General Surgeons Australia (GSA) Annual Scientific Meeting

General Surgeons Australia

4th Annual Scientific Meeting

From 08:30 Friday 21 through to 15:45 Sunday 23 September 2012

Wrest Point
410 Sandy Bay
SANDY BAY  TAS 7005

Wrest point, Sandy Bay

Hobart, Tasmania

Hobart, Tasmania

Yo hOO hoo! A paper that my surgical registrar and I have been working on has been accepted by the scientific committee to be presented in the Annual Scientific Meeting. WE ARE GOING TO TASMANIA!!! 

Tasmania is definitely one of my dream places to go! It's where mountains and sea are next to each other. I am very excited! Can't wait! :D 

I am one step closer to becoming a surgeon too! :D

Injuries and grace

The past week has been a roller-coaster ride for me. My knees were giving me a lot of problems throughout the week. Initially it was my left knee. Just when it got better, my right knee decided that it too, wants to create problem.

I feel like there is a constant enmity between me and injuries. They just won't let me go. I have tried a lot of methods and preventive measures, still i am haunted by injuries! Sadly i am not blessed with good bio-mechanics, and my muscles and all their attachments and interactions with surrounding structures are just a complex meshwork of mess. Poor flexibility, muscles imbalances, and slowness of my muscles to relax/recover are amongst some of the main reasons why i am always injured. I felt like i have already done a lot to modify my lifestyle, diet, training volume, but the intrinsic factors eg body bio-mechanic and muscle physiology, are frustratingly beyond my control.

Still there are positive sides to injuries. Each time i get injured, i am forced to look deep in my body and learn more about it. The whole leg is linked by a kinetic chain - from glutes in the butt, to the quads and hamstrings in the thigh, to the knee, to calves muscles and anterior tibialis in the lower leg, to the ankle, to the plantar fascia in the foot. Injury to one point, or tightness or spasms, will result in other parts working hard to compensate for it. I have learned that the site of pain is often not where the real problem is. It's only the reflection of compensation and imbalances that are at work leading to the final outcome, which is injury.

More importantly, injuries allow me to turn to my heavenly Father for comfort.

I have learned that you either trust Him whole-heartedly that He knows your pain and wants the best for you, or you don't trust Him at all. Half-heartedly trust is really no trust because you are in a place of conflict where your so-called 'faith' is constantly bombarded with doubts. To me, resting in my Father's presence and His love is the most comforting thing. David prayed: 'He who dwells in the shelter of the Most High, will abide in the shadow of the Almighty. I will say of the Lord,  'My refuge and my fortress, my God, in whom I trust.' Psalms 91:1-2.

I had yet another massive encounter with the grace of God this week. During the weekend, i joined the Relay for Life walk to raise fund for cancer. The walk started at 3pm, and was going to end at 9am the following day. I arrived at 11.15pm, and my initial plan was to run all night and see how far i could go. Within the first hour of my run, my right knee was decidedly unhappy with my endeavour and it started hurting really badly. I had to stop. I was almost at the verge of tears and I desperately asked God to intervene. I asked my pastor (who was there since 3pm) to pray for me too. I did some stretching and massaging of my hamstring, knowing that that's the culprit for my knee ailment. It's too tight, causing mal-alignment of my knee-cap resulting in mal-tracking in its groove when i run (known as Runner's knee, or patello-femoral syndrome). After a while, I started testing it out again. I managed half an hour of running before the pain became glaringly apparent. I stopped again for further stretching. In my heart, I was crying out to God to help me. 'Does lightning ever strike twice?', was the question i had in my mind. I was already very grateful that God healed me the week before, was i too greedy or naive to believe God for another miracle?

As i continued running, I could feel my hamstring becoming more relaxed, thereby allowing the knee-cap to return to its normal groove. The pain slowly subsided. I was speechless after a while. I know, with all my heart, that it's the hand of God. Of all injuries, Runner's knee is my most feared one as it takes an awfully long time to heal. That day, God touched my legs and allowed the pain to ease off so that i could continue running.

So i kept running and running. I stopped every hour for drinks, gel, food and to do some stretching.

The sun came out at about 5.30am. I was still running.

Finally I stopped at 8am. Completing 80km in around 8hours30mins (total running time is around 7hrs45mins). I was done. Finished. Overwhelmed. Grateful. And joyful. Throughout the whole time, a lot of people in the showground gave me a lot of encouragement. Some ran with me for a while. Some cheered me on. I was very grateful for their support.

Now.. Two days after the long run, both my knees are still very sore and i haven't been able to run a step without feeling pain. Haha.. The price i paid for foolishness. Yet the grace of God came to me freely without any price! Actually this is not true. The price was the life of Jesus - which He gave up in dying in the cross for the sins of the world.

I know my dream of running TMBT is almost officially over, given that I have Patellofemoral syndrome (Runner's knee) of both my knees. Somehow, I am not as sad as i thought i would be. I believe in my Father in heaven. I trust His heart. :)

An artist's impression of the Relay for Life

Another of his painting. Can you spot where i am? (clue: close to the olympics sign :D)

Hope, without which we are nothing. 

Guess where i am in this painting? (Clue: The only person who is running! :D :D :D)

Photo with Aunty Thana and her mixed Caucasian-Indian kids

Trust His Heart

All things work for our good,
though sometimes we don't see how they could.
Struggles that break our hearts in two,
sometimes blind us to the truth.
Our Father knows what's best for us,
His ways are not our own.
So when your pathway grows dim,
and you just don't see him, 
Remember your never alone.

Chorus:

God is too wise to be mistaken.
God is too good to be unkind.
So when you don't understand,
When don't see his plan,
When you can't trace his hand,
Trust His Heart.

He sees the master plan,
He holds the future in his hand. 
So don't live as those who have no hope, 
ALL our hope is found in him.
We see the present clearly,
He sees the first and last.
And like a tapestry He's weaving you and me, 
To someday be just like him.

*Listen to the song above by clicking to title of the song. Enjoy. :)

Ultra-Running Research - Completing 70km in 6 hours

Earlier in week i was a little concerned if i was ever going to make this run. After promising Colin - one of the sport science/human physiology professors from Sunshine Coast University (who is also an ultra-runner himself) that i would be healthy enough to participate, I was caught between doing what i thought would be best for my body (i.e. rest), or take another step of folly to see what the body is capable of. I was certainly not confident in the shape of my legs. They were still sore from all the running/hiking i have done the week before. Besides, the injuries that i picked up after the Flinder's tour have not been fully resolved yet. My left plantar was still a touch painful when i applied pressure on it.

The day before and the morning of the run, i made sure that i fully loaded myself with large amount of complex carbohydrates, protein and anti-oxidants, in order to deal with the repetitive stress of muscle contraction, tearing and shearing, and of joint-loading. I spent the night before the run with God too, reading His Word, being in His presence, and asking for His protection. Nothing is more comforting than to be in the presence of my heavenly Father. :)

Come the morning of the run, I arrived in Sunshine Coast University with a mixture of anxiety and anticipation. Colin brought me to his exercise lab and introduced me to his two other German scientist friends and told me how it was going to work. I was to run around the track (1.3km per loop), and every hour i would stop for an EEG for the analysis of the brain activity, answer some questions on how i felt at that time, and complete a mathematics quiz. This would go on for 6 hours.

I started the first hour without any sizable problem. Since this is a run against time, i know there is no point in going fast. I would just run at a very steady pace, to allow the body to burn as much fat (rather than glucose) as possible. The first hour went by quickly. I clocked 12.5km. Time for all the testing to be done. I was out in the door running in less than 10 minutes.

The second hour went fairly quickly too. I clocked another 12.5km.

Half way in the third hour, I started to feel some slight discomfort in my left plantar. My plantar was starting to spasm (instead of contracting properly). And each time i landed, the fascia was stretching against tension due to the spasm, producing great amount of pain. Within 15 minutes, my plantar fascia was as tight as a fully stretched rubber; there was no room for it to stretch any further. The pain just skyrocketed in a matter of minutes. I was visibly limping at that stage. The mileage read 36.5km.

At the end of the third hour, I was very fearful. On one hand, I was just too shy to tell them i was not able to continue. On the other hand, I was worried if i continued, I would incur irrepairable damage that would end my dream of running the TMBT 100km in Borneo.

The 4th hour was the hardest. The pain had obviously decided to stay. I had to stop every lap to stretch and apply pressure on the plantar. It was definitely the most painful run i have had. At the end of the 4th hour, I was seriously contemplating quitting. The mileage stood at 46km.

Throughout the time, I was praying to God that He would somehow provide a way for me. I know it sounds silly, that here i am inflicting pain and injuries on myself and then asking God to take it away. I knew no other way. Like how He often showed up in the most desperate of times in the history of mankind, I was praying that He would come through for me. At the same time, i could hear the familiar devilish voice in me: 'Why would He care about you, you insignificant punk? He does not listen, He does not care or maybe, He does not even exist!' The inner battle was on.

I started the 5th hour with the intention of alternating between walking and running. Somehow, as i continued, I started to feel the pain easing away. It seemed like the dark curtain of my mind was finally starting to lift. As i continued, I began to pick up my pace again. My heart was filled with joy and relief. 'This is impossible', I thought. I was so overwhelmed with gratitude. I looked to the heaven and all i could say was: 'Thank You, Father!'

At the end of the 5th hour, the mileage read 58.5km. I knew I just have to run another 11.5km to finish 70km in 6 hours. The rest of the run went exactly as planned. No dramas. I was like a little child whose daddy had just bought him a new X-box! Just so relieved and happy. I finished 70km with a few more minutes to spare. I was not going to go further. That was it. :)

For the entire run, I consumed 6 GU gels and 3 yoghurt bars, adding to approximately 2000kcal. I was not tired at the end of the run, even though this is the longest run i have ever done in my life. I think i am starting to understand the secret of ultra-running. There is definitely a built-in, God-given natural bodily mechanism that allows us humans to keep going and going. All it takes is for us to develop this natural ability.

I did not know whether to laugh or to cry at the end the run. I witnessed two things today. First - the miracle of God. Honestly i was not expecting Him to show up. I have had so many injuries so far this year that i know well enough to sit back and deal with it on my own. The nice healing stories described in the bible are, hmm.. nice. I never thought it could ever happen to me. I was so filled with indescribable joy and gratitude.

The second thing was - running is a gift from God, much in the same way as dancing, music, preaching are to other individuals etc. Whilst i was running, I saw a lady who was semi-crippled and she was walking around in a very unsteady gait. She kept walking back and forth like she was lost. My heart was touched by the sight of her. It made the pain in my left plantar seem like a child's play.  It then occurred to me that there are many people in the world who are not able to run because of their physical limitations. I thought about people like Singapore Blade Runner, whom i had the privilege to run with during TMBT 50km last year, despite having one of his legs amputated, he was still determined to pursue his passion in running and mountain climbing. It not only teaches me to treasure little things that we have, but also to be willing to use our gift and passion well for a higher purpose.

Everyone has a gift in something. It may be singing, playing a musical instrument, speaking/debating, writing, having administrative skills, possessing natural leadership quality, dancing, cooking, encouraging etc. They are God's gift to us to nourish, heal and build up the broken world we live in. I pray that we will all use our gift well for His Glory. :)

'I run in the path of Your command, for You have set my heart free.' Psalm 119:32

EEG (analysis of the brain) every hour during the run

Running around a 1.3km loop for 6 hours

The research team

Set back

Endurance running, i have come to realise, is never a smooth journey. It's not meant to be. The very essence of the sport is that you will be exposed to challenges, danger, injuries, unexpected circumstances, and lots of ups and downs. You have to learn to deal with them as they come, with whatever wits and resources and courage you can muster.

Nothing is more than frustrating than dealing with injuries. For me, after the Flinder's tour 50.9km, I thought i have given my body enough rest by taking 2 days off and then gradually start running again. At the end of the week, I suffered plantar fasciitis, an injury i have never had before. Thankfully it's a mild one. After some self-administered treatment, I got back into running again. Too fast too soon. At the end of the run, I sustained another injury again. This time - Cuboid syndrome and peroneal muscle tendonitis.  Ahh.. God help me!

TMBT is only 5 weeks away. The thought of not being able to run it because of injuries is certainly a hard pill to swallow, especially after all the effort and preparation i have put into it. I am at my wit's end. I cried this week. God is teaching me a very difficult lesson here. He is teaching me to trust His heart even when circumstances seem bleak. Guess i am in the arms of God's mercy now.

I have to switch to hiking to keep my fitness up. I am not writing things off yet. Will persevere and trust God. Maybe, just maybe, i might witness a miracle. :)