Hawaii

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

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

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

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

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

	2/1/11 (prior to surgeries and chemo)	5/6/11 (3 weeks after 1st chemo treatment)	5/27/11 (3 weeks after 2nd chemo treatment)	6/17/11 (3 weeks after 3rd chemo treatment)	7/29/11 (6 weeks after chemo treatment)	12/16/11 (6 months after final chemo treatment)
WBC count	5.42	7.01	8.33	6.48	3.63	6.82
RBC count	4.64	3.81 L	4.05	4.03	4.21	4.47
Platelets	285	379	280	277	178	193
Hemoglobin	14.1	11.7 L	12.4	12.2	13.3	14.3
Hematocrit	41.3	33.9 L	35.8	36.0	39.2	41.6
Ferritin						34

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

Definitions: 

L-Low value

H-High value
Chemotherapy's affect on bone marrow:  Chemotherapy suppresses the bone marrow.   Bone marrow produces cells that become white blood cells, red blood cells, and platelets making people who are undergoing chemotherapy treatment more susceptible to infection, illness, and anemia.
WBC count:  Cells of the immune system that defend the body against infectious disease.  The Neulasta shot I received after each chemotherapy treatment helps the bone marrow produce more wbc. 

RBC count:  RBCs deliver oxygen to the body tissues.  The Neulasta shot has no effect on RBC production.
Platelets:  Platelets help the blood clot.  High levels of platelets may indicate anemia among other things.  

Hemoglobin: Protein in red blood cells that carry oxygen.  Lower than normal hemoglobin may indicate anemia among other things.

Hematocrit:  % of the volume of whole blood that is made up of red blood cells.  Lower than normal hematocrit may also indicate anemia among other things.

Ferritin: Protein found inside cells that stores iron so your body can use it later.  Low ferritin may indicate iron-deficiency anemia.  

Interesting to note:

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

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

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

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

Happy Holidays

Fabulous Las Vegas

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

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

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

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

 My bike hanging out in the room

Fancy hotel on the strip

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

Bootleg Canyon. We rode till dusk everyday.

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

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

A lot of girl power in this photo!

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

Giving Thanks

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

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

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

I knew I needed an ultrasound for peace of mind.

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

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

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

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

My first mountain bike-1994 Univega fully rigid

Brand new to me used Redline BMXer

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