Wednesday, March 5, 2014

Not-so-quick 5-week post oophorectomy update

The original title of this post was "Quick 5-week post oophorectomy update", but after reading how lengthy it is, I changed it to "Not-so-quick.......".

In my last post I mentioned that my short-term goal was to ride dirt by the first weekend of March.  Well, it seems that my recovery from surgery is right on track.  Warm weather and dry trails tempted me to sneak in some short dirt sessions a week early; just enough to allow me to feel confident that my body was ready for some legitimate mountain biking on our trip to St. George the first weekend of March.
While the rest of the country is experiencing the Polar Vortex, 
it has been a springlike February in Salt Lake City.  
All the snow is gone!

It ended up being a quick weekend getaway to the desert, but it was the perfect test of my progress without over-doing it.  I started off riding a bit conservative. I was afraid to cause pain or damage by over-contracting my core to get up and over obstacles on the trail.  By the end of the weekend, I was confident that I could safely engage my whole body, however it was also clear that some strength had been lost over the past five weeks.   The past three years of my life have been all about building strength and fitness, just to be knocked down by surgery (six in total), chemo (eight months), or radiation (30 treatments).   Phew.  That's a lot of knockdowns!  I also know that with patience, time and a whole lot of hard work my strength and fitness will be back.

Being silly in the desert

Dizzy wasn't sure he wanted to leave the desert

While my active treatment (with the exception of Arimidex) has thankfully come to a close, I will continue being closely monitored indefinitely.  To kick things off, last week I had my first mammogram on my non-mastectomy side.  I got the dreaded call-back (anyone who has had a mammogram knows what I'm talking about), but it wasn't dreadful at all.  Instead of getting bad news, the radiologist just wanted to say hi and see how biking was going.  I loved it!  I truly appreciate when my medical providers identify me as not solely a cancer patient.  While cancer is (unfortunately) a big part of my life, I refuse to let it define me.  I am an athlete, occupational therapist, wife, sister, daughter, friend, animal lover (I could go on and on) who just happens to have (had) cancer......

That said, while I am moving full steam ahead from active treatment, it is always good to stop, breathe, and reflect on where I am in my recovery.  Here are some notes regarding my current state of recovery:

Post-Salpingo Oophorectomy:
-Yoga pants became my best friend.  Blue jeans became my worst enemy.  Since I am a blue jean girl, I compromised and ended up investing in a pair of jeggings that are much more comfortable on the incision line than my other jeans.  They're pretty cute too:)  Of note: Cycling bibs are pretty comfy too!
-After a Salpingo Oophorectomy there is a lot more pain on the right side of the abdomen than left.    This is normal, but weird.  I think it has to do with everything getting pulled out of the right incision.....
-Three weeks post-op I had some interesting tingling/sensation/itching in my abdominal/pubic bone area.  I think it was my skin waking up and regaining sensation.  The appropriate pants were key to comfort.  I still have some numbness.
-Four weeks post-op I was finally able to push hard on the bike.  Helllo intervals!  Did my first set of threshold intervals since May 2013.  Felt sooooo good!

Post radiation:
-Stretching of the shoulder, neck, and pecs EVERY SINGLE DAY is mandatory!  My pectorals muscle(s) seems to get especially tight, which makes sense as they were hit hard with radiation.  Without stretching, range of motion is impacted, and I can see how frozen shoulder can easily develop.  I was told that radiation continues to have an affect on tissue for up to a year after treatment concludes.
-Moisturize, moisturize, moisturize.  My favorite moisturizers on my radiated skin include calendula oil and beeswax lotion.  I also massage the radiated breast daily in hopes of limiting capsular contraction.

Post chemo:
- Like I was warned, two rounds of chemo have hit my bone marrow hard.  My white blood cell counts remain slightly depressed, therefore I seem to be wandering around in a state of mild immunosuppression.  Despite this, I have not had a single cold/illness since, well, long before I started treatment in July.  I attribute my good health to quality nutrition and exercise balanced with ample recovery.   Balancing hard workouts with quality recovery isn't a something I "should" do, it is something I "must" do and my training program and current lifestyle reflects this.  Instead of following the typical three weeks of training followed by a week of recovery, my training program is a bit more conservative with two weeks of training followed by a week of recovery.  While this may cost me a bit of fitness, I am hoping that a rested, healthy body will allow me to train harder and be faster in the long run!
-Another residual effect of chemotherapy is an elevated heart rate, especially while exercising.  My perceived effort just doesn't match up with what the heart rate monitor reads.  I recall this phenomenon after my first round of chemo in 2011, and for this reason I didn't even don a heart rate monitor for six months after treatment finished.  I am now almost six months out from finishing chemo, but I have also had radiation.  I am hopeful that my (exercising) heart rate will normalize soon.......That said, it is my understanding that at this time I am NOT at increased risk for exercise induced cardiac arrest.  So while it does perhaps affect how hard and ultimately how fast I am able to go, I am not going to let it slow me down (hehe, no pun intended).
-Neuropathy is also a common side effect of chemo.  While mine is mild, I do notice that my hands become cold and weak very easily.  Despite wearing the warmest cycling gloves I can find, when I return from winter rides my hands are so cold and weak and my dexterity so poor that I can't press the key code for our garage.  I don't miss the irony of the occupational therapist having poor fine-motor skills:)  Anyone want to help me develop heated bike grips?!?

So while I do have lingering effects from treatment, I really can't complain.  Considering everything..... I feel pretty damn good, my current status is NO EVIDENCE OF DISEASE, and since active treatment is over it is GAME ON!  First race in six weeks!  BRING IT!

The current state of my hair: 
 I'm probably told 5 times/day that I look good with short hair and
while I appreciate the complements, my opinion: Blah.
Certainly better than no hair at all, but does not come close to a ponytail. 
(My kitty's tail photo bombed this photo.  Looks like I have a tail:)