Showing posts with label radiation therapy. Show all posts
Showing posts with label radiation therapy. Show all posts

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.

Sunday, February 9, 2020

Seeds of Death

Seeds of Death
DIAGNOSIS

Sometimes life is a body slam, coming out of nowhere.  I was just going about my usual innocuous routine, when bam!, an event knocked the wind out of me.

“It’s cancer,” the radiologist informed me after a biopsy.

I really didn’t want to go to cancer land. It is an alien, dark, menacing place. Not the words I wanted to hear. Ever. 

The biopsy procedure had been unpleasant. Normally, I tried to avoid doctors and tests unless absolutely necessary. Now I was sucked into a situation with no control. Medical people lie that’s it’s only “little pinch,” or“it won’t hurt,.”  The test was supposed more tolerable than in the past. As the radiologist, guided the needle through the tissue, I felt searing pain. My skin broke out in a rash. The ordeal made was tiring.

I had never had this result before with the many mamograms, ultrasounds and biopsies I had had over the years.  Biopsies had involved sticking a needle in the tissue, guided through mamography, and punching out a ribbon of flesh. The nagging thought in the back of my mind every time was maybe something is wrong, but it never was. Until now.

I got a mamogram every year because my mother and sister had breast cancer and my father esophageal cancer. Still, I didn’t smoke or drink heavily like they had, so I assumed my healthier lifestyle might spare me. Or at least, I hoped it would. The results this time showed something suspicious and a biopsy was needed to see what it was. 

The cancer was small, slow growing and isolated, but still a seed of death. The radiologist said surgery and radiation was necessary, but probably not chemo. I was lucky in that regard.

The cancer cells were the type that responded to hormones. This meant I had to give up hormone replacement. Hormones made me feel better, less depressed and have more energy. They made hot flashes disappear. Without drugs, the hot flashes came back, got more numerous and intense. I woke up several times at night drenched in sweat. The sense of well being was gone and I mourned the loss.

It meant that Aromatase Inhibitors would be a suggested treatment. This drug sounded like a bad idea. A brief internet search revealed nasty side effects like joint pain and hot flashes, which I already had too much of. Maybe it would prevent recurrence of cancer in exchange for being miserable for five years. This could be a poor trade off, especially since I only had two tiny seeds of death.

The next steps was a breast MRI and seeing a surgeon after the pathology report was done. MRI’s are claustrophobic and very noisy. This procedure required me to lay face down and not move. While it wasn’t physically uncomfortable, the confined space made me panicky. I had on headphones that faintly played music, except when the technician talked. The music wasn’t calming. I had a panic button to push, but the technician ignored it despite my numerous times that I pushed it. When the machine moved over me, and loudly banged continuously, I desperately wanted out and felt like I was suffocating. I kept telling myself that “it’s only temporary”, while hyperventilating the whole time. At least the result of that horrible experience showed that the cancer hadn’t spread.

WHAT THE HELL DOES IT ALL MEAN?

I alternated between anxiety and depression, thinking about the unknown future. The surgery and treatments sounded painful, exhausting and. detrimental to my mental health, fitness and body.  A side effect of radiation was fatigue and sometimes skin burns. Radiation was every weekday for a month. Slice and burn me in order to be cured? My routine would be disrupted and I had better things to do, like an upcoming ironman race and a trip to Maryland to see my daughter. 

 My attitude might have been different if my cancer was more advanced, but it was early stage. I didn’t want weight gain, joint pain, fatigue or skin burn. Some of the treatments seemed like over-kill and the necessity of them was hard to accept. Modern medicine was my enemy more than the cancer.

The whole situation felt surreal. Instead of being a healthy person, suddenly I was diseased. Normalcy had disappeared. It was hard to grasp the idea of being weak and vulnerable. 

I felt utterly alone. Who to tell and when was a dilemma, until I saw the surgeon and discussed a treatment plan. Giving someone bad news is a downer and rather awkward. Maybe they really didn’t want to know. The whole “you poor thing” was repulsive and I didn’t want the attention. Setting up the surgery could take a while. Why tell someone and let them worry a long time?

Still, the knowledge that this drastic life changing event was a burden that I wanted to ease. The temptation was to tell someone, even if they didn’t want to know about it. I kept my mouth shut for a while, but it was difficult not to share the turmoil.

Deep down, I knew that I would eventually be fine, but that the journey would  challenging. Pain and discomfort awaited. The body assault loomed. 

NEXT: SURGERY