Running With Cancer

Seattle Half-Marathon Race Report

2010-12-22T21:38:00.006-05:00

So, the last race of the year has come and gone. Shortly after the Rock-and-Roll San Antonio Half Marathon, I packed up Pooh and Monkey and headed up to Washington. As soon as we landed in Seattle, we headed straight over to my parents' place -- La Toscana Bed & Breakfast and Winery in beautiful Leavenworth, Washington. Within hours of our arrival, the snow started -- and pretty much didn't stop until we left more than a week later! Leavenworth is a beautiful German village in the Cascade mountains, and although it's idyllic, it's not necessarily a training Mecca. But we've all got to "suck it up" at some point, don't we? Undaunted, I headed out the next morning for a beautiful 10-miler through the mountains...19 degrees and breezy when I started, with light snow falling, it was gorgeous but COLD. Mission accomplished, and on to turkey and stuffing!

Shortly after our family Thanksgiving, I headed back over the mountains with Pooh and Monkey, with my sister and brother-in-law (and Team Michael Moyles co-founder) close behind. The passes were pretty icy, but we managed...

We picked up Linda -- stalwart TMM member just flown in from sunny Florida -- at the airport on the way in to Seattle. I've never seen anyone so bundled up for November in Seattle! But more on that in a minute...after a few relaxing days at home, we all headed out for the race...

Pre-Race Expo. The expo was crowded, and the location they chose -- the Westin in downtown Seattle, the same place as last year -- simply isn't adequate. The facility in comparatively small, the vendors are packed together, parking can be hard to find and expensive, and both the hotel and the expo itself were rather difficult to find. Packet pickup was well-marked, and the technical tee provided (Brooks) was comfortable. The biggest score of the night -- a pair of Gel-Kayano 16s, size 12.5 for $50! The savings on that purchase almost covered the cost of parking.

Race Day. Race day was well-organized and easy -- everything the expo wasn't. It helps that we ran the same race last year, so we knew where to go, what garage to park in, and exactly how to get to the start line. Sunday morning dawned cloudy and very cold -- low 30s -- and we made our way downtown. We all froze, and took turns teasing Linda about her attire -- two pairs of pants, three shirts, two jackets, a scarf, two hats, and gloves. I was in shorts and a t-shirt with a disposable jacket, and my B-I-L (brother-in-law) and sister were dressed similarly. Fortunately, we found a large 24-hour grocery store right at the start line, and made liberal use of their clean bathrooms (no porta-potties!) and their heater. With nearly 30,000 racers, there were only about 25 people in the foyer of the grocery store...perfect for us. The Team stretched, warmed up, and made a dash for the start line with about 10 minutes to spare.

The Course. The course was the same as last year -- only last year, I ran the full marathon, and this year I ran the half. The half-marathon course really just preserved the hardest parts of the full-marathon course, removing only a five-mile out-and-back across Lake Washington and a 7-mile loop around Seward Park, both almost completely flat. The race starts by winding from the Seattle Center through Seattle's streets out to Lake Washington, then a rather confusing series of loops consisting almost entirely of on-ramps and off-ramps from Interstate 90 and Interstate 5. I ran the first 7 miles or so with BIL, at about 7:55 pace, then pulled off to the side to wait for my sister. There is a miserably wicked hill at mile 7.5 -- basically straight up -- and I actually got to run it twice, once with BIL and once with my sister. The last half of the course is almost entirely uphill, starting with the big hill, then transitioning into Intelaken Park, which is about a 3-mile sustained, gradual climb. The views of downtown Seattle, the Space Needle, and the Puget Sound are incredible, and are a fit reward for completing the hilly portion of the course. From the top at Interlaken Park -- about mile 11 -- it's downhill back to the Seattle Center, and the finish line. BIL finished first in about 1:49, and my sister and I finished together in 1:56, easily blasting away her goal of sub-2. It was a very emotional finish, and a great way to end TMM's 2010 season.

What a great surprise to see Ade, one of the charter members of TMM, waiting at the finish line -- along with Pooh, Monkey, and other friends and family. Not long after hooking up with our supporters, we spied Linda sprinting across the finish line, still wearing most of the layers and clothes she had on when she arrived at the airport...but she was comfortable and finished easily.

Support along the course was great, both spectators and volunteers -- aid stations were well placed, well supplied, porta-potties were plentiful, and miles were clearly marked.

Post-Race. The "finish festival" was hardly a festival, but it was fair -- decent food and supplies, but just like the expo, the facility was simply inadequate. Crowded, too hot, impossible to move, long lines, poorly organized, just not what you'd expect from a major race. As the race grows, Amica and other sponsors will have to find better facilities for both the expo and the finish festival. At the end of the day, the Amica Seattle Marathon is still my "hometown" race, and one I'll probably return to every year -- but I'd love to see the race sponsors and organizers find better and bigger facilities now that the race is drawing tens of thousands of runners. We all celebrated (medals still on, of course) with a big burger and beer at the Elliot Bay Brewery, and toasted a great race, a great year, and a great team. Go TMM, on to 2011!

Race Report: RnR San Antonio

2010-12-10T23:28:00.005-05:00

Editor's Note: Okay, so my posts are WAY behind. I've written a few, I just haven't posted them...so, ignore the posting date, and pretend I actually posted this when I wrote it a few weeks ago...

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Another race in the books! Rock-and-Roll San Antonio concluded on 14 November, ending my true "race" season. There is one more scheduled -- the Seattle Marathon on 28 November, but I'll run that race with the team, and won't really be racing.

Training for San Antonio has been an adventure. As long as I've been running marathons, I've trained by running on lunch breaks and Sunday afternoons after church. Well, that doesn't work so well in Texas, where it doesn't drop below ninety degrees until about 10pm, and only stays cool (relatively speaking) for a few hours. So, since moving to Texas in June, I've been getting up at about 4:30am and getting my runs in. I'm still using the "Run Less, Run Faster" training plans I've been on for the past year, and still think that program is one of the best around. Since starting those training programs, I've set a PR in every distance from 5K through half-marathon. So, on to San Antonio...

This was my first race in the Rock-and-Roll series, and let me tell you, these folks have figured out how to put on a great race. I've run literally dozens of races at all distances, including quite a few marathons and halves, and I can comfortably say that this was the best-organized race I've ever run. From expo through finish festival, every aspect had been clearly thought through, and was nearly flawlessly produced. The expo was quite crowded, and they really could have rented a considerably larger space, but they did well with what they had. Packet pickup was clearly marked, and if you couldn't see the well-marked signs, the volunteers were cheerful and helpful.

Race day was, again, very well organized. I arrived later than planned, and couldn't quite get up to my designated Corral, but managed to start in Corral 4 instead of Corral 2, and the difference was negligible. Let me just say I'm a HUGE fan of the wave start -- each corral was separated by about 30 seconds, which almost completely alleviated the problem of spending the first mile dodging and dancing through hundreds of other runners, many of whom had probably "corralled up". I was off and running at race pace with the first half mile or so. The course wound through the streets of old San Antonio, including some mileage along the historic Riverwalk and (of course) a lap around the Alamo. Surprisingly hilly for Texas, but nothing steep or uncomfortable. The full marathon route includes a great run out along the San Antonio mission trail, which I'm actually sorry I missed. Both the half and the full finished at the Alamo Dome in downtown SA, with the entire parking lot dedicated to sponsors and family meeting areas divided by last name. Only a minor complaint here -- I couldn't discern any rhyme or reason to how the letter were distributed, and it certainly wasn't alphabetical. Regardless, the wonders of the iPhone and text messaging made finding Pooh and Monkey easy, and they were in full "cheer mode!" Monkey even had her "LiveSTRONG" outfit on and her "Team Michael Moyles" shirt. Too cute.

1:44.12 (7:57 pace) for the finish time -- nothing spectacular, but right on my planned pace of 8-minute miles. I was very happy with my splits, which were remarkably consistent:

Mile 1: 8:23

Mile 2: 7:48

Mile 3: 7:47

Mile 4: 7:50

Mile 5: 7:50

Mile 6: 7:49

Mile 7: 8:01 (up the hill)

Mile 8: 7:43 (down the hill)

Mile 9: 7:54

Mile 10: 7:52

Mile 11: 7:55

Mile 12: 8:12

Mile 13.1: 9:05

Pretty much the most consistent race I've ever run. One down, and one to go! On to Seattle on the 28th!

Too Hot to Trot

2010-10-10T21:43:00.002-04:00

Wow, has it really been almost six months since my last blog? Well, so much has happened...just for starters:

1. Selected for reassignment from the Pentagon

2. Moved wife and baby to San Antonio, Texas

3. Tried a few runs and absolutely died in the heat

4. Spent three months trying to acclimate to the temps by running at 0430

5. Got a CLEAR brain scan in September!

6. Turned 29 (yes, again)

You get the idea...it's been a busy six months. The greatest news is, of course, the clear brain scan. There was no sign of cancer, though there are a couple of areas they want to keep an eye on, just to make sure the prosthetic is healing correctly -- but the important thing is no malignancy. Just some scar tissue and fluid buildup that, as long as it remains stable, shouldn't be a problem. I'm going back in December for my next update -- living 90 days at a time!

If you've never been here -- Momo, I suppose Arizona counts -- the Texas heat is positively oppressive. We arrived in June, so we've been here through the heat of the summer...over 100 degrees by about 9am, and it stays above 90 until about 10pm. Humidity hovers around 95%, so the heat index during July and August is usually around 110 - 115. I've never run in those conditions before -- it really saps both pace and distance. My first few runs left me laid out in the shade with a water bottle, wondering how I'm going to get home. Hitchhiking in south Texas can be dangerous! And, that's not all...there are really no hazards to running in Virginia or California. Here in Texas, you have to watch out for all kinds of crazy things -- on this past Sunday's long run, I passed four deer, then was nearly clobbered by a coyote, watched various rabbits and raccoons scamper out of the way, and to top it all off, came upon a sizable rattlesnake, sunning himself on the roadside, mere inches from my path. Yes, my pace quickened a bit!

Team Michael Moyles is doing well. We are approaching the 70% mark, with still three months to go in the year. Several Team members have completed marathons or half-marathons, a first for many, and a PR for most, even a podium finish for my sister! Next up on the docket is my buddy T running the NYC marathon in a few weeks, followed by LiveSTRONG Challenge Austin, then the Rock-and-Roll San Antonio Half-Marathon, ending the year with the Seattle Half-Marathon on November 28th. I also recently learned that Team LiveSTRONG has agreed to sponsor the Austin Marathon -- and the new "LiveSTRONG Marathon" will be in Austin in February. There NO WAY I can miss that one, so I'm already planning for next year! If you haven't had a chance to check out our website or donate a few bucks, we'd really appreciate it...we're really just a few donations away from our goal of $10,000.

Thanks for everything each of you do every day, inspiring others and posting your runs and other accomplishments. I don't always reply or comment, but I read your blogs every week, and love to hear from my friends in the endurance athletics community. I promise to update more often -- keep on running!

Not Bad for a Lunch Break

2010-03-14T12:24:00.005-04:00

Good evening! Things are going quite well at this end. Our fundraiser is making significant progress, thanks to many of you, my faithful readers. My training is also going well, I'm up to 8 - 9 miles on my long runs now, and speed is slowly returning...this week's runs of 8 and 9 miles were both about 7:45 pace, so I'm getting back into shape.

This week's 8-mile run was a wonderful runner's tour of DC, and I just had to share it with you...if you're local to the DC area, I highly recommend it!

Starting at the Pentagon, I headed out through Ladybird Johnson Park (by the way, in the fall this place rocks the fall colors), and hit the Mount Vernon Trail just opposite the Pentagon. Heading north, the two-mile point is marked by the bridge to Roosevelt Island, which makes a great five-mile loop by itself -- but not today! Struggling up the steep switchback to the pedestrian overpass, I cross George Washington Parkway and head over the Key Bridge into Georgetown. The Key Bridge hits Georgetown right on M Street, and as you reach the end of the bridge you're staring directly at The Georgetown Running Company, a local icon...and a great pit stop if you need a gel, some socks, or a new pair of shoes...check their blog for some great advice on the DC running scene and local race reports. Pulling a quick 180-degree turn at the east end of the Key Bridge, a quick jog through the Francis Scott Key Memorial (located just feet from where his home used to stand in old Georgetown) lands you on the C&O Canal Towpath, right at mile 3.

This little trail is worthy of a blog all it's own, but for now just know that you're actually running on an old cartpath -- when mules pulled barges down the C&O Canal, and occasionally still do during tourist season. Nowadays, it's a great running trail, and nine days out of ten I'm the only one on it. You can see from the photos above and below -- on a beautiful spring day at noon, in the middle of downtown DC, there's not a soul in sight. Love it! The path crosses under several pedestrian overpasses, and even winds its way through a few restaurant courtyards and business patios, but still makes a great and historic section of the run, taking you from mile 3 almost to mile 4.

A hard right at the end of the towpath puts you on the Rock Creek Park Trail -- familiar territory to any Marine Corps Marathoners, who spend almost half of their marathon time on Rock Creek Parkway (at least, they did when I ran it in 2006). By the time you reached the halfway point at mile 4, turn around and look behind you -- historic Georgetown University and the Key Bridge on the left, the Georgetown waterfront on the right, and the Potomac waterfront you just ran in between.

Don't miss the fact that at this point, only halfway into the run, you've encountered no less than five National Historic Landmarks, and even ran through two National Historic Parks. Turning around and looking ahead toward the Rock Creek Park trail, the scenery gets even better and more historic -- that's the infamous Watergate Hotel complex on the left, the Kennedy Center for the Performing Arts in the middle, and barely visible in the distance is the Lincoln Memorial and the Memorial Bridge.

The trail takes you along the Potomac, and eventually up a gradual incline to the Lincoln Memorial.

No matter what bridge you run over in the DC area, you're bound to be greeted (or chased) by "the guardians." These towering (and often intimidating) statues sit on either side of the bridge, on both ends, and were usually gifts to the United States by foreign dignitaries or nations. The two greeting you as you reach the top of the hill -- one called "Music and Harvest" (pictured below) and the other called "Aspiration and Literature" -- were gifts to the United States from Italy in 1925, and both bronze mammoths stand nearly 20 feet tall, peering down on miniscule runners below as if to say, "Better keep moving, boy..."

On the other side of the Memorial Bridge, take a right on the footpath just past the Arlington Cemetery Metro stop, and wind down the hill into Arlington National Cemetery. This stretch of the memorial bridge is a popular place for protests, by the way -- almost as much a DC landmark as everything you've seen so far. This one was for the crisis in Darfur...but tomorrow it will be something else. I just smile and keep running.

Arlington National Cemetery is a humbling and majestic place. On this run, at times you can look up the hill to Kennedy's eternal flame and The Arlington House, other times you can see gravestones that stretch to the horizon...and about 50% of the time I run this route, you can see the long processional from a military funeral.

Just past the 6-mile mark, you approach the Netherlands Carillon. Not a common or well-known landmark, it's really quite impressive....from its twin bronze lions guarding the entrance to its 127-foot bell tower, it commands quite a presence. With a little forethought and accurate pacing, you can schedule your lunchtime run so that you run under the carillon as it's ringing -- it didn't happen today, but I've been lucky a few times. The Netherlands Carillon is perhaps best known because it is rumored to have one of the best views in all of downtown DC -- standing between the lions, you can see -- from left to right -- The Old Post Office, Union Station, The Lincoln Memorial, the Washington Monument, and the Capitol building.

The path from the Carillon leads to one of the most famous DC landmarks, The Marine Corps War Memorial. I love this part of the run. I always slow down, and for my first year here in DC I would always stop, kneel and pray for my buddy Steve, a Marine who just returned from Iraq. Even now, I still slow down to pay respects to what Steve -- and Ty, and many others -- have done for us and for our country. God be with you, my friends, and thank you for your service.

A quick loop around the Memorial send me over the seven-mile mark and points me straight "home" to the Pentagon. Grand total -- 8.09 miles, 1:02.28, 7:43 pace. In one hour -- 8 miles, 11 National Historic Landmarks, one National Historic Park, 3 National Monuments, two angry horses, one protest, along with Watergate, the Kennedy Center, the Georgetown Running Company, and some great scenery. Not bad for a lunch break.

Living STRONG for Cancer

2010-02-24T12:10:00.009-05:00

First, thanks to all of you for your creative and thoughtful suggestions on "The Bright Side" of not running. I didn't realize how much time and money I could save by giving it up! Still, I just can't help it...I've gotta get out there. Training has gone well lately, though the snow has forced me onto the hated treadmill a few times. I'm up in the 6 - 7 mile range, and averaging sub-8...not where I was before surgery, but getting there.

It's been a while since my last update -- I've had the time to blog since I've been at home recovering, but have spent most of my blog time setting up this year's fundraising effort. This has been a momentous year for me -- in the past twelve months, I've had three surgeries, 42 rounds of chemotherapy and radiation, and six weeks of IV infusions for immunotherapy. I figured a record-breaking year should be followed by a record-breaking fundraiser. So, I'm overjoyed to announce: TEAM MICHAEL MOYLES!

After a suggestion from my brother-in-law

CJ, we contacted the Lance Armstrong Foundation, and worked with them for a couple weeks to set up a LiveSTRONG team and arrange a major fundraiser. This is by far my largest effort yet -- so far, this Team consists of eight runners and at least nine different races, every race and every runner raising money to find a cure for cancer. I am so incredibly excited about this effort! So, why not shoot for the stars? I decided to aim high and try to raise a whopping ten grand by the end of the year...with over $1,000 raised in just our first week, we're well on our way, but still have quite a ways to go. That said, we've just scratched the surface of the potential this team may have...CJ, a brilliant graphic design artist, has taken it upon himself to design everything from our webpage to our team logo, t-shirts, coffee mugs, the works...being the geek that I am, I've taken over the Team Michael Moyles website, our Facebook group, and fundraising mechanics, using his logos and advertising materials. So far, it's a perfect match, and we're both very happy. Here are a few samples...what do you think?

We're not ready to "go live" with everything yet (the full website, products, etc), but the fundraiser is already up and running (you can use the Team Michael Moyles link above). I think just about everyone who regularly checks my blog is also a Facebook friend and/or on my e-mail distribution list, but in case you aren't -- check the page, and if you're inspired, make a donation! I don't think you'll find a better cause.

Can we do it? $10,000 in a year? I think so, with your help. I'm off to recover from my root canal/crown excavation this morning...and what better way that with a nice long run?

The Bright Side

2010-01-25T15:04:00.008-05:00

As of today, it's been 10 days since my last run. For me, this is an eternity. I'll find out on Wednesday how long I'll have to wait before returning to the roads. So, in the meantime, I've been trying to find the silver lining in the whole thing.

Call me an optimist.

So, the bright side of not being able to run:

1. Recovery. I can heal, the incision won't split, my heart rate won't spike, the stitches won't come out, blah blah blah yada yada...that's a given. Moving on the more interesting things.

2. Time. Wow, running and training takes a lot of time! You don't really realize how much until you stop. I've been catching up on reading, schoolwork, blogging (yes, even blogging), podcasts, and especially playing with my baby girl...but in most cases (except baby girl, of course), I'd rather be running.

3. Toenails! What a novel idea. At least two of my toes are being-introduced to the concept.

4. Laundry. Okay, so I'm adding this one on Pooh's behalf, since I was banned from the laundry room about nine years ago. Let's face it, folks -- running generates a lot of laundry. At least two -- and sometimes three -- sets of socks and underwear a day, plus one set of sweaty/stinky clothes and at least one other set of clothes each day, plus uniforms...you do the math. And while we're on the topic, has anyone found a detergent that actually gets the stink out? I've tried WIN and SportWash, and neither one made any difference. Don recommends Pro-Wash, but I'm a bit put off by the price...other suggestions?

5. Hmmm. Ummm...shoot...

Okay, so I started this blog on Saturday with the title, "10 Benefits of NOT Running." I figured I could easily come up with 10 benefits of taking a break from training. I'm stuck at four, I've changed the title, and I need your help. What am I forgetting? Help me find The Bright Side! Six more...

Run For Your Life

2010-01-21T10:09:00.011-05:00

So, recovery has gone very well so far. It's been nearly a week since my skull reconstruction, and I feel very good...the headaches are gone, I'm off nearly all meds (only seizure suppression remains), and not in any pain. We're not completely out of the woods, as there is still significant risk of infection or other complications, but we haven't seen any signs of them so far. I look pretty good too:

No real swelling or discoloration to speak of. I also maintained my track record of being discharged from the hospital early. So, five surgeries in, I got to thinking -- is having brain surgery something you just get good at? Is a procedure so invasive, injurious, and with such a high risk of complications something your body just "gets used to"?

No way.

What makes my body able to handle these procedures with relative ease? Why do I recover so quickly? Why have my stays in the hospital always been cut short? After removal of the right frontal lobe, why was my stay in the hospital the same as someone who had their tonsils removed? Why am I still the only brain surgery patient in the recorded history of Cedars-Sinai Medical Center to skip ICU completely? How can I have brain surgery and run a half-marathon six weeks later, or train for and run a full marathon while undergoing twelve months of chemotherapy? I've discussed this with my neurosurgeon here, and with those at Cedars and elsewhere...and the answer, quite simply, is fitness.

You all know by now that I'm a man of strong faith, and I believe God has preserved me in this world to serve Him and testify on His behalf. No doubt in my mind that plays a role. But, to bring this blog to a close, let me say it quite clearly:

I believe fitness -- running, in particular -- has saved my life. After my first surgery, I made a decision to put my body in the best possible physical shape to fight cancer, and I think much of my success in the fight is a direct result of that decision.

Would I have made it through five brain surgeries if I had been out of shape? What about 22 rounds of chemotherapy and 42 rounds of radiation? Had I not been in marathon shape through all of it, would I have recovered as quickly? Likely not. Would I have recovered at all? Who knows. Would I even be alive today? Perhaps not. A few months ago, I watched the movie "Run For Your Life," the story of Fred Lebow, the founder of the New York City Marathon. The title of the movie indicates that running defined him, and was his primary reason for living. For me, it's not my reason for living -- it's the reason I'm alive. Don't miss the difference.

Alive and Well!

2010-01-16T13:50:00.002-05:00

Hello faithful readers and supporters! It's me, Mike -- out of surgery, out of ICU, and on the recovery floor. Now, if only I could convince the docs to put me on a regular diet and stop the IVs! Yes, I'm still causing problems...but in a good way.

From what I'm told, surgery went just fine. There were some delays initially, but once surgery started it went without any difficulty. ICU was, as always, a difficult time -- you're disturbed every hour for a neuro exam, and you're hooked up to every machine imagineable -- so sleep is basically impossible, and that's all you really want to do. To make matters worse, I was setting off alarms every few minutes -- if your heart rate drops below 60 beats per minute, or if your respiration rate (breaths per minute) drops below a certain number, it sets off an alarm. As many of my endurance athlete friends know very well, a heart rate under 60 beats per minute is quite common for us -- a resting heart rate of 44bpm, in my case. So, even if I could get to sleep for a few minutes, shortly after nodding off my heart rate would drop into the low 50s or high 40s, acting like an alarm clock and waking me up, not to mention the nurses and orderlies rushing in to see what was wrong. Same thing with respiration rate. Well, I guess I've found the downside of being in shape. All this to say that last night was a very long, very restless and very uncomfortable night...but I made it!

The biggest victory today was the removal of the EKG leads and the Foley catheter. With those two things gone, I actually have freedom to move and walk around...even run, if they'd let me! I'm up on the patient recovery floor now, where I have a TV and my own room, without the hourly wakeups and heart rate/respiration alarms. Much more peaceful and restful. I've spent most of the morning napping, and now I'm in the lounge on one of the computers furnished by the Wounded Warrior project. Yes, I'm on the Wounded Warrior wing again -- these guys are just incredible! I even had lunch next to a guy who had lost an arm to an IED. Please support this foundation if you can, and say a prayer for them. Hereos, every one.

So, the goal is to be home in time for the Duke game tomorrow night at 8pm. Any bets? Also, it looks like I'm teaming up with a few friends for my next race...the details are still in work, but stay tuned! Potentially big news shortly, if we can work it. Stay tuned, and thanks for your prayers! Pictures soon, I promise...

And the winner is....

2010-01-15T20:28:00.003-05:00

Whew-what a long day! For anyone who has had a loved one undergo surgery, you know what it's like to "wait" and waiting is what we did a lot of today.

Starting at 730am, Mike checked in, changed into a "beautiful" gown and was sent to the "holding" area. Yes, we were definitely in a military hospital this time. No fluff, no pampering, just "get it done". Once settled there, the doctor came in and told us that Mike's surgery had been bumped (much to his dismay) until noon. We were heart-broken. Mike was hungry, tired and begging for coffee. The neurosurgeon is outstanding and was very upset that the hospital had rearranged his schedule, but he was going to do his best to get Mike in early. With a 3 hour wait looming on us before they even came to get Mike, my dad and I decided we'd venture off for some breakfast of our own. Mike welcomed the quiet for some much needed sleep. We returned right at 9am, to find the "orderly" there to take Mike back to surgery. Great news for us-no more waiting for the day to get started!

Once again we said our tearful good-byes and parted ways. Now mind you, we have been smack dab in the middle of Beverly Hills for all but these last 2 surgeries and believe me, the thought, "Todo, we aren't in Kansas anymore" comes to mind. We headed to the "waiting room", which was crowded, loud and HOT! After two hours, which felt like seven by now, my dad and I headed to the desk to see if Mike's case had even begun yet. 11:45am: "yes, they just took him back"...Great news, again, no more waiting on the surgery to begin...

We decided to go downstairs and walk around. An hour later, while talking over lunch, we see the neurosurgeon walk by. I shouted to him "Hey, aren't you supposed to be in surgery?" but, he didn't hear me, so we decided to "follow" him. The whole time thinking "Is Mike already done? Did another surgeon "open" for him? Has he NOT even started yet?" Very confused at this point, we lost him, so we headed back to the desk. This guy must have thought I was nuts, but he politely told me that "yes, they were still "in" there!" Okay, back to WAITING!

Oh the waiting...sleeping, eating, talking, eating, watching TV, reading, eating, praying. Yes, there is a definite pattern here-eating. I eat when I'm bored and nothing was filling that empty, worrying void. Yes, praying helps, but your mind does these weird things. I was SO tired of waiting...

Finally, 230pm: "Mrs Moyles?" "Yes". "Let's step out in the hallway..." (gulp-even knowing this is standard) "Mike did great, he's in ICU, awake, semi-alert and almost completely out of anesthesia." WHOA--what a great surprise. The neurosurgeon had decided to wait an hour after surgery to come tell me things were fine due to the high risk of stroke in "head surgery" patients. Mike had not only come through the surgery fine, but was already well on his way to recovery. The "plate" fit perfectly in the forehead and the skin came together beautifully. The crown is a bit higher than it used to be (says the surgeon), but who cares...he's fine! :) He has a pump, to eliminate the fluid buildup. He'll be in ICU overnight and then to a patient room tomorrow and hopefully home on Sunday.

230: We got to lay eyes on him for the first time since morning. What a wonderful sight, bandages and all! Mike was awake (sort of) and talking. As usual, he wanted to be sure that I knew he was okay, so he says..."where am I?" I say "ICU". Mike-"What? They promised me NO ICU" (insert BIG pouty lip). I just laugh and say "oh dear, they didn't tell you that, but you can think that if you want." After giving the nurses some grief over being in ICU and doing EVERYTHING he can to bribe them to get out, he fell asleep!

I saw him one more time before leaving for the evening. Mike was still complaining about being in ICU and desparately trying to get some ice chips. A quick kiss good-bye and a few more reminders from Mike to get him out of ICU and we parted for the evening. Good luck nurses! :)

Oh, and more reason I know we aren't at Cedars Sinai anymore... 830pm: "Hi, this is Mrs. Moyles...how is my husband doing?" "hold on please"...(silence) "Mrs. Jones, he's resting now". "okay, but I'm Mrs. Moyles", "yes, he's resting now, we'll tell him you called-click!" Hmm... sure hope Mike gets the message! :)

We "Thank you" all for the prayers and support! We couldn't have done any of this without God and all of you. I will end with this....

"And the winner is... Mike!" Praise God for being The Great Physician and keeping Mike safe through another trying time.

Good night all and you'll hear from Mike tomorrow!

Round 5

2010-01-13T08:14:00.004-05:00

Well, Michael "Ali" Moyles has been through four rounds and gotten up every time -- tomorrow starts Round Five! Cancer has knocked me down three times, and I've gotten back up, then radiation and subsequent infection, and again I came back strong -- tomorrow, Round Five (reconstructive surgery) begins. I'm ready for it.

Pre-op started on Tuesday. The appointments were long -- over five hours' worth -- but we have a clear road ahead. I spent most of the time with the neurosurgeon and the anesthesiologist, who will be the most critical players in tomorrow's "game". There were a few amusing moments -- first, the EKG showed that I have "sinus bradycardia" -- as some of you other marathoners may know, this simply means my heart doesn't have to beat very often. With a resting heart rate around 44 bpm, I guess the EKG was a bit concerned. Second, my body type -- that is, part wookie -- wreaks havoc on EKG leads, which never stick. Fortunately, I have good veins (large and easily accessible). The nurse politely told me, "The problems you cause in EKG you make up for in labs." In other words, I'm hairy but have good veins. Nice!

Bottom line, everyone is comfortable and confident, and I think the team is the best available. There are three primary concerns:

1. Infection. Apparently, about an hour of the operation is actually replacing the plate, the other three or four hours are all consumed by "infection avoidance" -- sterilization, cleaning, and making sure the plate, sutures, screws, and other items are properly positioned and so forth. The sutures will be internal to minimize the opportunity of bacteria getting under the skin through holes (from staples or stitches). External will be steri-strips only. These surgeries have an extremely high rate of infection...by far the biggest hurdle.

2. Fluid. The body's natural reaction to a foreign body (like an acrylic plate) is to surround it with fluid, much the way an oyster responds to a grain of sand. So, they expect that there will be significant swelling after surgery -- if it's a knee replacement or something else, the swelling eventually just goes down...but they can't afford to let it swell since it's the skull. Therefore, I'll have a drain (like a shunt) placed into my forehead to help drain any excess fluid that builds up around the plate, potentially increasing cranial pressure. The bad part here is that I have to remain in the hospital until the drain is removed and the fluid buildup subsides -- probably at least 2 - 3 days, not the overnight stay I was hoping for.

3. Seizures. The foreign material, the cranial swelling, and pressure differential caused by sealing the brain inside the skull again all create a high risk of seizures. I've never had one and have proven amazingly resistent to seizures, so let's hope that trend continues. I'll be on some pretty powerful seizure suppressants after surgery, which should help.

If we can sidestep those three landmines -- infection, fluid buildup, and seizures -- then I should be in fine shape. I'm second on the schedule Friday morning, with an 8:30am showtime and 10:00am surgery time. I should be in the hospital about two or three days, just long enough to get past the window where infection or dural tears could cause major complications.

Pooh will be keeping up the blog and Facebook regularly...and if past battles are any indication, we all know who's going to win this round. Float like a butterfly...

A Bump in "The Road Ahead."

2009-12-21T22:25:00.005-05:00

There's good news and not-so-good news. First, the good news: for those who haven't heard, my scan on the 11th was clear. The cancer is still at bay, I'm still in remission! This is an incredible blessing...perhaps the triple threat (surgery+chemo+radiation) has done the trick. 90 more days, baby!

In the "not-so-good news" realm, the 18th came and went -- with no new forehead. The short version of a long story is that the prosthetic fabricator made the frontal plate out of the wrong material. For those who are interested in the long story...

Here's the original plan:

The image above is from the 1-mm brain scan I had a few weeks ago -- that's actually my skull, you can even see the scar from the bone saw used in previous surgeries. The gold portion is the plate they've created out of titanium mesh. Now, for nearly every cranioplasty patient, titanium mesh is the best option -- lighter, stronger, and integrates well with natural tissues (bone and skin). In numerous consultations with the neurosurgery team, the prosthetic fabricator was able to make a solid case that titanium mesh is the best way to go. Unfortunately, I am not your standard cranioplasty patient. Simply said, titanium mesh is the best way to go, if you never have to remove it. My neurosurgeon here is a fabulous guy and very experienced, and has put many of these plates in -- but, admittedly, has never had to take one out. With my history of tumors and prior brain surgeries, we are realists and understand that (despite the good news above) it is entirely likely that we'll need to go back in at some point to remove additional tumors. Titanium mesh integrates with the healthy bone, and the scalp actually settles into the mesh -- it really becomes a part of your head, which is a great thing for most patients, but not for me. In addition, titanium could mask a recurrence -- since it's metal, it can introduce imperfections and "false positives" into an MRI, and could even mask recurrent tumor tissue. So, for at least a few reasons, titanium mesh is a bad idea for me, and the neurosurgeon has made the right decision to cancel surgery and order an acrylic plate. We're back on the calendar for 15 January, so stay tuned!

Training has gone quite well over the past month or so. Those of you who know me are well aware of the fact that these little "bumps in the road" like cranial reconstructions and brain surgeries don't slow me down much...and you may remember from a previous blog that I've decided to specialize in the half-marathon. My goal is to break 1:30 next year, which starts with the National Half-Marathon in March. Goal for this race is somewhere in the 1:37s, around 7:25/mile pace. I'm focusing on the Furman Institute's of Running and Scientific Training (FIRST) half-marathon plan, and it really seems to be working so far. Has anyone used FIRST before? The book "Run Less, Run Faster" is largely based on Furman's research, and I must say I'm pretty impressed. PRs at both 5 and 8 miles just in the last few weeks (36:11 and 59:24 respectively), so it can accomplish some pretty good results on only 3 runs per week.

That's all for now -- of course we thought we'd be in recovery from surgery this week, so didn't make any plans, and will be spending a quiet Christmas at home with Pooh and Monkey. To be honest, I wouldn't have it any other way. Be thankful for life and loved ones today, my friends!

The Road Ahead

2009-11-22T17:13:00.003-05:00

Well, I promised an update after last Monday's appointment with the neurosurgeon. Good news -- I'm fully healed, and ready for reconstructive surgery! A concern and a praise at the same time, I suppose...I'm very ready for this whole ordeal to be over, but not necessarily looking forward to another major surgery -- my third one this year. But, if you know me, you know it won't slow me down. Here's the road ahead:

23 November: 1mm-cranial scan. This is like a CT, but a CT is usually done with 3mm or 5mm "slices." To reconstruct a 3-d image of my skull, they need to do one with 1mm slices...that just means a really long CT scan...probably two hours or more. They'll use the 3-d imaging from that scan to construct the prosthetic that will go where my forehead used to be.

11 December: Brain scan (MRI). Remember the "90 Days at a Time" blog? Well, my last scan was 16 September...so you can do the math. We've made it another 90 days in remission, and we need to check again to make sure the cancer is still at bay. This is basically unrelated to the infection and the reconstruction, but a significant event nonetheless.

14 December: Neurosurgery and radiation oncology consults. Basically, appointments to go over the scans and learn the results. Hopefully, we'll restart the 90-day clock!

18 December: Reconstructive surgery. They'll open me up again, place the prosthetic in, "trim to fit," and close me back up. In general, the shortest and simplest of all the surgeries I've had, but there are some potential complications and risks. If all goes well, I'm only in the hospital overnight for observation, and home that weekend.

31 December: The Fairfax Four road race! What, you thought I'd let surgery stop me from training and running? Come on...

So, there you have it! A new forehead for Christmas. There's a song there somewhere...

Race Report -- Richmond Half-Marathon

2009-11-14T21:16:00.012-05:00

Greetings bloggers! First, the running news. I've made the decision to specialize -- meaning I've probably run my last marathon. My challenge is to find a distance long enough to satisfy my love for the long run, but short enough that I can still be competitive. I realize that to be competitive at the marathon distance, I need to be in the 2:30 range -- something that is just not realistic for me. However, if I move down to the half marathon, in the 35 - 39 age group, I can place (and maybe even win a few) if I get under 1:30. I think that's well within my ability. So, let it be done -- I'm now a half-marathoner.

That said, today was the Suntrust Richmond Half-Marathon. I had not quite trained as much as I would like -- I ran the Leavenworth Half-Marathon in October with almost no training, then trained about five weeks after that race for Richmond. Still, I as hoping to break 1:40 -- about 7:37 pace. Well...

You've all probably heard of Hurricane Ida. It's been wreaking havoc across most of the east coast, and here in Alexandria it's rained for about five straight days...Richmond too. But, a little light rain isn't much of a deterrent...it actually makes for pretty good running weather, most days. The race started bright and early at 0730 -- parking was plentiful and easily accessible, and only a few blocks from the start. It seemed there were fewer porta-potties than there needed to be given the number of runners, but I was early enough to wait it out in line.

The course was flat and fast...beautiful fall colors, some of the course along the James River, and most of it in either historic oldtown or in one of the many city parks in Richmond. Live music was plentiful, and the water stops were well-placed and well-stocked. Unfortunately, there was almost a complete lack of any fan support -- perhaps because the half-marathon started 30 minutes prior to the full, or perhaps because of the weather, but it was really just a few hardy folks standing on their doorsteps and a couple dozen at the entrance to Joseph Bryan Park.

No problems during the race, but my legs started to get heavy around 10 miles...not sure why, but it made the last few miles some pretty tough ones. I can't really blame the course or the weather, so it was probably just a lack of training, lack of sleep, or nutrition issue. Final time was 1:42:23, about two and half minutes over goal time...398th out of 4578 total, and 45th out of 366 in my age group. Not too bad -- and the five weeks of training since Leavenworth paid off by knocking almost 10 minutes off my time from that race, but still a couple minutes short of my goal. Next up -- the National Half-Marathon, 20 March 2010.

In other news, my next neurosurgery appointment is on Monday (16 November). Hopefully, they'll do a physical assessment and schedule me for reconstructive surgery. I'm really not looking forward to another surgery and another 4 - 6 weeks of recovery, but I'm ready to get this episode over with. Put me head back together, and let me get on with living!

For the "Monkey Fan Club," you'll be happy to know that she is growing like a weed and expanding her vocabulary daily. I'm also afraid she's hit the "terrible twos" about six months early...it's becoming quite a challenge, but an enjoyable one.

Will let you all know the results of the Monday appointment!

90 Days At A Time...

2009-09-26T21:40:00.003-04:00

My brain tumor was first discovered almost 10 years ago -- in December 1999. It was a complete stroke of luck, if you believe in such things (I don't, but that's another post). While playing basketball with a city league in St. Louis, I dove for a loose ball and collided with another player, losing consciousness for about 15 seconds. When I regained consciousness, I couldn't move my right arm. An ambulance ride and a CT scan later, I learned that I had sustained significant damage to my C5 cervical nerve, weakening my right arm to the point where I couldn't lift a 16-oz can of soda. I was a Captain in the Air Force at the time, and Air Force policies dictated that I also have an MRI of the brain to rule out any hemorrhaging or potential complications from the concussion. What followed can only be described as surreal.

An MRI of the brain can be an intimidating experience for the uninitiated (of course, I sleep through them now). Your head is immobilized by a plastic helmet, and you are slowly moved into a tube about 24" in diameter. You must be completely motionless -- for about 55 minutes. In my case, there was a small mirror just above my eyes, which allowed me to see out the tube, between my feet, into the MRI room where the technician was sitting. I tried to count the minutes as they crawled by...15...30...40...and about 45 minutes into the scan, a Colonel arrived. Five minutes later, another Colonel. And then another. And another. An hour into the scan, it was finished -- but I was still in the tube, watching with growing desperation as four Colonels pored over the screen where I can only assume my brain was on display. Born in and raised under the care of military hospitals, I knew Colonels were the Chiefs of their various divisions within the hospital -- neurology, neurosurgery, radiology, internal medicine, family practice...who were they? What did they see? After an eternity, the table started to move and I slowly slid out of the tube. The Colonels were gone.

The next day I received a call from a doctor in neurology, who wanted to test my right arm to determine the extent of the nerve damage. He also provided me with a referral to Barnes-Jewish Hospital in St. Louis to see a neurosurgeon. After repeated questions, he divulged that they had "seen something" on the scan, but didn't know what it was. The subsequent neurosurgery appointment confirmed the rumor, but diagnosis remained elusive -- an arachnoid cyst, a birth defect, a hamartoma. A year and a half later, along with second and third opinions at Deaconness and Sacred Heart Medical Center, and still no real confidence in what the thing was. But it was there. And it was growing. And it had to be removed.

Thanks to an article I ran across in Time Magazine and the sheer brilliance of Dr. Keith Black and his team at the Maxine Dunitz Neurosurgical Institute at Cedars-Sinai, we finally got a diagnosis, and scheduled surgery -- going under the knife in April 2001.

That first surgery was followed by serial brain scans (basically MRIs) every 90 days, and for the last eight years, I have been undergoing a similar routine. Life really only exists until the next scan. Is it clear? 90 days of remission. Is there a recurrence? Then the process begins again. Surgery? Chemotherapy? Radiation? You literally learn to live 90 days at a time. Each clear scan is 90 more days of living. 90 more days of running. 90 more days of fighting.

Which brings me to the point of the historic tale. I had another brain scan just a week or two ago, and recently got the results. We're all clear! The infection is gone, and there is no sign of any recurring cancer. No more tumors. The surgery, chemotherapy, radiation, and antibiotics have all done their job. 90 more days, baby! 90 more days...

I'm Back!

2009-09-26T18:06:00.004-04:00

After six weeks of daily IV antibiotic treatments, I'm DONE. Finally. The good news is that the infectious disease docs think the infection is on the run, I've had the stitches removed, and the incision looks great. As you can see below, my profile still leaves a lot to be desired -- but that will all be fixed with some plastic surgery in December/January to rebuild my skull. The reconstructive surgery itself carries some pretty significant risks, but I won't bore you with those details. Here's the great profile shot:

Well, looks were never my strong suit anyway...and it makes Halloween easy...and GEICO has already contacted me about doing some commercials (just kidding).

I feel fine, and am even slowly starting back to work. Most importantly, the central line (PICC) was removed, which means I can run again! Yes, after, six weeks of sitting on my derriere, I laced 'em up again a few weeks ago. I sure didn't set any land speed records, but was able to run an easy four miles at 8:55 pace...much slower and shorter than my usual Sunday run, but it felt great just to be on the road again (thanks Willie Nelson). The challenge now is to run the half-marathon -- and finish with dignity -- next weekend. I usually train 16 weeks for a marathon, and at least 8 - 12 for a half-marathon...and somehow I'm going to give it a shot after only four weeks of training. I had my last long run today, and did 10.3 at about 8:15 pace. I'm definitely not going to meet my goal of breaking 1:30 for the half, but I'll at least finish. Stay tuned for the race report...it should be an interesting one! I've also registered for the Richmond Half-Marathon on November 14th, so maybe I'll be sub-1:30 by that time, but that's still pushing it.

Many of you who have contributed will be happy to hear that the helmet is truly a work of art. I've added stickers from Washington, Oregon, Texas, Kentucky, and Ohio, as well as a very special one from New Zealand (thanks !) and a few others. I also added a monkey, of course! Sticker count is now up to 30, with room remaining...though I did receive one Texas sticker that was bigger than the helmet itself...not sure what to do with that one. So, here's how it looks right now:

Your support and encouragement has been instrumental in my recovery -- thanks to everyone! Another blog soon, I promise...

Live Strong Action

2009-07-30T12:45:00.004-04:00

My wife is so awesome!
I've been working with the Lance Armstrong Foundation for a number of years, raising money and raising awareness. The LAF is now initiating "Live Strong Action," where you can pay tribute to those who have inspired you. Take a look at the dedication page my wife did for me. So cool! Even better, if I've motivated or inspired you in some way, feel free to add your name...it doesn't cost a cent!
LIVE STRONG...

Helmet Head

2009-07-29T21:32:00.005-04:00

Well, first and foremost -- I think I found the perfect helmet -- thanks REI!

It's even been approved by the neurosurgeon! Of course, you'll notice that it's completely blank -- no stickers yet. More on that in a moment.

Status Update: I'm doing pretty well. I'm not in any pain, just dealing with fatigue and the daily grind. I have medical appointments at either the National Institutes of Health or the National Naval Medical Center almost every day, with visits and deliveries from the home healthcare folks at CORAM at least once or twice a week. I also get daily IV antibiotics, and Pooh is a pro now -- we've got the whole IV thing down to an easy routine. The side effects of the Invanz antibiotics aren't too pleasant, but I won't bore you with the details.

Today was supposed to be a fairly big day...the day I get my stitches removed! We took the hour trip up to NNMC, waited for the neurosurgeon, and upon examination found that about half the incision had not yet healed adequately for the stitches to be removed. So, they took about half of them out...well, it's a start anyway! Back next week to get the other half out. Here's how it looked:

As you can see, I haven't been able to cut my hair for a few weeks. I think this is the longest it's been since high school! In any case, I'm doing well, feeling fine, and resting as much as I can. I'm off the roads and off the bike for at least four more weeks, but I'm still hoping to keep my race schedule intact. I might not meet my goal of breaking 1:30 in the half this year, but it's still on the books...it just might take a bit longer.

Finally, about the helmet. THANK YOU so much for all the stickers and support! Here's the current tally:

1 Ohio State Seal (thanks Jen)

1 Ladybug (thanks Jen)

1 Kentucky Wildcat (thanks Aunt Barb...tough one to use for a Duke fan, but I used it!)

1 "No Brainer" logo (thanks Pooh!)

1 "Good as New" logo (thanks Pooh!)

1 Band-Aid (thanks Brian)

2 Stars (thanks mom)

1 Mickey Mouse (thanks mom)

1 bunch of grapes (thanks La Toscana Winery)

1 Major rank, soon to be upgraded to Lt Col (thanks Don!)

2 American flags (thanks Brian)

1 "Custom Cruiser" (thanks Brian)

3 words: "Conviction," "Hope," and "Commitment" (thanks Sharon)

We're up to 17 stickers, with LOTS of room left. Keep them coming!

And, if I haven't told you before, all you bloggers are wonderful people...as are those who read and comment, but don't blog. The support (and stickers) you all provide is tremendous. Keep running and keep fighting!

Foreheads are Overrated -- And A Challenge to Bloggers!

2009-07-18T20:51:00.009-04:00

So, here's the latest -- along with pictures this time, finally!

After a great deal of research I don't pretend to understand, the petri dishes grew whatever they needed to, and we have a name for the bug that attacked my head and face -- enterobacter aerogenes. Go ahead and click the link or Google for yourself -- it's not pretty. Highly destructive, high mortality rate, all the nasties you don't want to read about. Fortunately, it's only really dangerous if you have "a prior history of surgeries in the area, cancer, or an immune system compromised by chemotherapy or radiation treatments." NICE! I'm batting a thousand on that one...but I'm doing well. The infectious disease docs at the National Naval Medical Center were outstanding, and isolated the bug in time to treat it appropriately. Once they found the bug causing my infection, they prescribed the right antibiotic and installed a Peripherally Inserted Central Catheter (PICC) line. That was quite an impressive process -- a 43cm catheter that goes from my armpit to my heart -- but in the end it was far less traumatic or painful than I had expected.

With the right antibiotics in hand and the PICC Line inserted, I was discharged from the hospital last night and sent home. This morning a home healthcare nurse from CORAM Home Healthcare infusion services arrived, and provided

me and Pooh with all the equipment and instructions on how to administer the antibiotics -- 30 minutes once a day -- not bad at all. It helps that Pooh's mother, who is a 30-year OR nurse, is staying here with us -- and our next-door neighbor is a transplant and PICC nurse. We're covered! The CORAM nurse walked us through the process this morning, and we're on our own tomorrow!

I'm not in any pain and I feel fairly good, but I sure don't look pretty. Here's the latest shot, taken just before I left the hospital:

There is still some swelling from both the surgery and the infection, but once that swelling goes down, there will be quite a canyon between the top of my head and my brow. I'll probably look like something between a cro-magnon man and a klingon, but that's okay...I was never much to look at anyway, and I've already got a wonderful wife who loves me to matter what I look like! At least, that's what she tells me...

A CHALLENGE TO BLOGGERS

Okay, here's where the fun begins -- because my brain is basically exposed and unprotected (only covered by a thin layer of skin), I have to wear a helmet whenever I'm out and about or doing anything active (including running). So, I'm going helmet shopping tomorrow. Here's your chance to "get involved" -- send stickers! I'll get a plain black biking, climbing, or skating helmet, and decorate it with all the stickers I receive from fellow bloggers against cancer and everyone else. Feel free to get creative as you like -- a state sticker from where you are, a sticker from your last race, a photo, your favorite slogan, whatever -- just please use good taste (no profanity), and I'll find a way to fit all the stickers on my helmet and show off the great support I've always received from blogland. If you don't have my home address, please send an e-mail to moylesm@hotmail.com and I'll send it to you. I'll even upload periodic pictures of the infamous cranium cap! Thanks to Peggy for the great idea...and start sending!

Next blog will have a few race reports and more photos. Signing off with a farewell from the Monkey...love to all!

Made it Through Another...

2009-07-15T18:09:00.002-04:00

Greetings fellow bloggers! It's Mike this time...blogging from the National Naval Medical Center (NNMC) in Bethesda, MD. Wow, what a turn of events.

Angie ("Pooh") gave a pretty good summary in the previous blog. Basically, I was fully recovered from December's surgery, feeling fine, the what appeared to be just a headache snowballed into a craniotomy #4! Far be it from me to place blame, but from what we now know it appears that something unsterile was introduced into the cranium during my last surgery. That was enough to foster an infection under the frontal plate, which has slowly festered for the past few months. It then exited through my right temple and began to attack the soft tissue above and around my right eye, which is when I first became aware of it. By the time we noticed and got to the ER on Monday afternoon, the infection had destroyed the entire frontal plate and done some damage to the sinus cavity and even the dura (sack surrounding the brain).

Surgery yesterday morning was actually not craniotomy #4, it was craniectomy #1 -- the removal of the frontal plate. After some pretty serious labwork to figure out which bug (or bugs) have been throwing a party in my head for the last seven months, I'll be put on targeted antibiotics and sent home -- probably 3 - 4 days. I'll come back in 14 days for a checkup and to get the sutures removed, then back in about 6 months for a cranioplasty. They've made a mold of the bone that was removed, and will recreate it with either titanium mesh or a plastic polymer. The idea is to make me look basically the same as I looked before the event -- I asked if they could make me better looking, but apparently it's pretty hard to improve on what I've already got ;-).

I feel just okay. Not a lot of pain or discomfort, this struggle is far more emotional. I wasn't ready for this. I didn't have time to educate myself or prepare, mentally, emotionally, and psychologically, for this event. The hospital is not nearly as nice as Cedars-Sinai, and it's pretty lonely. I think things will improve as I spend more time here, but more than anything I just want to go home.

I owe quite a few blogs, including several race reports. In short, training has gone very well -- I've hooked up with the FIRST folks, and their training plans have been working for me so far. They've been profiled a number of times in Runner's World, so you may have heard of them. I'm focusing on half-marathons right now -- did the Marine Corps Half, and was happy with 1:41, and had planned to do the Air Force Half on 19 September, but will probably have to miss that one to recover. I hope to follow with the Richmond SunTrust Half and the Oktoberfest Half-Marathon, but we'll see how recovery goes.

I'm on a public PC at the hospital, so can't upload photos...but if you're on FB, I've put a few there. More to follow...I may actually have time to catch up on my blogs now! Thanks to all the bloggers who have already sent me notes and posts on FB...you all ROCK, as usual. Keep praying!

Craniotomy #4

2009-07-14T20:45:00.002-04:00

Okay, this is Angie, so bare with me. I'm a bit tired, but am hoping this will all make sense.

To start, Mike wants to say he is sorry for the lack of updates since March.

Everything was going great, expect for a minor bone pain on the temporal area, right by his eye...we were starting to settle back into our "new normal". Mike has been training like mad and was preparing for the Leavenworth, WA half-marathon in October.

This bone pain was checked at his 3 month appointment and nothing was found. The MD said it was just still healing, some post surgical changes. So, he kept dealing with it, hoping it would go away. Thursday or Friday of last week he was having enough pain that he asked for some Ibuprofen. Okay, so that sounds minor to most, but for those of you that know Mike, taking even and Ibuprofen is a "sin"! Well, along came Sunday, he had such a bad headache, with some slight swelling, that he decided it was time to call the CA MD. They said it was unlikely that it was anything too serious since he had no symptoms...hmm...where have we heard that before? "Oh, nothing to be worried about", says Mike, "off for my 12 mile run". He had a miserable run. Chalked it up to lack of sleep and possibly, not enough to drink. Later that day we spent the afternoon downtown with my brother's family and his forehead and eye became swollen. By the time we got home he wasn't feeling good at all. He looked like he was in a boxing match--and he didn't win! (I'll try to post pics later--got to figure that out again :))

Well, Monday rolls around and we had another big day planned to see the "sights" of D.C. But, Mike woke up with his entire right eye swollen shut and the swelling was half way down his face (again, picture later). Needless to say Mike KNEW something was wrong. Made an appointment at the MD for that afternoon... As suspected his GP (general practioner) could do nothing, so up to National Navy Medical Center's ER. Some labs, a CT, LOTS of waiting, an MRI, neurosurgery consult with Walter Reed Medical Center, they determined that Mike had osteomyelitis. At about 4am...they FINALLY admitted him to the hospital to start massive IV antibiotics. There were several questions still to be answered... is the bone (in the forehead) dead, if not will the antibiotics save it? Did the infection cross the dura into the brain tissue?

Well, my brother and I went home to catch some zzz's, not knowing what to expect. Mike was NOT optimistic about this. Finally home at 5am, and asleep by 530 or 6, my phone rang at 855am...it was Mike stating that the head of neurosurgery at Walter Reed Medical Center reviewed his case and they were doing surgery immediately. My heart sank, I was hoping he'd just have to do antibiotics. He said they'd wait on me to get there..."I'm thinking, what, is this a dream?" I hop in the shower to wake myself up, grab my brother and off we go in rush hour traffic on I-495 north. I'm mad, scared and nervous...and I-495 was a parking lot. Thank the good Lord my brother was with me. 930am and only to I-66 (those of you who know the area, feel my pain)..Mike calls..they are doing surgery at 10..I thought, "no way I'm gonna make it"...Mike trys to stall and I push a little harder through traffic. Finally I get north of Tyson's Corner and "free" road. I get there 1015 am and rush into Mike's room where we both share our feelings, crying and then get strong for one another. 1040 and off he goes...

The MD said that he can't save the bone and removing it is the best thing to avoid further infection. This means that Mike will not have a forehead bone for 6-8 mo. He will be in the hospital for the rest of the week getting heavy antibiotics while the Infectious Disease MD's figure out what is growing. Once that is determined and he heals from the surgery he will come home with a pic-line so that we can do more specific IV antibiotics at home for 6-8 weeks. He will be off work for 4-6 wks and, I assume, no running for 8 months, or more. He will wear a helmet to protect his head from any head trauma. Once the infection is gone for good they will put in a titanium plate.

The infection could be a delayed onset from surgery or, before the bones fused back together Mike could have gotten dust in his eye, nose or breathed in something that caused this. It's hard to tell and at this point not worth worrying about.

The surgery went smoothly, he did well. The infection was localized, and did not cross the Dura. I saw him in the ICU briefly where he was quite the comic as usual. Good to see though.

I don't know much more about his treatment/care/post-op process at this time. All I know is that he made it through and has all his functions! Thank God!!

Thank you all for your prayers! We love you all...

The Fundraising Dilemma

2009-03-19T21:26:00.004-04:00

Without sounding too conceited, I think I have a pretty powerful testimony. Three brain surgeries, 22 rounds of high-dose chemotherapy, and now 42 consecutive days of combined chemotherapy and radiation. Originally given 6 - 8 years to live, since then I've married the woman of my dreams, had a beautiful daughter, and run marathons and duathlons. I'd like to think that all that could be used to motivate people, raise awareness of brain cancer, and maybe even raise some money for brain cancer research.

I think some people are motivated. I think I've helped raise awareness. Unfortunately, I've always struggle with the fundraising part. I remember, back in high school, volunteering to go door-to-door to raise money for The March of Dimes. As important as that cause is, I absolutely hated it. I hated asking people for money 20 years ago, and I still hate it. Even if I firmly believe in the cause -- or have a personal relationship in the cause, like brain cancer -- I hate the fundraising part.

Despite my dislike, I've been fairly successful. I've probably raised close to $50,000 over the past seven marathons -- sometimes the American Cancer Society, other times the National Brain Tumor Society, even the Leukemia and Lymphoma Society. I think that somewhere in the back of my mind, I harbor a hope that a cure will eventually be found, and perhaps some of the money I've raised in the past will help that happen. On a personal basis, I also know that it provides an added incentive. 22 miles in, when everything tells me to stop, I think about those who have pledged a dollar or two per mile -- hard-earned money out of their own pockets, every dollar one more reason to keep going, mile after mile. In the 2006 USMC Marathon, I walked the last 8 miles and passed out at the finish line. Last year, in Seattle, I ran the last 16 miles with quad cramps, stopping every few miles to massage my own legs. I'm fairly certain that I would have two DNFs on my record if it weren't for the support -- spiritual, emotional, AND financial -- of friends and family.

So, here we go again! You all know that the Rock-N-Roll Seattle Marathon on June 27th is my "comeback" race. I ran the Seattle Marathon a week before my third brain surgery, and I gave myself six months to come back to full strength and run the inaugural RNR Seattle. This race will benefit the National Brain Tumor Society -- an outstanding nonprofit organization that has been instrumental in my fight against cancer. Please, feel no pressure -- but if you'd like to contribute, I've set up a website at http://www.braintumorcommunity.org/goto/Moyles. One dollar a mile, two dollars a mile, $25 or $50 or whatever -- every little bit helps! Help me finish this race, and help NBTS find a cure!

A Rite of Passage

2009-03-09T21:10:00.006-04:00

I MADE IT.

I haven't been "on the blog" in a while, and there's good reason...this radiation is pretty nasty stuff! Combined with chemotherapy, it's a pretty brutal regimen. However, after 42 consecutive days of simultaneous chemotherapy and radiation, I'm DONE! Today was my last treatment. Praise God!

In retrospect, it really wasn't too bad...though the "radiation sickness" -- basically nausea and fatigue -- was pretty serious. You literally feel like you could sleep all the time, and you probably could. I ended up taking a few days off work in the past week or two, and spent most of the time comatose on the couch or in bed. The level of fatigue is unlike anything I've experienced before -- you all know what it feels like, waking up the morning after a marathon, where everything in your body hurts and you just want to stay in bed all day...this is similar, without the body ache. It takes every bit of will power you have to get out of bed, even to use the restroom -- let alone go to work, or go for a run. I also lost a bit of hair...mostly on the right side of my head, where the main beams exited:

Yeah, I know it looks like I just got a bad (or unfinished) haircut, but it's the radiation. I joke with my radiology tech, Anita, that she should be a hairstylist -- 'Hair by Radiation' or something like that. Actually, now that I look at it, this style is "in" right now...hmmm...anyway:

But I made it.

I'll spare you the cheesy parallels -- though the similarities between finishing a marathon and the 42-day treatment cycle are obvious. It's a marathon of a different sort, and in many ways was more difficult than the toughest of my marathons (Marine Corps 2006, if you're curious). I couldn't help but celebrate a bit -- and even talked the radiation team into a group photo after my last treatment. This is me, the radiation mask I wear (see my previous post), and the radiologist/techs who I met with every morning to work their magic. Anita dahling is on the far left, along with Tammy, me, Theresa, and Jim. Thanks team!

You may also notice that I shaved my head...not only because the beautiful "Haircut by Radiation" photo above isn't in compliance with military regulations, but because there's somewhat of a "rite of passage" there for cancer patients. If you could see all the children and elderly who go into the treatment rooms before me, or who are waiting when I come out...nearly all of them have lost all of their hair, or have shaved their heads. Cancer survivors form a very tight-knit family, and this is a rite of passage of sorts...and I was happy to join the club.

From here, it's back to the waiting game. The first time, in 2001, we tried surgery alone -- and the cancer returned. The second time, in 2005, we tried surgery plus 22 round of chemotherapy -- and the cancer returned again. This time, the third time, we're doing surgery plus chemotherapy plus radiation -- let's hope the tri-fecta will kill this bug! I'll now return to the National Institutes of Health's National Cancer Institute, where I'll again start the 90-day brain scan routine. If my scans are clear for a year, I go to scans every six months...and if those are clear after a year, I go to annual scans. I've never made it that far -- the cancer has always returned first -- but it won't this time!

From a training perspective, I've somehow been able to keep up with the plan. I started my Rock-and-Roll Seattle training plan on the same day I started radiation, and I'm up to about 10 miles on a long run -- yesterday's run was 9 miles, and I did pretty well, right on 8-minute miles. I'm on track to do the George Washington 10-Miler next month and the Marine Corps Historic Half in May as training races, followed by Seattle in June. Right now it also looks like I'll have some company at Seattle -- at least JD and a few others, including some from the Bloggers Against Cancer community. I'll be setting up a fundraiser, probably through the American Cancer Society or the National Brain Tumor Society...more on that later.

For those looking for an update on the Monkey, she turned one year old yesterday -- and had her first birthday party! Also her first taste of cake...she LOVED it, of course:

She even got some of the cake in her mouth!

Finally, I'll close with one brief tickler...I got a call from Runner's World last week. Nothing is finalized yet, but you may see something in the July issue. Stay tuned!

Radioactive Running

2009-01-29T20:39:00.007-05:00

Radiation has begun, and so has marathon training! For those most interested in the updates on my training, skip down to the next paragraph...otherwise, prepare for "Radiation 101" (reminiscent of Chemotherapy 101, blogged earlier).

In my ten-year battle with brain cancer, I've been through just about everything, including three surgeries, more tests and labs than you can imagine, literally hundreds of MRIs, and 22 rounds of chemotherapy. However, I've been able to avoid one thing: radiation. This time around, I'm not so lucky. Having removed the tumor mass, the doctors are almost certain that some invisible tumor cells remain, and the only way to get rid of them is to treat them with radiation. So, here we go -- five days a week for six weeks, a total of 30 treatments. As I mentioned in a previous blog, the docs at NIH are also using chemotherapy drugs as a radiosensitizer, making the malignant cells more receptive to radiation than the healthy brain cells (trust me, I need every one of them). So, after starting chemotherapy on Sunday night, I showed up bright an early on Monday morning...

The radiation machine itself looks pretty timid. It's like an open MRI, or a half-CT, something like that...here's a photo of the room where my treatments are done:

The machine isn't the hard part. That white thing at the head of the bed is a radiation mask, and that's really the intimidating part. It conforms precisely to your face, and holds your head perfectly still. This process takes pretty serious mental control and concentration -- imagine, if you will, a scene from one of those slasher movies. It's pitch dark. A man lies on a bed, as if asleep. Slowly, a man approaches, holding something that looks like a plastic bag or plastic wrap, moving it closer and closer to his face... Anyway, you get the idea. When the mask is first placed on your face, it feels exactly like someone has put a plastic bag over your head. It is incredibly tight -- my face looks like I'm staring into 100-mph winds -- and breathing becomes quite a challenge. Your first instinct is to panic, but as you try to maintain your composure you realize that you can breathe through small holes under your nose, and if you strain enough to part your lips by a centimeter or so, you can get some air through your mouth as well. As you fight to control the panic, the mask is bolted onto the table, and the technician leaves you to yourself for about 20 minutes as the radiation machine does its work. According to the technicians at NIH, about 80 percent of patients must be sedated prior to treatment in order to avoid panic attacks. Now, four treatments in, I'm getting better at it...but it's still pretty intimidating. Here's how I look with the mask in place:

The little "plus" signs on the mask align with lasers mounted on the wall (you can barely see one behind the tech) and on the ceiling, which ensure that my head is precisely positioned, and positioned exactly the same way for each treatment. So, once I'm in the mask, bolted down, and properly aligned and positioned, the tech leaves the room and the radiation machine rotates around my head, occasionally emitting loud buzzes and beeps that I can only assume are wreaking havoc on the rogue tumor cells camped out somewhere in my head.

The treatment itself only lasts about 15 minutes, after which I'm "unbolted" and on my way. If there's any question about how tight the mask is, I retain the battle scars from each radiation treatment for about 30 minutes after leaving the hospital. Like the pattern? It prompts some interesting questions on the subway...

The main side effect from radiation is fatigue, which is slowly setting in. I'm also battling the standard gastro-intestinal effects of chemotherapy...the combination will make the next six weeks very interesting! I'll also develop some surface skin burns (like a sunburn), and will almost certainly lose my hair (which is happening anyway). Most of the other side-effects from radiation are long term (like 10+ years from now), and can include everything from short-term memory loss, balance issues, cataracts, and more serious things like necrosis and secondary cancers. With those pleasant thoughts in mind, that's radiation! Now, on to training...

I'm not sure why I planned it this way, but somehow I started marathon training on the first day of radiation treatment. I may regret it later, but for now I'm managing fairly well. I've gotten two runs in this week, just 3 - 4 miles -- and I feel fairly good. My run on Sunday was the first run I've had since the marathon on November 30th, and I certainly felt it...I haven't gone eight weeks without running since I started this whole running obsession a number of years ago. Four miles today felt quite a bit better, but I'm in absolutely terrible shape. Regardless, I should easily be ready for Seattle, with a couple of tune-up races in between -- the George Washington 10-Miler in April and the Marine Corps Half-Marathon in May. Trust me, I'll be there!

In closing, I have to wish Momo a happy birthday...and my usual shout out to all the bloggers who have checked in on my recovery during the past six months! You guys (and girls) rock! Over and out, with a final farewell from The Monkey...

Run, daddy, run!

Surgery, Radiation, and Chemo: My Own "Triathlon."

2009-01-14T21:26:00.006-05:00

It's been a while since I provided an update, and I've also neglected commenting on other blogs...things have just been crazy lately. Recovery is actually going quite well, certainly the fastest and easiest recovery of any of the three surgeries I've had. The headaches are pretty much gone, the swelling is gone, the only thing that remains is some significant fatigue. I think I'll be ready to get back to training on the 26th -- and I'm counting down the days!

One of the big questions we've been facing after surgery is whether or not we'd follow surgery with radiation. Well, I spent eleven hours yesterday at the National Cancer Institute's Center for Cancer Research, most of that time with the chair of the Radiation Oncology Branch. He's an incredible doctor, and walked me through all of the options patiently and in great detail. It's a long story, but here's the bottom line: we're going through with radiation. Essentially, we tried surgery alone, and that didn't work. We tried surgery plus chemotherapy, and that didn't work. We then tried chemotherapy alone, and that didn't work. The docs at NIH (and at Cedars) are all in general agreement that we have no reason to believe that doing nothing -- "watching and waiting" -- will be successful this time. Left untreated, they all believe that the tumors will recur, and I tend to agree with them. Finally, the best time to do radiation is when there are the fewest number of malignant cells to radiate, requiring the least amount of radiation and thereby saving healthy brain tissue from exposure. Just a month after surgery, there is no better time to start than right now. So, I start radiation on the 26th of January, and will have treatment five days a week for six weeks. This particular type of radiation is called intensity-modulated 3-D conformal radiotherapy, a very precise form of standard IMRT. I'll also be taking chemotherapy (which serves as a radiosensitizer) at the same time. So, I have my own little triathlon going -- surgery, radiation, and chemotherapy!

While we're on the topic, if you've been following my blog for a while, you know about my Iron Dreams. Never one to let my cancer slow me down, I figure what better way to pay tribute to my surgery/radiation/chemo tri-fecta than to follow it with my own triathlon -- in this case, The Nation's Triathlon in September. It's only an Olympic-distance tri, but it's a start...and the timing is good. I'll train hard for the Rock-n-Roll Seattle in June, which still leaves me more than two months to get on the bike and in the pool before September.

In short, I feel good. My strength is returning, and I'm ready to hit the roads again next Monday. The time I've gotten to spend with Pooh and Monkey during recovery has been amazing. The continued support of friends, family, and bloggers has been outstanding -- and I still hope to see some of you in Seattle in June! Or, perhaps, in DC in September? Anyone? Anyone?

Cancer-Free for Christmas

2008-12-24T10:11:00.009-05:00

Okay, okay...I've received more e-mails and phone calls than I can count asking for an update, so here it is!

After discharge from the hospital, Pooh and I tried to occupy ourselves in Los Angeles, doing our best to "sight-see" in LA and Beverly Hills on a budget...which is actually quite a challenge. We ended up spending most of our time sitting in bookstores reading and relaxing -- I still fatigue quite easily, and can only go for about an hour before I need to rest or nap for an hour or two. I was even awakened by a security guard in the Thousand Oaks Galleria, who politely informed me that "sleeping wasn't permitted in the mall." I was tempted to take off my skull cap and throw out the brain cancer card, but decided against it...poor guy was just doing his job. Still, it would have been fun. ;-)

One of the great things that helped speed my recovery was a visit from my longtime friend and newly-minted marathoner JD, who flew down from Seattle just to spend some time together. We've been friends for 27 years, and this guy can make time fly. All of a sudden, a week from major brain surgery, I'm singing with the band at a piano bar in Universal Studios:
Strolling the Santa Monica Pier:
Even having our picture taken with Santa:
As a side note, this is particularly bizarre for me, since I never believed in Santa -- as far back as I can remember, I've known that it was mom and dad, and I don't think I've EVER had my picture taken with Santa before. So now, thanks to JD, at the age of 36 I've finally had my picture taken with Santa...and a real Santa at that!

So, after a few days with JD, Monday arrived and we checked back in with the neurosurgeon. He did another exam, looked at the incision to see how things were healing, and gave the approval for the staples to be removed. He also brought in the neuro-oncologist to talk through additional treatment options. The short version of the story is that we've tried surgery alone, and the tumors returned. We then tried surgery followed by 22 rounds of chemo, and the tumors returned again. So, the best alternative at this point is surgery followed by radiation. These alternatives were presented to the Cedars-Sinai Tumor Board, and the votes were about split...some in favor of radiation, some in favor of waiting. The problem is, radiation is normally a "silver bullet," and at my age it's very early to burn that card...given how well I respond to surgery, doing radiation at this point may eliminate an option we'd like to use later on. However, at the same time, radiation makes a lot of sense, since we've now removed the bulk of the cancer, and have a unique opportunity to kill whatever cancerous portions we didn't get with surgery and knock this thing out once and for all. Both the neurosurgeon and the neuro-oncologist, and both Pooh and I, are leaning in favor of radiation. We'll meet with our docs and NIH and get a second opinion, but I suspect we'll follow this surgery with radiation. After those discussions, the staples came out -- ready for the nasty pics? Okay, you've been warned...here they are...before:
During:
After:
The procedure was far less painful than last time, and pretty easy overall. Now, we're safely back in Virginia, reunited with little Monkey (who is now walking, by the way), and happily on the road to recovery. I still struggle with some pretty significant headaches, and some of the medications cause a bit of nausea and stomach problems, but I really can't complain after all I've been through.

On the training front, I have to wait about six weeks before I can run again, but that should still leave me enough time to train for the Rock-N-Roll Seattle Marathon in June. I'm still aiming for that 3:45 that eluded me a few weeks ago! In other news, it appears that Santa was good to me this year, and a treadmill may be under the tree. I'm not a fan, but the weather here just isn't as conducive to running as it was in Monterey. We're very happy -- we're home for Christmas, little Monkey remembered us, I'm unaffected by surgery, and just dealing with a few headaches and minor problems. The prayers and support of all the bloggers, friends, and family members have been instrumental over the past few weeks -- thank you all so much, and Merry Christmas!

Surgery Report -- From Mike!

2008-12-14T22:23:00.004-05:00

I'm back! Yes, I'm out of the hospital and back "on the blog."

First and foremost, THANK YOU to everyone who has thought, prayed, blogged, and communicated with us over the past week or two. The outpouring of support from friends, family, and bloggers has just overwhelmed us, and we never expected to have such an incredible support structure here. Thank you!

I'm back at the hotel, and out of the hospital. As you know from Pooh's blogs, I was discharged from the hospital a day early (yesterday), and I'm doing just fine. So, now you get to hear the story first-hand -- from the guy who actually went through this whole ordeal:

Wednesday, 10 December, 8:00pm. The whole surgery process actually begins the night before, when you're placed on a restricted diet. So, basically nothing to eat or drink after midnight the night before surgery -- not a simple feat for someone who normally eats 4,000+ calories per day. Anyway, I complied...and only complained a few times. In addition to the restricted diet, I have to wash my hair with a wonderful solution called, "Endure 400 Scrub-Stat 4," a 4% solution of "Chlorahexidine Gluconate" used for "surgical hand scrubbing." So, it's not Garnier Fructis, but I've never been very picky anyway, and honestly don't have enough hair for it to matter too much. So, after having one last meal and taking one last shower (does this sound at all like "The Green Mile?"), I headed to bed. Sleeping the night before surgery is always an adventure...I usually don't do much of it, and spend most of the night tossing, thinking, praying, and occasionally nodding off. With a 4:30am wakeup, it's not like I'm sleeping in anyway.

Thursday, 11 December, 5:00am: Check-in time! With a 7:15 surgery time, check-in is two hours prior. We check in at the Cedars-Sinai Medical Center South Tower, and are escorted up to the surgery floor (the 8th) by an orderly. Once checked in on the surgery floor, it's really just a couple hours of waiting...along with about eight other patients, all scheduled for surgery that morning. I was the only brain surgery patient, but there was also one there for back surgery, another for neck surgery, one for intestinal surgery, and a few others. About 6:45am, I'm called back by an attendant, and say my somewhat tearful good-byes to my parents and my wife, all of whom had accompanied me to the OR floor. This is often the toughest part of the whole procedure for me -- what I call "The Walk" (again, reminiscent of The Green Mile"). The walk from the waiting room back to the prep room is actually quite a long one, down a sterile, narrow hallway. The urge to look back over your shoulder is tremendous, and just about everyone around you is crying and walking backwards, catching final glimpses of loved ones. I usually refrain, but this time I did give a brief "thumbs up" to my wife. Thankfully, my buddy LDO (a co-worker and good friend) gave me a coin engraved with the "Put on the full armor of God" verses from Ephesians, which was the only thing I actually took with me on the walk...even my wedding ring stayed with my wife. Back in the prep room, I make a bathroom stop, then strip naked and put on one of the beautiful, multicolored, "fully ventilated" gowns, and get on my gurney. A lengthy interview by the pre-op nurse follows (medical history, allergies, etc), then the anesthesiologist arrives. The anesthesiologist hooks up a regular IV, and starts with a saline flush, then some of the same questions. The anesthesiologist, Dr. Xiang, told me she'd be adding some "good stuff" to the IV now, and I would soon "care a lot less" about what they were doing. Well, that's pretty much the last thing I remember.

Thursday, 11 December, 1230pm: Recovery! After that, the next thing I remember is waking up in the recovery room. This is not a pleasant experience. The complete rush of sensations is totally overwhelming -- from completely comatose to completely aware in a matter of minutes is a big shock to the system. As they slowly bring you back to consciousness, especially after a procedure like mine, I was in a complete rush of seeing if I could feel my feet, move my hands, speak, see, understand, remember, all those things. Still, you're not entirely capable of any of those things, largely due to medications, and anesthesia, but I can't tell...I can't see a thing, but don't know if that's because I don't have my contacts in or because I've lost my vision. I can't move entirely, but I'm also strapped onto the gurney. I can't remember the last eight hours, but I was under general anesthesia...you get the idea. The mental games that go on during this hour or so are pretty bizarre. Slowly, I get possession of my senses, they remove the straps or whatever, I get my glasses, my thoughts clear, and then -- after what seems like forever -- my wife pulls the curtain back. That moment is the one we've both been waiting for for weeks now. I made it -- I'm alive, I'm healthy, I can see/speak/hear/move/remember, and the cancer is gone. At that point, I relax quite a bit, and it becomes a day of alternating between frenzied activity and endless waiting/boredom.
I'll be honest -- Recovery is a miserable place. Two of the other patients in the room with me got sick from the general anesthesia, and were vomiting regularly...an unpleasant experience even when you're feeling your best. I've got two IVs in -- a regular up by my elbow, and an arterial in my wrist. I've also got a Foley catheter, which is tremendously uncomfortable. My head is wrapped tightly in a pressure bandage to keep swelling down, and I've got 50+ staples along the incision in my scalp from ear to ear. I also have those cursed leg compressors on, which inflate every minute or two, and a blood pressure cuff on one arm that takes my blood pressure every five minutes, along with a blood-oxygen monitor on one finger, and EKG leads taped to my chest at about ten different locations. This point, and the next 12 hours, are the hardest parts of the entire ordeal for me. I actually felt surprisingly good -- the headache was worse that I remembered it being, but other than that, I felt fine.

Thursday, 11 December 6:00pm: ICU! The move from Recovery to ICU is a big step for one reason only -- privacy. The Recovery bay is shared with seven other patients, and Cedars' brand-new ICU tower has individual patient rooms. Other than that, it's not too different -- the move to ICU doesn't mean they can remove any leads, monitors, IVs, or anything else, but I've got a room to myself. Visitors still can't stay for more than a few minutes, but it's still a big step up, and it's the first big step to getting classified as a "floor patient" -- one in a regular patient room! I remember the move from Recovery to ICU, across a glass skybridge over Santa Monica Boulevard, looking out over Hollywood Hills and Beverly Hills. It was my first glimpse of the outside world since surgery (there are no windows in Recovery), and it was beautiful.
In all but the most exceptional cases, brain surgery patients must spend at least one night in ICU. This is the part I had been dreading since knowing I'd be going back into surgery -- while the surgery itself is certainly the longest and most miserable part for my family, the one night in ICU is the longest and most miserable part of the entire process for me, the patient. It is impossible to get comfortable -- you have tubes and leads stuck to every part of your body (including some VERY sensitive ones), and the nurses are required to check in on you every hours for a full neuro exam. Checking pupil response, sensory perception, memory, and cognition every hour -- basically, they wake you up, tickle your feet, shine a flashlight in your eyes, make you wave your arms and legs, then take your temperature and blood pressure, then tell you to go back to sleep...and just when you start to nod off...they're back again. Within a few hours, the Foley catheter starts to burn and itch pretty badly -- I'm not sure if that happens to everyone, but when I mentioned it to the nurses, they said it was "completely normal," so I can't be the only one to suffer. Last time, an orderly tripped over it, which was decidedly uncomfortable, so this time, they taped it to my leg...and I'm not sure if that was much better. Fur and tape don't seem to get along well. My headache hadn't subsided much, so I took three Tylenol which brought it down to a comfortable level. Shortly before bed, I took two more just to take the edge off so I could sleep, and tried to get a few minutes of rest in between interruptions. After a long, miserable night, morning arrived, with check-ins from my neurosurgeron and internist, and (thank God) approval to remove the arterial IV, the catheter, and the leg compressors. I still had the blood pressure cuff, regular IV, and EKG leads, but freedom was that much closer!

Friday, 12 December, 7:00pm: A "floor patient!" Okay, Cedars does this right. I don't know if I scored the "frequent customer" card here or what, but somehow I ended up in one of two VIP suites on the patient floor. This room had basically a luxury bed and bathroom, with a whole separate area for friends and family -- dinner table, sofa, and extra bed for anyone who would like to stay. After Recovery and ICU, this was heaven! A "floor patient" is also spared the hourly interruptions, which means sleep is an actual reality...which, by this time, is all I wanted to do anyway. By Friday evening, I was off all pain meds, and only taking those that were required -- a lengthy list of anti-everything, from anti-inflammatories and anti-convulsants to anti-biotics and anti-nausea meds. My diet was still restricted to fluids and clear liquids, although I got a regular lunch of chicken and mashed potatoes shortly after moving to the regular room. By the way, the hospital food at Cedars is quite good...and they also have both a Tully's and a Starbucks, so coffee was abundant -- as soon as it was approved! The whole family joined me in the patient room for the evening, and we had a great time just chatting, breathing a collective sigh of relief that we all may have actually made it through this thing completely unscathed.

Saturday, 13 December, 1200pm: Discharge! Originally scheduled for discharge on Sunday, Dr. Chu mentioned on Friday night that if I had a good night and my vitals were still strong on Saturday morning, there was no reason I couldn't go home on Saturday. This would make me "three-for-three" on early discharges -- all three brain surgeries at Cedars have been followed by discharge a day early. Guess I'm an "old pro" at this stuff! Anyway, Dr. Chu came by with a few of his residents in the morning, removed the wraps and steri-strips, and exposed my beautiful scar...50+ staples, but only some minor swelling over the primary resection site (the right frontal area) and a good shiner to show off. One last neuro exam, and I had the green light! My family showed up shortly thereafter, and we signed official discharge papers an hour or so later.

So, that's pretty much the whole story. Now, Sunday evening, I'm basically back to my old self -- I took another Tylenol last night to help me sleep, but other than that, I haven't needed any pain meds of any kind. They had morphine, vicodin, and codeine all available, but all I took was Tylenol, and I feel just fine. I'm a little unsteady on my feet, and can't turn too quickly, but I'm otherwise completely normal. We have to stick around town for another week or so to get through the "danger zone" of potential bleeding or swelling in the brain or stroke, but once we're through those woods, I'll get the staples out on Monday (the 22nd) and we have flights home scheduled for the 23rd. We should be back with Monkey and home for Christmas!

Again, thanks to everyone for all the prayers and support...and for those who have been wondering, YES, I still plan to come back to full strength in time to run Rock-and-Roll Seattle in June. See you there!

Surgery Update #4

2008-12-13T00:54:00.003-05:00

Well, it appears I'm back at the hotel without Mike again, but there is good news on the horizon-actually there has been nothing but good news-Praise God!

Mike was finally transferred from ICU about 7 pm tonight, just as his long awaited dinner arrived. No, he wasn't excited about that. He's been SO hungry since his surgery and, finally, he was able to eat real food, only to have it postponed until after the "move"-how rude! He was also up and walking around this morning (much to my surprise). He had already been able to convince the staff to remove his catheter and part of his IVs. The walking also meant no more leg compressor things. This evening we got him out of the awful hospital gown and into some Duke clothes...that should make him all better!

This evening, after the "move" and dinner, we did laps down the hallway and he is, surprisingly, strong. I think he is even stronger than he was in the first two surgeries. He is begging for coffee, but that's not on the menu yet, hopefully tomorrow. I left him some books and magazines for entertainment. Mike even convinced me to leave his iphone there. I know he's bored silly, so I couldn't resist.

The doctor read the MRI and it appears there is no tumor visible. Also, he said he'd talk to us in the morning about discharging him since he is doing so well. Much to Mike's delight! Mike is quite proud of the fact that Dr. Chu called him his "poster child for brain surgery". He said "all surgeries should go like this." That made Mike feel good. The plan was to discharge him on Sunday, so, this will be the third time he was released a day early (assuming they go ahead and let him go tomorrow). The final pathology won't be done until next week, but they are optimistic about that too.

Mike has absolutely no deficits...sorry for not mentioning that earlier-lack of sleep I think. He is 100% Mike Moyles and we couldn't be more delighted! I truly believe he is acting better after this surgery than the previous 2-could it be that you get "good" at surgery? Hmm..let's not go there! :)

Well, good night to all and thanks once again for your continued support and prayers. Praise God and the next time you get an update it will be from Mike! YAY!

Surgery Update #3

2008-12-12T00:32:00.003-05:00

Well, I'm back at the hotel now. Unfortunately, without Mike, but he is still doing quite well.

We finally got him into ICU and I was able to spend some "quality" time with him. I'm not sure if there is such a thing as "quality time" when your loved one is in the hospital, but hey, we'll take it! For those of you who know Mike, let's just say he's back...for those of you who don't, I'll explain! He is joking, trying to entertain anyone who steps into his room, smiling and hating his catheter and IV. Although, he did persuade the RN to take the leg compressor things off for at least an hour, so that made him happy. He's asking about his blog, wanting to make sure I've updated it, making sure I've called everyone that I should have (even naming them by name--good sign!), asking for his phone...not a chance in .... he's getting that yet! I know him TOO well for that trick! He said, "it's just incase I need you for something"... ya, right! :)

His vital signs were good, there is a small concern that his respirations aren't staying stable, but the resident on call said that it was because he was a marathoner and since he didn't need to take as deep a breath as most folks the machine was "confused". Okay, for all you medical folks, I know that's not exactly what the MD said, or the correct medical terms, but I think you get the idea. Once, again he's in TOO good of health for the machines. He's had this problem in the past! He is running a slight temp of about 100, but this too is normal for only less than 24hrs after surgery. He is able to bend his legs some to exercise them...he says he's a bit sore and stiff-can you imagine? His main complaint, other than the catheter and IV, is the headache! Oh, I can't imagine how that feels, but the meds are helping, finally, and hopefully he'll be able to rest some tonight.

I think that's about it for now. I'm sure he'll be "itching" to get on the computer tomorrow, so I'll bet you get a post from him soon. (He made me take a picture of him in ICU to post so that everyone would know he REALLY IS OKAY, but I can't figure it out, so it'll have to wait-sorry!)

Thanks again for all your support!

PS...And moments later, I figured it out...here he is!

Surgery Update #2

2008-12-11T15:04:00.003-05:00

Good news! The MD just came out. Mike did well and is stable and in recovery. He will be moved to the ICU in about 2 hours. The tumor appears to still be low grade, but final pathology won't be done until next week. We won't know about deficits until later today. They didn't have to remove all of the right frontal lobe, and we're still able to get clear margins around each tumor (there were two). We should be able to see him in the next few hours, so stay tuned for an update after I see him!

Surgery Update #1

2008-12-11T12:48:00.002-05:00

To everyone that we promised updates too...here is the first!

Mike went into surgery at 7:15 and we just, moments ago, got word from the OR that things are going great. I assume that means they are about 1/2 way through, so stay tuned to more updates!

Thanks to everyone for your prayers and concerns...we couldn't do it without you!

Brain Scan, Surgery Thoughts, and Thanks

2008-12-10T18:33:00.004-05:00

Greetings from sunny Los Angeles, California! I just returned from my brain scan, which went without incident. A brain scan, for those who don't know, is really just an MRI of the brain, often done with a break between sessions for an injection of Gadolinium, a radioactive agent that highlights malignancies or other cell anomalies in the brain. These are things I have several times every year, and have had for about ten years...so I pretty much sleep through them, although they're quite loud and quite uncomfortable. However, pre-operative brain scans are a bit different -- they are accompanied by things called fiducials, which are small markers placed on the face and skull. These markers make for a curious appearance:

These little facial markers actually show up on the MRI, and make it possible for the neurosurgeon to establish the relationship between the inside and the outside of the skull. A bit intimidating, but oh well...
I realized, after posting yesterday, that my post was pretty clinical and descriptive, but didn't talk a lot about how I think about this whole thing. It's really quite strange...the things I'm most concerned about aren't the things you'd expect. I really don't worry much about the surgery itself, and the removal of most of the right frontal lobe. I'm pretty sure it's dormant, and I think the two prior surgeries have confirmed that. The things I'm concerned with seem almost petty:

I don't want a catheter. It's uncomfortable, and somewhat degrading and embarrasing.
I don't want an IV for three days. It's inconvenient, occasionally painful, and very restrictive.
I don't want leg compressors -- for those who haven't had surgery recently, these compressors are wonderful "attachments" reminiscent of medieval torture...they look like big knee-high socks, but they pneumatically compress every few minutes to force teh blood out of your legs and into your torso, preventing blood clots from developing. It sounds great in theory, but it's really pretty nasty in practice. Not painful, but it's very hard to get comfortable, and absolutely impossible to sleep.
I don't want to deal with the medications -- anti-seizure meds, pain killers, stool softeners, steroids, the works. For those who don't know me well, I don't do medications -- AT ALL. Not even Motrin or Advil. To the chagrin of my wife and doctor, I don't even take vitamins. Nothing. To go from that to getting pills pushed on me every hour on the hour is quite an adjustment.
So, as you can see, my concerns aren't over those things you'd expect. Of course, fear plays a part. The chance of neurological deficit -- likely speech or vision -- is always there, and weighs on the mind a bit...but the chances are small enough that they're easy (perhaps too easy) to dismiss. At this point, with less than 12 hours to go, I just want to get it over with. The anxiety and anticipation are at their worst right now...if they would do surgery NOW, I'd sign up!

Finally, Stronger, Momo, and a number of other outstanding Bloggers in Bloggers Against Cancer sent me the most wonderful care package, which arrived this evening, the night before my surgery. Treats, a monkey, and some great running gear...I can't tell you how much it means to me. I owe the entire community a huge debt of gratitude for their caring, their thoughts, their prayers, and their kind gifts. Thank you SO MUCH -- and you'll hear from me soon!

We've Arrived! (Plus Status Update)

2008-12-09T11:58:00.003-05:00

Well, the last few days have certainly been busy, but we’ve made it so far! Early Sunday morning, Pooh and I said a tearful goodbye to Monkey (who is staying in DC with grandma and grandpa) and headed for the airport. After arriving in Los Angeles, we went straight to the hotel and “set up camp” for the next 16 days. The hotel is just perfect for us, and we wish we’d found this place for the last two surgeries – the rooms are larger and nicer, unfortunately, no microwaves…and believe me, living/eating in Beverly Hills can get a little expensive if you’re going to restaurants all the time. Let’s just say that in this area, there’s not necessarily a Taco Bell on every corner. Problem solved by a quick trip to Wal-Mart…against hotel regulations? Probably. Is that my primary concern at this point? Probably not. ;-)
Okay, so we arrived at the Maxine Dunitz Neurosurgical Institute:

Yesterday started with what’s called a “pre-operative teaching” at 11:00am. An OR nurse walks you through the entire process, and tries to answer all of your questions. Everything was pretty standard, and although it’s been three years since my last surgery, I remember pretty well how things go. She gave me my “special shampoo” that I have to use before my pre-op brain scan (which disinfects the scalp and hair), and a whole stack of paperwork – consent forms, referrals, and so forth. From there, on to pre-admissions, where I go through the entire admissions process – contact info, next-of-kin, insurance, medical history, the works. After admissions, on to the lab, where they do standard bloodwork – the phlebotomist even told me I have “juicy veins!” I took it as a compliment. After a quick lunch break, Pooh and I headed up to the internist, who does the entire physical. Urinalysis, exam, interview, then the EKG and chest X-Ray. Everything went just fine, except the EKG…which they couldn’t get to stick, so they had to shave parts of my chest. Now, this could easily turn into a separate blog that would almost certainly have TMI, but I’ll summarize by saying that my Air Force callsign (nickname) is “Chewie” – yes, as in “Chewbacca.” So, I look rather amusing at the moment, with two significant shaved areas in the middle of my chest…oh, well. It will grow back.
The last appointment of the day was the actual consultation with the neurosurgeon. We had a great talk – I’m always amazed and how the surgeons here can really put you at ease, even with regard to a procedure this major. He explained the procedure and all the associated risks…they’re essentially the same as last time. Brain surgery always has a risk of stroke, coma, or even death, but they’re actually very small risks…the removal of this portion of the brain (the right frontal lobe) can introduce some memory or personality differences, but the doc reassured us that in right-handed males, language is in the left frontal lobe, so he doesn’t anticipate any language of speech difficulties. They’ll do a biopsy during surgery to determine the pathology and grade of the tumor, and make other decisions at that time – if the tumor has upgraded to WHO Grade III/IV, they’ll likely insert chemotherapy wafers (called Gliadel) into the brain before closing me up. Radiation is also an option after surgery, but one we’ll likely save for the future – and, hopefully, never need! He couldn’t promise a quick recovery, but I’ll likely be discharged over the weekend. If there’s anyone in the LA area who wants to visit after that, I’d love to see you!
At the end of the day, what this all means is that I’m medically cleared for surgery. At this point, there’s pretty much no stopping this train…unless I get seriously ill in the next 48 hours, we’re going to do this thing. I have one more appointment – my brain scan tomorrow at 1:00pm – but other than that, I’m pretty much done until I check in for surgery at 5:15am on Thursday. My wife may blog while I’m still in the hospital, but other than that, the next time you hear from me, I’ll be tumor-free!

Race Report -- Seattle Marathon

2008-12-03T21:00:00.016-05:00

We're back! Pooh, Monkey and I flew in from Seattle late last night, and I'm slowly managing to do stairs again. ;-) For those who haven't looked up the results already, I completed the Seattle Marathon -- but missed my goal time by a good 20 minutes or so, finishing in 4:08. The full story:

THE RACE

The morning dawned cool and foggy, with light rain...typical Seattle November. The rain had mostly stopped by race time, but thick fog and mist remained, especially along the lake. JD (in the middle with our training partner AA):

The night before, I was notified that King 5 (the local NBC affiliate) was going to use my story as a personal-interest piece on the evening news, and I spent the last 15 minutes prior to race start interviewing with NBC for the spot.

You can see it here. My friend JD was there with me (you can read about him in my previous blog), and we had a great time laughing and joking before the start.

Just prior to the start, I switched from long sleeves to short, remembering the mantra to always "dress for the finish." The course was a lot of out-and-back -- from the Seattle Center (basically the Space Needle) across the floating bridge to Mercer Island, then back across the bridge again to Lake Washington, down Lake Washington Boulevard to Seward Park, and back up Lake Washington Boulevard to finish in Memorial Stadium at the Seattle Center.

THE PLAN

In every previous marathon, I've carried all my hydration and gels with me, but this was my "hometown" marathon (where all my family lives), and this seemed like a good course for them to come and meet me on the course. So, I arranged for my wife and father to meet me at the 10-mile point, which is also the 15-mile point -- a perfect place for two passes where I could high-five and replenish fluids/gels. Mom, dad, and Pooh (with Monkey in tow) would then move ahead to the 20-mile point, and finally meet me with the rest of the family (all 20+ of them) at the finish. They even got T-Shirts made!

THE RESULT

As most of you know, my goal was 3:45. I trained at 8-minute miles (a 3:30 marathon), knowing that I'd need to make a pit stop or two, and that I usually spend the first mile or two just getting up to pace. That plan worked perfectly for about the first eight miles...at which point my quads really began to burn, which I attribute to lactic acid buildup...entirely unexpected that early in the race. I was barely breaking a sweat or breathing hard, and already my legs were going? By mile 9, my quads were cramping considerably, and I did something I never thought I'd do.

I gave up.

I called Pooh, and told her to have the car at the 10-mile point, and I was done. With quad cramps at mile 10, there was no way I could do another 16+. Well, as fate would have it, she couldn't get through the barricades to the 10-mile point. She called back shortly thereafter, in tears, and explained that she couldn't get to me. Two problems here -- first, she had my gels. If I was going to continue, I needed carbs. Second, I didn't plan to continue. If she wasn't there, I'd have to keep going...and keep going I did. I took a brief detour, running about a quarter-mile back to the last water station, one of only two on the course with gels. Fortunately, they had Vanilla Bean Gu -- my favorite! It added a half-mile to my race, but so be it...without Pooh to pick me up, I had to keep going, and I needed carbs. I passed the half-marathon mark at 1:51, right on pace for my 3:45. At the 15-mile point, Pooh was finally able to get through the crowds and barricades with gels and fluids (my arrival at Mile 15 below).

She and my father were a welcome sight, but my cramps were still pretty severe...I told them to go ahead to 20, and if I could make it that far, I could at least walk the last 6. By 20 miles, I was executing what I not-so-affectionately call my "550 plan," which is running 500 paces, then walking 50. That's how the last six miles went...almost two and a half hours' worth. Miserable quad cramps...one of those things I'll always question. I never had that problem in any other marathon, and never in any training run -- was it fatigue? Nutrition? Hydration? Cold weather? Who knows...anyone ever experience anything similar?

THE FINISH

Of course, I had saved up enough energy to run the last half-mile, up a small hill to Memorial Stadium, into the stadium, and across the finish line. As I approached the stadium, I saw my wife and baby girl standing outside -- I made my way over to the crowd, picked up my baby girl, and my wife hopped the barricade...and we crossed the finish line together!

My brother-in-law even managed to get it on video:

My time, about 4:08, was very disappointing...but it was tough to think about that when I looked around and saw all the family around me, and saw my baby girl in my arms and my wife beside me. I collapsed shortly thereafter, but had quite a crowd to keep my spirits up...

They even all had their "Running With Cancer" shirts on, and Monkey had her own made that said "Run Daddy Run" on the back! SO cute...and of course, she had to check to make sure the finisher's medal was real gold...

My buddy JD did an amazing job. After losing over a hundred pounds, he completed his first marathon. We've now been friends for 27 years, and it was an amazing experience to motivate each other during training, inspire each other during the race, and congratulate each other at the finish line. He crossed in just over four and a half hours, and is now an addicted runner. He may even join me (and many of you) at Rock-N-Roll Seattle in June!

Well, that's all for now...I'll blog again before surgery next Thursday, but it's odd to consider that running a marathon is the smaller of the two hurdles I have to clear this week...onward and upward!

Hell Week

2008-11-10T20:00:00.002-05:00

Just a short post today -- "Hell Week" is over! For the uninitiated, "Hell Week" is the training week that usually falls 2 - 3 weeks prior to race day, where you're at maximum mileage, usually without any rest days...well, Hell Week culminated yesterday with a 20-something mile run, and ended today with my first rest day in what feels like forever.

Despite my tendonitis fears, everything went perfectly. I got started late, so ended up running half of it in the dark (which isn't good for me), but I felt great for the entire run. My pace was a bit off -- 20.12 miles in 2:46.09 (about 8:14/mile), rather than the sub-8 pace I like to keep -- but I felt great the entire race, and even managed a 7:32 mile at mile 19, and 7:46 mile at mile 20. Even at 8:14, that's still about a 3:35 marathon in Seattle...we're on track, and now...the three words many marathoners (or marathoners-in-training) live for...

IT'S TAPER TIME!

The Forbidden Question

2008-11-07T21:57:00.004-05:00

Okay, let's talk running first. It's going very well -- I've been totally motivated, and have turned in some wicked runs (for me) in the past few weeks. I did my 18-miler at Burke Lake Park in Virginia, and it was absolutely beautiful...fall colors everywhere.

I felt great -- it was a bit slow, averaging 8:12, but still on track for about 3:45 at Seattle. The colors were so great that Pooh and I went back the next day with Monkey...she loved it!

I followed the 18-miler with a good 50-mile week, even turning in a 12-mile run at 7:32 pace...a PR for me! All ready for the 20+ mile run this weekend -- I'll probably try to hit 22, just to make sure I'm ready for 26.2 in a few weeks. So, I've been putting in a lot of miles...and am now battling what appears to be some pretty nasty tendonitis in my left Achilles. I've never had that before, and I'm a little worried that it may put a kink in the Seattle Marathon plans. Now welcome advice from BlogLand...

So, that's the news from the training side...on the side of the cancer battle, it's been a bit tough lately. In general, there is a question that is off limits for most cancer patients -- the unmentionable "WHY?" I stay away from it...it does no good to ponder the question, and the likelihood that you'll ever know the answer is basically zero. Well, let's just say I've been thinking about it a lot lately -- perhaps due to Monkey, perhaps due to the pending surgery, probably both. As a man of faith, it's been a subject of frequent prayer...and, for a number of years now, I've thought I know the answer. What I've been through, what I'm going through, gives me a tremendously powerful testimony that can be used to inspire and motivate people. It inspires and motivates some to run -- I can count about a dozen people who have run marathons (and more) after hearing my story. There is at least another dozen people who have been inspired to run or get in shape, though probably not marathons. More importantly, I think my testimony could perhaps even strengthen the faith of others.

In all honesty, that's where I've focused most of my testimony...but I'm having trouble reconciling it this time. Isn't there a "point of diminishing returns" on the power of this kind of testimony? In other words, is the testimony of someone who has had three brain surgeries really that much more powerful than the testimony of someone who has had only two? In Biblical terms, thinking of 1 Corinthians 11:23 - 27, would Paul's testimony have been any less powerful if he had been beaten with rods only twice? Would his testimony have been that much more powerful if he had been stoned twice instead of only once? I don't think so. I guess I'm just frustrated because I think my story is inspirational enough with only two surgeries...why go through a third? What's the point? If I'm correct, and the reason -- the why -- I'm going through this is to have a powerful testimony to inspire and motivate others, is a third surgery and recovery really necessary to achieve that end?

Well, enough lamenting...I have to keep my head on straight (yeah, I know...easy joke...). Now is not the time to get depressed or upset. Paul also suffered an affliction of some kind, and prayed for it to be removed. God's answer was simply, "My grace is sufficient for you, for my power is made perfect in your weakness." Roger, Boss -- my suffering will somehow glorify You -- and I may not ever know how or why. It's just...that can be a tough pill to swallow sometimes.

Central Park and Surgery

2008-10-22T21:14:00.010-04:00

One of the joys of being a runner is that you can do it just about anywhere. Last week, I was a guest speaker at a conference in New York City...and, of course, I brought my running shoes. We were staying only a few blocks from Central Park, which has some great running routes...so I gave one a try! The view from the Onassis Reservoir is amazing:

And, from the runner's perspective:

It was a great run -- planned about 6.5, but ended up running 7.2. It turns out that Central Park is easy to find and easy to run in, but almost impossible to get out of. I missed my exit no less than three times. Still, a great run! I also got my first real long run out of the way last weekend, and did 17.2 miles -- felt outstanding from start to finish, a great sign. I did the run in 2:17.28, right on 7:58 per mile. 3:45 in Seattle is still looking good!

Unfortunately, it's not all sunny skies and open roads -- from the prior blog you know that I'm on the road to my third surgery. I'm happy to report that I've successfully fought (for a third time) with the insurance company, and they will cover the full cost of the surgery and the travel. This is great news -- it means I can go back to Cedars-Sinai Medical Center in Los Angeles, to the same surgeon who has done my last two surgeries. He was recently profiled in a Newsweek article -- pretty fascinating! It's only a page and definitely worth reading, but feel free to disregard the statistics...I've already beaten all of them ;-). After getting the insurance approvals, I went ahead and scheduled surgery -- get your calendars out -- I'm going back for brain surgery #3 on December 11th. Pre-op labs and scans on the 8th, neuro consult on the 10th, and surgery on the 11th. According to the surgeon, I should be home in time for Christmas!

In all, we're very happy with the timing, and with the approval to return to the surgeon we know and trust. Of course, little Monkey had a great time in New York (here at the giant Toys-R-Us Times Square)...
So, we're all set for a third surgery. I'm running a marathon the week before I go into surgery, and already have another scheduled for six months after surgery...crazy? Sure...but what do you expect from someone who's had two -- soon three -- lobotomies?

Here we go again...

2008-10-05T19:56:00.007-04:00

Wow! Where do I start? Good news and bad news across the board. First the good news -- no more chemo! Now, on to the bad news...

As I mentioned in a previous blog, I was accepted into a research program at the National Institutes of Health's National Cancer Institute. After a few initial interviews, I had my formal in-processing and medical review on Friday. Here's where I spent much of my time:

The doctors there are stellar. Very thorough, very intelligent, and they have a massive wealth of experience and resources. They spent almost five hours with me, and the bottom line is this -- chemo isn't working. Starting this Tuesday, I'm back at NIH for another MRI, and on the road to my third craniotomy, where they'll probably remove the entire right frontal lobe. Surgery hasn't worked, chemo isn't working, so this third surgery will be followed by six weeks of radiation -- the only option we have left. Pending lots of legwork and insurance paperwork, I'll have surgery at Harvard Medical Center's Dana Farber Cancer Center, with Dr. Peter Black -- one of the most brilliant surgeons on the planet. Radiation will be here at NIH/NCI.

Now, those of you who know me are acutely aware that this is a serious blow, but it won't slow me down much. My "therapy" was a good ten-miler today, and I averaged 7:56...not blazing, but fast enough for me. I'm still on track to run the Seattle Marathon in November, and training is going quite well. My 14-miler last weekend felt great, and today's ten-miler was a walk (okay, run) in the park. JD (see my previous post about him) is also doing well, and he and I were both featured in a nice two-page article in Racecenter Northwest Magazine this month -- if you're in the USATF Northwest region, pick up a copy and turn to page 50!

So, how do I feel about it? It's strange how many people ask me that question, and I'm never sure how to answer. Yeah, it sucks. No, it's not what I want to do. No, it's not the news I was hoping for. Yes, I fear for my life and for my family. What do they expect me to say? But, you can't dwell on those thoughts. You have to keep living. You have to press on. In the words of Paul, embroidered into the shoes in which I ran my first marathon, we must "run with perseverance the race marked out before us." I've been here before. I've come through two prior brain surgeries. I'll come through again, have no fear. I'd love to power through in time to run the inaugural Rock-n-Roll Seattle Marathon in June. Here's a challenge to all the bloggers out there -- if I make it, care to join me?

The Youngest Runner...

2008-09-04T21:41:00.007-04:00

Okay, I couldn't resist. I had gotten back from a run and taken off my fuel belt while stretching on the floor next to Monkey. Fascinated by my fuel belt, she just had to investigate...

I'm afraid I just couldn't resist taking off my hat and putting it on her head...

Welcome Little Monkey, the newest member of the running community!

Feeling Fragile

2008-09-02T21:09:00.001-04:00

I'm tempted to start with another apology for it being so long since my last post, but I have a feeling that's getting old...so I won't bother.

Wow, it's been a tough month! The last two rounds of chemotherapy have really hit me hard, and made me quite sick...so, going into this last round (#9), I wasn't really looking forward to it (am I ever, really?). To make matters worse, I picked up a stomach virus two days before starting chemo, so I entered the chemo treatment barely recovered from a nasty bug...what I'm saying is that I wimped out. I only completed four of the five rounds of chemotherapy. It's the first time, in 21 rounds of chemotherapy over two years, that I've ever failed to complete a round. I had been physically sick off and on for two months, and seriously ill for four or five days before and during chemo...and well, I just...ran out. Ran out of everything. Stamina, the will and desire to fight it, physical strength...but it was mostly mental. I looked at my last dose of chemotherapy on Thursday night, having been sick for days, knowing the last dose would make me even more sick, and just couldn't do it. I tried a new anti-nausea med (phenergan), and it knocked me out like nothing has ever done...literally, I took one about 9:30am when I was feeling sick, and woke up eleven hours later. Somehow, Pooh tells me we went to the mall and had a burger, but I don't remember much of it. Crazy...but I didn't get sick, so I suppose it did it's job.

I'm always amazed by how many people tell me how "strong" they think I am. But in this blog -- more venting than anything else -- I sure don't feel it. On the contrary, I feel extremely fragile. More fragile than I think I've ever felt in this whole process. I feel weak, sick, tired, and run down. There are interesting ironies here, by the way -- isn't it ironic that a runner "ran out" of strength and feels "run down"? That might be worth a blog sometime...how our language has developed metaphors for fatigue focused on running...hmmm...

But I digress. As I'm learning to expect, the blogger community stepped up BIG...during three weeks of blog silence, I got messages on voicemail, e-mail, Facebook, even comments through this blog, all checking in to make sure I was doing okay. To answer everyone who so kindly thought of me -- I'm okay. But that's about it. Seattle Marathon training is going well, and believe it or not I've only missed two cross-training days (and no runs) in the last two months of off-and-on illness. 10-mile run planned for this weekend, and I feel up to it. Pooh, Monkey, and running remain my solace. Today, for the first time in a long time, I feel good -- healthy. Tempo run tomorrow, which is my favorite...and thanks to many of you, I'm ready. Next blog will be more positive, I promise!

Symptoms, Side-Effects, Surgeries, and Seattle

2008-08-13T20:40:00.000-04:00

Well, it's been quite a month. Yes, I know it's not even half over...anyway, a few things to share this time around:

SYMPTOMS and SIDE EFFECTS. Man, chemo has been brutal lately! Thanks to all my blogger buddies who checked in on me over the last two rounds -- I've completed eight, with four to go! That's 2/3 of the way through. Yeah! Unfortunately, I've gotten sick on the last two rounds...once on Sunday morning, then again this last round on Friday night. In both cases, I probably should have taken additional anti-emetic medications, but decided not to...and I'm learning that is a BAD decision. At the same time, it really doesn't make me look forward to the next four rounds. Which got me thinking...

With everything I've been through fighting this bug called Cancer, I've never had a single symptom. Not one. Oh, don't misunderstand -- I've had headaches, nausea, vomiting, constipation, diarrhea, memory loss, blurred and double vision, vertigo, weakness, and fatigue -- but every one of those were caused by either brain surgery or chemotherapy. Approaching my tenth year battling cancer, I still have not had a single symptom from the cancer. This must be the difference between a symptom and side-effect. I've had side-effects -- just no symptoms.

So in my case, the "cure" (though it's not one yet) is worse than the disease. It is extremely difficult to convince myself that chemo and surgeries are necessary, when I don't feel sick. Now, before you start drafting that e-mail, rest assured that I've tried homeopathic and naturopathic doctors, The Cancer Diet, MangoSteen, Xantha, Acai Berry, Antioxidants, and probably every other "cancer cure" you've read about in the National Enquirer or gotten forwarded to you in a spam e-mail...and without going down a lengthy rabbit hole, let's just say I've settled on conventional medicine. But that doesn't make it any easier. Round #9 starts on August 24th...bring it on.

SURGERIES. Okay, some of you know I had my six-month MRI and follow-up with neuro-oncology and neurosurgery. Having left California, I'm now being seen at Bethesda Medical Center and/or Walter Reed Medical Center in Maryland. Both are military hospitals, so that's not ideal...but I have good news:

They're referring me to the National Institutes of Health (NIH) one of the leading research centers in the world. Specifically, the National Cancer Institute -- that is SO awesome! I'm so blessed to be able to be seen by some of the greatest physicians on the planet. Second, more good news -- the cancer showed NO progression! That's the awesome news we were hoping for. The chemo appears to be working. However, it's not all wine and roses...the neurosurgeons here are far more concerned about my condition than the surgeons at Cedars-Sinai, where I've been going for the past nine years. They were amazed that I had decided to leave a tumor in my brain, and "hope" that it doesn't progress, metastasize, or upgrade. Dr. Rosen (has anyone seen "Fletch"?) at Bethesda recommended going immediately on a path to another surgery, and removing the tumor. We talked about it for almost two hours, and he eventually left the decision up to me -- and (see above) with no symptoms from the tumor, no and signs of growth or progression, I have no incentive to go back into surgery. Is that the right decision? Who knows. What do you think? Surgery has been far more harmful and traumatic to me than the cancer ever has been...so as long as the cancer is contained and I'm asymptomatic, what justification is there for surgery? Thoughts? It's a tough one, isn't it?

SEATTLE. On a lighter note, training for Seattle has begun! Two weeks ago I started my marathon training for the Seattle Marathon in November. I'm using the same training plan I used for Big Sur, which worked very well...based loosely on The Penguin's book "Marathoning for Mortals." If you haven't read it, it's outstanding...even if you don't like the training plans, the commentary and advice is wonderful. Finally, the Garmin ForeRunner 405 is amazing. I love it. Thanks for the advice, Momo -- you were right! I'm at about 30 - 35 miles per week, averaging about 7:43 per mile...I think 3:45 at Seattle is realistic. By the way, if you're following the story, I saw JD in Seattle a few weeks ago, and he looks great! The first time I've seen him since his dramatic weight loss, and he's a completely different person. And he's already running 10 - 11 miles on his long runs! He's an inspiration to many, especially ME. Running in DC is a joy...different from running along the ocean every day, but it's always fun to explore a new town (one of the reasons I never run the same marathon twice). Isn't that part of the fun?

Well, that's it for now -- thanks again for all your prayers and support. For those who asked, Pooh and The Monkey are doing just fine...and as cute as ever...here's proof:

Worth running for? You bet. Worth fighting for? ABSOLUTELY.

Yes, I'm Still Alive...

2008-07-26T08:23:00.000-04:00

Has it really been almost a month since my last blog? Wow, time flies...

Well, no doubt I've been remiss -- both in my blogging and my running. Moving and starting a new job with a wife and baby is pretty time-consuming!

In short, all is well. Pooh and Monkey are both doing wonderfully, and so far we love the VA/DC area -- we've almost completely moved in (only a few boxes to go), and I started work again last week. Going to be some long hours on this one...they don't mess around in The Big House. Regardless, we've found a bit of time to do some "touristy" (is that a word?) things:

Better yet, we found a great sandwich shop (called Firehouse Subs), with great sandwiches and brownies...little Monkey was a BIG fan:

Unfortunately, my running has really declined...simply no time...but as we're getting settled, I've gotten the chance to run from work a few times. It will be outstanding -- excellent running here in DC, and I can't wait to explore a bit more. Monday starts my training for the Seattle Marathon, so I'll have to increase the mileage in a BIG way.

Last bit of news -- a writer for RaceCenter Northwest magazine actually read my blog, and contacted me about it...they've now written a 2-page article about my running the Seattle Marathon with my buddy JD, and it will appear in next month's issue -- I'll post a link if it's in the online version. I saw a read-ahead copy of the article yesterday, and I think it turned out pretty good! Finally, I start chemotherapy round #8 tomorrow, so your thoughts and prayers would be greatly appreciated, as usual...I'll keep you posted!

I'm Back!

2008-07-04T15:34:00.000-04:00

Greeting! Thank you so much to all of my blogger buddies who checked in on me during the move -- you're so thoughtful! Being relatively new to the blogosphere, I somehow thought then when you don't blog for a while, folks just sorta stop reading your blog or forget about you...on the contrary, I found that I got as many comments when I wasn't blogging as when I was. So many people asked about the move and everything else...this blogger community is truly that, a community.

The move is nearly complete. After 3,128 miles of driving, most of it with a wife, baby, and 21-pound cat, we arrived in Alexandria, Virginia on 28 June. I checked in to work shortly thereafter, and the movers showed up with 12,200 pounds of furniture and books (mostly books) on July 2nd. Now, I'm living in a sea of boxes -- it's quite an adventure! I must say, this is my 13th move in 35 years, and it doesn't get any more pleasant or any easier. I'm not sure how many more of these I can handle! Fortunately, we really enjoy our new place, and love the area. If any of you are ever in DC or Alexandria/Springfield, please let me know!

In other news...I started my seventh round of chemo a few days after we arrived, and finished last night. Yesterday was a rough one, and I spent most of the time curled up on the sofa feeling pretty miserable. Or neighbor is also a runner and triathlete, so we've already had a few discussions on the topic -- he invited me for a quick 4-miler (he runs sub-7, so I'm not sure how much running we'll be doing together), but I just wasn't feeling up to it. I feel a bit better today, and actually made some progress opening boxes! I also finally got my new Garmin ForeRunner 405, and I love it so far. There is still a learning curve and I haven't figured everything out yet, but I think I'm going to love it. Thanks Momo for the good advice on the ForeRunners!

Between 12-hour days of driving and chemo, I haven't gotten many runs in...one in Cheyenne, on in central Illinois, and one here in VA...but I'll start putting more miles in as I prepare for the Seattle Marathon in November. I'll post more later...with ForeRunner screenshots! Yeah! Thanks again to JK, Streak, Jen, Alili, Stronger, and everyone else who checked in on me during the move...we made it! You all are awesome! More soon...

The New Normal

2008-05-31T15:35:00.000-04:00

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

2008-05-20T13:00:00.001-04:00

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

2008-05-14T19:00:00.000-04:00

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

2008-05-11T20:34:00.000-04:00

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

2008-05-09T01:41:00.000-04:00

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!

2008-05-06T10:59:00.000-04:00

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

2008-05-02T00:48:00.000-04:00

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!

Happy Anniversary

2008-04-29T10:52:00.000-04:00

Today is my anniversary. Actually, my "multiversary"...

Eight years ago today, I wed the only love of my life, Pooh.

We dated for almost four years before getting married, mostly because she kept turning me down (maybe I'll blog on those events sometime). For now, it's sufficient to say that the last eight years have been the greatest years of my life, thanks entirely to this wonderful woman. She is my stability, my rock, my comfort, my confidant, my true love. Happy anniversary, Pooh!

We haven't always been able to truly "celebrate" our anniversaries. Just a few weeks after proposing, after a freak accident on the basketball court, doctors discovered my brain cancer. We went through with the marriage, quite uncertain about what the future may hold. It wasn't long before we knew...and on April 29th, 2001, I spent our first wedding anniversary in pre-op, getting ready for my first brain surgery.

The surgery was done at Cedars-Sinai Medical Center's Maxine Dunitz Neurosurgical Institute, by a genius named Dr. Keith Black. It was successful -- and really, how many newlywed couples with our income get to spend their anniversary in Beverly Hills? The accommodations weren't impressive and I had just a little headache, but the company was perfect...and, I was cancer-free.

For a while, anyway. April 29th, 2005 -- four years later, almost to the day -- we were back in Beverly Hills, but we weren't on vacation. My cancer had returned with a vengeance, larger and more aggressive, and I had my second major brain surgery (by the way, is there such a thing as "minor" brain surgery? Anyway...) on April 28th, 2005, the day before my fifth wedding anniversary. Like my turban?

54 Staples and feeling fine!

Six months later, I ran my first marathon...and Pooh ran the second half with me. Nothing impressive -- 4:47 -- but not bad, just six months after a lobotomy!

Here we are, April 29th, 2008. Through eight anniversaries, I've spent half of them either in surgery or on chemotherapy. It's been eight years since marrying the love of my life. Seven years since my first brain surgery. Three years since my second brain surgery. The cancer is back, and I'm going through another twelve rounds of chemotherapy. Pooh is still by my side, and we have a new reason to run -- our little Monkey:

Like my Pooh, she's just gorgeous. Happy Anniversary, Pooh...you are my love and my life. Thank you for the last eight years. Thank you for modeling truly unconditional love to me. Thank you for our little Monkey. And thank you for running with me -- we have many miles yet to go, side by side.

Running WITH Cancer

2008-04-27T23:28:00.001-04:00

I am the son of a linguist.

I know that sounds like an expletive or an insult, but it's true. My mother married my father while she was finishing her Ph.D. in Romance Languages at the University of Washington, and to this day she speaks six or seven languages fluently. She even still writes to me in French sometimes...good thing I held on to my Petite Larousse...but I digress.

So, on my long run today (only 8.5 miles), I thought about my blog title, "Running With Cancer." The little preposition "with" can be interpreted two different ways -- first, it can mean you're running with something that is a part of you, your body -- like running with a headache, or running with a cold. Second, it can mean you're running with something outside of yourself -- like running with a friend, or running with your dog, or running with your local club. So, when I say "Running With Cancer," which is it?

If you talk to many cancer patients or survivors, you'll start to notice a fascinating trend. Most refer to their disease in the third person -- not something that is a part of their body or a part of them, but something that is independent of them. "The cancer is back," spoken of almost like an unwelcome relative. "Doctors are treating the cancer with radiation." "The cancer isn't responding well to chemotherapy." In almost ten years of fighting this disease, raising funds for cancer awareness and research, speaking publicly, and sharing with various support groups and fellow fighters and survivors, I very rarely hear any of them speak of their disease as something inside them...it is a foe, a hostile intruder, an unwelcome relative.

So there it is. I'm Running With Cancer -- but doing so in the sense that it is running alongside me. It does not define me. It is not me. This is a race like any other -- and I will win. I've sprinted ahead twice, and it has caught up both times...but I'm watching Cancer's pace, saving my energy, biding my time, and I'm making my move...leaving Cancer behind, this time for good.

Welcome!

2008-04-26T23:09:00.000-04:00

Greeting, and welcome to the first post in Running With Cancer.

Runners know that long road miles have a way of making your mind wander. It's truly bizarre the things you think of to keep your mind occupied after two or three hours, just you and the road. For a runner who has survived two bouts with cancer and is fighting round three, the thoughts can be even more sobering -- or liberating. This blog is simply a catalog of those thoughts. They may cover everything from how chemotherapy feels to the experiences of a first-time father. Again, welcome to the blog -- I'm glad you've decided to run alongside me, for one mile or for 20.