I didn’t get a tattoo today

I thought I was going to.  I was supposed to.  I was minutes away from getting one.  I wish I got a tattoo today.

Let me back up.

Last Monday was my last chemotherapy treatment.  I didn’t really celebrate much apart from a few classier-than-normal-dinners, because I was still dealing with the side effects, and, well, I’m not done treating this cancer yet.  In the past week I’ve had to shift gears from the relatively normal routine I was used to with chemo and get used to doctor appointment after doctor appointment to see what state my internals are in and to plan the next step in my treatment: radiation.

I met my radiation oncologist for the first time last Thursday, and he spent a significant amount of time walking through my history, telling me what the next steps will likely look like, and even showing me the details of my PET-CT scans from April and August.  I hadn’t actually seen the images before, and it was enlightening to see the improvement that the chemo had done in that time in killing off the cancer.  Also, the April images were still a little upsetting.  I was basically operating on one lung, and it was beginning to fill with fluid.  And my windpipe was not even close to where it should be.

August PET-CT scan. Still a lot of scar tissue in my chest.
August PET-CT scan. Still a sizable bit of scar tissue in my sternum.

So yesterday morning I got another PET-CT scan.  The nursing staff there are starting to recognize me by face alone.  The results, as expected, were still negative for active cancer activity and showed the scar tissue in my chest was even a little smaller than it was in August.  At my appointment this afternoon with my radiation oncologist, the plan was to get another detailed CT scan of my insides, this time lined up with lasers and marks on my body so that I could be positioned in the radiation machine the same way every time.  Hence the purpose of the tattoos.

I was taken to the scanning room by a student nurse, who, I swear must have quit a previous job as a supermodel because she was an effortless 10, and my immediate instinct was to check to see if she was wearing a ring.  All clear.  I think I could look forward to coming in to receive radiation every day.  Shoot, only a month?  Let’s make it two.

I was laying on the table that gets put through the CT machine with my shirt off, head locked down in a weird webbed cast formed to my face, belt undone and pants/boxers slid down just enough to be able to make some pen marks – where I was due to get tattoos – where the lasers crossed my lower abdomen, when the nurses stepped into the separate room to start the scan, and then my radiation oncologist ran in with jazz hands shouting “STOP EVERYTHING!”

He’d just gotten off the phone with another doctor at Loyola’s hospital in Chicago saying that, yes!, in fact, I would be a perfect candidate for proton therapy.  Not that normal photon and electron radiation wouldn’t work for my tumor, but there would be a risk of some permanent side effect damage to my lungs and heart because of how the radiation beams would have to be shaped to kill any leftover cancer DNA in my tumor/scar tissue.  It’s just how my tumor was shaped.  There’s always a risk of affecting nearby organs when getting radiation treatment, not that it would completely impair them, but apparently at least one other person with Hodgkin’s lymphoma has been treated with proton radiation, and I could be number two (or number 100, I’m not really sure, but it’s not common yet for Hodgkin’s lymphoma because normal radiation treatments are effective enough).

I will add one thing.  I’m very glad for my background and education as a mechanical engineer because all the physics talk of these treatments makes perfect sense to me.  It’s very comforting to know and understand – really understand – what’s going to happen me on the microscopic level.  I’m not usually very talkative in my doctor visits, but that’s because (I think) I have a fairly good grasp of what’s going on and what’s going to be done to me, and well, yeah it makes sense – no questions – let’s get on with it.

Either way, the pros are that I’ll probably have fewer side effects from radiation, and the cons are that I’ll have to move back home to Deerfield and drive to Warrenville every day for a month to get my treatment, as opposed to driving 15 minutes to the center in Holland where I thought I’d be getting all my radiation treatments.  This development came a little out of left field for me, and, well, even though I don’t always give glowing reviews of life in Holland, I definitely still prefer it to Chicago suburbia.

So it goes.

SavageMan 70.0 Triathlon 2011 Race Report

I’m often asked what I think about as I run. Usually the people who ask this have never run long distances themselves. I always ponder the question. What exactly do I think about when I’m running? I don’t have a clue.

Haruki Murakami, What I Talk About When I Talk About Running

I’ve had a lot of people give me incredulous looks over the past week when they find out I just completed a Half Ironman.  Like it was some Herculean feat that not only I shouldn’t be able to do, but that no one should ever willingly choose to do either.  I don’t know what others thought my chances of finishing were, but I never had any doubt I’d complete the entire triathlon.  I may have made deflecting comments in weeks prior about just quitting after the bike if I was too tired, but my training prep leading up to the event left me feeling 100% confident.

A 1.2 mile swim?  Puh-lease.  Granted I only found the time/energy to hit the pool three times in training, one ended with a coach stopping me on my way to the locker room to tell me what a beautiful stroke I had (like I don’t know), and the other included a solid set where after 600m of freestyle I finally found my groove and immediately declared myself ready.  A 55.7 mile bike?  I’ve had enough rides of greater distance than that this summer operating on less lung power.  I am as comfortable on my saddle as I am on my living room couch.  True, the hills would be a challenge, but I’ve been to hell and back on the bike before, and if there’s anything I know, it’s that I can survive.  And a 13.1 mile run?  My longest run of the summer was only 9 miles, but if had to walk, no worries.  A pain of a half marathon is minuscule and over in the blink of an eye compared to the pain of chemotherapy.  Bring it on.

SWIM

I slid into my wetsuit, and we waded into the water near the front of the 2nd wave for the in-water start.  As if I had any excuse to quit, there was a guy at the start floating behind me with no legs competing.  Just a flipper attached to one of his nubs.  Only a few minutes later, we all put our faces in the water and started spinning arms and kicking legs.  Maybe it was the fact that I wasn’t doing all I could to be at the head of the pack like in most of my triathlon swims, but it was very uncrowded.  I hardly bumped into anyone or had to swim over top of others.  I decided to stay within myself and take the swim easy – no sense in burning so much energy so early in the day for such little gain.  Before the first turn, I had already passed a few people from the wave that started 7 minutes ahead of us.

The swim course was one of the easiest open water swims to sight I’ve raced in, and on the back stretch, I finally settled into a groove where I didn’t feel like I was forcing my arms forward against their will with each stroke.  I drafted at the hip of other swimmers when I could, and, well, just kept on keeping on until the home stretch.  As I was nearing the beach, I noticed one other swimmer with a different color cap (meaning he started in the wave behind me) pass me, but by my calculations, only getting passed by one or two swimmers was a pretty good start to the day.  I exited the water in a little over 31 minutes, which is right what I predicted, and only a few minutes slower than my best time.

BIKE

And so began the heart and soul of the SavageMan.  My relatively quick transition saw me start the bike before Matt and Abe, even though they both swam faster than me, but I also bundled up less than them.  It was a cool and cloudy morning, and with a long descent to start the bike course (and still being wet from the swim), I threw on a vest, arm warmers, and gloves to ward off the cold.  Familiarize yourself with the profile:

Climbing Toothpick near the start, I immediately ran out of gears.  Looks like I wasn’t going to be setting any records.  It was time to stay within myself and just make sure I didn’t redline.  The few rolling miles before the descent were windy and cold.  We’d been instructed by the race directors about the numerous “dangerous, technical descents” on the course, but a fellow racer we met when setting up our in the transition area in the morning told us that aside from the first tight turn on the first descent, they weren’t that dangerous.

This was good knowledge to have.  And it was correct.  After a tight turn to start the downhill, I crouched down, took my fingers off the brakes, and sank like a stone.  I still didn’t know the course, so I wasn’t going at my limit, but I still passed more than a handful of racers more scared/cautious than me.

And then the real test began.  You ride through a couple of intersections in Westernport near the river, then take a 90 degree left turn, cross a timing mat, and if you’re foolish enough to look up at the road ahead, curse loudly to yourself.  This pictures from the top of the Westernport Wall can not accurately depict the steepness of the climb itself, nor the fact that the lower three-quarters of the climb is seriously steep itself.
That top section in the photo, partially hidden by the tree and paved with concrete instead of asphalt, is the steepest section, maxing out at 31%.  There’s no chance to carry any momentum into the base of it.  The shouting crowds and repeating loop of the Rocky soundtrack and concurrent surge in adrenaline weren’t enough to get me to the top without hopping off my bike and walking.

But after finishing that climb, the road only continues to tick upwards.  The Big Savage climb is timed (starting the clock at the base of the Westernport Wall), and it took me over 45 minutes to reach the top.  45 minutes of finding all sorts of different climbing styles.  Out of the saddle.  Paperboying.  Woodpeckering.  Hand in the hoods.  Hands on the middle of my handlebar.  The couple short downhill sections of the climb only meant that the other sections had to be that much steeper to make up for the lost elevation.  I tried to remember to eat calories as much as I could, but it took me nearly 30 minutes to eat a single Clif bar.  Any bite larger than a nibble rendered too much food in my mouth to both chew and breathe at the same time.

Though I will say, when I remembered enough to steer my head away from the road in front of me, there was some truly scenic countryside to gaze at and enjoy.

The descent off of Big Savage was my favorite part of the entire day.  After enough time to warm up (and shed the vest and arm warmers at the bag drop), I settled into my tuck and bombed it.  Sweeping turns through the forest required only a light feathering of the brakes, and all concentration turned toward carving up the road whizzing by me.  My biggest concern was finding the right line around the slower racers.  I’m told I caught a few of them off guard when my speed and closeness surprised them, but I never felt unsafe.

But on descent we shift from awareness to is, evaluating only the line itself, not how things could go wrong.

Near the bottom of the descent, I passed a few racers in full aero gear who were obviously not great descenders.  As the next Cat 4 climb started, one passed me again and remarked about how effortless I made it look.  Made my day.

I hadn’t memorized the course map or profile, so after Big Savage, I only knew what lay ahead of me based on how far I could see up the road.  There were more climbs, steep as all the others, and now only short descents off of them.  And then came Killer Miller.

Though at it’s steepest, the Westernport Wall is worse, Killer Miller is nearly just as steep in sustained sections, and much, much longer.  There were spectators on this section of the course as well, but honestly, I can’t remember what any of them looked like.  When my eyeballs weren’t examining the inside of my own skull, they were intently focused on the square meter of asphalt just beyond my front tire.  I turned myself inside out, used the entire width of the road, and finally found myself in the flow state.

The remainder of the ride was mostly an exercise in trying to remain in the zone despite whatever was going on around me, and then easing back a little to prepare for the run.

RUN

Through most of the bike, my feet were pretty cold.  I opted not to wear shoe covers, and I purposely over-tightened my shoes for most of the ride to make climbing a little more efficient, so the first mile of the run was simply an exercise in getting warm blood to my feet and feeling them out again.  After a short trip to the port-a-potty to relieve some liquids, I still struggled to find my rhythm.  I walked the uphill sections of the run, and waddled through the flats.  It’s not that my legs were coming unhinged, but my gut was still not cooperating.

I ticked through the miles and held a relatively pedestrian pace of 11 minutes/mile through the first half of the two loop course.  I don’t have a clue what I was actually thinking about.

Around mile 8, I stopped for another bathroom break – this time a little more lengthy -and finally, I could run.  I switched to a half cup of Coke at every aid station, and quickly found new life.  I was starting to catch and pass other runners for the first time, and my legs still weren’t tired.  By not redlining while trying to set a PR, I held a comfortable pace the entire day.  I negative split the run at a pace that didn’t exhaust me, and even after finishing, I felt like I could’ve continued on for hours more.  My legs didn’t hurt.  I’m not sure how else to explain it.  You either understand, or you don’t.

I’m still waiting for photos from others and from the race photographers, as I’m especially anxious to share some of the other parts of the course with everyone, and trigger my own memories of other sections on the course, so if they’re uploaded in a timely manner, I’ll update with some of the better ones.

Pain is inevitable. Suffering is optional.

Finished

Had my (hopefully) last chemo treatment EVER yesterday.  It was rather uneventful itself, with no fanfare or celebration, because there’s still a week of side effects to suffer through one last time.  And even then, I still have a month of radiation treatments coming up – I meet my radiation oncologist for the first time on Thursday – and another PET scan and some more tests to see what kind of permanent damage chemo has done to me.

But on Sunday, I guess I did have a little early celebration in the form of completing the toughest Half Ironman in the country.  I’ll post a full recap later this week, but here’s a taste of what it was like:That’s me with the handsome legs there on the Westernport Wall.  Go ahead and stare.  And yes, that’s several people in front of me who’ve fallen over on their bikes because the hill is so steep.  And that’s Abe over my right shoulder who had someone fall in front of him and was forced to unclip and walk the rest of the hill.  And for the record, yeah, I had to unclip and walk to the top too.  Turns out I needed more gears than a 39-25.  Here’s a comical video of lots of people struggling more than I did:

But, I finished.  And as my oncologist commented, most people just wonder if they can continue working while undergoing chemo.

 

Stopping to smell the flowers

There is this untamed field right off the strip mall next to my oncologist’s office.  No doubt it’ll be paved over at some point in the near future, but low economic activity and cheap rent have spared it thus far.  It’s part prairie, though not quite like we had in Illinois, part swamp (I guess it does it’s best job as a runoff retention pond), part overgrown weeds and thickets.  I’ve driven and walked by this particular parcel of land a hundred times, but never actually looked into it until the other day while strolling to lunch.

In the 200 yards of walking between getting blood tests done and ordering a sandwich at Panera, I had to constantly change my stride to avoid stepping on all the grasshoppers and crickets jumping about the sidewalk on the edge of this untamed land.  And the noise!  I didn’t know it existed.  Dozens of conversations trying to outlast the other.  Was it always so loud, so active?  I’ve never seen anyone besides me utilize that stretch of sidewalk, but what of all those cars driving by?  How often do you have the windows down?  When I drive, and it’s not too cold, the windows are always down.  Yeah, it’s partially because the air conditioning in my car is broken, but so what?  Is it really so bad if I feel hot for 10 minutes in my car?  And the sights and sounds and smells that pass you by!  Oh right, this is why I try to ride my bike as much as possible.  There were insects everywhere, all going about their busy lives.  What those lives entail, I really don’t know.

I took my roommate’s dog for a walk a few days ago, and as dogs seem to stop and sniff every odor that crosses their nose, we pulled up next to the fence of someone’s yard.  And there in the flowers, beautifully blooming themselves, were bees pollinating them, and a single grasshopper sitting on a fence post.  Thinking.  (I think).  Or sunbathing.  Or being thankful it wasn’t it some spider’s web.  Or contemplating it’s next massive jump, showing off to all the other busy insects scurrying about.  Or maybe just sitting there admiring another grasshopper’s springy legs.  “Yeah, I bet she can jump twenty-five times her body height…”

sunbathing

It goes all the way to 11

Not sure if it’s my level of caffeine intake or the needle sticking out of my chest, but I squirm in my chair every other week when getting chemo.  This latest round has been pretty “normal” as far as things go.  It took me 15 minutes to get out of bed this morning.  Not because I was sleepy, or I was otherwise an anti-morning person, but because it takes that long to pull my limbs out from the canyon of a depression my body creates in my mattress.  Every movement takes considerable mental effort, careful not to waste any momentum that might otherwise propel me out of bed and to my feet.  It’s like there’s lead pumping through my veins.  Like someone turned gravity up to 11.

Got a potassium supplement because my latest blood tests showed it was too low.  Another bottle of meds to add to the pile.

Meanwhile, I don’t know that I’ve mentioned in on this blog yet, but in a week and a half, I’m still planning on compete in a half Ironman distance triathlon.  The SavageMan Tri.  I signed up for it back in January or February with Matt and Abe, and for a while I didn’t think I’d be able to make it, but I think I’m over those thoughts now.  It has some stupid-steep hills on the bike course (like 31% gradient).  And, so even though today it’s too much effort to even contemplate any more physical exertion than a brisk walk, somehow it’ll all come together and I’ll make my way through 70 miles of Maryland countryside.  Hopefully in not much more than 7 hours.  I mean, how hard could it be?

daydreams