Superficial Lacerations

This is my favorite photo from 2011. Grandpapy Wolvo Thistle.

Hello December skies, if it wasnt so cold out I might be able to emit more energy but it just aint there when I go to make another lap around the planet, one'll do it these day. Beaming from fire soaked branches and candle sticks brings out my intensity more so that making a bold entrance on the morning horizon

Both Metro and Alex trying to send simultaneously

Mr Ed, v8, The Master Bedroom (NY)

So I rummage around rooms finding what I might illuminate; the corner of a couch or a long end of a book shelf,

but by far, and by far I mean far, the most celestial sheen has these days come from the strings of a my guitar

said the little photon

Maxamillion

2011 folks, was a good year. 2010 kinda supremely sucked but 2011 made up for poor focus and failing tenocytes (forgive me tenocytes I will give you more eccentric training and less ramen in 2012) and a vacuum that swallowed many good question

The Claw, v10, Ice Pond (NY)

2011 was South Africa and Lincoln Lake and Harriman Park, was me leaving a long sought-after job in orthopedics for a not so obvious choice in community health, recovering from my worst climbing injury (-ies) to date and still somehow climbing v10 in South Africa, having an epic backcountry (spring 2011) season, finally getting a job in the ER, connecting with people I shouldnt have lost touch with, realizing I'd lost a few good questions and welcomed some home, Replacement Killers and Grand Tension sit and The Amendment, starting an anusara practice but flowing more with my spanish speaking patients, reaching the compete bottom of motivation like never before but correcting that abysmal nonsense right quick, fingerpicking on the porch, my first garden, and joining 8a.nu.

My yoga conclusion for 2011; I think the philosophy in yoga in way more vital to me than the practice because honestly, after 10 years of practice nothing changes but my mind ('cause the overweight soccer mom here for her first yoga class is sticking the position with a smile that I've been working on for over 2 years... without progress), in fact my shoulders and hips may get worse with intense yoga, so just take in the teachings, accept that I'm not a skinny-jean yogi, and go run a mountain, sit a bit, and mix in a weekly class that gives what I need, which is essentially a reminder and a hammock.

ER in Clanwilliam (S.A.) where I lost my first attempt at leading a cardiopulmonary resuscitation.

Best book: How to Live Safely in a Science Fictional Universe or.... Blood Meridian. That said I havent finished "Cutting for Stone" yet and Dr Gosh is a complete badass.

Best Album: Tyvec "Nothing Fits" or Phosphorescent "Here's to taking it easy" or Mumford and Sons' "Sigh No More"

Topside's perfect stone

For 2012? Rock Rodeo? Will I take the MCAT, transition to full time ER, keep working in community health? V11 or v12? Have I climbed v11 is a damn good question. Goddam I need to train my fingers more. Keep up the guitar and more painting are mandated! China and Japan at my the top of my list for this year... but I would love to go back for another month in S. Africa, for Topside and out towards the Indian Ocean coast. I also want to explore Harriman Park, NY.
Did I fail to report sports med journal update again? Sorry, coming soon, maybe next update. I've got 1 article about female (joint) laxity and a couple about PRP that should be shared.

The Apprentice Changing Orbitals Thursday Remix

Recently I went out to Joe's Valley with my buddy Al Lew on a mission to meet up with Dr Ben Elkon. Ben's been MIA doing his Peds residency in Utah. I was MIA for his wedding when traveling in South Africa, bad timing but damn it was a good trip

Before I left there was the final harvest of my first garden which is the setting of my forthcoming, long self anticipated next painting, really want to connect with the brushes and color again. Sometimes the side of an apple become really important.

Al displayed some serious off-the-couch-ness skills on our Joe's trip by doing Playmate of the Year in a matter of 30 mins.

Oddly I found myself completely uninspired in Joe's. Maybe a bit of burn out after nearly a year of finger recovery and then a big trip to Rocklands and then wrapping up a season in Wolvo. I felt like speeding through outer space, visiting other planets, or chasing down an astroid or working my way between branches at local canyons.

Meanwhile, I got myself into another PA job closer to Boulder and in the ER. I'm not saying that my current job isn't working but it is a long drive from Boulder and the promised loan repayment fell through.

This past Saturday I did my first day of training at the new job then ran up Boulder Canyon to finish off The Amendement V10/11 (Grand Tension was harder so maybe Tension was v11). This is somewhere in the range of the 3rd or 4th v11 I've done that has been down rated to v10. Nobody else has done Tension from the way I started it so I'm psyched to see what people think it is next summer.

I love the local climbing season. So often climbing can dominate my free time, it's nice to have local projects that I can push myself on but don't require so much commute time. Time to sip some coffee at a cafe, read my book (now reading Cutting for Stone which is spectacular, you should read this, read it in a day, be the first to read it in a day, Cutting for Stone in day) and journals, study a bit, hit a yoga class, play the guitar, sit, and not feel too overly rushed.

The Top 3 list for Boulder Canyon this season (the conquest for v12):

#1--Authentic Battle Damage

#2--Burnout

#3--Hug Right

Other of note are: Headless Horseman, Get Over It, Graham Arete Right

My apologize for not posting the sports med update. I have a lot of PRP data to down load on y'all from my journals and a recent conference.

I also have ideas to share from my practice in psychiatry these days, as in DONT do meth, you may become schizophrenic and loose your teeth.

Nex blog post, I'll try to bring you the sports med data and an update from the east coast, looks like I'm head to the Gunks and Farley for bouldering and NYC for family for Turkey Day. Gobble gobble.

Poison Dwarf to Topside

If you’re traveling in a recreational time machine and happen to see you’re self step out of a spaceship, its best not to shoot yourself, just run.

Did you know that whales do head spins? This blows me away.

The send tally after 24 days in South Africa:

2 7c+, 2 7cs, 3 7b+s, 4 7bs, 4 7a+s, and 7 7a's. Best problem I did was probably White Mazda Clan 7c+. Best problem I tired was 8a and called Gliding Through Waves Like Dolphins... amazing feature. Did all the moves on Black Shadow 8a+ my first day, and only day, on it but never returned to project. There was no project. All sends were done on the express, let's get this done now, wisdom. Training conclusion: I was strong but had no flow, shoulda spent more time at the Spot doing laps on 4+ and 5-. Next time.

Grades dont mean shit, no seriously, for the most part v7-v10 took abut the same amount of time to finish, I just tried way more 7 and 8’s and stuck to them until they were done. Poison Dwarf, the hardest problem of the trip, 7b, took more effort than any other problem. Poison Dwarf, according to urban dictionary = “A selfish, untrustworthy, deeply obnoxious or evil person of diminutive size, whose ostensibly unthreatening appearance allows them to fulfil their predisposition for causing unprovoked pain and suffering in an under-hand manner for anyone who has the misfortune to strike-up a friendship them.” Frumpy little poison dwarf, why'd you have to treat me so ill?

Rob Guin on the best line I tried in S. Africa. A nameless white roof blob of perfect stone nestled in the thicket peering out over False Bay. iphone-ed.

Cape Town has lots of quality boulders but also lots of bunder-bashing.

http://sites.google.com/site/cutloosebouldering/topos/cape-town-bouldering/topside

Topeside, Echo Valley, 30mins from Cape Town International Airport.

Ostrich burgers are the future and if we had springbock biltong, I’d eat it every day.

Turns out I don’t have faith in probability and I’m a fair weather surfer. The cold water and great whites makes me hesitant to surf. The second week we of the trip a surfer was killed by a great white. The last week I was there a local lady was going for a swim and was eaten. That was enough for me to stay ashore, I dont like wearing wet suits or anything tight for that matter, like I could never be a road biker, wouldnt make it out the front door. Great whites and thick head to toe spandex, count me out.

Atlantic cold, Indian Ocean warm. Must make a trip to Durban next time down.

Oodshorn has sick limestone and it’s close to Vic’s bay with Warm water surf, another destination for the next trip that will be based more out of Cape Town.

South African’s love the BBQ, called the Braii. Kudu steaks are tasty.

There aint shit to do in Clanwilliam, serously, there’s more to do in Orangeville, Utah.

Slopers are a rarity in Rocklands; all those aretes and so few slopers, dumbfounding. Not everywhere can be Font.

Giving chest compression and breaking ribs for 45 mins is a bitching workout. I was debilited for a day after this experience. I volunteered in the Clanwilliam ER for a couple rest days.

Doctors in S. Africa follow the euro model and skip doing an undergraduate degree. They community doc’s (i.e. the doc’s that dont work in the private clinics; all South African have access to free health care at the community clinics and hospitals, no bill.) they get burned out too.

South Africa has a serious problem with HIV and MDR TB. Patients from the Suti (a country within South Africa that speeks a completely different language but uses the free health care of South Africa) don’t speak english or africans and they have a high rate of TB.

I may be TB postive now.

Some white south africans now resent resent affirmative action

Go to Potterville, hike the waterfall trail and then drive over the pass and swim in the lake on the other side, and drink some wine.

Drinks lots of wine in South Africa and dont bother with the beer.

Renting a surf board in the small towns of SA aint happening.

Trust your gut, study people’s faces, make calculated simple decisions and less calculated complex choices

I suck at dyno’s and on-sighting, Rob Guin doesnt

In the 80’s-mid 90’s white men in S. Africa, 100% of them starting at age 18, were drafted for what they call the Boarder Wars. My understanding is that the wars were over other nations protesting against appartide. One guy I talked with remembers killing many Cubans on the Namibia - SA boarder. If the young men didnt report to raft they were arested and put in prision.

http://en.wikipedia.org/wiki/South_African_Border_War

Pinotage is a wine specific to SA

In the rural hospitals there are few beds abd resources for premature babies. They have a developed a program called Kangaroo Kids that involves teaching mothers to hold their children skin to skin with the mother’s breast throughout the day.

Most climber in Rocklands are from Europe. The euro’s and one canadian coulple say that cheep tickets can be bought in the early spring and that prices get higher through the summer. This was my experience, I saw tic’s for 14 hundred at the beginning of the summer and ended up paying 1,850 because I waited and bought late, thinking prices would come down.

There's a place at the end of a dirt road deep in the Cederburg where economic development, invested from the state, failed but people still live there, at the end of the dusty dirt road that must be impassible in the rain, raising their cows and daisies and roosters.

The sounds and site of Riverside, the most aesthetic crag in RL.

Working with One's Limitation

In Wolvo you get to see a weekly change in the alpine flora as you do the hike in and out of the boulders. 2 weeks ago it was thistles. Last weekend it was certain white flowers that draped them selves over the steep hilside.

I've been, or should I say my left hand has been, injured for the last year. I was training for a South Africa trip last spring and tore my A-2 pulley on my 3rd left digit, made a loud pop, lame. Over the summer I, first, cancelled my trip to S Africa the, second, started running and swimming instead of climbing. I did that for 2.5 months last summer and made a rapid return to climbing v8/9 within a couple weeks of being back. I was nearing healed this past spring when I pulled onto a slab in Joe's Valley, a v4 called Bowling Ball, and felt a twing in my left ring finger. I'd been trying to avoid pockets with my middle finger and tweaked my ring finger in doing so. Early the next day, I went on a mission to finish off my long time crimp project, yep... ignoring the twing, and hiked out to Resident Evil v10. I felt strong, taped my finger well and quickly found myself with my hands matched over the lip, staring down the "starfish." At that point my left ring finger made a funny feeling and I dropped off.

In the months that followed I've tried tapping the finger and avoiding all crimps but this was hard, in particular cause i climbed at Movement this winter/spring. Long story short, I wanted to make this South Africa trip this summer and I didnt want to take another 2-3 months off so I tried doing hang-board sessions as a means of keeping some strength in a controlled routine. It's been a struggle no doubt but Im in the airport on my my to Rocklands and my finger has been feeling better and better the last few weeks, but clearly not 100% recovered or strength.

My routine was to do weighted hangs on edges and pinches 1 night a week and then to tape my finger multiple times during a boulder session to hold the pulley/tendon down, but never pushing it.

The other interesting aspect of this spring training was dealing with schedule. I'm spending more time at work then ever in my life and thus am forced to train wisely.

Here are a few observations on my training. Last summer I came back feeling strong and light after running and swimming all summer, 5lbs ligher than I am now. This summer I havent found the time to run and instead have trained finger power. The end result so far is that being light seems more important than finger power.

We'll see how South Africa goes. Stay tuned, I'll be in Rocklands in 36 hours.

Below is Tom C. on Grand Tension v10 at Lincoln Lake.

Sport medicine update #2 and Rocklands bouldering next post!!!!

Lincoln Lake Shorties Vol.1

4 weeks till S. Africa, just did an ultrasound of my finger and all is not lost, I have a little tear in my ring-finger A2 pulley but nothing that I cant tape aggressively for the next 2 month. That said, it hurt tonight as I cut my feet on a edgy problem in the Movement cave... but then it didn't hurt when I went upstairs to train on the woody and campus board. When I come back from SA I'm PRP-ing it. I'm not sure that PRP has been used for pulley recovery in the past but I think it's the future.

Recent sports meds stuff that I'm going to make an effort once a month now to update y'all on:

(1) PRP vs steroid injections for medial or lateral epicondylitis. Go with PRP and your outcomes are, without a shade of doubt, better and longer lasting. A recent long term trial compared the two and was publish in American Journal of Sport Medicine 6/2011.

(2) In the same issue of AJSM an article looked at the healing effects of icing. Cold water bathing of leg as done using 8 and 22 degrees C. The two water temperatures both reduced blood flow to the limb to the same extent but the colder water caused more vasodilation. Thus, under the principle that more loss of blood flow to skin causes a reduction in blood flow to muscle and other injuries, colder water causes less blood flow to tendons and muscles. The article makes that point that muscle inflammation is a limiting factor in the recovery from muscle strain... so a reduction in blood flow means an increase in healing/decrease in recovery time. BUT!!! for finger injuries the opposite is true, the huge issue with finger injuries is blood flow. So, based on this study I would suggest cool but not cold water baths.

Interestingly, this study makes the point that hand circulation is different than legs because hands have more anastomoses and need to be studied independently.

Ok, now I need to get my shite together for my colorectal cancer screening talk tomorrow morning.

1 Year Out

This week marks 1 week out from PA school. To reflect a bit, as I've been feeling a bit run down lately, I was going to recap the whole career progression, as I've found that career stress, sending, and social life are all intimately intertwined.

A year ago I graduate from CU's 3 year PA program psyched on going into orthopedics and sports medicine, I'd done nearly all of my elective rotations in ortho and enjoyed them all. But meanwhile, building throughout PA school were 2 opposing/conflicting tides, one was this thought that I wanted to go on to become an MD, i.e. do residency and specialize, and two that I'm an intellectual dork and something like internal medicine or emergency medicine would provide the intellectual stimulus and variety more than ortho. But, being as life is that you start one thing and it's best to see things through on occasion, I finished PA school planning to go into ortho.

I had 3 job offers within a month of passing my boards and almost moved to Cali. The summer was a bit of a mess, no job, no money, I was injured, had called off my S. Africa gradation trip so I started work in August at an ortho group outside Boulder. The group seemed a good fit in the interview but as it turned out there was no availablity of mentoring for me, a new grad, and I was left boarded and frustarated and undertrained working way too many hours, climbing like poop and wishing I was in residency getting the training I really wanted and making use of my time.

I left that job, sent a boulder problem, and then started a job in Community Health. Communty health is under-served work; no insurance, poor health, at least 50% spanish speaking, family medicine/urgent care. This was not my focus in PA school but I figured it could provide a strong basis for any other job and it may help pay off my loans and get me to where ever I want to be next without the burden of debt. As it turns out I'm working tones of hour at this job too, still climbing like poo but I am intellectually stimulated.

I've made arrangement to go to S. Africa to do my graduation present a year late. I'm psyched for this but just hope I can find the time and energy to train for this.

I laughed at myself yesterday as I stepped onto the scale in my room. 172lbs before the run 169 after the morning jog. 1 year ago I was at almost the exact same weight, shooting for the exact same goal, 165 and crushing v10's, and on my way to Rocklands.

As for the MD question, time will tell. I have research questions I'd like to pursue and I like the idea of being a sports medicine doctor but going back to repeat the same courses for 3 years is a tough pill to swallow. Taking the MCATs again (I took and crushed them 8/2000 and for various reasons never fully when down that path) is an even tougher pill to swallow.

So, if you see me staring off lost in muddled introspection that may be my inner discourse, quality of life questions, PA with less comitment or MD with bigger loans and bigger hurdles.

Weathered Defiance

Al Lew giving a go on Koyaanisqatsi (v11) near Castle Rock in Boulder Canyon. I've checked this problem out and seems do-able but a more pervasive issue has blocked my radiation

The intention and belief,

I am light

fragmented light

in instances coming together

between the trees
Lauren Wilson (http://laurenhillwilson.blogspot.com/) getting her first taste of the Cowboy sandstone of Joes Valley. Someone help me defend my "cute" GTI. "My ride, my ride, our relationship is classified" --Andre Nicotina... maybe she has a point.

We skirted around the sun's fiery intent using the new guide book http://www.joesvalleyguidebook.com/ which helped keep the psych up cause temps were hot and I'd blown my tip out on the first warm up of the trip and had to get out the glue and tape, we needed new material, the old project were not going to fall, not this trip, not in these conditions, not shackled with an ailing adrenal gland.

Big moves in Joe's. Lauren learns that big move bouldering in the Spot can pay off, next season.

So feeling weathered and raw and short a stove we went to the local saloon and met with the locals. Two guys told us about the recent mining history in the area. Turns out that the mine in Huntington Canyon had a collapse in 2007 that killed some of these guys' friends and registered on the richter scale many miles away (http://en.wikipedia.org/wiki/Crandall_Canyon_Mine). According to these guys, this mine supplies energy to Nevada, Utah, and SoCal. If you've had your ear to the floor, you may have hear of bouldering development happening in Huntington.

They also say that the mine/refinery that we pass as we turn off for Joe's, the one on the right as you turn left for Joe's, in one of the worst around, i.e. it's mostly run by illegal immigrants that dont speak english and in the case that the whole place is going to blow up, which is a risk you swallow when you work in these sorts of places, you cant even communicate the urgency your co-worker. That and the safety checks and part updates, all of which these guys we're chatting with know in great detail, all are poorly kept. They say that a good majority of the towns population works in the these two mines or the one near new Joe's. Most of the immigrants that work the smaller refinery do not live in Castledale or Orangeville, they live in a town out east into away from town where there's only one cop and a lot of trailer homes.

The mine out near New Joe's collapsed a couple years back and killed another friend of the guy I'm chatting with. He says these lands make you hard. Says that the guy from Aspen who cut his arm off and is now the star of a movie came to the local high school, the one in Castledale, the closest high school to where the man lost his arm (he was hiking in the San Rafael Swell which can be accessed by a dirt road not far from the pizza shop in Castledale), and was booed off stage 'cause the public in middle-of-nowhere Utah thought this guy was a fool for getting lost, not a hero of any sort.

The wind picked up that night and it got cold and damp. Something big wobbled through camp that night and brushed our tents and left with less bluster than the canyon's vast dark howl.