attack. Riding in a police car across NYC with a machine gun mounted vehicle at each intersection. To the medical staging area at Chelsea Piers. The line of ambulances that never brought anyone – the first wave of victims went directly to the hospitals. The next wave of survivors walked out. Walking home from Chelsea Piers because it was the only way to get there. Remembering the people, the sights, the sounds and the smells. Mostly remembering my City coming together, figuring out how to get through a terrible day and find tomorrow.

Chatting about Health Screening

Enjoyed my chat with Elizabeth Millard @Emillard_Writer and @SharecareInc about Health Screening. Preventing disease and finding it before it can harm you is one of the things I like best about being an #Internist @NYULangone

Breast Cancer Awareness

It’s been awhile since I’ve updated my blog – but I wanted to remind everyone that it is still Breast Cancer Awareness Month. There are conflicting recommendations out there – bottom line – talk to your doctor, know your body, and if something doesn’t seem right – get checked out.

With that introduction, I’d like to post this note from my wife who completed another phase in her treatment of Breast Cancer.

Dear Chemo,

I’m just not that into you. We’re done. Our 4 months together needs to end. It’s been a one sided relationship. You took my hair, my eyebrows, my eyelashes. Because of you I needed 5 units of blood. You sucked the energy out of me, left me with fevers, a barking cough, severe nausea that had me vomiting in mid sentence. Not to mention you consumed most of my thoughts. My hands peeled off and now my cellphone won’t recognize my fingerprints! You tried to strip me of my identity, my dignity and my pre-menopausal status. But I’m still standing! So after 4 long months I am so glad this relationship is ending today. My only request, you did your job. You killed any remaining cancer cells. If you did, then the past 4 months with you was worth it.

Signed,

Breast Cancer Survivor

P.S. we are never, ever, ever getting back together.

#lastchemo #finishedontime #cancersurvivor #fightlikeagirl #halloweenchemo

By the numbers – my 2016

The end of 2016 – and every year – brings out the numbers – 10 best events, top news stories, greatest moments in sports, etc.  People have a natural need to quantify and rank things.  It gives us a sense of control over our lives – very important in a year that so much seemed beyond our control.  I am no different – living my life by the numbers.  I track my activity and sleep with a Fitbit, my runs with Runkeeper, occasionally track my calorie intake with Lose It! I track the number of patients I see every day, the articles I post on TheDiagnosisMD, number of hits it gets.  While the numbers are not the sum of all that is important in my life, it is an interesting lens with which to view it through!

Blog

  • 11 posts – missed my goal of 2 per month
  • Wrote 4/11 in January – meaning I went months without updating TheDiagnosisMD, other than via observations on Twitter and Facebook.
  • 824 people visited this blog in 2016 – less than in 2015 – perhaps an indicator of the lack of consistency last year!
  • In 2017, not only do I want to write more – I want to write consistently.

Activity

  • Tracked 4,463,882 steps – over 700,000 more than 2015 – NYC is a walking town for sure!
  • Ran 375 miles – 25 more than last year
  • Average distance per run 5.4 miles
  • Average pace of 8:56 per mile –  32 seconds per mile faster
  • I sleep an average of 6.5 hours per night – 12 minutes more per night than 2015

Work

  • Not going to attempt to count hours!
  • Became more involved in a leadership role in our practice and the Department of Medicine
  • Was co-investigator on a grant submission (decision pending) to develop a clinical research project and education program
  • Taught medical students and residents
  • 2940 face to face visits with patients

This last number strikes me as incredible – not for its absolute value, but the opportunity it represents.  2940 chances to make a difference in someone’s life.  2940 shared moments of success, failure, hope and fear as people cross my path.  My goal in 2017 is to make the most of these moments – for myself and my patients!

What are your goals for 2017?

The path to wellness begins with a proper diagnosis

Drug Holidays – what are they and when to consider

A drug holiday is a conscious decision to stop a medication.  The reasons to do so usually revolve around “seeing if I still need it” and side effects.

I was interviewed by Sara Klein in Prevention Magazine on this topic.

Click here for the story!

http://www.prevention.com/health/drug-holiday-facts

The path to wellness begins with a proper diagnosis

The circle of life (or Kreb’s)

This is a time of year when people think back over traditions and nostalgia flows as freely as eggnog and holiday cheer.  Of course, in my house, with a teenager ending her semester we have to get through exams and projects before there is anything to cheer about.  I was very excited this year – after I struggled mightily to help with math – apparently I don’t do it right – she is taking biology.  I figured even if there is “new bio,” as a physician I should be able to handle any questions.  When the Kreb’s Cycle was the topic this week I had a flashback to medical school, where we studied every detailed reaction to generate ATP.  The nostalgia began, and I can’t get the Farnesol song out of my head – sung to Jingle Bells.  This tale of how Acetate can become cholesterol is riveting.  Not as universally appealing as the Preamble on Schoolhouse Rock, but still fun. So I present the only online version I could find.  And a few, more modern takes on biochemistry in today’s world. Enjoy!

 

Wishing everyone health and happiness!

The path to wellness begins with a proper diagnosis

Don’t wait for New Year’s – exercise now!

Wishing everyone a very Happy Thanksgiving – I’m thankful for the opportunity to continue sharing my thoughts on health with everyone!   I know the holiday season is here – because last night when I was walking my dog I saw the sidewalk Christmas tree vendors setting up!  I also knew a big meal awaited me this evening – so I went for a run this morning to prepare.

Starting an exercise program is a recommendation I make everyday – to patients, family and myself.  The answers are often the same – “I know I need to exercise, but I don’t have time”, “I have bad knees”, or even “I don’t know if it is safe for me to exercise.”

Everyone faces hurdles in developing a routine.  Change is hard.  We go through periods where we exercise regularly, then the pattern is broken.  Getting started again is much more difficult.  Besides getting back on track, there is muscle soreness and risk of injury when coming back too fast.  But what about heart risks?  There are stories of people having heart attacks during marathons and other races, or even professional athletes who have heart attacks despite being in presumably peak physical condition.

Regular exercise has repeatedly been shown to reduce the risk of heart disease, diabetes and stroke.  It has also been linked to lower rates of certain cancers.  However, in what may be one of the more profound ironies of life, the risk of a heart attack goes up when you first start to exercise – the older you are when starting and the more intense the activity – the greater the risk!

Statistically higher – but meaningful?

The good news is while the risk of a heart attack or dying when first exercising is increased compared to sitting on the couch – it is still exceedingly rare!  To be clear – if you already have heart disease these numbers don’t apply – I am referring to people who don’t have existing disease and are starting to exercise to keep it that way!  If you already have disease – exercise is essential for you, but you should speak to your physician about how to safely start (this is why cardiac rehabilitation programs after a heart attack are so important).

The risk of a fatal heart attack is literally 1 in a million  – this number comes from studies of people having heart attacks at the gym (over 22,000,000 hours of exercise evaluated) and half/full marathons – and most of the people in these settings had pre-existing heart disease.  That risk goes down with repetition – so the more you exercise the less likely you are to experience an exercise induced heart attack.

Start now – or pay later

The holiday season begins now.  Snacks start arriving in the office, there are holiday parties and dinners and more alcohol than usual – yet over a month before the inevitable New Year’s Resolution to exercise more!  Think about starting now.  Regular exercise now may not make you lose weight – but can limit the gain from all the festivities.  A habit started now will make a resolution unnecessary!

So follow common sense – start gradually and consistently, and increase the intensity of your activity as your body gets used to exercise.  Don’t let something very rare keep you from achieving your best health.  As Nietzsche said, “That which does not kill us, makes us stronger.

The path to wellness begins with a proper diagnosis”