Am I Back?

I’ve had several people ask me in the past week… “Are you back to running?”  Well, the answer, I guess, is yes.  I’m not AS BACK as I’d like to be, though.  I am struggling.  I’ve been having some difficulty being able to tell if it is the 105 degree weather here, my lower than normal red counts, or just being fat and out of shape (Breast Cancer weight and Post Chemo muscle atrophy) that is causing my struggles.  I’ve been working on the breast cancer weight and I’ve made some progress.  I’ve lost about 3 lbs.  I was working my A** off to eat a diet above and beyond healthy in order to get my red blood counts back up ($12 salads).  4 weeks ago, they were up a little (seemed to be a slow steady rise) but then last week they dipped back down to: RBCs = 3.27 (normal is 4.2-5.4), Hemoglobin = 10.7 (Normal is 12-16) and Hematocrit = 30.5 (Normal is 37-47).  The good news is that this time around my White Blood Cells were Normal at 5.2 with normal range being 4.8-10.8.  So, it is kind of odd or ironic that today, I am actually experiencing a fever/sore throat/illness due to some virus.   Am I back?  Today is a bad day to ask me that.  Ask me in 10 days.  This is how long I’ve got to get over this virus, and get my weekly running average up to 34 miles/week in order to start my 24 week training plan for the 50 mile trail run I want to do on March 3^rd.  My highest weekly mileage, yet, (since surgery) has been 30 (mostly trail miles, however).  That was one week ago, the week before my last Herceptin.  Last week during a down week, my calves began to flare up like they used to…Posterior Tibial Tendonitis, plus some gastroc issues.   September 19 is Day One of my 24 week training plan.   I just completed my spreadsheet for this training plan, and I’m going to tell you the truth, here.  I’m a bit concerned that I’m going to be cutting it pretty darn close and pushing the envelope on what is reasonable considering my medical situation.   Mind you, prior to cancer, when I was training for the Bandera 50K, my plan topped out at 62 miles/week and I commonly did 40-55....but that was before.  One bit of good news is that my Herceptin treatments should be over in the end of December, so I should have 8 solid weeks no chemo (except the daily oral Tamoxifen) before the race.  

Here is what the plan looks like: Click on link below :)

Nueces 50 miler Training Plan : Top 60 miles per week                                                

This is a rough draft, and I’m sure there will be some changes in the plan once I start up with

Tejas Trails.  I’m planning on starting up in October, once the weather cools down a bit more.

Besides being initially upset by my drop in RBC counts, the ensuing complications due to my initiation of iron pills in order to improve the red counts, contracting this irritating virus, and my inability to hold my alcohol, I’ve had a pretty darn good week.    You need to know that I did not take this decision to start taking iron pills lightly.  I’ve been holding out on taking iron, since, basically, the beginning of all of this treatment.  Despite being borderline anemic pretty much my whole life, I’ve never been able to tolerate taking iron pills.  I tried taking them when I was pregnant because I was trying to be a good parent, and I’ll just say that that plan ended with me spending 45 minutes in a friend’s bathroom, during a party, giving what I later called “practice birth” to something too hideous to describe. (Severe Constipation).    But, I’m desperate.  I know I need these counts back up to be able to run…especially up hills.  I plan to ask my physician if I can get a transfusion of my own blood, or EPO, or something, but I’m about 100% sure they won’t do it.  My counts are low, but just not critical according to a new friend of mine who is a chemo nurse. (I know, befriending the enemy….you know what they say…friends close….)  Maybe if I explain that it could become critical at mile 40 or so, they’ll listen.

This week, I had some great times.  It was a holiday weekend and I enjoyed a 4 day Staycation!!  My favorite band, Downtube Shifter, played on Friday night and I was able to go to the show.

Downtube Shifter
Next Show: Saturday October 1st  Carousel Lounge 10 PM!

Downtube Shifter Fans!

It was a late show, and here’s where my inability to hold my alcohol comes in.  It’s not that I drank very much.  On the contrary, actually.  I just don’t have the constitution, or the ability to process the alcohol, so I am a pretty cheap date.  I had a lot of fun on Friday night, but Saturday morning was not pleasant, except that Grammy and Dpo took the boy off to Houston for a 3 year old Princess Party, so we had a quiet day.  I think maybe in some ways it was a good thing to have suffered a bit as a reminder that I need to be putting as few toxins in this body as possible, especially once my 24 week plan starts.  

Saturday afternoon, Richie and I got to go out again, together, onto a party Barge on Lake Austin for a couple of my friends’ birthday party.  It was a blast hanging out with my friends from the Outpatient department! and the weather and sunset were beautiful. 

Awesome Chicks of Outpatient!

This time I paced myself and was able to get up the next morning to complete my 5 mile trail jog on Sunday.  Monday was Labor Day and for the first time in about 3 months the temperature dropped below 74 degrees overnight.  It was awesome.  That morning I got to go out to my beloved Hill of Life and run 7 miles with my good friend, and the temperature was between 75 and 78 degrees and not humid.   It was beautiful, and I did not feel like total F****** S*** during the whole run. I actually had fun.  Progress.  Monday afternoon I enjoyed a wonderful nap, and then some of our close friends came over for a barbeque and fish fry and we got to play outside with the kids and enjoy just being out, for the first time in Months!  What a perfect day!

Worlds Collide: Pre-3G, 3G; Before Cancer, Since Cancer

It’s been 10 days since my last Herceptin treatment.  It’s been good in many ways, and, as you might have guessed (cough….Ballotable) challenging in many ways.  I’m back to work, and things are going well.  I’ve done some patient lifts and my arm has not fallen off.  Of note, however, is that my “core is VERY weak!”.  I’d forgotten I had muscles in the lower pelvic region.  Despite that, it actually feels good in many ways to get back to work.  Also, last Tuesday….Herceptin Day, was what I've started calling my official Day 1 of my 7.5 month training plan for the 50 mile trail run that I want to do in March. I’ve been working up to this Day 1 for a while, mind you.  I called it “Day 1” because it was my first day back to my Tuesday morning running group.  It was very fun to be back in the group environment even though it made it very obvious that I have a long way to go in my fitness. Day 1 felt pretty good.  The run was in the morning before my Herceptin treatment.  Then, things started to go downhill a bit.  I’ve not been feeling well, throughout the better part of the past 10 days.  I’ve been concerned that the Tamoxifen has been causing this general malaise feeling.  In some ways I really want to blame it on that, but it is difficult to clearly know what to point the finger at, when everything is taken into consideration.  It’s true that my Hot Flashes are back, full on, due to the Tamoxifen, and are interrupting my sleep again.  It’s also true, however, that each of my offspring has had an illness in the past week and a half. The boy with what I was calling the “snuggle fever”, my favorite of all childhood illnesses, up until the projectile vomit got all over me and the kitchen. The girl simply had the loose stool.   It’s also true that with me being in week one of training mode, being fat and simply out of shape,  just getting back to work,  and it being over 100 degrees here every day, it is very possible that I’ve overdone myself. 

 I called my oncologist’s nurse practitioner yesterday to discuss these ill feelings and my (continued) fear of the Tamoxifen.  When she returned my call today, she mentioned that that the Herceptin “can cause flu like symptoms, but they usually only last a couple of days.” ( AH HA!!  I knew that Herceptin was not just nothing like they had originally told me!!). http://www.herceptin.com/metastatic/breast-cancer-treatment/side-effects.js  She feels that my ill feelings have probably been a combination of the Herceptin, plus possibly having mild forms of my kids’ illnesses and not the Tamoxifen.  I did not mention to her that I also wrecked my car on the way to my Sunday run due to taking directions from my iPhone to the nearest gas station: to get gas because I was on empty, and to get water for my run because I was already thirsty.

 I did not mention that I did not make it to the gas station, because… A.) I KNEW in my GUT that there was NOT a gas station where my beloved iPhone said it was, and,  B.) Had I gone to the next station, I would not have made it to the run.  (The LUCKY :) thing about the wreck was that the guy that I wrecked into was very nice and was actually on his way to a group bike ride!) I also did not mention that it was very possible that I got overheated and dehydrated on that 1.5 hour HILLY Sunday trail run, (with no water of my own…I only had Cytomax which does NOT help when one is thirsty! A really nice guy did donate a few swigs of his water to me though) and that it was very possible that I was over trained (too much too soon).   So, anyway, I took Thursday as a rest day, when normally, I would run, and I completed 3 hours of a juice fast.  and purchased a juicer. http://www.fatsickandnearlydead.com/  It was really amazing how much better I felt after that detox.   I might just try a whole day. :)

It is sometimes surreal when you have an awareness that you are experiencing life today in both the perspective of a BEFORE and an AFTER, a certain life changing event.  All of us can identify events that have changed our lives, or changed us in many ways. For example, most people, whether we plan on it or not, change (over time in many ways) after having children.  I know, I personally call the time before kids… “B.K.”  for…yes, you got it….. I also know that I changed in many ways after Adaline was born, due to the circumstances of her birth…which I’ve mentioned at length in other posts.  What’s weird or surreal about THIS event, for me, right now, is that I’ve been away/out, for a while and I’ve recently made an abrupt re-entry back into my same old life.  Back to work and running.  I suppose it is obvious on the outside that I am different physically (the hair and the uniboob :)  but, I usually forget what I look like, and in so many ways, I feel that I’m carrying around a secret.  The secret about what I’ve been through over the past 11 months.  The secret that I am now a different person, but other people don't, and can’t really know.  

The other day, at my running group I was doing my "first" track workout.  It was a poignant scene for me because this workout was the exact same first track workout that I did back in 2005 in my very first running group. "Straights and curves".  To further add meaning to the situation, the girl (49 year old woman) that I was running this workout with, had been my Coach back in 2005,  on that very first day, for the very same workout 6 years ago.  Here I was now, doing the very same thing.... but I've changed.  In a surreal way it was like there were 3 of us there running.  My old self of 2005/Pre-Cancer, my new self, and my running friend, Carolyn.   During this dreamlike scenario, i imagined my two worlds/selves ( Before Cancer and Since Cancer)  coming together with a clash, or colliding.  It was quick and kind of awkward, but painless. Much like my car collision days prior.

Ballotable

The past few weeks has been quite a "BALLOTABLE" time period. ( I'm now using this word to describe ups and downs, or periods of mixed or unsteady emotions.) Last week I blogged about my toenail while I was processing the situation.

I'll start with my last Doctor's appointment/Herceptin chemo treatment 3 weeks ago.  At that visit the doctor started me on the Tamoxifen. http://en.wikipedia.org/wiki/Tamoxifen. Short exerpt from the blog that week:

 I am scheduled to be on this drug for 5 years. Sounds overwhelming, especially when the doctor and the pharmacist review the side effects…” some people just don’t feel good…” said the doctor. “Like what”, I said… ”well, it could be a whole host of things…you’d have to go to the PDR (Physician’s Desk Reference) to see them all”, he says…”Greeaat”, I thought to myself. Of particular note is the possible WORSENING HOT FLASHES, Increased Risk for Blood clots and therefore possible pulmonary embolism which could lead to death, increased risk of endometriosis and endometrial…you guessed it…CANCER.

Due to the above, i began to have some severe anxiety about taking this drug, and i did what I have kept myself from doing for the past 7 months, or so.......GOOGLING!  I continued to become increasingly upset about the cancer risk and the worsening hot flashes, especially in the light that my previously HORRENDOUS HOT FLASHES had pretty much subsided.  Due to this stopping of the HHFs, i figured that  i was now POST Menapausal.  This assumption heightened my skepticism about the Tamoxifen being the right drug for me.   I also began to think about how, up to this point, all of the chemo drugs (toxins) i had taken so far had been administered by someone else.  I've mentioned many times before that I've had an extreme aversion reaction to the chemo drugs and the cancer treatment building.  While i understand on one level that these drugs (were and) are saving my life, there is just an animal instinct that  i have that tells me it is NOT good for me.  But, for those drugs there were appointments, doctors, nurses, and family and friends,  all there supporting this act of me taking these drugs.  This time, i began to realize, it would be up to me to administer this "toxin", all on my own and i just wasn't sure i could do it.  I decided to take a week to think about the drug and to try calling the oncologists office to get some more encouragement to go ahead and take the drug.  During this "break" week, i began feeling not only anxioius, but also very randomly emotional.  This emotionality was upsetting me and confusing me at the same time.  Considering the cancer and everything, i've been surprisingly, and notedly level (even keel, if you will) emotionally for the past 9 months.  My severe HOT flashes had replaced any emotional ups and downs i MIGHT have had in years past.   But, my hot flashes had diminished drastically since the end of radiation, and I was actually starting to feel a bit more normal with increased energy levels at times due to slowly rising blood counts.  So, why now, have i thought to myself for the first time in over 9 months..."Does HE (Richie) REALLY love me".  It had all been so clear, and i'd believed it without a doubt for the past 9 months that he DID. On the second night of having this thought of doubt creep into my head, i woke in the middle of the night crying.  VERY odd.  I can't really even remember the last time i cried. (Oh, yes.  I did cry the night before my mastectomy.) Probably about 1/2 of you have already figured out where this is headed.  YES.  The morning after i woke crying, I was gushingly informed that I was PRE-MENAPAUSAL AGAIN!! DAMN IT!!!  It now all made sense.  The increased anxiety, the emotional lability, and later that evening, my moment of creative genius which borne unto it a new spectacular dessert that i named "caudled chocolate".   

It's as if i've been given a looking glass (what is that anyway?) that has allowed me to see the menstrual cycle from both sides.  It's almost creepy.  It's like a Twilight Zone Episode.  A woman moves in and out of inexplicable emotional zones.  A given scene plays out over and again with different emotional angles, or, emotional stability, portrayed.  The emotional stability zone (Menapause) teaches her how to better view and understand the other zones when she returns.

Back to Ballotable.   My menstural Cycle bounced back, and I, of course, had MIXED feelings about it.  Part of me felt good to be home again, part of me was/is very frightened that these hormones that we've spent the better part of the past year killing, are back, and part of me is upset that now i'll have to go through the Menapause Again....very possibly on a continual basis for the next 5 years.

Now, back up to today.  I'm back to the GawdAwful Place (GAP for those who follow closely).  Things went well today.  The nurse practitioner was not upset that my period started.  She was happy with the range of motion I'd gained in my arm.  My white cell counts are back to normal range and my reds are getting closer.  I've been taking the Tamoxifen for about 2 weeks and seem to be "tolerating" it OK so far.   I discussed my plans to run a 50 miler in March with the Nurse Practioner in order to make sure that she did not think it would be a problem medically and she said it would be fine.  I said,  "I know it seems a bit extreme, but, it's just that these were my plans prior to breast cancer".  She said ... "I expected nothing less from you". :)

Normalcy. Hmm. Not exactly.

Just when I began to feel my first hints of normalcy in life and health, I had to, against my better judgement, go, and show back up to this…. GAP (you know, the GawdAwfulPlace that I will have to keep coming back to every 3 weeks through December…the oncologist’s place and the chemo room). Today was a bonus day too, in that I not only got to see the Oncologist himself, but also got to also see the radiation oncologist’s nurse so that she could check out my burned skin.    Good news on the radiation end of things is that, as you may have noticed from last week’s countdown, radiation, itself, is over.  The burn, however, is improving in some areas and worsening in some areas.  It is also actually hurting worse on the inside.  The muscles under the skin feel kind of like cooked meat, if you will.  Overcooked really.  They feel tough and stringy.  You know how I am not impressed by overcooked meat.  Good news on the oncology end of things is that the oncologist actually accurately dictated everything I could hear him say today! And as far as we know, I still do not have Cancer!   On the more disturbing end of things, I still get to start the new oral chemo drug, Tamoxifen, this week.  I am scheduled to be on this drug for 5 years.  Sounds overwhelming, especially when the doctor and the pharmacist review the side effects…” some people just don’t feel good…” said the doctor.  “Like what”, I said… ”well, it could be a whole host of things…you’d have to go to the PDR (Physician’s Desk Reference) to see them all”, he says…”Greeaat”, I thought to myself.  Of particular note is the possible WORSENING HOT FLASHES, Increased Risk for Blood clots and therefore possible pulmonary embolism which could lead to death,  increased risk of endometriosis and endometrial…you guessed it…CANCER.  But, since I’m on a lucky streak lately, I’m feeling pretty confident none of these will apply to me. J  I forgot to ask if, my plans to begin training for, and running a very difficult 50 mile race was going to be a problem.

Oops. White count back down below normal. Darn.  Red Counts about the same as last week with HGB slightly up and RBC slightly down. All still in the below normal level.

Now for a quote that I saw recently on the internet that I liked: (I know, what’s up with all the quotes lately? I must be in an introspective phase.  Note to  WWFFss...I’m out.  Except for Olyveoyl.  Sorry, it’s been a great run, or rather something to do instead of running…I love you all but my time is up). Back to the quote:

“The only dream worth having is to dream that you will live while you are alive, and die only when you are dead.  (Do to the author’s use of the word ONLY, it might seem like the quote would end here, but it does continue on with some more pretty good stuff.) To love, to be loved. (Good one.)  To never forget your own insignificance. (Easy enough).  To never get used to the unspeakable violence and vulgar disparity of the life around you. (Not a problem).  To seek joy in the saddest places. (Doing that now).  To pursue beauty to its lair. (I’m not sure what that means.) To never simplify what is complicated or complicate what is simple. (I’ll need some work on that one.) To respect strength, never power. (Not even PowerHowell? Not sure I like that one.) Above all, to Watch.  To try and understand.  To never look away.  And never, never forget. (Done.  Unless the Oldtimer’s get’s me.)

--Arundhati Roy

Now, Here is a new, just fresh off the lips of the chemo nurse l quote that I heard just now:

”We’re so screwed today… that’s just the way it is”.

Frustrated Chemo Nurse