I’m not so sure I’m gonna make it….

Two Debbie Downer posts in a row – promise not to make this a habit!

I’m starting to doubt myself with this 10-Miler. Always knew that I was just a little crazy to want to try it, but now I’m pretty sure I’ve lost my ever-loving mind.

My foot pins and needles has gotten steadily worse, and even happened on the Treadclimber (i.e., the thing I almost fell off more than once during my workout). Link is for visuals and not for endorsement. I’m becoming more and more convinced it is sciatica. The pattern my doctor described is pretty much what I am experiencing.

Now, here is the irony. Running (cardio in general) reduces most of my back pain. This is not uncommon when the cause is disk degeneration and arthritis. But it also irritates my back. I’m trying to find peer-reviewed articles on running and sciatica and coming up sadly short. It looks like that is because sciatica is treated the same way other lower back pain is – through movement. Therefore, there is very little research about how it might be different from other types of back pain.

This makes it quite hard to stay positive.

I have been looking for articles that talk about evidence-based ways to stay positive when having chronic health issues. I found one article about mindfulness, but nothing else when I use the term resilience. Turns out spelling matters in a Google Scholar Search. Mom was right. I found one qualitative study by Kralik, van Loon, and Visentin (2006) that suggested it is more about bouncing back from depression and setbacks. Not letting your issues or reactions to it define you. This sounds like Acceptance and Commitment Training, doesn’t it?

Griffith (2018) suggests that cultivating hope might be the antidote. He describes hope as a set of behaviors, rather than an emotion or thought, that will help counteract feelings of loneliness and a reduced sense of agency. So far, so behavioral. Some suggestions are:

  • Stress reduction activities
  • Goals and action plans
  • Defining yourself as something other than just “sick”
  • Finding friends to advise you and that you can confide in
  • Finding a good mentor

Huh…does this sound like things academics do all the time? So, if I apply the model I used to get my last grant, publish my book, and finish my dissertation, I should be ready to take on this 10-miler. Worth a try!

Handling the Bad Days

It’s been a while, I know…that is because I have been struggling a little.

Yesterday was the pièce de résistance of all days. In my top ten of bad days. Minor things got major and fit hit the shan. What are some of the things that are contributing to bad days in academia?

We live in interesting times right now. Just reading the Chronicle of Higher Education and Inside Higher Ed can make one fearful of how things are going. Learning about takeovers of for-profit institutions, questions about the transparency of central administrations, Federal funding for higher education questions, and other issues abound in their (electronic) pages. Maybe you are feeling the pinch in your institution.

Maybe your concerns are more of the local type. Things like student issues, holdups at the bookstore, and tech issues can be just as much of a pain, if not more so, than the big things that hit the national news. It’s now not unusual to have students experiencing homelessness. Dealing with issues such as acute mental illness in the classroom can really sap your reserves.

And the struggle is even more real because you got into this – because you care. Grammar aside, right?

In helping professions such as counseling and social work, much time and effort are linked to the well-being of staff. Us, not as much. We are often more concerned about our students and fellow educators than we are about ourselves. So how can we make sure that the issues of our day-to-day don’t end up consuming our physical and mental health?

O’Halloran and Linton (2000) discuss something they call Secondary Traumatic Stress. When you empathize with someone experiencing stress, that stress often transfers to you. It causes symptoms very similar to PTSD, like nightmares, re-living the event, and exaggerated startle responses. It seems as if the very traits that make great teachers and administrators can be the things that cause us the most stress.

How can you get through this as unscathed as possible? One study by Newsome, et al., (2006) suggested that programs such as Mindfulness-Based Stress Reduction (MBSR) resulted in reports of reduced stress and greater efficacy for students in counseling programs. MBSR involves meditation, mindfulness training (being in the present moment) and yoga to help individuals detach from stress. Trippany, Kress, & Wilcoxon (2004) suggest some protective behaviors that could be applied to the higher education environment. These include:

  • Building safe opportunities for collaboration and communities of practice
  • Education on how stress and trauma affect the teaching and learning environment
  • Including rest and leisure on a regular basis
  • Educating administration on how to spot stress and trauma, and how to respond
  • Keeping a journal and attending counseling sessions
  • Having some sort of spiritual connections

Do you have these in place at your workplace? Would it be possible to create space for them? Admin (I’m talking to me here), can you create these opportunities and find ways to educate yourself?

I’m off to journal a little bit…well, maybe I just did….

The Dreaded Chronic…Pain

The runs themselves are going great. I’m at a pace that I can sustain cardiovascularly, and I’m (gasp) actually enjoying them.

But yesterday the dreaded running monster reared its ugly head. My left leg goes numb when I run too much. It starts in the foot and I get major pins and needles that go up the calf, as if I were wearing a ski boot. My calves (gastroc and soleus) have also been super tight. I wake up in the morning like Frankenstein, stomping. Spousal Unit gets worried that I am upset and stomping around.

I’ve gone to the doctor to have this looked at. While I do have herniated disks and little spots on my spine and such, none of that explain the leg thing. I’ve been evaluated by a sports medicine PT. Gait is fine. No one can say for sure what is going on, so I’m kinda on my own.

Someone brought up Plantar Fasciitis or a neuroma (a thickening of the nerve), but no medical professional ever suggested it. So, I rejected it, too. Plus, I once had PF so bad I sprained my ankle. Dr. Google says yes, but as we know, Dr. Google also has a dubious medical degree. So, I’m going to ask my doctor when I see him on Friday.

For now, I’m gonna keep on keeping on.

Days 4-5

Yesterday was a cross-training day. Usually I reserve Sundays for my R&R but now that I am in training I guess that will have to wait.

I did a 30 minute kettlebell routine that was way more difficult than I thought, followed by a 10-minute yoga. The kettlebell routine was a free one on YouTube. It showed me that I really need to consider my upper body strength during this training. The yoga was nice, but I think I could have used an hour instead of just 10 minutes.

Today I barely made it to the gym. I woke up entirely too late and had to push myself to go. (Apparently I thrive on negative reinforcement – the avoidance of looking like a fool). I did a 45-minute run walk, with 3 minutes running and two minutes walking alternated. No stretch (what?). Faculty meeting instead. Today, again, I felt pretty good – even though that old turf toe injury is flaring.

The next few sentences are not for the squeamish. I was doing a burpee during a kickboxing class years ago. I kicked out, but my big toe got caught in the seam of the mat and went the opposite way. In this case, it seems that having Ehlers-Danlos was a good thing, because I had very little injury. The pain is just enough to be annoying and somewhat limiting.

Today I did have a mystery flare, though. For some reason no one can figure out, my left leg goes numb with pins and needles when I run. Only when I run. Nothing shows up on an MRI to explain the problem, and my gait analysis doesn’t show any issues. I just have to stop and walk on a regular basis to keep it from happening. That will be something I need to watch during my training.

Tomorrow is another run and Body Pump. Wish me luck!

Day 3 (or 48 days to go)

Today was a running day. Spousal Unit wanted to go to the gym, and I thought the treadmill might be a better challenge for a beginner. So I agreed.

Instead of the plan I posted yesterday, I decided to use an app dedicated to training couch to half marathon. It was a 45-minute training run – 3 minutes run, 2 minutes walk, with a 5-minute warm up and cool down.

I found a classic rock playlist that syncs with the app. Being a musician, one of the things that makes running difficult for me is the disconnect between the beat of the music and the cadence of my stride. The way this app is set up, the cadence varied between walking and running. I really appreciated it.

To be honest, I didn’t think I could do a 45-minute run. When I got to the gym, everything went wrong. My ear buds weren’t actually charged like I thought. So I walked around for about 10 minutes until I found Spousal Unit. Luckily I keep spares in the car at all times. Then when I went to fill my water bottle, I accidentally activated the hand sanitizer at the same time. So far, so good, right?

Once I got on the treadmill, though, the run was do-able. My heart rate didn’t get out of control. Neither did my breathing. The playlist was awesome and the experience was pleasant. Yay! Maybe I will enjoy running at some point?

After I finished, I stretched and foam rolled again. My calves are super tight so I have to keep working that. I also did a set of planks (front and side). Times planking were decent.

Tomorrow is a rest day, so you’ll probably hear from me on Monday. Hope you have a great weekend!

Day 2 of Training, Active Rest – In Theory

Day two of training is supposed to be a rest day. As we have discussed, I’m not good at resting – all or nothing for me. So, what should a rest day include?

This article from Runner’s World talks about why rest days are important. Over-training is one reason, but injury prevention is another. Shin splints and tendon injuries can be avoided by resting and not trying to do too much, too fast. They suggest cross-training on rest days if you aren’t a gold medal rester (hmm…that should be a thing).

I’m a huge Spin fan. I have been doing Spin since 2004. My family and I recently joined a new gym, and I thought a nice Spin class would be just the thing for my rest day.

But – somehow I walked into the Super Extra Intense Spin class. I looked around the room and it was clear no one was prepared for the level of Extra this class would be. Huffing and puffing, heart rate elevated, we were in a bit of shock when she suggested an easy increase in tension while increasing our pedal speed – about 10 times. Each one built upon the last.

Usually, I’d be right on board with this – suck it up, buttercup – but today I was thinking how this was going to affect my tomorrow. I foam rolled like my life depended on it, and I must say I am enjoying the endorphin kick. So maybe I’ll be ready for those three miles tomorrow after all!

This afternoon I’ll finish my work and prep for the weekend. Will check in soon!

What Exactly Was I Thinking, Again?

Well, since thoughts don’t necessarily cause behavior, I guess I could say I wasn’t thinking.

Right after a day and half of fatigue, I decided it would be a cool idea to invite students to join me at the Soldier Field 10-Miler. Yes. 10 miles. Me, of the I-Hate-Running crowd. I will not be the incredibly photogenic racing behaviorist.

Every year, the Association for Behavior Analysis International has its convention over Labor Day. I’ve only missed one in over 20 years. This year, the convention is in Chicago, so the Health, Sport and Fitness Special Interest Group puts together a few health-related activities. Doing the 10-miler is one of those activities.

You don’t have to run all of it; walking is fine as long as you get done in two hours. But even that is going to require training on my part. Well, I’ve paid for it, gone public, invited students to join me, there’s no going back now.

via me.me

So, anyway, some training is necessary. I don’t want to over-train, and I don’t want to under-train, either. So, I went to the American Council on Exercise website to see what they suggest.

Given that the closest standard time is a half-marathon, I figured that was the distance I should look to for training plans. It was slightly dated (2010), but I found this article. Through that search, I happened upon this training plan. I have 50 days to train, so the plan seemed do-able.

Unfortunately, I’ve already worked out on Day 1, so I’ll pick up on an active rest Activity for Day 2. Will post progress as I go along!

When to work (out) and when to rest

The question of working out versus resting up has always been a source of confusion for me. Should I stay home? Am I lazy? Am I overdoing it? So, I’ve checked some of the guidelines for fitness and present their suggestions here. But first, let’s talk about how being sick can affect your productivity.

Recently researchers have been warning us against the practice of “presenteeism” – coming to work even though you don’t feel well. In a Harvard Business Review article written by Hemp (2004), coming to work sick so you don’t fall behind can backfire on you. I was heartened to see that depression and migraines made the list of illness that people tend to power through instead of taking a break to heal.

The costs to productivity are high. People are, of course, less productive when they are sick. They might be more cranky and more difficult to get along with. Constant pain may be exacerbated by work requirements (e.g., carpal tunnel).

Those of us with chronic illness are most prone to presenteeism, and that makes perfect common sense. Not every supervisor is kind to those with chronic illness. It costs less to have someone come to work than stay home. If we stepped out of life every time we didn’t feel well, you wouldn’t see us.

So for most of us, knowing when to rest can be difficult. If the issue is depression or anxiety, then working out most definitely will make you feel better. But what if it is sore muscles, a cold or flu, etc…?

According to the Mayo Clinic, if you have just a headcold, go ahead and work out (but please wash your hands and wipe down the equipment). If your symptoms are “below the neck,” like coughing, joint aches, and fever, take a day off and let your body recover. Either way, take it easy. You aren’t going to make a personal record.

What about the soreness that comes from a new workout? That stuff hurts. How do I know if I’m just sore or if I injured myself? The distinction between soreness and injury can be a subtle one, especially for newer exercisers. The American Physical Therapy Association has a handy table in the article I’ve linked. To sum it up, Delayed Onset Muscle Soreness (DOMS) is a normal reaction to exercise. Your muscles might be really sore for 24-72 hours after you worked out. If it’s just the muscles that hurt and stretching and movement help, then it’s probably DOMS. Keep moving at least a little bit. Anything else is probably an injury and best addressed by a physician.

So, anyway, there is no harm in taking a day off when you are sick or injured. Your body and your productivity will thank you.

Hydration!

This one hits close to home. I’ve been on the couch today with a mild headache (migraine) and just feeling generally like doing nothing.

About halfway through the day, I started to wonder how much of my malaise was due to dehydration. I’d only had one Spindrift and a cup of coffee. But how much is enough, what’s too much, and what is the best thing to drink?

Thomas, et al., (2008) defines dehydration as “the loss of water from the body…at a rate greater than it can be replaced.” Keeping the water balance in your body is a complex process. That is why older adults often suffer from dehydration – which in some cases, can be fatal. The authors suggest examining urine to determine hydration levels. The more concentrated and dark the urine, the more off-balance we are.

Let’s examine with the symptoms of dehydration. Remember, now, I’m not the kind of doctor that is an expert in this area, so make sure you are always checking with your doc if you don’t feel well.

Picture of the symptoms of dehydration
http://shine365.marshfieldclinic.org/wellness/stay-hydrated/

The interwebs are full of suggestions on how to keep hydrated, usually involving their product. Heck, the infographic above has all kinds of ideas for you. What do the doctors say?

The American Heart Association says that you should be aware of your hydration needs, and basically listen to your body. Certain medications as well as excessive sweating increase the amount of fluids you need. Changes in climate and elevation can also affect your need for water. Water, in most cases, is enough to hydrate your body.

The Cleveland Clinic advises against relying on caffeinated beverages and alcoholic drinks to meet your hydration needs (boo!). They also recommend limiting fruit juices and sugary drinks, as the carb/sodium ratio might upset your stomach. I notice that after drinking really sugary beverages, I’m slightly nauseated – especially on a hot day.

In my case, I have orthostatic hypotension (part of the cocktail that comes with my genetic issues – did someone say cocktail?) and have been advised to use an electrolyte supplement. When I’m really behind in the hydration game, the best thing for me is Gatorade. But on a regular basis, I’d rather not consume that many calories. Plus see the upset stomach suggestion above. There are some really good, low-calorie hydration tabs on the market that I use in those cases. But does the average Dr. Prof need it?

Strangely enough, a lit search on the topic turned up a lot of research in bulls and horses. Wonder why? But anyway, back to humans.

If you are prone to foot or calf cramps with sustained activity, then Jung, et al., (2005) suggests that electrolyte supplementation might be a good idea for you. They compared dehydrated participants to those who consumed electrolyte enhanced drinks, though – they did not include a water-only group. This, in my opinion, limits their conclusions. But it seems that if you are training in the heat, for long periods, or at a high intensity, an electrolyte drink might be for you.

Also remember that it is possible to drink TOO MUCH water. Too much water can throw off your electrolyte balance as well, and can possibly be fatal. It’s rare, but if you feel terrible even though you are drinking enough water, you might very well be overdoing it. Your urine should be light in color, but if you’re peeing what looks like water at a high rate, you might be overdoing it.

So if you’ll excuse me, I’m going to have a glass of water, or maybe a nice herbal tea….

Schedules of Reinforcement

Before I took a brief hiatus, we were talking about reinforcement and how to use it effectively. I mentioned that there is no such thing as intrinsic reinforcement. What could I possibly mean by that? Of course there are inside sources of pleasure and joy!

Yes, and I don’t deny that is true. But many of the things we think we do for altruistic reasons just ain’t altruistic at all. Why thanks, Dr. Buzzkill…. Sorry. The truth is most of the things that we do are either 1. Reinforced by something other than what we think it is; or 2. Reinforced so infrequently we don’t even realize it’s happening.

So far, we have talked about identifying your reinforcers, but as we said before, if it doesn’t increase responding, it ain’t a reinforcer. Sometimes, things happen like good feelings and that warm feeling in your stomach. Sometimes there is a skip in your step. They can reinforce your behavior, but reinforcement is more complicated.

Take, for example, me running. I hate it. No, really, I hate it. Yet I sign up for 5ks, get on the treadmill occasionally, etc… Am I just masochistic? Nope. A Cochrane Review on exercise and depression shows evidence for the mood lifting effects of exercise. The most frequently studied type of exercise? Running. Therefore, I get a good hit of neurotransmitters, and that seems to lift me out of my ruts. I run 5ks because I like being with others. Working out alone never lasts very long.

But back to schedules of reinforcement. Here’s the thing – behavior isn’t necessarily reinforced every time we do it. Most behavior is reinforced on some sort of schedule. Sometimes, two or more schedules might be in effect. This always boggles my intro to ABA students, so we might need more than one blog to talk about it.

Most long-term behavior is on some sort of intermittent schedule. Please forgive my lapse into Wikipedia here, but it is accurate information. Basically, with intermittent schedules, reinforcement comes after a certain number of responses, a certain passage of time, or in discreet bursts. The more regular the intermittent schedule is, the more we adjust our behavior to be around that specific time frame. This can explain why we tend to diet and exercise more closer to specific events, like competitions or high school reunions.

It also explains why even though we promise ourselves we won’t, we typically fall off the wagon right after these events. If reinforcers are predicable, we tend to pause for a little and wait until just before the next reinforcer is expected. So, cut weight for the match, fill back up for a while, cut weight for the match, etc…. you can see where this is going.

So, how do I make healthy living consistent? First of all, accept that you won’t be perfect. It is not achievable and don’t let anyone tell you it is. I guarantee if you talk to the most dedicated triathlete, they will tell you they have times where they sit on the couch and eat ice cream.

One of the best ways is to made reinforcement unpredictable. The more unpredictable and the more we have to do to get the reinforcer, the more persistent we become. Think of lottery tickets. What if I get the payoff this time? So we buy the tickets, and usually, nothing happens.

Which brings me to the second part of why the lottery is so brilliant. You might not win a million dollars (and if you do, adopt me), but you might get a dollar or two. Or if you are my nephew, $400 on a scratch-off. These little wins (reinforcers) keep you going in hopes of the bigger prize.

This is where the behavior analyst as coach has an opportunity to help. They can put together a plan that reinforces little things as well as keeps things unpredictable. I’m thinking of some little things can occur when I least expect:

  • Last week, I was able to lift a 45-lb bar over my head more than once without fear of it crashing on my head. Very little win, very big reinforcer.
  • My favorite Spin instructor plays cool, obscure music and has music trivia days. His favorite musician happens to be my cousin. I get to his class when I can, and I never know what will be on his playlist.
  • I have 10-15 minute stretches without back pain. They are rather random and I don’t know when they are going to happen, but when they do, they are awesome.

Your reinforcers will, of course, be different, but I challenge you to consider the little, less expected things that keep you going. How do they work in your life? Would love to hear your comments!