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.