Monday, December 26, 2011

6 months-Looking at the numbers

My six-month anniversary for finishing chemotherapy has come and gone.  It is already hard for me to fathom that just six months ago I had days where my resting heart rate was 120 and when I would try to ride my mountain bike (for whatever reason) my spinal column felt like it was going to explode.  The day was marked by a routine (6-month) visit to my medical oncologist.  The appointment was pretty straightforward; reviewed how I am doing since finishing chemotherapy, discussed any side-effects I'm experiencing with Tamoxifen, and we all poked and prodded at that little nodule I found in November.  The consensus with this team is that it is probably a normal lymph node that can be felt because of my lack of adipose tissue in my breast.  I was then reminded to not poke and prod at it.

The Huntsman medical oncology team is great, but the most interesting part of the visit was getting the results from my labwork.

Since I like numbers, I made a chart comparing how my lab results fluctuated over the course of my treatment and recovery from treatment.


2/1/11
(prior to surgeries and chemo)
5/6/11
(3 weeks after 1st chemo treatment)
5/27/11
(3 weeks after 2nd chemo treatment)
6/17/11
(3 weeks after 3rd chemo treatment)
7/29/11
(6 weeks after chemo treatment)
12/16/11
(6 months after final chemo treatment)
WBC count
5.42
7.01
8.33
6.48
3.63
6.82
RBC count
4.64
3.81 L
4.05
4.03
4.21
4.47
Platelets
285
379
280
277
178
193
Hemoglobin
14.1
11.7 L
12.4
12.2
13.3
14.3
Hematocrit
41.3
33.9 L
35.8
36.0
39.2
41.6
Ferritin





34

Note: My labwork was much more comprehensive than this summary, but these are some of the values I was always most interested in.

Definitions: 
L-Low value
H-High value
Chemotherapy's affect on bone marrow:  Chemotherapy suppresses the bone marrow.   Bone marrow produces cells that become white blood cells, red blood cells, and platelets making people who are undergoing chemotherapy treatment more susceptible to infection, illness, and anemia.
WBC count:  Cells of the immune system that defend the body against infectious disease.  The Neulasta shot I received after each chemotherapy treatment helps the bone marrow produce more wbc. 
RBC count:  RBCs deliver oxygen to the body tissues.  The Neulasta shot has no effect on RBC production.
Platelets:  Platelets help the blood clot.  High levels of platelets may indicate anemia among other things.  
Hemoglobin: Protein in red blood cells that carry oxygen.  Lower than normal hemoglobin may indicate anemia among other things.
Hematocrit:  % of the volume of whole blood that is made up of red blood cells.  Lower than normal hematocrit may also indicate anemia among other things.
Ferritin: Protein found inside cells that stores iron so your body can use it later.  Low ferritin may indicate iron-deficiency anemia.  

Interesting to note:

My WBC count increased while undergoing chemotherapy.  This is because after each infusion I got a Neulasta shot that helped my bone marrow produce white blood cells.  Clearly this shot was effective in doing its job and I didn't have to become a complete germ-o-phobe during treatment.  

I was always interested in the value of my RBC count because the lower my RBC, the more fatigued I felt, and the less I was able to do.  If it dropped too low I would have needed a blood transfusion.  Fortunately it never came to that.

My lab results indicate that at a cellular level my body is back to pre-chemotherapy status!!!!!!!!, I am now most interested in my ferritin level. My plant-based diet is not especially high in iron and my ferritin levels are on the low end of normal.  Because of this, my oncologist recommended I take a small iron supplement.  

Now that my six-month anniversary is in the books I look forward to my seven-month anniversary being celebrated by my first MRI and Sonocine since finishing treatment.  That comes after my little trip to Hawaii with my favorite person in the world though!

Tuesday, December 13, 2011

Fabulous Las Vegas

After my little scare a few weeks ago, I quickly compartmentalized the experience and moved on.....

Last weekend Shannon and I traveled to Las Vegas.  For Shannon it was part work/part play.  For me, it was all play.  How did I chose to spend my time in Vegas?  Mountain biking of course!

The trip started in standard Shannon and Jen fashion.  We left Wednesday night after work and stopped in St. George, Utah for a quick night ride on Prospector.  We soon realized that we left the key for the Rocket Box (our rooftop storage) back in Salt Lake City.  No worries, all of our bike stuff was in the car so we proceeded with a fun spin on Prospector.  Once we were done with our ride we started scheming how to get the Rocket Box open.  I had a personal interest in this because it was all of my clothes that were up there.  To make a long story short, Plan A panned out; we made it to the Las Vegas REI just before closing and they were able to get us a key to open our box.  Phew.

We then drove over to the Wynn hotel right on the Las Vegas strip.  Not typical lodging for a mountain bike trip, but Shannon's conference was at the hotel, so it was convenient and free.  It was pretty comical hauling our bikes through the casino everyday.

 My bike hanging out in the room
Fancy hotel on the strip

Thursday, Shannon was in conference all day, so I was on my own.  Never one to have any difficulty entertaining myself,  I cruised down to Bootleg Canyon with both my bikes.  Yep, the BMX bike made the trip to Vegas as well.  An hour on the pump track at Bootleg was worth it!  Friday and Saturday Shannon was able to do some afternoon riding with me.  We rode Bootleg Canyon and Blue Diamond and while the riding was fantastic, I'm pretty sure our lack of trail knowledge resulted in us missing some epic singletrack.

Bootleg Canyon. We rode till dusk everyday.

Saturday night, disaster struck.  Shannon got sick.  Blah. Our delightful weekend came to an end, at least for Shannon.

Sunday's plan was to meet friends and ride in St. George.  Ride time 10:30 AM.  I woke up plenty early however we got on the road admittedly a few minutes late.  About an hour into our drive I looked at the clock in the car and it said 10:30.  Damn.  St. George is in a different time zone than Vegas.  Because all of our electronic devices automatically switch times, we overlooked this minor detail.  Oops.  We were now running more than a few minutes late and speeding up I-15 wasn't going to make up for this! Luckily, the planned ride had a few different trailheads so I met the group about an hour into the ride and didn't hold them up too much.  Lucky for me too as the riding and company were fantastic.  I rode hard and felt great which was especially pleasing since it was my 5th consecutive day on the bike.

A lot of girl power in this photo!

Never one to want me to miss a ride (or a good time for that matter), Shannon waited patiently in the car, feeling like dirt, while I rode for 3 hours.  He didn't complain once.  I guess I'm on cooking duty this week!

Friday, December 2, 2011

Giving Thanks

I realize that Thanksgiving was actually last week; hopefully the late post has allowed me extra time to reflect on what I am truly thankful for.

If you asked me last Thursday what I am thankful for, I probably would have said the typical (and I suppose some atypical) things like a husband who rocks-he really does by the way-I'm not just saying that, great friends and family whose small and large gestures of support will never be forgotten (you know who you are-thank you), new friends who I only met because of mutual unfortunate circumstances but whose incredible spirt and zest for life helped me realize how great life can be after treatment which allowed me to (on good days) enjoy life during treatment, a warm home, yummy food, a ton of bikes including a brand new to me used BMX bike, a mischievous and energetic puppy who has turned into a great hiking/running partner, a loyal and tolerant cat who reluctantly puts up with above mentioned pup, a head full of hair, increased energy and strength every single week, and of course being healthy.

Saturday night, my perspective changed pretty quickly when I found a small nodule in my left (non-mastectomy) breast.  I tried to stay calm, take a deep breath, and convince myself that it was nothing-stastically 80% of the time it is nothing-but when you have heard the words cancer before there is a new sense of urgency when you find something abnormal.  Admittedly, my mind was racing with every potential scenario.  I had already decided that I was going to get a mastectomy; obviously my breasts were doomed.  I rescheduled my training and race season.  Mastectomy in December, on the trainer two weeks later, mountain bike at four weeks, legitimately training at 6 weeks?  Oh god, would I need chemo?  I was also thinking, perhaps prematurely, what would I do with my work bag?  Certainly a sentinel node biopsy would be done and after this procedure one of the precautions (to reduce lymphedema) is to avoid compression on that extremity.  The type of compression that a heavy work bag slung over your shoulder provides.  I already follow these precautions on my right side....now my left too?

I knew I needed an ultrasound for peace of mind.

So Monday it was back to Huntsman for a mammogram, ultrasound, and exam.  The mammogram and ultrasound found nothing abnormal.  I was not surprised the mammorgram was negative, mammogram has never been a good diagnostic tool for me, but I was incredibly relieved that the ultrasound showed nothing as well.  Phew.  My surgical oncologist and NP were able to palpate the nodule, but only when I was in certain positions.  Specifically, laying on my right side with my left arm over my head.  Anyhow, their best guess is that it is a lymph node, fibrous breast tissue, or part of my pectoralis major muscle.  I was told by multiple medical professionals that because I don't have much adipose tissue, that any normal lump or nodule feels more pronounced.  The best news.  No mastectomy and no need to reschedule my race season.  I follow-up in two months. Another phew!!!  and a deep sigh of relief.

So....I am still thankful for my above typical (and atypical) list.  But I am also reminded in a pretty harsh way that I am mostly thankful, beyond words, that I continue to have no evidence of disease.

On a lighter note, I got my very first post-chemo haircut this week.  Like I said, I am thankful to have hair, even if it is short.


I'm also thankful for my brand new used BMX bike.  This thing is so cool.  It is just asking to be hammered.  Whenever I see it in the garage, I have to ride it up and down the street, and visualize pumping it over BMX jumps.  It is also the least expensive bike I have ever purchased.  It cost less than my first Univega mountain bike that I bought way back in 1994!


My first mountain bike-1994 Univega fully rigid

Brand new to me used Redline BMXer

PS-Huge shout out for the wonderful staff at Huntsman Cancer Institute and although I am very thankful for them, I hope I don't have anymore unplanned appointments with them!

Wednesday, November 23, 2011

Pedal hard, pump harder

What do closing the door, shutting you out, high/low line, low/high line, pumping, and manual all have in common?  BMX of course!

Last weekend was all about BMX.  I raced Rad Canyon Indoor BMX Friday, Saturday, and Sunday.  The folks over at Rad Canyon put on a stellar series.  I have heard that their outdoor series is the largest in the country!

Why the attraction to BMX?  I'm not sure.  A few years ago I thought about trying it, but my plate was full and it never really fit in my schedule.  So, since I'm currently not officially training - yet- it is perfect timing to try something different.  I also like that I can go race BMX and have no expectations and therefore no disappointments.  Just pure joy of being silly on my (er....a borrowed) BMX bike.  That is a good thing in my life right now.

I've only ridden a BMX bike four times-the same number of times I've raced- but I've quickly learned that there are other reasons to love BMX.  Here are my top 5 reasons:

  1. No chamois necessary.  That is because in BMX racing you are either standing up hammering or pumping jumps....for about 45 seconds at a time.  There may as well not even be a saddle because you don't sit on it.  Cross-country mountain bikers often joke that chamois time is training time.  I'm not sure how this equates in BMX.  I had NO chamois time last weekend, so I guess no training time?  In case you're wondering what people do wear.  The cool kids wear the equivalent of cross country racer's sponsor kits but in BMX style.  (Baggy, pull-over jersey with sponsor logos and long, baggy pants).  The super cool kids have their name, nickname, and ranking on their jersey.  Since I'm not cool nor super cool at BMX, I wear jeans and a sweatshirt.  
  2. The key to being fast at BMX (as I overheard a 5-year old girl tell her friend) is to pedal REALLY hard and pump REALLY hard.  Sounds simple enough, right?
  3. You don't have to be super fit (although I'm sure the top racers are), but if you are not fit, you better have skills and tactics.  I think if BMX racing were a time trial, I'd do great.  Well, it is not a time trial and I apparently don't have skills or tactics.  I get blocked a lot on the parts of the course where I can go fast and passed a lot on the jumps so that I can then be blocked again where pedaling is required.  
  4. BMX racing has a way of making you feel really young....or old....depending on how you look at it.  Practice is divided into 13 and under and 14 and over.  They don't card you or anything, but I'm pretty sure that I didn't get mistaken for belonging in the 13 and under group.  On the other hand, Sunday I got my ass handed to me by a 12-year-old.  (In my defense, she is supposedly really, really good:)  In BMX (cruiser-24" wheels) there are no categories for beginners, intermediates, or experts.  It is divided by age-group.  If there are not enough people to fill an age-group, they are combined.  Sunday, the youngest person in my race was 12. The oldest in her 40s.  It was awesome!
  5. It appears as though trophies are very important in BMX.  One of the FAQ on the RAD Canyon website is 'How big are the first place trophies?'  In case you are wondering, the answer is...."First place trophies for a regular race are 16-18".  Double points races are larger and triple points can be 36" or taller"!  
  6. Okay, I can't limit it to just five.  Finally, BMX is awesome because it is cheap!  The only requirements are that you wear long pants, long shirt, and a helmet.  Easy enough.  Pretty much any bike goes (in the cruiser group), although having a legitimate BMX cruiser bike appears advantageous.  A full-face helmet is not mandatory, but probably a good idea as well.  Races cost $10.
Me & the Park City dirt jumpers.  We were all BMX newbies.  
(Photo Aaron Kruger)

Old people do BMX.  Photo from old guy (&girl) clinic.  
(I'm bottom right, Shannon is back row ~4 from right)


As for how the racing went....since I had no expectations, AWESOME!  I am most proud of the fact that my starts are improving every singe race.  I went from 2-weeks ago being waaaay off the back at the starts, to last Sunday being 2nd (behind that dang 12-year old) until the first big jump where I proceeded to get passed by 3 girls and then shut out in the first corner where I can go fast.  So according to that 5-year old girl, since I can pedal hard, I just need to learn how to pump hard and I will be fast at BMX.  Simple enough!

Sunday, November 13, 2011

After cancer.......

It is now over four months since my last chemotherapy treatment (June 17th) and three months since my last surgery (August 15).  I am completely healed from surgery and done with cancer treatment. (although technically I still have 4 years 9 months to go before I take my last Tamoxifen pill).

In general I feel good; better than I thought I would feel at this point in my recovery.  There is a sense of normalcy back in my life as I have started preparing my body, with a bit more focus, to 'officially' start training for the 2012 race season in January.  My atrophied upper extremity muscles (due to surgery) are getting stronger every week.  I would estimate that at this point I have regained approximately 75% of my upper extremity strength.  Every day on the bike is a great day.

As much as I want to move on and look optimistically to the future, I have reminders each and every day of what I've been through and what still lies ahead.

There are physical reminders.  I now have five new scars to add to my collection of scars scattered over my body.  Obviously there is the mastectomy scar, there is also the sentinel node biopsy scar, breast biopsy scar, axillary biopsy scar, and two scars where the drains were post-mastectomy.  I have always been fond of the scars on my body, they tell the story of my life, but for some reason these scars are just....different.  I could do without these five new scars.

I am also adjusting to my new body (i.e. breasts).  I really, really liked my former body.  I liked the way it looked and the way it felt.  I will admit that it is possible I have put my former body on a bit of a pedestal and 'think' I liked it more than I really did.  Regardless, my body is different, and I am working on getting used to it. Fortunately each day my new body is feeling more and more like mine.  I spend a lot less time examining and scrutinizing it in the mirror.  My new breasts are feeling so much like my own that I no longer fear crashing my bike and damaging them.

Daily medication and side effects also make it difficult to put this year completely behind me.  Each morning I pop a Tamoxifen pill.  Tamoxifen is a very powerful anti-cancer medication for estrogen receptor positive breast cancer.  This little white pill reduces my risk of local recurrence (yes, cancer can recur in my mastectomy scar or axillary region) and distant recurrence  (metastasis to other organs/bones) as well as developing a new cancer in my other breast by about 50%.  Pretty significant in my eyes.   It is not without side effects, though.  The most frustrating being hot flashes.  Yes, between the chemo and the Tamoxifen, my hormones are completely out of whack; possibly permanently.  I often get hot flashes at night that wake me up in a hot sweat.  Then I get cold because I am sweaty.  This makes me cranky because not only is it a reminder that cancer treatment has put my 35 year-old body into essentially menopause, but I don't like being awoken in the middle of the night!  The 50% reduction makes it worth it though.

Then there is the fatigue.  I realize that I am fortunate that I have been able to exercise consistently through and after treatment, but there does seem to be some mild fatigue.  It is very subtle and sometimes I am not even sure if it is real, but I do know that after a long day at work my brain is tired and I need a short nap before I can even consider doing my workout.  I have a lot of second guessing in how hard to push myself and how long to recover from hard workouts.....and even when I should start racing seriously again......will it take my body a month to recover from a 100miler?  will I ever be able to recover fast enough to do a stage race again?  will I be competitive?

Finally, there are the doctor's appointments.  Granted, it is wonderful to not have weekly appointments, but routine oncology visits will never go away, ever.  That is because with (invasive) breast cancer you never know if you are cured.  That is, and I'll put it bluntly, until you die of something else.  It can come back in 6 months or 20 years.  Honestly, I don't know where these billboard statistics of 99% cure rate if caught early come from.  My guess, Stage 0 (non-invasive) cancer.  Anyhow, I digress....  Since risk of recurrence (both local and distant) IS greatest in the first 5 years, I am to see my medical oncologist and surgical oncologist every 6 months.  I also alternate mammogram, MRI, and sonocine every 6 months.  My plastic surgeon would also like to see me annually.  Each appointment and test will likely bring some fear in what may be found.  I believe this gives a whole new meaning to 'test anxiety'.

I've recently been looking at photos of me from last year this time.   Even though it was only one year ago, I see a sense of innocence in me in those photos.  I had cancer at that time, but I didn't know it.  To have so few worries, such freedom, I miss that.....

So I have a few more things to think about than I did before I was diagnosed with cancer last January.  Who knows, maybe someday I won't think about these things but in the meantime life is different.  I am different.

In 2008 racing TransRockies was the hardest thing I had ever done.  Many of the days were cold and wet.  I had been battling a foot injury all summer and developed a knee injury on day 2 (of 7) of the race.  When I returned, everything seemed easier.  I thought, if I can finish this race, I can do anything.  In comparison to what I have done this year, TransRockies was cake.  Who knows what I can do now.

Saturday, November 5, 2011

RAD

Overall, this week was just rad.

It started with my birthday Monday.  Yep, I'm a Halloween baby.  It was a beautiful fall day and I spent most of it in the mountains.  A great start to my 36th year....

Tuesday I found out that I was selected by Cycling Utah as Female Rider of the Year.  To put this in perspective, the Utah Rider of the Year title has been awarded to Tour de France stage winners in the past.  I am completely speechless about this honor.  Okay, I will say this...  The love and support I have received from the Utah cycling community has helped me beyond words get through this difficult year.  Thank you.  I hope that I can live up to this honor.  I plan to work hard, doing what I love, and return to racing as strong as ever.  Maybe reading my story will help newly diagnosed women to be a little less scared about cancer treatment.  This higher purpose is definitely aiding in fueling my fire now.

Thursday and Friday I started working on my 2012 race schedule.  Somehow, it keeps getting more and more ambitious.  It is certainly not solidified yet, and some of it will depend on how my body responds and recovers from actual training and racing, but so far, in my opinion, it is a perfect mix of my favorite classics and new and exciting events.  I am really, really, REALLY excited.

Today, to conclude an already incredible week, Shannon and I raced BMX at RAD Canyon.  This was my first time on a BMX bike,  I had a loaner, and it did not disappoint.  We participated in a clinic in the morning where I (along with about thirty 10 year olds:) learned some basic BMX techniques such as taking the high/low line and how to survive the starting gate.  I never did master the track-stand (something to work on) in the starting gate and my starts paid dearly, however I had a great time drilling it for the 45 second effort.  I also need to work on my post-race high five and fist bump coordination with my fellow competitors.  I quickly learned that BMX racing is different from mountain bike racing as blocking and cutting racers off is acceptable and even encouraged.  We had so much fun; I will definitely go back.  First I need to sharpen my elbows though:)

Sunday, October 23, 2011

Weekend update

Yesterday I raced my cross bike-singlespeed.  It was the annual Cross out Cancer race/fundraiser and I wanted to support the event.  I usually (as in pre-cancer) race with the A women, but I decided to race singlespeed for two reasons:

1.  I didn't want to take the race too seriously and I knew that if I raced A I it would be impossible for me not to.
2.  The A women are fast.  They scare me right now:)

I definitely succeeded in not taking the race too seriously.  I missed the start.  I have never done that before and it is kind of embarrassing. I take full responsibility, but here is how it went down.  Three categories were to go off with 1-minute staggered starts.  The order was posted to be Men B at 11:15, Singlespeed Men at 11:16, and Singlespeed women at 11:17.  I figured there was a possibility that the Singlespeed men and women would go off together because the women's category is so small, so I was socializing not far from the start line at the Revolution tent, keeping an eye on the start, and waiting for the Men B to take off before I rode over.  Next thing I know the Singlespeeders were off and the other lone woman was with them.  Duh!  Apparently Bob (my friend) talked the official into starting the singlespeeders before the Men B category to help with course congestion.   Thanks Bob:) I rode over to the start and it took a minute before I figured out exactly what happened....and then I was off, with 50 Men Bs not far behind.  I felt kind of stupid riding alone, but was giggling to myself, and enjoying the new excitement I created for the race.  It wasn't long before I realized I had made stupid mistake #2 when I hit the first rough singletrack section.  Since I hadn't done a hot lap on the course, I didn't realize that I had way too little air in my rear tire.  I was bottoming out on everything and was relieved that I made it safely to the Revolution tent for some air at the end of the lap.  (Thanks Theresa for holding my bike while I put more air in my rear tire).  The rest of the race went much better and I was able to catch the other woman and take the win.  More importantly, I felt really good and had a blast.  


 (Those are dollar bills in my shorts.  Thank you random spectators for the hand-ups:)  I will be donating them to Cross Out Cancer.  Wouldn't it be cool if everyone, for the rest of the series, donated their cash hand-ups to Cross out Cancer?



(Photo credit: Cycling Utah)

Today, I definitely paid for yesterday's gear mashing effort.  My whole body is tired, but that didn't stop me from riding the Crest trail with friends for what may be the last big mountain ride before the snow flies.  I brought Flat Stanley along for the ride.  I'm not sure exactly what Flat Stanley is, but my niece asked me to take him cool places and take photos.  Today he posed for pictures at the top of Puke Hill.  

I hope Stan had fun.  I know I did!

Wednesday, October 19, 2011

Utah Cyclocross-Cross Out Cancer

This weekend is the 2nd annual Utah Cyclocross-Cross Out Cancer event.  The Utah Cyclocross series (UTCX) is a 12 race series that is hugely popular in Northern Utah.  Last year, the promoters decided to dedicate one of the races as a fundraiser for Livestrong Foundation.  It was incredibly successful and they have committed to the Cross Out Cancer event again this year in hopes to raise money for Huntsman Cancer Foundation in addition to Livestrong.


The day is packed full of fun with something for everyone.  There is a 5k trail run in the morning and a fun ride later in the day.  Between these two charity events will be cyclocross racing.  In cyclocross racing, racers ride basically a road bike with a little beefier tire.  They race around a relatively short circuit and have to get off their bike and run over barriers. 




It is incredibly spectator friendly and rowdy spectators and heckling of the racers is actually encouraged!  The beefier tire is necessary because racing is mostly on dirt in the Fall when it is typically cold, rainy, or snowy.  




This weekend is looking to be beautiful though.  There will also be a silent auction all day long where you can bid on fantastic schwag.  Proceeds go to Huntsman Cancer Foundation and Livestrong Foundation.  


Here is basic information for the event:
Where: Wheeler Farm
When:  October 18, 2011
Schedule:
7:15  Registration opens
8:00  Start of 5k trail run
9:00  Silent Auction Opens for Bids
9:10 Course open for pre-ride
9:30 Racing begins (I'm going off at 11:15)
1:25 Fun ride
3:00 Silent Auction Bidding Closes


If you cant make the event, you can still participate by donating!  I have set up a page for donations.  Of course, every small amount is truly appreciated.  I recently saw a statistic where it was projected that a total of 1,596,670 new cancer cases and 571,950 deaths from cancer will occur in the United States in 2011 alone! (CA: A Cancer Journal for Clinicians Volume 61, Issue 4, pages 212–236, July/August 2011)  Clearly cancer affects many and continued research is imperative.


If you would like to donate, click here.  Donations can be made through the middle of December.  100% of the donations will go directly to research.  

Saturday, October 15, 2011

There is pink everywhere

It is hard to go anywhere this month without noticing the pink.  I don't know when pink started to symbolize breast cancer or when breast cancer started having its very own month, but I notice now.  Although pink is not my absolute favorite color, never has been, I truly appreciate the recognition the color brings to a disease that affects 1 in 8 women.

Early detection directly correlates with survival, so in honor of breast cancer awareness month, I ask that everyone do a self breast exam.

Although self breast exams are controversial because research does not show an increase in survival by women who routinely do breast self-exams, I stand here to say, the cancer I had would have been discovered at a much later stage had I not done a self breast exam.  Staging does affect survival, and although I realize there are no guarantees, I feel very fortunate that I found this lump at a fairly early stage and followed up on it. Otherwise, it likely would not have been discovered until I started doing routine mammograms at age 40.  Even then, it may not have shown up on mammogram.  

As I've mentioned before, mammograms are not always effective for young women.  Young women tend to have dense breast tissue that shows up as white on a mammogram.  Cancer also shows up as white.  My entire mammogram was white because of my dense breast tissue so any cancer that was there could not be seen.  The density of my breast tissue may or may not have changed in the next 5 years and this is one of the reasons that mammograms are not recommended routinely until age 40 (or 50 depending on the source).  Regardless, in 5-years time my cancer would have most likely been more progressed.

Okay, I digressed, but hopefully emphasized my point, just do a self breast exam........

and on a lighter note, my hair is growing in really thick.  I have always had incredibly think hair; too thick in my opinion, and it looks like post-chemo that has not changed.  So far it is a bit darker than it was before, but perhaps that is because it hasn't had a chance to get bleached by the sun.  I'm not one to take lots of photos of myself, but when they include Dizzy I'm game.  We took these this morning.

Dizzy on the deck looking for treats in my hand
Dizzy in the backyard looking for treats in my hand
Dizzy being cute hoping to get more treats
Dizzy showing that he is done taking photos
As you can see in the photos, it is a beautiful October day in Utah.  We're off to ride mountain bikes.  I hope everyone is enjoying the great weekend.  After a self breast exam.

Tuesday, October 11, 2011

A really cool thing.......

Last week I had the opportunity to participate in a really, really cool thing.

The Utah State Championship Series (USCS) is a new 4-race mountain bike series in Utah.  The promoters, whom I know well, are all really great guys and decided long before the first race of the series that they wanted to give back to the community. So it was decided that $5 from each entry fee along with money made from an opportunity raffle and Silver Bean coffee sales would be donated to Huntsman Cancer Foundation.  Coincidentally my husband is one of the aforementioned 'great guys' and even more coincidentally it was decided that the money be donated to Huntsman Cancer Foundation before I was diagnosed with breast cancer.

So, for the first time ever, I stepped into Huntsman Cancer Institute not as a patient, but as part of a really great group of people donating $5000 to cancer research.  There was a giant check and everything.

(Note:  I have more hair than 33% of the people in this photo:)

Even cooler was how genuinely excited the Huntsman Cancer Foundation event planners were about the $5000 donation.  $5000 is a lot of money, but compared to the millions that Huntsman donates, it is pocket change.  Regardless, the sincere appreciation made it seem like a million was donated.   We were also reassured that 100% of the $5000 would be used for cancer research.

I hope that the USCS continues to grow and is able to increase the donation next year.  This year a brick on the 'path of hope' will mark the USCS donation.  Maybe in a few years it will be a hospital wing.  Better yet, bikes for the fitness center.

Monday, October 3, 2011

6 Hours of Frog Hollow

6 Hours of Frog Hollow was my first 'official' mountain bike race since being diagnosed with breast cancer in January.  Although to many it may be just another race, to me it was much more.  This race marked the end of my breast cancer treatment and the beginning of many epic things to come.

The weekend was full of anticipation, excitement, an epic course, great friends, a silly puppy, joy, giddiness, and much more.......

In summary of the weekend:

My friend Jo and I won the Women's Duo category.  It was awesome, but more importantly we both exceeded our personal lap time goals.  I exceeded my personal lap time goal by 5 minutes, which consequently was the fastest female lap of the day.

I completed 3 laps on the 13 mile course.  My lap times were 1:00:05 (including LeMans start), 1:00:34, and 1:02:49.

Shannon and my good friend Bob were the fastest team of the day.

Black beans, brown rice, and yams mixed with leafy greens make a good vegan pre-race meal.  Even when camping.

I still have not figured out an easy vegan appropriate recovery drink.

Dizzy is going to be a great race puppy.  He hung out at the tent all day and was as excited about rolling in the dirt as I was about racing my bike.

Cancer has changed me.  It has taken things away from me.  It has not taken away my ability to race my bike!

2012.  Game on!

Me and Jo posing after awards

Thursday, September 29, 2011

Up Next

Back in, I don't know, May or June, I thought it would be a good idea to race 6 Hours of Frog Hollow.  The Frog Hollow races utilize the epic trails in Hurricane, Utah including the IMBA award winning Gem Trail.  This race course rates very highly on my all-time favorite list.  The trail traverses the Virgin River Gorge making the scenery tough to beat as well.  Since I didn't want to race 6 hours by myself, I asked my friend Jo if she wanted to race it duo with me and she said yes.  Now, my first bike race in 10 months is only a few days out.

Am I nervous?  Maybe a little, but mostly I'm psyched to travel down to Southern Utah, rip the whoop-de-doos on the Gem trail, and hang out with friends for the weekend.

Being a somewhat competitive person, in order to have fun, I'm going to have to go into this race accepting of where I am at, both physically and mentally.  I'm not in bad shape by any means, but I am only 6.5 weeks out from my last surgery and I have done exactly 5 legitimately hard efforts since March.  That said, I will not put any limit on what I believe I can accomplish on the bike in the future.  Next weekend, next year, and beyond........

Even though this weekend will mark my technical 'return' to racing, I am not planning on racing anymore this fall.  Instead, I will continue to allow my body to heal from this year while I work on building back some of the muscle and strength that I lost.  Stay tuned for exciting things to come......

and since I don't have any new photos, I will post some photos from the last time I raced in Frog Hollow.

 Racing down Gem trail in 2010

 Sun rising over the plateaus  
Beautiful sunset in Southern Utah

Monday, September 26, 2011

A beautiful day....

September 17th was a memorial service for my Dad.  It was a beautiful weekend on so many levels and the service was exactly what I wanted/needed.  It started with a dinner Friday night with my siblings, niece/nephews, and my parents closest friends from Chicago.  The actual service was Saturday.  Family and friends shared experiences/memories of Dad and the service culminated with a 30-minute slide show, that my talented sister put together, of over 400 special moments with Dad.  The day was full of laughter and tears; truly a celebration of life.  I spent the rest of the weekend with family.  My niece and nephews were constant entertainment especially when Dizzy joined in on the fun.  I wish my Dad were there......

Family photo

Since then, I have occupied my mind by keeping extremely busy.  I must admit, it has worked quite well.
Now that my post-surgical precautions are basically non-existent, I have started to slowly introduce some weight training to build back some of the muscle I lost.  I have also been riding my bike.......a lot........In fact, last weekend I clocked over 6.5 hours of ride time in 2 days and probably double that in shammy time.  Like I always say, riding is my best therapy, and I have been getting lots of therapy recently!  

Friday, September 16, 2011

Dad

I have had a bit of writer's block lately.  So much has happened over the past few weeks, but I feel like I have done so little.....

On Wednesday August 31, 2011 my Dad passed away.  I miss him.

Growing up, I remember my Dad was always 'young' for his age.  He was an adventurous soul who loved to hike, ride horses, play ice hockey, ski, joke, fish, golf, and throw back a few beers and have a good time.  Some of the crazier things he did were sky dive and go to bull riding camp.  Yes, you read that correctly.  My city slicker dad, who wore a suit to work everyday, went to camp to learn to ride bulls!




A few years ago, we noticed some cognitive changes.  They were subtle at first, but continued to progress.  Suddenly, my 'young' Dad became very old.  After a few incorrect diagnoses, my Dad was finally diagnosed with Frontotemporal Dementia.  Frontotemporal Dementia is defined as "disease process that results in progressive damage to the anterior temporal and/or frontal lobes of the brain. The hallmark of FTD is a gradual, progressive decline in behavior and/or language that often has a relatively young age at onset (mid-50s to 60s), but has been seen as early as 21 and as late as 80 years. As the disease progresses, it becomes increasingly difficult for people to plan or organize activities, behave appropriately in social or work settings, interact with others, and care for oneself, resulting in increasing dependency".


Even while my Dad's cognitive ability rapidly declined, he still enjoyed physical activity with me and for this reason, we became very close.  One summer, I went up to Park City (where my parents live) and did all of my recovery bike rides with Dad.  The next, when he was no longer able to safely ride a bike, we walked together.

As my Dad continued to decline, one thing remained constant, his clear and unwavering love for me.  I have no doubt that my Dad knew exactly who I was up until the very end.  It made my two hour round-trip commute to visit him incredibly rewarding.

Over the past few years I witnessed my father's cognitive and then physical decline and it is ingrained in my head.  I am trying to remember my 'young' dad; the one who was a giant goofball, loved horses, played ice hockey in his 50s, and climbed Mount Elbert in his 60s.



I wavered back and forth if I should include this post in my 'athlete with breast cancer blog', but the truth is, life doesn't stop when you have breast cancer and athletes do have 'life' besides training, eating healthy, recovering, and competing.

I love you Dad.

A link to my Dad's obituary

Saturday, August 27, 2011

Final reconstruction and hair update

I'm just under two weeks out from my final reconstruction surgery.  I have admittedly been going a bit stir crazy.  The funny thing about this surgery is that I felt pretty good pretty quick, but I know that my body isn't healed and I certainly don't want my impatience to cause a complication or poor cosmetic outcome!  I've been sticking to activities that don't use my arms and don't get my heart rate up.  Thus, my primary exercise has been walking around the neighborhood and riding the recumbent bike at the gym.  Walking is fine, but it has been insanely hot in the valley this week and I can only handle about 45 minutes on the recumbent bike before I'm bored.  I have certainly been short on my daily quota of exercise to keep me smiling.

Yesterday, I visited my plastic surgeon for my first follow-up appointment.  Everything is healing really well, but yes, I still need to wear the bra-thing for another week!  Fortunately (one of my co-workers) suggested that I wear a tank top under the bra-thing and while it is still annoying, it is way more tolerable.  I have also purchased a high impact sports bra to wear when exercising.  My plastic surgeon (kind of) says it is okay to wear.   My PS also (kind of) told me I could do activities as tolerated. Actually, I think he said don't do anything that hurts, and I interpreted it as do anything that doesn't hurt.

So, today I finally got some nice, cool mountain therapy.   Dizzy joined in on the fun.  Notice the smile on both of our faces.

Despite the big smile, I am truly disappointed by how little hair it looks like I have in this photo.  When I look in the mirror, I see a head full of hair and I do not think I am delusional.  I think the sun was hitting my head just right.......Anyhow, I'm really digging the buzz cut look.  Perhaps it is because I haven't had hair for so long or maybe it is because it is incredibly easy or possibly because all of my kids at work say "Cool hair cut"!

While hiking, we witnessed a pretty large rock slide on an adjacent peak.  It was so loud that it sounded like it was on top of us, but fortunately we were safe.  At first I thought it was a tree falling over, but then we saw the rocks moving and smoke in the air.



My tentative plan, because I always need a plan, is to get on the road bike Monday and then the mountain bike a little over a week from then.  I think I will bring out the full-suspension...............


Tuesday, August 23, 2011

Tips for staying fit and healthy while undergoing chemotherapy

Chemotherapy was not easy.  In full disclosure, I had some really bad days.  I still do.  But I had many more good days.  My primary goal while undergoing chemo was to live life to its fullest.  My goal as a competitive athlete (who hopes to compete again),  was to maintain fitness and to stay healthy.  For me, the two goals were completely intertwined.  Now that I am over two months out from my final infusion, I can say with some certainty.....GOAL(s) MET!

Although I am certainly not an expert, and realize all women experience chemotherapy differently, I feel like I now have enough perspective on my experience to share my personal strategies for meeting my goal of staying fit and healthy while undergoing chemotherapy.

1.  Keep moving.  There is quite a bit of research that supports the importance of exercise during chemotherapy, however I don't think it is emphasized enough.  In my experience, exercise is the single most important way to feel better during chemotherapy.  Somedays it may be a short walk and/or stretching.  Others it may be a 2-hour mountain bike ride.  Doing something always felt better than doing nothing.

2.  Keep a log of how you feel each day over your first infusion cycle.  For example, Day 1 post infusion I had minimal fatigue.  This was a good day to take advantage of a nice mountain bike ride.  Days 2 & 3, I felt like dirt.  I would plan to take the dog for a walk to get outside and then stretch. That's it.  Day 4 through Day 7, I started to feel better physically each day, however I still only tolerated bland food.   Each proceeding day I would feel a bit better until my next infusion.  I would plan exercise and meals accordingly.

3.  Have simple goals and try not to compare yourself to pre-chemo performance.  I put away my heart rate monitor and bike computer.  My exercise goals became very simple.  To maintain conversation pace and to keep my rides under 2 hours.  In my opinion, a heart rate monitor is useless for monitoring zones during chemotherapy anyhow.  My zones most likely changed daily.  As for keeping my rides under two hours, I noticed that if I rode for more than two hours, I would feel fatigued instead of invigorated.

4.  Try not to set yourself up to feel bad about yourself.  No matter how much fitness you are able to maintain during chemotherapy, you simply are not going to feel as strong as you did before.  I tried to ride with people who were not out to do hard training rides, but content riding at conversation pace.  Pushing myself hard to keep up was not a goal of mine during this time, while being dropped hard was bad for my fragile self-esteem.  My husband was especially generous in that he would always let me stay a wheel length ahead.  No matter how slow I was going, this little trick helped me think I was strong.

5.  Eat healthy.  During chemotherapy I started experimenting with a mostly vegan diet.  A vegan diet is not for everyone, but eating healthy meals really does help improve energy and you need energy to exercise.  Eating healthy also helps prevent weight gain.  It is well documented that most women gain weight while undergoing treatment for breast cancer.  Through exercise and a healthy diet, I was able to maintain my weight throughout chemotherapy.

6.  Eat something.  I found that the first week post-infusion I only tolerated bland food such as toast or pasta marinara.  My options were to eat a less 'healthy' bland diet this week or not eat.  For me, eating was always better.

7.  Do what you love.  Obviously I love riding my bike, but I feel most alive and free when riding awesome singletrack.  Anticipating a fun ride made it really easy for me to get out and exercise even on bad days.  In fact, riding singletrack provides such an endorphin rush to me, that I would often forget, for just a moment, that I was undergoing chemotherapy.

8.  Take care of your body.  I did acupuncture throughout treatment and had some incredible cranio-sacral sessions at the Cancer Wellness House.   I really think these sessions helped me stay strong and healthy allowing me to exercise and maintain fitness.

Well....that's it.  Those are my main tips for staying fit, healthy, and for me, happy, while undergoing chemo.

Now, if I could only figure out how to stay happy (and not cranky) while following post-surgical precautions........

Thursday, August 18, 2011

Post-Final Reconstruction surgery

Last Monday I went under the knife for what will hopefully be my final surgery related to breast cancer.  The lead-up to surgery wasn't exactly full of epic last rides; other more important, and not exactly happy things came up.  That said, I did have the opportunity to test my fitness prior to surgery.  I jumped into a few Tuesday night races and I'm happy to report that I can still keep up with the fast girls! (at least for short distances)

As for recovery from surgery, so far, it seems to be going well.  My favorite anesthesiologist gave me what she calls the cadillac treatment and as usual I woke up quickly and was ready to get home.  The total procedure only took about 2 hours, but of course, with surgical delays we were at the hospital eight hours.  Once home, I was recovered enough to have a full dinner.

The worst part about the surgery (so far) is that I woke up in this compression bra:


Besides being ugly, it is horribly uncomfortable.  I am supposed to wear it 24 hours a day, for 3 weeks, except when showering.  I've been taking very long showers.........This is the most miserable $90 bra I have ever had, and now I have two!

Pain has been quite manageable.  I took Lortab day 1, Tylenol day 2, and nothing today.  So far, the incisions look good, but I have strict precautions for at least two weeks.  Basically, I am not supposed to do anything that stretches or puts tension on the incisions.

My hopes are to get on the trainer at one week post-op, road bike at two weeks, and mountain bike at three weeks.......It's going to be a long few weeks, but then again I have already managed to somehow keep my sanity with eight months of treatment....

Once I am completely healed and back to normal activities I will be able to officially celebrate being done.