Tuesday, May 26, 2020

CANCER TREATMENT AND EXERCISE

Ironman California 70.3, 2016, Last official 70.3 finish

I NEED exercise. Without it, I get depressed and cranky. An addict must have the fix despite bad weather, injury or sickness. I have ridden my bike with a broken hand in a cast, in hail storms and in hundred degree heat. I have limped to finish a run race with my knee torn open from a fall. Common sense does not always prevail.

Some people that know me think I am insane for even attempting long distances, or any distance at all, for that matter. I don’t do many full or half ironmans anymore due to injury and lack of speed. On the spectrum of crazy, I consider myself to be fairly reasonable. A hundred mile trail run or double ironman is not in my future. A reach goal is fine, but suffering excessively is not. Nor is being pulled from a race because I am too slow the finish the long distance within a time limit.

People who are seriously active also like to compete with one another in races and socialize. We have a common bond of loving physically brutal activity. It transcends political views, economic status and even personality. It doesn’t even matter how bad we suck at the particular activity. I am a horrible swimmer, a mediocre cyclist and a slow runner, but I do it anyway. Competing against myself is the object, since I have little chance of beating anyone else.

So anything that is an obstacle to this fix is a major imposition. Even early stage cancer treatment is disruptive. The body does not like being cut open, given toxic chemicals and being burned from the inside out. The abused tissue and bone reacts by saying “piss off, I am going to take a nap” upon any request to expend energy.

General recommendations for exercise with cancer treatment are 150 per week aerobic, 75 minutes harder effort. Quantifying effort is a vague target. One is supposed to be able to talk with effort during aerobic, but this would vary according to how physically active one was before cancer. If a person never got off a couch to walk a mile, it would be way more effort when unhealthy and suffering from the inevitable side effects of treatment.

Information about recommendations for a person used to activity is sparse. Maybe the “experts” assume no one does more exercise. Some say “listen to your body.” This advice is not helpful if the body and the brain is giving conflicting messages. Experts suggest some movement even if tired, but what is the limit? My heart rate goes up higher than normal even with slow movement. The balance is finding what the body can tolerate without stressing it too much.

Before, only two to three hours per week of physical activity was very little to me. When my cancer was diagnosed, I was training for an ironman. The peak was almost twenty hours of swim, bike and run. This amount is not typical, because it is entirely too time consuming and exhausting. Normally, it used to be about twelve hours per week for me.

Along came cancer and smacked me down. My usual training was altered drastically. Instead of biking or running hard or long, the intensity was determined by  fatigue. My body was in control, not my mind. The effort that would have been pathetic six months ago, was now the norm. It was utterly humbling. A ninety minute bike ride was now forty-five minutes. A ninety minute run was now thirty. It was a big loss of fitness from where I used to be in. I lost my mojo.

Each treatment had its insidious effects and misery. Surgery made me tired and healing cut tissue and chest muscles hurt. After clearance from the doctor, it was tough to run with the pain at first. The parts did not want to be jiggled. Gradually, I recovered enough to run a 5k race three and a half weeks later with a fairly normal time. That was the last race for a long time due to fatigue, weakness and the coronavirus cancelling the world.

Radiation, which was only a week, but twice a day, made me feel weak, tired and a little nauseated. The feeling of an all over body sickness would come and go.  Short bikes, swims and runs were s a struggle to get through.

 Unlike radiation, chemo had cycles in which I felt like utter crap for ten days, then merely bad for the other ten days. The predictability was an advantage in planning, but the side effects on the bad days were worse than the other treatments. Minimal training was a struggle in the bad days, then a little better in the good days. Sometimes I could barely walk a mile. It was nothing resembling what I used to do. The goal was to not totally deteriorate into a sagging bag of bones.

The easiest form of exercise was walking, which was done in the days right after an infusion. The hardest was running, which only went well in the second or third week of the three week cycle. Even good runs were slow with not much stamina. My legs were too weak to push off and I would have to stop and walk to catch my breath. Improvement was slow, only to be destroyed with the next infusion. Races became only a memory. So did having fun.

Even with a weakened physical state, some exercise was better than nothing. Sick or not I had to have my fix.  I would have been in a much worse state without it. It felt much better to move than to give into the depression and fatigue. It was a weapon to fight back with. Cancer and it’s toxic treatments wouldn't win. But some days it felt like I was losing to it.

Whether I will ever feel normal again to is yet to be seen. Losing physical capacity and energy is frustrating. To not be in control is scary. All I can do is forge ahead and hope some semblance comes back of what I was before treatment. It will take time, patience and persistence.

Monday, May 4, 2020

HAIR LOSS AND CHEMO

When I had more hair





My initial negative thought, when I found out about needing chemo was, besides the million nasty side effects, that I would be bald. I get to feel bad AND look ugly. Baldness was not a good look because I just didn’t have the face shape for it. My high forehead desperately needed to be covered with bangs. Only I wouldn’t have them. The whole concept was difficult to imagine while my head still had hair.

Having hair is something that I took for granted. It kept my head from getting sunburned in the summer and from getting cold in the winter. A strand of hair was something to fiddle with when nervous. Destroying this feature was a drastic change and I hated change..

My hair was thick, straight, medium length and grew fast. Not liking the natural drab color with gray, periodically I had it colored with blond highlights. Hair was good to have.

Hair loss typically occurs between the first and second chemo treatment. The toxic drugs kill healthy, growing cells along with the cancer. Medical people dismiss the impact and say that it will grow back . But they aren’t the ones with their hair falling out. The condition being impermanent doesn’t make the process any easier or lessen the shock of losing  hair. Something that had been there forever is gone. It’s death at a cellular level. And it looks bald for MONTHS.

My hair loss began at two weeks from the first treatment. I dreaded the start of this but knew it was inevitable. One day clumps of hair came out when I passed a comb through it. The bare spots started at the top at the part, then spread gradually out all over. Eventually, long strands tentatively hung on, with large areas of baldness like Gollum from Lord of the Rings. The look was hideously corpse like and worse than being totally hairless.  

Shaving it was inevitable. I hated to give up the last remnants, but they were uncomfortable. The hair shed all over, my scalp hurt and itched. Finally, my hairdresser shaved it off. I covered my bare head with a cap. 

Now bald, unexpectedly the exposed skin felt cool. This sensation was weird, like wet hair that wasn’t there. When I shampooed my head, I still expected to touch hair and only had stubble. It dried almost instantly. My blow dryer and curling comb sat in the cabinet abandoned. 

The worst part of being in this state of appearance was that it screamed CANCER PATIENT and SICK It told the world what my state of health was, which I would rather people not know. It reminded me that life wasn’t normal right now. But I wasn’t motivated to get a wig. The summer heat was coming on and encasing my head in a hot wig sounded unappealing. Besides I had a hermit like existence due to the coronavirus anyway. Not that many people I knew were going to see me.

I was numb about the hair loss, in order to not think about it. The other side effects felt worse and were more difficult to deal with. Losing my appetite and feeling dead tired plunged me into a depression. I just accepted the condition, though being bald sucked. The actual event wasn’t as bad as the anticipation, though. 

I still am a little self-conscience and don’t want people to see my present state. I always put a cap on when going outside just to fetch the newspaper. I wear a hat in anyone’s physical presence or in teleconferences. Out of sight, I don’t even think about it. My image in the mirror looks like a stranger.

It’s just not about being bald, it’s the difficult process of toxic chemicals also taking well-being, energy, a sense of peace and joy. As I have now finished the chemo, the day awaits when the side effects wear off and my hair starts to grow again in a month or so. My body will heal from the poison and come out on the other side to recovery.