The Non-Compliant Patient

More of a misnomer than a fact

I’ve been a healthcare provider for over 23 years. As a physical therapist, I get to spend more time with my patients than most medical professionals, and I’ve learned a few things about the description of “non-compliant patient.”

I’ve spent the majority of my career practicing in a hospital-based setting. This is one place where this term is thrown around quite a bit. But this is also where the safety net lies for the critically ill. When we round on patients, we often hear this phrase tossed out as a reason for the medical disaster that caused one’s admission. 

A younger version of me bought into this phenomenon, asking questions like, why wouldn’t someone just take the medicine they are prescribed? Why won’t they listen to their doctors? Why would they eat junk food and eat most meals at fast food restaurants, contributing to various chronic diseases? I really didn’t get it. 

Certainly, patient education is an important component in managing this common problem, but there are other factors frequently beyond the control of these patients that come into play.  

When my eyes were opened

My first round of practicing in the home health setting was truly revealing, and I expanded on this enlightenment when I returned to this setting years later. 

What you see as a home health practitioner can be both frightening and sad, provoking anger with our society. It also leaves you at a loss for how to best help your patients. How can we call ourselves civilized when we don’t take care of our most marginalized?

I saw patients in some of the poorest parts of Richmond. Some of my patients were on food stamps, Medicaid, and in HUD housing. I had patients who rationed insulin and blood pressure medications. On many visits, I would observe wrappers from fast food meals, empty refrigerators, and mold on the walls, not to mention critters not meant to cohabitate with humans. 

How can anyone with a limited income, living amid a food desert, and in terrible housing be “compliant” with recommendations from their doctors? You simply can’t. You’re merely trying to survive.

Add to these problems often associated with aging like limited mobility and dementia, and you have a recipe for disaster. 

I encountered one elderly patient who had mobility issues herself but was the primary caregiver for her husband, who had his own mobility issues on top of dementia. She also had diabetes. She couldn’t even successfully load her syringe for her insulin, and often neglected to eat or care for herself because of her husband’s needs. I ended up getting the nurse on my team involved to facilitate a change in her insulin regimen, switching to pre-loaded pens. That was a small help. 

But I also had another patient who had no business living on his own. He was also dependent on insulin, and he couldn’t even walk the 15 feet from his couch to his refrigerator to access his medication. Every time he went to the ER, they immediately sent him home, as he was a frequent flyer, even despite my intervention with our agency’s liaisons in the hospital. It was frustrating. He desperately needed help that was beyond my scope of practice. 

In these conditions, problems manifest themselves as all of these deficiencies compound upon each other. As a healthcare provider, I was at a loss about how to fix it. I’m the type of practitioner who looks at their patients holistically. 

I’m not just there to throw a band-aid on one problem. I want to address all of the contributing factors to health issues and prevent future ones from developing. 

Photo by Pixabay on Pexels.com

Is preventive care the answer?

Preventive care is not a novel idea, but as a healthcare system, the United States fails at this. Yes, with the Affordable Care Act, mandating that this type of care be covered under insurance is a step in the right direction. 

But the ACA has also been an excuse for insurance companies to increase premiums exponentially. And with high deductible plans the norm, many average Americans take a wait-and-see approach to any problems that do occur, even among the insured, potentially making a small problem something much worse by the time it gets addressed. How sad that the financial burden of medical care keeps us from seeking help. 

Cheap calories equals full bellies

No one will dispute the fact that diet contributes to your health. You could even go a step further and say it’s your health’s foundation. But when your nearest grocery store is a Walmart several miles away, and your only transportation is the bus, how do you buy healthy food? 

Food deserts are more common in America than you might think, and are a real barrier to living a healthy life. And even if you make it to the store, subsidized food sources like snack foods are much cheaper than whole foods. And if you can’t make it to the store, the neighborhood fast food joint with a dollar menu will suffice. 

Poor diets, although filling, can lead to a multitude of issues. Obesity, diabetes, high blood pressure, and high cholesterol can all be symptoms of less-than-ideal food choices. But if you look at the circumstances, these aren’t entirely choices. They are strategies for survival forced by the system in which we live.

Photo by Isaac Taylor on Pexels.com

The traps of being poor

As a physical therapist, I often encourage my patients to get more active. The simplest form of exercise is simply taking to the streets to go for a walk. But if you look outside the door of many of the homes of my patients, their streets aren’t safe at all. Some neighborhoods don’t even have sidewalks. 

Other safety issues besides traffic can also be barriers to exercising outdoors. Some of the neighborhoods I visited as a home health provider were notorious for drug trading and random gunfire. It was always unsettling to see a place on the news close to where my travels had taken me that day. 

I had one patient describe the time that she and her husband endured a night of terror where 38 bullets were fired into their house as they lay under their bed, holding tight to each other. How can you ask someone who lives in a neighborhood like this to risk their life just to go for a walk? 

Someone with average means may argue that they should join a gym. Sure. Take that extra money you need for medications and food and spend it on a gym membership. That doesn’t make sense. In Richmond, we do have some programs that teach group exercise classes for free in underserved communities. That is helpful, but it’s only once a week. But that also takes transportation to get there. 

When you have limited means, you may be forced to make difficult choices between paying rent, buying food, or paying for lifesaving medications that you need to survive. It also affects what medications your doctors prescribe. 

Say you have atrial fibrillation and need to be on blood thinners to prevent a stroke. Instead of a new generation, safer drug like Eliquis, which costs upwards of $400 per month, you may stay on traditional coumadin, which requires frequent blood tests to maintain safe therapeutic levels. And then the transportation issue comes into play again, unless you are lucky enough to have home health services that can run these labs for you. It’s a real rabbit hole.

Once poor, always poor, and it’s your fault

Our society is only as strong as its most marginalized members. One of the problems, however, is that in America, we blame the poor for being poor, like it’s a sin. It’s one of the many downfalls of capitalism and even a common theme taught by evangelical churches. 

Do a quick Google search on “poor being a sin.” I’ll wait. Some of the results might make you feel ill. Our society takes no responsibility for creating the circumstances that keep people economically disadvantaged. We blame it on the poor. But there’s a whole industry focused on preying on the marginalized, from our prison system to payday loans. 

Photo by Lukas on Pexels.com

Can we make it better? 

To make these problems better, to ensure that patients can be compliant with recommendations for safer housing, better diets, exercising more, and taking their medications as prescribed, we need systemic changes. 

Eliminating food deserts, creating safe and affordable housing, making our neighborhoods safer and more inclusive for outdoor recreation, and regulating the cost of medications would be a great start. The problem is, there are too many obstacles in the way. Corporations and localities that will profit from the sick and poor are one problem, but I also don’t think that lawmakers want to hear what it’s really like in the trenches. 

I was only a tourist in the world of the marginalized, but I take the lessons I learned and observations I experienced with me back to my hospital practice setting. I can now be that voice in rounds who can educate my colleagues on how challenging things can be for those “non-compliant” patients, and I can serve these patients with a greater lens of compassion. 

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Have you heard of this term? What’s your impression of the “non-compliant patient.” I’d love to hear your perspective. 

As always, I hope you all are safe and healthy. 

South Beach: Vegan Restaurant Review

The Outer Banks of North Carolina is not a place that is super vegan-friendly, surprisingly. But you can manage to find a few places on the island which serve vegan eats!

One of these places is South Beach, located around milepost 13.5 between the bypass road and the beach road in the Surfside Plaza shopping center. 

They make several vegan options but have an extensive omnivorous menu as well. During a past visit, I got an item made with buffalo chickpeas that was delicious. During this visit, I was simply craving a burger. 

Their vegan burger is made with Beyond beef, and it was everything I hoped it would be. I kept off the vegan mayo and added mustard, ketchup, and pickles. This was served with fries for $14.95. 

They pack up all their items to go. When I opened the bag, I realized that the portion of fries was huge! They were also a unique, swirly shape. And these were perhaps the best fries I’ve had in a long time! The shape made them extra crispy on the outside and perfectly tender on the inside. My daughter loved them, too. 

South Beach’s several vegan options have multiple flavor profiles, so there’s something to fit every savory craving. Vegan protein options vary from tofu to cauliflower to chickpeas and can be assembled in a bowl, tacos, or a wrap. Flavor profiles include Mexican, buffalo, and Asian. And, of course, don’t forget their Beyond burger options!

Will I go back? Of course! I’ll go again just for the fries! If you’re a vegan on vacation on the OBX, you definitely need to visit this place!

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Have you ever vacationed on the OBX? With its proximity to Richmond, my family loves to visit here. What are some of your favorite restaurants with vegan options on the OBX? I’d love to hear about it!

As always, I hope you all are safe and healthy.

We Were Adopted!

They say that cats adopt people, not the other way around. 

I really wanted another cat. Ever since my baby boy Tigger passed away in 2018, I have felt a void in my life. 

Yes, I do also have a dog, But my 75 lb. lab mix, Ellie, is more of a bed thief than a lap dog. 

I’ve always had a cat in my home. Now that I didn’t, I missed a cat seeking attention, cuddling in your lap. I missed the antics and zoomies a cat brings to a home. I missed hearing gentle meows and chirps. And so I tried to convince my family that we should adopt one from a shelter.

My husband, however, was not on board with this idea. He was just fine with a cat-free household. And our dog certainly was as well. 

But this summer, a little orange tabby showed up. We weren’t sure if he was a part of my neighbor’s feral colony (they have several wild cats that they feed). But he was different. And he was neutered! 

It began as casual interactions with my girls. He became more and more friendly as the familiarity progressed. They named him Chicken Nugget. 

I suppose naming him was step one in this process of being adopted. It was a slippery slope from there.

Soon, I found myself looking at cat food and toys at the store. Once I started feeding him, he really turned on the charm. Step two. 

He was quite the companion in August when I had COVID. I could sit on the back porch, and he willingly got in my lap. 

Gradually, we began letting him inside, all supervised, of course. We made sure there were no negative interactions with our dog. Surprisingly, our dog (mostly) tolerated his presence. Although she loves to discipline the cat if I tell him no to something, like jumping up on the kitchen counter!

This cat seemed very well socialized and was attuned to very human sounds, such as a can opening. He even tolerated me giving him a flea bath!

As it began getting too cold for a domesticated animal to stay outside, I had one final test of indoor cat-dom: can he use a litter box?

Again, my husband was not exactly on board. In fact, when I walked in the door from the store with a plastic bin and a bag of litter, he decried, “What the f*ck is that?”

“A litter box,” I replied. Big sigh from my husband. 

I kept placing the cat in the box whenever he would come inside. Imagine my delight to see that he had actually used it! Step three. 

And that’s the story of how a stray cat adopted us. 

He’s now mostly inside. He has a favorite place to hang out on our patio and pretend to hunt for birds. But he seems quite content to rest close to me, wherever that may be. As I write this, he’s sleeping on the chair next to me. 

The universe found a way to fulfill my dream of having another cat, and I’m grateful!

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Do you love fur babies as much as I do? I’d love to hear about your pets!

As always, I hope you all are safe and healthy.

Marathons and Dinosaurs and College Trips, oh, my!

Richmond Marathon Weekend 2022

This isn’t a race recap, exactly. I didn’t race this weekend. I was simply there to support everyone who was! 

I woke up Sunday feeling sore from hours of walking, running, and standing. My throat hurts a bit from yelling all day. I’m sunburned from spending a couple of hours on the Lee Bridge without shade. But I’m also immensely proud of my Pink Nation, one of the subteams of the Sports Backers Marathon Training Team. 

Mother Nature threw some curve balls in the weekend’s weather. Bearing the brunt of the remnants of Hurricane Nicole on Friday, thankfully, race day eve was punctuated with periods of torrential rain, wind, and tornado warnings. 

Those of us Pink Nation coaches who could adjust our work schedules made it out early in the rain pre-race day to hang the Pink Nation sign at the Pope Arch, which greets both half and full marathoners as they enter Northside. I’ve never been able to be a part of this coach’s tradition, so I’m grateful to have learned the secrets! And, y’all, it’s really something! But secrets are secrets. 

The Expo

Those who chose to attend the expo Friday may have had to wait in their cars or shelter in place at the Richmond International Raceway as the worst of the storm passed! Trust me when I tell you that it was equally frustrating for the volunteers. But safety first!

I volunteered at the expo on Thursday, spending most of my time at the Richmond Road Runners Club booth! We have new merchandise for sale, including some pretty fabulous custom BOCO gear hats which will be in Lucky Road stores soon. We were also in charge of issuing pacers their official shirts. 

I couldn’t make it to the expo last year, so I didn’t get to see how impressive the venue is! Imagine being mere steps from a Nascar track. It was surreal!

Race Day

Saturday morning started with a 4:00 AM wakeup. I made it out the door by 5:00 and had parked downtown before 5:30, even before the folks in charge of the parking garage were there. I was assured that where I parked was fine and that I would only be charged the special $12 rate. They lied. It was $21. Yikes. Volunteering is expensive. 

We hung out in our usual space before the race: the Omni Richmond lobby. They are such gracious hosts to all of us! Amazingly, they put up with our shenanigans every year. 

We had our benediction and team photo and then headed to the corrals to wait for the start. I found myself grateful to be coaching instead of running. I was already sweating! It’s November!

Although grateful we didn’t have to deal with the severe weather threats from Friday, the storm left sunny skies, heat, and humidity in its path. It’s a bad sign when you are comfortable in a running singlet at the start of a marathon. 

As coaches, we harp on our runners to control what they can. Well, the weather is definitely something beyond our control. And it’s been so long since we’ve run in these temperatures, most of us have lost some of our skills in managing our responses to running in summer conditions. 

My original plan to support our team was to run the first 5 miles as I have in years past, but after I cut last week’s 8 miler to 2 because of right knee pain, I nixed that plan. Instead, another coach and I rode out to the 5-mile point and cheered our runners, then made our way to the Lee Bridge. I went through an entire bottle of SaltStick fast chews and nearly depleted a can of Biofreeze spray. 

The bridge is mentally challenging, and you hit this right before the 16-mile mark. For many runners, the wheels have begun to fall off at this point, especially with the heat and humidity being what it was. Sometimes some electrolytes and cool pain relief are just what you need to power through the next 10 miles.

The concrete monstrosity that is the Lee Bridge carries you across the James River and is usually a place to cool down on the course. Winds are notoriously strong here, and I’d often tell my runners to keep their gloves until they’ve passed the bridge. Those winds can cut like knives! But on Saturday, there was virtually no breeze. We simply baked in the hot sun. 

At some point, a runner alerted us to someone who had almost collapsed and was sitting on the sidewalk. I ran back to find her. There she was, on the sidewalk, as described. She was with the larger Sports Backers team, but on a different subteam than mine. She was almost incoherent but still talking. Her heart rate was also pretty high. 

Her husband was on speakerphone, obviously concerned. I assured him I wouldn’t leave her until I knew she was OK. I called our head coach, and she tried to get medics to us, but there were so many runners who needed medical care that it took a long time. 

I gave her the only aid I had: pickle juice, Biofreeze, and salt. She started to feel better. The medics called her, and she refused care, partly because of the possible medical bills. Who can explain the irrational runner’s mind? Suddenly, she was determined to walk and finish the race. I took her to Main Street at about mile 17 where some members of our walking team adopted her. 

This also changed my coaching strategy. I was supposed to ride over to the Diamond, home of Richmond’s Flying Squirrels baseball team, to provide support at around mile 20 of the route. Missing my ride, I cut the course, making my way toward the finish line instead to help the final runners in the last miles. 

I found myself standing right in front of NuVegan Cafe, a place I’d never been to! Needing real food and a restroom desperately, I popped in for something to eat that I could grab quickly. Cornbread and cheesecake it was. Both were delicious, by the way, but left me wishing I had picked up something saltier!

I did finally find the coaches’ pod. This was loaded with snacks and drinks for the coaches since we are typically on the course for hours. As I guessed, there was very little that was vegan. I’m glad I stopped at the cafe!

As coaches gathered and waited to cheer on our final runners at the turn to the downhill finish on 5th street, I was surprised to see who did well and who struggled. But to witness perseverance in the face of such brutal conditions is inspiring. 

After crossing the finish line with our very special Team Woody, we waited for the very last finishers. Team Woody is our wheelchair participant, his mom, and several other members of our team who worked together to push him! Watching them cross was a great moment!

You can learn more about Woody’s story here!

Several minutes later, I saw a gait I recognized. It was the runner I helped on the bridge. She was lilting to the side, walking with our head coach, who picked her up at mile 20 and walked with her all the way to the finish! I’m so glad she earned that medal!

This is what it’s all about on race day for the coaches. Seeing our team finish, especially despite all of the challenges and uncontrollables, like the weather, is amazing. 

The Running of the Dinosaurs

On Sunday, race weekend was capped off by a Road Runners Club event. We finally brought back the T-Rex run, which hasn’t been put on since before the pandemic. It was hilarious to see so many folks in inflatable T-Rex costumes all at once! By the signup numbers, we had enough to break the record. However, only about 200 people in qualifying costumes participated. We hope that next year, we can break a world record. 

Another trip to Longwood

My younger daughter signed up for a STEM immersion day on Monday at Longwood University, which is on her short list of possibilities for schools next year. It also happens to be where my older daughter goes to school and where I went as well. We met some very lovely fellow prospective students! I think after this trip, it’s more than likely that we will have another Lancer in the family. It was a nice way to cap off a very busy weekend!

Time to Regroup

One thing is certain: this introverted runner is tired. My body took a beating this season. And I’m peopled out for a while. I will take some time to rest from running heavy miles, focus on my diet, and try some other workouts for a bit. But I will find my joy in running again. I always do. 

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Did you participate in any of the Richmond races last weekend? I’d love to hear about it!

As always, I hope you all are safe and healthy. 

Pizza and Beer of Richmond (Hanover): Vegan Restaurant Review

After a long day of work for me on a Saturday, and with nothing to cook that made the omnivores in my life happy, we decided to venture out for dinner. My daughter had a craving for Mexican food, but I had another idea. I’d heard from vegan and non-vegan friends that PBR Richmond is awesome! And since they opened a second location in Hanover, we had to try. (I ran past the original Richmond location on my run the next day!)

PBR is a part of EAT restaurant partners in Richmond, who are also the culinary geniuses behind Boulevard Burger & Brew, another family favorite. 

PBR Hanover was packed that night! I think there was a large party on the patio, and this was the majority of the diners that night. It was only a 15-30 minute wait for the table, but we ended up eating at the bar. Service at the bar was speedy!

We each ordered a pizza. I got the Farmer’s Market, their version of a veggie pizza, which had tomato sauce, fresh tomatoes, mushrooms, artichoke hearts, and olives, topped with fresh arugula. I subbed vegan cheese, as you may have guessed. 

It was pretty tasty! I enjoyed the crust and the sauce especially. My pie was a bit delayed, however, as our server noticed that they put parmesan cheese on my pizza, even though it was specifically ordered vegan. I’m grateful that he caught the error!

For my vegan and/or gluten-free friends, note that PBR does not charge extra for making your pizza with vegan cheese or a gluten-free crust! Other restaurants routinely upcharge for these options. 

I liked that the location has garage doors, which were open that night, so we got to enjoy some fresh air with the comforts of indoor dining. 

I will go back to PBR. The pizza was tasty, the service was great, they have a good adult beverage selection, and they don’t charge extra to make your food vegan! I’m also really grateful that there is a location that’s in my county! 

Sometimes it’s just nice to go out and have a fantastic pizza and a beer, you know? 

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If you live in the Richmond area, have you tried PBR? What did you think? I’d love to hear your thoughts!

As always, I hope you all are safe and healthy.

I Ran an Ultra Marathon, but I’m not sure I’m an Ultra Runner

The Conundrum of Facing the Ultra Challenge Again

Reflecting on my running journey, the ultra was a test I promised I’d never endure. 

“I’m not that crazy!” is what I told myself, my husband, and all of my friends. Of course, I also said that about running a marathon, but I was crazy enough to try that, too. 

Truth be told, I’m actually pretty jealous and impressed by my friends who run ultras on a fairly regular basis. Their persistence and tenacity are something to admire. I’m just not sure that’s exactly who I am. Loosely translated, perhaps I haven’t reached that level of insanity yet. 

My best friend, the instigator of all great shenanigans involving running, is signed up for the same ultra we ran together last year, the Freight Train 50k. Am I crazy enough to do it again? I’m not sure yet. 

Maybe it’s the course on the High Bridge Trail in Farmville, VA, an old rail line that consists of endless pea gravel and dreary winter trees of December that are deterring me. Of course, the route is punctuated by the High Bridge, which, considering that it’s two out and backs, makes up about 2 miles of the 31.3 mile route. The bridge itself is quite lovely, perched at what seems like a mile over the Appomattox River.

Did I enjoy doing that? Again, I’m not sure. The pain wasn’t that much different than running a marathon. You simply endure it for longer. But you do feel 100% more badass casually mentioning that you ran an ultra last weekend (or month, season, or year.) 

Runners don’t need an excuse to drop facts like that into casual conversation. It simply spills out of our mouths. 

I suppose I feel challenged with finding my why for running a second ultra. Surely I would beat my abysmal time from last year. That may be reason enough.

I did learn a few lessons from my effort last go round. If I choose to run this race again, I will KT tape my knee to ensure that my patellar tracking issue doesn’t cause problems. I was forced to run quarter-mile intervals for most of the race last year. I now have a hydration vest I’ve had lots of practice using. And I will certainly stay overnight in Farmville after the race. 

Driving almost an hour and a half both ways in the dark and rain was less than ideal. I don’t even know how I did that now, other than I had to. 

Plusses for this race include the super long time limit thanks to the concurrent 100k race, the amazing race support at the aid stations, and how well organized the event is. There was even food for vegans at the finish party! With the race in early December, it’s also timed really well to use a fall marathon training cycle to prepare for an ultra race. 

If you are looking for a “first ultra” event, the Freight Train 50k is it. Non-technical trail with very little thought about where your feet land. You only cross four roads the entire time, with the worst of those in the town of Farmville itself, where the drivers don’t necessarily get the whole “state law to stop for pedestrians in the crosswalk” thing, even with signs explaining it. Sigh. 

Last year, my bestie convinced me to sign up for this misery on the last day that guaranteed a shirt with your entry. She was lucky I had consumed two adult beverages before she texted me. Otherwise, my rational mind would have taken over. 

If I decide to run this race this year, and that’s a very big if, I hope that the last three miles of my run won’t be in a torrential downfall like last year! 

Of course, I could choose to run a different ultra marathon, right? 

So is ultra running my thing? That’s the conundrum. 

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Ultras are fun, right? Or am I just a special kind of crazy? Don’t answer that question. 

After my fall marathon, I’ve decided that running an ultra isn’t the best idea for me right now. I am going to let my body rest and heal. 

As always, I hope you all are safe and healthy. 

Devil’s Lettuce: Vegan Restaurant Review

How exciting that the far West End of Richmond has a new all-vegan restaurant! If you read my earlier review of Hurley’s Tavern, this is the vegan comfort food kitchen they built in front of Hurley’s dining room. 

The brainchild of chef Janice Rossano, pictured with me above, she’s been envisioning a space like this for a while. While Hurley’s has a nice variety of vegan items she created, she wanted to offer a separate restaurant with an all-vegan menu. Janice shared that she has been vegan for 10 years, and many of these recipes have been in development for quite some time. 

With a name like Devil’s Lettuce, you may pick up on a theme here. There are several references to the herbal refreshment, from the “vegan food joint” to the “420 herbs and spices” blend for their Gateway burger. It’s cheeky!

The space is colorful and cozy, with a separate kitchen and meal prep area from its companion, Hurley’s Tavern. There is both indoor and outdoor seating. 

I’ve now been twice, sampling different menu items each visit. Any vegan will tell you what a strangely wonderful phenomenon it is to have multiple choices on a restaurant’s menu. Knowing that everything is safe to eat is like realizing a vegan utopia!

On my first visit, I got the tofu melt, pictured above. This was excellent with seasoned, roasted tofu, peppers, and cheese served on bread panini style. I had to pause a few times and make sure I wasn’t eating chicken, the tofu was seasoned that well!

On my second visit, I got a bowl of chili with a side of mac and cheese, pictured below. Both were perfect for the day’s weather, which was cool and dreary. The chili was mildly spicy, and the mac and cheese was creamy and satisfying. 

I will definitely be back! Hurley’s has quickly become a family favorite since I live with omnivores, and now with the Devil’s Lettuce in the same space, I will have even more options when we dine there. 

If you are in the Innsbrook area, check them out! It’s worth the drive from other parts of the RVA. And if you’re passing through Richmond, it’s really convenient to I-64 and 295. 

Check out their menu:

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Are you as excited about an all-vegan restaurant in the West End of Richmond as I am? Have you been here yet? I’d love to hear about your experience!

As always, I hope you all are safe and healthy.

Chessie Trail Marathon 2022: Race Recap

“I’ll meet you at the cow!”

This is one phrase you may not typically hear from your running partner during a marathon. But we did encounter quite a few of these majestic creatures during the race. They were mostly curious and/or unbothered by our presence. 

The cow patties, on the other hand, were not so majestic. Those kept you on your toes, as they often punctuated the divots in the trail where it was most convenient to place your feet. 

To be fair, we were warned about the cows ahead of time, and in particular, to not get between a mother and her baby. A point I clearly understood!

For my fall marathon, I chose to take on a smaller race, the Chessie Trail Marathon in Lexington, VA, which is in the middle of the Blue Ridge mountains. The mountains are definitely my happy place, so I was excited to run a different kind of marathon in the midst of so much beauty. 

This was my 10th marathon, and perhaps my most challenging. Considering that I ran the Marine Corps Marathon in 2019, which began in a monsoon and ended in sweltering heat and humidity, that’s saying a lot. But it’s done! 

Positives from this race? 

  • I got my money’s worth. I finished 15 minutes before the course officially closed in last place. With only about 50 marathoners and as slow as I’ve been running lately, it wasn’t hard to do. 
  • The shirt. I love the long sleeve technical shirt for this race. Simply designed and in a fabulous light aqua color, I will definitely wear this a lot!
  • The scenery. This was a rail trail, so fairly flat. Some rail trails I’ve run have little to no scenery, but this one was different. We ran along the Maury River for most of the route, and it was beautiful. We were also surrounded by mountains. And although peak fall colors were earlier this month, the leaves were still pretty. 
  • The wildlife! Besides cows, we saw squirrels, chipmunks, wild turkeys, and deer. For the record, turkeys do fly. Sort of. And the deer just jumped on the trail with you. Crazy stuff!
  • The crew. The volunteers at this race were really supportive, which was very helpful since there weren’t many spectators.

With a race that took me this long, there were some negatives:

  • It’s four out and backs. Not my favorite route format, especially when you bypass the finish line 3 times. It was so hard to not give up at the half-marathon mark. My running partner, Becky, carried me mentally through most of this race.
  • The cow patties. Tough to dodge, as previously mentioned. 
  • Aid stations had nothing salty! I appreciated the water and orange and banana slices, but I wish they had had potato chips or pretzels to accompany these!
  • Little to no crowd support. But this is to be expected at a trail race.

Some things that worked out for this race were just luck. We had fantastic weather! It was really chilly at the start, so Becky and I went to Walmart the night before and bought mylar blankets from the camping section for about $3 each. This was a great decision and something I will definitely buy again. They folded up super small and fit nicely in our hydration packs to use next race. Temps started in the 40’s, warming up to 60 degrees toward the end. It was mostly cloudy, which I actually love for running. 

Clearly, though, this was not my day for racing. My right knee started hurting before we hit double digits. And even though I’d taped my knee to help prevent this, it still happened. This race just hurt. Everywhere. But considering that I had COVID 3 months ago and struggled for weeks, that I missed a few training runs because we lost a family member, and that I had a cold all week, I’m surprised I finished!

I would not recommend this race as your first marathon. I think it’s super important to have that big race experience for your first marathon, as that crowd support is amazing and so helpful mentally for runners new to this distance. But for folks that get overwhelmed by crowds, this may be a great race for you. Just be prepared for that mental challenge of the course setup. 

The town of Lexington is so quaint! Home of Virginia Military Institute, the downtown area is filled with cute stores, locally owned restaurants, and even a local running store. The ladies we met at Lex Running Shop were super nice. I highly recommend stopping by if you ever visit the town. Surrounded by mountains, the scenery is stunning. 

I think this race is a one and done for me. It’s not that it wasn’t pretty or unorganized. I just had a tough time mentally, and I’m not sure I can overcome that if I tried again. It is a challenge that I’m glad I did, though!

That being said, I might be tempted to run one of the shorter distances they offer, especially the half marathon. There’s also a 10k and a 5k, so this could really be a family event!

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Do you run a marathon in the fall? If so, what has been your favorite? Mine will forever be Richmond, but now that I coach with Sports Backers, I can’t run this race. I’ll be on the course to support runners! If you plan to run Richmond, let me know! 

As always, I hope you all are safe and healthy.

A Body in Motion Stays in Motion

Running through post-COVID symptoms and grief

My current mantra. The law of inertia: a body in motion stays in motion, and a body at rest stays at rest until another force acts upon it. 

These last few weeks have been extremely challenging. I’m now 12 weeks post-COVID and am still not back to normal. Sure, my energy levels for day-to-day activities have returned, but my running is most definitely not what it was pre-COVID. My pace is still so very slow, and while I may feel like I’m putting out an effort that would pace me at 10:30 minutes per mile, my watch says otherwise. It’s depressing. 

At least my lingering chest pain from the infection is subsiding. This used to be a constant companion, but over the past week or so, it’s become far more intermittent. This is a very welcome change. I’m hoping this indicates my speed will begin to improve as well. 

My strategy for healing is to stay in motion. One foot in front of the other. To give myself some grace when my runs are a struggle. To appreciate the fact that I can still run despite having had COVID. 

The recent loss of my father-in-law also weighs heavily on me. As we kept vigil in the last week of his life, I lost so much sleep, and my energy needed to be spent doing things other than running. I missed two planned runs, including my Sunday 12-mile long run the morning that he passed. Besides being up most of the night, my family needed me, especially my young adult daughters, who both went above and beyond in giving care to my in-laws. 

My family and I are navigating our new normal, as my father-in-law was a big part of our lives. Living next door, we saw him almost every day for years, and recently, several times a day as caring for him required more assistance. And now, we are helping my mother-in-law adapt to a life without her partner. 

I hopped back into my running schedule for taper. I won’t make up the 12 miles I was supposed to run the Sunday after my 20 miler. My final long run before my marathon was a mere 9 miles. I’m grateful I managed to get a 20 miler done this training cycle. And now I’m fighting a cold, and I skipped all of my runs in this final week. 

My marathon will be run on a wing and a prayer, relying more on my mental toughness than my athletic ability. But then, that’s typically how they go, anyway!

For now, I’ll simply keep moving. A body in motion stays in motion. I run the Chessie Trail Marathon on Saturday. 

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I’m pretty sure the expression on my face in the lead photo says everything that needs to be said about my expectations for this weekend’s adventure.

Are you a runner who is trying to maintain a training schedule for a race post-COVID? I’d love to hear about your experience.

As always, I hope you all are safe and healthy.

Saying Goodbye

We laid my father-in-law to rest on Saturday. 

The visitation was Friday. When it was just family, I looked at all the flowers there, and when I saw a large, pink arrangement, I already knew before I read the card. It was from my sole sisters, the loving term my running friends and I have chosen for our core group. Pink for my running team, the Pink Nation. Adjacent to that was another arrangement from my best friend and her significant other. She is one of my sole sisters. 

That was the first time I cried that night. The second time was when I saw my parents and brother who had made the trip from Hampton Roads. Seeing the sheer number of people who came out to pay their respects, including many old friends I haven’t seen in years, prompted more reasons to tear up. 

My wedding anniversary with my husband was Sunday. It’s not the first time a funeral was involved in our anniversary weekend. My husband’s cousin Ronnie passed away a few years ago, and we celebrated his life as part of our anniversary. When I saw his son and daughter walk into the funeral home, who are about the same age as my husband and me, I couldn’t help but think of the mixed emotions they must be feeling as well. 

The service was beautiful. The current pastor at my in-law’s church officiated, and our former pastor sang a hymn and delivered my husband’s eulogy. His words were beautiful and perfect, capturing every aspect of his dad and the influence he had on his world. 

The graveside service was brief, but touching. From watching our friends who served as pallbearers carry him to his final resting place, the perfect fall weather with crisp air and bright sunshine, to the bumble bees who were delighted to busily collect nectar from the funeral flowers, to the care and precision with which the Army soldiers folded the American flag draped over his coffin, there were so many things to notice.

Their church hosted the reception. I’m still a bit bitter that the church where they have their plots refused to host us, but there’s not much we could do about that. But their church was warm and welcoming. I also got to catch up with their previous pastor, a woman who I still regard as a friend and perhaps the most influential pastor in my life, even in my present state of deconstruction from the Christian faith. 

The flowers after the funeral.

Now the fight or flight is over. All the ceremonial duties are done. And we are left with memories of my father-in-law and the care that our community showed to us during these final days. The next step is to establish the new normal, whatever that may be. 

Grief is a strange thing. We go on with our lives because we have to, but may find times during the day when we think about the person we lost. Maybe we’re running errands, thinking about something they would need or want, and then realize they aren’t there to receive the gift. Maybe it’s a time of day passing, our brain telling us it’s time to do a caregiving ritual, like helping put someone to bed or change them, and realize that burden is done, with both relief and sadness in that realization. Maybe it’s something we see that sparks a memory of them, and suddenly our state of feeling OK is no longer that. 

Hopefully soon, our voids in life will be replaced with good memories of who my father-in-law was before he became ill. My daughter says she struggles to remember what he was like then, which I can understand, especially as we navigate this new world. 

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Are you navigating a new world without one of your parents? I’d like to hear about it. 

As always, I hope you all are safe and healthy.