Jan 10th- Running with the Kenyans

Back to work today but first...a run with a Kenyan! I ran with John Maina, a 20 year old training for 1/2 and full marathons. He has already won a Kenyan marathon in 2:30 and 1/2 in 1:05. He trains with 10 other Kenyans here; there are about 3000 runners training in Eldoret at one time. They then go up to Iten which is about another 1000 feet higher to train 4-8 wks before a big race. John's main job is training and he helps his brother in a small shop in Eldoret. It is not clear how he can earn a living except by winning races. We past alot of other runners..or should I say they glided by me.

We went out about 615 am for 8 miles which was all uphill the first 4. I felt winded because of the pace and I think I was a little dehydrated from the weekend. This was an easy day for him; he usually runs 120-130 miles a week. Monday and Wed are easy runs am and pm, Tues and Thurs are interval runs. Easy on Friday and then 15-20 miles on Sat. They eat a big meal Friday night and don't carry any gels or water for the long runs. Once a month they run a 26 miler. I finally found a guy who weighs less than me! He is tall and thin and his gait is so light and easy.

Back to the wards today. New DM1 who was on regular insulin q 6 hrs with BS>300. The resident was arguing with me about the best way to treat her. They don't take kindly to suggestions here as it seems to question their authority.

I spend the afternoon with Dr. Kimoono who is the designated diabetes expert. She is the attending on the ward service and is an excellent teacher and clinician. She can easily discuss if a pt with a fever has malaria, TB, meningitis, pneumonia or just the flu! She is in charge of a regional initiative to diagnose and treat DM in the outlying areas of Eldoret.
Right now the severe cases are coming to Moi University inpt or outpt facility. The goal is to develop simple protocols for nurses/nurse practitioners  in the outlying areas to start treatment for DM.

It looks like I will be collaborating with the DM team long distance to review protocols, etc. This will involve monthly conference calls and maybe another trip back here.  Hopefully Dr, Kimoono will come to the states for training and our Endocrine division can sponsor her.

Sara has continued her work at the orphanage and read stories to the kids this am.