i freakin’ did it! :) 480!

In this blog

  • i freakin’ did it! – 480
  • humble pie
  • future plans

i freakin’ did it!

I guess there’s a story here but there also is much I’d rather not admit to.  The number of times it took me to finally pass my Part III board exam is one thing I’d rather not advertise.  I wish I could say “third times a charm!”  but … it was more like 5 times and possibly 6.

I hone in on my brother who didn’t even attempt Part III until after he graduated because he failed it on his first attempt but passed it on his second attempt.  So, if you don’t count all the attempts prior to graduation then, at least, I was able to emulate him.

Age is another matter I don’t really want to own up to so….hypothetically speaking ….it’s like I started this new adventure when I was still 41 years old and, after I get results for my Part IV exam which I’ll be taking in May of 2015 I …could be ,,,49.

Then things become a little surreal.  Have I actually spent a decade of my life in this pursuit? 20-25% …  and this is all post college.   As my brother described it before I started my attempt to become a DC, he said it was “balls to the wall” and, that may even be an understatement.

Humble Pie – sort of fits in with all this since I just finished up a week of reviews in preparation for my May 2015 exam.  Within minutes of the first day of reviews you realize you’re eating humble pie – within the first hour, you realize it’s more like a humble buffet that’s being forced down your throat.

The questions are rapid fire, like a machine gun.  Is body temperature increased or decreased with Graves disease?  Temperature?  Don’t we have a lab panel to look at?  I never thought of a simple vital sign pointing me in the direction of Graves disease, I think of exophthalmos – eyes bulging out, increased T3, 4, TSH …oh, OK, hyperthyroidism, I guess it would make sense that we’d have an increased temp but, by the time my 10-speed brain figures all that out I’m 3 questions behind and we’re talking about Thalassemia – …I just studied some anemias the other day, maybe I can feel a bit smug as opposed to stupid …not a chance.  I’m confusing Coombs (a test for Rh factor with Cooley’s Anemia which is a subset of Thalassemia.  Now I’m falling farther behind, feeling stupid, wondering if I even belong there.  It’s a trip – that much is certain.

That’s pretty much how the days go, from 9 a.m. to 6 p.m. save an hour for lunch.  We covered 2 years worth of radiology in a day and a half this past weekend.  At which point, I’m thinking the words ‘self torture’ and really don’t want to go back for any more.

Mock exams are Monday, the 27th of October – gotta show up for that.  These upcoming Part IV exams – one day is all radiology, the other consist of 25 different rooms filled with actors pretending to be patients with certain diseases.  We get a whole 5 minutes per room to ask questions and test accordingly after which time we move to another room and have 90 seconds to look over x-rays and lab results then need to come up with a diagnosis, differential dx, and appropriate case management & treatment.  I guess it’s not so bad but, this goes on for 3 hours straight.

The DC program is kind of like signing up for a slow death and you just need to graduate before it kills you.  And, other than the 20% or so that don’t make it to graduation after 15 semesters a few do die.  I remember one guy died from a heart attack one weekend when I was at school because, you know, 8 hours of classes along with clinic during the weekdays is never enough and the stress is very real.

The most self induced stressful times I’ve had this year have been at those reviews.  That’s when I’m reminded that we actually have three autonomic nervous systems.  Most everyone knows about the good old, fight or flight – that’s the sympathetic nervous system and is sort of like the bodies gas pedal.  Somewhat lesser known would be our parasympathetic nervous system which would be like our brakes or some say ‘wine & dine’ or even …poop & relax.  Probably the least well known autonomic nervous system would be our enteric nervous system which is made up of two subsets known as Aurebach’s and Meissner’s plexuses.  This system basically has to do with our gut.  and – without exception that’s where I feel a great deal of stress making itself known but, it also helps me make greater sense of various ailments such as enteropathic arthropathies and remembering to ask patients about various work and social aspects of their life to help gauge levels of stress in their lives.

March of this year was my first post graduation attempt at Part III and I failed it worse than any other time I attempted the exam with a very dismal score of 340.   A score of 375 is needed to pass Part III.  I did learn that we needed to have everything from Part II down cold and wholly memorized as a prerequisite for getting through Part III so I scheduled review sessions for Parts II, III and even a few PT reviews this past August.  Essentially 23 solid days of reviews in 3 different states – Iowa, Kansas and Missouri and averaged about 12 hours a day of worthwhile study.

Well – it freakin’ paid off!  A few days ago I checked to see when the scores might be available and to my surprise the website said results would be available Monday morning, 8 a.m. MST.

I crushed it!  Bested my previous score by 140 points and ended up getting a 480!

2014-10-27 14.11.43

There was a week between my last review session and that exam and that week was probably unduly stressful because I had to work every day leading up tot he exam – my fault,  for not requesting more days off but, I had already taken off nearly a month – still, I’d done enough to pass with flying colors! 🙂

In order to finally get though school, I had to break things up by first finishing all my classes then I focused exclusively on completing my clinics.  That strategy did work and got me to graduation.  However, a lot of the kids I talked with during this past week shared with me that they were in the process of finishing up their 2nd year of radiology with me – I have to go back about 3 years to when I finished and I realize, every day that passes between when all these classes ended and now all tends to make that humble buffet a little bigger every single day.

On the other hand, maybe it’s a bit like that Leitner method of memorization with spaced repetition and perhaps I can at least say I’m on my way to eventually consuming, digesting and assimilating that humble buffet.

I’ve got about 6 months before that exam.  I just need to up my game.

oh yeah – one of the last hotels I stayed at when prepping for my Part III retake didn’t have a desk, it barely had room for the bed so I spent a lot of time outside with a book and leaning on the balcony.  I spent so much time with my elbows on that balcony holding my books that I eventually wore the skin away on my elbows to the point of bleeding.  Study battle scares!  Good for the male ego and kind of funny.  About a week later my brother took a picture

2014-08-28 01.15.46 - Copy

well, not overly dramatic but, if you look closely you can still see the study scars 😉

Honestly, it was pretty emotional to see that score.  Anyway, I suppose that’s enough musing.

Time to look forward – There is one state in the country that allows you to get a license with Part III and that state is Illinois where I happen to live 🙂

and, with that license I can finally apply to test and become an NRCME! – Nationally Registered Certified Medical Examiner.

How long does it take to get a license…. (had to Google this)  looks like once I tic off 15 or so items the state requires and get everything sent in then I should have it within about 2 and a half months.  ….hmmmm, maybe by Valentines Day 🙂

Pondering 2015 – real possibilities include that license and a black belt in karate.  I think I’m signed up for 3 half marathons – 2 in April and one Rock n Roll in October.

I did play it a little smart and allocated some post-review time at my parents condo so I’ll have some time to get some plans in motion and figure out more for 2015 and, ideally not end up as sick and strung out on stress like I was after my last bout of reviews.

I did learn on that site I Googled that only 150 hours of CMEs (Continuing Medical Education) is needed each year, I thought it was 200 hours.  This will afford me some great opportunities.  I think one of the first things I’d like to go after is a diplomat (specialty) in Neurology.  A first step there will be searching out a former teacher by the name of Dr Bub!  🙂





10 Strategies to Empower Your Life

In this blog:

  • Day 14:  Say No – 10 Strategies to Empower Your Life
  • Week 39 Weigh-In
  • 5K – Karate Testing – Half Marathon
  • Future Plans & Death
  • Week 2 – After Action Review

Start Saying No.   The Day 14 Video is called Say No.  There is a pretty detailed 10 step list which can help a person empower their lives.

A short Yes List and a long No list.

10 Powering and Productive Strategies you can use to empower your personal & professional life.

  1. What strategies, initiatives and activities will you say “No” to?  List the activities that can slow down or prevent progress from happening.  Everything is fair game – nothing is sacred in this exercise.  Simply put, if an activity does not advance you forward, then say no immediately.
  2. What meetings will you decline or delegate?  List every meeting you have in the remainder of the challenge and determine which you will NOT be attending.  Meetings consume large chunks of productive time and most can be declined or delegated to someone else.
  3. What relationships will you not keep?  The way you manage your relationships has an enormous impact on your ability to perform at high levels.  Identify the top three energy draining relationships you are committed to saying No to then, focus on creating strategies to free yourself from each of them immediately.
  4. What competitors will you not follow?  Too much time is lost by following and focusing on too many competitors and so-called gurus.  Identify the top 3 and immediately remove yourself from all of their email distribution list, blogs and other related communications.
  5. What websites will you not visit?  Websites are like magnets & vampires they draw you in and suck away your productive time.  Pull up your list of favorites and delete most from your favorites and keep only the ones of greatest value.  You must institute a “No Surfing” policy and stick to it.
  6. What money will you not spend?  Put yourself on a fiscal diet – every dollar spent should be thought of as an investment towards greater operating income even petty cash.  With this in mind, what things or entire even budget categories will you not spend money on.
  7. What foods will you not eat?  We are all reservoirs of energy and everything we do requires that we use it wisely.  So, it’s imperative that you focus in on your nutritional intake and exercise.  Eliminate any food or drink that compromises your energy levels.
  8. What thoughts will you not entertain?  Remember, that which does not move you towards your goal, takes you away from it.  Therefore, remove those thoughts that are limiting, defeating or downright negative and consciously replace them with thoughts of abundance, optimism and positivity.
  9. What television shows will you not view?  If there was ever a time hog that needed to be slaughtered, television tops the list.  If you stop to think about it those tv hours don’t take long to add up.  Even in a moderately tv watching household, it’s amazing how many hours are spent in front of the box.  The solution — go cold turkey and focus on making huge performance gains.  Take control of those previously lost hours and put them to good use.
  10. What will you no longer tolerate from yourself or others?  Identify the standards you wish to measure your life by and reuse to lower or negotiate at any time or any reason.  No is a tool of liberation and empowerment so use it with absolute authority and conviction.

That’s one heck of a list!

Week 39 Weigh-In

While updating my weekly weigh-in wallpaper for my computer, I realized my weigh-in isn’t until tomorrow BUT …I’ve already done it and we’ll just say it’s close enough for this week.  For today I’m weighing in at 263 pounds which is a 2nd consecutive week of declining weight.  Overall, still maintaining +/- 3% of that 260 weight I started at from a week after my winning weight loss contest so – ….27 weeks of maintaining a weight loss is fine by me!  🙂

Week n - 2nd 12 Week Session Weeks 39-27 - Copy

…maintaining a 50+ lb weight loss for over 1/2 a year – 27 weeks 🙂

5K – Karate Testing – Half Marathon

This should be a really fun weekend….

On Saturday I have a 5K in downtown St Louis at 8 a.m. – and ….as soon as that is over I’ll need to get my butt to the dojo back over in Illinois because Karate testing starts at 10 a.m.  On Sunday, the St Louis Rock n Roll half marathon starts at 7 a.m.   Packet pickup for these events ….I’ll do that Friday – there is supposed to be a wrist bank in the 5k packet that I wear during the half marathon then when that run is finished there is supposed to be a tent where I can get my Spinning Guitar Pick medal for participating in back to back runs 🙂   …just remembered – since this will be my 2nd Rock n Roll half marathon of the year I’ll also be getting some kind of repeat performance medal… I think i have pics of these somewhere …. all told, I’ll net 4 medals from this weekend.

obtained for running back to back races in the same weekend

obtained for running back to back races in the same weekend

obtained for running two Rock n Roll runs in the same year

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HalfMarathonMedal Sat5k_Medal

Future Plans & Death

Running – Here I’m looking at repeating the 26/30 week program I was doing for my 3rd full marathon. It was originally a 26 week program and I added four blank weeks so it would end on the date of my 3rd marathon (November 1st) and, ironically enough, I pretty did exactly what was listed during those extra four weeks …nothing – pretty close to nothing anyway but, I did get in a good 1/2 year of training and made running progress.  When I started that 26 week program it was kicked off by a couple half marathons so I’m going to let this week’s half marathon be the kick off for my next 1/2 year of running.

I will be going back to Kansas City for a week long review for my part IV boards exam which is scheduled for May of 2015.  Part IV is interesting and once you pass you can never take it again and whatever score you get is what you live with for the rest of your life.  It determines which states you can practice in and even which insurance companies will pay you.  It is quite important so – KC review beats out my trip to Wynne Arkansas.

There is a nice half marathon on Sunday, November 2nd which I have run in before – maybe I’ll make that my 2nd kick off half.

Scrolling through media to find those upcoming medals reminded me of several events I want to do in 2015 – Macklind Mile, Tour de Belleville, Moonlight Ramble, Tour de Donut, Lincoln Presidential 1/2 mary, Go! St Louis 1/2, etc.

New Spreadsheet plan – shorter distances but maybe faster times.  I want a much higher percentage of running as opposed to walking … I almost forgot what the Future Plans referred to but I think I remember it mainly pertains to setting up a new program and creating a new spreadsheet.  I think I’ll start a new weigh-in wallpaper with that new spreadsheet.

Death – I’m still pondering this concept – this reality.  I went to another Masonic Funeral last week for a fellow Mason who had been a master mason for 61 years and 9 months.  I remembered during my first Masonic Funeral that one of the higher ranking members of the lodge tried explaining to me that one of the objectives of freemasonry was to overcome the fear of death.  What exactly does that mean, I’ve wondered.  I suppose ….well, I can’t speak for everyone but thinking about dying isn’t a constant thought in my head.  I suppose it’s just ignored but even my awareness level of an impending death but, at this point, I know one thing.  I know partly how my funeral is going to look.  I know there will be Masons present and I’ve heard what they are going to be saying a couple of times now.

I think part of this Masonic teaching kind of embodies that Carpe Diem notion which was briefly mentioned in a previous blog.  Some of the lines from the Dead Poet’s Society such as…. “did these boys wait until it was too late to take one iota from their life of what they were capable of?”  …just paraphrasing from memory there.   or that poem – To the Virgins, to Make Much of Time by Robert Herrick – “Gather ye rosebuds while ye may, Old Time is still a-flying and this same flower that smiles today Tomorrow will be dying.”

I’ll keep learning.  On a kind of related note, it looks like I’m going to be an officer in the lodge come 2015 or maybe starting in December of this year so… still more to learn.

Week 2 – After Action Review (AAR) phone call – 

compare & contrast….  wow, what a difference a week can make.  week 1 of this 100 Day Challenge was fraught with poorly defined objectives and mainly only served to provide a greater awareness of what a loser I was in certain aspects of my life.  Week 2 AAR – huge difference – yesterday was a simple day consisting of work, karate and then coming home and kicking butt around the house with various endeavors but, at the end of it all, I could honestly say that I had lived that day about the best I possibly could.

Anyway, each week at Noon (CST) there is an AAR phone call with Gary, the guy that made up this 100 Day Challenge and in that 40 minute phone call he mentioned a list of 12 things to help improve our lives so, I took notes in this blog to share with others who might be interested.  My list has 14 items but I wasn’t able to completely differentiate between all the items so …there is a two item bonus in my list.

Also – I mentioned previously that this was a $147 course but there was an offer extended for me to be able to add up to 3 people to the program for $47 each.  Not that I would pay that but, if anyone is interested I’ve still got two extra people I can add to the program.   Leave a message – paypal me $47 to my email address of dukowitz@gmail.com and we’ll set you up.  I’ll probably shoot out a mass email to the 300 or so Masonic brothers in my lodge, maybe one or two of them will be interested as well.

There are 77 days left in the 2014

  1. Elevate your conversations
    – High Achievers talk about Big, Bold, Better Ideas
    – Average People talk about common events
    – Little People talk about other people – gossip, etc
  2. Elevate your Beliefs –
  3. Elevate your Actions
  4. Elevate your Attitude – expose your mind to a better life.  expose yourself to excellence – surround yourself with it
  5. Elevate your expectations by demanding more from yourself and others.
  6. Elevate your discomfort by elevating & challenging your discomfort zone.  it’s inconvenient to workout when you’re tired – reality is it’s convenient and easy to make an excuse.  it’s inconvenient to make a good meal and convenient to buy fast food.  expose yourself to discomfort.
  7. Elevate your value by raising the bar and going the extra mile.  the difference – go the extra mile –
  8. Elevate your gratitude by elevating your consciousness.
  9. Elevate your future by focusing on key priorities.  What we think, know or believe is of little value compared to….
  10. Elevate your joyfulness – it’s perfectly fine to have fun in everything that you do.  joy is a virtue that hides in plain site
  11. Elevate your reputation by delivering exceptional results.
  12. Elevate your network
  13. Elevate your Focus by saying No and Setting Boundaries.  Have a short Yes list and long No list.
  14. Elevate your Fun by laughing more and worrying less.   outlook not determined by circumstances (reminds me of Victor Frankl)

Your thoughts your words and your actions & beliefs can help improve your situation.

77 days left in this year and Each One Counts

– Everything Matters –

Everything Counts

Your thoughts, words, action, beliefs are like an elevator that can either help bring you up or take you down.  Well said, Gary 🙂

Boldness and Audacity

In this blog

  • Boldness and Audacity – Day 2 of the 100 Day Challenge
  • Week 26, Day 1 Run
  • Karate
  • National Boards Part IV
  • November 1st Full Marathon in Wynne Arkansas

Boldness and Audacity – Day 2

Have you ever noticed who gets the most respect and the most rewards in life?  It’s not the wallflowers, it’s not the thumbsuckers, it’s not the people that sit back and wait for others to do things for them.  Those who achieve much in life do so with a spirit of boldness and adventure.  Boldness is a fundamental right and a pragmatic reality.  These people are able to challenge and question the existence of a comfort zone.  They are willing to try new ideas and attempt the seemingly impossible.  They thrive under pressure and take risks lesser people are too afraid to attempt.

  • Boldness is the act of responding to a situation in a manner that may be viewed as daring to some, but is essential to effectively addressing the issue at hand.
  • Boldness is a strategic tactical approach to a given situation.
  • Boldness also involves taking risk.  When you decide upon a specific course of action boldness demands that you execute it aggressively.
  • Boldness does not mean being rude, arrogant, insensitive or even a bully
  • Boldness is a spirited word that eloquently describes bravery.
  • Boldness is not an inherited trait.  It is a characteristic that will blossom with determination.
  • Boldness comes from making valued decisions and moving forward for what you believe in.

When will your finest hour come and how will it arrive?  Do you really think it’s going to materialize without a supreme act if confidence, audacity or boldness?

What bold initiatives are you planning for today?

Today’s Challenge:  Act with boldness in every situation.  Speak up, act up with complete confidence and expect that things will go your way.  A behavior of boldness will help propel you today and everyday beyond what you might imagine and otherwise achieve.

This video then closes the same way as yesterday by reminding us…

There will never be a day that will not require
Personal Integrity.

Boldness and Audacity – my interpretation

Boldness reminds me a bit of courage.   My original thinking was there isn’t much on my list of things to do which require any great amount of courage, just things that need to be done but then I started to fill out my list of 10 prioritized activities, commitments and Deadlines for the day and noticed that if i double clicked on an entry, it would bring up what I last wrote down from yesterday.  Well ….I have 6 items left over from yesterday that never really got done.  I was basically trying to participate and get started with this program.  Yesterday was work, dinner with the family and doing my blog.

However – there is one item on my list which scares me.  Again, it’s nothing I haven’t done before.  well… the components which make it up are all things I’ve done before so, that would be one area where a little boldness or courage could be useful.

Week 26, Day 1 – 2 Miles

Before I worked on my 10 item list for today I wanted to take action and get something done.  I need to get my running going again.  I had 100 miles in August but only around 16 in September.  I still need to update the Running tab on my blog w/ my miles, times and average weight.


The path I run on is 1.5 miles long and, prior to this year, it had been about 20 years since I’d ran that path non-stop so I was pretty happy that I could head to the park even with my lapse in running and still crank out a bit over a lap non-stop.


I guess karate is another area that could use a little audacity.  In two weeks from tomorrow I’m scheduled to test for my Ni-Kyu brown belt.  I’ve been back once since my Part III study stint this past Tuesday.  I’ll be available for 4 more workouts before that testing which occurs on October18th after my 5k Rock n Roll 5k over in St Louis.

If I am to pull it off, this is something I’ll need to put on my 10 item daily priority/commitment list.  I know I have enough talent for that rank and probably a few ranks higher because I’ve been doing it for so long.  Simply making sure i have the necessary katas and yakusokus memorized will be enough to get me through and promoted to the next rank.

Part IV National Boards

This is an exam I’m looking at taking in May of 2015.  There is a review session which runs from Oct 11th through Oct 19th.  I would miss the 18th due to the 5k & karate testing and miss the 19th due to the Rock n Roll half marathon.  But, I can make 5 other sessions.  It’s been a little while since I’ve looked in anyone’s ears or eyes with my medical equipment so the experience could be very useful.  Pending passing Part III and getting a licence in the state of Illinois, I may then register for the NRCME – and become a Nationally Registered Certified Medical Examiner.  I guess that’s another thing I need to add to my goals list 😉  🙂

November 1st Full Marathon in Wynne Arkansas – 

I’ve done great with my running this year and have progressed a lot but not to the point of completing a full marathon the way I would like to complete it.  I don’t have a goal of completing a marathon – I’ve already done that …twice.  I want to complete one in fine fashion.  Say, a 4:21 time or better – even under 5 but, I’m still a ways from that kind of shape and condition.  I probably have an option of swapping over to the half marathon but, even then I would still need to make some travel arrangements.

….i need the 2015 schedules from NBS for Part 3 & 4 reviews …… Part IV review in Kansas is compressed into 6 days ….5 nights would do it there … about 6 months before the Part IV exam….

Wynne Arkansas …. for a full marathon, i’m on board but for a half?  Do I want to spend the time & money for that?  With karate, like I’ve said, I’ve already got the talent and just need to put in the effort.  For a full marathon … I’m just not that good yet.  I think around 6 miles is the longest I’ve gone non-stop.  I know there’s some biomechanical deficiencies with my right piriformis muscle that are exacerbated with the longer distances and needs to be improved upon.

There are a lot of things like that.  If we don’t push ourselves then “as is” is usually good enough but, when you’re pushing yourself then even small defects can be enunciated to exceedingly painful proportions.

The most noticeable advancements I could make with my running in the next four weeks wouldn’t be from gains made from running but rather by a reduction in weight.  Right now, I’d have to say I’m on the fence regarding Wynne, AR 🙂

July Recap – August Projections & W17D3 Run

In This Blog:

  • July Recap
  • August Projections
  • Week 17 Day 3
  • Weekly Weigh-Ins
  • Spinning Guitar Pick Medal

Overall, this was a very good month for training.  I had 16 running workouts in July compared to 17, 20 & 18 running workouts in April, May & June respectively But, I did have two biking workouts including the Tour de Donut which was 35 miles.  In terms of my training averages ….

Average Stats 2014-07-31

  • Total Miles increased about 50%
  • Average Distance increased almost 100%
  • Average Duration increased over 100%
  • Fastest Mile Average increased about 3%

It’s nice I was able to double my distance and duration while maintaining my average speed & pace.

I’ll have 4 full weeks of training in August, Weeks 18 through 21 of my program.  The mileage will increase by 2, 3, 3, 1 miles in each of those weeks over my last week in July which doesn’t seem too bad – quite reasonable and certainly within the 10% rule (not adding more than 10% per week to the weekly mileage)

However … there is a rather daunting 140 mile total scheduled for August.  I’ll really need to take this one day at a time.  After all, it still is only 4 days per week that I’ll be training and the Saturday Long Runs will be the only new training distances for me.

August Travel – I’ll be out of state for weeks 19, 20 & 21 of training.  The short & medium runs will take 1-2 hours but, these long runs of 16 & 17 miles have me a bit concerned.  I catch a break in Davenport because it looks like board reviews will be taking place while school is in session so those reviews will be 5-11 p.m. through the weekdays and I can move my 16 mile run from Sat to Friday since the weekend review sessions are always 9-6 p.m.

Overland Park, Kansas is a little different since all the days are basically of the 9 a.m. -6 p.m. variety so I’m thinking of breaking up my 16 mile run scheduled for the 23rd into 8 miles on Friday and 8 miles on Saturday.  Even 8 miles is going to take me the better part of 2 hours so maybe I’ll have to get out the door and hit the road by 5:30ish a.m. on Fri & Sat.  I know from experience that I’m dead after 9 hours of reviews and if I hit the runs in the morning it might help me to pay better attention during my board reviews.

Chesterfield, Missouri – I’ll be commuting each day to Chesterfield but that also adds about an hour each way so the 9-6 review shifts are more like 8 to 7 p.m.  I think I might split things up like I’m planning in Overland Park, KS and break up my 17 mile run scheduled for 8/30 and do half early morning Friday and the other half early morning Saturday.

I guess I’ve done harder things.  Sept 6th is an 18 mile run which is being replaced by a 50 mile bike ride and the following Saturday is my Part III Boards Exam ….I have 20 miles scheduled for that day.  That’s over 4 hours and probably closer to 5 hours on my feet.

Weeks 24, 25, 26 & 27 are blank …they don’t exist because my training program is only for 26 weeks and the final 3 weeks are for tapering.  On my spreadsheet I simply have myself repeating Weeks 22 & 23  twice to fill in those 4 weeks.   I’ll know better when the time gets closer as to what might be best.

Week 17 Day 3 – 4 miles
This was a heck of a run.  It’s the 4th time in the past 2 weeks that I’ve covered 4 miles in training and those first two times had exactly the same time of 56:52.  I was 16 seconds slower on my third attempt but tonight, I had to get my 4 miles in after karate so, it was a late night run BUT I finished the darn thing in 53:16!  That was 3 min 32 seconds Faster than my previous last two attempts.  I had a 13:16 average pace and …keep in mind, I’m a 260 lb man so, my legs are hauling some weight around with them.  Anyway, that was my best training pace ever for any distance over 2 miles.  Back on June 9th I had the same pace with a 2 mile run.  I’m guessing the hour and a half karate I did before hand was a good warm up 🙂

Well, I’m tired and need to get to bed – I’ll hit the Weekly Weigh-In and Spinning Guitar pick medals some other time.  In short – I weighed 261 this week so, I’m basically the same weight as I was the week after my 12 week weight loss contest ended back in April.  I signed up for a 5k on October 18th which is the day before the St Louis Rock and Roll Half Marathon but …by doing both there is a really sweet looking medal with a Spinning Guitar pick I can earn.

Other than that I might preview a 5 mile run i have coming up this Sat over in Washington, MO.

W9D1 – The Nifty Fifty

The Nifty Fifty
W9D1 – Week 9, Day 1

The Nifty Fifty

Pictured above is Dr Norman Kettner DC, DACBR, FICC.  He’s a board certified radiologist and one of the best and highest quality teachers we had at the school I attended to become a chiropractor.  Dr Kettner understood things so well that he could make almost anything understandable.  One of my favorite lines was “an embolism is just a thrombosis on vacation”  🙂

I always remembered one day in class when Dr Kettner first mentioned the Nifty Fifty, apparently these were the top 50 diseases and conditions that doctors saw in their office on a regular basis.  Since then, I’ve tried a few times to write down what I figured the those top 50 diseases were but have always done so on paper which, tends to get lost over time.  So, I figured an extra page on my blog is something that would not get lost.  I have no evidence that my list comprises the top 50 items, it’s more a list of what I could recall studying the most in school.  I’ve got 3 months and 10 days until the Part III exam and I’ll need to be familiar with pretty much everything I can by then.  The list I came up with is a start.  I figured I’ll be rewriting and reorganizing that list several times but, that kind of repetition is usually useful to me.

I’ll need to expand each item with some fundamental knowledge about each one …and for right now, that’s something I need to figure out – …here’s an initial guess

  1. What it is – brief definition
  2. etiology – where does it come from
  3. prognosis
  4. tx (treatment)
  5. lab test associated with dx (diagnosis) of condition
  6. incidence – who gets it?  male/female?  age?
  7. Ortho test used to confirm?
  8. basic pathobiology
  9. dx – Diagnosis – test mentioned above would probably be a subset here
  10. ddx – differential diagnosis
  11. risk factors
  12. category of disease or condition
  13. pertinent or necessary diagnostic imaging
  14. what exam might reveal this condition
  15. …..

Ugh….you see, it’s looking like a lot, i know i already have well over 100 dz’s & conditions listed and I know Huntington’s dz just came to mind – I think that one involves a repeating sequence of CAG and, if that sequence repeats more than 30 times then one is susceptible to the dz and the greater the number of repeats, the younger in life a person may get Huntington’s but ….i know there is another version with a sequence of 5 repeating amines

anyway, a dozen or so bits of info times the 100+ items and we’re looking at over 1,000 bits of info but….I’m glancing through the list – well, gotta know it and i’ve got over 3 months but …there are 9 parts to the exam.   maybe a thorough enough job on that list could cover 3 or 4 of the parts covered.

I did notice those tabs go in alphabetical order so, maybe I’ll put the letter ‘z’ in front of my boards stuff to push those tabs to the end.

W9D1 – Week 9 Day 1
Well…..  not so hot when compared to recent runs but, as my brother pointed out – How did that run compare to last year?  From that perspective my first run of week 9 was pretty good 🙂

I’m not exactly sure what’s going on.  I know that night at the ballgame kind of set me back a bit.  Even 4 days later I felt like I had lost 2 or 3 happiness points.

I’m pretty much ready to take a mulligan on my pending weight loss goal as well but, I just remembered something.  I may have mentioned this before but, it does seem like whenever I try to artificially generate some kind of a huge push that I tend to get knocked back down into humility.  I do remember mentioning this before or maybe it’s just something I’ve thought about before.

By default, I have to stick with my plan and keep hitting each day the best I can.

I do remember one thing I wanted to do and that was to update a portion of my running log which looks at some average statistical type data for the past three months since we just ended May.  I know there has been some really nice improvement and I at least need to give myself a chance and do the best I can this month for any hope of being able to see even more improvement.

Still have work to do today.  I did pass my pizza test!  Ha!  🙂   I am somewhat amazed at how much testing is now involved with just wanting to deliver pizza’s a few days per week.  For Domino’s, a place I’d worked at before about 20 years ago, I had to go to a site called snagajob.com and literally spent hours taking different exams to be able to submit my application.  This other place where I’ll probably end up getting hired had nearly an hour of timed testing I had to take in person with a couple other candidates.

i did miss question 20 on a math page …they asked for the square root of a 5 digit number but now – i’m wishing i would have just put that number in parenthesis and raised it to the 1/2 power!

I’m frazzling my brain and… I’m not liking sitting in one spot for hours on end studying.  I have to break that up.  Maybe interject some walks every hour or two.  maybe taking flashcards with me on walks.  I do have a version of The Raven on my phone mixed in with all my music.  maybe there is something worthwhile I can read and have played back between songs.

Still need to make one more tab for part III regarding logistics and administrative type stuff.  All I really need is a hotel in Davenport and one in Kansas.    There’s so much frickin material that it does make me want to go to the first set of board reviews in Florida, just to get some structure.  idk – i’m a little freaked out but, this is that Blue Arrow stuff – pushing myself, the anxiety and, it is a self generated issue – ie, a good problem to have.  A very good problem and situation.

I’ve got a good hundred days so, even if i add to that list, knocking out a couple a day would get things done in less than two months.  …

yeah…I’m freaking out.

8 Weeks of Training Completed!

8 Weeks Completed!
The Philosophy of Failure
National Boards, Part III

8 Weeks Completed!
There’s still a long way to go but a long way has been covered since those first 10 second of jogs when I worried that I might break something by moving faster than a walking pace.  In two weeks, I’ll be 1/3rd of the way through the program.  After two weeks, I’ll be on week 11 of the program which starts the actual marathon training portion of the program, that last for 4 months plus, I’m still 4 weeks ahead of schedule so, as of today, I have 5 months left to continue my training before November 1st.  Week 9 training, as shown in the remaining schedule below, is a bit more running than week 8 but actually less than called for in Week 10.  This is one of the first things I’ve had to learn (or relearn) in that giving the body a chance to rest & recover is imperative.  It’s something I first learned with weight lifting when I remained stuck for about a decade with a 450 pound bench press.  It wasn’t until a personal trainer told me to cut back on my lifting and only lift heavy one day per week that I allowed myself to recover and shoot my bench over 500 pounds within a matter of months.

26 Week Marathon Program Wks 9-26


Beyond the physiology of training and recovery, the mental aspects have been quite interesting.  Some of my first visions were of being “plugged in” to an energy source I had not felt in a very long time.  I used to always feel there was enough inside me to light up all of New York city but, somehow, someway, those feelings dissipated over the years of my life and I wasn’t even very much aware that I had lost those feelings and perceptions of myself.  The window pane where I could feel like each run was wiping away smudge from a glass pane that separated me from the person I was going to become was another really cool vision and then the latest daydream of creating a safe place for me to be while completing my hourly runs.  Personally, I really don’t have an overwhelming amount of time to daydream, ponder and visualize these types of things in my normal everyday life and, if or when I do daydream, it’s usually just something much smaller and insignificant and usually designed to help avoid whatever task I should be doing.

I watch very little television but, I think the brain wave state the mind is put into after watching a few minutes of tv is ….. well, I’d rather create my own life.  It’s back to having to either deal with a life that is of your own choosing or having to deal with a life created as a result of neglect and, sometimes abuse.  And, by abuse, I’m mainly talking about not caring enough about ones own life so as to let it degrade to crap then having to lament the situation(s) we let ourselves get into.

I used to always have that type thinking handy.  Whenever I thought someone else had done me wrong, I would step back a second and, instead of undue pondering over how someone else may have let me down, I would think ….how much have I let myself down?  Inevitably, I would always have to conclude that I have always let myself down far more than everyone else combined could have possibly done.

One of the most useful mental fitness type of training that has been done has been to become more aware and less afraid of failure.  After my first 20 minute non-stop run, I was ecstatic!  Kind of happy beyond measure but, the very next run I could only complete 13 minutes of nonstop running and was very disappointed in myself.  That was a failure – at least it was in my mind at the time it happened.  I believe what happened was I had just completed a mile and heard Nikeplus tell me (via my earbuds) that I had just completed a mile and was told I did so in record time.  I was looking for an excuse to stop and told myself that hitting that new PR was good enough…

I think that was part of a default safety mechanism that most people have – to stay where they are.  To stay in their comfort zone where everything is familiar.  To not change.

Philosophy of Failure
Reading about that graph which plotted the Challenge level of a situation against the ability needed to perform a given task gave my mind an extra framework with which to ponder failure.
In some of the reading I did pertaining to that graph, it was stated that the best way to improve oneself is to go from the flow area, straight up into the Anxiety/Frustration/Fear of Failure portion of the graph, maybe not to a huge extent but, at least to push ourselves into that realm and then do what we needed to in order to increase our skills or ability to get back into the flow area.
Intuitively, this made sense.
direction arrows
Better and faster results could be obtained from following the path of the blue arrows as opposed to the path indicated by the red arrows.  Of course, it’s not exactly, easy or fun to push ourselves into that area indicated by the blue arrows.  I remember the first 20 minute run – I took some notes on my phone while jogging – before I started I told myself everything I needed to succeed was already inside of me but – after a half mile or so, I told myself “Do the Scary” which, maybe sounds a little weird but, it’s pretty clear now that I was pushing myself into that anxiety state, the one where failure exist but I knew I had to co-exist and do my best to get along with that scary stuff in order to have any chance of getting better.

The path I’ve been running around has been a very good classroom.  My thoughts on failure have gotten much clearer and are tending to make perfect sense to me.  The need for failure, the need to push ourselves into a position where failure may be an outcome.

Part III, National Boards
I have 3 months and 13 days before the next Part III board exam.  I have until July 8th to pony up $610 for that exam and the best part about that is it has to be cash – no credit cards accepted.  I have one of my review books out and ready to go.  A five day per week plan has come to mind.

There’s self study and board reviews with NBS (National Board Specialist).  Florida & Georgia are the first two locations for reviews but, Florida would be a 1,000 mile trip but, Georgia could be hit on the way back home.  If I had a newer car that might be a more reasonable option.  As is, it may be a trifecta of Overland Park, in KS, Davenport IA again and, of course, Chesterfield, MO.  Parts II and III reviews at all three places.  I’ll have to look up those dates again or find the blog where i originally posted those dates.  I suppose the PT reviews could be added in as well.

If I keep things local, that is, within 4 hours drive from home then we’re looking at the following 20 days of board reviews (3 extra days if I add those PT reviews…)

  1. Davenport, IA – Sunday, Aug 10th through  Sunday, Aug 17th (8 days)
  2. Overland Park, Kansas – Friday, August 22 through Wednesday, August 27th (6 days)
  3. Chesterfield, MO – Thursday, August 28th through Wednesday, September 3rd (6 days)

Most review sessions run from 9 a.m. to 6 p.m. with an hour for lunch but usually run over.  …looks like the Tuesday through Friday sessions in Davenport will run from about 5 p.m. to 11 p.m.  Well, easily over 100 hours worth of reviews.  I still need to create an extra tab here on my blog to help track this stuff.

I better get moving, still have a lot of work to get done today.  🙂

Week 5, Day 2 & other stuff…

The training run was OK.  2.75 miles which is short of the 3.00 mile goal.  I could tell I was dehydrated in the first tenth of a mile, mouth was dry, even the walking felt kind of hard …harder than usual.  I did notice something interesting on a spreadsheet I’m keeping of some run data.  During the month of April my average pace ranged from 16-18 min/mile.  In May there was a jump and, prior to today’s run, all paces were under 14 min/mile.  Even today wasn’t horrible with a 14:29 pace and I did have my third longest non-stop running stint of 3:30.  Calculating some quick averages, my distance is up 0.5 miles and average pace is up from 3.6 mph in April to 4.3 mph this month 🙂

Mostly what’s been on my mind are the latest NBCE national board scores.  Looks like from the data I have available my best score of 356 was in March of 2012.  I had a score of 299 in September 2012 but I don’t think I even did the board reviews for that exam and was mainly in survival mode with school.  Anyway, 340 is where I sit now.  375 is what I need to pass but, I would really love to knock it out of the park …who wouldn’t.  If you fail any of the NBCE exams they now give a “Failing Score Analysis” which rates my content of knowledge in 9 different areas as either Insufficient, Borderline or Sufficient.  So, I don’t feel too horrible about myself, I’ll be noting below the best I’ve done in any area over the last three attempts at this exam.

  1. Sufficient – Case History
  2. Sufficient – Physical Exam
  3. Borderline – Neuromusculoskeletal Exam
  4. Borderline – Diagnostic Imaging
  5. Insufficient – Clinical Laboratory & Special Studies
  6. Borderline – Diagnosis
  7. Borderline – Chiropractic Techniques
  8. Sufficient – Supportive Interventions
  9. Borderline – Case Management

3 Sufficient
5 Borderline
1 Insufficient

Anyway, those are my best ratings.  For some reason, Supportive Interventions was sufficient the last two times I took the exam but actually came out as insufficient on this last attempt.  I don’t even know exactly what Supportive Interventions are – maybe PT stuff?  I’m not sure.  I stayed an extra day in Iowa for the PT board review.  These are things I’ll have to figure out.

I was thinking of bringing a radiology book with me to the park.  I like to sit down at one of the picnic tables after my run to shoot a screenshot of my run to my brother or post on Instagram – close out NikePlus and save my run from Sports Tracker (another running app on my phone)  

…lots of pausing, thinking and reflection here…. kind of tough shit to face up to.  not fun but, can’t fix it if it’s not acknowledged.  What are those 10 two letter words?  If it is to be, it is up to me.  I know there’s a good life waiting for me once I get through this exam.  All I can say is insufficient effort and I obviously didn’t do enough to pass the exam.  I have to take full responsibility for my results.

There are some specific things I want …travel, 968 Porsche convertible, Airplane, Boat, nice house …quasi typical kinds of things but, there is one thing I’ll take over any material item and I’m already working on that.  I know where I want to be and what I want to look like.  This running program – 4 days per week.  Completing a marathon, having the discipline necessary to see through a training program that last the better part of a year, It’s something money can’t buy.  

Part II – Daytona Beach, FL – Fri-Mon – July 18-21
Part III – Daytona Beach, FL – Tue & Wed – July 22 & 23

Part II – Marietta, GA – Thur-Sun – July 31 – Aug 3
Part III – Marietta, GA – Mon, Tue, Wed, Thur – Aug 4 – 7

Part II – Davenport, IA – Sun, Tue, Wed, Thur, Fri – Aug 10-15th
Part III – Davenport, IA – Sat, Sun – Aug 16-17

Part II – Overland Park, KS – Fri, Sat, Sun, Mon – Aug 22-25
Part III – Overland Park, KS – Tue, Wed – Aug 26&27

Part II – Chesterfield, MO – Thur-Sun, Aug 28th – 31st
Part III – Chesterfield ,MO – Tue&Wed – Sept 2-3rd

<the next day…>
whew….i was up until nearly 6 a.m. last night going over as much NBCE related stuff as possible –  The list above is for all the Part II and Part III board reviews available between now and Sept from NBS (National Board Specialist)  I’ve contacted Dr James & Dr Laura about my situation and they’ve already gotten back to me.  on all the analysis I sent them they said it looks like I’ve passed all of part III at one time or another but, there’s 10 different state boards that contribute to that exam.  This is the one exam that’s written by doctors in the field while all other parts are written by education professionals.  It covers anything that a practicing doctor has ever screwed up and potentially gotten in trouble for.  It’s definitely a no bull-shit exam and it’s the shortest exam of all the parts – only about 130 questions which is down from over 200 in years past.  Part I was 9 hours of testing, Part II was close to 13 hours (over 2 days)

It’s hard to believe I’m dealing with scores like 340 and 299 in my last two attempts at Part III.  When I look over My unofficial transcript from NBCE I’m seeing scores in Physiology, Chemistry, Pathology and Microbiology of 561, 533, 482 and 485 respectively and from Part II, General Diagnosis and Associated Clinical Sciences show scores of 482 and 510.   However, those scores were while I was still in school and back in 2010.  That was 4 years ago.  

The response from NBS was to attend any and all sessions of reviews for Parts II, Part III, PT and Part IV that I can travel to.  

The PT reviews are usually tacked on to the end of the Part III reviews so that might add a day, at most to any of the above Part III schedules.  I’m not sure if there is a Part IV review available before the Part III exam in September.  

right now, I’m thinking of Daytona Beach since it’s the soonest available and about two months before the exam.  Marietta, GA would be on my drive back from Florida but there is a 7 day gap between the FL and GA reviews.  That would be a good 1-2 punch.  OR Florida and Iowa ….Chesterfield, MO is a given.

The only Part II review I had was two weeks before the last exam, up in Iowa and there was a Part III exam just the week before which didn’t really allow me enough time to fully own all the material in Part II the way I’ve learned I was supposed to.

I’ll definitely have to make a new tab here for Part III.  It’s not running but, it is part of my life.  I’m sure there’s plenty of running related stuff, knee, hips, acetabulum, feet, etc., that should be relevant to running to keep things interesting.  I have to focus and keep my head clear.  

…kind of a later start to the day than I anticipated but, finally faced up to those scores i got on Monday.  …took a couple days to actually look at them on my laptop instead of my phone.  The marathon training is going to be instrumental in getting through all this.  …if you want what you’ve never had you have to be and do what you’ve never done …that old saying …