Before I had children, I had run over 30 marathons—some fast and some not quite as fast. My life revolved around work, sleep, and running. While working as an internal medicine and emergency medicine resident, I somehow managed to juggle working 80- to over-100-hour workweeks with 60- to 80-mile running weeks. The relative easing of the time commitment to my professional responsibility finally came as I finished my second residency in June 2005. Devoting more or better time to training for marathons wouldn’t come, though, as I was eight months pregnant with my first child.

Evan was born August 15, 2005, and my life changed immensely. Although I was eager to return to working out and lose some of the 39 pounds I had gained in pregnancy, the reality of caring for a small infant and recovering from childbirth set in. I listened to the advice of my doctors and didn’t attempt to resume running until at least a month after Evan was born. I can remember getting dropped off at the fitness center with an optimistic expectation that I would be able to run the two miles home. After about 100 yards, I sheepishly called my husband on the cell phone and asked if he could come back and pick me up; I had some sharp pains in my pelvis and did not want to get injured.

Without saying “I told you so,” he came and drove me home. A few weeks later, I tried running again and managed about eight short runs before I began to have pelvic discomfort. A trip to the physical therapist confirmed that I had persistent laxity in the pelvic area. Despite my doing Pilates and other core exercises, the laxity persisted somewhat, probably because I was still nursing. I had had in the back of my mind that I would start running again and try to run a marathon again just to prove that I could. (The Dallas White Rock Marathon was in December, four months after Evan was born, and the Cowtown Marathon in Fort Worth was in February). Nevertheless, by February I was still having some hip discomfort and wasn’t running again. Finally, at the end of March 2006, I gradually—slowly and conservatively—eased back into running, more than seven months after I had given birth.

I had several months of enjoying running again until December 2006, when I began to experience the horrible morning (and noon, and night!) sickness of another pregnancy. I had been hit pretty hard with nausea and vomiting while pregnant with Evan, and many people had offered me advice: “It can’t be as bad the next time . . . no two pregnancies are the same . . . maybe you won’t be sick this time.”

Despite the fact that running didn’t make the nausea any better (and I was so tired that I wasn’t necessarily running very quickly), my daily runs seemed to distract me temporarily, at least. I was able to run several times a week until about my eighth month of pregnancy, with the blessing (and encouragement) of my OB-GYN as well as the national guidelines. The last month, I quit running partly because of my size and partly because it was summertime in Dallas. People tend to stare when they see someone running midafternoon when it is 110 degrees; seeing a very pregnant lady running under the same conditions would probably elicit a few extra stares! Because exercise is such an important part of a healthy pregnancy, I shifted to working out on the Stair Master every day instead. I worked (and worked out!) right up until I delivered. In fact, I went into labor at 2:00 a.m. on my due date, dropped my (nearly) 2-year-old off at my parents’ house, and then went to work. Luckily, it was my half day, so by about 1:00 p.m., when my contractions were about five minutes apart and all my charts were dictated, I was able to check into Labor and Delivery. On August 15, 2007, several hours later (but still on my due date, which also happened to be Evan’s second birthday!) Reagan Preston Graeme was born.

I was a little more ambitious after Reagan was born, and when he was 8 days old, I managed to run a mile and a half—no pain! I had really worked on my core strength during this pregnancy to avoid the problems I had had before. I took it easy and gradually worked back into running several days a week. In fact, I ran the Race for the Cure in honor of my mom, who is a breast cancer survivor, in under 21 minutes in October. I began running two to three days a week with my running partner, covering eight to nine miles on our usual loop. I also managed to fit in one or two other days of running, along with some cross-training on the Stair Master, while trying to get the pregnancy weight off. This, while juggling a very colicky baby, returning to work full time, and making sure my 2-year-old received enough love and attention.

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The author, with son Reagan, juggles motherhood, running, and work in Dallas, Texas.

Courtesy of Riva Rahl Graeme

Starting over—again

In December, I was lucky enough to run the half-marathon of the Dallas White Rock Marathon with Bill Rodgers. He comes down every year as an invited speaker for the expo; my running partner is on the marathon board, so we usually end up running with him. Despite losing track of Bill in the crowd during the first few minutes, we met up with him again at mile four and managed to run about 1:35. The next month, several of my coworkers were entering a 15K cosponsored by the Cooper Aerobics Center (my workplace), so I also entered. The race lived up to its name, “Too Cold to Hold,” with a temperature below freezing and strong winds. I managed to win the 15K in 1:01. During the last (cold) mile of the race, I began to become confident about racing again. When I got home, I looked online to search for a half-marathon and signed up for a local race in February. Although my weekend nine-milers and the 15K were my longest runs to date, the half-marathon distance was not at all daunting, and in fact I was excited at the prospect of running one again!

It was cold again two weeks later, so my husband and two kids stayed at home instead of coming out to support me. What a pleasant surprise, then, at a little past the halfway mark, that I saw my sister on the course, camera in hand, cheering me on. I had spent the first few miles behind a very good masters runner and then passed her around mile six. I ran most of the rest of the race by myself, occasionally coming up to a man, running with him for a few minutes, and then separating one way or another. The race was fairly even, and I finished first in 1:29. During the last few miles, I began to think it might be possible to run in the Cowtown Marathon, although I was pretty sure it was only two weeks later. After finishing the half-marathon, I ran an additional three miles and figured I had totaled 17 miles with the warm-up taken into account. I was a little tired but invigorated nevertheless.

I’ve always heard that timing is everything, and I agree, based on several life experiences. That next week I had a lot going on at work and didn’t have a lot of time to train. I ran a hard nine miles on Saturday but took Sunday off because I was scheduled to do my annual treadmill stress test at work on Monday. Part of my job at the Cooper Aerobics

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The author with Evan (left) and Reagan (right).

Courtesy of Riva Rahl Graeme

Getting back into the racing scene

Center is to interpret my patients’ stress tests, and I do mine annually as well, if only to fully understand the strenuous nature of what I am constantly cheerleading my patients toward. I performed better on the stress test than I thought I would and actually only slightly worse than my best performance ever—when I was in tiptop shape a few weeks before running a 2:58 marathon in Chicago. The next day I called the race director at Cowtown and explained I was interested in running but hadn’t signed up yet. She was gracious enough to arrange for me to get registered (I had won the women’s division both in 2000 and 2002).

The trial of getting to the start On the morning of race day, I set my alarm a little earlier than usual so I would have enough time to get everything done at home, drive to the race, and make the starting line on time. While I was upstairs nursing Reagan, my sister Marisa arrived and we quietly got Reagan changed and dressed to weather the February outdoors. The three of us headed west to Fort Worth. We hit some traffic halfway there at a point where the road was closed down to a single lane—all this planning and I might miss the race!—but ended up close to downtown with 15 to 20 minutes before the race started. I had plenty of time to grab my race number, find and attach my chip, and of course take one last potty break. Because of the traffic

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downtown, I had jumped out of the car while we were stopped in traffic several blocks from the race start and as a result did not bring anything extra such as a jacket or sweatshirt. I ended up putting on my race T-shirt over my racing shirt just to keep warm at the start but discarded it as the race began—an action I later regretted as I had no memento from this race!

The race started out downhill, and I tried to run conservatively, in light of my relative lack of base, speed work, or marathoning in the last few years. The first mile was 7:12—a little faster than I had expected, but it was downhill. I ran the next several miles between 7:10 and 7:12 per mile, and it felt smooth. There were many people to run with since the 10K and half-marathon were all together for quite a while. I first saw Marisa and Reagan at mile five, waved, and said to the woman running next to me, “That’s my baby there!” A few minutes later, she asked me whether I was running the half-marathon, as she was. “No,” I replied, “I’m going to try to do the whole thing.” At that point we were both happy to work together for another mile or two before the races split off.

Marisa and Reagan were there again at about mile 10, and she said she thought I was in fifth place. Wow! Still on about 7:12 pace. At that point I could see two women running together several hundred yards ahead, and I kept them in my view. I may have picked up the pace at the halfway mark; eventually, I passed both of them. At that point the race wound around some neighborhoods, and I couldn’t see any women in front of me for quite a while, so I had no idea where I was relative to others. Marisa was there at mile 15 and told me I was five to six minutes behind the leader. Well, I thought, I’m in third place, and that isn’t too bad. Picking up 30 seconds each mile (five to six minutes over the next 10 to 11 miles) was insurmountable. I mean, I might slow down by 30 seconds per mile but couldn’t speed up like that!

I did come up on another woman runner in the next few miles, but after I talked a little to her, it turned out she was running in the 50K ultramarathon, which was also being contested on a similar course. So I passed her, but it was bittersweet—she was not one of the women I would have been trying to pass. Since Marisa had somehow managed to figure out the course map and maneuver her way around Fort Worth while packing and unpacking Reagan, his carseat, and stroller, occasionally changing his diaper and still setting up at each five miles, I expected to see her around mile 20. I had counted on her being there to give me a status report on whether I had made any headway on the leader. She showed up around mile 21 but had arrived just a few minutes before I did, so she had no idea how far back I was. She said she thought she had been there at least five minutes, so I was least that far back. That told me the leader was opening distance on me and speeding up. I remember thinking that I would just run my own race and was on pace to break 3:10—which was my goal. I was definitely feeling the effect of the previous miles, particularly because I did not have much

of a mileage base going into the race. My legs were aching, and I was ready to get the last few miles over with.

I slowed a bit, to 7:30 at the 24th mile, and started the familiar marathoning “modify your goals as the race unfolds” strategy. Just let me finish so I can go home and take a nap. I hit the 25-mile mark and realized that I was around the one-mile mark—that first downhill mile from the start was now the last uphill mile to the finish! A spectator yelled to me, “Hey, you’re in second place, and the first woman is slowing down!” I yelled back, “How far ahead?” and he gestured, “She’s just ahead at the top of the hill, and she is really looking tired!” I was so grateful for this notice and I looked ahead, scanning the distance in front of me. There she was, 300 or so yards ahead, flanked by the motorcycle escorts. I recognized this from my previous victories, when the motorcycles drive alongside the lead runner the last few miles. A little bit of adrenaline and a lot of hope helped me pick up the pace up that hill. The crowd was growing at that point—only about a half mile from the finish. Within two minutes, I had overtaken the leader; she started walking just as I passed her. She had led the race from the start, and I had never seen her until that point. Without looking back, I gave everything I had for the last half mile as I pushed toward the finish line. I saw Marisa and Reagan on the right, about 100 yards before the finish line. She had her camera out, and we exchanged a few awed looks with each other. I am glad I continued to push that last half mile because it turned out that one of the women I had passed at the halfway mark was staying right behind me and was only about 15 seconds back at the finish line.

I ended up finishing in 3:08—pretty much on that same 7:12 pace I had kept the entire time. The first thing I did after crossing the finish line was look for Marisa and Reagan. I grabbed Reagan and started carrying him around with me; it was almost as if he was my trophy and I was relishing the opportunity to show him off. After arriving at the media area a few blocks away, I disappeared for a few minutes to nurse Reagan—it had been over four hours since I had fed him! I got to bring Reagan up to the stage to get my award and definitely got as much mileage (no pun intended) out of having a new baby with me as I could! One of the local newspapers summed it up with the headline for the story the next morning: “Doctor has prescription for victory!”

Courtesy of Riva Rahl Graeme

Time to modify the goals