The New Normal

Two quick things to start:

First, thanks to all of you who were so encouraging with regard to my swim times and my "Iron Dreams."  Thanks to you, they're still alive!  

Second, I apologize for dropping off the map for a week or two...if you are or have been in the military, or if you're a dependent like Momo and JK, you know that every few summers is PCS (Permanent Change of Station) season!  Yep, that's me.  I'm headed to the Pentagon in about three weeks, and I just got back from taking Pooh and Monkey over.  I'm back just to pack up the house, graduate, grab the cat and the car, and head out behind them.  I've been repeating to myself, "Don't forget the cat, don't forget the cat, don't forget the cat..." for several weeks now.  I flew back on Monday, and sat in the empty house for a while just thinking...what did I used to DO when I was single?  How did I use up all this time?  MAN, it's quiet in here...there was a baby three or four rows back who cried for almost the entire flight from Denver, and it was strangely comforting...who would have thought I'd find comfort in a crying baby?

So it's been a bit hectic around here lately.  Not to mention that I started chemotherapy (again) this week.  Round number six...four days in, and I feel absolutely miserable.  I wish I had a better report, but that's the truth.  Woke up about 4:45am this morning with terrible nausea and cramping, and fought it for about six hours -- only started feeling better just a few minutes ago.  Doesn't help to be going through it solo, with my support structure (Pooh) and my beautiful baby girl absent.  Fortunately, we have a tremendous support structure through the church and through friends, who have done everything from shopping to making meals and watching the cat while we were gone.  Thank God for friends!

So, the trip to Los Angeles last month has brought with it a realization.  As long as my wife and I have been fighting this cancer battle, our hope has been that we would beat it and go back to our normal life.  This disease is an obstacle, like the wall at 20 miles, that we just need to push through so we can win.  Once we "fix this," we can go back to normal.  Well, we've recently had to rethink our approach.  Coming up on 10 years of fighting, including two brain surgeries and 18 (so far) rounds of chemotherapy, with many more to come, we both realize...there is no "going back" to our other life.  This does not appear to be a situation where we "beat it" and go back to normal.  On the contrary, this is the new normal.  Cancer will be a part of our lives now and in the future.  Even if we beat it (a third time), it will still be there, hovering overhead, lurking in the back of our minds at every annual checkup.  Once you face a foe this formidable, you can never go back to what you thought was your "normal" life.  You find that "normal" just changes.  

I'll make it through this round, and the next one.  And the next.  The neuro-oncologist mentioned records of folks staying on chemotherapy for as long as five years -- and if that's what's in store, so be it.  Bring it on.  Faith, family, and friends -- including the "extended family" of bloggers -- will carry me through.  Thanks for all your support...and welcome to The New Normal.  Anyone up for a run?

Iron Dreams

We all have ambitions, and most of us have ambitions within marathoning, ultras, or multisport.  Perhaps it's qualifying for Boston, perhaps it's becoming IRON, maybe you're as crazy as Donald and want to complete the Western States -- maybe even get a belt buckle!  

Well, after a few marathons, a few years ago I set a goal of competing in triathlons, eventually working my way toward becoming an IronMan.  I've always been a biker, and a fairly good one -- and with a few marathons under my belt, my confidence in my running ability has increased significantly.  All that was left was the swimming!

Now, I'd never been much of a swimmer.  In fact, I'd never swum a lap.  Not one.  Pools were for Marco Polo and relaxation.  I literally hadn't been in a pool in over 20 years -- I could probably dog-paddle to the deep end if I had to, and if shipwrecked I could probably make my way to the nearest lifeboat...but that's about it.  So, I was literally starting from scratch here.  I read a few books, watched a few Total Immersion videos, and started making thrice-weekly trips to the local pool with my training partner.  Six months of hard work, and I still sank like a rock.  What to do?  Hire a coach, of course!  Fortunately, I knew a guy who wasn't just a swimmer, he was a two-time All-American and Division I coach who still holds several records at the University of Florida.  Perfect!  So, back to the pool...three times per week...but once with the coach, and twice with my training partner.  And...

After six months with the coach, my 1500m time had miraculously dropped below 30 minutes to about 26 minutes -- a major success, right?  Well, many of you probably know that a 26-minute 1500m is almost, but not quite, fast enough to make most junior high school swim teams.  So, after a year of swimming and six months of work with a top-notch coach, I was just fast enough to get lapped by most decent 14-year-olds.  Humbling?  Yes, to say the least.

I'm not much of a quitter, and a quick browse of my blog will reveal a fair amount of determination and drive.  But, apparently, I'm also not much of a swimmer.  I'm also enough of a realist to know when it's time to move on.  It's in this spirit that I ask you...is it time?  Focus on marathons, duathlons, perhaps ultras?  Is it time to give up my Iron dreams?  

The Moments We Remember

Fair warning: Today's post isn't much about marathoning or multisport.

Many of you know that on March 8th, at the age of 35, I became a father. I mentioned our daughter briefly in one previous post, and she's now just over two months old. As any parent can tell you, the first few months can be pretty tough, and sleep becomes a luxury -- but there are other luxuries that aren't mentioned nearly as often, but are even more important. One of those luxuries is simply time with my beautiful daughter.

To give my wife a few extra hours' sleep, I usually take the early morning feeding (about 0600 or 0630), and feed her from a bottle. I gently pick up our little Monkey from her crib, and hold her while I warm the milk and get things ready. She usually barely stirs at this point, and settles into my arms and chest in a way that only a baby can -- it's amazing how they just fit. The house is completely quiet, and it's usually still dark outside, and it's just me and my little girl. I couldn't manipulate my regular camera with her in my arms this morning, but was able to reach my phone -- but this is what I see as I look down:

Now, somehow, I'm supposed to wake her up and feed her -- but I often end up just staring at her for a long time, marveling at our miracle child. To make matters worse, shortly after picking her up, as she relaxes, her arms move to her sides -- and about nine times out of ten, she actually holds my finger:

Trust me, as a new father, this is enough to melt your heart and bring a tear to your eye. Running, races, training, and cancer fade into the background, and only my daughter and I exist for those moments. And it occurs to me that as I hold that same hand to walk her down the aisle 20 or 30 years from now, I know -- this is a moment I will always remember.

Reasons for Running

If you've been following my blog for long (it's only been around a few weeks), you'll see in my sidebar that my next big race is the Seattle Marathon in November.  Now, this should generate one obvious question -- who would schedule a marathon in Seattle in November, one of the most dismal, dreary, and miserable months of the year?  In general, most normal runners don't like running in conditions like uphill, into the wind, in the wet, and/or in the cold -- basically, Big Sur -- but Seattle is a close second.  So, why run Seattle?  

I want to tell you about my friend JD.  Now, I have known JD since the fourth grade, when his father and mine were stationed together at a small outpost called Camp Walker in South Korea (eating ice cream after playing soccer -- JD is standing, I'm the one with the wristbands. Trust me, they were cool then):

We were next-door neighbors, and did almost everything together -- played soccer, played Dungeons and Dragons, had sleepovers, the works.  Through the years, our friendship has changed and grown, but we're still as close as we were in the fourth grade -- and in 2000, JD was the Best Man in my wedding.  

JD was never a small guy.  At least, he was always bigger than me -- taller, stronger, and so forth.  The problem was, as he got older and started working harder and caring for his family, he just kept getting...well...bigger:

Being a senior executive at Microsoft and a workaholic didn't help, neither did genetics.  Last Thanksgiving, JD decided to try losing some weight...then, this past New Year's Eve, JD -- at 36 -- nearly had a heart attack, resulting in an ambulance ride to the emergency room, and a diagnosis of atrial fibrulation, a condition often caused by obesity.  The condition continued, happening sometimes multiple times in a day, resulting in three cardiology visits in six weeks.  Doctors then discovered a mitral valve prolapse, and a left ventricular hypertrophy -- combined, the conditions paint a scary picture of heart condition.  So, JD made a commitment that many of us have made -- get in shape, and lose weight.  A LOT of weight.

By March, JD had lost 72 pounds, at which point he and I had a long talk.  He talked about his wife and two beautiful children, and how the New Year's Eve episode had scared him more than he had been able to express -- especially with regard to his children.  In the photo above, he tipped the scales at 320+ pounds -- and his goal was to 100 pounds by summer, which would take him back to size he was when I knew him in high school.  You've done the math by now -- radical change in diet, exercise, and lifestyle -- and dropping 100+ pounds in about six months.  It seemed impossible, but with dedication and the watchful eye of a physician and nutritionist, he thought he could do it -- but was concerned that he wouldn't be able to keep it off.  So, I told him -- if he met his goal of losing 100 pounds, I'd come out to Seattle and run the marathon in his honor, raising money for his favorite charity -- but he had to run it with me. It would give him a goal to work toward, and help keep the weight off -- and we'd get to spend 26 miles telling great stories about the pranks we pulled on each other 25 years ago.  

By April, he had lost 95 pounds.  About a week ago, JD called to tell me that he had accepted my challenge -- to run a marathon -- and that he had met his goal, and sent this pic:

Yep, that's the same guy -- 100 pounds lighter.  So, the game is on -- and I'm heading to Seattle to reconnect with an old friend, honor his accomplishment, and toast his success.  

We all run for different reasons.  Some run to get in shape, some run for fun, some are social runners, some run for competition, some run just to get outside.  I run to beat cancer, and to inspire people.  So, what inspires someone who runs just to inspire others?  JD does.  Way to go, JD.  See you in November.

Kicking Cancer's Butt

So, here is the scan I had last week:Compare it to the one in the post below -- see any change? Well, neither did the specialists at Cedars-Sinai! Bottom line, the news is mostly good. The cancer has not progressed, so the chemo is working.  Officially:

If you can't read it, the important part starts on line four:  "...the region does not show any evidence of enhancement or other signs of active disease.  It is unchanged from the study 11/20/07.  There are no new pathologic findings in the rest of the brain and specifically, no evidence of additional mass."  Yeah!  That's the good news, but that's also the bad news -- since the chemo appears to be working, we're going to continue on chemotherapy as long as it proves to be effective. That means finishing the next seven rounds of chemo in this cycle, then perhaps starting over for another year...or two...or five...however long it takes. Make no mistake, chemo is miserable -- but I'll manage. At least we've found something that can stop the progression...so, I'm back to kicking cancer's butt, one round at time.

So, how do you celebrate a pretty good diagnosis and prognosis? A run in the Mojave Desert, of course! After the medical appointments, Pooh and I spent a day doing photography in the Antelope Valley Poppy Reserve near Lancaster, CA. After hiking a bit in the reserve, I was pressed for time, so only got 6 miles in...but it was in the high desert. I've never really run in the desert before -- I've spent most of my time in the Midwest and Northwest -- WOW!  It was hot, dry, and a few thousand feet above sea-level Monterey, so 6 miles felt like about 10. But, isn't running in new places and trying new routes part of the fun? Isn't some of the joy of running found in trying new roads, exploration, and getting personal with terrain that just flies by in a car? I'm always amazed when I run a road that I've driven many times...the things I notice that I never would have seen, even completely insignificant, like litter or glass. Running roads will actually change the way you drive. And isn't is odd how driving on a road you've run a hundred times feels almost personal? Don't believe me? Try driving Big Sur after running the Big Sur Marathon. Trust me -- it will never be the same again.

So, the Mojave run kicked my butt (could you imagine Badwater?). But I'm kicking cancer's butt, again. As butt-kicking goes, I think I've got the edge.  The cancer is still there, but hasn't grown in the last six months.  Is that a victory?  Sure.  Remember, to win a race, you don't need your opponent to drop out -- you just need to be one step ahead when you cross the finish line. 

Tomorrow is a big day!

Chemotherapy round #5 is complete!  Five down, seven to go.  I even got my long run in on Sunday -- cut a 10-miler down to 7.7 just due to dehydration and fatigue from the chemo, but it was great to get out on the road again.  I bought a new pair of Asics Gel Kayano 14s at the Big Sur Marathon Expo, and so far they're outstanding.  I've been wearing Kayanos since the 10s almost five years ago, and they just keep getting better.

One brief question -- it's time to replace my old Nike Triax Elite, and I'm looking at the Garmin ForeRunner 405...any feedback?  Does anyone out there have or use one?  Heard anything?  RW Reviews only go up to the 305.  Momo, you use a Garmin, don't you?

Anyway, on to more important news.  Every six months, I have a brain scan, then travel down to the Maxine Dunitz Neurosurgical Institute at Cedars-Sinai Medical Center in Los Angeles for consultations with a neuro-radiologist, neurosurgeon, and neuro-oncologist.

I had my brain scan on Wednesday -- I haven't seen the results yet, but here's what my last one looked like:

You're looking from the bottom up, so the sides are reversed, but you can see an obvious hole (a good friend likes to call it a "divot") where the right frontal lobe has been basically removed -- the result of my two brain surgeries in 2001 and 2005.  Well, toward the back of the cavity left by the surgeries is a lump of bright, white tissue...that's what they're concerned about.  It's only about 0.5cm, whereas both of my tumors were close to 3cm, so it's not big enough for surgery -- but if it gets any bigger, we'll have a problem.  

So, your thoughts and prayers will be very welcome over the next day or two.  Tomorrow will culminate the last six months of chemo treatments, and I really hope it hasn't been for naught. If so, we'll take the next step -- and I know you'll all be running alongside me, whatever the result is.  

Chemotherapy 101

First, a confession -- I skipped my run today. I'm really in "maintenance mode," down around 30 - 35 miles per week, until training picks up for the Seattle Marathon in July/August. So, only running 3 or 4 time per week means missing a run can be significant -- but I had a good reason, I promise:

When people hear that I have cancer, one of the questions I get most frequently is "How do you run while on chemotherapy?" Well, the answer for today is, I didn't. I started chemotherapy round #5 on Sunday, so today is day five...and I've felt absolutely miserable. In honor of completing another round (I'll finish this round with my last dose tonight), I'll give you a (relatively) brief answer to another frequent question: "What is it like being on chemotherapy?"

Well, chemo sucks. And that's not an opinion -- I'm pretty sure it's an objectively verifiable fact. There are many different kinds of chemotherapy, but for me, a single regimen consists of twelve rounds -- one each month for twelve months -- a full YEAR of chemo. Each round lasts five days, with a significant dose of chemo each day. In short:

Sunday night, I start with Zofran (anti-emetic, keeps me from vomiting).

30 minutes later, I take 400mg (four pills) of Temozolomide (Temodar), the chemo. I'm usually nauseous instantly, so I have to take two pills at a time to break it up a bit.

As soon as the chemo is down, I head to bed. To goal here is to sleep through the worst of the nausea, but it doesn't always work that way (especially with a brand-new baby). So, I often wake in the middle of the night with horrible nausea. The challenge here is that I take the chemotherapy orally, so I must keep it down. If I get sick, then I have to go in and do the whole IV thing, which is terrible. So, most of the night is spent fighting the urge to get sick, which makes for a few long nights.

Starting the first day after chemo (usually Monday), the stomach troubles begin...pretty much running the gamut. The Zofran does a good job or preventing me from vomiting, but it also prevents me from doing...well...anything else. So, I also have to take Colase (a mild laxative) to help keep things moving (running helps too). To make matters worse, the toxicity of the drugs causes some acid reflux, so I also take Zantac to combat the heartburn. So, for at least the five days I'm on chemo (and usually one or two days after, as it gets out of my system), I'm a walking Pepto Bismol commercial -- nausea, heartburn, indigestion, upset stomach, diarrhea...I know you're singing the song in your head right now. It's okay, I do too -- I just add "constipation" to the list!

In 2005, I went through a complete regimen (12 rounds), and kept everything down 9 of the 12 times. Two times it was probably my fault -- once I ran a half-marathon on the fifth day of treatment -- and once I decided to fly while on chemo. I called the oncology nurse after the half-marathon to ask what to do and see if I needed to schedule an IV...when I asked what to do, she simply said "That was stupid. Don't do that again." Gotcha. Point taken. But we're runners, right? And runners run. I ran my first marathon two months later, in between my eighth and ninth rounds of chemo. My wife will be the first to tell you that I'm not very good at following the doctor's advice anyway...

See, the chemo treatments are cumulative -- toxicity builds up in your system. I usually feel okay on day one...a bit worse by day two...starting day three (Wednesday), I really start to feel miserable, and Thursday and Friday are usually spent curled up in a ball on the bed or in my chair, not wanting to eat, move, or -- like today -- run. I ran eight on Tuesday, but just couldn't get out there today. So, I'm blogging instead. Hope you'll forgive me.

Five down, seven to go!