Building Up. Breaking Down.

I’m fascinated with the process of running progression, primarily because it requires a deliberate destruction of the physical body. You simply can’t become a better runner without pushing your body past its previous boundaries, without stressing oxygen delivery systems, without tearing muscle fibers. You just can’t.

Fortunately, over time we’ve figured out how to precisely damage the body in a way that is controlled, restrained and does not lead to complete deterioration. On the contrary, we’ve learned to damage ourselves in increments, subtly, so that we are able to continue running through the damage and allow the body to repair itself, in effect making us stronger, more efficient runners. It’s a fascinating process and it was crucial to always keep in mind during high-mileage training in order to keep myself from running recklessly, from not letting my body recover from previously sustained damage and therefore damaging myself further. As my coach would put it, “From saving you from yourself.”

The process went like this. Run HARD during Tuesday speed workouts. Push the oxygen delivery systems to their breaking point and deplete the body. Strain the interconnected muscle fibers throughout the body, creating micro-tears that resulted in soreness and precarious steps the following day. Then back off. Run EASY the following day and allow the systems to recover, the muscle fibers to repair and rebuild…even stronger. Then run HARD on Thursday, mimicking the previous damage from Tuesday’s workout. Follow that up with an EASY run on Friday, repeating the same necessary recovery. Put in a long run Saturday, straining systems in a different manner, breaking down muscles more and more…then repeat the recovery on Sunday and Monday. Wash, Rinse, Repeat. Over and over. Damage, repair. Damage, repair. Damage repair.

It sounds mildly masochistic, or fulfills the idea that “One definition of insanity is repeating the same thing and expecting a different result”, but the most important dynamic of this process is the strength gained in recovery. We create not only a process of reparation, but also of progression. We get better. We become more efficient. We get stronger. We get faster. And that’s why we force ourselves to break down in a controlled manner, so that we can build back up ever so slowly, increasing our ability to run at new speeds, new distances. Very few people can just leave the house and run 26.2 miles, but leave the house and run further and further, in increments, and suddenly you go from exhaustion after 3.1 miles to euphoria (well…and exhaustion) after 26.2 miles. You get the picture.

I’ve always been fascinated by that controlled progression, feeling it’s upward trajectory, it’s positive outcome, and I’ve always tried to hone it to my utmost advantage….

Which is why I’m struggling so much now.

I’m trying to engage with that process of damage and repair, of breaking down and then building back up, but the effects of accumulated chemotherapy have now become so strong that the procedure has been reversed, the terms switching places. I’m now building up incrementally only to be broken down to a greater degree. I run at every opportunity I can get, trying desperately to stress my systems yet again, to create tears in my muscle fibers, to push my oxygen delivery systems to their brink, then let the repairs take over and create a stronger, faster me. But chemo is too strong and I can no longer run with any sort of consistency, any reliability, and repetition. I’m now relegated to running one day, ANY day I can, breaking my body down, letting it recover…but then unable to build it back up again to create that continued progression where I’m getting stronger and stronger.

Instead, I’m breaking down, building back up ever so slightly and then breaking down even further. Building back up just a bit, then breaking back down again. Over and over. I’m now running only trying to maintain small progressions, to slow the deterioration process as much as I can. Maybe at some point I’ll hit a happy medium, a stabilization of sorts, but in no way am I able to get stronger and stronger anymore, as I was trying to do after my surgery and through the first handful of chemo treatments. Eleven, going on twelve, treatments, and the chemical foe is proving stronger than my physical resolve.

I don’t mean to be such a downer though. This is, undeniably, not a fun process to experience, but it’s not like I’m being pushed into a dark corner, blanket over my head, waiting this whole thing out like a seed in winter. I’m still trying. Every opportunity I can get, whenever my feet are free of pain and not disabled from “falling asleep”, I get to the gym and run. Even if just five miles, I still manage to run and try to retain some sense of strength, of continued progression, of fighting back the breakdown of my body. If there is any agency I have over this cancer experience, keeping my physical self as strong and as healthy as I possibly can is it, so all I can do is keep at it and wait for that moment where I can switch the ratio of building then breaking back to breaking and building.

Run Easy. Run Hard.

I was recently asked to contribute a piece geared towards new runners joining a vegan running group in the Boston area. I kept it pretty simple and since it applies to all new runners I thought I’d share it here as well. Some of this (most of it?) has been written about on the blog in the past, but hey, it was nice to get out of my head and just focus on running instead of all this other stuff going on at the moment. Enjoy.

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Here’s the thing with running. It’s really easy.

And here’s the other thing with running. It’s really hard.

It’s easy because it involves a very simple act, putting one foot in front of the other and then repeating this motion again and again until you decide to stop. That’s it. Considerations about hydration, form, shoe selection, matching apparel, complex equipment, interval training, weather, terrain, and so on…well, that’s all secondary, and often unnecessary. The most important thing to always keep in mind is that running is simply doing just that, running. There is something very comforting about this simplicity, about marking off a mental checklist as you head out the door, “Shorts? check. Shoes? check. Ok, then…let’s go run!” In that, running is easy.

But let’s not mince words. Running is also hard. It’s hard because it involves continuously pushing your body’s physical limits to a threshold, whether that is through speed or distance, and that is not easy. It is a stressor placed upon the body’s systems, but this stressing is also a necessity in order to push those limits further out of reach and therefore making you a better runner. To know that you are going to willingly push your own body into that zone of discomfort is NOT an easy thing to do, but as it is said, “Nothing worth doing is easy.”

With that in mind, I can offer some advice that has worked for me in the past, when I first started running again, and even now, after putting an absurd number of miles into many demolished pairs of shoes, that will help tip the ratio of easy/hard to the former.

Diet.

Runners and vegans/vegetarians alike often have an obsession with eating, whether that is an interest in new foods or for athletic performance…I’m no exception. As a long-time vegan, I certainly enjoy visiting vegan restaurants in new towns, trying out the latest junk food concoction or experimenting with my own banana bread recipe, but as a runner I also pay strict attention to fueling needs, nutritional concerns and portion sizes (usually making sure I’m getting ENOUGH!). The good news is that because vegans/vegetarians often pay attention to the foods we eat, we’re already comfortable making changes where necessary or have a leg up (pun intended) on others when it comes to eating nutrient-dense, energy-rich foods for running. I could go on about this forever, but for brevity’s sake, I’ll highlight one aspect of eating that has benefited my health and my running.

Eat simply and diversely. This means eat foods that are quick and easy to prepare (that don’t involve trips to South America to discover secret grains eaten by tribes that have yet to have contact with modern civilization) and that contain a variety of ingredients. I like to refer to this as “the kitchen sink method”, which means eat everything including the kitchen sink. The obvious benefit to eating this way is that you are constantly getting a diversity of nutrients into your body, so that you reduce the risk of becoming deficient in any one thing, which can lead to compromised running performance. A lack of iron creates anemia and significant fatigue and recovery reduction. A lack of calcium can lead to stress fractures in your bones. A lack of protein can lead..well…no one ever ends up with a lack of protein.

How I like to prepare foods in this way is to have a “base” and then add as much extra as possible. So if I’m making stir-fry, I’ll start with a bag of frozen veggies and then add any number of ingredients including almond slivers, sesame seeds, flax meal, raisins, spices, spinach, kale, tofu/tempeh/rice/or cous cous, more veggies (red pepper, avocado, etc.), bragg’s amino acids, nutritional yeast, etc. etc. etc. Now, you don’t have to add EVERYTHING, every time, but the more ingredients means more nutrients, and if you mix it up each time you won’t get bored with with what you create and you make up for things you might have missed last time. I do the same with oatmeal, creating my “base” of oats and bananas and then adding everything plus the kitchen sink, like peanut butter, raisins, spices, almonds, cherries, flax meal, protein powder (usually for flavor), etc. etc. etc.

Both of these meals, I hope you notice, take VERY LITTLE preparation time and involve whole foods that usually just need cut and heated up before eating. I stick primarily to meals such as this and have yet to develop any nutritional deficiency or experience performance sapping fatigue even during my most intense periods of marathon training, which would max out around 110 miles a week. Although it can’t hurt, you absolutely don’t need to use obscure ingredients, spend hours preparing a simple veggie patty, or supplement your meals with protein powders or specially concocted energy bars and expensive nutritional products. Just simple EAT FOOD and eat a variety of it. That’s all. Keep it simple to keep running easy.

Training.

To succinctly offer training advise is difficult as each runner is performing with individual limitations and goals. Some of you may only be able to run 3 days a week, some 5, some every day, and each training plan will be adjusted to your ultimate goals and abilities, so no one plan will work for everybody. With that said, I can offer you what sort of plan I worked from during the height of my training and you can determine what you might consider cherry picking to suit your needs.

To start, a plan that involves running every day of the week consists of three different types of runs. A recovery run, a speed workout and a long run. The speed workout and the long run, which total three days of the week, are the most crucial for stressing the body’s various systems and pushing your abilities as a runner, and the recovery run is just that, to recover from those stresses and allow you to do it again and again as your training progresses. So for me, a typical week was as follows:

Sunday – Recovery run (10 – 12 miles)
Monday – Recovery run (10 – 12 miles)
Tuesday – Speed workout (10 – 15 miles)
Wednesday – Recovery run (10 – 12 miles)
Thursday – Speed workout (10 – 15 miles)
Friday – Recovery run (10 – 12 miles)
Saturday – Long run (20 – 22 miles)

The speed workouts, as the foundation of quick, competitive running, were highly varied and where one day consisted of measured intervals of high intensity, other days would be long runs at a slightly lower intensity, or hill running with varied intensities. The long run, being the basis of your endurance, most often consisted of simply an even paced long run, but at other times during training involved higher intensity intervals of 3 – 5 miles during the run. The recovery runs were just that, very slow running that maintained fitness, but allowed the body to rest and relax from the stresses of the speed workouts and long runs, setting you up for more of those at a higher and higher intensity.

For your individual purposes though, it will be up to you to decide if you simply want to run a distance to finish, to compete against others, to run a PR, etc., and then adjust your training plans accordingly. The problem is that could involve any number of variations on your runs, and without a training group or coach to guide you through that, you’re left to scouring the internet…which can be very helpful if you look in the right places. Personally, I would advise reading running magazines as they are always filled with either general advice or specific training plans and workouts. That is exactly what I did when I was first fumbling through my attempts to get better at running and it served me quite well. I would only advise that you don’t take everything as gospel and simply pick and choose what sort of training plan or workouts sounds appealing to you. That will allow you to shape your training as you go and not stress you out if you can’t keep to the suggested intensities or goals. Again, keep running easy by keeping it fun and fluid, varying your runs as what feels best for you each day.

Avoiding Mistakes.

Avoiding mistakes is easy advice….don’t. I made mistakes all through the beginning of my training and that’s how I learned to get better, whether that involved the right clothing, more honed training methods, race strategy, etc. etc. etc. All that learning has kept running interesting even years down the line and ultimately made me a better runner, able to gauge when I’m screwing up and adjust accordingly. I can highlight this point with two examples.

The VERY FIRST time I went out for a run as an adult I was wearing worn out shoes a full size too small for my feet, swimming trunks with a mesh lining, and a cotton t-shirt. I decided to run into the town I was living and back, but by the time I arrived home everything in my body hurt…EVERYTHING. It felt like my lungs were going to burst, I was drenched in sweat and it felt like someone had shot me in my shoulder. I had run 5 miles unwittingly and probably too fast at that. It was as awful as it was exciting. But you know what, that experience allowed me to appreciate all the changes I started to make from there on out, from more manageable mileage, to a tempered pace, to appropriate shoes, to shorts that didn’t chafe, to tech-T’s, etc. etc. etc. The “mistakes” I made didn’t kill me and won’t kill you either. And down the line, I continued to make mistakes and learn from them, feeling shin splints and getting advice on fixing them, and so on. It has made me a more knowledagble and effective runner.

Secondly, even after honing my body to run further and faster, I had an issue with running. When the gun went off..so did I. My second half-marathon I ran involved a first mile at 5:05 pace…which did NOT translate into my best race. My tendency to start off very quickly was noticed by my teammates and coach and after some simple suggestions, I learned to pace myself better, which ended up in many PR’s and podium finishes. The thing is, since making those mistakes and now knowing what that quickened pace FEELS like, I can now temper myself if I start off too quickly or better understand when I’m running past my limits. Those speedy mistakes and subsequent corrections, again, made me a better runner down the line.

Of course, there are things you certainly want to avoid in terms of not injuring yourself, but to be honest, the factors that can affect your running are many and I wouldn’t want to overlook anything specific. I can really only advise you to build slowly, listen to the messages your body is giving you and adjust accordingly. Making those small mistakes is one thing, but learning from them is the most important thing you can do to avoid making the bigger mistakes down the line. If a pain is not going away…back off until it does. If the pain gets worse, seek professional help to diagnose the issue and make the corrections so that running which has suddenly becomes hard, becomes easy again.

Remember, running is easy and you can keep it that way. But also remember that running is hard, and that’s what makes it so rewarding.

Trapped Inside

The temperature has been cold here lately. Genuinely cold. Brutally cold. -35 degree (F) wind chill cold…and I hate it. I don’t hate it, however, like most of Facebook hates it, complaining about putting on an extra layer just to drive to work in a heated car and into a heated office complex. Or how parents hate having to actually be parents and entertain their kids as day after day of school is called off. Or hating the cold because hating a change in temperature has become a self-fulfilling prophecy. No, I hate it because I can’t be in it.

One of my favorite rewards of being an everyday runner was experiencing the very subtle changes in the seasons, shifting from one range of temperature to another, taking in the smells and visuals that accompany these changes, and yes, finding out what it really feels like to run in the extremes of Summer and Winter.

The extremes of Summer have their own distinct forms of suffering – the sensation of breathing through a wet blanket, the chafing that comes with excessive sweating, the slow burn of sun on skin. But all that is relatively tolerable. Winter, on the other hand, isn’t so forgiving. There is both a physical preparation in figuring out just the right amount of clothing for any given temperature, but also a mental effort just to get out the door and hit that point in the run where pain and discomfort warm up, literally, to an invigorating pace. Then there are those negative wind chills, where any tiny bit of exposed skin burns with the pain often felt after getting stung by a wasp. There are ice drops that form and pull down at the end of eyelids. There are icicle stalagtites that shoot upward from the breath trying to escape your face mask. And there is, of course, the machismo that comes with the post-run brag about putting down another 10 miles when the city has warned everyone to stay inside for their own safety.

Honestly…I miss that. I miss those subtle shifts in the seasons and I miss those moments of extreme adversity that offer both new experiences and yet another opportunity to overcome. There is a reward that only a relative few of us know from forcing ourselves into those circumstances, from scoffing at the treadmill and preparing to do battle both against and in concert with the elements.

And damn I miss it, because I’m trapped inside.

Over two weeks have passed now since I ran my last 5 miles on the treadmill, confined to the indoors from the accumulated cold sensitivity of my latest chemo treatment. It’s funny, because I wrote that on my calendar, “5 miles”, as I decided to start keeping track of how much I end up running each week, as both encouragement for myself and to see how I’m handling each session of treatment. And although I planned on getting up the very next day to add another “5 miles” to the calendar, I knew the second I put my foot down that the day would be left blank. My feet were in pain. Great pain. I felt them a little on the treadmill the day before, but sometimes the hand and foot syndrome attacks me rather suddenly and intensely, and I’ve learned that when my feet feel a certain way in the morning, there is going to be no running that day…barely even any walking. Since that day my calendar has stayed blank. Not a step of running. And that’s when I realized I’m not only trapped inside from the cold sensitivity, hiding from the dangerously biting air, but that I’m now also trapped inside my own body.

The deterioration of my hands and feet has hit a point that I can’t simply grit my teeth and fight through. I can’t start running and hope the adrenaline numbs the pain. I can’t tell myself to suck it up and just go. This time it’s too much, far too much. This past week has been so incredibly bad that the moment I step out of bed I have to take incredibly soft steps just to get to the bathroom, to make my coffee, to somehow work up the will to go to work where I’ll be standing and moving on my feet all day. This is all very sudden and I’m trying to find a way to deal with this emotionally.

As I explained in a recent post, the side effects have gotten so bad that we had to take out one of the drugs from my infusion and alter my Xeloda schedule so that I can hopefully manage the pain and not become completely immobile. I know that sounds like an exaggeration, especially considering how much I’ve talked about running and being physically active in the recent month or two, but this has come on quite suddenly and put a little scare in me, to be quite honest. Each step, all day, is like walking on sandpaper, sharp pebbles, burning asphalt. If I step on any uneven surface in the morning, even a folded up towel after getting out of the shower, my body threatens to buckle under the pain. After some significant work to get my socks and shoes on as painlessly as possible, I can then at least move around for a couple hours with a little less abrasion, but the weight only builds on the pain until I’m seeking relief at any opportunity.

I’m still having trouble accepting that this is my body, that I’m breaking down like this. I’m a fucking distance runner, damnit. Just last week I inadvertently hit the buttons on my watch up against a box, triggering a sequence that brought up one of my last speed workouts prior to diagnose, that I had never erased.

5:30, 5:35, 5:26, 5:28, 5:24. Mile splits.

I looked at them with a mix of both excitement and pride, yet frustration and dejection. They were like reading the times of another runner, another person. It’s been that long and I’m not convinced I’ll get back there again, no matter how deep a fire still burns within this body. It’s a fire that is trapped inside me, continuously smothered by the accumulation of poisons that prevent me from using my body in the way I so desperately desire.

And yet, I still have complete freedom in my mind. I am entirely conscious, able to process and reconcile my situation, draw value from the experience and attempt to relate it to others. In that, I can hold onto some sense of not feeling trapped, of being able to progress in some way, mentally and emotionally if not physically. But that scares me too. Because I can’t bare to lose that.

My sister wrote a blog before and during her cancer experience, and one of the hardest parts was reading her last posts where the drugs were taking over her ability to communicate well, to be aware of her reality. It was consuming every part of her, even the seemingly untouchable part that lets us endure through some of those worst pains and depressions. I don’t want my mind to become as trapped as my body.

Last night was rough. I searched the internet for ways of alleviating my hand and foot syndrome, but the suggestions seem to be more akin to appeasement than actual solutions. On the contrary, the clinical descriptions of the symptoms were less hopeful and only stated that the pains would go away after the dosage was dropped or eliminated from the infusion schedule, something we haven’t done yet. And so my physical situation feels worse than it ever has at this point, at least as far as side effects go. I continued looking and stumbled across some blogs where people detailed their fruitless efforts at dealing with Xeloda side effects and as I continued down some of their worm holes I found myself reading story after story of physical digression, until some of the posts started to mimic my sister’s in their lack of lucidity. Their mind was going along with their body.

And there I had to stop. I went to bed fighting back tears brought on by a sense of futility.

I woke the next morning with very little relief in my hands and feet, spending the morning building the drive to get ready for work, to prepare for a day of physical activity that I knew was only going to get worse as I stayed on my feet. I felt trapped inside, in my body and in my circumstance…

But…well, there are small victories that I have to rely on right now. I tapped the Instagram community for suggestions on physical activity that doesn’t involve my hands and feet. It was suggested that I resort to swimming, but the water would only make things worse for me. Yoga was suggested, but ANY pressure on my hands and feet is out of the question. All I could think of was doing core exercises I used to do to supplement my running, and so that’s what I did. I pulled out my padded mat, turned up the metal and got a very small workout in that had me putting most of the weight on my butt and back instead of my hands and feet…so…that’s something. It’s not much, but at least it’s not giving up…and that’s something.

And when I got home after work today, when all I wanted to do was go to my bed and lay down, taking all the pressure off my useless feet, I decided that the 30 degree weather and the little will I had left to be physical would be well spent shoveling my elderly neighbor’s walk, if not only because she no longer has the ability to do so (something I’m trying to avoid), then at least to make myself feel a little less helpless. And so that’s what I did.

Now I wait. I wait to see how my feet will feel tomorrow. If I’ll wake up with bloody creases in my fingers again. If I’ll struggle to pull on my socks. If I’ll remain trapped inside, inside my own body, or if there will be a little more relief, a little light creeping under the door that might give me hope that I can get out of my indefinite state of relative helplessness and, even maybe, back into the cold winter air to remember what a biting air feels like on my ankles.

I genuinely hope you are of the sort that finds the same reward in loosing your chains to get outside, to feel the subtle changes of the seasons and to overcome the adversity when things get downright dangerous. I may be trapped inside right now, but I’m quietly cheering you on.

Smoking Doesn’t Cause Cancer

When I was first diagnosed with cancer it really took a lot of people by surprise, myself included of course, however, it seemed I was a little less caught off guard than others. I remember sitting in the parking lot immediately after that fateful doctor’s appointment and calmly thinking,

“Ok…I have cancer. I wonder what comes next.”

And that was it. I didn’t gnash my teeth, punch the steering wheel, break down into hysterics or anything like that. I just accepted it and moved on. Others, I came to find out, were a little more introspective, which is understandable. They didn’t have to figure out how to deal with cancer physically, but were left to just debate the how’s and why’s of it all. Admittedly, I didn’t realize just how many people were confused by my diagnosis and how deeply it affected some of them. Little by little though, friends and acquaintances of mine let on that they were really confused by the diagnosis and it really shook their perception of health, both in general and for themselves. A couple people even contacted me privately to inquire about my symptoms before diagnosis, afraid they might be dealing with a similar circumstance. Fortunately, nothing turned out as dire as expected.

The surprise and confusion others felt was related to the perception that I was “that healthy guy”, the one doing all the “right” things to avoid cancer. I was active, eating a vegan, primarily whole foods diet, etc. etc. For ME to get cancer was just absurd and, in some people’s minds, meant that they were all the more susceptible. Now, I’ve always taken every opportunity to negate the “bulletproof” health claims attributed to a plant-based diet, but it wasn’t lost on me that I was following all the suggestions related to diet and lifestyle in order to “fight cancer”. Eating more fruits and vegetables? Check. Getting at least 30 minutes of exercise 3 times a week? Try at least 60 minutes, 7 times a week. I was doing everything “right”.

But here I am with a scar that nearly cuts me in two, a body filled with poisons, and no end in sight.

So what went “wrong”?

Honestly….nothing. Nothing went “wrong”, the process of evolution and biological “imperfection” simply went “right”. That is to say, the process of cancering was triggered in me by a number of genetic misfirings that enabled my cancer to reproduce out of control, or from the perspective of my cancer, it subverted all my biological checks and balances and managed to succeed in winning the game of survivalism. It kept itself alive with a vigor that we all aspire to achieve amidst all the things that could go “wrong” in our existence. Just as the lion kills the lamb. Just as tornados wipe out entire towns. Just as pine trees choke out the sun from fledgling saplings. Just as armies kill invading armies. Just as surgeons slice out disease.

So does disease consume bodies.

There is no moral right or wrong to this process…it is simply a process of evolution and biological living and dying that is a tiny part of a much larger picture of existence, of population control, of genetic culling, of unconscious, unintentional reproduction. That’s it.

However, this idea of chance and circumstance and evolutionary biology has not resonated deep enough in our collective psyche to dissuade us from looking for an enemy, a singular force that uses cancer against us. We look for something to blame, to explain it all away and afford us the idea that we have some degree of control over this process, that we can know EXACTLY what to do in order to avoid getting cancer. And so we look for that singular enemy. Industrial pollution. Smoking. Carcinogens. Sugar. Meat. Nitrates. Stress. Coffee (ridiculous, I know). Etc. Etc. Etc. We want to believe that one thing or another CAUSES cancer, so that we have somewhere to point the finger and can explain away why people who do all the “right” things still get cancer.

I used to think this way as well. Before actually getting cancer I really didn’t understand the process of how it develops, but now that I’m in the thick of it, my knowledge has grown and I see the inadequacy and confusion popular culture inadvertently creates through addressing singular cancer causing agents. Most people are led to believe that individuals who smoke get cancer because they smoke. At best they are pitied, at worst they are vilified. We are led to believe that maybe drinking contaminated water creates cancer in people and so fingers are pointed at polluters and corporations (which isn’t the worst thing if you ask me). We are led to believe that any one lifestyle habit creates cancer and so it’s the fault of the person who gets cancer that it happened. There is one problem to this though.

People who smoke their entire lives often don’t get cancer. Notice I said “Often”. That’s because, statistically, those that smoke their entire lives and don’t get cancer are not anomalies….they are the norm. And people who eat hot dogs in excessive proportions don’t often get cancer. And people who are glued to cell phones, live under electrical wires, drink suspect water, etc., don’t often get cancer. Statistically, it has been shown that any ONE factor simply doesn’t CREATE cancer.

I read a quote recently that said, “We don’t get cancer…we are always cancer-ing”, which is to say that cancer is a PROCESS. We ALL have cancer cells in our body that are reproducing, but we have biological checks and balances that reign in the growth and kill the reproducing cells. The problem begins when those walls of defense against cancer growth are somehow subverted, and not just ONE wall, but multiple walls of defense.

Cancer cells reproduce out of control when an aggravating factor leads to a genetic misfiring, or informational signals between cells get crossed, and then happens again, and then again, and then again, and then again….and suddenly cancer cells become “Cancer”. They go from being small C cancer to big C Cancer. But it doesn’t just happen because a person smoked cigarettes and the toxins in the cigarettes somehow caused cancer to simply form and grow. And that’s why I say, “Smoking doesn’t cause cancer.” Smoking is a proven aggravator to cancer reproduction, but it isn’t THE factor, because it is merely ONE aggravator among a handful of other aggravators….and in that is why cancer is so seemingly impossible to “cure” in the way we’ve almost cured Polio.

We can’t simply find ONE enemy that creates cancer and legislate against it, or find ONE drug that stops cancer from reproducing, because it is seemingly more than one disease….it is like a unique disease to every individual unfortunate enough to have all the misfirings lead to full blown cancer. And finding out what those misfirings are in each individual is a, as of now, impossible puzzle to decipher. That, of course, doesn’t mean we shouldn’t try.

This awareness that cancer is unique to each individual and is caused by so many misfirings or genetic abnormalities, however, helps me to reconcile the fact that there are those of us that happen to “do all the right things” and still get cancer. Yes, certain lifestyle habits aggravate cancer reproduction and increase the probability of getting full blown cancer, and I would never advocate smoking, eating animals, drinking contaminated water, living next to nuclear reactors or any other such habit, but to singularly blame one factor or another is misunderstanding how cancer reproduces and leads to a lot of confusion and heartache for those that are unfortunate enough to get it.

I DO understand why friends and acquaintances want to explain away my cancer, want and almost NEED to find an enemy to point to…because I think it not only helps them reconcile my situation, but also gives them some comfort in relation to their own circumstance, to convince themselves that they will most likely not get cancer because they didn’t grow up where I did, or don’t engage in some of the lifestyle habits I do. Unfortunately, this is just an act of appeasement and doesn’t address the specifics of the biological process of cancer reproduction, but then again, when it seems like we are just banging our heads against a wall of ineffective treatment and only episodic “cures”, it’s understandable that we are compelled to seek some manner of control and reconciliation with this losing battle against evolutionary checks and balances.

Trust me, I fault no one in this perspective. Until I had to face it head on, I grasped onto the same simplistic justifications to explain why cancer rates continue to rise, why my sister died, and why my friends continue to get cancer.

It’s much easier, and human nature, to point a finger at the intentions of an enemy or conscious force than it is to just accept that we live in an abstractly defined “imperfect” world, that we are pushed and pulled by forces beyond our control, and that we are merely physical beings subject to all the processes of a physical world that we arbitrarily define as good or bad. Sometimes “bad” things happen and we have no comfortable grounding or perspective to make sense of it…and that’s just how it is.

Everything happens without a reason.

This Is What I Do Now

My oncologist has an unfortunate facial feature, or perhaps it is only unfortunate for his patients. When he talks, the corners of his mouth turn up and his teeth show through slightly, giving the impression that he is enjoying the information he is offering you, unable to stifle a smile. I’ve noticed this accidental smile when during previous meetings I have found myself almost smiling back, despite the information he gives me being nothing to smile at. Often, quite the opposite.

Today was no exception.

I walked in for my 11th of 12 scheduled infusions, though if I’m to be totally candid, I assumed that my infusions were not going to stop at 12. That didn’t keep me from getting lost in my daydreams for the week leading up to this post-CT scan meeting. I not only thought about a meeting that ended in legitimate smiles, but even let myself get carried away in the emotional wave of it all. I envisioned my oncologist bringing in other doctors to help deliver the news, exclamations of an astonishing and dumbfounding reduction in my cancer, plans for a final surgery, and continued expressions of my singular and unique recovery from the edge of the cancer cliff. I let myself get so carried away that I almost started to believe it was a possibility, a probably reality, though I’ve always seemed to recognize that if I’ve even imagined something so grand it’s more than likely not going to happen, as if I’ve jinxed myself simply by considering the extravagance of it all.

When my doctor began the meeting with the same formalities as before, I knew my daydreams were just that, dreams. I could only hope a more dire revealing wasn’t to come.

We talked briefly about my recent travels and general activities, this time confiding that I haven’t been able to run much at all due to heightened side effects from treatment. He distractedly responded as he typed away at the computer screen positioned to his side. I told him about how useless my hands can get. I told him about the sensitivity to the cold. I told him about the dead spots in my feet and how they feel as if they’ve completely fallen asleep now. I didn’t try to brush aside the complications in an effort to continue working through them. I was tired of it and I wanted to let him know.

All this was enough to trigger a change in treatment without hesitation as he quickly explained we would immediately take away the Oxaliplatin to reduce side effect accumulation. For this treatment and the next we would give my body a break from the onslaught, eliminating the cold sensitivity, part of the hand and foot syndrome, the nausea, and other effects I might have forgotten about beneath all the other discomfort. Oxaliplatin is the drug that attacks not only the cancer cells, but all the cells in the body, bad or good, leading to so much deterioration where problems didn’t previously exist. The consideration, of course, is if taking away this drug is going to allow the cancer to take hold elsewhere or give it free reign to grow. I am still administered Avastin, which is a drug that targets the cancer cells only (we hope) and so doesn’t wreak so much havoc in the rest of the body.

Further, we are also adjusting my Xeloda (chemo pills) schedule, so that I am only taking them one week on then one week off, and repeating until a change is needed. This will give me another form of respite from the deteriorating effects of these drugs.

I was relieved to hear I have a break from the discomfort, a period of healing that will hopefully allow my skin to grow back on my hands and feet, the pain to fade away and maybe a strength to take its place that will allow me to run more consistently again. Admittedly, I don’t know how this is going to play out, but I can tell you that I feel as if I skipped my infusion all together today with only the Avastin deliver in a quick 30 minute session. Minimized is the cold sensitivity, gone is the overwhelming feeling of grossness and nausea, the horrible taste in my mouth, the cold sweats, the fatigue. Now I just wait for the other effects to dissipate in the coming days and weeks. I hope. I’m not sure how this is going to play out.

We then talked about the scan itself, and just as I suspected, nothing was different. His inadvertent smile may have been more genuine when he explained that no cancer was found anywhere else in the body and although no reduction was found, neither was any growth. We are still completely “stable”. The cancer is a strong foe, but I suppose my body’s defenses in conjunction with the chemotherapy treatments are equally as strong. SOMETHING is working. It’s a little disconcerting, despite his smiling words, but he again let on that most people with stomach cancer don’t respond to the treatments, implying that the cancer usually grows, so it follows that we have something to smile about considering that mine is just in a holding pattern. My excitement at this news has become tempered, worn thin.

Without dwelling on this repeated diagnosis I asked the question pressing more heavily on my patience, “So we scheduled 12 of these treatments…since the cancer has stayed the same…what happens after the 12th? Do we keep doing this or is there a possibility for surgery? Or is this just indefinite?”

This is where I could have gone without the accidental smiling.

“Well, we know Dr. Arregui (my surgical oncologist) had problems removing the cancer at this point, and most people just don’t respond to the treatments, so right now we are in a “management phase”. We will follow up with Dr. Arregui in a couple months, but while we keep the cancer at bay, this is what we will continue to do. If the cancer starts to grow, we will add another medicine, but as long as it stays how it is, we will continue this management indefinitely.”

Indefinitely. That word was like a kick to my stomach.

I felt an initial sense of relief that I had an answer from him, a projected plan of sorts that gave me a sense of what to expect for the time being, but quickly it turned into an unavoidable dread that this is now WHAT I DO. I’m a chemo patient. There is no part of my daydream to draw from. There is no triumphant return to running. There is no sense of relief that I can just let go and feel my old life again. There is no seemingly miraculous turnaround. This is just what I do. I get chemotherapy until something happens either way. This is what. I. Do.

Forgive me for my lack of clarity in this realization or an absence of reconciliation….right now I’m still struggling to internalize that for the time being, into a future I can’t see, this is just what I do. I am, again, left with a number of NEW questions to consider as I wait through this process again. What are the chances my cancer will grow? What will my quality of life be like with reduced side effects, how much of my old life can I get back? How often will we reintroduce the more debilitating chemo drugs? How do I conduct my life from this point? What is worth pursuing and what do I need to leave behind? This is, for the time being, what I do….but what does that mean for who I am?

I didn’t want this. In a more desperate state I wanted to be told that I would either live indefinitely, or die definitely…that way I could at least make a solid decision about my life and start from there, but again, I’m left in a sort of limbo, as if I have more questions unanswered than answered. The only definitive I have at this point is that chemotherapy is what I do.

There are positives in this scenario, I know. My foundational circumstance is still that I am here to even have these considerations, and I will surely address them soon, but for now, I need the time to really sift through what my life has become and how I take this realization and get the most out of it. Honestly, Im’ not sure what that is right now, and I have no choice but to leave it at that until I figure it all out.

In the meantime…I guess this is what I’ll keep doing. Time to drop my head and push forward.

The Love of Losing

Let me tell you a little secret about elite runners…we’re completely scared of running.

Well, we’re scared of failing at running…and more specifically, of GIVING UP on running. We’re ultimately scared of ourselves. We love running, don’t get me wrong, and we love training, putting in 20 milers on the weekends before most of the world wakes up, pushing ourselves to complete mental and physical exhaustion during speed workouts, repeating the simple act of putting one foot in front of the other for days into weeks into months into years, and even the sensation of completely freaking out for the days leading up to any specific goal race (or any race for that matter actually). We love it, just like any other runner, we love it all. Hell, we HAVE to love it if we’re going to put that much effort into an activity that affords us very little external reward than the satisfaction of simply doing so.

But equally, we’re just as scared as anyone else of STOPPING running.

We can’t imagine our lives without it, but the impetus to stop running…to just leave our shoes next to the door, to pull the covers over our head every morning, to spend the day relaxing while we drink coffee, read books or any of those other normal, passive activities…well, the siren call is quite strong. Very strong.

And we’re scared of our willingness to listen to that siren call of warm beds and heavy blankets and just simply NOT RUN. It scares us so much that we, in a way, punish ourselves for even considering it. Or we scream at ourselves so loudly that we try to drown out the siren call before it even gets close to our ears. Personally, I’ve lost count of the times I’ve berated myself for not getting up as early as possible to get my run in before the day starts, only to see other runners pounding the pavement, and then almost angrily drive home to throw on my shoes and get back into the streets. I see the same drive in my friends, teammates, and social media friends who walk back and forth on the planks of guilt for thinking of running and not doing so, or who fill their character limits with motivational quotes that speak more of convincing themselves to go run than inspiring others to do so.

It’s funny, because we berate ourselves again and again in fear that if we just take it easy, sleep in this morning, or do something that is entirely NOT RUNNING, that we may never do it again! We’ll just quit on the spot and start using the phrase “…once a runner” instead of “Once a runner…”. But we also know, deep down, that this is entirely absurd. In the moment we freak out…

“Oh god…I don’t feel like running today. I’m just tired. I’m unmotivated. I just can’t imagine getting out there and starting to run. Shit…I’m done. It’s over. I’ve given up. I can’t keep this up anymore. I’m burned out.” Etc. etc. etc.

But give that person one day…just ONE DAY without running…and all of a sudden the messages and tone becomes the exact opposite…

“I gotta run! I love it! I’m getting faster! I’m running further! I can’t imagine anything else I’d rather be doing!”

And so on. The pendulum swings back and forth, something that feels like both a blessing and curse depending upon which direction it’s swinging.

I was certainly no different in these considerations. I was angry with myself when I skipped out on a morning run more out of fatigue and laziness rather than injury or rest day. I berated myself for justifying taking a day off here and there under false pretenses. I was scared of quitting, of letting myself sink back into my warm bed in the morning and then never getting out again, drawn in by the comfort and ease of passivity.

And now…well, I AM scared of that same consideration…this time forced into a state of relative passivity, of deteriorating running fitness, compromised strength and unpredictable inconsistency. There is no way around it, and although I can recognize these obstacles thrown in front of my desire to run as unavoidable and not of my own making, they don’t help ease my concern that I could just quit if I wanted to or that I’ll never regain the fire that woke me up every morning for years to put in absurd amounts of miles and speed trying to reach my lofty running goals.

Though, I’ll tell you, I’ve come to understand something from this unique position of looking back at my running…it’s ridiculous. That fire doesn’t die. It may lose fuel as we burn it, but regenerates stronger with every flickering…and that fear of quitting isn’t because we actually doubt ourselves or that we WANT to quit…it’s there because we desperately DON’T want to quit.

We’re scared of quitting running because of how much value it adds to our lives, how much satisfaction we get from it, how it essentially completes us and feeds into the core of our being. It’s something to LOSE, and so when we decide that for some temporary period we don’t want to run, we inevitably fear that we are going to lose something we so intensely want to keep.

It’s the pain of true love.

From my new disadvantaged position in life (or advantaged depending on how we look at it) I’ve come to really feel the fear of losing. There were times when, throughout this cancer experience, I didn’t really feel like I had a lot to lose and so could go about the process without much emotional struggle, but as I came to recognize more and more that I had and wanted to hold onto, it became a catch-22. I now had great things in my life, but now also had them to lose in death. It’s the love of a child. The love in a relationship. The love of an incomplete process.

And our love of running is no different. We so desperately want to hold onto it, to never lose it, that we fear ourselves and our desires to quit.

But here I am, really unable to run anymore. Yeah, I run, a maximum of 5 miles at a time, inconsistently, and not near the speed or ease that I used to be able to…and where I have a VERY COMPELLING reason to stop running, where I can choose to “take it easy” every morning, or pull the covers over my head from here on out…and although most of the time I’m forced to do that…the fire inside still burns strong…very strong, making me realize how ridiculous it is to actually think we can quit this thing called competitive running. Yeah, taking the easy way out every once in a while is enticing and we do engage in it from time to time, but the concern that doing so means we’re done, we’re through, washed up..well…that’s just ridiculous.

‘Cause I’ll tell you something, I can barely run right now and I still don’t know what my future holds, but I can tell you that the second I’m either cleared of cancer or the chemo that is preventing me from running is halted, I’m going to take off out the door like I’ve been in a starting position since last April. There is simply no quitting. No comfortable passivity can ever outlast the desire, reward and value of getting out there to run, to feel post-workout satisfied fatigue, of crashing through the woods, of all the frustration and accomplishment that comprises this drive within us.

Believe me, I understand the fear of quitting, the self-flagellation, the siren songs of warm beds and soft pillows, but I now also know these competing desires come from a position of having something we can’t bare to consider losing….because right now I’ve all but lost that love…but that fire still stays burning deep inside, and the heat is far warmer than any number of blankets piled on top of me.

Friends, it’s ok to fear losing what you love (and sometimes beat yourself up over it), but always know the value of having something so great that it instills such a fear.

The Good Year

“This is the New Year and I don’t feel any different.”

This is that time where we all make our general, blanket statements about the past 365 days based on some arbitrary timeline. We try and diffuse all the complexity into a sentence or two, giving a thumbs up or thumbs down to the past year…because most of us have that privilege. Then we tend to make plans for the future that, let’s be real here, move to the back burner and then fall off the back of the stove just a few weeks later when the reality of our daily drudgeries comes to the forefront. Granted, there are successes from time to time, “resolutions” that stick, promises to make it to the gym kept relatively intact…but often we just try to keep pushing on and enjoy ourselves as best we can. I see no fault in that.

And so I make no resolutions yet again. Though I’ll tell you, where most people want to “lose a few pounds”, I’d really enjoy the same, though my weight would be cellular if you know what I mean.

I will, however, make a general, blanket statement about the past year.

It was good. It was very good.

And this is awkward to reconcile.

Let’s not romanticize this circumstance though. Physically..this year sucked. SUCKED. SUCKED. SUCKED. Just as soon as it had started, just as soon as I had begun digging myself out from my dark emotional hole of 2012, fittingly through morning runs under equally darkened skies, things started to really go wrong. Despite winning that frigid nighttime trail marathon, despite finishing off my racing with another trail win, despite finally breaking into the spring weather with epic strides through the forest…everything fell apart. And it has, understandably, only gotten worse.

With each passing chemo treatment I have had to fight harder and harder to keep some consistency to my physical existence, trying to run at every available opportunity and resorting to the bike trainer when running wasn’t an option. And still things fall apart. My hands continue to slowly deteriorate after each chemo treatment, making tieing my shoes, turning on lights, and any small task that involves pressure to my hands incredibly difficult. My stomach still processes any foods slowly and sometimes painfully as the various meds I’m taking make digestion something less than quickened. My feet push back against the forces I put down upon them, layers of skin seemingly not regenerating, discoloration now almost permanent, and a new tingling “pins and needles” sensation that has yet to subside since the last treatment over a week ago. The morning routine of expelling sinus bleeding continues on without reprieve…and the cold sensitivity…ugh, the cold sensitivity. I’m essentially confined to the indoors now, with any temperature around 70 degrees being too chilled for my body to bear comfortably, my hands filling with a numbness and feeling of electric shock as I dream of warmer weather and humid climates. And so on….you’ve heard me talk about all this before..

And yet…I’m continually amazed at my body’s ability to recover from these subsequent poisonings, as if it is learning this new routine of stresses and adapting each time, like it’s still in marathon training mode where each breakdown is followed by an even stronger regeneration. With each passing treatment I’m able to recover to some degree and prepare for the next…until I can finally be done with these awful experiences. And so that part is good.

But that’s not why this past year was good. That’s just the physical struggle that still has to be carried out to it’s ultimate conclusion…whatever that may be.

This year was good…exceptionally good…because this experience has afforded me the ability to better myself, to receive so much care and support from family and friends across the country and world, and to simply appreciate my existence to a degree I had previously not found.

To be succinct, this year wasn’t just good…it was awesome.

It was awesome to understand just how many people I have been able to influence through my running and writing, even if those efforts were primarily selfish and not intentionally directed at others….still…to be able to offer something to others just through my normal expressions and ways of living is incredibly rewarding.

It was awesome because I developed very meaningful friendships with people I have never met (and STILL haven’t met) as we struggle through similar physical circumstances and offer encouragement and perspective through each other’s individual paths.

It was awesome because the friends who always cared for me stepped up and continued to care for me in any way they possibly could, allowing me to feel the value of our friendship to a much deeper degree.

It was awesome because the friends who always sat on the periphery of my individual circle made efforts to step further in and become the friends I can rely on even deeper and be those with who I can share my own experiences.

It was awesome because through all the potential obstacles a circumstance like this can create in one’s life, I was still able to keep some semblance of my routines, to hold onto my house for me and my son, to get back to working a job (part-time at least), and to continue developing my design skills in hopes of making it a career down the road.

It was awesome because it allowed me to really appreciate the love and support I’ve received from others and open me up to giving it back as much as I possibly can, essentially breaking through that toughened wall of identity and accumulated expectations, and begin to shape my life in ways that are both rewarding for me and the same for others. I have learned to take in as much positivity as possible and restrict myself from giving out so much negativity.

It was awesome because despite all the seemingly insurmountable mountains placed in my line of sight, I can still see beyond them to some sort of horizon and even begin living out aspects of life that lead to a drawn out future past cancer. I can see a relationship. I can see my son’s accomplishments. I can see running.

Of course, I could go on. And I could also give into the somewhat negative and, in a way, regenerative statements of, “Good riddance 2013…here’s to a better 2014!”….but I won’t. Because it wouldn’t necessarily be true.

I will be as succinct as possible though. In the typical manner of generalizations…this past year was awesome. I got cancer, yes….but I got a lot more at the same time. And although I wish I could join some of you in your expressions of resolution, of “losing weight…starting now”, and saying in concert, “This year I’m going to get rid of my cancer!”…well…it just doesn’t work that way. But I can tell you this…I do have SOME control over my existence, both physical and emotional, and just as every year in the past, I’m going to continue trying to maximize both, drawing the best from every moment and creating the most rewarding experiences for myself and every human and non-human animal I can effect.

Arbitrary timelines not withstanding, the past 365 days have been really awesome and there is no reason not to make any future timeline all the same. Come what may, let’s live all out.