Monday, January 21, 2019

2019 BHAG - DK200 !

Hey, team! Well, it was a very eventful fall and early winter. I got my stem cell transplant on 18-sep and things have gone great since then. You can get more details over on my MyLifeline site - https://www.mylifeline.org/gflorentine .

The big news is that I've set out on my 2019 BHAG (Big, Hairy, Audacious Goal). I've signed up to do a 200 mile gravel bike race - the Dirty Kansa 200. Details about the event can be found here. It'll be a very big accomplishment if I can complete the race! I'm going to start blogging about my training here, since Susan thought it would be fun and informative to hearof my story from stem cell transplant to DK200 finisher.

I'll start with a bit of context. For a few years, I've toyed with the idea of doing this race. It's long, tough (gravel, hot, humid, maybe bad road conditions if it's rained alot). Last year there was a head wind for 50 miles of the race. The race draws riders from all over the world and is considered one of the premier gravel races in the world. For me, the goal will be to survive and finish and beat the 21 hour cutoff time.Susan and I made an agreement that if I got through the transplant OK, I would try this race, which is on 1-jun. So here we are!

The race in brief:

  • Long. 206 miles in one day is alot.
  • Gravel is slow compared to paved road
  • My power output is about 80% of what it was two years ago
  • I've lost 15 lbs, probably about 10 of it being muscle mass. In general, being lighter means being faster on the bike, but not if you lose 7% of your body mass in muscle
  • It's self supported. There are four places on the ride where you can get help from your support team (aka Susan). Other than that, you  have to be self sufficient.
  • It's long. Might have already mentioned that
  • It's a fueling and hydration marathon. If you don't put food and water in the top, power won't come out of your legs.
  • I've got two great team mates which will ride the race with me. Their lives have both been touched by cancer so they "get it". 
  • If the race was tomorrow,  I absolutely could not finish it. I have 4 1/2 months to get strong and be ready for a fantastic day in the saddle
  • I'm excited, apprehensive and SO happy to be healthy enough to at least try to do the race.
  • I have no idea if I can get ready. But  the challenge is fantastic and if my body responds well to the training loads we'll take on, I should be ready.
  • For the first time since I stopped racing crew after college, I have a coach.I also  have a new bike and new  power pedals to help me train. The bike is great,  my coach is great and I've got all the tools to make this thing happen.
We'll see how it goes!

Thursday, August 9, 2018

Speed bumps and false summits

Hey, guys! I thought I would give you an update on how the summer  has been going. In my previous post, the timeline for a BMT  was late June. But surprise! That didn't happen. What did happen was two months of fun and games that I know some of you have been wondering about. So here's the summer '18 recap!

  • How about some leukemia to top off your tMDS diagnosis? Over the last 12 months I have developed a genetic mutation in my bone marrow, probably due to all the chemotherapy I recieved in '10 and '11. This causes me to become anemic and if untreated would eventually kill me by preventing my marrow from producing blood products - RBCs, WBCs, platelets. Hence the need for the bone marrow transplant. So, we get the BMT scheduled for late June, and in mid-june I go to CBCI to get checked out. But surprise! Sometimes tMDS morphs into AML (Acute Myeloid Leukemia). This is anotherr blood disease caused by problems with your bone marrow. This can also kill you. So - great. Now I have two things trying to kill me. Ugh.
  • Once we discover this, my care team tells me that we need to knock down the leukemia before we can do the BMT. "Great!", I  say, What does that entail? Oh, just a 30 day stay in the hospital. And the first 7 days you're looked up an infusion poll EVERY SINGLE FUCKING SECOND OF THE DAY. So - rather than going in for a bone marrow transplant in late June, I have to go to chemo  summer school and do a  30 day session. IN THE  HOSPITAL. EATING HOSPITAL FOOD. WHICH SUCKS. 
  • OK, to be a bit more fair. Foothills Hospital in Boulder is just awesome. New facility, great staff, great resources. And the food is a solid B-. It's  definitely not a C. But after several days, it just starts to wear you down. Everything is just kind of mediocre, unoffensive and it but it was definitely a drag and you  realize that they could make it better by simply spending more money on the food and preparation. But in this climate of ultimate cost control in the health care industry, that's a tough sell.
  • What to bring when you're in the hospital for 25-30  days? I knew up front that for much of the time, I would actually feel OK. So for me, the biggest challenges were boredom and also a strong desire to support my work colleagues as much as I could. Here are the tools I  used to create my own mini VRBO/consulting gig at the  hospital:
    • Chromecast ultra device, talking to my hospital TV and my laptop over a private LAN I setup. Important for streaming World Cup games (and other things like Netflix). The hospital staff were super nice in helping me set this  up and it was great to be able to watch World Cup games over fubo.tv and stream our favorite shows on the room TV
    • Road bike and resistance trainer. Because it's Boulder, the culture is very supportive of staying active while receiving care. I setup my road bike and my bike trainer in the room and would try to spin for 30 minutes/day. I used Zwift and Strava to  post my results online. Zwift is a fun virtual cycling community and Strava is where I  post all my workouts. I'm very anemic (hemoglobin hovering around 6.5) so I'm not putting much power into the  pedals. But it was emotionally a great lift to get on the  bike and push myself a bit and I did elevate my heartrate a bit on  these rides (usually < 155 bpm), so I was getting a bit  of  a workout.
    • guitars. Because of course, music therapy is awesome!
  • here are a few pics from the VRBO/jail cell:
  • Susan playing guitar while I do a Zwift workout on my bike:
  • guitar, workstation, bike setup:

  • missed our 3rd family member Athena, so a quick skype session with her and Susan:



  • low points of a 30 day leukemia induction
    • You're in jail. In my case, it was a very nice, 5 start VRBO kind of jail, but it still's jail.  I got outside every day and tried to get in between 1-2 miles of walking. That was a huge win for me. Not everybody getting this treatment is healthy enough to do  this but for me, it  was great. The hospital staff was great in their  support of me being active. When I was on  the pole,  I would do 21 laps/mile inside and get outside a bit to have meals on a nice patio. Once I was off the pole,  I would do laps inside and outside of  the hospital. Huge plus for me.
    • Neutropenic fevers. When your white blood cell counts go low,  it's very common to get fevers. In my case, they were pretty intense. > 103 fever all night is not a recipe for a good night's sleep! And as an added bonus, try slamming an ice bag on your femoral artery (aka groin) at 2 am in the morning. Gets your fever down, but not much fun.
    • low platelets causing leaks. I had a 14 hour nose bleed due to some irritation I had in my nose and a low platelet count preventing good clotting in my nose. We tried clamps, ice, (multiple) tampons up my nose. It started out slow but just got worse and worse through the day. By the evening, I was getting two units of blood (more on that later!) and the blood was flowing out of my nose at about the same speed as it was coming into my arm. Eventually I got a  bag of platelets and the bleeding finally stopped. This was the only time in this 30 day run where I started thinking "OK, I'm ready to be done with this." I'll be happy if I never have that experience again!
    • I literally shit myself. Yes, this was disgusting. In my defence, you try having a messed up GI tract and a night of hallucinating with a 103 fever and see how you do. I woke up one Saturday morning and thought "what the fucking hell happened in  here last night? This room smells like death". And then I realized - great, I really am two years old and have shit myself in my sleep. I got up, changed all the  sheets and moved on. But - ugh. 
    • Privacy? Nope. You are a science experiment. These are common questions that you will be asked multiple times/day:
      • Have you taken a shit? What consistency? What color? How many times?
      • Have you peed? How much, how freqeuently?
      • Let me take your vitals. AGAIN and AGAIN and AGAIN. Every 4-6 hours for 30 FUCKING DAYS. Yes,  it's necessary and yes, all  the staff was awesome and would be flexible in their timing if I was on the bike or walking (love you, 1 North team!) But it's still a super invasion of your privacy. Of which you have none.
    • Hurry up and wait. This therapy strips alot of cells out of your bone marrow, with the hope  that when they come back, the good cells will be much more plentiful than the bad cells. There are some general guidelines for how much recovery (as measured by blood counts) you need to  have before being discharged. So for several days, you anxiously await your blood count results to get an idea for when you can break out of jail. For me, that was day 30. That's A LONG FUCKING TIME TO BE IN THE HOSPITAL.
  • Ok, so after the leukemia induction, we're FINALLY ready to rev up the bone marrow transplant. I go back to CBCI, where I again go through a battery of  tests:
    • blood work
    • pulmonary function test (I always do great this so I enjoy taking them). I mean, who else can do 100% O2 sat on room air at 5400 feet with only 40% of normal red blood cell count. That would be me, bitch! So, serious humble brag on this one.
    • bone marrow biopsy. kind of like having a cork screw drilled into your pelvis. Some people really hate this but I've had quite a few and have gotten  used to them. Not a big d eal.
    • echo cardiogram. Go in a dark room and have a (typically 30 something woman), rub goo on your chest and rub a sonic transducer on you while taking pictures of your cardiac function.  Yes, it's just as weird as it sounds. Again, I do well on this test so it doesn't cause me any anxiety,  but it's just another irritating thing you have to go through to get your all event pass to the big BMT dance!
    • psych/social eval? More fun  questions:
      • Do you have anxiety? no, I'm perfectly happy undergoing a procedure that may cure me, not cure me, or sort of cure me but give me live long, serious new problems. OF COURSE I HAVE ANXIETY, YOU IDIOT! But it's not cool to get all jinky on these guys. So I take a big breath  and try to gently describe my coping strategies, my zen like calm in the face of this serious illness. But again, it's some work to get through this.
    • So after a few days of tests, we sit down with the  oncologist. And here's where I learn another lesson - you never want to  hear your oncologist say "speed bump" related to your treatment plan. Good news - my bone marrow looks quite clean after the 30 days hosing down we gave it. Bad news - one of those red blood cell transfusions caused me to develop an antibody to a particular protein structure on some red blood cells. And this means that my donor  (son Kyle) cannot give me his stem cells. So we have to find another donor from the donor database. And my great care team has already done this and have found a good match. My reactions too all of this:
      • Yeah! you guys are great. Thx for having a solution to this new problem.
      • WTF? You gave me the blood products that fucked up our plan. Aren't you guys supposed to be good at this? Why the heck are you giving me blood products that could cause this problem? Isn't this why we qualify blood products? Argh. 
    • So now we have a harrowing few days trying to track down the donor and getting a final head nod. Because, you know, if he  says no, I'm KIND OF FUCKED. But yeah - he says yes!
    • So we're back on the happy path to a  BMT and living happily ever after! But - and my summer has been full of buts - my care team is worried that too much time  will have passed between the leukemia induction completion and the BMT. So - surprise! Let's do more chemo.
    • This session is  a six day session - one day getting chemo, one day off, repeat 3x. The normal protocol is to into the hospital for six days. To which I politely replied "NOOOOO!" So, working with my great care team,  we've figured out a way for me to do this as a pseudo out patient, so I can sleep at home and not be trapped in the hospital between actual infusions.


So here we are! New BMT date is  11-sept (auspicous, eh?) I finish my latest chemo today (9-aug-2018), recover for a few weeks and hopefully climb into the ring for a very successful allogeneic stem cell transplant. Fingers and toes crossed!

Friday, June 15, 2018

Summer camp!


Hey, guys. I’m getting to go to a cool summer camp in July! It’s got 7x24 room service, in room dining and you can play your guitar and ride your stationary bike anytime you want. Pretty cool, eh?

Translation – I’m getting another stem cell transplant and will be at PSL in Denver for all of July. Ugh. Long term prognosis is good but early July will suck pour moi. As a result of all the chemo I've received my bone marrow has developed a genetic mutation and I'm having trouble generating red blood cells.

Susan and I will start blogging here to keep folks updated and I'll also be posting some very, very slow Zwift rides on Strava from my road bike/trainer I'll have in my hospital room.

Here's the long life and the hard work to make it happen!

Sunday, February 12, 2017

7 years

Well, it's been a few years since I've updated this blog. With my 7th cancer-versary  coming up this week, I thought I would check in and give the blogosphere an update on  wazzup. So, without further adieu...

I'm still (pretty) healthy! That of course is the big, fantastic news. I'm down to yearly oncology visits and I'm also participating in a long term study of patients that were given a regimen of SGN-35 (commercial name is brentuximab) following an autologous stem cell transplant. These studies are pretty funny (if you have a macabre sense of humor). They call you every year and ask you "hey, are you still alive? If so, any symptoms of a relapse? If not, how are you answering the phone?" Or something like that...

More on the health department. In 2010 I developed a blood clot in my left arm, probably due to the  port I  had in my chest. Over the following year, that  clot resolved into some scarring in the vein under my armpit. My body compensated in a pretty cool fashion - I developed some pretty large surface veins above my left pectoral muscle. As my oncologist described it "your vein interstate has got some debris in it, so your body enlarged the surface streets." Pretty amazing, really. My left arm is almost completely normal, which is great. If I exercise a lot (ex: swim several hundred yards of free style), my left hand will turn a bit purple, due  to delayed blood flow return. I'm not sure this will ever resolve, so my hope is that it doesn't get any worse.  I can play hockey, do push ups, pull ups, ride my mountain bike, etc. so it's not held me back much from being as active as I want to be.

Next health issue - bleomycin induced damage to my lungs. I still notice this and I suppose that after 7 years, it's likely that it won't get much better. But my oncologist is fairly confident that it won't get any worse either, which is good news. I've had several PFTs and I always test as super-positive, but I definitely notice that my lung function is less than it was and I have periodic episodes where my lung function seems off a bit. I tend to exercise very hard on my bike so it's pretty obvious when my lung function is different than normal. After the initial problem in 2010, my oncologist was hopeful that my lungs would completely recover in a few years. But after 7 years, I'm thinking that this is about as good as it's going to get. I wish it was better but I'm still plugging away, running, biking, playing hockey, etc. So compared to most people that have any sort of significant pulmonary illness, I'm doing great so I'm not going to complain!

Mental health check - pretty  good, I think. Susan and I continue to have a tremendously awesome relationship and we've both had enough health issues over the years that we don't take anything  for granted. Our immediate family is very healthy and we're getting new grandchildren and grand-nieces/nephews every year or so. Whenever we get a new arrival in our extended family, I take a moment and realize that this was one of the things that I was fighting for - living long enough to see my family continue to grow and get to know the next generation. Grand-parenting - greatest thing ever!

My cancer advocacy continues -  Susan and I have volunteered in an infusion department and we are involved in supporting a couple of local Camp Kesem chapters here in Colorado. It feels good to give back after  having received such great care and having a pretty good outcome, considering how sick I was in 2010/2011.

I supposed that after 7 years of survivorship, you might wonder if I've gained any great perspective on life, serious illness, death, etc. I think the biggest thing I've taken out of the experience is what many people feel - the sense that every day is precious and to take nothing for granted. I've also realized that the most valuable thing you can have in your life is love. Your health might be great or not so great. But if you have love in your life, you'll do fine. And if you don't, being a world class athlete or acquiring great material wealth doesn't fill the gap. I'm lucky to have a tremendous  life partner in Susan and lots of love in my immediate family and friendships.

So I'll close by hoping that if you're reading this and you're dealing with  cancer in your life that you take the time and pay attention to your loving relationships. Do that and you'll be OK, regardless of how much time you have on this shiny blue ball. Here's to life!

Tuesday, March 4, 2014

Another clean CT scan

Yeah, yeah, YEAH! Another clean CT scan today. Wow, that's a relief. It's hard to put into words how unbelievably stressful and scary it is to face this kind of event in your life. But I guess I will try to do it. Ok, here we go:

Last month I had a few days when I felt kind of 'blah'. Just a general feeling of being off - a bit of nausea, feeling pressure in my head. Kind of like I was fighting a cold. No fevers, no night sweats, no itchy skin. In other words, no Hodgkins 'B' symptoms. But I'm worried that I have nasty tumors growing inside of me so I work up my courage, call my oncologist (who is awesome!) and ask to move up my CAT scan from late march to early march. So, we get it scheduled...

As the time of the CAT scan approaches (usually it's about a week or two out for me),  my imagination starts going. And I apparently have a REALLY good imagination when it comes to thinking about all the possible ways I could be getting another recurrence. Feel a pain in the middle of your chest? Before cancer, I would not have given it a second thought, or perhaps attributed it to muscle soreness from riding my bike or swimming. With a CAT scan approaching, I immediately have visions of mediastinal tumors. Pain in your back? Most likely from doing hill repeats on your bike. But me? Nope, I'm thinking that I have a tumor in my back, similar to the Hodgkins patient I saw when I volunteered at the infusion center last week. Trouble breathing? Probably an allergy, maybe a leftover from the bleomycin toxicity? (which isn't something to sneeze at - this article indicates that bleo toxicity is not good for long term survivability). But no, I've completely convinced myself that I have several large tumors that are restricting my lung capacity. This is primarily due to me knowing a few people that have had lung problems due to thoracic (chest) cavity issues - tumors, blood clots, etc. And then I start thinking about all the ways my life is going to change with a bad diagnosis - lots more treatments, lots of bad side effects, higher likelihood of an early death from this damn disease. So by the morning of the procedure, I'm basically a  mess. I feel like I'm going to puke, I have diarrhea (stress induced hyper-bowel, thank you very much) and I feel like either not saying anything to any body or start screaming at everything and everybody. And then the test. Which goes fine.

And then - The Wait.....

The wait sucks. You watch your phone, wanting it to ring so you can get the news and move forward. And wanting it not to ring, because you're afraid of what the answer is. So you decide to do some work. Which of course is close to impossible, because YOUR FUCKING LIFE IS HANGING IN THE BALANCE, WAITING FOR THE GODDAMN PHONE TO RING!

If you've followed the blog, you know that this is not a new condition for me. Back in 2012, I got all worked up, as I describe here. So you would think that with every passing CAT scan I would mellow out. But somehow, I seem to always engineer some set of ailments that put me on edge.

So I get the news, and it is awesomely awesome. And yes, that's a phrase that's OK to use because I just GOT MY LIFE BACK!!!! So after a few seconds of wild fist pumping, I calm down enough to chat with my oncologist and we talk about my symptoms that made me move up the CAT scan. When you have a stem cell transplant, you reboot your immune system, with either your own or some donor's. In my case, it was my own stem cells, so I now have a 3 year old immune system. And it's not quite perfect yet. So although I don't get sick much, I do have periods where I feel like I'm fighting something. Which I probably am. With my original immune system, I would never notice these battles. But with the Geo V2 system, it's still kind of immature and I can feel it when it's working. At least, that's the prevailing theory. I hope over time that these periodic, sub-clinical symptoms will go away and I will finally be able to relax in the period building up to my CAT scan.

But to end on a happy note - it looks like I'm still pretty healthy. More yeahs! It is so awesome not to be sick and have a good chance of living a long time. It's really fantastic, because I have had plenty of opportunities over the last four years to see things end differently for friends I've lost to cancer. So I'm so very grateful for pretty good health and the love and support of lots of people.

That's my update for today - health, happiness and joy. And now, off to write some code, ride my bike and hug my most awesome wife! TTFN - I'll probably do another post at the end of the month when I have my 3 year old immune system birthday party.

Sunday, February 16, 2014

4 years in the books

Well, today is the 4 yr anniversary of my cancer diagnosis. Yeah! I'm still here! And still pretty healthy! I was chatting with Susan today and we were reminiscing about how we felt that day four years ago. Surprised, shocked, scared, confused.  (I describe that day in this blog post). Mostly though, I just remember feeling determined to get through it. Looking back on it, I don't think I had a real idea of how hard it would be. No one ever thinks they'll have a relapse and Hodgkins has a very high survival rate, so I guess it was reasonable for me to think that I would have a few months of chemo and be done with the whole thing. If only!  Four years later and I still have a few symptoms from the treatment that I notice every. single. day. Here's a summary of the little presents I've received that keep on giving:

  • Peripheral neuropathy. This is mostly in my feet and it isn't too bad. It's hard to describe but in summary, I feel like I have little pads of something under the balls of my feet. My feet are always cold and I get random pains through my feet frequently. I've been able to run, mountain bike, ski and swim OK so in the grand scheme of things, this isn't too bad. In the cancer world, they talk about the "new normal", meaning you have to get used to changes in your body. Ok, I get it, but I reserve the right to privately (well, maybe not so privately) still feel that the New Normal SUCKS. I want to feel my feet, point my toes and have ALL of them point and in general not feel like I'm wearing an extra layer of cotton socks under my toes all the time.
  • Low hematocrit. My oxygen transport system isn't so great. I'll get  my blood work done in the next couple of weeks and maybe things have improved a bit, but my crit has been running around 38-39. Low normal for a man is 41 so I'm not too far off - the crit threshold for getting a  red blood cell transfusion is 24. I don't normally notice this when I'm walking around but as soon as I start running or biking (which for me is about 25 days/month), I notice it. My personal 10k best time is 38:42 and I'm now running around 70 minutes at altitude. I ran the 38:42 time at sea level 25 years ago so undoubtedly some of the slowdown is just age and altitude. So these days I'd be pretty happy running a 10k in around 50 minutes. But 70 minutes? I've gotten 20 MINUTES SLOWER than a typical pace for a recreational 55 year old runner. I mean, WTF? So this part of my health really, really frustrates me. I spend a lot of time saying to myself 'you're healthy, you're doing fine, quick whining, enjoy life." But just between you and me, dear blog reader, I FUCKING HATE IT that I am running so much more slowly than my body used to be able to run. Now, if you're a 70 minute 10k runner, you're probably hating me right now. I know it's all relative and there's nothing magical about running a 40/50/60/70/80 minute 10k. This is just me being a little whiny bitch, but if not hear in my blog, where can I get these things off my chest? So I keep running (25 runs in 2014 so far) and keep hoping that my blood chemistry will improve. My times haven't significantly changed in the past year so that's something but I sure would like to have more red blood cells!
  • Pulmonary health. I can still feel the damage from the bleomycin. Some days my lungs feel totally normal and other days I feel a fair amount of tightness and phlegm in my chest. I also tend to notice my lung (dys)function after I come home to Boulder after being at a lower altitude for a few days. I think that most healthy people can go from sea level -> 5400 feet without noticing anything so the fact that I notice it is a sign to me that my lungs are still not completely normal. This is probably also contributing to my relatively slow running/biking. When your lungs aren't great at taking O2 out of the air and you don't have your fair share of red blood cells, your little mitochondria in your (muscle) cells are not going to be very happy when you exercise. 
  • Scar tissue in my neck. I had nodular scerlosing Hodgkins (the most common type) and the result of this disease includes scar tissue from malignant nodes that have been whacked by the chemotherapy. So I still experience some random pains in the left side of my neck, especially after long bike rides. Of course, any pain near where you had a tumor instantly puts you into hypochondriac mode so I have to constantly reassure myself that there are no bumps and that the twinges are not a sign of any new disease. But it's stressful - I just want both sides of my neck to be perfectly, completely normal!
Ok, that's the irritating stuff. On the plus side of the ledger, I have lots of love and happiness in my life. Lymphoma is a tricky disease and it frequently can reoccur (as I know all too well), so my medical team will always be watching out for signs of a recurrence. But for now, all signs are that I'm pretty healthy!

 Four years ago I did the math and figured that if I wanted to live to 85, I needed another 12,410 days. Well, since then, I've had 1460 days of living which I'm very thankful for. Some of them have really sucked but by and large, it's been a pretty good four years. Our immediate family is in pretty good health and we've seen family members get married, have babies and have fun in their daily lives. We've also seen our share of fellow cancer survivors run out of time and pass away. Susan and I are volunteering in a local infusion center and that work certainly gives you perspective and makes you appreciate the good things in your life. 

So as I head into year 5 of survivor-ship, I'm thankful for my health, the most excellent wife any man could ask for, two most awesome children, two also awesome stepchildren, an amazing grandchild, a loving brother, a great extended family, love, friendship and, oh yeah, some seriously fun bikes to ride.

Ok, that's the year 4 anniversary summary. More updates after my next CAT scan in a couple of weeks!

Thursday, November 21, 2013

watching people die

Hey, the simple truth of the matter is that people die of cancer. When you're in the survivor battle it can be hard to verbalize this. We tend to have this "let's not talk about the bad stuff, because talking about it makes it real, gives it power, scares us, etc." So we frequently focus on the positives, give all our cancer survivors hugs and positive encouragement, chant the mantra that we can create our own reality and sweep the scary stuff under the rug. But today I got the privilege of talking with a couple of folks that are staring their mortality straight in the face, and doing it with a calm grace that was truly inspiring to watch.

The first person is an elderly woman, in the infusion center to get platelets. Normal platelet count is 150-400 and you can walk around with a platelet count of 80 and in general be ok. Her platelet count was six. At 15 they give you a platelet transfusion. So she is basically a train wreck waiting to happen. Brain bleeds, internal organ leakage - nasty stuff. You really need platelets to do what you'd like to do - like walk around without having your organs bleed internally. So you'd expect this woman to be super stressed, or terrified or something. But no. She just walks in (carefully, because if you bruise yourself when your platelet count is six, you are some kind of fucked.) Sits in the chair, gets hooked up, calm as can be and sucks up the life giving platelets. And oh yeah, she has an incurable blood disease and will be dead in six months. And her daughter is with her, bemoaning how the universe can allow someone to hit and run her car while she's transporting her dying mother to the infusion center. But through all of this, these people are as nice as can be - loving to each other, finding ways to laugh at all the little things in life that you have to deal with to live in the modern world. All the time looking down the barrel of the mother's imminent demise. It's just so amazing to see people cope with this kind of mortal threat with  dignity, grace and loving approach. When you talk to them, your efforts to help seem so puny and useless given everything they're going through. But as a social worker told  me, we give them a gift when we stand witness to their journey. So my pillow plumping and warm blanket wrapping may not have been much, but I was there (after a 2 hour commute in the snow) and it really felt like an honor.

The next guy is an old Russian. And he just looks like a zombie. I mean, really. He's old, yellow skin, skinny to the point of looking like someone from a concentration camp. He got three bags of red blood cells the day before. At the nadir of my treatment, I got two bags one day and it made me look and feel great. But he had three bags and still looked horrible. So you can imagine what he looked and felt like before he got his transfusion. And here is the dialog he has with the nurse:

"How are you feeling today?"

"Good!" (which is hard to believe, given his obviously whacked out blood chemistry and extremely low weight). "I was a bit tired, but better today. " Translation - if you need three pints of red blood cells, feeling a bit tired is a code word for being flat on your back, unable to move due to a complete lack of oxygen delivery capacity.

"How are the sores in your mouth?"

"Still there a bit, but getting better every day."

The nurse asks him several more questions and although he's not evasive, it's pretty clear that he's just not going to admit to anything really bothering him. And he does it all with a calm, dignified demeanor. Although I don't know the details of his prognosis, he's in WAY worse shape then when I saw him a month ago. If it was Vegas, I would bet heavily that he'll be dead in a month or two.

It's kind of a freaky thing to be in the presence of dying people. Somehow you think they should be wailing or shouting or paralyzed by their fear of dying. But in general, they just kind of look and act like you or me. Granted, they usually look pretty messed up but I've been amazed and impressed that these people manage to keep it together. Of course, they may be doing a lot of screaming and moaning and wailing in private but when I see them in the infusion center, their behavior is really a testament to the strength of the human character. They may not look like much to the casual observer, but I've gotten to know them enough to see the hero and heroine inside. It's an honor to get them a pillow and a blanket and maybe share a story or two.

That's the report from the infusion center. Just wanted to share the powerful things that go on in such a place while the rest of us stress out about whether our favorite football team wins on Sunday or what kind of dressing we'll prepare for our Thanksgiving dinner. Intense stuff, for sure. But rewarding to be able to witness.


Thursday, November 14, 2013

Geo on video!

This summer, I had the opportunity to participate in a video for Patient Power, a web site that provides information to patients about a range of health issues. It was really fun - we filmed for about three hours and talked about my cancer experience with a few folks from my care team. I never met a camera I didn't like! So if you want to hear me talk about my cancer journey with an emphasis on the recurrence phase, check out the links below.


another good doctor's visit! A healthy fall with lots to be thankful for

Howdy, all! Today I had another six month check with my oncologist and everything is still going well. So - yeah! I've been meaning to post for a while but thought I would wait to get through this visit and summarize how things are going for me. Here's the latest stream of consciousness on my health. If you know me personally and are just checking up or you found this through a web search, I hope this is interesting. If not - well, close that browser tab and go out for a bike ride! Ok, in no particular order, here we go:

  • Lots of things are still getting better slowly:
    • Lung function. Definitely better. Over the last few months I've basically stopped thinking about my lungs. They just feel normal. I haven't had a PFT in quite a while so I don't have quantitative data, but qualitatively, things are better. Less coughing in the morning, less tightness in my chest when I get up to higher elevations, no wheezing. It's been over 3 years since I had the interstitial pneumonitis (brought on by Bleomycin toxicity) and it seems like the lungs are still healing.
    • Peripheral neuropathy in my feet is less noticeable. Still there but less obvious than in months past. I'd like to start ice skating and playing hockey again and see how my feet do. Maybe this winter and next spring respectively for those two events.
    • Left arm is working better. I can now swim 800 yards and use my arm pretty regularly. By the end of 800 yards of freestyle my hand has a definite purplish tint so I have still have some problems with delayed blood flow, but again, seems to be better. As the days get shorter and colder, I think I will start swimming more. The only negative is that in the dry Colorado winter air, being in a chlorine pool a lot definitely is hard on your skin so I'll have to be better about applying lotion than I have been. The side effect is dry, itchy skin and since itchy skin can be a Hodgkin's B symptom, I definitely don't want to do anything to cause that symptom, less I get my hypochondria dialed up and start stressing about a relapse.
  • Things not getting better:
    • Blood chemistry. Hemoglobin is getting a little better (13.1 today) but hematocrit is still about where it was last May (~38). That sucks. I love riding my bike hard and running hard and both are pretty painful when you're anemic. I'm participating in a double-blind study for the use of Brentuximab vedotin in relapsed Hodgkin's patients that have had a stem cell transplant, but I'm pretty sure from my response that I got the drug. And one of the adverse effects of the drug is low platelet counts (mine is 115, low normal is 150). So my oncologist and I are thinking that my anemia and low platelets may be a side effect of the brentuximab jacking around my bone marrow. Another data point is that my red cell average size is still around 110%. This is a sign of immature red blood cells. My onc isn't worried and I'm really living a pretty great quality of life, so I'm going to try to be a bit more healthy in my lifestyle (more fruits and vegetables, less alcohol, fats and sweets) and give my body all the help I can to have healthy bone marrow.
    • I have some intermittent, low grade chills. This is the most worrisome symptom since this can happen with lymphoma. But I'm also a bit temperature sensitive, so we're thinking I may have some thyroid issues at work. We took some blood for that today and we'll have results in a week or so. I don't have night sweats, not running any fever, no other 'B' symptoms so we think there's nothing serious going on. But it is one of those nagging things that can be stressful.
    • Thin hair. My hair is definitely thinner than it was before. I'd like it to be thicker, primarily as another sign of health. The good news is that I have less grey hair! Anyway, I'm not going to do anything about this either, but it is another subtle sign that my body has been through a lot in the last few years.
  • To CAT scan, or not CAT scan? I'm now far enough out from my transplant that I can have some flexibility in how frequently I get scans. The upside of a scan is that you can find problems early and early detection can help long term prognosis. The down side is that CAT scans give you A LOT of radiation and at some point, you start entertaining serious risk for radiation caused illness - leukemia, heart problems, etc. I've gotten a number of CAT scans in the last three years so today we decided that I would not do a CAT scan this month, but wait until next march and then do them for the next three years on an annual cycle, assuming that no other symptoms present themselves. So again, it's a bit of a crap shoot and you kind of worry that you might be sticking your head in the sand and give tumors another six months to grow in your body. Which is pretty much a disgusting thought. But if you get too much radiation, you will get sick. Mutations can cause malignant cells to be produced and it would be a really stupid move to get another cancer from doing so many diagnostic tests to detect a cancer that you don't have. Now that would be ironic - but not good. So that's the decision. If something bad shows up in march there will be a lot of anguish that we decided to go this way, but with no acute symptoms today, I feel comfortable with the decision.
Well, that's about it on the health front. Everything else is also going pretty well. My immediate family are all healthy and happy and I'm enjoying riding my bike, running and being with friends and family. I have had a few folks I know die of cancer in the last few months which is super sad and obviously strikes close to home. But I don't think that's anything special to me - if you're a 50 something in this day and age, you probably know people that are both cancer survivors and have died of cancer. So when I get down about that, I give Susan a big hug, think of all the good things in my life and get on my bike and ride!

that's it from here. I hope you're having a healthy fall and thx for checking in! Look for my next post where I will shamelessly post pointers to a video I shot this summer about cancer survivorship. ttfn!

Tuesday, May 14, 2013

Another clean CT scan - yeah!

Yesterday I went in for my 24 month post stem-cell transplant CT scan. Today I got the results - everything looks OK! Before every one of these I manage to hypochondriac my way into believing that there is all sorts of problems looming. So far, this has all just been me misinterpreting the various groans and false starts you get from a body that has been through 2 years of chemo and a stem cell transplant. So it looks like I'm doing pretty well - no signs of any problems with my lymphatic system. Yeah, me!

That's the big news - other than that, I've been basically just living life. I'm working hard to get fit and have been making some progress, although my blood chemistry isn't totally great. I'm still a bit anemic and I really feel it when climbing uphill on my bike in the mountains of Colorado. This may get better in time or this may be as good as it gets. On the bike I get a little angry and frustrated at times but whenever I apply some perspective, I'm really happy with where I am. A few other check points on my overall health:

  • My left arm still has some venous scaring - probably from the failed port I had in my chest 3 years ago. I went to a vascular surgeon and the only possible remedy now is some major thoracic surgery - remove a rib, pull out some chest muscle in an effort to increase the pathway for the major vein in my upper left arm and hope that it will expand a bit. No thanks! But my swimming is getting a little better - a few weeks ago I swam 800 yards of freestyle and although my hand was a little purple, my arm basically worked. This is a big improvement from last year when I could only swim about 200 yards before my arm really got tired and swollen.
  • Had a cardiac stress test in March. I'm down about 8% in performance from 2009. Adjusting for age, this isn't bad. No signs of heart problems. Good news. I can hammer on the bike without fear of dropping dead from some undiagnosed heart condition.
  • Had a PFT (pulmonary function test) in March. Also good news. I've got about 130% of predicted function for a guy my age. This is a good sign that the bleomycin toxicity I had in 2010 hasn't seriously damaged my lungs. Some days my lungs don't feel totally right but I have some tree pollen allergies and it's spring in Colorado so it could be some allergies. I'm deciding not to worry about this.
  • As I mentioned, the big inhibitor to my performance (I think) is my red blood cell chemistry. Two issues here:
    • My hematocrit is hovering between 38-41. Low normal is 40 and I used to be 46 so I'm down about 10-12% from what I was in 2009. 
    • My red blood cell average size is 110% of normal. This usually means that I have immature red blood cells - my understanding is that your RBCs shrink a bit as they mature so my guys are young and not as good at O2 transport as more mature RBCs. Hopefully this will get better over time.
But in general, all things considered, I would say that my health is good. Susan and I have traded a nasty upper respiratory tract viral infection over the last month but I'd say that I did as well with that as a person with a normal immune system. So no complaints there. And that's a funny thing about my blood chemistry. You'd think that with lymphoma and a whole bunch of chemotherapy that targets my white blood cells that my WBC counts would be the ones that are abnormal. But those are all very normal - WBC count, ANC count, neutrophils all normal. My RBCs are a bit off normal and my platelets are also a bit low (125, low normal is 150). My last dose of chemo (SGN-35) was last May so maybe my blood cell chemistry is still rebounding.

So that's the quick update. To close, I'll post a fun note I sent to my oncology team today. I got a chance to do a fun obstacle course race with Kyle and Caitlyn over the weekend so I sent some photos to my oncology staff and thanked them for helping me return to a relatively normal, healthy life. I hope you enjoy the pictures and remember what you promised me 3 years ago - keep getting all your preventative checks - as bad as cancer is, it's WAY better to find it early than late. Early = treatable. Late = not so much.

----

Team – you all have diagnosed, treated and healed me over the last 3 years, for which I will be eternally grateful. On Saturday, roughly two years from my stem cell transplant and 39 months from my initial diagnosis, I got my Christmas present from my two children – we ran a mud/obstacle course race together outside of Glacier National Park in Montana (http://www.spartanrace.com/). In no small part you are directly responsible for me being healthy enough to be a Spartan Warrior! I thought you would enjoy these pictures:

Caitlyn, Kyle and I before the race:









Trying to get to the top of the rope obstacle:


Dammit, didn’t make it! So, 15 burpees:




Caitlyn and I leap the fire obstacle at the end of 5 miles, 900 feet of climbing, 38 obstacles of mud, climbing, crawling, rock dragging and javelin tossing:



The happy warriors post-race:





 

Monday, January 14, 2013

Happy 2013!

Hey, all. I've been meaning to write for a while but have been busy with life. So here is a quick update to summarize the last few months for me:

  • First and foremost, no sign of disease. Hell, yeah! I had my last CT scan in November and will have another one in February. All my CT scans in 2012 were clear so that's a good sign that things are going in the right direction.I'm still getting pretty nervous before each scan but each one has been uneventful. 
  • My overall fitness continues to get slowly better but it's been a very long road. In each of my CT scans my lungs still show some scaring from the bleomycin induced interstitial pneumonitis I developed in 2010. I'm also suspicious that I've had some COPD like symptoms develop from the BCNU I had as part of the BEAM protocol in March of 2011. I especially notice some funkiness in my lungs when I travel back to my home in Colorado (5400 ft) after working at sea level. For a few hours my lungs feel a little tight and I develop some sputum. I haven't had a PFT since September of 2011 and I suppose I could get another one. But from a quantitative perspective of how my bike and running workouts are going I'm still improving so I take that as in indirect sign that my pulmonary function is ok.
  • The left side of my neck still doesn't feel like the right side. No new bumps and nothing on the CT scan that indicates a problem but I still get twinges now and then. I had nodular schlerosing Hodgkins which basically means I've developed some scar tissue in my lymph nodes. It's kind of a drag because every time I feel something at all out of the ordinary I instantly worry that I'm growing new tumors. But my neck has basically felt abnormal for almost 3 years now so I guess that's starting to be a new normal for me? 
  • My left arm is still a bit messed up in terms of blood flow. No one has been able to find a specific site in my arm that shows a deep vein thrombosis but my left hand is slightly more pink than my right hand and my left upper arm is slightly swollen; all signs of a delayed blood return issue. In my November office visit I got some prescriptions to see a bunch of different folks to see if I can get this straightened out - a vascular surgeon, an acupuncturist, a message therapist and a PT. I've started to swim again and my arm is perhaps a bit better than it's been, but I still get a purple hand (delayed blood flow return) after about 200 years of freestyle. So still a work in progress.
Mentally, I'm doing pretty well, I think. Susan and I had lots of fun travel in 2012 - went to Europe together, Montana, Seattle, Ohio, New York, Massachusetts. Married off a niece and a nephew, got the great news that we'll be grandparents in the spring, visited with family and old friends. Susan retired from her software job in the spring and has refocused her energies on her writing, singing and charitable works.

As Susan posted in the fall, we've been pretty involved with LIVESTRONG so it's certainly been "interesting" to see how the fallout of Lance's activities on the bike are influencing LIVESTRONG. It's really a shame that all of this is going on because I think that LIVESTRONG is just a great organization. It helped over 13,000 cancer patients last year and raised over $38mm in funds to support cancer survivorship. Everyone I've met with LIVESTRONG has been really great and it's sad, frustrating and upsetting that the organization is being tarnished by all the doping that's gone on in cycling. I hope that the organization comes through in one piece - there are certainly lots of people in the world that need the services that LIVESTONG provides and I hope that it can continue its good work.

Well, that's a quick summary. Just wanted to let you know that in the world of cancer blogging, infrequent blogs are generally an indicator that we cancer survivors are out writing our bikes, drinking beer and enjoying life in general. Rock on!

Friday, October 26, 2012

Lance Armstrong, LIVESTRONG, and Werner Erhard


 by Susan


With recent events in the cycling world, we are being forced to re-evaluate Lance Armstrong as an athlete and as a person.  Do we need to also re-evaluate Lance as an ass-kicking cancer survivor and founder and spokesperson for LIVESTRONG? 

I’ve worked for LIVESTRONG as a volunteer and LIVESTRONG grassroots leader for the past two years.  I’ve been a founding member and board member of the Colorado Cycling Team Benefiting LIVESTRONG.   Last April, I retired from my job in the software business and announced to my colleagues that I was going to devote my time and energy to LIVESTRONG.    Why did I do this?  Well, both my husband, George, and I are cancer survivors.  I was diagnosed with breast cancer in 2003 and he with Hodgkin’s lymphoma in 2010.  Although we both got “cured” by our teams of doctors, our own strong wills, and sheer luck, the messages we’ve received from LIVESTRONG have made a huge difference in our mental outlooks. 

If you’ve never had cancer, it’s hard to understand what it feels like to the person who hears those three dreaded words, “you have cancer”.   With those words, you can feel the bottom dropping out of your world, and everything you think you knew comes crashing down.  There’s tremendous fear, shock, and yes, anger. Why did this happen to me?  Anger:  there is no God because God wouldn’t have let me get cancer; my body sucks for getting cancer. Even betrayal:  it’s all a mistake – those results aren’t mine they’re someone else’s, please, let it be anyone else but me.    Then you think maybe you did something to cause the cancer – I drank too much alcohol, I had the wrong diet, I didn’t exercise enough, I let myself be exposed to toxic environments, I had fear or guilt within my soul that erupted into cancer in my body. 

When I was diagnosed with breast cancer in 2003 I hid it from the people I worked with.  I left for tests and doctor appointments without telling anyone why; when I took off for a month to have bi-lateral mastectomies I just told people that I needed a month off for undisclosed surgery.   I was ashamed of my cancer diagnosis, ashamed of having my breasts removed, and I thought that people at work would see me as sickly and weak and I’d never get a promotion or an important project again.    I came back to work and acted like nothing had happened, even though my whole outlook on life and my self-image had changed.    I went from thinking of myself as an active and attractive young woman to being a damaged, scarred, middle aged woman who thought she would never be attractive again. Most of all, I felt like a loser, which in our culture is the greatest sin of all.

When my husband was diagnosed with Hodgkin’s lymphoma in 2010 attitudes toward cancer had changed dramatically.  He told everyone who would listen what was wrong with him, he kept a very public blog about all the details of his diagnosis and treatment, he kept his position at his company and even got promoted during the year that he was going through some very heavy duty chemo treatments. 

What happened between 2003 and 2010? I think that a large part of these changes was due to Lance Armstrong and LIVESTRONG. 

When I was going through my cancer diagnosis I read Lance Armstrong’s book, It’s Not About the Bike, and reading about Lance’s cancer journey helped to give me the courage to face my own possible mortality.  I thought, if Lance could do it, then I can do it.  I used his story to show how I could get back up and be active after my surgery, working through the chest pain of the initial surgery and all the reconstructive surgeries, working through the brain fog I felt from multiple general anesthetics, working through going to the gym and wearing my t-shirt into the shower because I didn’t want anyone to see my chest.    I saw pictures of Lance looking like hell after his multiple surgeries and chemo treatments, then going on to great cycling achievements.  This was at a time when we were used to seeing cancer patients as skinny, bald people with big hollows under their eyes who were just one step away from the grave.  To see a healthy, fit Lance wearing the yellow jersey in triumph gave a whole new meaning to survival.  We could not only survive, we could thrive and go on to great achievements. 

People everywhere started wearing the yellow LIVESTRONG wristbands as a show of support for cancer survivors – most of them either because they or someone close to them had cancer.   People started talking about their cancer survivorship.  LIVESTRONG held sports events to raise money for cancer and they gave out roses to cancer survivors.  We were cool - we were on Team Lance.    Was this because Lance was a seven time Tour de France winner?  Well, that was undeniably part of it.  He went from having cancer to being one of the most successful athletes of our time.   He hung out with celebrities, he had access to the highest levels in government.  He was a hero. 

Let me say here that although Lance has been accused of being an arrogant asshole with some kind of megalomanic complex by some sports writers and fellow cyclists, he was never that way within the cancer community.  He was unfailingly generous and kind with those who worked and volunteered for LIVESTRONG.    He has opened up his home to LIVESTRONG employees and volunteers, he gave a friend who needed a ride to a Team LIVESTRONG event a lift on his private jet, he has smiled and shaken hands and given support to countless cancer survivors who looked up to him.   He has given large amounts of his own money to help LIVESTRONG get going and has never taken any kind of salary from the organization. 

Within LIVESTRONG and among cancer survivors, Lance has been a hero.   There may have been some unhealthy “cult of Lance” behavior, too – where people tried to get into his inner circle or just be near him, or gave him undue worship.  

Recently we have found out that Lance was not a hero in the cycling community.  There is now enough evidence against him that it seems that in spite of his assertions of innocence, he was involved with doping over a long period of time.  While he was not the only one, he was certainly influential due to his success and fame.   If he had refused to dope, he probably would have ended up in the middle of the peloton and would never have won the Tour de France.  Someone else who doped would have and would now be stripped of their titles.   Would Lance’s refusal to dope have changed the environment of the tour and caused others to re-think their own doping, or would it have just relegated him to obscurity where he had no influence?  I guess we’ll never know. 

There is a huge part of me that is heartbroken, sad, and disappointed about all of this.  I no longer have a hero in Lance.  Is that good or bad?  I’m old enough to know that heroes don’t exist and aren’t really going to save us from anything – it’s up to us to be our own heroes and to save ourselves.  Still, it hurts.  I’m angry too – how did it go on for so long, and why now, after all these years, after Lance has retired from cycling and has been spending most of his time working for LIVESTRONG, have these allegations come home to roost?  I’m angry with Lance for lying to all of us and for putting me into this position.  I don’t want to spend my time and energy being an apologist for Lance, and I don’t think that’s my job.   Certainly he never asked for this – he’s a big boy and he needs to get himself out of the mess he got himself into and figure out what to do with the rest of his life.  

I do want to spend my time helping others with cancer. I want to give others the message that there is life after a cancer diagnosis, and that they can be healthy, active, and happy during and after cancer treatments.    I want to tell other women with breast cancer that they can be athletes; they can be sexual and attractive. In LIVESTRONG I have found a caring community of people who are passionate about helping cancer survivors.  There is so much heart and hard work within the organization that I am in awe.  I have found friendship and camaraderie among the people I’ve met through LIVESTRONG.  I remember at one of our leadership events I was standing around with four other survivors and we were having a contest to see who had the most gross and disgusting cancer treatments.  We were each telling our worst nightmare treatment stories, then laughing about them, and saying, “Oh yeah?  Well you should hear what happened to me …..”    It was so healing, so cathartic, and  I realized that there was probably not another place in the world I could have had that discussion with such total empathy and understanding. 

So, the crazy thing is that today I started thinking about Werner Erhard.   Werner Erhard is a familiar name to all of us baby-boomers, but for those who’ve never heard of him, he was a really popular figure in the so-called “self-help” movement of the 1970s and 1980s in this country.  He was a self-taught former salesman who created the transformational program known as “est”, or Erhard Seminars Training.   Thousands of people went through the est training.   The training was a blend of Dale Carnegie positive thinking, Silva mind control, and Zen Buddhist teachings.   Kind of like the precursor to ‘The Secret”.    I went through the est training in 1980, and I was really wrapped up in it for a while.  I felt that it had a lot to offer and had made a tremendous difference in my outlook on life.   The one part I was always uncomfortable with was that Werner Erhard was such a charismatic leader that he was almost regarded as a demi-god by people within the est organization.    They attributed almost supernatural powers to him (for example, I heard one story that Werner had caused himself to get a tan overnight by just thinking about it).    In 1991 Werner retired from the est organization amid allegations of tax fraud and sexual misconduct and disappeared to Russia for a while.   After he left, the est training found a second life as The Forum and then Landmark training, but it never again had the almost religious fervor and high profile media attention that it had while Werner was leading the organization.  The problem is that when your organization is defined by a charismatic leader and that leader falls, you have nothing to base it on any more and it quickly loses its power.   I did a little research on Werner recently, and found that he successfully refuted the allegations of tax fraud and sexual harassment, and now continues to do some much lower profile leadership training and management consulting in the United States.  However, he has never gone back to his former level of fame.

What does Werner Erhard have to do with Lance Armstrong?  Both have been charismatic leaders who have rocketed their organizations to fame.   Both started out in lowly circumstances and ended up hanging out with celebrities.  Both took big falls.  And both of them were heroes of mine. 

I remember when Werner Erhard got divorced from his second wife and I was having my own relationship problems.  I was really mad at him.  I thought, “If he can’t even stay married then why should I listen to any of his advice on relationships?”  I had been listening to his tape on Relationships in the cassette deck of my little orange hatchback car.  I realized then that I was on my own – there was no magic knowledge or 60-hour program that was going to get me through the thorny patches of life.  There was nothing that was going to keep me from dealing with those tough circumstances that define adulthood – rocky marriages, loss of people you love, death and disease. 

One thing I do know is that I have made many mistakes in my life and I still have a lot to learn.  I’ll probably go on making mistakes and acting stupid until the day I die.  There are things that I’ve done that I’m not proud of, things that, were they held up to public scrutiny would definitely disqualify me from being anyone’s hero.    I think most of us are in that boat; still, we search for people who are better than we are, who have found “the secret”, who somehow have transcended the ordinary lives of “quiet desperation” that Thoreau wrote about.    We put people on pedestals and then, when they fall off, we feel angry and betrayed. 

When I was helping my husband George through his grueling stem cell transplant to fight Hodgkin’s, people asked how we ever got through it.  The answer is, we got up every day and put one foot in front of the other and just thought about getting through that day.   And there was really no way around this.  As I told George, “the only way out is through”.    We learned to embrace what our friend Josh Schwiesow, another Hodgkin’s survivor, calls the principle of “One Fun Thing,” which means that you try to find one fun thing to do every day, even if it’s something as simple as enjoying a nice cup of tea with a friend or taking a walk around the block. 

There’s actually some good news about Lance’s fall from grace.  The people at LIVESTRONG now get to take ownership of the tremendous work that they’ve been doing.   It’s really not about Lance – it’s about George Florentine, and Rich Easton, and Steve Burns, and  Tara Williams and Mike Dunkle and Meg Halford and all the other local heroes who are doing what they can in the fight against cancer.  

In doing research on what happened to Werner Erhard, I found some clips of him talking on You Tube.  Actually, he said a lot of great stuff.  One thing he said was “What you resist persists”, and he told us that if you move from resisting something to first just letting it be and then finally taking responsibility for it, it puts you in a position of power so that things aren’t just “happening” to you.  My advice to Lance right now would be just to come clean and admit to everything he did and take responsibility for it.  That would be healing for all of us. 

Now, we in LIVESTRONG get to take responsibility to where the organization goes from here.  We, not Lance,  are LIVESTRONG.  We get to take ownership of this huge task and responsibility to help the 28 million cancer survivors in the world.  Will LIVESTRONG survive without Lance?  It’s up to us. 

Tuesday, August 7, 2012

maximum intensity workouts and why I love Strava

Howdy, all! I hope you are all doing well. I am feeling pretty good these days - riding my bike, living life, enjoying friends and family. Here's a little article I wrote for our bike team newsletter I thought you might also enjoy reading. Ride on!


Maximum Intensity Workouts and Why I Love Strava

After you've gone through a cancer journey, you lose many things and part of the recovery process is finding them again. Things that you might have lost along the way:
  • Faith in the universe
  • Faith that you will live a long and happy life
  • Faith in your body
Today I want to talk about the last item - faith in your body. Almost no one goes through a cancer journey without a few permanent "gifts". Some of these are mental, some are physical and some intertwine the two. If you've had breast cancer, maybe you've had surgery or radiation that has left scars, changed musculature, caused skin changes. In my case (lymphoma), you may have a changed blood chemistry that reduces your aerobic capacity or leaves you more vulnerable to infections or more susceptible to bleeding. If you've had lung cancer, you've probably ended up with reduced pulmonary capacity. Fill in your story here!

So, OK. You're through with your treatment, your body isn't the same, but it looks like you're no longer on the verge of dying anytime soon. Now what? I think that in our culture there's a general sense that you have to be careful, you have to take it easy. By God, you just had cancer and lots of treatments! You should just be enjoying life. Go for long walks, watch beautiful sunsets, hug a tree. But hey, guess what? That sounds pretty damn boring to me. But whoa! Aren't you afraid that your new, warped, bent, slightly broken body will collapse if you work out too hard? Remember when you thought you would be a healthy, happy, vibrant 100 year old? And remember when you weren't strong enough to mow the lawn, to climb a set of stairs, to sing a song, to even talk because your lung function was so bad. And now you want to - what? Climb 4,000 feet on your bike, up to 12,200 ft? At night? And come screaming down a road with no guardrails, no street lights, where a wrong turn causes - ahem - bad things to happen? After all the work you've done to get through chemo, you should just sit down and take it easy. 

For me, the answer is: YES! I do want to push my body as hard as it can go. NO! I do not want to sit around and watch sunsets and be afraid that the slightest physical exertion will cause some strange, unpredictable catastrophic failure in my now slightly beat up body. So earlier this summer, I did climb up Fall River Road on my mountain bike. At night. Under the full moon. To the top of Trail Ridge Rd - 12,200 ft. And then a screaming descent. 30 miles, 4,200 ft of climbing. And I was dead last every foot of the way. My companions were very supportive of me - making sure I didn't have a break down, riding up, riding back, waiting for me. And it was HARD. 3+ hours with my heart rate > 150 bpm, which for my age is pretty much rockin'. 

As I collapsed in the car after the ride, I wondered. How many adults, cancer survivors or not, actually do something like this. Challenge themselves to a maximum intensity workout? Push yourself so hard you break. Then you recover, push hard again. Break again. Your fingers are numb, your toes are tingling, you're getting woozy. Because you're at 11,000 ft, you're climbing a 10% grade and your hematocrit is 38? Not many, I wager. And what a loss for them. When you push yourself beyond what you think you can do, you give yourself a wonderful gift. And this gift is especially precious when it comes after your body has been so ravaged by a disease and the poisons and medieval torture we inflict as part of cancer treatments. 

So my advice for every cancer survivor I meet will be this. Do a maximum intensity workout. Don't worry about pushing too hard. You're much, much stronger than you think you are. And to get stronger still, guess what? You have to push hard. It's just that simple. No hard work, no improvement. A pretty good life lesson, by the way. So I'm going to watch the pretty sunsets. But only after I've hammered myself on a bike, a run, a swim - something.

And finally, why do I love Strava? Because it's got the suffer score. This is based on your heart rate during a workout as a function of your max heart rate. So when everyone is ahead of you and you think to yourself "Yeah, I'm only in the 11th percentile of all Strava users that have climbed this segment. But I sure as hell am in the 99th percentile when it comes to working hard!!" Well, now Strava gives you quantitative support for your argument. So get a Strava account, punish yourself on some rides and then compare your suffer score against all those slacker, healthy guys and gals that were just coasting up the road ahead of you!

Here's my Strava segment for the Fall River Ride in July of 2012. Beat my suffer score and send me your Strava workout! cya on the road!!!