Saturday, December 17, 2011

Saoili runs barefoot, take 1

I've been reading a lot of things lately that have me considering taking up barefoot running. The foremost of these is Christopher McDougall's excellent book Born To Run. I've also read warnings against simply throwing your shoes in the bin and expecting a lifetime of injury free barefoot running to come straight from that. So this morning, despite not having read much detail on the actual mechanics our techniques of the whole thing, I decided to give it a shot. Not quite throwing my runners away and heading out the door. I ran two miles to the nearest beach, took off my shoes and socks and ran half a mile down the beach and turned around. I put my shoes back on when I reached them and ran back to the house.

My personal best pace is just under 8 minute miles, on a track, at peak fitness, on a calm night, in a race. Since I ran a marathon I've only once or twice managed to sustain 9 minute miles for any length of time. Which is why, when I glanced at my GPS watch .15 of a mile down the beach and it told me that my pace was 7 minute 14 second miles, I figured I should probably slow down, and did so. I was kinda sorry later, because it probably would have been a better experiment if is kept going at whatever pace felt comfortable until the end. About a quarter of a mile in I remember thinking about how I'd read that one of the reasons barefoot running is better is because your feet tell you things. I figured that any minute my feet were going to be to numb from the cold to tell me anything. By the turn around point they were clearly communicating. They were saying ow. Not just the cold, but the unfamiliar uncushioned impact hurt a lot. This will take practice. In short, I was glad to put my shoes back on, but I also look forward to taking them back off.

Friday, November 25, 2011

Why I uninstalled Stupid Zombies

Stupid Zombies, for the uninitiated, is a free game for smart phones.  The screen is filled with zombies.  Your character has a gun and limited bullets.  Later on you get different kinds of bullets, which are lined up in the gun and you have to use them in order.  You need to shoot all the zombies.  If you succeed you get one, two or three stars.  There are at least three chapters, each containing at least three stages, each containing at least sixty levels.  It's a big game.  And it encourages you to play until you've gotten three stars on every level.

A week or two before I got a smart phone I saw the guys I hang out with in work playing it.  One gave me a go and it seemed like fun.  So when I got a smart phone, it was one of the first things I downloaded.  I've been playing it more than I should ever since.  Until today, when I uninstalled it.

I did so because I realised I was playing it again, even though I had decided not to.  And I wasn't even enjoying it.  And, on reflection, I wasn't sure I had ever really enjoyed it.  So why had I played it so much?  I wasn't learning anything.  I wasn't acquiring any useful skills.  I wasn't even relaxing, particularly.  And I just didn't actually find it fun.  But I wanted to defeat it, to clear it.  And I found it engaging and compelling.  I have a theory now as to why.

One of the striking things about the game is that there doesn't seem to be much of an order to the levels.  There are 600 of them (I just looked this up), so I guess it would be hard to have them in increasing difficulty.  But the way it is seems silly.  I've gone through 10 levels in a row clearing each on the first try, only to get stuck on a hard level for half an hour, or have to come back to it several times.  And that was pretty normal game play.  The hard levels are sometimes pleasantly challenging.  And I did enjoy clearing even the easy ones a little.  Even the ones that you could accidentally clear with one bullet when picking up the phone.   But the real thrill was defeating the difficult levels.  And it reminded me of something.  I remembered hearing that a pigeon that gets food some of the times it pecks at a button will keep pecking long after a pigeon that gets food every time it pecks the button stops.  I wasn't enjoying myself, I was being conditioned.

Extra Credits have discussed the Skinner Box and how it applies to video games much more eloquently than I could: http://penny-arcade.com/patv/episode/the-skinner-box.

And the reason the designers of the game want me to be conditioned to keep tapping through the 600 levels of the game even though I'm not enjoying myself?  The ads.  I am familiar with the internet method of making money where 'free' products are paid for by ads.  I'm fine with that.  I like it actually, as I basically never click through on any of the ads and I still get these things for free.  But the ads in Stupid Zombies are offensive.  Even back when I thought I liked the game I hated the ads.  The ones that come up between levels, sometimes, where you have to click the phone's back button to get rid of them (nothing tells you this, you just have to work it out) are annoying enough.  But the little banner ads at the bottom of the screen that actually prevent you from playing the game properly?  Well, they'd almost make a GOOD game not worth playing.  Not to mention the fact that it's the same couple of ads over and over again, for products and services I wouldn't buy even if they weren't obviously dodgy in some way.

The thing that really gets to me though, is that the guys in work still think this is a good game.  The 26270 people who gave it a five star review on the Android market and the 8068 people who gave it a four star review thought it was a good game (compared to 2437 three star, 735 two star and 1843 one star).  I feel like all those people are being fooled.  And I feel sorry for them.

TLDR: Don't download Stupid Zombies.  It isn't a fun puzzle game.  It's a skinner box with annoying ads.  And watch the video I linked to.

Friday, November 18, 2011

An open letter to Dr Fidelma Fitzpatrick HSE Clinical Lead for the Prevention of Healthcare-associated Infection

Dear Dr Fidelma Fitzpatrick,

I have just read the 'the journal' article ‘HSE wages war on unnecessary antibiotics use’ in which you are quoted talking about the need to wage a war on the growing resistance to antibiotics.  As the daughter of a retired Medical Scientist and Lab Technician, I am very familiar with this war.  From a young age, I was trained to always finish my courses of antibiotics and I was disgusted when I changed GPs to one nearer college and found that he seemed to prescribe antibiotics for everything I went to him about, whether it seemed to be bacterial or not.

But I believe that, in targeting the public with the message ‘do not take antibiotics for viral illnesses’ you are sending the wrong message to the wrong people.  The message to the public should simply be ‘finish any course of antibiotics you start and only take antibiotics that are prescribed for you and at the time they are prescribed for you’.  The message needs to go out loud and clear to DOCTORS not to prescribe antibiotics when they are not necessary.  It seems that doctors prescribe antibiotics for viral illnesses to provide a placebo effect and satisfy patients who feel that they should leave a doctor’s surgery with medicine of some sort.  This is not ok.  Patients go to doctors because the doctors are supposed to know best when it comes to the patients’ health.  Doctors need to stand their ground on what treatment they know to be best.

If people are taking too many antibiotics, it is because doctors are prescribing too many antibiotics.

The article also quotes ‘the HSE’ as saying that ‘taking antibiotics for a viral illness is:
-          A waste of a life-saving resource, and can cause bacteria to become resistant to antibiotics, so they may not work if you take them properly in the future
-          A waste of GP fees and prescription fees, or for medical holders a waste of taxpayers’ money
-          A waste of time – visiting the GP and taking time off work
-          A waste of time for the GP who doesn’t need to see patients with colds and flu.’

I agree only with one and a half points.  Yes, it is a waste of a life-saving resource.  Yes, it is a waste of prescription fees and in taxpayer’s money in the case of medical card holders.  But it is not a waste of GP fees, GPs time, patients time or time off work.  People who have viral infections, including colds and flu, are sick.  When you are sick it is perfectly reasonable to go to your doctor.  It is up to the doctor to diagnose the illness and prescribe the correct treatment, even if it is just bed rest.

Patients should not be expected to diagnose the source of their own illness before going to a doctor.  They should be able to trust doctors not to prescribe the incorrect treatment.


The HSE has diagnosed the illness; people are taking too many antibiotics.  But it has prescribed the wrong treatment.

Regards,
Sorcha





Updated to add her reply:

Dear Sorcha

Thank you for your email and apologies for only getting back to you today.  I was out of the country giving a lecture from Friday afternoon so only back today.

The public education campaign is part of a bigger package which includes a GP education programme via the ICGP and also printing out updated antibiotic prescribing guidelines, an updated patient information leaflet and a ‘no antibiotic prescription’ sheet for GPs (see http://www.hpsc.ie/hpsc/A-Z/MicrobiologyAntimicrobialResistance/Antibiotics/).   The campaign has been developed by a group of healthcare professionals which included GPs and also modified after feedback from patients and members of the public.  The reason that we have included a public education campaign is that we know that there is misinformation among some patients and members of the public that antibiotics work on colds and flus and we want to address this also.

Studies have shown that prescriber (mainly GP) education alone does not produce a sustained reduction in inappropriate antibiotic use: patient and public education is needed as well.   Data from other countries show that for many conditions (particularly upper respiratory infections), antibiotics are prescribed when they are not needed in up to 50% patients.   We know that public expectation and pressure can influence prescribing decisions, and that public education has been shown to be an essential component in reducing inappropriate antibiotic use.  A Europe-wide survey, which included Ireland, showed that members of the public often mistakenly believe that antibiotics can hasten recovery from upper respiratory tract infections (coughs & colds) and prevent more serious illness.  Such misconceptions were lower in countries that have succeeded in maintaining low levels of inappropriate antibiotic use.  Surveys have shown that nearly half of the adults that go to their doctor expect an antibiotic once they get there.  In the US between a third and half of patients of parents with children presenting with mild respiratory symptoms said that they expected an antibiotic for a cough and cold.

Antibiotic use peaks every winter in Ireland, during cold and flu season, hence why the campaign will run over the Winter months.  We know from published evidence from other countries (e.g., France, Belgium, UK, Australia) that these type of campaigns do help improve public understanding of when antibiotics work and also help reduce antibiotic prescribing. 

You are absolutely right with your point regarding the importance of completing antibiotic courses, hence why we have included this in our patient information leaflet and also a downloadable powerpoint for GPs that they may wish to run in their waiting rooms.  Of course it is important that if somebody is concerned/feels unwell that they still go to their doctor – the thrust of the patient information leaflet is that if you do go to your doctor and your doctor does not feel an antibiotic is warranted, then don’t pressurize your doctor for one, rather ask what you can do to feel better.I don’t think the campaign is the wrong treatment – there is misinformation among our patients and members of the public regarding the role of antibiotic is colds and flu so the campaign is trying to address this and from other countries there is evidence that it does this.  Of course though it needs to be part of a bigger package which is why it has included an update of the GP prescribing guidelines.

Thank you for taking the time to email me – I appreciate your feedback.  If you have any other comments or thoughts as to how a campaign like this could be developed over a number of years please let me know.

Regards
Fidelma

Monday, September 26, 2011

I accidentally ran one of the hardest and hilliest marathons in the country

Cross posted from my old blog.


Short version: I missed my pessimistic goal time by almost twenty minutes, did a lot of walking and failed to get a negative split. But I not only completed a marathon, but one of the (if not the) hardest and hilliest on "these Islands", with no hill training. Ow.

I set myself two different goal times for the marathon; 1) the somewhat arbitrarilly chosen, should be doable, time of 5 hours (11 minute 27 second miles) and 2) my BHAA Standard, probably unrealistic, time of 4 hours 39 minutes and 13 seconds. My pace on my 20 mile training run was 11 minutes 45 second miles and I had read that you should do your long training runs a minute or a minute and a half per mile slower than your marathon pace, so I thought it shouldn't be a problem to knock 16 seconds a mile off. I was thinking that I'd do the first half as though I was going for the slower goal and speed up in the second half if I felt up to it. But when I set my goal (and did my training), I did not know about the hills.

The first I learned about the hills was when I went to pick up my chip and bib and saw TShirts for sale advertising the half marathon with the slogan 'are you tough enough?' and a graph of the 750 foot climb and drop. I hoped that the marathon route didn't follow the half marathon route. Or failing that, at least that the second half of the full was flat. I was wrong on both counts. I also should have seen the problem coming by the number of people who told me I'd picked a hard one for my first. The second half is flatter, but we're still talking a climb of over 100 meters. And not in the reasonable 'we're still going up' kind of way that the first half is. But rather in that 'really, that's not the top either', up a lot, down a little, up a lot, way than any hiker or hill walker will be familiar with. Over the course of the whole thing I went up over half a kilometer.

elevation profile picture
elevation gain 512m, elevation loss 541m

The first two miles flew by in a brief blur of pleasant conversations with mostly foreign strangers (who were mostly doing the half marathon) and thoughts of 'I'm running a freaken marathon!'. I managed to stop myself going much faster than the 11 minute 27 second miles. Mile three was where the first hill kicked in. One American I talked to later said that she figured the cow theme was because that first hill you come to makes you say 'holy cow'. I was quite proud of managing not to drop to a walk on that first hill, which was most of miles three and four and the start of mile five. I passed a lot of people who had done so. Just after the four mile marker there was a water and aid station and a fantastic drop with a beautiful lake view. I released my inner five year old, shouted 'whee' and ran down the mountain, passing a bunch more people. I say ran, it was more like controlled falling. A couple of times I had to slow myself down because I actually felt in danger of falling over. After that I ran for a bit with a guy called Fergus and a girl called Eithne who told me they were very amused by my going 'whee' by them. After a while I glanced at my watch and realised that I had now more than made up for the time the hill had cost me and needed to slow down, so I said goodbye.

I'm not sure when the first time I got chatting to Eimhear was. She reminded me a lot of another Eimhear I know in that 'bubbling with enthusiasm and confidence, crazy in a good way' kind of way. She was running the full with her friend Colette. Most of our conversations ended with her dropping back to let Colette catch up with her. She sang a lot. She was the one who christened my fiance and son my 'support car'.

My support car drove by me just before the first water station. I saw them and wasn't sure if they'd seen me. My fiance later told me that he had but was too busy trying to get the car up the hill and not hit any runners to wave. Shortly after the water station my car was there in a lay-by with an adorable little hand stuck out the window looking for a high five. Which, of course, it got.

Another person I talked to a lot was an American woman that I kept catching up with when she stopped to take photos. She had brought along the camera mostly to make sure she took breaks. She was rewarded with some of the most scenic views I've ever seen and has promised to email me the photos. I've run a few races that have claimed to be picturesque. But I've never felt any of them really pulled it off before. The views on this one were stunning.

sea between mountains

My legs and hips started making themselves known to me at about mile eight. Not that they were really complaining much, they just thought it was important that I was aware of them.

My support car turned up another once or twice in the first half. Always a delightfully welcome sight. The stuff that motivation is made of.

At the halfway mark I passed the finish line and lost most of my company as the half marathon finished. After that point pretty much the only person I saw was a woman who was alternating between running and walking, when her preset watch told her to. At first she would catch up to me when she was running, then fall behind me when she was walking. Then she would pass me when she was running and I'd pass her when she was walking. Then I'd catch up with her only when she was walking. Then she was a spec on the top of a hill when I reached the bottom. I guess that strategy was working for her :).

The route was very well marked. As promised, whenever you had to turn the ground had a little white 'moo' and an arrow. Everywhere else you just followed the road. That said, after a long few minutes of not seeing any other runners, I started worrying that I had interpreted where the road went differently to them at some point. This happened repeatedly, but every time I eventually came across another mile marker to tell me I was still on track.

Once it became clear that I wasn't going to have any more company I started playing my audio book, as I usually do when training.

Mile seventeen and eighteen brought the first serious hill in the second half of the marathon. And it was a serious hill. This time I conceded and walked for most of it. I just didn't have the juice left to run it.

Speaking of juice, I brought along five energy gel packs, planning to have one every fifty minutes. I'd used them once in training, on my 20 mile run, and had found them very useful. I didn't feel the need for the first until well after the first hour. The second and third were similarly over an hour apart. So, when I wanted another about a half a hour later I figured I could take it and still be behind schedule for taking them all. And so I learned why you don't take them so close together. Lemon bile, delightful. Thankfully I managed not to actually get sick, but it was a close call once or twice. I never got around to the fifth gel, funnily enough.

Mile eighteen was also where I finally gave in to my bladder and asked some nice strangers if I could use their toilet. They let me, saying that I surely deserved it, given how far I'd come. I noticed at some point later that I was reaching all the mile markers about 0.08 miles after my watch said I was. I was confused by this but just tried to recalculate based on it and carry on. It was only after I finished the race that I realised those guys' toilet must be 0.04 miles away from the road. I was very amused.

In mile twenty I was close to tears in a good way, knowing I was going to finish and thinking that I could catch back up with my goal time if the rest was mostly downhill, which it surely had to be.

And I actually managed something resembling running in miles twenty, twenty one and twenty two. Though progressively less so.

I think mile twenty three was possibly where I started running into to wind for the first time. Before that I had noticed it at my back once or twice and been grateful for it, particularly going up the hills, but I hadn't really been aware of how strong or cold it was. Mile twenty three was certainly where I hit the wall, realised I wasn't going to make my goal time and lost most of my will to go on and some of my will to live. I was so sore, so tired, so cold and so beaten that I was close to tears. When I saw a water station coming up with my support car at it, well, it helped a lot :).

From that water station I had to run down a road, turn around, run back up that road (into the wind), run down another road, loop around a church with another water station at it and back to that first one again before heading for the finish. My support car managed to be at that point each time and also at the church, where they gave me a jumper that may have been the difference between me finishing and not finishing.

One of the times I approached the car I heard my son say 'run Mammy, run!'. Which I dutifully did, for a few yards :). I later learned that he had said, disgustedly 'I see Mammy, and she's not running!' just before that.

The last few miles I was really upset at missing my goal time. I kept telling myself that it was an arbitrarilly set limit, chosen without all the information. But I wasn't listening, and I was distraught.

I managed a little bit of running in mile twenty four, but mostly walked it. Walked mile twenty five pretty much entirely. At that point I was just determined to finish, even if I had to walk the whole way.

When I reached the twenty five mile marker I thought 'just 1.28 miles and I get to see my fiance and son again'. Then I thought about how long it would take to walk that and decided I couldn't wait that long and ran the last stretch.

Just before the finish line my finance saw me taking off the jumper, which didn't fit the black and white theme, and ran over to grab it from me. I really didn't want to be wearing it in the photo at the finish and it was great to not have to carry it either.

I crossed the finish line and sat down, with a view to lying down, but my son ran over and gave me the world's biggest hug, holding me in a sitting position.

I recieved my ridiculous but precious full mooathon finisher's medal. It's a cow with flashing eyes.

it's a cow with flashing eyes, and a sweatband

We went back to our hotel, with me munching on the peanut butter and mashed banana baguette that had been prepared for me. I had a cold bath that was not as useful as the last one I had (I suspect this one was not cold enough). Then we walked to the main race hotel. It was further than we thought and the walk was torture. I know it's a good idea to keep moving afterwards. But ow.

We sat around chatting to other people who'd done the race. They were mostly people who had done the half marathon, were jealous of my medal and thought I was crazy.

Myself and my son went in to the prize giving. I got called up for a photo for being the fastest woman in my age category. With an over all time of almost five hours and twenty minutes, I can only assume I was the only woman in my age category. Or that all the others had been disqualified from that prize by winning overall prizes. It was still nice though :). My son was delighted.

Over all, I'm very glad I did it. I'm sorry I had a goal time, because of how bad missing it made me feel. In fact, I think I'd have run more at the end if I hadn't been so upset by that. So I'd have actually finished faster. And I wish I'd known about and trained for the hills. Or maybe started on an easier marathon. All the same, I did this:

very impressive map of where I ran