7 Day Crossfit Juice Fast-Day 5

     Love your weakness. That's right, love it. Embrace it and nurture it. In both your internal and external dialogue, speak positively about your weakness. Instead of saying "I suck at x" or "I hate to do y", try "x is challenging, but Wow! it's going to be cool when i get it" and "y is uncomfortable and I fail at it sometimes, but I will not give up until I have it mastered!". 
     I began doing yoga this year and have found it tremendously helpful in gaining balance and flexibility, both inner and physiological. One of my personal mantras has always been, "attitude of gratitude". However, I've never really applied this to my body because I've always been pretty unhappy with it. At the end of every yoga class, we hug our knees to our chest, lie in the fetal position, and thank our bodies for serving us, literally showering our physical container with love, respect, and adoration. This has been a beautiful paradigm shift for me. 
     I started today with only about 4.5 hrs of sleep and the WOD this morning was centered around my weakness, squats. I was dreading it since the night before when I saw it on the website. I have a history of low back pain and injury. In addition to this, 21 yrs ago I was in a car wreck that crushed my right ankle. I now have some stiffness and pain in that joint. Then, freshman year at college, 18 yrs ago, I blew out my left ACL hiking. So that joint has some issues too. Now, mix in tight, underdeveloped, largely ignored hip flexors and... you get the idea. Squats are challenging to me. 


Front squat
3-3-3-3-3 (record 3 highest sets)
then
AMRAP in 15 min:
10 front squats 115lb
15 pull ups
25 double unders


weight-206.3lb (post WOD)
emotional status-anxious today (lack of sleep,WOD, hungry???)
stamina-not great today. I failed at 185lb and I have done this wt before. 135lb and 155lb were manageable, but I couldn't dig to that deeper place. I also gassed out during the workout. 


     The food part of today was the easy part. I had a great time working out with my friends and got to spend some quality time with my brother. We made a big Costco run and I restocked the fridge with my last cache of fruits and veggies to carry me out to Sun morning. The diet felt easy and natural. 
     My body continues to recover faster than normal. My soreness is minimal, if at all. I went four rounds deep today and my competitive partner finished fifteen reps ahead of me (~1-2min of work). He has very strong legs and performs 115lb front squats with ease. So, I wasn't terribly disappointed with my output, but I did rest and struggle more than usual. We'll see what tomorrow holds...
favorite juice today: 1 lemon, 1/2 cantaloupe, 3 carrots, 2 cups spinach juice 


*I want to add that despite my previous injuries, I have never been stronger or more flexible in my lower body than I am now. More importantly, the low back pain and weakness I once had is almost completely gone after this year of fitness dedication.*

7 Day Crossfit Juice Fast-Day 4

     Today, I am so thankful for food. It's not that I miss it all that much, I just appreciate it. I am thankful to live in a country that allows me so many wonderful choices and am blessed to have the financial means to afford any food I choose to eat. That being said, today was great. I had a great workout and felt normal throughout. I even had the thought of doing two WODs today, but just a thought...

3 rounds; AMRAP in 1 min:
Ghd sit ups
Row calories
Russian twist 35lb
Box jumps 24"
Jacknives
turkish get ups 35lb
rest 1 minute after each round


weight-208.8lb
emotional status-calm, confident, got my swagger back
stamina-as good, if not better than normal


     This process is about doing, not thinking about, talking about, researching, or bragging. We either do a thing and learn from it or we don't. I'm learning so much about who I am and my relationship with my body. I'm amazed at my willpower. I brought some sausage biscuits home to the family a couple of mornings ago and they ordered pizza tonight. I wasn't even tempted because I'm dedicated to this process. 
     I feel really good. I'm recovering much faster and I'm not feeling as sore as usual. I attribute this to the diet, because nothing else has changed. I've never felt like doing two-a-days before, so this is truly unusual. 
     Juicing may become my new preworkout supplement. The nutrients and sugars energize me. I usually take a scoop of Jack 3d or Superpump 250. I'm letting that go. I don't need it anymore. 
Favorite juice today: 3 carrots, 2 small green apples, 2 stalks celery, large cucumber

7 Day Crossfit Juice Fast-Day 3

     I have heard that day 3 of a juice fast is the toughest. I didn't have this experience today. My energy and mood was good and I only missed the act of eating a couple of times. The morning WOD was heavy, but I set a new PR on consecutive 70lb kettle bell swings (21). I also posted a respectable time (14:56) and beat my competitive partner. It definitely is more challenging right now than day 1, but i'm cool.

For time:
21-15-9 reps
kb swings 70lb
bar facing burpees
push press 95lb

cash out:
800m run

weight-210.3
emotional status-strong, confident
stamina-normal


     My workout went great today. It was an evil mix of strength and cardio. I didn't bonk or hit a wall. I just got normally tired. After that, I worked out in the yard all day trimming hedges and spreading mulch. Then, I picked up the kids, played, and cooked dinner. The whey protein and almond milk must be helping.
     I drank broccoli, carrot, pear, apple juice for breakfast. I've been trying to get a juice in me at least 45 min prior to my WOD. I feel this is imperative to get some gas in the tank. Then, I drink my protein shake within 30min or so before that hyperdynamic, vasodilated, rapid cellular uptake window closes.
     This journey has given me lots of time to think about my food choices. It has also shown me how good raw fruit and veggies are. I had an asparagus, carrot, cucumber, romaine, lemon juice for lunch. It was hearty and interesting. The lemon cuts the bitterness from the greens, plus I really like lemon. I also like drinking out of my English pint pub glasses. It makes me think about beer (ahh, beer) and you get to really see the frothy, pulpy juice. That makes me feel good about the nutrients I'm taking in. Forging ahead. 

7 Day Crossfit Juice Fast-Day 2

     Today was a great day. I felt great, clear headed and strong. I made it to a morning WOD. It was cardiac and power intensive. I went seven rounds deep and got the last set of cleans before time expired. There was no noticeable difference in my endurance. It was just hard. 

AMRAP in 20 min:
5 power cleans  145lb
10 toes to bars
15 wall ball  20lb

weight-209.8lb (post WOD)

emotional status-more emotional than normal???

stamina-seemed normal during workout little tired in the afternoon

     So, it looks like I dropped a ton of weight in one day. How can this be you ask? Well, the night before I started this endeavor, I had a cheat meal. It was salty Mexican and it was delicious! I have been peeing like crazy, so I am downloading water. I do feel wonderfully hydrated. As a side note, I had a headache one day at work and my friend Cindy asked me if I was adequately hydrated. I really hadn't thought about it. I went and drank 30 or 40oz of water and felt better within the hour. 

     I forgot to state what supplements that I am taking in my previous post. I take fish oil (usually 1-2g, but i'm upping it to 5-6g), vit D3, and a men's health multivit. This process is working for me, so far. I'm learning about new foods. I drank fennel, pear, lime aid today. I've never even looked at a fennel in the market before! It makes me feel good to try these new healthy options. I could see chopping up this herb on a salad.  

     My wife and I went to lunch at an organic cafe today. I had a ginger, garlic, cayenne, beet, apple, kale, and carrot concoction. It reminded me of a spicy soup... It was interesting and flavorful and i'm glad I tried it. Two days down. 

7 Day Crossfit Juice Fast-Day 1

     Today is Superbowl Sunday. This may not have been the best day to start a juice fast. Tonight, my friends are all going to be drinking beer, eating nachos, wings, brats, and various other delectable game day treats. I will be drinking vegetable and fruit juice. In order to maintain the intensity of my workouts and prevent muscle breakdown, I am supplementing my fast with two unsweetened almond milk and whey shakes a day (~120g protein). One before bed and another post WOD. The rest of the time, it's raw, freshly juiced veggies and fruit. I'm using a Breville BJE510XL Ikon 900-Watt Variable-Speed Juice Extractor. 


weight-215.8lb
emotional status-anxious
stamina-did a 1hr yoga class & I felt normal


     First, I'd like to admit that I have a problem with food, an unhealthy obsession. I'm an emotional eater and I am attempting to step back from this paradigm so that I may examine it more clearly. I want to see what it feels like to live a week of my life with an ultra clean diet without the food getting in the way. 
     Being raised in the south eating southern foods, e.g. fried everything salted & buttered, white rice, potatoes, & biscuits, over cooked vegetables seasoned with fatty meats, pies, cakes, cookies, etc.., I have a history of making poor food choices. This week will allow me to saturate my cells with vital nutrients while I get my head right about how I choose to fuel my body. 
     Two years ago, I was a fat, depressed, stressed, over-worked father of a 3 & 4 year old. I was getting ready for work one day and I looked in the mirror and it hit me. I was on a bad trajectory. So, I joined a gym and began to work out. I got a little stronger. Later, my buddy asked me to run a 5k trail/mud run and I did. It was fun, so I began to jog a little. Then, a year ago, I began doing crossfit. 
     This has changed pretty much everything. I didn't know what a workout was, but I do now. I didn't identify myself as an athlete, but I do now. I think about nutrition, flexibility, strength, endurance, agility, and, power. My new body is leaner and I can see the fruits of my labor. This makes me want to be even better, train harder, and eat cleaner. 
     I started yoga this year and am really enjoying it. I can feel my balance, both physical and emotional, getting better. My workouts are getting better. I push as hard as I can, but I stay within myself, enjoying the struggle. I've learned to accept my faults and thank my body for how it serves me in this life. 

5 Ways to Shine

Your anesthesia clinical rotations are hard. Suddenly, you are thrust into a foreign environment and culture and are expected to instantly assimilate. You also have to prove yourself each time you rotate to a new clinical site. Then, just when you feel like you are getting your legs and jiving with the swing of things, poof! You’re gone. Then you move on to the next hospital and start the maddening process of proving you’re not a liability and moron all over again.

The anesthesia community is a small one. It seems like everyone knows each other through some complex, six degrees of separation, social network. This is why it is imperative that you look good, wherever you go. Each rotation is a potential working job interview or reference source. This becomes especially crucial in a tight job market!

We all are being judged on a daily basis. Every day we step into the OR, we are on stage for our CRNA peers, anesthesiologists, surgeons, scrubs, operating room assistants, and circulating RNs. You can know every drug in the anesthesia cart and intubate class IV airways all day long, but if you don’t project yourself well, you won’t gain the respect and admiration of your colleagues. Keep these five points in mind the next time you are in the OR.

1. Show up early and stay late. Arrive before the anesthetist you are working with does. Set up your room for the cases that you will be doing that day and read about any surgeries and pathologies that you are unfamiliar with. If a great case is about to start in your room around quitting time, call home and let them know you’ll be late for dinner. This segues nicely into the next point.

2. Seek to learn. This is the time in your career to dive in to the big, complex cases. Don’t worry about looking like a fool, you’re a student. Expectations are adjusted accordingly while one is actively learning. Besides, if something goes wrong, this is the time to have it occur. You can tap the mind of a knowledgeable and experienced CRNA!

3. Don’ t be afraid to say “ I don’t know”. (just don’t say it too much) If you have no clue to the answer of a question that you are asked, be honest. Write it down, go home and look it up, and find the CRNA or MD that asked you and knock their socks off with your new and exhaustive knowledge of enflurane and its link to thyroid dysfunction in the fetal cat.

4. Talk the talk. When you explain a drug, organ, or physical ailment, use the appropriate terminology, i.e. medical lingo/jargon. Talk to your friends, spouse, or dog about up/down regulation, rate pressure product, endogenous vs. exogenous ligands, kallikrein, ad nauseam… This will serve you well while abiding by the law of being a student. Be able to explain your rationale for each and every action you initiate.

5. Offer to do the little things. This is where hidden gems of clinical education lie. Go start that IV on the 400lb ESRD guy who hasn’t been dialyzed in several days or intubate the lady in NICU who extubated herself in a halo. Assist the CRNA or MD with preop blocks or a blood patch in the ER. Go see the patient that is having their tongue and mandible resected in the AM for oral cancer. Do postops in OB and talk to the lady who had to be put to sleep after a bad SAB and unsuccessful ketamine IV sedation. Help set up the heart, vascular, ped. ENT, neuro, or trauma rooms. People will notice and you will be exposed to some special learning opportunities.

Bad days pass, bad rotations end. Good luck, and remember how far you have come!

CRNA Scientist

I have spent a lot of time and consternation considering the problem of the anesthetist technician and the apathy exhibited by this type of practitioner. I believe this lackadaisical attitude springs from a root problem which lies in the nurse psyche. Nurses are issued orders and warned against thinking and acting too freely (so as not to cross the line into the practice of medicine). Also, no one tells a nurse that they can be a scientist, thus enabling them to realize and practice within this paradigm. Additionally, many nurses who want to be CRNAs seem to just be reaching for the brass ring. Once it is in their hand, many just hang on until retirement, sometimes loosely. Physicians, on the other hand, are extremely driven individuals considered by society and trained to consider themselves as scientist.

Well, I too consider myself a scientist. I had to study anatomy, physiology, chemistry, physics, pharmacology, math, statistics, etc. to achieve my degree. Once I became a CRNA, the study didn't just stop. I still read textbooks, journals, and the internet to stay abreast of the ever changing advances in our field. I attend meetings and am a member of forums such as the Learn to Sleep Google group and Yahoo’s Clinical Anesthesia forum to learn from others, and hopefully teach when the opportunity presents itself.

Like a scientist, I develop hypotheses on a daily basis regarding my patient and some deviation from their normal homeostatic state. I then test this hypothesis with an appropriate clinical action. Then, I collect data and analyze it to determine if my educated guess was right. Based on these results, I gather knowledge and learn. I know this is happening because I am developing better clinical judgment and avoiding some problems that I used to have to fix (or at least anticipating the problems that I have no power over and will have to address, i.e. surgical blood loss).

There's an old saying "you are what you eat". I agree, but take this axiom one step further. I think that you are what you consume. All anesthetist consume science and the scientific method on a daily basis, whether we realize it or not. So, once we clearly see ourselves as what we are, perhaps we will hold ourselves to a higher standard of knowledge acquisition and retention. So, dust off those old books, read your AANA journal, join an online forum or discussion group and embrace that scientist inside.