Catastrophes and how to save a life.

Medicine:

Catastrophic event occurred yesterday. One of my patients, who underwent a a heart cath had one of the more severe complications associated with the procedure: a retro-peritoneal bleed. We were called to bedside for a rapidly dropping blood pressure. After some well placed phone calls and bullying, we rushed this patient to the CT scanner ( which showed a massice bleed) pressures still dropping, even after 3 liters of fluid and maxed Levophed. Rushing them up to the ICU, we eventually got blood running, 4 units in 30 minutes.

Continuing the blood, I called for massive transfusion protocol, did my best to keep the patient awake. The OR and heart surgeon were notified. We lost pulse twice awaiting the OR,  Epi brought recovery, thankfully. I held off calling a code during this, as the only way to save the patient was getting them to the OR. On the way down, we lost pulse again, and CPR was started... And continued throughout the procedure repairing their femoral/iliac artery. Eventually we regained a pulse... During this, I believe they received a total of 16 units of blood.

Saved a life. But the prognosis is still... Unclear.


Lifting:
Week 2 lower 2: tempo/hypertrophy

Superset pairs

Deficit DEadlifts 6x5 @ 275 slow damn eccentric
Hamstring curls

Romanian deadlifts 5x6
Glute bridges

Back squats 5x8@. 225 slow decent, with long pause in the hole.
Step ups 5x12@25

Prowler pushes
Prowler drags. Both at 225

I was in a heap of burning leg pain at the end... I love/hate that damn prowler...




Diet:
Medium carb: going strong. (Slipped a bit today: 2 oz Gouda cheese on my post workout sammich)



Didn't weigh in today...

Additionally, I tried hydroxycut hardcore elite or extreme? It was a sample sent with my last order from bb.com...   Crazy strong. I'm well conditioned to caffeine, 600-800mg easily/day. This is on another level. It took a solid 1-2 hrs to fully kick in. It was intense. I was dizzy and seeing stars... I totally ordered a bottle, with plans on half doses... :).

I'm considering running clomid at 25mg every other day, considering the low long term risk and documented natural increase (roughly double) in testosterone in men... Hmmm...

Mocha, bitter pills, and old hearts.

Diet

Wt was 264.4 this am. After a brief discussion, were dropping one high carb day to a med carb day. Still trying to figure out how my body handles carbs...

Medium carb day: had to turn down free potbelly subs at lunch today... Seriously, THAT was willpower...

Optimum nutrition mocha cappuccino arrived... Tastes like neither mocha nor cappuccino.  Tastes more like burnt marshmallow.  It does mix well with water/coffee and isn't repulsive....


Medicine

Times magazine : Bitter Pill  from March 2013... Read it.

Seriously, if you want to know why we are broke/broken as a healthcare system.

Also got to watch a TAVR procedure today... This is replacing a heart valve through a catheter ( like stenting a clogged vessel... But wedging a valve in there instead....).

Cost of the valve? $35,000...  After deployment, it was leaking... So guess what? Boom.
Another $35,000 valve was deployed on top of the first one. $100,000 on this procedure/ hospital stay alone for a person who is expected to live less than 2 years.

No longevity data on these valves, either. So we don't really know how much time we're buying these folks... Who are already expected to live less than a couple years anyway...

At what point do we say that enough is enough, and we as a society shouldn't pay for things like this? These minor temporizing interventions done in 85+ year old people...

When I reach 80, I'm eating nothing but pizza and ice cream until I die. Fuck it.

Dignity. There are worse things than death.




Lifting week2 upper1 tempo/hypertrophy
Super set pairs

Seated military press 6x6. @. 115 tempo'd
Pull-ups (6 sec eccentric)  6x6 @ bw- only used bands for the last 2 reps of the last two sets...

Wide bench 225 5x6 tempo'd with pauses...
Underhand row 135 5x6  5 sec contract at the top.

Band push-ups 3xfail
Band pull aparts 3xfail(20's)

Shakes and squats

Medicine:   Parkinson's clinic today... Good day in clinic, all of the patients were well treated and doing well on their meds, so its actually hard to tell they were Parkinson's patients... (Get it, shakes?)

Diet:
Matrix 5.o orange cream and carnivor protein... With oats... (And more shakes? Ha!)
Lunch.  Grilled chicken breast & salad...
Dinner: chicken chimichangas... Wife tried a healthy baked recipe.  Awesomeness.



Lifting:  week2lower1: tempo/ hypertrophy
Superset pairs:

Front squats 6x8 4 sec eccentric and pause in hole:  145 all sets felt so much more comfortable. Still limited by thoracic fatigue... Not leg strength.
Band hamstring curls tempo'd

Snatch deadlifts 5x8   4 sec concentric @275
Wide good mornings @135 tempo with pause.

Split squats
Glute bridges

Band walks
Zerk holds 5+sec holds at 135... T spine shot by these...


Buddy ran the Boston marathon today: thankfully he finished 30 min before the bomb...  Strong run, Kyle.

 Fucking cowards.




Welcome to my dungeon.

Babies, man purses, and pressing.

My daughter, who just turned 6 mo, is pretty angry after her shots. She's still not really keen on the idea of lifting weights with me out in the garage. I'm finding myself rushing the workout because she is screaming... Or like today, I'm going to have to break it into 2 sessions, maybe add some bonus Olympic technique work in.

Additionally: I'm looking for a man purse. I love the look of saddleback leathers briefcases, but at $400+... It ain't happening on a resident's salary. ;) I need something for the hospital to carry various neurology tools, blender bottles of protein, papers, and a tablet...

Searching around, copper river bags seems comparable in quality(warranty too!), very stylish, and less than half the cost of saddleback... Maybe I'll pick up one of the 10" camera bags and give it a whirl...


Lifting:

Week1upper2 tempo/hypertrophy block
Super set pairs

Multigrip chins 4xfail
OHP 1.25 reps. 4x6-8 (2sec pause at the face, drop to shoulders then full press). Only made it to a measly 115 lbs due to being rushed/no rest as above... Not to mention the quarter rep pause was brutal.

Band pull downs 4x12 with pause
Seated ohp lockouts 4x8 @145

Cobra presses
Band pullaparts.



Diet: bw: 262.5
med carb day
shakes and oats abound!

Seizures and squat pain

Medicine:
Spent all day at lectures about seizures, rather informative... Still realize I have quite a bit to learn about these...



Lifting:
Week1 lower 2 continuing with tempo hell.

Deficit deadlifts 2 plates + oly shoes. 275 5x8. Supered with
Hamstring curls: elitefts light band 5x8

Front squats: had to cut these early due to a strange hip pain, definitely not a nice feeling. I'm very weak at front squats, largely due to me not doing them often. I'm already feeling more comfortable under the bar with these.
155 2x7 supered with
Rom. Deadlifts 225 5x7 multiple second concentric/eccentric.

Sled drags supered with
Step ups with 25lb plates

Heavy prowler sprints supered with
Glute bridges

Decent workout: quads were screaming by the end.



Diet: bw: 262.4
high carb day: post workout meal was a dinner out with the wife: Mediterranean: rice and chicken kebobs..

Here chubby chubby chubby.

Starting photos... wt 261.8

I'm embarrassed (to say the least) at my current level of physical fatness. How much you can lift doesn't mean shit if you're a fat fuck.

Apparently I can't be trusted with my own body... Being a previous collegiate and professional athlete/fighter, I've sustained some significant injuries: bilateral ACL, MCL, and meniscus all status post hamstring graft repair... So... I'm missing part of my most vital pulling muscles...

Diet:

Medium carb day.

2 protein shakes with oats
Additional 60g carbs post workout
Minimal carbs otherwise.

Approximately 50g protein/meal 300g goal daily... regardless of carbs level of the day...

Lifting:

(upper body 1 today...considering the daughter crushed my workout yesterday...)

Everything has crazy tempos... Which pushes the difficulty level through the roof.

Seated mil press max 115. 5x7 supered with
pull-ups (6 sec eccentric-had to have band assist after the first 2 sets).

Bench 205 5x7 supered with
Underhand rows max 115. 5x7. 5 second contract at the top.

Band resist push-ups. 7,7,6 supered with
Supine grip band pullaparts 3xfailure (15ish reps) elite monster mini bands on both of these



Steady state cardio (not fasted):30 min dedicated walking around the hospital/stairs... my current role on this hospital rotation is redundant, so breaking away for this walk was possible...

New diet, New goals

Since roughly Christmas, ice been running carb nite. Great diet from DHKiefer. Pretty much a cyclic ketogenic diet (30g of carbs/day with one night of a re feed). I dropped from 285lbs to about 255. Good results as far as weight/fat loss is concerned, unfortunately there was a marked loss of strength and work capacity.

Frustrated with my strength level, I decided to work with Brandon Crabill, a fast rising star in the power lifting community. I've seen him drop 50lbs of fat, while nearly doubling his big lifts over the last year or so (700+/600+/700+ @ 200)

He's running my diet and lifting/conditioning... 

Diet seems based on carb cycling, with 2 high carb days, 2 medium carb days (these 4 carb days occur on training days) and 3 low carb days.

Just trying to settle into the diet, which is rather difficult, as I'm used to fasting must of the day. Thus current scheme has me eating very often, which ends up with me drinking various zip lock bags full of oats and protein powder that I procure from my white coat all day while rounding...

I need to plan my meals better, as I can see myself getting tired of this quickly if I'm not careful.

Lifting is currently based on tempo lifts done in super sets of seeming antagonist muscle groups. I'm trying to keep rest periods low,