Come What May

Ok…..deep breath.

I drove my son and I to the appointment with my oncologist this morning, navigating roads through a windshield smeared with a rain so cold it verged on freezing into snow. The wind shook the car, turned pedestrian umbrellas into catchers rather than deflectors, and seemingly tried to prevent us from actually entering the hospital once we parked and walked, leaning forward just to stay upright, into the entrance doors. I would like to say that was the most difficult part of our day, but the warmth of the waiting room interior was a deceptive comfort to the information I would soon be given.

August and I sat relatively silent in the exam room, when the crack of the door internally jolted me, and my smiling oncologist walked in. My startling conveyed more about the suppressed tension I held in my body than I was acknowledging. We shook hands, moved through our typical friendly small talk, and then quickly got down to business.

I relayed the pains I was feeling again and said, somewhat cautiously,

“No disrespect to your practice, but when I looked online, I’m pretty confident I have an enlarged spleen by the symptoms I’m feeling.”

He countered immediately,

“Well you definitely DON’T have an enlarged spleen…”

and then went on to explain the results of the MRI more in depth, then the secondary tests we did for amylase and some other measurement that escapes me right now. Everything looked great. He reiterated that tumor growth was still relatively stable, and any growth they could detect was negligible.

But there was that significant, seemingly increasing, pain that prevents me from eating fully, comfortably, or even move throughout the day with ease. Something, I knew, was more than just difficult. Something was wrong.

In hindsight, I got the sense he knew what was going on prior to our discussion, but wanted more confirmation before he gave a specific diagnosis, rightfully, scientifically, so. He pulled out a diagram of a stomach, liver, gallbladder, and then drew in the spleen, areas of tumor growth difficulty, some arteries, and began explaining.

To be honest, I won’t try to recreate the exact processes going on in my body, but his speculation is that I had formed a number of gallstones in my gall bladder, that were causing significant discomfort and potential blockages around my stomach. He then considered the potential of the gallstones working in concert with tumor pressure near the spleen, around the stomach, and finally discussed the systemic workings of the pancreas and a potential problem there related to blood flow, compressed arteries and some how that relating to the gallstones. Honestly…I don’t know…the inner workings of the body are complex.

August messed around with Minecraft on his iPad and listened in from time to time while the oncologist started talking treatment specifics.

He wanted to give me an ultrasound to look into the idea of gallstones as the primary consideration for my pain, which he referenced on the diagram he showed me, drawing all sorts of relationships through lines and circles and notes. In the end, it looked like he had drawn out a play for the last push to win the Super Bowl.

“Ok, we’ll send the spleen around right, drop back into the gallstones, sever off the pancreas line, then throw a hail mary into the liver, and…touchdown!”

Well, not really, but you know what I’m saying.

What he really said was, “I need to make a compromise with you.”

See, my oncologist is leaving the country for a conference and vacation with his family. This is part of the reason they pushed back my surgery another couple of months, which although sounds kinda crazy and insensitive, the plus side is that they were able to push my surgery back precisely because I was doing so well…until I wasn’t. But up until now, I had no cause for immediate concern, with no tumor growth, no life-threatening difficulties, no nothing really.

I told him I understood his need to go on vacation.

“Look, I completely understand you actually have a life outside of your work and you need to do what you need for your family. I hold no frustration against you for that. And if all I had to do was deal with the pain until the surgery, I would, but my concern is that my difficulty in eating is going to lead to decreased weight and strength, which I know isn’t good for the surgery or recovery.”

He agreed, completely. He said I was right to have these concerns and this is the reason he wants to compromise for me.

He said he is going to push my surgery date forward, and he will do the surgery, but he won’t be there for my recovery. One of the other doctors that works with him and performs the same extensive HIPEC surgery is going to assist the operation, but he won’t be there for the recovery. I saw no reason for concern, but he assured me that he trusts the other doctors.

The bigger problem he said, is the surgery itself. HIPEC is so extensive and can involve so many complications that many doctors aren’t doing it anymore. There is even difficulty in convincing new doctors to enter into the procedure, which I’m aware of as the number of oncologists that will actually perform the operation are problematically small. I’m beyond fortunate that my oncologist is here, in my state, in my city. The only other reputable oncologists for the HIPEC operation of which I’m aware are in Pittsburgh and the UK. He even let on that he isn’t taking anymore patients for this surgery, because of it’s intensive, difficult nature.

So yeah, there is cause for concern in relation to the recovery. He conveyed a story about a patient who had the HIPEC operation, successfully, and the oncologist had to leave, but then an infection or similar problem arose and the patient died..or well, as he put it, “It didn’t end well”…while he was away, which he feels terrible about.

So that’s the compromise…the surgery will be performed by my oncologist, but I’ll be in the hands of his trusted colleagues for the recovery. Considering what I was about to find out…it’s not really a compromise at all. I’ll take it.

We left into the exam room and walked to another small room for the ultrasound. Spoiler alert, I’m not pregnant! August watched the computer monitor as he rubbed the cold jelly around my abdomen, looking into various organs, measuring tumors, and trying to get a definitive sense of what was going on. He was absolutely great with August, having him come to the screen and explaining the entire process, answering all of his 9 year old questions and making jokes all the same. And August had me beaming the proud dad with his insightful questions and understanding. At one point the doctor said in surprise,

“Wow. You understand this better than my residents!”

Very quickly in the procedure his concerns were confirmed. The gallstones were readily visible in the ultrasound, of which couldn’t be detected in the MRI, and this led to a number of other concerns, the worst being pancreatitis. Again, I’m not going to labor into the details of the relation between the two, but I could tell the concern was real and relatively immediate.

Then it was Auggie’s turn for an ultra sound…no, really. He had August get up on the table, rolled the device around his stomach, and took a handful of screenshots to print out and give as one of the most unique souvenirs I can imagine. I was so grateful he engaged with August in this way, relieving any unexpressed fears he might be harboring about the whole situation, or at least distracting him from tedious adult medical practice boredom.

We began talking about what he saw, namely the problem of pancreatitis, which I could tell escalated the response to my pains. I still don’t know how the process plays out, but my pains are increasing warning signs towards pancreatitis, which is life threatening. From what I could gather, there is no option to wait two months for surgery, which is why we’ve scheduled the surgery for January 12th, two weeks from today.

It’s hard to say I’m relieved about that, but in a way, it’s good to know we’ll get this inevitable process on and I can move to the next period of life where I might be getting away from this yet again….might.

I don’t know, I’ve long stopped expecting a plan. I mean, you’re moving along with cancer like everything is just a mental exercise towards the physical surgery, and then BAM, you’re being told you’re actually residing in a place of high risk for a life threatening sickness that can pounce quite quickly. Who knew? Obviously, I didn’t.

I pryed him with a few more questions about pancreatitis specifically. Can it come on suddenly? I mean, does it just take me out right away? What can I do to not aggravate the situation? And so on.

He didn’t belabor the point, but I could tell through his expression and seriousness that it can be bad, like real bad, like real quick. I mean, from my web research, I don’t think you just drop dead walking to the mailbox, but it’s nothing you wanna stick around and wait out either.

Which is why I found it somewhat amusing that the scheduler asked me, “Is January 12th ok?” As if I had a choice. I looked pensively and said, “Let me think. January 12th? Well..I mean…it’s not like I have a choice I think. Of course, I’m just thinking about who I might need to tell. But yeah, January 12th. That’s fine.”

August and I took our ultrasound photos, gathered our coats, and walked out of the office, into the hallway, and back into the biting, cold rain and wind. And I walked back into an entirely new consideration for my time ahead, of which I can’t even really imagine anymore…again.

Oh…and I forgot. Chemo. Shit. Did I forget or am trying not to remember?

The best case scenario for surgery will most likely require post-operative chemotherapy, as in systemic chemo, as in back to that horrendous life I had to live for a year after my first surgery, with the side effects that completely ruined me.

The best case scenario involves the doctor removing my gall bladder (a guarantee this time), a possible spleenectomy (and temporary colostomy bag…hopefully temporary), and complete removal of all remaining tumors. Considering the tumors are tucked behind my spleen, behind my stomach, and in other difficult to reach areas, complete removal isn’t a definitive, it’s just a hope. But if they are removed, that pretty much ensures systemic chemotherapy for a while, which will help eradicate the “stragglers”, or the little cancer cells that can’t be detected, but will inevitably grow back into tumorous masses. My tumors are enough and tough enough right now that systemic cancer can’t do anything to them, while the surgery can, but if we get rid of all them, then systemic chemo steps in to finish the job. That is, somehow, the best case scenario.

And right now I don’t have the energy to consider what that means for my life after surgery. I’m not even imagining now. With two weeks to surgery, I don’t even really have the time. I need to be with August this week, then double up on work focus and get my loose ends tied before going back into the hospital.

And that’s that. This feels familiar, and that feels disconcerting.

And THAT’S cancer. This crazy shifting of comfort levels, of moving through your days as if nothing is happening inside you, even if only because you can’t feel it, until, well, you can feel it. It’s 180’s when everything was moving dead ahead. It’s having no floor beneath you when you thought you were on solid ground.

And then it’s adapting. It’s coming to terms with no degree of routine or expectation, and only THAT being your expectation. With that realization comes a certain readiness, a cat in pounce mode, an always being on your toes sort of defensive posture, where you steel yourself against what seems to be an inevitable attack on your body, your psyche, your emotional stability, and ultimately your life. So you prepare for anything to happen, and when it eventually does, you adapt. You readjust and keep moving forward, as much as is in your control, to keep your emotional life together. To keep your financial life together. And then to keep your physical life together. Those seem to be the only simplistic battles worth fighting anymore. We tend to whittle away the excess, the petty problems, the extraneous considerations, the abstract absurdities of shopping malls, celebrity culture, diet fads, and Facebook arguments, until we are left with the ultimate battle of reward versus risk.

Well, that’s how I tend to navigate the world anyways, in part because I want to, and in part because cancer has compelled me to.

So I’m back here again. Not just entering surgery to manage the cancer, but entering it abruptly to avoid some manner of dying. And yet, here’s the good news, I can still run for the next two weeks. And August is here for one more week, so if you’ll excuse me, I have some more non-cancerous living to get back to. And then, chance and surgical skill willing,  I have more life to get back to living…come what may.

Biology Always Wins

I had committed to writing more creatively again, as I felt I had gotten away from the practice, whether relate to running or cancer. I seemed to have gotten mired in squeezing out blog posts in between jobs, rushed and semi-frantic, while also detailing the physical mundanities of cancer and running rather than the general experience and considerations. I had committed to doing so, and then I felt a pain in my side.

It wasn’t an abrupt pain, but slowly built over the past few weeks, until I had been sufficiently drug back into the physical reality of cancer again, necessitating a great deal of hypothesizing what was going on inside my body, scouring the web for any reliable correlation of symptoms, and probably annoying Laura by thinking out loud about what was happening inside me throughout the day.

It’s hard to pinpoint exactly when the first sign of a more serious issue was felt, but while going through sufficient run training, any little issue in the body is often ignored as it can usually be related to training stresses, disappearing in a day or so. This pain, located on the side of my abdomen and tucked under my rib cage, didn’t go away. It came and went throughout the day, but tended to increase in intensity when it did show itself. I did what I often do with running stresses, I evaluated the trends.

First, it didn’t really hang around in the morning. I could feel it at the beginning of my runs when I took deep inhales, but it subsided by the time the run was over. Then, after eating my daily bowl of oatmeal, I could definitely feel the pain as the food moved through the first portion of my digestive tract. As it passed by the problematic area, the pain would heighten and then slowly disappear, until I tried to eat again later in the day.

Then, as a week or two went by, I noticed the pain becoming more and more pointed, especially after eating in the morning and then lingering towards lunch. I didn’t instantly cry cancer, but I started going through the considerations again. I mean, anytime I feel an aberration in my physical state, I no longer think much but cancer. It’s essentially impossible. And couple the pain with my abdominal area, and what else could it be?

But I was waiting for my MRI results, so there was no point in really evaluating the situation until I heard back. But, of course, I didn’t hear back (as relayed in the previous post). And the pain increased yet again. By this point, I could tell something was definitely out of the ordinary and the degree of pain had reached something of a fight or flight degree, where no matter what hopeful distractions I offered to myself, I felt more and more compelled to seek help.

The patterns continued. I could run in the morning with minimal issue, then as soon as I had breakfast, I was in trouble. The pain had me wincing and clenching my fists. I tried not to bother Laura with my discomfort, but it was too obvious to just let pass without reassurance. Then, as the day wore on and I continued to eat normally, the pain barely subsided, and breathing became more and more difficult right after meals. I would hold my breath until each spasm or shock of pain filled my side, sometimes radiating around my back, and finally surging into my shoulder of all places. Sleeping at night was difficult as I struggled to find a position that didn’t aggravate the discomfort. Couple the restless nights with unpredictable bathroom visits and I was drug back to my days of pre-diagnosis.

Again, I couldn’t help but cry cancer, though after finally getting results from my MRI back, which didn’t show any significant tumor growth, I didn’t know what else could be the case. I had a follow up scheduled with my oncologist so he could physically examine me as we waited for more blood test results to come back, wondering if my digestive enzymes were in crisis and causing the pain.

With a trip to North Carolina for Xmas and a visit with my son scheduled, there was no option to stay home and be close to the emergency room should things get really out of control. Laura and I drove to her parents and went about everything as usual, but that night the little food I ate, despite the deep hunger I should have been feeling, but didn’t, spiked everything to a new level of pain. I went off by myself to ride out the intensity, wondering if I should have stayed home, and figured out contingency plans should I end up in a North Carolina emergency room. After some considerable time, I was able to handle the pain and managed some sense of normalcy within spasms, at which point I took to the internet.

Looking through images of human biology I narrowed the location down the to the spleen, then looking up “spleen pain”, or something like that, I came across a pretty exact description of the pain, an amateur diagnosis solidified by the description of pain radiating into the shoulder. Without an official diagnosis given yet, I’m 95% to 99% sure I have an enlarged spleen.

Essentially, what is happening, is that for a number of reasons I can’t determine at this point, but can be related to cancer processes, my spleen is enlarged, so whenever I eat, any food moving through digestive tract is getting backed up or pushed by and into the spleen, causing significant pain. Obviously, there are many other concerns to this. Does the spleen keep enlarging? Why is it enlarging? What happens if it ruptures? How quickly am I going to lose weight now that I’m barely hungry? When I do eat, which foods cause the least amount of pain and can I get enough calories to remain stable? And on and on.

Further research shows that an enlarged spleen can be caused by cancer spreading or from overworking to fight anti-bodies or expel blood cells. These are all cancer related causes, but there is no way for me to tell what’s going on from just my own assessment. All I can do is be careful with eating, while actually trying to eat as the sensation of being neither hungry or full is quite awkward, and wait for the appointment with my oncologist…then who knows what.

Will he determine I just need to wait it out for 2 months? Will he prescribe an immediate spleenectomy? Are there pills for this?

I don’t know, but I am relieved to be home and waiting out the next xmas day with my son until I can get a plan of action.

But in the meantime, my comfort has been shaken once again, dragging me abruptly back into the world of cancer, where before I was just running along, literally, into my next surgery where I could pretend I’d be so much further away from 180’s like this.

I’m not the normal cancer patient…I keep telling myself. My cancer is rare. It grows abnormally. I’m succeeding in ways other cases have not. I’m thriving in ways others haven’t. So it’s easy to get lulled into this somewhat delusional state that I’m just living with cancer, or just living with the yearly interruption of necessary surgery, instead of walking on eggshells that many patients find themselves doing, wondering when the other shoe is going to drop.

I’ve been there, barely thinking past the next two months, really unsure what to expect no matter how good things are going, and as I’ve expressed before, that’s an emotionally dangerous place to be. It’s a setup for a terrible letdown, where the hopeful expectations lead to an even darker disappointment. I try to continue walking that line, but as run training gets better and better, that precarious hope creeps in without me even realizing it.

Then all of a sudden I feel a pain in my side, and I’m suddenly jerked back into the world of cancer, of not just knowing, but directly feeling the precarious nature of our complex biologies, where things go awry, where things fall apart, where expectations of how we want to operate disappear at each meal.

I remember that I’m never safe. That I’m a different person than I was 3 years ago and I can no longer get comfortable again, no matter how comfortable I feel, that nothing is going to be as it once was. And I’m ok with that, when I remember it. Biology will always win, and it’s probably better that way. The success is in staying humble to our tenuous bodies, to doing our best at every opportunity, knowing forces beyond our control may conspire against us without warning.

So even with surgery 2 months away (again, I hope), the immediacy of my body’s crisis has risen yet again, and I have to duck and move, readjust, and run that course of a fulfilling, strong, and stable life in the face of a cancer that never lets me rest.

But hey, at least I’m running.

To Know Cancer. To Feel Cancer.

Writing has always been something of a catharsis for me, so when cancer hit, I needed to write often, allowing me to formulate my thoughts on everything that was happening. And a lot was happening. But over time, as I adjusted to chemotherapy treatments, surgery, recovery, and all the considerations that come with managing cancer, I started writing about it less. It’s not that it went away or anything…wouldn’t that be nice…but that I simply adjusted, and my life became about living with cancer more than living against it.

As I wrote less about cancer, I felt compelled to write a little more about other subjects, but the motivation to do so often waned as nothing seemed to compare anymore. The importance I once held for so much has been tempered, almost humbled, by the greater consideration of living a valuable life in a potentially shortened timeline. Of course, it’s not that I ever DIDNT try to live a valuable, exciting life, but getting distracted from doing so became less a reality in the face of dying.

There’s something really great about being forced to more directly face one’s mortality, to derive the most from every experience created, but there is the other side of the sword where life’s more basic routines seem so mundane as to be worthless. It’s hard to reconcile the boredom and insults of our forced existence when you know they may all come to an end sooner than you had planned. I find drawn to ignore so much absurd excess and eschew easy comfort for the value of adversity and struggle.

And on one hand I love the idea of drawing the blood from every moment, but I’m also not sure this is an emotionally stable or sustainable way to go through life in our current context. What I do know, is that I benefited from facing cancer by living as fully as possible, no matter how physically compromised I was, and yet, at the same time I craved getting my old life back where my work routine was normalized, income was expected, future plans could be made and built upon. I wanted some sense of a non-cancer life, even if it meant going through those petty grievances and daily boredoms once again.

It even felt like I was getting there, living with cancer more than against it. I felt like I was on the verge of building my life back to where it once was. I had a third surgery scheduled and although I wasn’t looking forward to waking up into a nightmare world of confusion and pain, I was looking past it to more long term hopes and the possibilty of years and years without surgery interrupting my plans.

But then the surgery got delayed two months due to a State insurance change. And although I made the most of those two months, as the next surgery neared, I prepared again…and then it got delayed again, for reasons that have shaken my trust in the consideration of my oncologist’s practice. But I chose to put my head down and just get to the next surgery date and try to focus on what was to come after, that hopeful future, on the trajectory of a cancer-free life. Or at least a cancer-minimized life.

But here I am, writing about cancer again. Because although I had been cruising through the past year and a half feeling not the hint of cancer growth, and even though I had surgery on the schedule to deal with what was left inside of me…it’s back.

I mean, it was never gone, but the constant physical reminder that I had cancer was never an issue. I feel the damage done from a year and a half of chemo. I feel the damage done from two surgeries. But I had never felt cancer. I had never felt the problems that caused me so much confusion almost three years ago, until this past month.

I can’t even say when I started feeling it, but there is a very specific spot in my side that started hurting, primarily when I ate full portions or too quickly. I tried to adjust, but the pain persisted, and over the past two weeks it has gotten worse. The mornings aren’t too bad, but I wake with a mild sensation in my side letting me know that something is going on. Where I initially thought it might be a muscle strain from so much hill training, the sensation didn’t subside, and gets noticeably worse after I eat. After each run in the morning I have my oatmeal and coffee, which skyrockets the pain as the food tries to pass through that area of the intestinal tract. Then I can pretty much count on discomfort throughout the day in various states, always heightened by eating. Similar to what I felt just before diagnosis the first time.

When I go to bed, I now have to find comfortable positions on my side so as to not aggravate the pain, compressing the organs inside of me onto the growth…or whatever it is. I’m reminded again of the incredible discomfort and problems I had sleeping just before diagnosis, when my crowded abdomen gave me no relief.

It’s not as bad as it was the first time…but it’s not NOT bad either.

I can’t help but know this is cancer. A tumor growth? Compressed and compacted cancer fluid?

And in that questioning is another great frustration. I had a pre-op MRI scan two weeks ago, and then received the call that my surgery was delayed. The new pain I was feeling two weeks ago wasn’t a concern as I was going into surgery no matter what, but now I’m faced with 2 more months of…whatever is going on with me, and that’s concerning. The frustration, however, is that I still don’t know what my scans showed. The follow up appointment has been cancelled, and when I call to get the results from my scan, to tell my doctor that I have a significant, concerning pain in my side, I get nothing. I get a voice mailbox and no return calls, even when they are promised, even when I know the employee I’m to talk to is there. And honestly, the excessive workload of the oncologists’s office acknowledged, this is still unacceptable. If this pain is something unrelated to cancer, I still should be told. If no cancer growth is shown on the MRI, I should be told. If only because I’M A PATIENT DEALING WITH THE EMOTIONAL WEIGHT OF FACING MY OWN MORTALITY….I should be told.

This is the root of that shaken trust I had for my oncologist and his office, of which I’m at their complete mercy. To put it bluntly, again, if this is cancer, and I’m going to have to deal with this pain, potentially increasing, for the next two months…I SHOULD BE TOLD.

So I keep calling and build to harassing. The next step might involve going directly to the office, once my dejection of feeling cancer again turns to frustration and resentment.

I’m off track.

I’m writing because cancer is back (never left). Because I can feel it again, and the emotional safety net I had of running and running and running and not worrying about it is gone again. I feel myself being pulled back to the emotional state I had to manage during the first year of treatment, the fears of mortality, the wondering about what might happen the next year, the concrete realization that my cancer isn’t so different from the cancers that have killed my friends with little warning. This isn’t to imply that cancer will take my life in a matter of months…it won’t (right?), but that I’m not ever far away from it so as to be living with it, managing it, instead of fearing it.

I won’t go as far as saying I’m fearing it, if only because I know the options are still there to beat it back again. But there is always the unknowing medical protocols. When do they say, “There is nothing more we can do.” How do they determine, “This isn’t going to help anymore.” At what point do they throw their hands up and explain, “It’s out of our hands.”

I don’t know, and although I’m not there yet, I’ve begun harboring these thoughts again, which I’ve so comfortably kept tucked away as I went about my life, running, training, building, planning.

And that’s the worst part about cancer. You think it’s gone, or at least securely compartmentalized somewhere that you don’t have to worry about it…until it’s not. Until it’s back, directing everything you do, dictating your life once again.

Which is why I’m here writing again, far away from life’s mundanity and petty critiques. But here no less. I’ll spare the greater perspective of being here for now, but to simply say, as much as cancer is here, then so am I. The difference being, that not only do I KNOW cancer is here, now I FEEL it again.

Life goes on, and I’ll stick to the trail I’ve been cutting from day one, letting the doctor’s decide when I’ll finally have to diverge and deal with this head on.

UPDATE: After calling again today, I received a call from my oncologist. The report he gave over the phone sounds similar to past reports, which is good…sort of. There has been very little progression of tumor growth, though some of my markers went up a bit, and I’m still a little anemic (time to get more molasses). He’s confused as to the pain I’m feeling and has scheduled another blood test for tomorrow, then a follow up next week to examine me directly. As of now, I’m no wiser as to this pain, if it’s cancer related or something else, though I can’t imagine what else might be causing this. I’m not encouraged that he couldn’t give me an answer straight away, but I’m not saying it’s a fault of his. Hopefully the in-person examination will give me an idea of what’s going on and I’ll just keep monitoring the progression of pain leading into the surgery if nothing else is to come of it. I’m at least relieved that I talked to my oncologist and have a brief follow up.

Phantom Pains

Runners facing their marathons distinctly know the worry of “phantom pains”. These are sudden, unexpected issues that develop within the two final tapering weeks leading to race day, ranging from a tender spot in the muscle, a weird pain in the foot, or any other little problem that has them doubting the sanctity of life itself, or at least their race day performance. There is reason for concern, of course, as the runner has put in months and months of training through all sorts of adversity, only to fear all the effort being for nothing when the unforeseen injury stops them from making it to the start line.

But they are called “phantom” pains for a reason. Because they tend to be illusory and never develop into anything once the gun goes off.

I experienced my own phantom pain before my first marathon, a pointed spot in my quad that had me worried I’d be limping just past half way. I stretched and massaged it as best I could, but went to sleep the night before trying to pretend it didn’t exist. Turns out, with all the crazy the next morning, I don’t even remember thinking about it leading to the start…and it never made itself known the entire race.

A phantom indeed.

Now, however, I have no race to run, but I am entering a physical trial no less. Surgery is just over 3 weeks away, and I’m experiencing my own phantom pains. At least, I hope they are.

For the past year and a half since my second surgery I’ve been on a relatively steady trajectory of strength and running fitness, entering back into competitive racing for a brief period and even completing a pacing marathon, with no real cause for concern, until now. Mind you, it’s nothing drastic, but I’ve noticed certain foods have become problematic when eaten, getting slowed or temporarily stuck in my digestive tract, causing extended discomfort. Laura can attest to the problem with my incessant whining and wincing when foods become problematic. That’s not even mentioning the deep sadness when I realize a trip to the Indian buffet will only warrant one plate of starchy, potatoey goodness before I have to call it quits. My concern with all this is that the cancer has grown and crowded the area around my digestive tract, forcing certain foods to become stuck and radiating weird pains through my body.

I don’t know, with cancer, no matter how resigned and comfortable you’ve gotten with the experience, every abnormality snaps you back into a state of heightened awareness that, yes, the body is revolting against itself.

These momentary blockages also had me aware of my hunger, or lack thereof. One of the most disappointing parts of my pre-diagnosis symptoms was the absent hunger, no matter how far and fast I had been running. Again, nothing is as drastic as it was the first time around, but I simply haven’t felt that gnawing, impossible hunger that used to mark my training days, and my oncologist often asks if my hunger has been satiated during visits. It’s always something to be aware of, and although I haven’t been knocking out 20 milers every weekend, I haven’t necessarily woken every morning with the primal craving to gorge either, so, I don’t know, I’m hoping these are phantom symptoms again.

Then there were those handful of days marked by chest pains. I didn’t experience these sensations the first time around, so I can’t relate them to my first symptoms, but they are concerning no less, because I’ve NEVER felt these. Admittedly, these came after a momentary increase of strength training, including the upper body, but these pains weren’t muscular. They were more internal and only arose after I ate. I couldn’t help but wonder if the cancer had spread, as incredibly rare as that is in my case.

My only solace in all these concerns was the scheduled MRI I just had performed with the surgery coming in a few weeks. I mean, despite the “stability” of my cancer these past three years, if it did happen to be growing and becoming symptomatic, the surgery has always been the stated cure to my disease. Whatever it was doing within me, it was at least going to be dealt with right away.

Part of me can’t help but imagine the cancer remaining dormant and being fully excised, if not once and for all, then at least for another 5 to 10 years, this surgery, but the grounded, experienced part of me knows to stay neutral. And the pessimistic part of me knows too many stories of cancer patients who experienced a resurgence, too many times fatal, without warning.

I want to believe I can plan my life out again. I want to believe I can train past a year and a half. I want to believe I can go back to expected employment and income. I want to believe I can forget about this whole thing a little more than I already manage to do. I want to believe these pains are as phantom as marathon runner pains.

Unfortunately, those pains just might be real and those desires the phantoms. I hope, of course, it’s the other way around.

Whatever the state of my body is, surgery is close again, so they’re going to be dealt with one way or another. I’m preparing for what is to come, both physically and psychologically, and after this round, I want to imagine the only phantom pains I’ll feel in the future are during taper weeks of a marathon.