Jen Hanks' Story: An athlete fights breast cancer

What a difference a year makes

2012-03-05T21:29:00.004-08:00

It is an annual tradition for Shannon and I to travel to Southern Utah the first weekend in March for the first mountain bike race of the season.

Last year, it was one of only three races where Shannon was able to race. I was able to ride my bike, but racing was out of the question. I had just had a second lumpectomy one week prior and the margins were still not satisfactory. I was in the process of making the decision to try for another lumpectomy and follow that up with radiation or to go ahead with a mastectomy. I had also just found out that chemotherapy was certain which made my future as a mountain bike racer very uncertain. Despite everything that was going on, our 2011 annual trip to St. George, was a great weekend of friends, riding, and warm weather.

What a difference a year makes! This past weekend, Shannon and I once again made our annual trip to Southern Utah for the first mountain bike race of the season. This time, I was planning on racing with the pro women for the first time since 2010. I had every reason to go into this race with confidence. I have been training hard, riding well, and things have generally just been going good. Despite all the positives, I had a lot of self-doubt the week leading up to the race. Was I racing in the right category? If I couldn't keep up this weekend, would I ever be able to race with the pro women again? Would I be full of doubt and afraid to push myself hard? Would my body shut down midway through the race? Is racing and pushing my body so hard good for my health? and so on......

As soon as the race started, I no longer had questions. In fact, I no longer had thoughts. I didn't feel like 'that girl who had cancer', I became a 'girl racing my bike'~as hard as I could. By the end of the race, my questions were answered. Yes! I was racing in the right category and I can keep up with the incredibly fast local pros. As the race progressed, I became less and less afraid to push myself hard and no, my body did not shut down midway through the race. Most importantly, I am confident that racing is good for my health. It simply has to be. If I couldn't race, I wouldn't be happy, and that is not good for my health.

I ended up finishing 3rd in a very talented field of pro women and was happily surprised that I put down my fastest time on the course ever. Like I said, what a difference a year makes! This year, it was a great weekend of friends, racing, and warm weather.

We're lucky to have such beautiful weather and awesome trails to ride in the winter

Podium shot: Erika Powers, me, Kathy Sherwin, KC Holley, Kelsey Bingham

Results and more photos can be found here

6 months, 1 year, 3 weeks

2012-02-07T18:26:00.000-08:00

This post begins with a giant hell yeah! All of my 6-month tests came back negative! So my status remains the same. No evidence of disease.

I wish I could say that I remained cool, calm, and collected during these past few weeks of tests, but that would be a big fat lie.

It started off with an MRI two weeks ago. I was pretty anxious about this procedure because I remember it from last year as being a totally claustrophobic experience, face down, in an uncomfortable contraption for 45 minutes. This time, they slid me into the MRI machine feet first, I listened to chill music, and that made all the difference. It was a totally peaceful experience until I was done and told that the results would be read shortly. Suddenly, I was a basket case and needed to know the results stat! A few hours of complete inability to focus later I had the report read to me word for word and I was relieved for the no evidence of anything suspicious results. I did take this with a grain of salt, though, as my initial MRI from last year, when I had a known cancer, was a false negative.

Next up was the Sonocine, or automated whole breast ultrasound. This is the only diagnostic imaging tool that clearly detected my known cancer last year. Nope, the routinely used Mammogram and ultra-expensive MRI were not very useful. Of course it has to be the test that insurance does not (yet) pay for. I traveled up to McKay Dee Hospital, the only facility that has a Sonocine, and gladly paid out of pocket for the test. The procedure was short and sweet and I was told that my radiologist would read the results later in the week and if anything suspicious was found I would get a call back. I really didn't think about the test for the rest of the week or weekend, which is pretty atypical for me. Perhaps it was because I was more focused on a big training and busy work week? Perhaps it was the totally blissful weekend of endless riding in St. George? (more on that later) Regardless, when I hadn't heard anything by the following Tuesday, I called over to McKay Dee to get the results. When they wouldn't give me the results, I started to have a mild freak out. The last time someone balked at giving me results over the phone was my pathology results at initial diagnosis. Did this mean something was found? Anyhow, I was told that my results were faxed to Huntsman and to contact my referring physician. After not much luck, I finally resorted to emailing a super duper awesome NP at Huntsman who I swear lives with her iPhone on. She pretty much immediately found the report and called me back with the good news. I think I said AWESOME like ten times to her!

So, not exactly cool, calm, and collected. Oh well.

Two other significant events happened over the past few weeks. First, I celebrated my one-year anniversary from diagnosis. Some people call this their cancerversary. Since it is only my first one, I silently acknowledged the day and went about my business.

Shannon and I also traveled down to St. George for Camp Lynda, an annual weekend of mountain biking in southern Utah. I spent the weekend under bluebird skies, in what felt like 70 degree temperatures, ripping trail and talking healthy food with an amazing group of women (and some men too) including the camp host herself! It was the end of an amazing week of training that was definitely my biggest block of riding in over a year. The best news. I feel good!

Lunch break.

Favorite lunch snacks from Camp Lynda include a red potato (or yam) stuffed with pumpkin and hemp seeds as well as oatmeal and fruit mashed in a baggie. I'm really trying to eat whole foods on my bike rides. I ride enough that the majority of my diet could come just from energy foods consumed while riding. Not exactly nutritionally dense.

An amazing and super fun group of women

Even took time to practice some techy sections.

The extra push and spotting on the big rocks was a great bonus!

Looking forward, it is hard to believe that my first race is only three weeks away. I have (what I think is) a pretty incredible race schedule put together. It keeps getting more and more ambitious. My mantra for 2012 is:

1-No excuses. How can I reach my full potential if I make excuses for myself.

2-Be forgiving and kind to myself. Like most athletes, I tend to be hard on myself when I have a bad day. It is okay to have a bad day, but no need to make excuses for it!

3-Have fun! Every single day. But if I do the above two things, fun will just happen.

Hawaii

2012-01-22T17:11:00.000-08:00

The light at the end of our cancer treatment tunnel, and I say 'our' because both Shannon and I needed a light, was a trip to Hawaii. Out of all the islands, we chose Kauai. It came highly recommended by friends and there is no shortage of adventure or beach to be had. So last week, we packed the bags, left the dry winter air, and headed South.

We pretty much jam packed every single day with a new adventure, but we allowed for some chillin' too. The best part though, was the complete lack of responsibility. We were just two kids having a good time.

Here are some of my favorite photos with brief descriptions:

Day 1: We woke up early and snorkled in Poipou (South shoreline). The reef and fish were fantastic, but we were not prepared with a water camera. It was a bit chilly for me to be snorkeling as I'm a water wimp unless it is above my very arbitrary temperature of 87 degrees. We then rented Specialized Rockhopper's (circa 2001) and rode along the eastern coastline stopping at numerous beaches along the way.

One of the beaches we stopped at along the Eastern coastline

We spotted an endangered Monk Seal. There are less than 1000 of these guys left.

Beautiful Eastern coastline.

We could see Humpback whales splashing and blowing bubbles in the distance pretty much everywhere

Since there was still daylight left, and we had bikes, we mountain biked Sleeping Giant, a popular and scenic hiking trail. It just so happened that it was great for mountain biking as well.

Day 2 was probably the most epic. We rode our rented bikes up Waimea Canyon along the Western coast. The scenery was breathtaking, on one side of the canyon it resembled the Grand Canyon. On the other, a beautiful valley 5000 feet below leading to the ocean. The ride was pretty epic too.

The little Grand Canyon

A little more than halfway up the canyon. Snacking on fresh pineapple.

Over 5100 feet above sea level

Day 3: We hiked the Na Pali coast (Kalalau Trail) to Hanakapi'ai Falls. This is one of the most beautiful hikes I have ever done. Okay it IS the most beautiful hike I have ever done. It is also a pretty rugged hike and is listed as one of the 10 most dangerous hikes in the world.

The lush Na Pali coast

We were rewarded with a beautiful waterfall. I enjoyed it from a rock.

Shannon jumped in. And froze.

Day 4/5: I found my perfect water activity for when it is below my arbitrary 87 degrees to get in the ocean...stand-up paddle boarding. You don't get cold unless you fall. There is also something meditative about floating down the river, yet you are still totally engaged because it is a physical activity. You can also make it as easy or hard as you like. I was kind of a lazy paddle boarder and would always fall behind Shannon until he suggested we race. Game on. I kicked his ass. Mostly because he was laughing so hard at my flailing technique.

Sunset was spent at Hideaway Beach

There's a reason many of the beaches are secluded

Day 5: In addition to paddling, we went for a hike on the Okelehau Trail.

Another beautiful lookout

We were high enough to overlook the tops of the trees and see Princeville in the distance

This hike had some pretty rugged spots. Ropes were needed.

Day 6: We were scheduled to go sea kayaking, snorkeling, and whale watching, but when we awoke to torrential rain, wind, and a power outage I figured I'd call to ensure the trip wasn't cancelled. Sure enough, the trip was cancelled. This was a bit of a bummer because the trip is only available twice a week and this was our last chance. The day was salvaged, though, with clearing skies, the discovery of another secluded beach, and a running race between me and Shannon on Hanalei Bay beach. Although I'm sure it was comical, two cyclists trying to run fast, it should be noted that I once again kicked Shannon's ass and this time he wasn't laughing!

Kiluea lighthouse~a great place for whale watching

A beach to ourselves

We could not figure out how these rocks were balancing

Hanalei Bay sunset-where the barefoot running race went down

Final day: On our final day we woke up, packed up the rental car, and drove down to Lydgate Beach for some morning snorkeling. It was low to mid 80s so I broke my 87 degree rule. There were some pretty cool fish, but the water was a bit murky from the previous day's storm. We then ventured to the Keahua arboretum and hiked on the Powerline trail. It, too, was still muddy from the storm with the highlight definitely being swinging from a vine over the mud. I've always wanted to do that. It was hard. Vines are slippery.

Swinging like a monkey

Wailua Falls was raging with rain water

We wanted to kayak into the falls, but the rivers were too swollen with debris from the storm

We are now back in Salt Lake City and have been greeted by the first major snowstorm of the season. A welcome sight for the skiers, but I was rather enjoying riding dry dirt in January. In addition to continuing with training, I also get to return to the role of cancer patient. Over the next two weeks I have my six month MRI, six month Sonocine (ultrasound), and a visit with my surgical oncologist. Here's to hoping my next post if full of good news!

2011 in photos-A Year Worth Remembering

2012-01-01T07:23:00.000-08:00

In January 2011, I started to get worked up for a small nodule I found in my right breast. It began with an appointment to a primary care physician, then a mammogram and ultrasound, and finally a core biopsy. On January 25th, I received the news that I had Invasive Ductal Carcinoma~breast cancer.

Later that very same day, my 2011 race bike arrived. The irony.....

Receiving the diagnosis triggered a cascade of medical appointments and surgeries. In 2011, I had 68 cancer related appointments.

Shannon and I spent many hours in the Huntsman Cancer Institute waiting rooms.

Packing snacks was essential.

On February 18th I underwent my first surgery, a lumpectomy. After surgery I received the excellent news that my lymph node biopsy was negative.

Relieved and happy to be done with surgery

Post-lumpectomy bandaging

Later in the week I received bad news from my final pathology. The tumor was larger than what we originally thought and the lumpectomy margins were not clean. This meant 1-chemotherapy was certain and 2-there were still cancer cells in my breast.

On Friday February 25th I underwent my second surgery to try to remove the rest of the cancer from my breast. The pathology report after this surgery indicated that my margins were 'clean'-there was no more cancer in my breast-however they were 'close'-less than 1mm of cancer-free tissue surrounding where the tumor was removed. A 3rd surgery to obtain greater than 2mm of cancer-free tissue was inevitable.

I ultimately decided that enough was enough, and my third surgery was to be a mastectomy. Words can not describe how difficult this decision was for me, but at this point, today, I do not regret my decision.

The weekend before my mastectomy, Shannon and I traveled to Fruita, Colorado for one last hurrah. This was our last trip out of town until July.

I also went on a hat buying binge in anticipation of losing my hair during chemo.

I later found out that hats really aren't that comfortable when you are bald and it is 90 degrees outside. Cotton, Buff headbands are much more comfy.

The week of my mastectomy, I chopped my hair off. I thought it would be easier to manage with my post-mastectomy limitations.

I went from this

to this

and finally this

My ponytails were donated to Locks of Love

On March 25th, I underwent a total skin/nipple sparing mastectomy. Surgery was uneventful and I was discharged from the hospital the following day.

A tissue expander was used as a temporary implant. Saline was injected every few weeks to gradually stretch the skin so that a permanent implant could be placed later. Although I joked that I was going to upgrade to a DD, I was very assertive with my plastic surgeon that I wanted to stay as close to my original size as possible. I ended up deciding to have a small implant placed on my non-mastectomy side to help with symmetry.

This is a photo of 3 tissue expanders

On April 15th I was cleared to begin chemotherapy. I received 4 treatments of Taxotere/Cytoxan (TC) spaced three weeks apart.

It was very important to me to stay fit and healthy during chemo. Click here for some strategies that worked for me. Although there were certainly side effects, I exercised almost every single day. Some days it would be for 30 minutes, some 2 hours. Moving helped me feel alive.

Rippin' trail is still possible while undergoing chemo

For me, wearing a bike helmet was my favorite and most natural way to cover my bald head

Oh yeah, my newly cut short hair started falling out in chunks

three weeks after my first chemotherapy treatment

Although as a cyclist, I have always strived to eat healthy, I made the personal decision to switch to a plant-based diet. Shannon and I spent the summer becoming fairly proficient at preparing plant-based meals.

Beans, kale, onions, garlic, and mushrooms. Yum.

Black beans, yams, spinach, onions topped with almond cheese on a whole wheat pita. Yum, yum.

I also have a green smoothie every day. My favorite ingredients are kale, brussel sprouts, spinach, almond milk, hemp protein powder, frozen fruit, banana, ginger, and MILA. It is definitely an acquired taste, but with my smoothies I am more concerned about nutrition than taste

Some of my favorite books that help guide my diet

My final chemotherapy infusion was June 17th

I then had six weeks off work for summer break. Perfect for rejuvenating the body after chemotherapy.

I spent the summer riding my bike

Hanging/riding with new friends

and old friends

and playing with my crazy puppy

We also traveled to Steamboat, Colorado and Jackson Hole, Wyoming. Admittedly, I wasn't too keen on photos when I was bald:)

On August 15th I underwent my final reconstructive surgery. Around the same time, my Dad's health started to decline. He passed away August 31st due to complications related to Early-onset Alzheimer's. I don't like to talk about it, especially on my blog.

Me, Dad, and Gordie December 2008

This fall/winter has been spent rebuilding strength and fitness in hopes that I can compete at an elite level in 2012. There. I said it. I plan to return to racing in 2012! Training officially starts today.

I have already dabbled in a bit of racing

I added a BMX bike to my fleet that now includes a full-suspension, 29er hardtail, singlespeed, cross bike, road bike, and now BMX bike!

By the end of November I was ready for my first haircut.

Christmas was spent with family,

and this photo serves as evidence that after four short weeks I was already ready for a second haircut

2011 will always be remembered as a trying year: physically and emotionally. That said, when Shannon and I finally came to terms with the fact that most of the year would be spent undergoing treatment, we made a choice. It would have been easy and even understandable if I hid out for the year, miserable and sick, feeling sorry for myself. But life is too short. Instead, we decided to live life to the fullest extent possible, despite the circumstances. Even though 2011 wasn't the year it was supposed to be, there were many great times. Thank you everyone who was part of those great times! Although I am enthusiastically ready to move on to 2012 and life after cancer treatment, 2011 was a year worth remembering.

Here's to a full, healthy, and happy 2012-for me, my family, and everyone!

Happy New Year!

6 months-Looking at the numbers

2011-12-26T18:49:00.000-08:00

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 1^st chemo treatment)	5/27/11 (3 weeks after 2^nd chemo treatment)	6/17/11 (3 weeks after 3^rd 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!

Happy Holidays

2011-12-22T17:21:00.001-08:00

Fabulous Las Vegas

2011-12-13T20:07:00.000-08:00

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!

Giving Thanks

2011-12-02T07:00:00.000-08:00

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!

Pedal hard, pump harder

2011-11-23T18:21:00.000-08:00

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:

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.
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?
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.
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!
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"!
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!

After cancer.......

2011-11-13T08:30:00.000-08:00

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.

RAD

2011-11-05T20:41:00.000-07:00

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:)

Weekend update

2011-10-23T17:50:00.000-07:00

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!

Utah Cyclocross-Cross Out Cancer

2011-10-19T07:38:00.000-07:00

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.

There is pink everywhere

2011-10-15T11:28:00.000-07:00

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.

A really cool thing.......

2011-10-11T19:06:00.000-07:00

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.

6 Hours of Frog Hollow

2011-10-03T22:36:00.000-07:00

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

Up Next

2011-09-29T15:42:00.000-07:00

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

A beautiful day....

2011-09-26T18:21:00.000-07:00

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!

Dad

2011-09-16T07:52:00.000-07:00

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

Final reconstruction and hair update

2011-08-27T18:52:00.000-07:00

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...............

Tips for staying fit and healthy while undergoing chemotherapy

2011-08-23T19:11:00.000-07:00

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........

Post-Final Reconstruction surgery

2011-08-18T15:53:00.000-07:00

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.

Reconstruction

2011-08-05T06:57:00.000-07:00

Talking about your breasts is a pretty personal thing, talking about reconstructing your breast after a mastectomy is even more personal. Not something I would ordinarily talk so openly about, but it has really helped me to approach this experience very methodically and openly. I warn you in advance that this post is blunt and to the point.

The time has come for me to have my final reconstruction. My entire life, I have never once considered having plastic surgery, especially breast augmentation, however when given the choice between plastic surgery or no breast....I choose plastic surgery. Perhaps I am more vain than I thought I was. Really I think I just want to be able to wear the clothes I like, look good, and not worry about symmetry.

One of the hardest decisions of my life was back in March when I chose to have a mastectomy. Since then, I have spent a tremendous amount of time learning about reconstruction methods.

The easiest method of reconstruction is to use an implant. This surgery is relatively quick and usually results in a nice perky breast. The problem is, real breasts aren't as perky as round implants. So then the decision needs to be made if you want to have an implant placed in your other breast to help with symmetry. This adds another surgical site, and since you are adding an implant makes your breasts larger than they originally were (although you can choose how much larger). The end result is two perky breasts that hopefully have good symmetry. Although this is the simplest reconstruction method, there are some downsides. Implants don't last forever, even in straight forward augmentation (boob jobs). Additionally, reconstruction with implants often is not successful for women who undergo radiation.

Another method of reconstruction is a flap procedure. Surgeons take fat, muscle, and a blood supply, usually from your abdomen or trapezius, and somehow reposition it to your breast. Obviously this is a lot more invasive than implants. Not only is recovery time longer, but since muscle is sacrificed there is a good possibility of reduced strength or muscle imbalances. Surgeons, however, seem to like this technique because the blood vessel is pulled from the original location to the breast and no reattachment is necessary. For me, this was never an option. I'm simply not willing to sacrifice muscle for reconstruction.

The final method involves fat, skin, and associated blood vessels being taken from the abdomen, butt, or inner thigh and transplanted (actually removed and then reattached) to the chest wall. The surgeries are called DIEP, S-GAP, or TUG depending on where the tissue comes from. No muscle or motor nerves are sacrificed with this procedure and a gifted microsurgeon can produce amazing results. I've heard some women say that their new breast perfectly matches the other side. The downside of this surgery is that it is an incredibly tedious surgery; often patients are under general anesthesia for up to 10 hours, thus increasing the risk of surgical complications. After surgery, if all goes well, there are strict precautions for up to 6 weeks. This procedure also requires a sufficient amount of adipose tissue in either the abdomen, butt, or inner thigh so often is not a viable option for extremely thin women.

To help me make my decision, I have met with three different plastic surgeons as well as consulted via telephone with a microsurgical specialist in New Orleans. Since I had taken flap procedure off the table, I had two options: implants or S-GAP. I am a perfect candidate for implants because I am young, healthy, and did not get radiation. I was told that I was also a candidate for a S-GAP. Apparently I have enough butt fat to build a small breast.

Based on this information, I have decided to have implant based reconstruction. I chose this procedure because of the reduced surgical and recovery time. I have also chosen to have my 'other' breast augmented slightly to help with symmetry. So the end result should be slightly larger and more perky than I was before. Although I wasn't really looking to increase my breast size, I do want to have good symmetry, and S-GAP aside, this is my best chance for that. If for some reason this is not successful, I can always pursue the S-GAP in the future and the 'other' implant can be removed. There are also new reconstructive techniques emerging all of the time. Maybe, down the road, there will be a procedure that uses your own tissue without the surgical risks and extended recovery time. In fact, one of the plastic surgeons mentioned one such new technique.

I did not take this decision lightly, in fact, it probably took me a few months to come to a final decision. Seriously, my plastic surgeon just found out my final decision this week.

I would advise anyone who has to make this decision to meet with multiple plastic surgeons. I found that different surgeons feel more comfortable with different techniques. If one surgeon is not trained in a specific technique, he/she may not mention it as an option.

This week when I met with my plastic surgeon I told him my final wishes. I said words that I never thought would come out of my mouth such as 'I don't want my breasts all jacked up, try to make them droop more like natural breasts'. Apparently this is possible. and 'I want the very smallest implant possible'. Throughout this process he has been very respectful of my desires and I feel that he truly understands my wishes. We'll see.......Surgery is August 15th.

6-week anniversary

2011-07-29T14:22:00.000-07:00

To celebrate my 6-week anniversary since my last chemotherapy infusion, I got to visit my oncologist today. Overall, the appointment was a breeze. I had blood drawn for labwork, a physical exam, and I got to ask my rather short, but always interesting, list of questions.

Today's appointment reinforced what I am feeling; that I am doing well. I am happy to report that my labwork results look really good! Everything continues to be in the normal range and my red blood cell and hematocrit levels are creeping up closer to my personal baseline in February. No wonder my energy levels are increasing. I am not scheduled to see my oncologist again until December!

The past six weeks have gone by pretty quickly. I have spent the summer nurturing my body and hitting all of my favorite singletrack up in Park City. It has been nothing less than sweet! I have also spent a good amount of time watching and supporting at bike races. I genuinely enjoy doing this and seeing fellow racers, especially women, achieve their personal goals. That said, I get bummed that I'm missing out on the epicness (is that a word?) of the experience, especially when I see high quality ultra-endurance events.

There were two such events that I got to watch this summer. The first was the PC-50. This 50-mile race in Park City (part of the Utah State Championship Series) somehow found 50-miles of super-fun singletrack to link Park City Mountain Resort to the Canyons. I've ridden most everything up in Park City, but this course found some gems that I have never been on. Since my husband (along with 3 others) promoted this race, I got to see first-hand how tirelessly they worked with the highest priority being to make it an excellent experience for the racers. Based on the racer vibe at aide station #2, the race was a huge success. It should also be mentioned that the payout was HUGE and deep. The fastest male and female went home with close to $1000 each!

Steamboat appears to be mountain living at its best

Another super cool event that Shannon and I traveled to was the Steamboat Stinger. This 50-mile race was also a first year event held in Steamboat Springs, Colorado and was promoted by, you guessed it, Honey Stinger. The town seemed genuinely excited to host an ultra-endurance mountain bike race, the race promotion was slick, and the course stellar. I definitely want to return next year! Even though I didn't get to race this event, I did achieve my goal of completing a 25-mile lap with 4000 feet of climbing....rather easily. We also had a great time staying with great people and meeting some new friends.

My attention is now turning to my final reconstruction. Next week, I meet with my plastic surgeon to reveal (and I do mean reveal, as in I have changed my mind quite a few times and he probably has no idea what I'm thinking:) my final reconstruction decision. Surgery is scheduled for August 15th.

and if you haven't read enough already, here is a link to a blurb that Gene Hamilton with BetterRide (skills training and coaching) posted. I attended a BetterRide clinic last fall and it completely changed and improved my riding technique. I continue to do my 'drills' and am hoping to see big payoff when I start racing next year. Gene found out about my diagnosis last week.

(lack of) Hair

2011-07-19T21:13:00.000-07:00

I did not lose all of the hair on my head during chemotherapy. Only about 75%-90% of it:) The funny thing is that the hair that I did keep kept growing. It made for an interesting look for a while. Well, I have finally shaved it (again) in hopes that my hair will grow in more even. I am starting to see some little hairs burst from the follicles. Very exciting stuff!

I really do not mind the simplicity of not having hair. I'm really not a big fan of styling, and now I can seriously take a shower in less than 2 minutes which leaves a lot more time for things like.....blogging. I even think I look pretty good bald (ok, so I exaggerate); but I definitely look more bad-ass than I've ever looked before.

Honestly, though, I am very self-conscious about not having hair. Even though I strut around my house hatless all the time; I have not gone out in public without something on my head. I think it is because the bald head is like announcing to the world that I have (had) cancer. I realize the irony that I write a blog about my experience with cancer, yet I don't want to go out in public and be thought of as that poor girl with cancer. Interestingly, I must be good at not looking like I just finished chemo as not once has a stranger asked me a question about my headwear or treated me like I was sick. I like that!

So, without further ado, here I am:

I'm trying to look as bad-ass as I can. Notice the rain drops and cloudy sky.

Profile of my bald head. Notice the beautiful blue skies.

This is 15 minutes later; storm passed, sun out, need sunglasses.

I really wanted a more professional bald photo with beautiful scenery in the background, but we haven't really had time for that, and thankfully I'm running out of bald time. Our deck will do!

Not related to hair, but warranting mentioning, my body seems to have adjusted to the Tamoxifen. The muscle cramps seem to have gone away. Yeah!!!!!

I also had an incredible acupuncture appointment yesterday. Today, I feel like a rock star.

Little White Pill

2011-07-13T20:01:00.000-07:00

Monday I started Tamoxifen. This little white pill will be part of my breakfast for the next five years. I already have a love/hate relationship with this pill. On one hand, it is very effective. Tamoxifen blocks the actions of estrogen, and since my breast cancer is estrogen receptor positive (it requires estrogen to grow), it reduces my chance of distant metastasis, local recurrence, and new breast cancer by about 50%. On the other hand, it is a medication, and like any medication it has side effects. I know many women who take tamoxifen with little to no side effects (I'm hoping to fall into this category), but then again I have heard horror stories as well. I have had significant muscle and joint cramps/aches this week. I did get out for a nice bike ride yesterday and a good hike today; exercise seems to help. But not for long. I'm hoping that as my body acclimates to the new medication, that the annoying discomfort subsides.

Another new consideration is that I need to consciously avoid soy and flax products. Both soy and flax are very strong phytoestrogens and they may compete with Tamoxifen for estrogen receptors thus reducing effectiveness. I realize that soy is in just about everything making it next to impossible to completely avoid, but I am going to make an effort to avoid foods with soy listed on the ingredient label. I certainly don't want to be taking this medication only to reduce its effectiveness by eating the wrong food. This may not sound like too big of a deal, but do you know how hard it is to find an energy bar that does not have soy OR flax? I have been scouring labels, to no avail, please let me know if you have any suggestions.

***Blog Amendment: After consulting with the nutritionist at Huntsman, it appears as though flax is potentially okay to have in my diet even though it is a very strong phytoestrogen. Although there is no current research on humans, according to an article from the American Institute for Cancer Research, flax had an enhancing effect for Tamoxifen when tested on mice***

Besides this, I have been keeping myself surprisingly busy for being off work. or maybe I'm just good at wasting time? I have been exercising (almost) every day and worked my way up to a nice, easy 3-hour bike ride on part of the PC-50 course last week. My current motto for exercising is to keep the efforts at conversational pace. This is allowing me to maintain some fitness, reap the therapeutic benefits of being on my bike, and not overtax my body as it recovers from chemo.

One of the bigger creek crossings in the PC-50

I have also continued with my plant-based diet. Last week's theme was cauliflower and quinoa. I now have 3 really good recipes with cauliflower, one that includes salmon (ok, so not completely vegan, but pretty close). As for the quinoa, I did not have as much success. One of my recipes wasn't clear on how to prepare it and it ended up being undercooked. The other, quinoa and veggie stuffed bell peppers, was pretty good....not great. To top it off, I finally bit the bullet and purchased a Vitamix blender today. One of my co-workers has generously 'loaned' me hers since February. She called me today to say that she saw them at Costco for $100 off (hint, hint). The sale is for 3 more days, so if you're thinking about getting a Vitamix..........

This really is a green smoothie. It has loads of Kale and red cabbage. It also has protein powder, MILA, banana, strawberries, blueberries, and blackberries.

Next week it is off to Steamboat I go. I can't wait to explore some new trails.

Dizzy loves to hike. He doesn't love to come....

Food

2011-06-29T16:53:00.000-07:00

I am 12 days out from my last infusion and just finishing up with the week where my immune system is weakest. Once this week is over, I really feel like I will 'officially' be on the mend from chemotherapy! My poor body has been through so much since February and my goal for now is to nourish my body and help it heal.

Over the past few months, I have accumulated quite the library to help me do just that. Up until now, Shannon has taken primary responsibility with cooking healthful meals for us. Since I'm done with chemo and have a few weeks off work, I have decided to take over the cooking duties and become (more) proficient at our new style of eating.

Some of our anti-cancer cooking resources

Even though I have 'no evidence of disease,' I will never know for sure if I have been 'cured' of cancer. The one thing I do have control over is how I take care of my body. Basically, we are focusing primarily on a plant-based diet. Even the Nutritionist I consulted with at Huntsman recommended a plant-based diet. This is not to say that I can not/do not eat any animal products. I'm still eating quite a bit of greek yogurt and I do occasionally sprinkle some low fat cheese on my food, however the literature (I have read) strongly supports limited animal product as part of the anti-cancer diet. In support of our new diet, Joel Fuhrman, M.D. writes in Eat to Live that countries that get the greatest percentage of their diet from unrefined plant foods have the lowest percentage of deaths from heart disease and cancer and David Servan-Schreiber, MD, PhD recommends that "the anticancer diet is made up primarily of vegetables and legumes prepared with olive, canola, or flaxseed oil, or omega-3 butter, herbs, and spices. Unlike the traditional Western diet, meat and eggs are much less prominent; they are served as accompaniments in small amounts".

The second staple to the anticancer diet is reducing sugar/white flour - foods with a high glycemic index. It is common knowledge that when sugar is consumed blood glucose levels rise rapidly and insulin is released. Insulin release is accompanied by IGF (insulinlike growth factor) whose role is to stimulate cell growth. Basically, according to Servan-Schreiber, sugar (indirectly) nourishes tissues and makes them grow faster and essentially serves as fertilizer for tumors. Pretty good reason to reduce sugar intake!

I definitely still have room for improvement at implementing this diet, but it does seem to be getting easier especially as I become more proficient at preparing meals.

How does this fit in an endurance athlete's diet? I'm not quite sure yet, but there are successful elite level athletes who are vegan so I'm confident that a modified vegan diet is possible.

Here are some yummy meals I cooked up this week. I'm not very good at following recipes, so usually I start with an idea from one of my cookbooks and then wing it.

I can't remember exactly what I put in this, but it looks like pinto beans (cooked in a slow cooker) topped with sauteed kale, corn, mushroom, red onion, olive oil and garlic.

Black bean, yam, spinach, onion, garlic, and sprinkled mozzarella cheese on a whole wheat pita. This meal had 26 grams of protein!

2 egg whites (see I do eat some animal product) topped with sauteed kale, mushroom, red pepper, and green onion makes for a yummy breakfast.

The very best breast cancer fighting foods (According to Servan-Schreiber in Anti Cancer): kale, broccoli, cabbage, cauliflower, brussel sprouts, scallions, leeks, and garlic. Our fridge is usually loaded with this stuff, although I need a good cauliflower recipe.

And of course, the requisite Dizzy photos:

Dizzy likes to watch me do yoga and I guess he thought he would try out my mat. He is now almost one year old and is earning more house privileges although he did chew up Shannon's flip flops this week:)

**I suppose I should have a disclosure that this anti cancer diet is what I feel is right for me at this moment. I am in no way suggesting that I have any idea what the best diet is to prevent cancer**

Certificate of completion

2011-06-17T18:14:00.000-07:00

Yesterday I was awarded my certificate of Chemotherapy completion and a nice fuzzy blanket for completing 4 rounds of TC (taxotere,cytoxan) over 9 weeks. Even though when I finished my final infusion, I really just wanted to get the hell out of there, my eyes swelled up with tears as the Huntsman infusion room staff presented me with my certificate and sang me a song. I am so happy and relieved to be done and I hope that the next few weeks go smoothly. Basically, the drugs given to me yesterday will be in my system for around 3 more weeks and then my body will officially be able to start healing.

Overall, my final chemo infusion was pretty uneventful. I started a few hours earlier than usual which meant that I was on the bike a little after 7:30 AM to ride to the hospital. It was a beautiful morning and it felt so good and empowering to ride in. A little dirt therapy prior to a long day in the hospital works magic on the mood. My long day started with an appointment with my plastic surgeon. Over the past month, I have been busy consulting with 4 different plastic surgeons; I think I have a pretty good grasp on ALL of the options available to me and am getting closer to making a final decision. I am tentatively scheduled for this surgery the middle of August at Huntsman. I promise to do a complete post on this.

After meeting with the plastic surgeon, it was on to having an IV placed, blood drawn, and meeting with my medical oncologist. My oncologist is out of town so I met with her nurse practitioner and nurse. My labs came back almost great. Red blood cells, white blood cells, liver, and kidneys all appear to be maintaining levels and functioning very well. My bilirubin was slightly high, which (I think) indicates that my liver is working extra hard to metabolize the chemotherapy drugs, but I was cleared to go on to the infusion room later in the day.

During this appointment, I had a lot of (what I thought) were interesting questions for the oncologist. First, I wanted to better understand how my red blood cells are affected by chemotherapy. Basically, my bone marrow (which produces white and red blood cells) is being suppressed by the chemotherapy drugs. The Neulasta shot I take the day after infusion helps with white blood cell production, however does not help with red blood cells. My bone marrow will be suppressed for approximately 3 more weeks and then it takes up to 120 days for my red blood cells to be replenished. Even though my red blood cells are considered in the normal range right now, they, along with my hematocrit values are significantly lower than what they were prior to chemotherapy. I hope that as my levels improve, my strength and speed on the bike improves as well. 120 days is a looooooong time!

I also discussed with my oncology NP my final reconstructive surgery. She recommended to wait 7 weeks from today for final reconstruction. Although waiting this long is not ideal (drags out the process), I am willing to wait to make sure my body is completely recovered from chemotherapy prior to surgery. I am tentatively scheduled for August 15th. Recovery from this surgery should be fairly quick, and I should have absolutely no restrictions after 3 weeks.

Today's actual infusion was uneventful. I was given the IV benedryl first which immediately put me to sleep and once again I slept through most of the infusion.

Now that I have finished chemotherapy, I get a 3 week break before I start Tamoxifen. This medication is pretty mush as effective as chemotherapy in reducing my risk for local and/or distant recurrence. Tamoxifen is an antagonist of the estrogen receptor in breast tissue. According to Wikipedia, "Some breast cancer cells require estrogen to grow. Mine is estrogen receptor positive. Estrogen binds to and activates the estrogen receptor in these cells. Tamoxifen is metabolized into compounds that also bind to the estrogen receptor but do not activate it. Because of this competitive antagonism, tamoxifen acts like a key broken off in the lock that prevents any other key from being inserted, preventing estrogen from binding to its receptor. Hence breast cancer cell growth is blocked". I will take a daily pill of Tamoxifen for the next 5 years!

In the meantime, I haven an appointment at the Cancer Wellness House for Therapeutic Touch on Monday and my weekly acupuncture on Tuesday. I plan to meet with the naturopath to work on completely detoxing my body after about 3 weeks. I'm also looking forward to a highly recommended detox acupuncture appointment. Also, since I have the next 6 weeks off work, I plan on scheduling free appointments for therapeutic touch, massage, and craniosacral therapy at the cancer wellness house.

Hair update:

I'm also looking forward to my hair growing back in. I still have quite a bit of 'fuzz' on my head, but I plan on shaving it down and taking some photos before it starts growing back in. As for other hair, I have so far kept my eyelashes and eyebrows. My leg hair has thinned significantly but grows quite long. I actually had to shave last week. I haven't lost a single arm hair, son of a......it hurts whenever they take my IV out. How long will it take for my hair to grow back? Who knows. I can't believe how slow Shannon's hair has been growing back though!

The Chemo training plan

2011-06-13T19:46:00.000-07:00

The first week of June 2010, I rode my bike 9 hours 15 minutes. That was including a Saturday 5.5 hour training ride in preparation for Lumberjack 100 two weeks later.

Here is my training log for the first week of June 2011:

(Note: Yes, I still keep a training log. I have documented every workout since I was diagnosed in January)

Monday: Mountain biked from house-up drycreek-shoreline trail-to city creek- home.

1 hour 45 minutes. Endurance pace.

Tuesday: Work day. 1 hour hike with Dizzy in Round Valley (watched part of the Midweek race).

Wednesday: Work day. Rest day/no workout.

Thursday: Work day. Craniosacral treatment. Mountain biked on Shoreline for 1 hour. Endurance pace.

Friday: Mountain biked on Shoreline for 1 hour 15 minutes. Endurance pace. Acupuncture.

Saturday: Mountain biked Corner Canyon. 1.5 hours. Endurance pace. Upper extremity/Core workout.

Sunday: Mountain biked Glenwild. 2 hours. Endurance pace.

Even my over-achieving self admits that this was a pretty good week (my highest volume since February) for being two months into chemotherapy. The only pathetic part is that I don't have a single photograph. Obviously I'm not doing any sort of hard efforts or ultra-endurance rides, and I do fatigue easily (I nap after every ride), but I really feel like I am maintaining at least a little bit of fitness. More importantly, I think that the consistent moderate exercise is helping to cleanse my body of toxins and allow me feel the best I can under my current circumstances.

Up next is my last week of work before a 6-week hiatus for summer break.

Oh yeah, my FINAL chemotherapy infusion is this Friday too. I am so ready to be done!

Officially 75% done

2011-06-06T15:08:00.000-07:00

There is a light at the end of my chemo journey. It is faint, but it is shining brighter every single day.

Infusion #3 side effects so far have been really similar to infusion #1 and infusion #2 side effects. The only difference was that I had a super low grade fever over the weekend. I actually bore myself talking about it, but just as a reminder, mostly to myself, Sunday and Monday post-infusion suck. I know that Sunday and Monday will be my bad days, but somehow seem surprised each time when the fatigue sets in and food tastes like cardboard. So far, I seem to have bounced back nicely and have once again been enjoying life.

The weather has been drop-dead gorgeous in Salt Lake and I got out this morning for a perfect ride.

A beautiful day in Salt Lake City

I really wanted to ride up Millcreek Canyon to Pipeline and Rattlesnake Gulch, but since this is my low immunity week there are two things I'm trying to avoid: rattlesnakes and bees. Actually there are a million things that I'm trying to avoid, but for my ride's sake I stuck to rattlesnakes and bees. Since there are frequent rattlesnake sightings on Rattlesnake Gulch (hence the name), I opted for a more chemo 'safe' ride on the Shoreline. I'm usually bored to death by the Shoreline this time of year, but since chemo has restricted me to the road every third week, it was a treat to ride some dirt.

It was warm enough to sweat a little today

At the bottom of the 'grassy climb' on Shoreline.

As for the light at the end of the tunnel, my final infusion is scheduled for June 17th. I won't consider myself officially 'done' with chemo until the first weekend post-infusion when I start to feel more like myself. After that, I have my final reconstruction surgery (date to be determined). There will be a few weeks of restrictions after this surgery, so unfortunately more downtime. This may be a good thing, though, so I don't go too crazy and overdo it as soon as I am done with chemo. I know my body will need time to recover from chemo; I hope I have the willpower to give my body that time. As for final reconstruction, I am still in the process of deciding what I am going to do, and since it is an elective procedure I am not in a huge hurry. There are lots of options, options are good, but make the decision a bit harder, especially for a person who has a tough time making decisions. I will do an entire post on my decision making process when I am ready.

As for post-chemo plans, I am ready to start making some. We have not traveled since the weekend before my mastectomy in March. I think that is a record for consecutive weeks spent in Salt Lake City. I am ready for some trips! We are planning a trip to Steamboat in July and Wyoming in August. Perfect timing to get a break from Salt Lake's high desert summer heat! In the meantime, I hope to spend the next two weeks enjoying our mild weather and rippin' some trails.

Chemo # 3/4-Check!

2011-05-28T09:41:00.000-07:00

Yesterday was a pretty good day for infusion Friday. Woke up and generally putzed around the house before I rode my mountain bike to my first appointment of the morning with the plastic surgeon. My ride on the Shoreline trail was fantastic. I can literally ride dirt to the entrance of the hospital. I think I was also experiencing a 'Floyd' high as I had started my pre-infusion regimen of steroids on Thursday. I haven't felt this 'high' before, but for some reason, I was just giddy yesterday. Shannon was at the hospital waiting for me with the car so we would have a safe place to park my bike for the day.

Can I say, once again, best. husband. ever.

I was visiting with the plastic surgeon because the time is getting closer for my final reconstruction surgery. Yes, I have one more surgery after I finish chemo. As I have mentioned before, a temporary implant was placed at the time of the mastectomy. This gives my breast some shape and it also has a port in it that allows us to inject saline and slowly stretch the surrounding skin and muscle to my final desired size. We have expanded a few times and it seems to me that there may be some leakage. Slow leakage, but leakage none-the-less. This is only saline and is not dangerous to be absorbed by my body, but it does add a possible complicating factor in to my final reconstruction. Yesterday was kind of an experiment. My plastic surgeon inflated the expander himself and I will report back to him in a few weeks if I notice any leakage. Fortunately, if it is leaking, it is happening slowly and since I decided against the DDs we can probably get a way with a few small expansions right before my final surgery and be just fine.

If you're interested in what the expander looks like here is a photo:

The black spot is the port where saline is injected to expand. It is all under the skin so a magnet is used to find the port. Expanders are not the most comfortable of things, they're not soft like permanent implants, but I'm fortunate that my has become quite tolerable and I only occasionally notice it. This is all pretty amazing. I'm assuming that the 'small' size is what is in my breast right now.

This appointment went pretty quickly and since we live so close to the hospital, we were able to go home for lunch and 45 minutes of puppy play time. Dizzy was more into sunbathing though.

At 1:15 we were back at Huntsman for my blood draw, IV placement, and meeting with my oncologist prior to my 2:30ish infusion. My bloodwork all came back in the 'normal' range. I was psyched that my red blood cells and hematocrit were back to 'normal' and this added to my giddiness. White blood cells are holding up nicely thanks to my post-infusion Neulasta shots (these shots cost $7000 each! Fortunately insurance pays for them) and liver and kidneys continue to be working great as well!

At around 2:45 I was called back to the infusion room. Pre-infusion meds took a good 45 minutes. I got more steriods, anti-nausea meds and then we added IV benadryl and an antacid. I had a short reaction at the start of my last infusion, where my throat closed off and I got scared; these additional meds were to help combat that. They seemed to work, but they also put me to sleep. So much for my 'Floyd' high. I slept through most of my infusion. At 6:15 we were done, the IV was removed and we were on our way by 6:30. I was the last patient in the infusion room once again!

Today, as usual, I'm feeling pretty good. I'm being diligent about my post-infusion medication and I just got back from a delightful ride with Lyna on the Shoreline. It is a perfect day and we thoroughly enjoyed it. Now a short rest (for a few hours) and then it is back to Huntsman for my Neulasta shot. Tomorrow, I fully expect to wake up tired and achy, however, as much as it sucks, I must remember that too will pass. As usual, I will not consider myself officially 75% done until after my post-infusion hump week.

This week is looking to be perfect. Not to be selfish, but the weather looks to be crappy on my crappy days and then turn around and be warm and sunny just as my body hopefully starts to turn around as well.

'On the mend'

2011-05-26T15:06:00.000-07:00

I was hoping that I wouldn't have to be 'on the mend' until after my 3rd infusion, but unfortunately this week did not go quite as planned. I was recovering from my second infusion as planned until Monday night. A few hours after dinner (Note: a dinner full of steamed veggies that was SUPPOSED to make me strong and healthy) my stomach started to hurt. As I was trying to fall asleep my stomach started to hurt so bad that I actually took one of my anti-nausea pills. Now, over the past six weeks I have NEVER needed an anti-nausea pill except for the mandatory days post infusion so I really wasn't feeling well. I had a terrible time falling asleep and by morning I was achy all over. I felt like I was back to day 2 post-infusion with an upset stomach as a bonus. Needless to say, I never made it into work that day and the highlight of my day ended up being a warm bath. The good news was that I had no fever. In fact, I was questioning the accuracy of my thermometer because my temperature was well below normal. Regardless, this was a relief. Anyone who has undergone chemotherapy has had it pounded into their head that a temperature above 100.5 is considered a medical emergency. Since my temperature was in the 96-97 range, I was not too worried.

Tuesday night my stomach was relieved. I'll spare the details, but it was not pretty. Not as bad as my epic food poisoning incident post Whisky 50 last year, but I did need to stay within 20 feet of a toilet for a couple of hours.

By Wednesday morning I was starting to feel better and ventured into work for a caseload meeting. Once at work I found out that quite a few of my co-workers were out with the flu, so now I'm not sure if it was food poisoning or the flu. I suppose it could be either as chemotherapy messes with your gut AND makes you more susceptible to viruses. Fortunately, I am certain that I am recovering and should be able to proceed with infusion #3 tomorrow.

Overall, I am happy that my body was able to recover relatively quickly from this little set-back and that I was well enough today to sneak a ride in on dirt.

There are a lot of epic cycling events taking place this weekend. My teammate Karen Potter is racing the Tran-Sylvania Epic Stage Race, a 7-day stage race in Pennsylvania. She finished second last year! Gunnison Growler is also this weekend. Shannon and I ventured to Gunnison to compete in this race last year. Locally, there is the Stan Crane Memorial race. This is one of my favorite local races on the super fun Corner Canyon trails. I will not be competing in any of these races, but I will be participating in my own personal marathon tomorrow. It all starts when I meet with the plastic surgeon at 11:15. I still have one final surgery that we will be discussing. Then I proceed to have my blood drawn and IV placed prior to my 1:15 appointment with my medical oncologist. My infusion is scheduled to begin at 2:30 and usually lasts a couple of hours, however I have never started on time so I plan on being at Huntsman through dinner. As has become my routine, I will get a little bit of dirt therapy in the morning.

After that I will be back to week one post infusion. The good news is that I will be 75% done!

No news is good news

2011-05-22T16:13:00.000-07:00

Week 2 post infusion 2 seems pretty similar to week 2 post infusion 1. This week I worked, rode my bike, and even did some core/upper extremity work a few times. Don't get me wrong, this is NO walk in the park, however I feel fortunate that so far I am strong and healthy enough to remain somewhat physically active. For this my sanity is happy as well.

I am over being worried about my elevated B12 levels. Both my oncologist and naturopath say, "better high than low". Instead I will focus my worries, because of course I need to worry about something, on my red blood cell count. Prior to my last infusion, my bloodwork indicated that my RBC count was just below the normal range, indicating that I am slightly anemic.

Low red blood cells=anemic=low energy levels=can't ride my bike.

I am certainly not to that point yet, but I don't want to get to that point either. I have noticed that when I get up too quickly that I am dizzy, just like my puppy:) and a sign of anemia. There is not a lot I can do to control my RBCs, however I am trying to get plenty of rest and eat well. The moment of truth will be this Friday when I go in for my 3rd infusion and get a new set of bloodwork results.

Honestly, if this is my biggest worry at this point, I'm pretty fortunate. This is hardly worthy of a post. Like I said, no news is good news.

In cycling related news, there is the possibility that I may do a little bike race in October. This would be strictly for fun (as in I have no intention of 'training' for quite some time), but then again, bike racing isn't fun unless you are going hard:)

50% done

2011-05-15T17:19:00.000-07:00

Even though my second infusion (halfway mark) was over a week ago, now that I am through week one of infusion #2(the hardest post-infusion week), I am officially considering myself halfway done with chemo!!!!! You can pretty much look back at this post to know how I've been feeling this past week. But to summarize.....

This time around, because I kind of knew what to expect, my odd side effects were not as alarming. My worst days for fatigue were once again Sunday and Monday. I still had (have) the tachycardia although like last time it is improving. It is pretty annoying and a bit scary those few days when you can feel (what should be) your resting pulse racing throughout your whole body. My pulsating low back pain was not as significant this time around. I think I did not push myself as hard physically those first few days and I have also learned that Tylenol really does help:) My skin seems much happier this time around as well and even though my mouth got all yucky again, it doesn't seem as bad as last time either. Honestly, I'm not sure if my symptoms really were less this time around or if I have just learned how to manage them better. Either way....I am 50% done!

The one thing that remains a mystery is what my red blood cell count is doing. Prior to my last infusion, my RBCs were slightly low, meaning I was slightly anemic. We did an iron panel to make sure I don't have an underlying iron deficiency. The iron panel results are back and my iron and total iron binding capacity are within normal limits. Although, interestingly, my B12 and folate levels are high. B12 is actually really, really high. I am not taking any B12 supplement with the exception of my daily vitamin. My oncology nurse was not concerned about this, but I plan on talking with my oncologist more at my next visit. If anyone has any insights, please let me know! Keep in mind that my liver enzymes and WBC are all in the normal ranges.

As for physical activity, I took it a little easier the first few days of the week. Partly because I knew my body would come around and partly because I was trying to work and I only have so much energy this first week. By Thursday, I felt good enough to go for a road ride. I rode up Emigration Canyon with this girl and felt surprisingly good. I think the good company helped:) I managed to ride dirt with Shannon both Saturday and Sunday. I'm still keeping my rides to sub 2 hours, but it was a beautiful weekend and it felt so good to be out.

Walk for the Cure

2011-05-10T18:25:00.000-07:00

Last Saturday, the day after my second chemo infusion, was the Salt Lake City Race/Walk for the Cure. Almost 20,000 people participated in this event. It was truly overwhelming to see the endless pink train of participants. Our team raised almost $2000 for the cause. My sincerest thanks to everyone who donated or participated.

We met near the start for some pre-race beverages. Alcohol may or may not have been involved, but I stuck to the virgin OJ. One of my co-workers stayed up late the night before making team shirts. There was even a bike on the shirt. Very cool!

Team captain, Bob, preparing OJ

We then pretty much split up and walked, jogged, or ran full-out the 5k race. Shannon and I hung with a few of my co-workers who were jogging at a nice pace. I've raced my mountain bike for 100 miles, but I don't think I've ever run a 5k. I guess I can check that off my bucket list.

Shannon looking hawt in pink

Thousands of participants at the Gateway

By Sunday I was already starting to feel the post-infusion fatigue and muscle aches and Monday wasn't much better. The good news is that I'm already starting to snap out of it and am looking forward to feeling better each day for the next three weeks.

In other news, Shannon is now a skinhead, although in my opinion he looks like Mr. Potato Head.

The Good, the scary, and the funny in no particular order

2011-05-06T19:06:00.001-07:00

This week started out a bit scary for me. On Monday I found out that one of my 'survivor' friends and mentors had found a new lump and she was going in for a MRI later in the week. This is an amazing woman that I deeply admire and I was devastated. If cancer could return in her, it can return in anyone. I immediately started (probably over) assessing everything that I felt in my body and convinced myself that the tightness I had over one of my ribs was concerning. Bone metastasis to the ribs is one of the most common places breast cancer spreads to. I spoke with my oncology nurse multiple times on Tuesday and we decided I would take Ibuprofen for the rest of the week and do an x-ray if it was still bothering me on Friday. The 'pain' I was feeling was weird. I only felt it when I would do certain stretches or when I would poke in a certain place on my rib. I was told to quit poking myself. This week was kind of long. I was a bit cranky and I was genuinely scared. On Thursday I found out that my friend's lump turned out to be nothing. I was ecstatic. Today when I saw my oncologist she thoroughly examined me and immediately noticed that when I did my 'stretches' that the sore area was actually a vessel. Not sure if it is a blood vessel or a lymph vessel, but who cares. This was great news. My oncologist said that this sometimes happens after surgery and she is not sure why. Nothing to be concerned about. No x-ray even needed. She recommended that I stretch, massage, and apply warm compresses and it should go away. I was giddy and could finally take a real deep breath. I then proceeded to spend 7 hours at Huntsman, most of it waiting, to finish my 2nd round of chemotherapy. I am a bit tired to say the least.....but very relieved. I truly believe that I can get through this journey and be as strong or stronger than ever before. It may take some time, but I believe. The one thing that I have to learn to live with is the fear of the cancer returning.

Other good news is that my white blood cells are maintaining good levels. Actually, my WBC level is higher today than it was before my first infusion. I guess that Neulasta shot is doing its job. My Hematocrit and red blood cells have dropped. Maybe this is why I feel slow on the climbs? My levels are just slightly low today, and hopefully they will not drop more. I don't get to be a doper either as my oncologist said that EPO can actually reduce the effectiveness of my chemotherapy drugs and I certainly don't want that. Worst case scenario would be a blood transfusion (is that doping?), but hopefully we don't get to that point. We did do an Iron panel today to determine if I have any underlying iron deficiency.

That was the scary, now for the good. Yesterday was the most beautiful spring day we have had so far. I actually was able to wear a short sleeve jersey on our bike ride. Shannon and I had a perfect ride on the Shoreline and he took loads of photos to remind me how good life will be once I get through my chemo hump days. Shannon always helps me feel strong on the bike by letting me ride just a little bit ahead of him. It almost makes me feel fast:)

Some fun photos from our ride:

Climbing grassy hill

Before the river on dry creek

Dry Creek should be renamed Creek Trail right now

My favorite photo: I love the snow capped mountains in the background

And now for the funny. Well, my hair is officially on its way out. I was shedding profusely for a few days and then on Wednesday we 'tried' to shave my head. Even though clumps were coming out, it was still too thick for our electric shaver. Shannon basically did a hack job on my hair, but there is still enough left that when I wear a hat it looks like I have hair. Thursday I wore a hat to work for the first time. I was at one of my schools and a teacher who doesn't know I have cancer said that my haircut looked soooo cute and she wanted to see it with my hat off. I didn't want to tell her that I had cancer and that my hair was falling out, and I certainly didn't want to show off Shannon's hack-job, so I said I had terrible bed head. It was kind of funny how persistent she was, but there was no way I was going to take my hat off! Even though it was awkward, I was giggling. I imagine I will have to get used to this over the next few weeks as my hair is quickly thinning and we are going to try shaving it again this weekend. BTW: Someone else in my family is getting a shave job and it is NOT Dizzy!

Tonight, Lyna brought over the yummiest meal from Mazza. My taste buds are still working (they probably won't be tomorrow) and it was truly appreciated. Thank you Lyna!

Tomorrow is the Race for the Cure and there are 20,000 people expected to swarm downtown Salt Lake City. I think we are going to park by the Hospital and take TRAX over to meet our team. I got this idea from Mandi another young woman who is undergoing cancer treatment. We've been supporting each other through this journey online and I finally got to meet her in person in the infusion room today. We both have to return to Huntsman for our Neulasta shots tomorrow in the afternoon.

I think I am going to go wear civilian clothes as opposed to the survivor t-shirt to the race/walk tomorrow. I am getting through this journey, but I certainly don't quite feel like a survivor yet!

Spring has sprung?

2011-04-30T11:33:00.000-07:00

Spring has been a little slow to arrive this year. It keeps teasing us with a nice day here and there but if you like to ride your bike on dirt, it has been a pretty awful spring. Hopefully, and according to the weather forecast, today was the start of a long string of sunny and warm days. I look forward to fully appreciating these mild days, because in Utah it will be 90 and bone dry before you know it (or for me, before I'm done with chemo).

Speaking of chemo, my side effects continue to be mild this week. I would say that I'm functioning at at least 90% of normal for my daily activities and probably 50% of normal (or less) as an athlete. Yes, I am able to work, cook (although I don't:), tend house, tend myself, etc. No I am not able to drill it for 4+ hours on the bike. This makes for interesting conversation when reporting how chemo is affecting me to my doctors.

I am able to ride though. In fact, I rode off road three days last week, ran two days, hiked one day, lifted weights twice, and walked the puppy everyday. I will say that although a two hour ride feels great and is fantastic therapy, I am always spent afterwards. Today we headed down to Lambert Park so I could ride the course from last weekends race. It was fun, but by the end of two hours of singletrack bliss I was mentally and physically wasted. It was worth it though:)

(Photo credit Bonnie Schreck)

Hair update: Somehow, miraculously, my hair is hanging on. I am 'shedding' more than my puppy though:) I figure every extra day I have hair is one more day that I don't have to leave the house feeling like a cancer patient. I like that feeling.

Soapbox: I have already mentioned that next weekend is the Susan G. Komen Walk for the Cure fundraiser. I will be participating as part of Jen's Jug-ernauts team. I want to thank everyone who has already donated to this team; the team is already well over the goal of raising $1000. However, I want to encourage everyone who has not already donated to consider. Even $5 can make a big difference. The truth is breast cancer affects 1 in 8 women in this country. Eventually, someone you love deeply will be affected by this disease. Although I realize that a lot of research dollars have/continue to be spent to research breast cancer, there is so much more that needs to be understood in order to provide treatment with the best possible outcome. For example, two women with Stage 2 (which is what I have) breast cancer may have two completely different cancers that respond very differently to treatment. Other tumor characteristics that may affect how a tumor responds to treatment include: nuclear grade, size of tumor, estrogen receptor status, progesterone receptor status, Her2/neu status, lymph node status, Oncotype dx score, type of cancer, tubule formation, nuclear pleomorphism, mitotic activity, lymph-vascular invasion, and I'm sure a lot more. I find it interesting that if you speak to three different oncologists, you will most likely get three different opinions on how to treat your cancer. Clearly there is so much more that needs to be learned.

If you would like to donate to our team, you can here:

http://slc.info-komen.org/site/TR/RacefortheCure/SLC_SaltLakeCityAffiliate?team_id=159706&pg=team&fr_id=2133

or please consider donating to someone else's team. The money all goes to the same place, and that is what really matters:)

On a lighter note: This is why my puppy is named Dizzy:

Week Two

2011-04-26T20:17:00.000-07:00

I realize that I haven't posted in a while. The truth is, once chemo started my life got a lot less (medically) busy. In fact, I have only been to see a doctor once in the past two weeks! Amazing.

I am happy to report that most of my chemo side effects have resolved and I am able to carry on with life as usual. Not exactly my 'usual' life of racing and training, but life is moving forward.

Spring break is over and I am back to work this week. I have to be especially careful though because even though I feel fine my immunity is at its lowest point right now. It is nice to have some normalcy back in my life, and to feel good enough to be able to enjoy it. I am going to take a moment to brag about my job. I am an occupational therapist and work in one of Salt Lake City's school districts. Many of the students I work with have fine-motor delays and I often develop programs to help remediate their skills. Over the winter, many of my students crocheted hats as part of their fine-motor program. Mind you, I have no idea how to crochet, but fortunately my aide does:) This spring, my kiddos crocheted two beautiful hats for me. They are all so proud and the hats are absolutely perfect! Like I said. Awesome job. Awesome co-workers. Awesome kids.

I also appear to be completely healed from my mastectomy and am pretty much able to do whatever I want physically. I am continuing to stretch daily and am doing some light upper extremity weights to help maintain strength. I seriously doubt that I will be able to gain muscle during chemotherapy so I will focus more on making gains later this summer. The rest of the time I try to spend biking. The odd, pulsating low back pain seems to have (mostly) resolved and my tachycardia is also improving although not yet normal.

Right now, the most annoying thing is my skin. It is sensitive, yet oily and my normal skin products don't seem to be working. It is kind of like going through adolescence once again. I also have to be really careful in the sun, although recently in Utah that has not been a concern. I'm not sure if Spring will ever arrive.

At this point, I still have a full head of hair and my short hair keeps growing. It is really out of control and I need another haircut, but I'm sure the chemo will take care of that any day now......

As for the rest of the week, I think the sun may actually venture out so I plan on taking full advantage before I hit the (chemo) chair again next week.

1.5 weeks down, 10.5 to go

Week One

2011-04-21T18:21:00.001-07:00

Note to self: Monday after infusion will be the worst day. At least as far as energy levels go. After Monday, I was seriously reassessing how to prioritize my work caseload for the rest of the school year. I'm happy to say that since Monday my energy has been improving and although I still only have a fraction of the energy I normally do, I am able to live a (somewhat) productive life.

As for other side effects, I don't have many of the 'normal' side effects. Still no nausea, yeah for that! The side effects I do have are more odd. I have a significantly increased heartrate. As an athlete, I know what my 'typical' resting heartrate is so when I am sitting at 20-30 bpm higher I get concerned. That was call #1 to my oncologist this week. The exact cause, in my case, is not exactly known. However at this point we are optimistic that it will return to normal post-chemo.

Call #2 occurred after I experienced an odd pulsing low back pain when I was 'trying' to ride my mountain bike yesterday. It was most pronounced when I would try to get low and aggressive on a downhill, but I was partially attributing it to my increased heartrate from the climbing that preceded the downhill. The pain would decrease when I would sit up more perchy on my bike. Not exactly fun for downhilling. This pain has been more noticeable today ever since my ride yesterday. Anyhow, this was somewhat puzzling to my oncologist, but she attributed it to side effects from the Neulasta shot (helps improve white blood cells) I had Saturday. If this is the case, this side effect should improve over the next two weeks just in time for my next infusion May 6th.

On a non-cancer related note, this weekend marks the first race of the newly established Utah State Championship Mountain Bike Series. In my humble opinion, this series is going to RULE!!!! The series has reasonable entry fees for all racers, kids race for only five bucks, plus $5 of every entry is donated to Huntsman Cancer Institute. The icing on the cake is that over $8000 was secured for pro payout over the 4-race series. This is seriously what mountain bike racing should be, although I may be a bit biased because the series is promoted by some folks I know pretty well. Actually, no, I'm not biased. THIS IS WHAT MOUNTAIN BIKE RACING SHOULD BE! I will be helping with race-day registration so if it is all f****d up, I'll blame the chemo:) Check it out here: raceuscs.com

One week down. 11 to go.

The Fatigue Monster

2011-04-18T16:09:00.000-07:00

Although the effects of chemotherapy vary for everyone, I am now going through what is often considered the hardest few days post-infusion.

I have no fever, vomiting, nausea, convulsions, significant pain, or any of the other horrible side effects you often hear of related to chemotherapy. For this I feel fortunate. I do have fatigue. It is the type of fatigue that I have never experienced before and it is not fun. Mornings seem worse. The thought of getting out of bed to make breakfast seems like too much work and once I do I go back to bed and rest again. I am always disappointed that rest does not really make me feel any better. By early afternoon, I seem to have mustered up enough energy to do a few things around the house and go for a bike ride. Today it was just an hour on the trainer. After my ride I thought I would just sit and relax for a few minutes. An hour later I was still sitting there staring at the wall. I am incredibly bored but lack the motivation to do anything fun, especially when it is raining. As for food, there is no point in eating yummy food, because nothing really tastes good. My go to has been toast with peanut butter and agave nectar. I think I had 4 pieces today.

On a positive note, I seem to feel better in the afternoon/evening and that is about right now. My puppy is patiently waiting for a walk, and since the rain has stopped for the first time today, I think we will go.

and now I feel bad for writing how tired I feel because right now I feel okay. Certainly not myself, but okay. Mornings are rough though.

Chemo #1

2011-04-15T19:30:00.000-07:00

Preparing for my first chemotherapy infusion started yesterday when I had to remember to take Dexamethasone. Although I was not looking forward to taking this steroid because it can cause weight gain and bloating, not exactly performance enhancing, I knew it was necessary to help reduce possible side effects of today's TC infusion. I was also happy that I was able to talk my oncologist into reducing the typical dosage to only 4mg twice daily because I am a lightweight. I have to take two more doses tomorrow as well.

I have spoken with enough people that nothing about today's infusion really surprised me. It was, as expected a long day. I arrived to Huntsman via bike just before my 10:50 blood draw appointment and realized that I only packed a t-shirt. Not exactly what you want to be wearing while having cold liquid pumped into your body for 2 1/2 hours. Fortunately Shannon drove from work and was nice enough to go home and get me a sweater. When I hear of people commuting 3 hours to see their oncologist, I feel very fortunate that we live only 6 miles away from Huntsman Cancer Institute.

I then met with my oncologist and she looked at my incision one last time before clearing me to start chemo today. So far my mastectomy seems to be healing very nicely and I feel very fortunate for this as well. I am also happy to say that through a lot of hard work the past 1.5 weeks, I have full range of motion back. I have been diligently performing the recommended range of motion exercises twice daily and every day I notice improvement. I have not yet started strengthening exercises, but I am hoping the plastic surgeon will allow me to start this after I meet with him next Tuesday. I can already tell that a lot of strength is coming back just using my arm functionally. I am completely confident that I will regain full pectoralis strength and I plan on writing a paper on my progress. I have baseline pre-surgery strength measurements and my goal is to regain full strength my January.

Back to chemo. Like I said it was pretty uneventful. After given my final clearance we were off to the infusion waiting area. It takes at least 30 minutes to prepare the chemo drugs after MD orders. During this time I was approached by a research assistant who asked if I wanted to participate in a study. The study requires that I call a hotline daily and answer questions regarding any side effects I may be experiencing. The study group gets a return telephone call that same day from a Nurse Practitioner to help manage the side effects. The control group does not. Fortunately for the Huntsman staff, I was assigned to the study group, so I may be bugging them a little less. I pretty much agreed to participate immediately to help support research and later found out I would be compensated $300! I see lots of acupuncture in my future.

Speaking of acupuncture. I had my first visit on Tuesday. My goal for acupuncture is to help reduce any chemo side effects. There is some research that shows that acupuncture helps with chemotherapy induced nausea and acupuncture practitioners claim that it also helps with fatigue, muscle pain, stress, etc, etc. I decided to give it a try. The women I saw took a very thorough medical history and I was impressed by her breast cancer knowledge. She seemed to ask key questions that helped me to respect her as a therapist. Then she stuck needles in me. She stuck them in my feet, ankles, tummy, chest, (left) arm, and a surprisingly large number in my head. The focus on my head I found interesting:) I then took a nap and 30 minutes later she took them out.

Back to chemo, like I said it was very uneventful. Eventually, my cocktail was ready and I was called back to the infusion room. Huntman is the most beautiful hospital I have ever seen, however the infusion room was really nothing special. It was crowded and noisy, but the staff was wonderful and my recliner was really quite comfortable. My IV was placed easily and I was given some more steroids and anti-nausea medication. Then on to the infusion. All week I have been pretty relaxed about starting chemo although I admit when the poison started to go in I became quite nervous. It makes more sense to me to pump your body full of good things not bad, toxic, debilitating things, but I am making an exception just this once. The first drug was Taxotere. Apparently there can often be an allergic reaction in the first 20 minutes and I was watched very closely. I even gave my nurse a scare when I choked on my smoothie, but fortunately no reaction. A few hours later we were ready for Cytoxan. 45 minutes later, and 6 hours after we arrived, we were released to go home.

Overall, I feel really good, but it may hit me like a brick tomorrow. I'll just have to wait and see. Everyone responds differently to chemo so it will be a waiting game to see how my body responds. My immune system will be weakest at about day 10 and then I should start to get stronger as I get closer to my next infusion. The one thing that was emphasized over and over again is to exercise. I am planning on riding my bike tomorrow to the hospital again to get my Neulasta shot (to help white blood cells).

In the meantime, I need to stay on top of my medications. I have been told about a hundred times to not try to tough it out and to just take the meds. I suppose, just this once, I will comply with this as well. The amount of medications I am on is pretty daunting. I already made a cheat sheet and my nurse made another for me as well.

Next week I am on Spring Break so the timing is perfect to give me time away from work to see how my body responds from this first infusion. I am looking forward to lots of yoga, bike riding, acupuncture, yummy food and rest.

Getting ready to run my first infusion. I was nervously drinking a smoothie here. I was told that popsicles during infusion help reduce mouth sores. Unfortunately the popsicle I brought melted, so a smoothie had to suffice.

A melancholy weekend

2011-04-11T15:00:00.000-07:00

Back in December, when I was planning my 2011 race season, I registered for Whiskey 50 and 12 Hours of Mesa Verde with the intention of peaking in late April/early May for these two races. I was especially looking forward to Mesa Verde May 7th. The course is wicked fun and a large SLC contingent heads to Colorado contributing to the 'party' atmosphere. Shannon and I were to race as a Duo relay team for 12 hours. We did this race in 2009 and finished 2nd and the plan was to improve upon that finish this year.

Well, I have now sold our registration to this race and instead Shannon and I will be participating in the Salt Lake City Susan G. Komen 5k Race For a Cure that same weekend. This is a bit melancholy for us, however I am truly honored, if not a bit embarrassed, that some of my incredibly supportive co-workers have started a team in my honor. The team name is Jen's Jug-ernauts. As one of my co-workers pointed out, Juggernaut is a term used in the English language to describe a literal or metaphorical force regarded as unstoppable. It is often applied to a large machine, or collectively to a team or group of people working together, or even a growing political movement led by a charismatic leader-and it often bears an association with

being crushingly destructive. This name choice is incredibly flattering plus it has 'Jug' in it which adds to the appeal:)

Admittedly, I am fearful to be around so many women who are and may look sick, especially when I continue to feel pretty darn good. I like to deny anything is wrong with me at all. However, each one of these women is a survivor which should serve as incredible inspiration plus the Susan G. Komen foundation is an incredible resource for people with breast cancer and I want to show my support. Their website was my first resource when I was diagnosed in January.

If you would like to participate in the walk or donate to the Susan G. Komen foundation in honor of our team, follow this link: http://slc.info-komen.org/site/TR/RacefortheCure/SLC_SaltLakeCityAffiliate/97412945?pg=team&fr_id=2133&team_id=159706

On a positive note, I just finished my first ride outdoors in over two weeks. I may have gone easy, but I felt so ALIVE!

Cleared for chemo

2011-04-10T19:50:00.000-07:00

Friday I met with my medical oncologist, Dr. Buys, at Huntsman Cancer Institute to get final clearance to start chemotherapy next week. I haven't seen her for about a month and I've been keeping a running list of questions to ask. This list was long to say the least and the questions ranged from her opinion on eating soy (a phytoestrogen) with estrogen receptor positive cancer to her thoughts on using taxotere (a chemotherapy drug) despite research showing some tumors to be taxtotere resistant. Question everything, right? I was initially checked in by an internal medicine resident who listened to my heart and lungs and asked if I had any questions. Ha! Did I have questions! I pulled out 'the list' and started asking away. He listened and then left the room. When he came back he brought Dr. Buys, her Nurse Practitioner, the nurse, and another women (I'm guessing another resident). I guess they all wanted to hear my questions:)

Anyone who knows me well knows that I can be a little shy especially with large groups of people. Even though this was my 24th doctor appointment since the middle of January, I felt a bit of stage fright as I went over my list of questions with five medical professionals in the room. On the flipside, my questions must have been interesting enough for everyone to want to listen. Fortunately, I had my trusty list (and Shannon) and all of my questions were answered.

I appear to be healing very well and Dr. Buys cleared me to start chemotherapy Friday April 15th. My chemotherapy cocktail will be TC (taxotere, cytoxin). Yes, in regards to one of my questions, some tumors are resistant to taxotere however there is no reliable test to determine this. Studies show that overall this regimen is very effective. TC is quite toxic though and I will have some crummy side effects, however Dr. Buys is confident that this regimen won't negatively impact my future physical performance. I will be having four total infusions; one every 3 weeks. My final infusion will be June 17th. I am picturing a summer party to celebrate this milestone!

In the meantime, I have been feeling good and exercising every day, although I do still seem to fatigue easy. I still haven't ridden my bike outside, partially because it has been uncharacteristically cold and snowy. Friday afternoon, on what should have been a sunny spring day, we took Dizzy for a hike in fresh snow.

This trail was dry enough to ride over a month ago. Not today!

Dizzy doesn't mind a few more days of winter

Really, I just want to blog about biking......

2011-04-06T12:31:00.000-07:00

......but I can't do that quite yet.

Yesterday I had an appointment with my plastic surgeon. Everything is healing very nicely and my final drain was removed. 11 days of drains was enough for me. I am supposed to take it easy for a few days so that I don't have too much fluid build up now that the final drain is removed. I was also cleared to do some structured stretching which I started pretty much as soon as I got home from the hospital. I have been very careful (at least I think so) during this initial healing process. My goal is not to see how fast I can get back on the bike, but to heal completely and get through this stage complication free, and then get back on the bike. I did go to the gym tonight and pedaled the recumbent bike though.........

I also visited with a Naturopath yesterday. My goals for this appointment were 1) To support my body during chemotherapy and 2)Reduce chance for future cancer recurrence. We tackled goal #1 yesterday. We discussed a few different interventions. The primary recommendation is high dose glutamine. The following research was sited:

Clin Cancer Res. 2001 May 7(5). "Patients receiving Taxol given glutamine vs. no intervention". Dosage of glutamine was 10 gms 3 times daily for 4 days, starting 24 hours after treatment. Showed statistically sig reduction in: motor weakness, gait deterioration, numbness/dyesthesias; and improvements in overall activities of daily living.

We also discussed probiotic use and antioxidant use. Antioxidant use is controversial with chemotherapy so I will present this to my oncologist later this week. Fish oil was also recommended as it enhances the cellular 'killing' effect of taxanes. Interesting stuff....

Today was also my first day back to work. I worked a 1/2 day as to not overtax my body on my first day back. I felt pretty good the entire time and after the initial socialization with co-workers was really quite productive. I'm hoping to be able to work a full day tomorrow.

Even though I am back to work and able to carry out most activities, I am certainly not back to normal. Simply lugging my stuff in and out of my car is difficult right now. Hopefully every day continues to get better.

Next up, I meet with my medical oncologist on Friday to get final clearance to start chemotherapy April 15th.

Numbers

2011-04-03T09:58:00.000-07:00

When faced with cancer, you are constantly being presented with statistics. Or in my case, being presented and personally researching statistics. This has me thinking a lot about numbers recently. Here are some numbers that are on my mind.

1. I had a .6% chance of developing cancer as a healthy 35 year old.

2. Being diagnosed with cancer is a whirlwind of doctor's appointments. I have consulted with my primary care physician, surgical oncologist, medical oncologist, radiation oncologist, (2)plastic surgeons, nutritionist and soon a naturopath. This has resulted in 20 doctor's appointments since January 13th. That is at least 2 appointments per week for 3 months straight. I have three more appointments next week.

3. When I fill out my 'new patient information forms' (which I do quite often recently) I don't have to check any health problems with the exception of occasional heartburn and now cancer. Checking cancer freaks me out.

4. I've never needed surgery. Since January 20th I have had two surgeries requiring general anesthesia, one with heavy sedation, and two procedures.

5. Interestingly I was given 40 pain pills post lumpectomy and only 30 post mastectomy. Mastectomy (with tissue expander) is much more painful than lumpectomy.

6. I have had a little less than 200grams of tissue removed from my body. This is a little less than .5 pounds. As a cyclist, this inches up my power to weight ratio just a little bit:) I do not recommend removing body parts to improve power to weight ratio though. Also, I am not accounting for the weight of the tissue expander. Maybe I will ask my Plastic surgeon how much this weighs for more accurate measurements.

7. I was told that there is a 1% chance per year of developing a new cancer in my other breast over the next ten years. If I take hormones for 5 years this is reduced by 50% so there is a 5% chance of developing a new cancer in my other breast.

8. According to my Oncotype Dx score (gene expression of my tumor) my risk of distant recurrence (this cancer coming back somewhere else in my body) with hormone therapy alone is 13% over 10 years. Chemotherapy reduces this by 4-5%. I chose to undergo chemotherapy and get that 4-5% reduction.

9. I like to ride bikes. I also seem to collect bikes. I currently have 7!!!!! bikes. I have two carbon fiber 29er hardtails, one carbon fiber 26" full suspension, two cross bikes, a 26" single speed, and a road bike. I like to ride all of my bikes.

10. I have worked in the school system at my current job since 2005. I use on average 1 sick day/year and I don't go to work sick (which would skew the statistics). Somehow my immune system is strong enough to prevent me from getting sick even though I am exposed to sick children daily, yet I develop cancer at 35 years old. I will never understand this, I am working on coming to terms with it.

11. I am currently on a plant-based diet based on the recommendation to primarily eat plant-based foods to reduce risk of cancer. A funny story related to this is when Shannon and I stayed at the Bed and Breakfast by Colorado National Monument a few weeks ago. Instead of bringing a cooler full of wine, we brought a cooler full of leafy greens! I have had animal product exactly 2 times over the past six weeks. A friend brought over fresh Elk chili. It was yummy.

12. I have never taken supplements, pretty much just a daily vitamin. Now I take a daily vitamin,a calcium supplement, a vitamin D supplement, and a fish oil supplement.

13. I am an extremely healthy person, however I am going to make myself very sick because of a 2cm tumor that I found myself. I often wonder what my life would be like right now if I never found that 'nodule'.

14. I think (based on this post) it is clear that when I'm not keeping myself busy working, cycling, visiting, and doing other fun things that I have toooo much time to think.

Post-Mastectomy Follow-up #1

2011-03-31T16:44:00.000-07:00

Today I met with the surgical oncology team at Huntsman. Everything is looking pretty good. There is still some swelling and some possible redness of the skin that will be watched closely although Shannon thinks that it is just my normal blotchy skin. The good news is that my drain output has been minimal so we were able to remove one of the two drains today. This made me especially happy because it was the more superficial drain and I could see it under my skin. Totally creepy. The build up to drain removal was intense. For some reason I was convinced that it would be excruciatingly painful. I described to the nurse how I envisioned a hook at the end of the drain (I was certain I could see that under my skin) tugging at my tissue as she pulled it out. I also envisioned her ripping it out like a bandaid. I lay on the table hardly able to breathe with my eyes closed. I didn't even know when it actually happened as Vicki (the nurse) kept talking. Felt nothing. So for all of you who keep telling me I'm tough......I'm really a wimp!

I don't meet with this team again until June. I think I may be on to the next phase of this journey.

As for post-surgical discomfort (aka pain) that has been decreasing every single day and I am pretty much tapered off the pain meds. Sometimes I find myself feeling so good that I will jump up and and do something out of habit. The associated discomfort (aka pain) often reminds me that I am still really sore with certain arm movements and lifting is not yet allowed.

My next follow-up is with the plastic surgeon on Tuesday. Hopefully the swelling will be down, no sign of infection, and the final drain can come out. Later in the day I have an appointment with a Naturopath. I'm really excited to meet with this woman. Hopefully she can help me cruise through chemo although I'm not sure that is even possible. Then, Friday I meet with my medical oncologist who will give me final clearance to start chemotherpy the following week.

I also want to thank everyone for the cards, flowers, food, and goodies. We have not had to cook a single meal this week and have had the yummiest plant-based, leafy green, anti-cancer meals brought over. I must say that I feel kind of guilty when people bring things over. All this resting has resulted in a lot of pent up energy. I am kind of a spaz. Even though I feel great it is really difficult to do things around the house. We really appreciate everyone's kindness.

Radiation

2011-03-28T18:49:00.001-07:00

Radiation is often used to control for local recurrence with breast cancer. When a lumpectomy is performed, even if clean margins are obtained, radiation is indicated almost 100% of the time. This is because there is the possibility of some stray cancer cells wandering the breast tissue that increase the likelihood of local recurrence. Post-lumpectomy radiation significantly reduces this risk.

With a mastectomy, radiation is NOT indicated if 3 criteria are met. The criteria are as follows:

1. Tumor less than 5 cm in size

2. Negative lymph nodes

3. Completely clean margins of greater than 2mm (it is possible that the cancer gets too close to the skin or chest wall)

Up until today I had 2/3 of these criteria met. This is one of the reasons I chose mastectomy. I was (kind of) gambling on getting completely clean margins in hopes of avoiding radiation. Today, I won that gamble. My margins are clean! As far as I know, I will NOT be needing radiation. Although radiation techniques have improved significantly it is still a 5 day/week treatment that lasts 6 weeks (unless you are lucky enough to get into a clinical trial). Not needing radiation also opens up my reconstruction options. Options are good. Also, long term implications of radiation (for a 35 year old planning to live another 70 years:) are not completely clear.

Besides the good news, I think I am healing right on track. I once again feel great and if it weren't for some physical limitations and discomfort from the expander I'd be rearing to go. I've been told that I can walk as much as I feel like. Today I walked around the block whenever it stopped snowing. Tomorrow it is supposed to be nice, so maybe I'll increase distance and duration:) Thursday is my first follow-up so I'll know for sure if my healing is on track.

Sugery Numero Tres

2011-03-26T17:46:00.000-07:00

Pre-surgery blues (self portrait)

Hopefully three is a charm.

Yesterday I underwent a right mastectomy. So far, everything has gone well.

I arrived at the hospital at the requested 9:00 AM time, even though my surgery wasn't scheduled until later in the day. Apparently I had been wishy-washy on my final surgical decision and the ever-understanding Huntsman staff wanted to give me time to talk through any last minute wish-washiness.

I knew that I wanted to have a mastectomy, but I was undecided about when to do it. This is very complicated, but I will try to explain it while under the influence of Lortab:)

Actually, nevermind. I just typed up a whole page trying to explain all of my options and it didn't even make sense to me. I will try to summarize later this week.

In the meantime, this is what we did:

1. I had a right total skin/nipple sparing mastectomy. I can not describe how comforting it is to wake up and see your 'stuff' down there. I am very fortunate that my surgical oncologist is so experienced with this procedure. The same incision was used as what was used for my lumpectomy so there will be no additional scar.

2. The plastic surgeon placed what is called a tissue expander inside my breast. This is basically a balloon that can be filled as much as I like. I see 'DD' in my future:) Just kidding. I've already been getting a hard time because I choose to be the same 'small' size I was before. Already there is not much expanding left to do.

3. This approach is called the 'Burn no bridges' approach. There are a few options for final reconstruction and I will go into more detail later this week when I am more coherent, however have some time to make this decsion.

In the meantime, I have recovered well and am now at home after spending one night at Huntsman. I must say, the accommodations at Huntsman are very nice. It is kind of like staying at a fancy hotel with free room service. Shannon stayed with me so I truly had nursing care around the clock. My only post-op complication was some nausea when I got up to walk last night. It would go away as soon as I sat down. My anesthesiologist once again did a great job and I have a good appetite today.

Relieved to be done

Shannon packed my Breck Epic belt buckle to remind me how tough I am

Homemade granola bars. Yummmm. I love the compression boots. I could have taken them off hours before, but chose to continue the lower leg massage up until we left.

The view from our room. Not bad. I could see runners

and cyclists on the Shoreline all morning:(

It is ironic how crazy busy I made myself last week prior to surgery trying to get things done. I wanted to get some 'last chance' workouts in, clean the house, stock the cupboards, etc, etc. Now I have endless amounts of downtime ahead of me. I can already tell that it is going to be a long week or so while I wait to have the drains removed and can start to be able to use my right arm more.

I really appreciate all of the notes and well wishes I have been receiving. It means so much. And now I will actually have some time to respond:)

It is what it is

2011-03-24T16:15:00.000-07:00

Tomorrow I am going in for what will (hopefully) be my final surgery in awhile. Or at least for a couple of months. After weighing my options, researching thoroughly, talking with others in similar situations, and lots of tears I have decided to have a mastectomy.

I could go on and on about how I came to this decision, but basically it came down to my young age and increased chance of local recurrence if I don't have a mastectomy despite research showing similar long-term survival in mastectomy vs. breast conserving treatment (lumpectomy). Fear was definitely a factor in my decision. It scares me that cancer somehow found a way into my strong, fit, and healthy body. More than anything, I want to move on with the next chapter of my hopefully very long life.

This has been the hardest decision of my life. My head is constantly spinning weighing the pros and cons of each option and the possible outcomes that I have no way of predicting. Over the past few weeks I have been all over the place emotionally. Some days (or moments), when I choose not to think about it, I feel great. Other days (or moments), not so much. 3 months ago if you asked me how attached I was to my breasts, I would probably be more or less indifferent. When put in this position, it is amazing how that changes. I also worry about needing more procedures down the road. Really I just want to be done!

The good news is that there are options for reconstruction, some of which I just learned about this week. My surgeon(s) are very skilled in this area. I am hopeful that I end up with cosmetically attractive and perpetually perky breasts:)

I catch myself sometimes feeling sorry for myself, however with everything going on in the world today I really do feel fortunate. I feel healthy, have a wonderful husband, supportive family and friends, a great job that I love, and medical insurance.

Most importantly I have passion for living.

Hair

2011-03-22T18:44:00.000-07:00

My hair is so thick it took 4 ponytails. All of which will be donated.

I can honestly say that the one thing about this cancer experience I have been looking forward to is chopping my hair. My hair has been in a ponytail since about 2004. I like my ponytail. It is easy, familiar, and comfortable. Cancer is not easy, familiar, or comfortable. I wanted to do something crazy. I'm not a very crazy person, so I expressed this feeling by chopping my hair.

I have been planning this haircut for quite a few weeks. In fact, I've been researching 'styles' much like I do everything else. Originally, I found a cute short cut that wasn't too short, not too daring. I was certain that was what I was going to go with. Then I found a picture of a super, duper short cut and I knew that I wanted to be brave, braver than ever, and chop it all. So we did.

Here is the progression of my hair cutting experience. My stylist was game to take photos and was very enthusiastic about chopping it all off. Shannon even joined in for some of the fun.

This is how my hair looked when I walked into the salon

The back

I think Erica left a little rat tail to be funny

Scared to look?

I am strong. I can do anything. Even rock a short cut.

Pigtails?

I may want to replace the 80s rocker muscle Ts for something more feminine for a while!

Fruita, CO

2011-03-20T20:00:00.000-07:00

Shannon and I took one last getaway this weekend. We traveled 4 hours south (east) to Fruita, Colorado where there is an abundance of beautiful scenery and super fun singletrack. Shannon also booked a room at a bed and breakfast overlooking Colorado National Monument. Much nicer than our typical 'cheap-o' weekend motel. This weekend was all about riding and relaxing and yummy home-cooked breakfasts!

Friday afternoon we got a short ride in on the Kokopelli trails. It was a beautiful afternoon and the dirt was tacky from rain earlier in the week.

Overlook Day 1

Diggin' (not too) deep on a short climb

The scenery is always epic

Saturday we ventured to 18 road. These trails have been some of my favorites in the past, but today most of them were just lumpy from cow tracks. I decided to rename 'Chutes and Ladders' to 'Chutes and pot holes'. It was also super windy and I thought I may blow off some of the exposed cliffs. Fortunately I didn't. We had a great time regardless. My highlight of the day was cleaning all of 'Zippety-do-dah'. It is not the most technical of trails, but it seems there is always something that causes me to dabble. Not today! We got in a solid three hours of riding on this day and many more hours of relaxing.

18 Road trails

Shannon and I have debated this photo. I think it is sideways. He says that it is an optical illusion because of the steep (in Shannon's words: "Super steep, almost vertical") downhill before the photo was shot. I still think it is sideways.

We traverse the limestone mounds in the photo. I always think I'm going to blow off.

Sunday, we were back at Kokopelli trails to get in a couple hours before traveling back to Salt Lake City. We did most of the big loop and some of the more fun smaller loops. It started out beautiful, however the wind picked up on the cliffs of Mary's Loop. I did blow off the trail and into a tree today. Another great day of riding.

This was supposed to be a cool overlook on Mary's Loop. We kind of missed it in the photo:(

Finding speed on Rustler's Loop

(Don't worry Dicky, the visor comes off when I race for real)

This weekend was also unique in that it was the first time we left the puppy home. We had someone stay at the house, and it must have gone well. He hardly seemed to miss us and is already back into his routine.

Hats

2011-03-16T16:09:00.000-07:00

Since I will be starting chemo in a few weeks, I have a new interest in hats. I have pretty much decided that I won't be wearing a wig, unless of course I stumble upon a hot pink or flaming red one.

Here are some of the hats I have so far. I was a bit spunky when I purchased a few of them, so fortunately I still have the tags and receipts. Not sure if I will actually wear most of them; I'm guessing that when it comes time for me to actually need a hat, I will be lazy and end up wearing a beanie like I do now everyday.

The prana beanie

Shannon picked this one out. Weirdo.

Basic corduroy

Classic khaki

This one was my favorite. Although I think it looks silly in the photo

This will probably be worn under a hat to add some color

In the meantime, hair is getting chopped next Tuesday. Now that will be a fun new adventure. I've been wearing a ponytail since about 2004 when my last short haircut grew out.

We're also heading to Fruita, CO tomorrow for one last getaway (sans puppy) before my own personal hell begins next week.

Downhill TT

2011-03-13T13:52:00.000-07:00

Last fall, long before I was diagnosed with cancer, I attended a BetterRide Mountain Bike Skills clinic with Andy Winohradsky. Prior to the clinic I did a downhill time trial on a popular trail in Corner Canyon. This allowed me to get a baseline of my downhill speed on a trail I know well. I did this Time Trial three times and had almost identical times of 3 minutes every run. I then attended the clinic and practiced skill drills a few times a week over the fall. Then winter came and I spent more time on the trainer and at the gym than outside riding my bike. This spring, as we headed south a few times for singletrack Shannon kept telling me I was riding the downhills waaaaay better. I did feel pretty good, but then again maybe he was just being nice, you know, to the girl with cancer:)

Fast forward to this weekend. We have had unbelievable weather in Salt Lake City this week. So nice, that I was able to ride dirt every day for the past three days! Yesterday, I decided to put my new skills to the test and drove to Corner Canyon for some downhill time-trialling. My fitness isn't race ready, but it really isn't too bad. I thought it would still be a valid test. My goal was 10 seconds faster. I did a short warm-up and then headed to my downhill trail for my moment of truth. I rode as fast as I could but never felt out of control or like I was pushing the limits to0 hard. When I got to the bridge (my finish line) I looked at the stopwatch and it read 2:37. I took 23 seconds off my time from last year! I then recovered and did it again. 2:30. Now I was going a full 30 seconds faster than last year! It was amazing and I felt so good on the bike. When I do the math, I reduced my downhill time by 17%.

How will this affect me? I'm hoping in a big way. Park City Point 2 Point took me 9.5 hours last year. Looking at my GPS file, approximately (and I mean really approximately) 3 hours were spent downhilling. If I reduce that by 17% I can take a full 30 minutes off my race time without even climbing any faster. and I will be climbing faster:)

This photo just shows off my cool/fast bike

Here it looks like I have floaties on!

Trying to be low and balanced; allowing the bike to move under me

Hammering out of a turn

Still working on drilling the corners

Beyond the Cheers: BlogTalkRadio: Breast Cancer and Athletes

2011-03-08T18:47:00.001-08:00

Dave Ferguson of Beyond the Cheers BlogTalkRadio contacted me a few weeks ago regarding being a guest on his upcoming show Breast Cancer and Athletes. I admittedly was reluctant at first. This diagnosis is still new to me and I certainly don't have much perspective yet, however I could not resist the higher calling of sharing my story and spreading the word that cancer can happen to even the youngest, strongest and healthiest.

The show starts at 5:00 PM MST tomorrow (Wednesday March 8th)

Information on the show including call in number and radio stations can be found at:

http://www.blogtalkradio.com/beyondthecheers/2011/03/10/breast-cancer-one-athletes-story

Cancer Free Weekend

2011-03-06T17:14:00.000-08:00

This weekend was the kickoff of the mountain bike racing season here in Utah. I have raced the Desert Rampage in St. George every single year since 2004. It is one of my favorite races of the year. Not only because the course is so much fun, but because all the racers travel south for some fair weather riding. Although it is technically a race, it is really a social event. Even though my fitness is now nowhere near where it needs to be to keep up with the pro women, I headed south for some desert riding and to soak in a comfortable and familiar atmosphere.

Before we left, I wasn't sure if I would even be able to ride off road at all. My last surgery was exactly one week ago and I certainly did not want to do any damage to the incision. We arrived at twilight Friday night and wasted no time getting on the bike. Basically we threw on our helmet and shoes and took off wearing blue jeans and sweatshirts. It was still 60 degrees out and the (relative) warmth felt fantastic. I took off up Prospector and felt great to be on the bike riding singletrack. I could immediately tell that there would be more off-road riding for me this weekend.

Saturday was race day. I had mixed emotions about showing up to the race. On one hand it was going to be great to see all of my racing buddies. On the other, it was going to be really hard watching from the sidelines. It was a bit of an emotional day, but the joy of seeing friends and being part of the race scene overrode my sadness of not being able to race. I rode for a couple hours in the morning before the race and then was assigned to be photographer for MTBracenews.com. I was uninspired to take photos and did a lousy job basically staying in the same place the entire race; fortunately some of my photos turned out okay:)

Rippin' Stucki Springs

Sunday was another beautiful, warm day and we took the puppy for a hike before a fun ride on Bear Paw and Stucki Springs. I felt pretty darn good for a girl with cancer.

The best part about the weekend was that I took a 'break' from cancer. No doctor appointments, no books, no internet searches (well...maybe one or two). Basically a cancer free weekend. Ahhhhh, loved it.

Dizzy only gets to sleep in the bed when we travel. He took full advantage of that this weekend!

Pathology, chemo plan, and more

2011-03-04T20:07:00.000-08:00

Thursday ended up being a full day at Huntsman. First we met with my surgeon to see how everything was healing. My incision looks good, but unfortunately the pathology report was not yet back. Apparently, it was not straight forward and the pathologist was taking her time reading it. The results did come back by the end of the day. My margins are clean (relief) however there is some DCIS (non-invasive Stage 0 cancer) less than the .1cm required margin so more surgery will be in my future. I knew that this scenario was pretty likely, but at least the margins are clean and if anything is to be close to the margin I would prefer the DCIS over the invasive cancer.

Next up I met with the medical oncology team. This pretty much took the rest of the day as they were very thorough. I was not surprised to hear that chemotherapy was recommended. Basically, there were three criteria that qualified me for chemo.

1. My age. Young people have a much higher risk of the cancer returning

2. The Grade of my tumor (grade 3)

3. The size of my tumor (2cm)

My chemotherapy 'cocktail' will be TC (Taxotere and Cytoxin). This has less side effects than the typical adriomycin 'cocktail' and is still very effective. Unfortunately there are still side effects and yes I will be losing my hair. I held it together pretty well all day until we started talking about the side effects of chemo. I was not concerned about the short-term annoying side effects (although they do suck) I am mostly worried about returning to my pre-chemo physical condition. The oncology team reassured me that yes, it will be a long recovery, but YES I WILL BE BACK! My eyes swelled up with relief. Chemo is scheduled to tentatively start Friday April 8th. I will get four cycles spaced three weeks apart.

The day culminated with a chest x-ray. I was told it was to get a baseline, but that didn't stop me from worrying about the results. Fortunately, they came back negative.

It was a long draining day and we were both ready for a break. Shannon and I headed down to St. George this weekend for some sun and singletrack. We arrived at twilight and threw our helmet and shoes on and rode Prospector. I was not sure if my incision would be ready to ride off road yet this weekend, but if our little appetizer tonight was any indication I should be fine. We were ripping it! I am sooooo excited to have a weekend that does not revolve around cancer.

Up next I will meet with the Radiation Oncologist and Plastic Surgeon next week. I have a lot of big decisions to make, but at least I feel confident about chemo.

Post Surgery Numero Dos update

2011-02-28T17:06:00.000-08:00

Post-op recovery from my second surgery has so far gone really smooth. Since I didn't have general anesthesia this time, my energy levels were much higher the following day. This was nice because I felt really good, but kind of a drag because I knew I had to take it easy. I didn't have too much pain last time around and this time I have even less. I think that the axillary incision was more painful than the lumpectomy incision. Both seem to be healing well.

Sunday morning I woke up and same as last weekend the bandages got to come off. Ahhhh, felt so good. Everything looked good too and I was wanting to get out on the bike. So, in order to support the 1 1/2 day old sutures, we put the bandages back on and went out for an easy spin. There was some bandage slippage, but besides that the ride went pretty smooth.

Today, I got out for an easy ride this morning before my afternoon Huntsman appointments. Once again, it felt great to be on the bike. This afternoon I met with a Lymphedema therapist and Nutritionist at Huntsman.

Lymphedema therapist: Basically we reviewed precautions, took baseline measurements, and Shannon and I were shown manual lymph drainage. I also had a compression sleeve ordered for air travel.

Nutritionist: Huntsman offers free Nutritional consultation to all patients. The following is what was recommended:

-Guidelines call for 800-1000 units of Vitamin D/day, however this nutritionist recommended getting closer to 2000 units/day

-Fish oil supplements with both EPA and DHA. Take 1g/day.

-Be sure to get daily recommended amount of Calcium as chemo can cause osteoporosis

-Adopt a primarily plant-based diet. Fish, poultry, meat, or low fat dairy should cover no more than 1/3 of the plate

-No more than 18 oz. of lean red meat/week. Deli meat is not recommended.

-3 1/2 cups of fruits and veggies every day.

I pretty much do all of these things already (with the exception of the supplements) but it is still interesting information and something I plan to follow diligently.

We also discussed me starting to use Chia seed (MILA). My friend Stacy introduced me to this and it sounds ideal for a person fighting cancer. Chia is a food (kind of like flax seed) and it is incredibly nutrient dense. It is supposed to help improve cellular health and that is exactly what I need right now. The nutritionist gave me the green light to start this.

I have also started making green smoothies. I admit, they are kind of disgusting, but they are incredibly nutrient dense so it is worth it. If anyone has a (relatively) yummy green smoothie recipe please send it my way.

On top of this I have been continuing with my visualization. I envision my immune system killing all of the cancer cells in my body. I have even ordered a CD to help guide me in this process, although I find that I am fiercest in fighting the battle when I am on my bike!

Most of all I am hoping for a little luck. Some luck came my way this weekend when the Saffell's brought me a beautiful lucky bamboo. Hopefully this bamboo will work its magic this week.

I am really frightened for what the future holds.

Sugery Numero Dos Report

2011-02-25T16:52:00.000-08:00

Today's surgery was pretty uneventful. My surgery time wasn't until 2:00 so I had the morning to blow around the house. I took this time to tie up loose ends and......clean.

Surgery went really smooth today. I was under heavy sedation with propofol. I could hear everything that was going on in the OR, but thankfully I couldn't feel anything. Even with the drugs, my mind was working overdrive. I kept thinking of questions I wanted to ask, but I didn't want to distract anyone. I waited and started talking as they finished suturing me up. Hopefully I didn't say anything too loopy and if I did I'm sure the OR staff got a few good laughs.

Besides that, recovery was short and quick. I was ready to go home right away, but had to wait for my IV to be removed. Shannon immediately rewarded me with some yummy chocolate from Germany. I also get to live with the bandages again this weekend, but they're not as bulky as last time as there was only one incision today.

I should hear if the margins are clean next week. I am very hopeful but really nervous as there are no guarantees.

I am probably a little over one hour post-op and my pain level is 0. I hope it stays this way and I can be on the trainer tomorrow:)

Pathology Report and Update

2011-02-24T14:22:00.000-08:00

Since hearing 'You have cancer' in January I have received only positive news regarding my diagnosis. I was even looking ahead to a post-cancer life by the end of this year. On Wednesday that changed.

My nurse at Huntsman called me as soon as my pathology results came in. This I appreciated. I did not appreciate the results. The most immediate concern was that the tumor margins were not clean. The pathologist closely examines all of the tumor margins and if there is a single cancer cell within 2mm of the margin it needs further excision. This means that I will be going back to surgery. Tomorrow. I will not lie. This really sucks. But I knew that there was a 25% chance of not getting clean margins and I am extremely thankful that I am able to have my second excision so quickly. There is no guarantee that we will get clean margins this time, however my surgeon knows which margins to dig at more so I suppose that is something. She also says there is 'no penalty' with survival rates by having to go in and remove more tissue.

My second piece of bad news was that the tumor removed was measured to be 2 cm. This is much bigger than the original 1.2cm tumor but included the other small tumor that was found on Sonocine. This size is relevant because it pushes me over the cusp to Stage 2 cancer and it is pretty much guaranteed that I will need chemo. I meet with the medical oncologist March 10th.

Other not so happy news is that the grade of my tumor changed from 2 to 3. This means that when the entire tumor was examined some nasty, angry, unpredictable cells were found.

And finally, there was focal lymphvascular invasion. This means that there is the potential that the tumor could be spreading, but on a positive note the final lymph node pathology was negative indicating no metastasis.

Based on this information, my tumor is classified as Stage 2, T2,N0,M0. This is still Early Breast cancer, it is just not my 'best case scenario'.

Besides this, my week was going quite well. I really enjoyed the 'care packages' I got. One all the way from Germany! Thanks Heather. I also got a surprise Slyfox Moonwillow care package that included super light mountain bike rotors. I can't wait to weigh my bike now.

I hope the weather is good in St. George next weekend.

Weekend update

2011-02-21T12:26:00.000-08:00

Friday after surgery I felt pretty great; I was kinda a spaz. Maybe it was just relief that surgery was finally done? Maybe my IV was spiked? Regardless, by Saturday I crashed, and although I wasn't in too much pain, fatigue had finally set in. After an awkward night of sleep with all the bandages I woke up Saturday morning just in time to go back to sleep until after lunchtime. My goal for Saturday was to rest, rest, and rest some more. My family was visiting in the afternoon and I wanted to be able to spend some quality time with them.

It just so happened that my surgery coincided with my sister's annual family Park City ski trip. Saturday afternoon everyone came down to visit including my adorable niece and nephew who were highly entertaining all night. It was so nice to see family with the highlight being my niece and nephew playing with my puppy. By the end of the night my nephew was saying that he wanted to pee in the grass like the puppy. Sorry sis, good luck with the potty training.

Sunday morning I woke up early to take my bustier (er, bandages) off. Although I realize that the bandage served the important purpose of keeping swelling down, I had been looking forward to getting that uncomfortable thing off all weekend. I was a bit scared to see what was underneath it all but was pleasantly surprised. The incision is large; a couple of inches. But the edges are smooth and there is no swelling that I can see and little bruising. For a cyclist with lots of scars, it was nothing to look at. I would have posted a photo to prove this point but that would probably make this a Rated-R blog:) Then it was back to sleep until 10. I haven't slept this much in......ever. By Sunday afternoon I started to feel more like myself and by the end of the day I was ready for some physical activity.

Today, I awoke at the crack of dawn, 8:30:) I feel pretty good, actually really, really good. There is still some mild discomfort when my arm rubs in the axilla area where the lymph nodes were removed. Push-ups and tricep dips are out of the question. Besides that, pain free! We already took the pup for a hike, played with my new bike, and rode the trainer for an easy spin.

Below is a photo of the new bike. It is a zaboo terra29. It is so beautiful and insanely light too, especially when built up with the Lefty fork. I will write more details when I actually have the opportunity to ride it off-road. We're still planning on heading south in two weeks.

Tomorrow it is back to work and that 6:00 AM alarm is really going to hurt!

Surgery

2011-02-18T19:21:00.000-08:00

I have been quietly anxious about surgery most of the week. My stomach has been upset and I have had no appetite. I even thought that perhaps I was getting sick. Turns out it really was just nerves as I feel fine now.

Yesterday I followed my pre-op instructions to call the surgery scheduler between 2-4 PM to find out my time of sugery. I was told to be at the hospital at 6:00 AM and that my surgery would start at 7:30.

6:00 AM in the waiting room

I know that sounds really early, but I was quite happy to be the first surgery of the day.

At 4:00 PM on Thursday I decided to call my nurse. She had called me earlier in the day and I had returned a message but had not heard anything back. Normally, I would have tried calling every 10 minutes, but I am working on not being too annoying of a patient:) (Note: I have questions and call my nurse on an almost daily basis. She is always very patient with me).

When I got hold of her at 4:00 she asked how my marking went. What marking? I guess I was supposed to see the radiologist to get my tumor marked the day before the surgery. Oops, I had no idea. Fortunately I live 10 minutes away from Huntsman and I drove very quickly (to Shannon's dismay) to meet the radiologist. The radiologist then used the ultrasound to identify the tumor(s) and marked my breast with magic marker. I thought it was kind of funny that it was so urgent that I get 'marked' with magic marker. I probably could have done that myself! (I kid).

On to today. We woke up early and I took a final shower before we headed to Hunstman. No breakfast or water for me and my mouth felt like sandpaper by the time we arrived to the hospital.

I lucked out and got the pre-op 'room with a view' and watched the sunrise over Salt Lake while I was greeted individually by the wonderful and professional team that would be handling me in surgery. The young and friendly anesthesiologist, Sonia, placed my IV and we discussed anesthesia options. Initially we discussed using heavy sedation with a mask which was quite appealing, however once I decided to donate a small amount of bone marrow to cancer research it was decided that general anesthesia with full intubation was warranted. I expressed my concern for becoming nauseous because basically I had been nauseous all week. Sonia told me that they would take precautions against nausea. I am not sure exactly what they did, but I have not had any nausea since I woke up.....and my appetite is back:)

Final meditation/visualization before surgery

I also talked at length with my surgeon, Dr. Neumayer. I have not hidden my concern for removing lymph nodes from her. We discussed exactly what was going to happen. First, a sentinel lymph node biopsy would be done. Dr. Neumayer injects a radioactive substance that basically leads her to the sentinel lymph node(s). These are the first nodes that lymph drain to in the axillary area. While she is working on the lumpectomy a pathologist quickly looks at these nodes for any sign of cancer. This quick 'look' is 90% accurate, so the lymph nodes would also be sent off for further testing post-op. If cancer was detected, she was going to have to remove more lymph nodes, however she promised me no more than 6. I was told that when I woke up I would have a drain if my lymph nodes tested positive for cancer. If they were negative, no drain.

The first thing I remember about waking up was speaking with a women. In all honesty, I have no idea who it was (I have a hunch that it was the NP). I immediately asked if I had a drain. The women replied that I must be pretty coherent if I was asking that, and no, I did not have a drain. I was so happy....and groggy. I then proceeded to tell her that I had been dreaming about blogging. I don't remember anything else.

I was then in the PACU recovering. The nurse there was very nice and took my vital signs a million times. I was getting anxious to see Shannon and was finally released to short-stay recovery. That nurse checked my vital signs and then left me alone for a few minutes. When she came back I was scrambling around the room. She asked what I was doing and I told her that I was looking for a phone so I could call my husband. I guess I should have just asked because she immediately got him. She then took my vitals a few more times and then that was it, my discharge instructions were reviewed, I got dressed, and we went home.

Sooooo happy to have water post-op, notice the phone right behind my head. I never found it.

Overall, I have felt really good today. I do tire easily, but I suppose I should not be trying to do house chores quite yetJ. Surgery went as well (or better) than I could have hoped for thus far. I am very grateful for the fantastic staff at Huntsman that took such good care of me today.

I am stuck in a bulky bandage until Sunday. I see the lymphedema therapist in 10 days and return to see my surgeon in two weeks. I will also be scheduled to meet with the medical oncologist to discuss systemic treatment. This is not a huge hurry as treatment can’t begin until the surgery site heals. In the meantime, test results should be trickling in.

Bandaging comes off Sunday

I have not needed to take a single pain pill yet! My surgeon told me I could do physical activity as my body allows. She is confident that I will be able to ride dirt in St. George in two weeks! My new bike is almost built as I write!

It is 9:00 at night and Shannon has spent his entire day taking care of me. He is just getting on the trainer right now. I am so fortunate to have such a dedicated husband who sacrifices so much to take care of me. We are really in this together.

Enough (probably incoherent) babbling for now. Please continue to send positive thoughts my way and for that matter in the direction of all people fighting cancer. All the positive energy is obviously working and I know some people who could really use it.

Good News From Surgery

2011-02-18T09:08:00.000-08:00

Jen has been in surgery for about an hour now. She is just about finished. The doctor has already come out and told me that everything went great.

Her lymph node biopsy was negative, meaning that there was no evidence of cancer. In this case, negative is good. The tissue samples still have to go to pathology but they say there is only a 10% chance that pathology will find anything new.

Dr. Neumayer also showed me an ultrasound of the tissue they removed from Jen's breast. You could clearly see both the tumors. That should be all the cancer in her body. It's all gone!

It's weird to think this is such good news and she doesn't even know yet. She is going to be so happy! I can't wait to tell her.

I am sure Jen will post an update when she is awake and alert. I wanted to give everyone the good news.

Jen ready for surgery at 6:30am

Sonocine

2011-02-15T05:59:00.000-08:00

Yesterday, Shannon and I drove up to McKay Dee Hospital in Ogden. There is a radiologist there who does a procedure called Sonocine or Automated Whole Breast Ultrasound. I don't know the history of the Sonocine, except for the fact that it is not (yet) routinely used and insurance does not (yet) pay for it. I do know that my surgeon at Huntsman is a big believer in using this procedure to screen for and detect early breast cancer. Especially for women in my situation (positive pathology for mammary carcinoma and negative mammogram and MRI).

I was admittedly a little grumpy during the 45 minute car drive. I think I have had more doctor appointments in the past few weeks than my entire life put together. I am pretty sick of it, and I get even grumpier thinking of all of the appointments I have to look forward to.

Once we arrived at McKay Dee, I checked in for my appointment via telephone. They were sure to get my credit card number before the procedure :) Then I was whisked back to the Sonocine room where I got to wear another flattering top. I don't see why hospitals can't have gowns/robes that are a little less dorky? Anyhow, it made me laugh.

Way too happy while modeling a hot open buttoned hospital shirt

After the procedure I was taken back to Dr. Babcock's (Radiologist) imaging room. It was amazing. The room was full of monitors and she pulled up every image from every procedure that I have undergone up to this point. This includes two mammograms, an ultrasound guided core biopsy, an ultrasound guided axillary biopsy, MRI and now the Sonocine!

There was a lot of radiology going on in that room to say the least. Dr. Babcock was phenomenal. She reviewed the Sonocine results with me and showed me the tumor that she was able to see. This was great news. Finally a screening tool to help detect any future cancers. Unfortunately, she also saw another small tumor that was hiding underneath the one we already knew about. The tumor that we already knew about is about 1.2 cm in size. This second tumor is about half the size and there is no way to feel it. Fortunately, the Sonocine detected it and my lumpectomy margins can be adjusted appropriately. I am now a huge advocate for the Sonocine procedure and encourage insurance companies to pay for them:)

The other interesting piece of information that I gained from this consultation was that Dr. Babcok did not necessarily think my MRI was negative. She pointed out one slice that showed my tumor. She did say that it didn't "light up" as most malignant tumors do, however she could clearly see it. This was incredibly reassuring to me because I no longer need to be hung up on the negative MRI. I can now confidently go into Friday's lumpectomy surgery and have (once again) requested that the sentinel lymph node biopsy be done at this time as well.

What does this mean? Well, I am having surgery this Friday. Hopefully they get clean margins and it will be my only surgery. They will also test my lymph nodes for any spread of cancer. Hopefully this test comes back negative. If the lymph nodes are negative they will do what is called an Oncotype Dx test on the tumor. If this comes back with a low risk of reoccurrence I may not need chemo. I will definitely need radiation. This kind of puts me back to where I was a few weeks ago, however now I have the information to move forward confidently.

My workout goals for the week are a rest day today, weights tomorrow, and one last ride Thursday before surgery. Who says training stops when you have cancer?

And finally, I couldn't resist posting a picture of my puppy. He spends most of his time upside down. Today, while I was at work he also ate the handouts from puppy school. Coincidence...I think not. He's quite smart.

Perfect weekend

2011-02-13T17:43:00.001-08:00

Our plan for the weekend was to head south to Moab for some singletrack and bike therapy, but on Friday the weekend weather forecast for Salt Lake City was just as warm as Moab. I decided to stay put. Although Moab may have been my last chance to ride singletrack for a while, we had a pretty perfect weekend here in Salt Lake City.

Saturday called for a morning weight workout. I've been going to the gym focusing on my upper extremity strength every other day. My goal is to get as strong as possible as quickly as possible. I know that after my lumpectomy on Friday I probably won't be lifting weights for a few months. As it warmed up in the afternoon, Shannon and I headed out for a road ride. I think every single cyclist in Salt Lake City did the same. We probably spent as much time talking to friends on the side of the road as we did pedaling. It was a great day.

Sunday was quite possibly the most beautiful February day ever. We did a group ride with the boys (and Monique) up Emigration to Mountain Dell Golf Course. I cheated and rode my cross bike while everyone else was on their mountain bikes. It was a beautiful day (I can't emphasize this enough), we had great company, and I even felt frisky enough to throw down some hard efforts.

As my weekend riding binge comes to a close, I realize that I rode as much this week as I would have if I were preparing for an epic year of racing. In my mind I suppose I am still training. Just with a different purpose.

Change of Plans

2011-02-10T19:55:00.000-08:00

This week has been a bit frustrating. I am still hung up on the results of my MRI. Although I am pleased that no other cancers showed up, I am frustrated that my malignant tumor did not. Although I am not an oncologist, I find this alarming. I have researched this to the best of my ability. My pathology report diagnoses me with Invasive Carcinoma with Mixed Ductal and Lobular Features. From what I have researched, this particular type of breast cancer shows up on MRIs over 95% of the time. I could go on and on citing research articles I have found that support how unusual this is.....but basically, because of this, I feel that we need to investigate further.

My surgeon has asked for a 3rd pathology reading on my tumor biopsy. I inquired today about results but have not heard back.

I am scheduled for a a Sonocini (Automated Whole Breast Ultrasound) next Monday at McKay Dee Hospital. This procedure is only done on Mondays and Tuesdays so I had to reschedule my lumpectomy surgery for later in the week. I REALLY need this to show my tumor. We can feel this tiny tumor and see it on ultrasound, but both of these methods are not very practical or reliable for detecting early cancers in the future. I am at an increased risk of developing cancer in the future so I need a good screening tool. Like I said, I REALLY need this Sonocini to work.

Soooooo because of all of this my surgeon (Dr. Neumayer at Huntsman) and I have agreed to postpone the lumpectomy to February 18th. This is only 4 days later and I have been told that I am not putting my health at risk by doing this. We have also decided to do only a lumpectomy on this day. We will wait on pathology results before deciding if a sentinel lymph node biopsy is necessary. It most likely will be necessary, so I already have booked that surgery for March 7th. As you can probably tell from my earlier posts, I am a bit freaked out about messing with my lymph nodes. I want to be absolutely sure we know what we are dealing with before I proceed with the sentinel lymph node biopsy. I am trying to look out for the best interest of my body so that I can live a long, active, and happy life.

Although I feel that I am getting very good care at Huntsman Cancer Institute, I continue to be frustrated by the sloooooow process. I always have a difficult time getting call backs on my biopsy results and scheduling appointments is very difficult.

Besides cancer, I have had a pretty good week. I have been maintaining my cardiovascular fitness by doing 2-3 hour bike rides and have been working hard on increasing upper body strength before my surgery. My puppy, Dizzy, also graduated from puppy school this week. Although he is still a nut, he did the best 'sit' out of all the puppies in class when he got his diploma. Way to go Dizzy!

Medical Anomaly

2011-02-08T18:06:00.000-08:00

Only 5% of all breast cancer diagnoses occur in women under 40 years old. I am 35. According to my research, mammographic sensitivity decreases from 100% in fatty breasts to 45% in extremely dense breasts. My mammogram is negative so I guess I have extremely dense breasts. Ultrasound shows higher sensitivity than mammography with ranges of 86%-94% detection. My Ultrasound is positive for an approximately 10mm mass. MRI shows the highest sensitivity of ~95% detection (Radiology. 2004 Dec;233(3):830-49. Epub 2004 Oct 14.

My MRI results read as follows:

Impression:
Left breast: Negative, no evidence of malignancy
Right breast: Biopsy-proven invasive breast carcinoma not seen on MRI. No abnormal right breast lesions on MRI.

Even with the little titanium piece of shrapnel that is now located in my tumor to help identify it, nothing can be seen on MRI.

My surgeon told me that 10% of cancer are occult to any imaging. I guess I am part of that 10% as well. From where I'm sitting, I feel like a complete medical anomaly.

What does this mean? Well, more tests. We are trying to get an appointment for a Sonocine http://www.sonocine.com/ this week. McKay Dee Hospital has one of these; it is FDA approved however not covered by insurance. From my understanding, this is like a full breast ultrasound. We still want to rule out any additional breast cancers, but it is kind of hard to do when the cancer we already know about doesn't want to show up on anything. I'm also getting orders to see a lymphedema therapist this week and thanks to some great friends I will be getting a final massage this weekend before my Valentine's Day lumpectomy.

I will keep you posted on what we discover.

I also want to thank everyone for continuing to send me positive energy, research articles, inspiring stories, etc, etc. It means so much. I can not believe the amount of women who have/had breast cancer that have opened up to me. Although I am not thrilled about being part of this 'breast cancer club', I am truly humbled by these women's support.

More Good News

2011-02-06T20:25:00.000-08:00

It was a pretty typical weekend for us. We rode our bikes a couple hours each day, ran errands, worked around the house, visited my Dad, had dinner with my Mom, watched the Super Bowl (I admit I took a short nap during the game), and played touch football. This last one was a bit weird and after about 10 minutes I decided that I much prefer riding my bike!

I also did a lot of research. Some may say that I'm obsessed, but I want to be educated and confident in every decision that we make so I have been tapping into PubMed an online source for medical journal abstracts. I now feel really comfortable with my surgery decision for next Monday.

And finally, more good news. Shannon called me from work this morning. The results from my lymph node biopsy are in. They are NEGATIVE. This is not to say that all of my lymph nodes are negative, but it does mean that the sentinel lymph node dissection will be done as opposed to the axillary lymph node dissection. Sentinel lymph node dissection reduces my chance for lymphedema in the future. Lymphedema is a condition where fluid collects in the arm (or other areas such as the hand, fingers, chest or back) causing it to swell (edema). Not something that a cyclist, or anyone for that matter, wants to deal with. I am still going to take maximum precautions against lymphedema and plan on learning manual lymph drainage techniques this week.

There are three more giant hurdles to get through for this to be 'best case scenario' for me. I need my MRI this afternoon to be negative (with the exception of the tumor that we know is already there). If this is the case we will have a screening tool to help detect future cancers (since mammogram does not work for me) and we can be confident with a lumpectomy. I also hope that it does not show any additional cancers that we have not yet found. Please send positive energy my way at 1:15 for a negative MRI. The rest of the hurdles are dependent on pathology reports from my surgery. I need the sentinel lymph nodes to come back negative and the Oncotype Dx on my tumor that is removed to show a low risk of reoccurrence. I still don't know exactly what this will mean treatment wise, but I know that it is 'best case scenario'.

Overall, I am doing okay. I still feel great physically, but my emotional strength and mood change frequently, although I guess that is not too different from before :)

This I know. I feel strongest, most confident, and almost invincible when I am on my bike. I will fight this. I will race my bike.

Thank you everyone for all of the kind notes, gestures, and positive energy. I am amazed at the outpouring love I am receiving from old friends, new friends, and people that I don't even know. It really does make a difference.

Genetic Test results are in!!!!!!

2011-02-04T17:55:00.000-08:00

Everything is relative. A few weeks ago I was barely familiar with what BRCA1/BRCA2 testing was. Today, I burst into tears when Dr. Regina Rosenthal called me personally at 6:00 on a Friday night to tell me my test was negative. NEGATIVE!!!!!!!! They were tears of joy of course!

This is huge. People who carry the BRCA1 or BRCA2 gene have a 50-80% chance of developing breast cancer and a 20-60% chance of developing ovarian cancer. They are also more likely to develop other types of cancer. If I were positive the recommendation would most likely be bilateral mastectomy and to have my ovaries removed. This test was especially concerning for me because my Mom is a breast cancer survivor and I am so young at my time of my diagnosis.

Tonight, even though I still have breast cancer I am feeling very fortunate.

Someone must have sacrificed a pig for me.

Moving forward

2011-02-02T19:53:00.000-08:00

In my last post I expressed frustration with the slow process of biopsy, diagnosis, meeting with surgical oncologist, etc, etc. This week that has all changed. My life has turned into a complete whirlwind and you will have to excuse me if I don't make sense or mumble.

Tuesday afternoon I met with the surgical oncologist at Huntsman Cancer Institute. We waited forever in the waiting room, but it was worth it. I was there for almost 4 hours. First, I was hustled up to Radiology for another ultrasound. This time they looked at my lymph nodes. I then met with the Surgeon, NP, and Nurse and we thoroughly discussed my options. Next was some bloodwork and finally I filled a script for Ambien. Ahhhhh, sleep.

I now have A LOT to think about, but at least I have a plan which is empowering. My next step is to have one of my lymph nodes biopsied. I will do this tomorrow. A lymph node probably should have been biopsied at the same time as my tumor two weeks ago, but because my tumor was not suspicious this was not done. This biopsy will be significant in that if it comes back positive I certainly will need chemotherapy. If it is negative, I may not. Here's hoping for a negative biopsy! I am also meeting with a genetic counselor tomorrow to discuss the implications if my genetic testing for BRCA 1/BRCA 2 gene is positive. Then on Monday I am having an MRI. My hope for this test is that it will show my current tumor and nothing else. We are doing this to try to find a screening tool that works for me since mammogram does not. We are also looking for anything else that looks suspicious. I also want to consult with a lymphedema therapist as to try and prevent any future post-op lymphedema. This two week whirlwind will culminate with surgery on February 14th. Happy Valentine's Day to me and Shannon! The current surgical plan is lumpectomy which is a pretty simple outpatient procedure. The amount of lymph nodes to be removed will be determined by tomorrow's biopsy. After the surgery a pathologist will look at all of the lymph nodes removed for any sign of cancer. If they are all negative, no chemo. Here's to negative lymph nodes again! It is certain that I will need local radiation post-surgery though.

All of this changes if the genetic test for BRCA 1/BRCA 2 gene is positive.

On top of all of this I have gone to work, ridden the trainer, lifted weights, done yoga, and attended puppy school this week. Life certainly doesn't get any slower when you have cancer.

A few things of significance this week.....First, I keep saying I did this and I did that. Really it is WE. Shannon has been there every step of the way. I can't even describe how fortunate I am to have him in my life. I love you Shannon! I have also quickly learned how important it is to have support from friends and family. Thank you everyone for all the love and support. It means so much.

Also, on Monday I had the opportunity to speak with Annabeth Eberle. She is one of the University of Utah Gymnastics team most decorated athletes. She is a phenomenal person as well. She also had breast cancer. I found this out on Facebook of all places and I got in touch with her. She immediately emailed me back and eventually we spoke on the phone. She was incredibly open with me and did not sugar coat anything; just the way I like it. Although I realize that our paths for curing cancer will be very different, she gave me hope. A lot of it. I can not thank her enough.

When I look in the mirror I do not see a person with cancer. I see a strong, athletic woman who takes care of her body. All of the "things" you are supposed to do to prevent cancer, I already do. I often wonder why I am going to put my healthy appearing body through hell. In fact I sometimes wonder if there was just a mix up in pathology. That said, I accept our 'plan' to treat cancer. I am ready to move forward.

Last weekend I escaped to St. George for some on-the-bike therapy

Public Service Announcement #1

2011-02-01T20:38:00.000-08:00

I want every single person (men too if you want:) who reads this to do a breast self-exam tonight.

That is how I found my cancer. My cancer did not show up on mammogram and mammograms are not even recommended for women my age. I found it and I pursued it. I still do not have a clear picture of treatment and prognosis (still waiting on more diagnostics), but I do know that it would have been much, much worse had I not found this now.

This can happen to anyone. To emphasize this point even more.....I have a good friend who told me that she has 3 friends, all under the age of 40, who have been diagnosed with breast cancer in the past two months.

Do your self exam. Now.

Searching for inspiration

2011-01-30T20:26:00.000-08:00

2011 was going to be a great year. Work, family, and training were pretty well balanced after a tough couple of years. I felt fantastic. I was strong, lean, and overall felt great on the bike this early in the season. My race schedule was coming together and included some epic events such as Whisky 50, Pierre’s Hole 100, Park City Point to Point, and BC Bike Race. On January 25th everything changed. I was diagnosed with Invasive Mammary carcinoma. I was a 35-year-old athlete in phenomenal shape preparing for a season packed with 50-100 mile races and beyond. Suddenly I was looking at a very uncertain future.

This journey actually started January 12 when I found a small ‘nodule’ in my right breast. Being incredibly proactive and constantly concerned about my health, I visited my Primary Care Physician the next day and I was able to get to Huntsman Cancer Institute one day later for a mammagram and ultrasound. The mammagram came back negative meaning they didn’t see anything. Because I am so young and my breast tissue is still dense, the mammagram is an unreliable diagnostic tool. My ultrasound showed a fairly small 10mmx12mm nodule with fairly symmetrical sides and no shadowing. Plus, only 5% of all breast cancers occur in women under 40 years old. Statistics and nodule characteristics were on my side and I was told that it was most likely a benign (non-cancerous) fibroadenoma.

It was recommended that I get a biopsy for a definitive diagnosis. Unfortunately, there were no openings for this procedure for a whole week. Waiting an entire week seemed unfathomable, however I really had no choice. In the meantime, my husband and I traveled to Southern Utah for a weekend of mountain biking. I was emotionally tired on the car ride down, however as soon as I got on the bike I felt fantastic. I remember telling my husband ‘there is no way I have cancer, I feel too good’. Feeling relieved that I felt so good, we rode three consecutive days and put in almost 9 hours on the dirt.

The following week dragged on as I waited for my biopsy appointment. The procedure took approximately 20 minutes. I was told to not lift anything over 5 pounds for 24 hours and to take it easy on the physical activity. The next day, I felt good enough to put in another two hours on the bike and completed my largest 4-day training block of the year strongly. I figured I didn’t want to be behind on my training when the biopsy came back negative.

Four days later I got the news that I had breast cancer. I was/am shocked and scared. Immediately my husband got on the phone setting up appointments with surgical oncologists.

I have immersed myself into researching this disease. This is what I know so far. My tumor is fairly small; just slightly larger than 10mm. Perhaps the size of a pea? Interestingly, breast tumors grow at a rate of 1mm/year. They can usually be seen on mammogram when 5mm in size and can be palpated at 10mm. Fortunately, I found mine pretty early, however it is scary to think that it has probably been growing for 10 years! The tumor is being classified as Invasive carcinoma with ductal and lobular features. This falls into the category of most common type of breast cancer. The invasive part means that the cancer has spread from the original site (either the milk ducts or the lobules) into the nearby breast tissue and possibly into the lymph nodes and/or other parts of the body. Only 5% of initial breast cancers metastasize to other organs of the body. I won’t know if this is the case until after my surgery. My treatment plan will be dependent on a few diagnostic tests including genetic testing which is pending as well as if we find that the cancer has spread to lymph nodes and beyond.

My goal for this unexpected journey is to stay fit and strong and to return to competition stronger than ever. To stay true to myself, I traveled once again to Southern Utah with a few great friends this weekend. I admit that this weekend has not been easy. I am emotionally exhausted, have been sleeping poorly, and did not feel fantastic on the bike. I am thankful for such great people who rode with me and helped divert my attention.

For me the hardest part has been telling people. Because I feel so ‘normal’ I can almost pretend that this is not happening. Once I tell people it becomes real.

I have been extremely frustrated by this whole process. It took over a week to get in for the biopsy and another week to see the surgical oncologist. I am a very pro-active and goal-oriented person. I need to know where I stand and the course of action. This waiting around to see specialists is literally driving me crazy.

I am strong, but scared. I am scared that I won’t be the athlete I was before. I am scared that I won’t have the ability to become the athlete that I dreamed of being. I am even scared for my life. With such an uncertain future what is hitting me hardest is that I won’t be racing my bike in 2011.

I am looking for inspiration.