Four Years Out From Cancer Treatment

Does time heal all things? Four years have passed since the end of active cancer treatment and almost the same amount of time since starting “inactive” treatment or aromatase inhibitors. So far no evidence of disease, though the effects of treatment of disease still hang around–scars, numb toes, joint pain, brain fog, slightly wavy hair, sparse eyebrows and eyelashes.

Time hasn’t done much for my disgust with fragrances, but they usually aren’t the gut punch that they used to be. Why do people buy these toxic products? They are putrid, noxious, fake versions of odors that are supposed to smell good. Fabric softener wafting through the neighborhood is air pollution. Stop putting this crap in your laundry.

My energy has never really come back to pre-cancer levels. Maybe some of that is old age, but I suspect past and present drugs to prevent or kill cancer cells also sapped the life out of me. It’s hard to know if I am overdoing it until afterwards, when the urge to lay down hits, but it doesn’t ease the fatigue. Part of me wants to do a lot of projects, but the other unmotivated part says “meh”. The list of things to do sits with few items crossed out, especially if they involve hiring a stranger to fix things.

I still try to be active, but not as much as before. Overdoing sometimes has the consequence of an overwhelming feeling of fatigue. A lot of energy went away and never came back. Part of that is the hormone blocker sucking the life out of me. Doing things requires weighing the cost in energy and mood. Exhaustion from a cough and cold made me cancel a bird trip signed up for weeks in advance.

The loss of motivation and ability to do a long run or race is depressing. Most people don’t do ironmans forever, but at least they have a choice. Racing used to be important to me, but after the pandemic, not as much. Time is limited and the world is out there to be explored. Hours long workouts don't seem viable.

Pain comes and goes. My tooth hurts, then the ache goes away. Excruciating back pain comes on suddenly, then goes away, usually when I see a doctor about it. It’s maddening. It’s nice that the problem goes away, but only after worry, time and money are spent chasing the solution.

 I have learned to take the initiative and not wait for a doctor to notice a problem. After repeatedly tripping, I saw a neurologist who ordered a brain MRI and then PT. Falling often banged up my poor knees, which would then bleed profusely, dripping down my legs. A bad fall would hurt for weeks. Luckily, a good physical therapist helped my balance as well as neck and back pain.   

The supplements that make life semi-

                                                      bearable. Not all are pictured

I still use support groups, but they seem less important.  Just out of treatment, support groups helped my sanity and pandemic isolation. Now, being this far out from treatment, hearing about about breast amputation is a bit triggering. Still, maybe I have moved on, but need the connection of people with similar experiences. People who haven’t been through this experience generally don’t understand it. “You are back to normal, right?” Not really, like ever.

Brain fog has stayed the same, probably because of the hormone blocker. The brain needs estrogen to work well. Everything takes longer due to not remembering what the hell I was doing or need to do. Leaving the house requires an inventory of what I need to bring. Sunglasses? Oh, they are in my hand. Forgetting costs time and money. The right word escapes me in a conversation. An important detail gets lost in the muddle of scrambled thoughts. Multi-tasking is out because it requires the mind to work well.

My biggest issue at this point is whether to continue more than five years. My oncologist thinks that the Breast Cancer Index Test would not be helpful, since I am “high risk”. I disagree since I was only one point into the range of needing chemo according to the Oncotype Test that analyzed the tumor genetics. The tumor was small and had not gone to nearby lymph nodes. Counter to that is a strong family history of cancer and dense tissue that can hide suspicious areas. Logically, it would be better to have more protection against recurrence, but quality of life is also a factor.

All the forced interaction with doctors have made me skeptical about what they say. One of the side effects of hormone blocker is loss of bone density. Reclast was recommended for me, but it caused me eye inflammations. Doctors don't want us googling everything, but they don't tell us enough. Trust, but verify is the old adage. Being one's own advocate is essential. I declined any more bone drugs. Hopefully, the bone density will not decline too fast.

Hormone blockers for me have ranged from utterly unbearable to barely tolerable. Tons of supplements, an antidepressant and lots of exercise make taking it manageable, but at times the side effects are miserable. The drug sucks out life and joy. Even fun activities have the happy edge dulled into a numb emotion. Sleeping is difficult at times, making me feel like a zombie the next day. Sleep is precious and I need it desperately.

The worst is the fatigue that it brings on.  Stamina to do things like travel or even yardwork seems precarious. Will a burst of activity result in an exhausted stupor the next day? I never know. I don’t expect pre-cancer levels, but it would nice to be more functional.

Sometimes, I cheat and not take the pill if I need to travel or engage in a strenuous endeavor. The brain needs to function to solve various challenges of navigating in a strange place. The body needs energy to hike across challenging terrain. Living takes mental and physical stamina that lack of estrogen takes away.

I want my life back, or some semblance of it. The idea of continuing the drug distresses me hugely. It’s mental as well as physical torture. A little pill cannot definitely prevent cancer, just give me better odds. The question is whether it’s worth it. More misery for more maybe disease free years? I just don’t know.

So no, time doesn’t heal everything, but I am grateful for what I have and what I have avoided. No amputations or recurrence yet. But life is short. Happy needs to be chased. I can’t wait around for someone to take me on a trip, to do something scary and adventurous with, or to do a bucket list item. I just have to find the damn energy to do it.

 

Mountain Man Olympic Race Report

I always debate doing Mountain Man because it’s HARD. This would be my thirteenth one, so I knew better. Did I really want to swim in a lake at 7,000 feet? Climb the hills on the bike and the run? All with a lack of oxygen? But it the summer had been sizzling hot and miserable and the race would be a distraction in a cool place. Plus it would be a reason to train in the ninety degrees at dawn weather, which it seemed pointless otherwise.

So I swam in bath water temperature pools and lakes, sweated on the bike and run and came home to collapse in a dehydrated state of semi-heat exhaustion. This summer exceeded itself in pure crapitude. Even normal thriving trees and Saguaros were dying in the excessive heat.

I regularly do things like this to myself. Normal people think I am nuts. You rode or ran in this heat? It was uncomfortable, but bearable up to about 93 degrees, depending on the humidity.

 The hassle of driving to Flagstaff did give me pause. The day before the race, I drove up on I-17, which was more clogged than usual on a summer weekend when Phoenicians are desperately trying to escape the heat. Parts of the road were under construction, which was a perpetual endeavor. The drive took thirty minutes more than normal.

 I always hate pre-race, getting hyped up and wondering what will go wrong and what essential thing will be  forgotten. I didn’t sleep very well. The hotel is close to a busy street and it was noisy. I used the fan feature to drown out the noise, but didn’t get much rest.

I got up at 3:50 race morning, packed up my stuff, forgetting a pillow and drove in the dark to the lake. It was warmer than usual, in the 60's. One year the car windows were fogged up, a baffling condition to clear up. Another time it was foggy, which delayed the swim.

The swim was always tricky for me. To get out of breath and hyperventilate, was difficult to impossible to recover from. Usually, my chest gets tight and I have to go slow and rest a lot to avoid panic. This seems to go on forever, but I always finish. 

We had a rolling start and I seeded in the back. It started and ended at the ramp by transition. The swim went clockwise south instead of going north. The lake looked like it had more water in it than in the past, but also more weeds and was fairly calm. I didn’t panic, but found it hard not to stop and rest often, especially in the beginning. I swam by people freaking out and had to avoid a back-stroker most of the swim. It got better the second half, but not by much. I resorted to inhaling deeper to suck in more air, but it was hard to get enough oxygen. The water temperature was stated as 68 degrees and was 70 degrees by my watch. It wasn’t as warm as in years past, though not by much. It took 50 minutes, but seemed longer. It’s always a relief to get on land.

My fifteen year old bike had been giving me problems two weeks before. The hub on my expensive wheel had given out and it wasn’t shifting well. The bike held up on the hills and the chain rubbed the gears sometimes, but was much better than before it was fixed. I didn’t hear any tire squeals from brake rubbing on the downhills. I admired the wildflowers on the side of the road, though they didn’t seem as lush as other years.  Sunflowers, Indian Paint Brush, some pink flowers and scarlet penstemon dotted the roadside. Goldfinches sang in the fields of sunflowers and crows screeched in the pine trees. 

Off the bike, my legs felt clumsy and stiff. Running was painful, but I pushed myself anyway, though not fast. My body felt miserable, but my mental state was okay. The goal was to be faster than the last time here. I had given up beating myself up for not conquering this course with the hills and altitude. I argued with myself to move my feet faster.  The cracks in the road didn’t trip me.

Moving up the long, steep hill, white blossoms from the bushes growing on the hillside smelled fragrant. This was a unique experience on the run. Finally, the top of the hill and a half mile of dirt trail. The lake road at the bottom looked far away.

Running downhill was a relief, except for feet snaring road cracks. Too bad it wasn’t all like that to the finish line. A mile to go, a truck was blocking the way. Thankfully it backed away. With a tank in back, it looked like a septic tank emptier. Almost foiled by a outhouse shit collector. Weird.

The end didn’t come soon enough. Random people cheered, but not anyone that I knew. In the past, I would bemoan lack of support, but the finish line was all that I cared about. That and stopping the pain. I finished twenty minutes faster in total time than the last time in 2021.

Since only three people in my age group showed up, I was third and got one of the tree stump awards. Of course we had to nag the awards announcer because he didn’t have the results yet. Not everyone can finish in two and half hours.

As hard as this race was, it was a nice distraction. I always get sucked into the “can I really do this?” trap. Olympic races don’t seem like a given anymore. I used to worry about how fast I could go, and now lingering doubts in my abilities makes finishing is a goal in itself. It’s fun to find out that I CAN do it. 

 

The Paw

 She steps into my life.

A feline disruption.

Demanding affection, food and a lap.

She complains, and wants attention.

Her paws destroys furniture, claws ripping cloth;

Feet stepping on the table, the desk, fresh laundry, my lap.

She crawls into my lap and purrs.

Soft brown and beige fur; with big blue eyes a mystery of emotion.

A cat that’s both aggravating and ingratiating.

Until she isn’t.

Weak, pain-filled legs can’t jump up onto the table, the desk or my lap.

Walks along the wall, not knowing where to go. Her eyes don’t see.

She can’t find her food nor the litter box.

Leaves vomit, pee, poop on the floor.

Her spirit is gone; it’s time to go. I kiss her good-by.

Her absence leaves holes in my heart.

And an impression of her paw.

Cats are simultaneously adorable and annoying. They have big eyes and are soft, furry and cute. They sleep a lot and drape themselves over various surfaces and purr when they are happy.  But it’s hard to know what they are thinking and what they want besides food and a soft lap. Their emotions are not readily discerned. A cat language translator needs to be invented. Are they bored, in pain or lonely? An owner is never sure about this mysterious creature.

My cat came into my life when my daughter, on one of her rare visits in 2016, insisted that we go to  the animal pound, since I “needed” a cat. I don’t know why I agreed.My thought was to get an older cat or a cat that was not likely to be adopted. A kitten did not interest me because of the longer commitment and possible obnoxious behavior.  A black cat looked promising, but it had behavioral problems. They brought out a tuxedo brown and white female siamese. She REALLY wanted to be adopted and was friendly, but she didn’t like other cats. We took her home. I kept her previous name, Mama Cat. Why she was named that is unknown, but it could have been her affectionate behavior. Most of the time she was just “cat”. 

Any pet is a lot of work, especially when older. They rip up furniture and vomit on the floor.  I thought that an older cat would be easier. Ha! She had thyroid cancer, peed like a horse and had arthritis, then kidney problems.

Mama Cat never liked to play with things. She was more interested in being petted and snuggling. Previous cats I had owned weren’t overtly interested in affection. She DEMANDED it. This aspect of her personality was both gratifying and annoying. She never seemed to get enough. Being siamese, it was probably due to her breed.

Mama Cat would always wait by the couch until I sat down and then jump in my lap. She was never a good jumper and could be let out in the back yard to lay in the sun on the patio. But she could still jump on the desk or in the chair during my zoom calls. In the last year of life, I had to pick her up because her legs weren’t strong enough to jump at all. Lacking any ability to do this was sad, not being able to make her wants known when the body was incapable of expressing them. 

Mama Cat’s health when downhill when she was twenty. For a couple of years prior, she needed to go every week to the vet for hydration because her kidney function was marginal. She would complain after eating for an unknown reason.  Her right eye became dilated and it was difficult to know if it was painful. A vet eye doctor said that she was okay, but a cat neurologist five months later thought that she was blind and probably had a brain tumor. This is when I especially longed to know how she felt, but she couldn’t tell me.

It was difficult to know what to do about Mama Cat. She would walk in a daze along a wall, not knowing where to go. The litter box was unused and she peed and pooped on the floor and sometimes smeared it on herself. I had to put her food in front of food, because she couldn’t find it. Walks were a painful limp. 

After talking to the vet, I made the decision to end the suffering. It feels terrible to have to power to kill a pet, but I didn’t want her to have more pain if the tumor progressed. In the back of my mind, I dreaded finding her dead.

 The vet gave Mama Cat a sedative, then the drug that would kill her. It didn’t take long until she was gone. I gave the cat a parting hug and also hugged the vet. They took her away. I opted for cremation, but not to keep the ashes. I couldn’t imagine burying her in the garden. It was bad enough with the parakeets when they died.

They made an impression of her path, a faint trace of her existence.

With her gone, it was a relief and painful. I didn’t have to fed a cat, clean up her poop and pee or worry about her health. I didn’t have to take her to the vet every week for hydration. I could leave the house without worrying about feeding her when I got back. I could go anywhere for any length of time without having to arrange a sitter. 

But her absence was a emptiness, as if a little furry cat had a big presence. No purring lap sitter, no head nudges, no adorable sleeping poses, no blue eyes watching me. It was an un-needed and lonely feeling. Nothing was vying for my attention or wanting affection. The loss of a small creature leaves a big paw-shaped hole.

Grand Canyon Rim to River to Rim Hike

 The allure of the Grand Canyon is indescribable; a visual masterpiece that is always changing in the light. Some rock layers are millions of years old, in myriads of fantastical shapes. But hiking to the bottom is a serious undertaking in the rugged harsh climate. The price of admission to the wonderland is grueling physical stamina to climb in and out of it. Lack of preparation or training can be deadly. At the same time the vast expanse is magical. Going below the rims is an adventure, and the first step on South Kaibab trail to descend is both exhilarating and terrifying at the same time.

We started down South Kaibab in the pre-dawn gloom at 4:30. I avoided looking at the dimly lit depths and shear drops offs that promised certain death if I fell, and kept my eyes down on the steep slope of the ground. The hazy sun was still under the horizon, glowing behind the rim.

So many steps.

Going down was strenuous with the endless steps and my knees ached already. The rock walls were spectacular in the growing orange glow. A bunch of hikers gathered to see the sunrise at Oh Ah Point. We took pictures. I reluctantly posed by the sign because I hate pictures of myself and don’t smile if I can help it. Moving on, my group stuck around with me for the most point, though it was hard for me to keep up.

We really had a lucky break with the weather. It was fifties at the start, with a nice cool breeze, and high clouds that kept the sun intensity lower. It could have been much worse. My biggest fear on this hike was getting overheated, especially in June. The bottom is known to be an inferno in the summer. Anxiety made me fill up on water almost every stop, though it wasn’t always necessary.

At Tip Off Point, the formations were still orange in the low light with dramatic deep blue shadows, making them resemble temples. The first glimpse of the silver green river thousands of feet below was always amazing.

We crossed the river and went on to Phantom Ranch. I got ice, a postcard to sent to my daughter and of course lemonade. My pack was heavy with snacks, so I didn’t buy food. I filled up with the ice and water and kept out a wary eye for the evil, obnoxious squirrels who never miss a chance to grab a snack from unsuspecting tourists. Sometimes they followed me along the trail. What a menace.

We went back to Bright Angel Trail and followed the river in a sandy path for what seemed a long way until we started ascending. It was warmer and I was drinking more water, but still felt dehydrated. My system of using an insulated small bottle with a three liter bladder to refill it  wasn’t efficient because I kept having to stop and pour water into the bottle. The bladder tube didn’t work at all. Next year, I will just get another three liter bladder.

My group got ahead of me, so I hiked alone. The trail was a lovely riparian paradise of creeks, waterfalls and plants hanging out of the rocks. The Canyon was greener than last year from all the rain and snow it got this winter. Flowers were blooming and birds called. One sounded like it was whistling at me. The peace of flowing water is my happy place as long as I can cross them or walk on the side of them.

But when the trail turned into a creek, requiring stepping on rocks to keep my feet dry, it elicited anxiety. This was one of those “where the hell am I, am I lost” moments. Am I doomed to wander around, getting nowhere? The watery pathway finally turned into something resembling a trail again. 

The rock formations were interesting, especially in my tired, mushy mental state. One undulating ridge had dark pancake batter layers. Some looked like faces. Whatever kind of rock it was, it was millions of years old.

I headed for a shady spot to pour some more water into my bottle and tripped. I had avoided this calamity up until now. My knee was bloody and my ankle bone had banged hard into a rock. Hopefully, it wasn’t broken. I could still walk, but it was still a long way up. It could get worse and my feet hurt enough as it was. I cleaned up the wound, but couldn’t find a band-aid to put on the knee, so it just dripped blood.

After enough time on these trails, encountering mules are inevitable. They leave their droppings and puddles of pee for hikers to step around, like a fecal obstacle course.  A train of mules appeared up the hill with tourists riding them. A space off the trail was a good place to stand and they went by me. The leader called out “that rock up there is Elvis, the king. You never know. Stranger things have happened here.” It did look a little like Elvis, if you used your imagination.

Finally I reached Havasupi Gardens. My group had actually waited for me, which was appreciated. They always got ahead of me, but it still helped to see them. Havasupi Gardens didn’t seem like much, but maybe there was more to it near the campgrounds. At this point, I just wanted to get back up to the rim. Four and a half miles to go, but it was the hardest portion.

Farther on, I caught up to them again and we soaked our shirts, hats and neck things in the creek, It was refreshing.

Alone again, the waterways were gone, with only the endless switchbacks. Now I realized why people hated this part of the trail. It was hell. It wasn’t North Kaibab hell, where my legs felt like any moment they would collapse and I stopped every five minutes, but my focus was waning. It was difficult to keep hydrated. A misstep and I fell on the ground. It was a soft fall with no injuries, but my body was telling me enough.

The less serious hikers with flip-flops, purses and shopping bags appeared. A man asked me “how far to the river?” My answer made him turn around. A stone arch seemed to mark the end, but no, more trail. “Oh, come on!”

Finally the end after ten and a half hours, in plenty of time for dinner. I sat down near the Bright Angel sign to rest. Getting out of that deep hole seemed a win. No heat exhaustion, no major injuries and I got out on my own power and had survived the ancient, unforgiving landscape.

Ironically, the most painful part was climbing the manmade stairs to my room, which caused me to scream from the pain of severe leg cramps. This was my body’s revenge for the abuse all day. Pain isn’t fun, but overcoming it is. Being exhausted, stressed and feeling like crap isn’t something that I seek out, but it’s part of the adventure. It’s worth it in order to see new things, be in a different environment and get out of the bubble of ordinary life.

Even if the Elvis rocks weren’t “loving me tender.”

Cactusman 2023 Race Report

Every race, it’s the strangling anxiety of organizing all the swim, bike, run and nutrition crap, not sleeping well, going down the site at o' dark thirty and setting up all the stuff in transition only to waste time later. Being the usual basket case beforehand. I forgot to put on my required wristband and parked my bike in the totally wrong rack. Hopefully, no one noticed.  I was tired as hell from the lack of sleep.

I opted for the sprint distance of 750 meter swim, 12 mile bike and 5k run. This time of year is hot and two laps of run and bike in the olympic course would be too tedious.

It was hot standing around in the sun in a full wetsuit waiting to start the swim in Tempe Town Lake. Rumors were that the water would be colder, gauging from the 60's in the lakes, but it was above seventy degrees. Regular people are always horrified that I swim here, like it’s a cesspool of bacteria, scum and fearsome fish. I have never encountered live fish, but the birds that hang around manage to find them. Twenty-one years of swimming in this lovely lake has given me immunity from whatever is floating in it be it algae, wood bits, dead fish or even bodies.

My wave started and swam straight into the sun. My goggles fogged up, making it hard to see where to go.  Over the years I have mostly avoided feeling panic, unless people swim over me, the waves are huge or if the temperature is very cold. Meandering back-strokers and people stopping to see where the hell they were added obstacles to avoid. I almost swam past the first turn buoy. 

The water surface churned with all the swimmers and  and maybe some current generated by the flow over the dam.  Swimming straight was hard and not relaxing. despite my two prior open water swims in colder water. A fishing line caught on my arm and some floating debris bumped my face. They buoys marking the turns seemed inexplicably angled. At least not too many people ran into or over me. It’s always a relief to get out of the lake. Total yardage was 1039, 200 more than it was supposed to be. Maybe the distance was mismarked or it was me, but it happened every year.

I ran into transition, struggled out of my wetsuit, put the bike equipment on and started the ride. Most people whizzed by me, but once in a while I got to pass someone slower. The bike leg was a little better than last year, with a sizzling 15.2 mph for 12.3 miles. For the past couple of years, I have felt limited in riding hard, but this time my legs felt like they had just a little more power. It wasn’t to the point of pain, like in the past, but I had no motivation to visit that zone.  

It was getting warm, but not too bad, considering the blazing heat bowl that the area usually becomes. I enjoyed the novelty of riding hard without worrying if a car is going to kill me.  Ever the birder, I noticed a Peregrine Falcon suddenly turn to avoid us.

Picture Joshua Stacy

Miraculously, my legs actually felt decent beginning the run. Usually, the bike turns my legs leaden. The Salt River west of the dam looked like a real river, instead of creek, with all the water flowing through. Really remarkable. I ran hard, but as much as I tried, couldn’t get out of the 11 minute/mile mark. Former speed still eludes me. Total time was 36:55 for 3.29.  

Same site, different race.

Total overall time was 2:06:33. Compared to everyone else, it’s back of the pack, especially in the swim, but I have long ceased caring about that. Whether from age or health problems, loss of speed is difficult to accept, but at least my body can still do some semblance of “racing.” Mentally, I just am not as motivated to kill myself to compete. It’s great to still be able to push physical limits, but my energy has dwindled. The resulting bone deep fatigue from exhausting myself isn’t worth it. Or maybe it’s old hat because this was my 85th triathlon. Reasons for subjecting myself to the torture have evolved. Despite the insanity, I will probably still get up at o’dark thirty as long as the body is able.

 

 

Fifteen Mile Trail Run or What Was I Thinking?

 

 I had serious doubts about doing a fifteen mile trail race. I like to push myself physically, but what is that limit anymore? It used to be easier to assume that I had the stamina and ability to do just about anything. Now, I don’t know. My energy level could range from functional to dead tired with no consistency. Would I injure myself by spacing out, resulting in a fall that would render my knee into a bloody pulp? Get exhausted and walk the whole way? 

At least I knew what the course was like, having ridden it by mountain bike many times. It had some nasty rock strewn sections. Once to the seven mile point, it got easier and downhill. Still it was a long way. My goal was simply to finish in one piece.

At the start, everyone took off, leaving me mostly alone. This is a common event for me. I figured that I would catch some of them later. My arm and knee still hurt from a bad fall the week before, so I started slow 

After two miles was where all the rocks started. This was a tough part and went uphill. One time I fell lightly on my hands. Most of the time my toe would hit a rock with no loss of balance. I kept up with an older man, but passed him eventually. It was slow going. I wasn’t worried about time, just completion of the distance.

The older man picked his way carefully among the rocks. Maybe this was how he avoided injury. Is frequent tripping an old person thing? At one point, I saw that he took a wrong turn and yelled at him. It was my good deed for the day. I lost him and didn’t see him after that.

Occasionally, I could look at the desert vistas instead of staring at the ground hazards. Four Peaks mountains still had snow in the crevices. The park stretched on into the horizon. Trail running is certainly more scenic that the boring streets of road racing. Saguaros beat shopping malls anytime.

My gurgling insides finally forced me to stop and find a bush. Luckily, no one was around. This is an advantage to trail running–being able to use a bush rather than carrying a load around. It was a long way to a restroom. I cursed inwardly my colon, which wouldn’t behave itself.

Running this route verses mountain biking was definitely different . The distances that would by pass quickly with a bike stretched out with running. I can coast on a mountain bike. I can climb rocks without falling. It seemed like I was going nowhere slowly and sometimes the anxiety of wondering where the hell I was and if I was lost took over. I had done this trail many times on a bike, but it was more desolate and vulnerable on foot. I overtook people sometimes and wondered why the hell would they be lagging back there with me.

I knew that the endpoint of the climbing was the shelter with the skeleton dressed in a serape, but I thought I was lost in the endless twists and turns of a trail that went nowhere. I was happy to see my boney friend. 

My friend with a different costume.

The next aid station had coke! Coke has saved me on long endurance events when my energy was flagging. I drank some and continued. My slogging pace picked up. I think that a 50k runner lapped me because he was moving much faster . I was on the downside slope, with some rough, rocky patches that were not as bad as the first stretch. I shuddered to think what negotiated that when I was tired would be like. The miles seemed longer and longer.

I passed another runner who was walking fast. Being polite or annoyed, she let me pass. I moved faster. 

I crossed the park road, hoping that it wouldn’t be much longer, but it was. Would this trail ever end? Four miles to go and it was easier to run. The ground was smooth and the coke had kicked in. Where did this energy come from? Too bad it didn’t come sooner. The trail twisted and turned and I hoped to see some evidence of the parking lot, but nothing appeared. Then the restroom structure loomed in the distance. I kept running hard just to get the damn race over with. I was under my modest goal of 3:45.

Finally, the race ended at the humble finish line. Total time was 3:41. The skin of my knees and hands was still intact and I had mostly stayed upright.

This was a really low key race, so no medals, announcers or timing system, except someone writing the time on paper. This didn’t matter to me, but I wondered what was the point of running trail for fifteen miles. Running verses biking the trail was one of the draws  to see the difference. I had only run a tougher half marathon trail in Page, but two miles more wasn’t that significant.  Maybe it was to prove to myself that I could do a long run after a pandemic, cancer treatment and being older. I hadn’t even done a road half marathon since 2019.

We like to think that we are in control of our destiny. Doing crazy things gives me the illusion that I can defy age, expectations and physical limitations. If I can run fifteen miles, maybe that will hold off infirmity, fat and appease the joints that hate me. No one expects people my age to be doing such activity, but why should years dictate the end? I won’t live forever, or may even die next year, so why not do it now when I am able?

Or maybe it was just to feel just a bit like my old normal self again, rather than a depressed, achy, tired cancer survivor. I didn’t get my usual race high, but still could claim victory.

Grand Canyon Rim to Rim

 

Going down to the bottom of the Grand Canyon had long been a goal of mine. A mixture of curiosity, the exceptional scenery and a lack of common sense enticed me to trod the rugged depths.  It’s one of those trips that sounds great in theory, but the reality involves some serious craziness.  The hike is a strenuous long way down and up in a day in an unforgiving climate. It would be badass to do at my age, though and it’s fun to test myself physically, otherwise known as suffering. 

This goal had always been thwarted by circumstances. My ex went down with his brothers, but I had to watch our young child. The car really stunk when they got out after sweating and camping for days. Another trip, the person backed out. A prospective group never had room. A tour was expensive and camping was involved, which is a nonstarter. The logistics of going by myself was difficult and hiking alone wasn’t appealing. Then came cancer and the pandemic. My strength to hike to the river, let alone rim to rim, was doubtful due to health issues. The goal seemed out of reach. After all this disappointment, the time was finally right.

Looking down into the abyss on the south rim the evening before, the coming venture was daunting. The ancient rock faces and formations in the fading light were striking, but harsh. The vast terrain looked merciless. I had been on both rims before, and it was pretty to look at and not threatening. It’s one thing to enjoy the scenery on the surface; another to subject myself to the climate, ruggedness and perils of the interior. Be unprepared for heat, dehydration or exhaustion and the consequences were dire. I was scared, but still compelled to hike it.

Walking down should have been the easier part, but the thousands of steps put a strain on my knees.  Poles alleviated the effort, but my legs got really tired anyway. My lower right leg developed a persistent stabbing pain. Traversing by myself was isolating in the empty vastness of the landscape. By mile five, even finishing seemed doubtful. Step wrong and my shaky legs collapsed. I fell once and skinned my knee, which dripped blood. This prompted passers-by to ask if I was okay. Past experience told me to block out how far it was and to just keep going, even when it seemed impossible. Mental focus trumps physical pain. But despair lurked on the edges of my thoughts. Finally the trail smoothed out on the plateau.

A line of horses passed me twice, pissing and pooping on the trail, so I stepped carefully. These riders don’t know what they are missing. I went through the tunnel, got to Indian Gardens and reloaded on water and wet myself down at the water stop. People say to soak yourself in the stream but lack of time and a norovirus had been going around made it seem risky.  Being very tired by this point, I walked in a zombie state to Phantom Ranch and got the overpriced lemonade and sat down with a sigh of relief to write a postcard to send to my daughter. The $5 lemonade perked up me up again. I bought ice and put it in my water containers. Ice was my savior, since warm water is not thirst quenching.

The "Box"

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The riparian areas in the “box” of rock walls by Bright Angel Creek were lovely and soul soothing. Birds sang in the bushes and flowers dotted the banks. Brooks are my happy place; a zen place of peace.  An interesting snake slithered by and two deer appeared in the brush. The shade provided relief against the heat of the day. Sometimes a breeze kicked up and dried my sweat. 

Many people must have passed through here in various states of physical exhaustion. The rocks are 500 million years old, so they had seen a lot of souls. The rims are forests, the bottom is desert and two climate zones down and the reverse going back up. Basically 4000 feet down and 5000 up from South Kaibab to North Kaibab, so it was a wide temperature and altitude range to adapt to. 

I stopped to try to find food in my pack and a passerby rudely commented that I had thirteen miles to get to the north rim before sunset. Thanks a lot buddy, but I was acutely aware of the time limitations. The park rangers don’t encourage people to attempt rim to rim in one day because they don’t  want to have to rescue them. I was finding out why it was so tough for us mere mortals. The effort was taking everything that I had to keep going.

Some other members of my group caught up to me and I walked with them for a while. This area rose upward from the creek and was hot, desolate and dry. Getting cooked and very thirsty, I stopped at Cottonwood for more water. The group went on. It was difficult to suck water out of my camelback container, so I dumped its water into my water bottles and guzzled it. 

The people I had been walking with were resting at Manzanita. I was exhausted at this point, with the worst yet to come. The next stop had no water, so filled my bottles. Eating gels, jerky, bars, and salt tablets didn’t seem to provide much energy. Part of the problem was that my pack was disorganized and my nuts and trail mix were buried in its depths. My electrolyte mix had spilled. Digging through the pack was too much effort and I wasn’t that hungry. I nibbled on jerky, something that I wouldn’t touch otherwise. The misery of the ironman run came to mind. This seemed about as hard, but with no aid stations or cheering crowds.

Stairs were again a real obstacle now and North Kaibab had plenty of them. The ascending trail went down again and I thought really? The bridge that I had hiked down to from the North Rim with my ex in another life came into view. I even have a old picture of it in the time before digital cameras. Ascending North Kaibab long ago was a lot easier without the present previous twenty miles and a few decades of living. My legs were rubbery and threatened to collapse at any moment. The poles helped me to keep climbing, but didn’t always help my teetering balance. The stairs were dodged any chance I could. 

Another random rim to rim group caught up to me and decided to follow me. Maybe they were just being nice, but they weren’t in a hurry. Finally, a group going at my pace. One of the guys was really kind, offering to let me rest anytime. He gave me a caffeinated gel which helped some. The support of random strangers was nice. I would have probably married him at this point if he didn’t already have a spouse.  

My shaky, tired legs wanted to quit NOW. Supposedly, the total distance was about twenty miles, but it was longer and never seemed to end. A mile took about 40 minutes now. The altitude was 8,000 feet, which didn’t help. The trees on the north rim obscured the path, so gauging the distance left was difficult. Someone thought that it was twenty-two miles, which was a discouraging thought. After stopping and resting several times, I finally decided to forge ahead the last couple of miles after someone commented how hard it was to stop and go. My last vestiges of strength were being sucked away. Finally we heard cheering through the trees and knew the ordeal had come to an end. I had done it.

Total moving time was 11:25. Elapsed time was 13:17 for the 24 miles, probably due to water stops, Phantom Ranch stop, taking pictures and watching wildlife. It was a remarkable and excruciating experience.

It took a few days for the experience to sink in and the memory of the physical pain to fade enough to realize the impact of the experience. The exhausting ordeal didn’t seem worth it at first, but then joy seeped in. The ancient walls had dared me to defy age, physical limitations, dehydration, health problems, mental demons and common sense. The general suckdom of life was forgotten and replaced with lovely riparian scenery replaying in my mind. 

After struggling with fatigue, mental stress, joint aches, and residual weakness from cancer treatment for two years, I had serious doubts about my physical abilities. It took a long time to even get an opportunity to try and finishing a very difficult goal was gratifying. But the best thing was descending into the Canyon depths and coming out feeling invincible. And badass.

 It’s been two years since active cancer treatment ended for me, and life is different. People always assume that once  treatment is over that everything is normal again. The medical nonsense doesn’t end with the twice yearly oncologist visits, blood tests, yearly mammograms, in addition to the assorted other related and unrelated health problems. 

A sense of invincibility vanishes with a cancer diagnosis. If one bad medical thing can happen, maybe another one could? Every subsequent scan brings on the small twinge of “what if results are abnormal?” that wasn’t there before. The underlying anxiety never completely goes away even with “no evidence of disease.” Every little stupid medical problem takes on more significance beyond what it really is.

Physical reminders of what happened are surgery scars, less energy, more depression and strangely, still slightly curly hair from the chemo.  Blue dot tattoos are still on my chest from the radiation. My toes are still a little numb from chemo neuropathy. 

Invisible fallout from treatment can also manifest in weird ways. Laundry product scents are still repulsive. This reaction hasn’t diminished much since 2020. My theory is that while walking nauseated around the neighborhood after chemo, the strong smell of fabric softener poisoned my brain permanently. I lost the deep inadequate feeling of sickness and abnormality from having this weird sensation when I finally realized that the vile scents are being vomited into the air by countless suburban dryers, and that the ever present mystery smell was not a figment of my imagination. Now, being subjected to these odors is just irritating. I am the normal one and the users of stinky softeners are the insane ones.

For God's Sake Stop Buying This Shit!

Innocuous things like the freeway exit to the chemo infusion building used to make me inwardly shudder a little every time I passed it, but now it’s more of a shrug. Even a mere four rounds, three weeks apart, was traumatic. The exit was to a place of physical weakness and sick feeling, fatigue, hair loss shame, anxiety and fear of the unknown. Disassociating the experience from the freeway was a relief since I use or pass it often. I don’t have to go there anymore in my mind and it’s just a stupid exit.

Chemo rooms still invoke fear and anxiety in me. At a bone drug infusion late last year in a chemo room, a surprising strong urge to leave almost overtook me. I convinced myself to stay, and tamped down the fears by talking to the nurses. The bone drug was to counter the bone density loss caused by the Exemestane, a aromatase inhibitor drug that I take that blocks estrogen and therefore cancer growth. 

Part of the anxiety was due to being the first time I had it. The list of its side effects is disturbing, since I always endlessly google them ahead of time. Dealing with the worry about one scary drug is tiresome, without having to deal with others. It made me sick, but not in the same way as chemo. The next two days felt like the flu, with body aches, then I had an eye inflammation and fatigue for a month. If I ever have this drug again, the infusion won’t be in a chemo room. The side effects are bad enough without adding to the unpleasantness. I felt bad for the people who were stuck there through their treatments, when I could walk away.

I am tired most of the time. The cumulative effects of active treatment and Exemestane have dragged my energy level down. It took over a year to recover to a partial level of prior fitness. Twelve supplements, an antidepressant, an NSAID, an acid blocker, pain treatments and thyroid medication ease the side effects. Exercise and therapy have helped. It’s still a medical merry-go-round. My thyroid medication had to be adjusted. It was very difficult to sleep for a while because of low TSH levels. I spent a lot of time at the opthamologist for the eye problems.  My neck developed a constant ache and stiffness that was only slightly relieved by PT, drugs and steroid injections.

How can such a small pill be so evil?

                                              

Doctors push aromatase inhibitors claiming that taking them results in a 50% deterrence of cancer recurrence, but it is not guaranteed. They are all difficult to tolerate. I tried the three types and Exemestane was the only one I could stand.  Anastrozole was very harsh, messed up my thyroid and caused intense chest pain. Letrozole made me extremely fatigued. Besides the normal side effects were the unexplained weird ones. Random stabbing pains, scalp pain, tooth aches, muscle cramps, high cholesterol and the loss of any ambition to do anything, whether necessary or fun. 

Lack of energy brought on a case of I just don’t feel like it-itis. Everything seems like too much effort. The house can go clean itself. The cat can mop up her own pee. Getting one thing that needs to done in a day is a win. Forgetting what it was that I was going to do because of brain fog doesn’t help. The urge to just go take a nap is strong.

I miss estrogen. I used to take HRT and felt a lot better with more energy and less depression. The hot flashes came back and never left. Adjusting to a second menopause involved endless doctor visits, medical tests, support groups, therapy and anxiety. Cancer may feed on estrogen, but the body likes it too. Without it, the bones weaken, the joints ache, the brain forgets words, the lady parts dry up, and moods go south. An added bonus is belly fat. It’s a pharmaceutical crapfest.  

Because of the depression cancer treatment caused, I had to get therapy and take an antidepressant. Questioning all the mean things that I say to myself was an eye opener. Telling myself that I was ugly because my hair fell out wasn’t helpful. Thinking that I was stupid to run into a cranky Uber driver while changing lanes didn’t make the situation any better. My neck pain made it hard to turn my head and I didn’t see him. Saying to myself that people didn’t like me was an assumption not based on reality. It took practice, but I now try to be kinder to myself. My messy house does not mean I am inadequate.

 The thought of taking aromatase inhibitors for three more years seems an eternal punishment. The only thing I could do is make it as bearable as possible. Avoiding cancer recurrence versus the misery of the drug is a tenuous balance that requires a lot of effort to maintain. Neither cancer nor the stupid medicine will rule my life. If I learned anything, a difficult experience can be gotten through with enough help, determination and faith in oneself. And a lot of sticky notes to remember what the hell was it that I forgot to do.

Bird images from Eff'ing Birds by Aaron Reynolds

Tower of Terror

 

The end of chemo is a glorious time. It’s like finally reaching the mountain summit and all the muscle pain, strain and sore feet from climbing fades away. A year ago, April 30, 2020 was that day. 

The process to get to the end was wretched. The deep body sickness affected my psyche, with a  dive into a dark abyss of fear and misery. It was like having the flu for months on end. Even just four session seemed impossible to endure. End time felt worse and took longer to recover from. Just barely functioning was difficult.

The side effects were numerous. Hair loss, mouth sores, loss of appetite, nausea, weakness, extreme fatigue, gum pain, dehydration, eye inflammation, anxiety, high blood pressure, depression, neuropathy, rashes, brain fog, constipation, diarrhea, abdominal pain, among others.

It’s no wonder that I felt like dancing out the infusion room when the last drops of poison dripped from the I.V. bag. I would feel bad afterwards for weeks, but the healing process could begin. Hope shined in. It felt glorious.

I haven’t been back since to the four story building where I had the infusions, but passing the exit on the freeway reminds me of the experience and I inwardly shudder. It’s my Tower of Terror. The thought of even setting foot in it again brings up the memory of all the countless hours sitting alone in a chair watching the I.V. tube of death dripping into my vein. When the bag  emptied, my heart  raced and an overwhelming sense of panic set in.

It’s strange how the brain works. The sight or smell of something dredges up a long forgotten memory, like the scent of pine evokes Christmas or an old school building reminds an adult of  roaming grade school hallways. Just the thought of chemo brings out a deep revulsion and a flight response. I want to get away from any hint of it. Maybe that’s why chemical odors bother me so much, with the unconscious association 

Luckily, I haven’t had to set foot in the infusion building since last August. I don’t even like being on the same street or even in the same area.

It’s taken a lot work to beat back the mental trauma of chemo. Hormone blocker pills worked against recovery. It took a lot of Zoom support groups, doctor visits, tons of supplements, lectures, reading, therapy and tests to get to a place of healing. I still can’t sleep, have hot flashes, back, neck and hand pain mixed with bouts of depression and anxiety from the pill.  It’s a struggle to live with it and it’s tempting to quit and take my chances with cancer recurrence. 

Still anything is better than chemo. Hopefully, time and therapy will cure the cure.  Hopeless thoughts aren’t reality and the mind gives them more weigh than they deserve.

Maybe remembering the exhilaration of finishing instead of all the grueling discomfort to get there will diminish the weight of bad memories. 

Castle Creek Triathlon

 

Among the things I have missed in 2020 besides traveling and actual human contact is in person triathlon racing. Virtual just doesn’t cut it for the real thing, whether it’s social connection or racing. A decent conversation with a disembodied head on the computer screen is hard. Racing alone takes discipline with no one around to motivate me and it lacks the fun and camaraderie of the actual experience. When this Lake Pleasant Race was actually approved to go on, I signed up for a chance to have a modicum of normal.

I didn’t feel particularly in shape for it. I had been consistently training, but not intensely, since I was not feeling up to it. Chemo, surgery and radiation had sucked the life out of me and five months later I still wasn’t recovered. Lake Pleasant is nothing but rolling terrain and climbs. I had no energy to run train for hills and the weather had been insanely hot for months. Hilly bike rides and open water lake swims were at least some preparation.

Of course, if a race was scheduled, my bike had to fall apart. On a ride three days beforehand, the seat seemed loose. With no tools to fix it, I just kept riding. Arriving home, as I dismounted, the seat sadly flopped down and sagged sideways in disapproval of my ineptitude. Upon inspection, a screw and a part was missing. Without a functioning seat, the whole bike was useless. Maybe my mountain bike was an option, but it would be painful on the hills.

The next day, I retraced my route on my mountain bike and found the missing seat piece laying in the street, but no screw. During the ride the cog on the mountain bike drive train froze. Seriously?  Am I cursed by the bike gods? I still could ride home, but the chain complained the whole time.

Option C was my old road bike. It was nice in its time, but only three of the 24 gears worked because rear shifter just didn’t feel like moving anymore. Also the bike was an iron horse compared to my tri bike, so climbing hills would be a lot of effort. Between my bike woes and my tired body, my expectations were low. But at least it was a real event with actual people.

Racing during a pandemic is a different animal.  People are potential plague carriers and have to be spaced apart from one another. Mask wearing is necessary, at least while milling around. I got there early and set up. Due to Covid, there was a lot of space between the bikes, which was an advantage. No one to intrude on my space or knock my stuff around. For the water entry, we had to stand apart on the ramp and enter the water in timed intervals. 

Lake Pleasant can whip up with the wind, but the water was warm and smooth at 78 degrees. The temperature was cool enough to allow a wetsuit, but I would have worn one legal or not. Swimming in deep, murky water is scary enough without the buoyancy of a neoprene wetsuit to prevent drowning. At this point in 2020, I did not need more stress. 

Sometimes,  a swim start makes me hyperventilate with panic, but this time was easy. I swam fairly steady and went faster than I did in training. Somehow, I added 160 yards, not that I needed to swim any longer and took 27 minutes, not counting the long slog up the ramp. I tugged off the wetsuit in transition and mentally gritted for the bike ride.

The first hill was steep seemed liked a 10% grade and it was all I could do to keep moving. In laymen’s terms 10% grade is a “standing on the pedals to force them to turn and hoping not to fall over climb from lack of momentum.” If only the bike had a lower gear. Was I going to make it up without getting off and walking? Three speeds on my 2001 Trek road bike wasn’t enough. This bike sucked. I feared trashing my legs for the run, but got through the first loop.  Downhills saved me. In a sick way it was fun to conquer the terrain, despite the physical suffering. 

But it was still a relief to get to the end with no mechanical problems. The bike and I didn’t fall apart. I thought the ride would take an hour for 12.2 miles, which was slow as hell, but it was about 56 minutes, which was just less mediocre. I had remembered the hills as being tough, but not as bad as they were with an a three gear, heavy piece of crap old bike. It was a reminder why I don’t do a lot of Lake Pleasant races.  It’s humbling because the terrain reminds me of my strength and speed limitations.

I got into transition and dumped the bike to go slog on the run.  With a lack of run training on hills, they would be slow and painful. The route went up the god awful hill again, then turned down and up another nasty climb. It didn’t feel as bad as expected. I had estimated a lot of walking and except for some steep ascents, the miles were mostly functional running.  

The whole race took 2:11 to finish. It didn’t matter being at the tail end of slow, that I had to ride my crappy bike or that I wasn’t strong enough to run fast up hills.

After an abnormal year it was good to have “normal.” 2020 threw at me the physical discomfort and emotional distress of cancer treatment; long periods of social isolation; depression; the stress of dealing with a pandemic; and lack of anything to counter the bleakness. All the cheery optimism blather about “being in it together” and “you are not alone” didn’t make this steaming pile of turd year more bearable. 

So, it was a relief to finish, see people I knew and have an actual event despite Covid. Months of physical weakness from treatment made me doubt my ability to swim, bike and run in succession without keeling over. But my arms and legs still had the muscle memory to get me through water and up hills. They worked better than the ancient bike, which was reassuring.

All the crap didn’t beat me down. A hint of the high that I used to get when I first started racing emerged. Speed didn’t matter, but conquering the terrain did. Perhaps the threat of deathly disease changed my perspective. Or maybe this year sucked so bad that any good experience was appreciated.

For real.

UNPREDICTABLITY

 

Where did this bird come from?

Sometimes the unknown is exciting. A step into the future without certainty can be a chance for growth, success and joy. But then 2020 happened. It’s more like chaos, depression and death. People have adapted, but we all have lost connections to friends, family and normal activities.

I long for predictable. Too much uncertainty is terrifying. The pandemic has made planning futile. If I was depressed, I could sign up for a race, see a friend, go to a local museum, volunteer or book a trip. Now all these activities are pretty much impossible. Faces on Zoom don’t entirely make up for it. People are still dying, getting infected and can’t get tested. The end in not in sight. All my methods for coping are useless except for lone activities, phone calls and online meetings. Even as an introvert, I desperately miss traveling and seeing people live. Thrown cancer into this mix and it’s even more complicated and risky.

 Part of my struggle is that after five months, I still wrestle with continuing on  Aromatase Inhibitors. The drugs are supposed to decrease the chance of cancer recurrence. I tried Anastrozole, then Letrozole, then Anastrozole again. I hate Anastrozole, but hesitate to again switch to another. Some days it’s awful, with intense fatigue and some mornings I wake up very depressed. Other days, I am fine. Hot flashes, neck and hip joint ache are consistent, but mood isn’t. Other aches come and go on different body parts. My brain is in a fog and I can’t remember what I was doing a minute ago.

Even the IDEA of this drug is overwhelming because it is not kind. It weighs heavily on the body and spirit. A five year sentence of misery is a long time. But once a person gets cancer, they are tainted with the specter that it might come back, despite all the bodily assaults of treatment. An evil cancer cell might lurk in the depths of the body, waiting to grow. Obsessive research online yields no definitive answers on what to do. Prediction models of cancer mortality are just that--guesses of what might happen.

I want my old pre cancer life back. Estrogen helps with mood, bone health and the lack of it taxes the mind and body. I have gone from hormone replacement to hormone deprivation and it feels awful. It always feel like something good is missing.

I suspect a man came up with these drugs, and thought that they were a good idea to take for FIVE years or even TEN in some cases. If he had to subject himself to this god awful medicine, it would have been a different formulation. A woman would have found some way to make the drugs more bearable. 

It’s tempting just to chuck it all and take my chances for recurrence. Two other drugs are options, but not very good ones. Tamoxifin causes blood clots and isn’t as effective Aromasin is expensive even with insurance. They both still cause the hot flashes, depression, fatigue and joint pain. 

I don’t know where my life is going, but it would be nice to be able to diminish the specter of cancer that is looming over it. Meanwhile, the world stumbles through Covid and the election nears. With fires, floods, drought, hurricanes, murder hornets and a pandemic, what’s next 2020? 

At least my head is no longer bald, though five months after chemo my hair is not even an inch long and is growing in random direction. Maybe it’s waiting to thrive too.