No Words. Only Actions.

This post will probably fail in every way, because I’m struggling to find the right words to express the gratitude I hold for my family of friends, who came through in the best, most necessary, most unexpected way this morning.

I dropped Laura off at work – right after I was lamenting about the continued financial difficulty I’m navigating in the face of cancer treatments, not making rent each month and having to swallow my pride and borrow money from her, harboring the embarrassment and frustration of not being able to provide for my son’s needs, or even contribute to something as simple as going to the movies or buying dinner – and as she was getting out of the car she barely veiled her mischevious excitement through a stifled smile when she quickly blurted out,

“Check your email between 9 and 10 today!”

Completely unsure what that meant, I went about my morning as usual, knocking out a 10 mile run, shoving breakfast in my mouth on the way to the coffee shop, then setting up and getting to work in an attempt to tie up all loose ends before surgery renders me useless on Tuesday.

Then all of a sudden an email notification popped up, something about Paypal.

I opened it to see a donation made directly to me, an amount of which immediately lifted an emotional weight that has been so pressing, so relentless, so frightening, that it felt physical. I stared at the donation amount for a bit, trying to process what this meant for all my current financial worries and then after experiencing this incredible weight lifting from my shoulders, I felt…embarrassed, humbled, inadequate, and worried.

But in the best way possible.

I felt all these emotions, because I have been quietly struggling through unavoidable financial restrictions for many months now, of which countless cancer patients must experience, because no matter how physically well we may be doing, the financial burden and restrictions to work (whether to stay eligible for aid or other reasons) are crippling. I’ve heard stories where upper middle class families turned into welfare recipients over night. I’ve heard stories of individuals denied treatment at the check-in counter when payments couldn’t be processed. I’ve heard so many difficult stories of previous security and comfort wiped away in the face of cancer’s financial burdens. And although I’ve been staying on top of my burdens, they have periodically slipped again and again as I wait for each surgery to allow me to work without restriction as I have in the past.

But I don’t mean to dwell on a “woe is me” story.

I just want to convey how incredibly important this donation is to my emotional stability right now, and all those feelings I expressed above, the embarrassment, humility, and worry, are not an extension of ingratitude, but rather a different kind of concern, of being unable to reciprocate this unbelievable gesture. I know I won’t be able to convey how appreciative I am that these individuals came together and compromised their own financial state to support mine. I do NOT take that lightly.

To give credit where credit is due, two good friends of mine from the Strong Hearts Vegan Power running team, of which I am a part, facilitated this benefit on my behalf without my knowledge. They put out a call to the team and solicited donations to help support me as an individual, and I continue to be without words for this effort.

For those that don’t know our story, the SHVP team formed around a Ragnar Relay a couple years ago, during which we realized we had developed an incredible community and tool of vegan advocacy. From there the community of friends grew and grew and…well…continues to grow. Our team, turned community, turned solid family of friends now probably numbers 50+. Through these friendships we have supported our individual endeavors outside the team and I’ve been both floored by the generosity shown to others and inspired to become a more generous and empathetic person myself, through the example of their efforts as a team and individuals. Without reservation I can say I’ve never been part of a better group of individuals than SHVP.

But I expect nothing from them aside from reciprocated friendship and amusing Facebook banter. So as this donation now rests in my hands, I have the responsibility to use it as effectively as possible to manage my life while this next cancer treatment renders me relatively useless, but, even more so, to also continue this manner of reciprocation back to them and to others to my complete ability. This is the best burden I can ever imagine shouldering.

I want so say to them, again and again (and am doing so here), that I am so inexpressibly grateful for this donation, that you all are amazing individuals and as a team we’re like an actual Voltron of veganism, destroying stereotypes, exploitation, and apathy wherever we may find them. And when I despair of the world, and find little solace in any action I take, I can look to our example and know that whatever horridness the world continues to create, it’s not of our doing. This donation is a small example of the power we both contain and share.

And to reiterate, it would be an offense to simply express my gratitude to you all and leave it at that. This is both irresponsible and insulting to your action. What will only matter is that I use this donation as responsibly as possible and then reproduce this action to the best of my abilities going forward, so I’ll promise that to you now, that whatever personal compromise or sacrifice you made to support me, I’ll find a way to reciprocate.

I want you to know, all of you, what a donation like this does for me and does for others. While I’m unable to not only work, but to simply breathe on my own, I can’t create the funds that pay the mortgage, pay the utilities, buy food, etc. These aren’t the extravagances and excesses of our lives, but the basic necessities of survival. Without these, what does one have? How does one survive? And financial support will allow me to cover all these for a few months, letting my body heal, adapting to the unforeseen physical complications of such an incredibly extensive surgery that destroys my body, robs me of any creative inspiration or even the drive to complete the most basic tasks. A donation like this allows me to focus on recovery, to find the time to build my body back up, to get stronger and stronger in order to work again, to be creatively inspired, to find my way out of dark emotional places and back to positivity. This donation will also allow me to retain some sense of dignity in providing for my son, who is currently in need of dental work, of which I have struggled to provide. This donation will allow me to help in that regard, and that benefit to my emotional state is immeasurable. This donation will also help me dig myself out of some unavoidable holes of debt I incurred this past year, setting me up for more stability past surgery.

Out of appropriate discretion, I will spare you of financial details, but suffice to say this donation is less about the number and more about the emotional comfort you have afforded me by helping me pay for both the necessities of living and the integrity and responsibility I try to maintain for my son. There are no expressions of gratitude worthy enough to reciprocate.

As I navigate these last few days before this third surgery, I’ll be thinking how best to reciprocate to you all in action, how to equalize your gesture in kind and towards others. For now, I can promise you that this enables me to more quickly become physically able, physically strong, and back to running with you in the future. And when that happens, I’ll express all this again face to face.

With fingers crossed, I’ll enter this surgery with the measured hope that when I wake up, I’ll be that much further away from more treatment and that much closer to the financial stability of self-reliant work, knowing that in the interim, you have taken care of me and my needs until then.

“Thank you” sounds like an insult to the gratitude I feel towards you.

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.

Forever Falling

I knew a year and a half without chemotherapy between surgeries was going to be a completely different life than the one I experienced previously. The day to day relief would bring me to a new emotional baseline and the physical gains made from running without restriction couldn’t be ignored either. My considerations were just how much running progress I could make in this window of opportunity, to start, but then how would it feel to lose it all yet again.

Initially, being able to run, to progress, far outweighed my disappointment in losing it all, knowing the inevitability that was to come, but as the surgery neared and my fitness seemed to reach new levels, almost exponentially, as if I had flipped the switch inside me, the realization that it was all going to disappear the moment I laid down on the hospital bed began to wear on me.

I certainly didn’t think I was going to get back to sub-1:20 half shape. I didn’t think I would be strong enough to make a go for a relatively fast marathon if I decided to race one. And I didn’t think this progress was going to offer the promise of even greater competitive running fitness. But that’s where I am, looking forward like I have so many times in the past, recognizing that staying consistent with my running and training would only bring my times lower and lower and lower. How low? Well, that’s what I’m trying to find out.

But…January 5th.

The inevitable and total regression back to square zero, losing every bit of fitness and strength I’ve worked so hard to gain, will be lost and it’s putting me into a state of dejection I thought might come sooner or later. It would have been one thing if I had stayed in that place where my running and strength training was only to prepare myself for the upcoming surgery, but at some point I crossed a line, and running became about striving for more competitive goals than anything else. Running became about running itself again.

The fact that I was able to get to this place is not lost on me. I’m ecstatic that I’m strong enough to step to the line as a competitor, not an imposter trying to hold onto dreams passed, but at the same time, this excitement of this reality only heightens the dejection of losing every bit of progress for which I’ve fought.

It’s not to say I’m not prepared though. The cancer experience, from day one, has taught me that everything gets taken away. If not your life, then any expectation you might have had. Nothing is stable. Nothing is permanent. Your ability to work, your expectations of relationships, your self-reliance, your physical state. Everything gets yanked from beneath you without warning, and the fear it seeds deep within isn’t shaken so easily. I’ve lost that naive sense of expectation and and an understanding of what the future will hold. I’ve come to live more in the day to day and month to month when I allow myself the privilege.

I’d like to say I live in the year to year, but that’s where everything goes hazy, gets risky. It’s also probably the emotional saving grace of this surgery, because I’m so tired of not being able to plan ahead, to figure out how I’m going to provide for my son’s expenses, for how I’m going to provide for my own expenses, and this surgery is my hope, as dangerous as that is, for opening my life back up again.

I’ve found myself responding to so many friends lately, asking me how everything is going, with the repeated story of an upcoming surgery and my hopes going ahead. Sometimes I get lost in the excitement of the conversation, thinking about a future through rose colored glasses, where I can get a job with reliable income, have a predictable routine, forget about cancer that much more, and plan. Plan for more than 2 months out, and just feel stable again. Hovering in this in between surgery realm is kinda like perpetually falling, wondering when you’re going to hit bottom, and so not getting too comfortable in your relatively intact state, always managing a low level stress and anxiety, anticipating impact.

And I’m just done with it. I want to be past it. I want to look at my life the same way I want to look at my running, with limitless potential, only the most unavoidable restrictions lying ahead. But in the same way I know all this work towards competitive running is coming to a halt, so will my life again, just before I get to rebuild yet again.

I can’t help but daydream. I can’t help but want my state of being an anomaly in this cancer experience be that much greater of an anomaly. I have another MRI before my next surgery, so my surgical oncologist can see what he’s up against again. I can’t help but imagine the scan coming back with severe tumor regression, or NEC when I’m feeling especially hopeful, and he sits with me in the follow up, outlining a plan of indefinitely delaying the surgery and only checking back in with scans…letting me get back to my life as if cancer is gone.

But those are daydreams, and risky ones at that.

And yet, I still have just under two months before I start over, and there are things to do. I get my son for both Thanksgiving and Xmas, and I find it hard to think anywhere past our time together, not to miss a moment of it. There are friends to see, strength to build, and running to do…which is funny, because I thought the Runner’s World half I ran was going to be my last temporary hurrah of running, putting it all on the line, literally, and then my schedule opened up again (there’s that inability to plan) and I was able to pace the Monumental Full, and now I have two more months with nothing scheduled.

Honestly, I’ve been a little reluctant to look at any races within this time as I’m not sure I’m prepared to gear up for them with such little time, but there are opportunities to be had. One of the runner’s I coach is going at a 50 miler and then a 50k just a couple weeks later. The pacing duties at Monumental lit a fire under me to help others as best I can if I can’t do that much more for myself, so I’ll be crewing / pacing him in his attempt for a 50 mile PR. I’m also looking to make the most of our Winter Run Groups and the White Pine Distance Training group before surgery, in hopes that the momentum will carry on past surgery and into the new life that waits ahead.

And really, there is something ahead, so I’m hopeful for that, whatever it is. I can’t really see past the haze of surgery as to what that looks like, what my abilities will be, what my treatment plan will look like, what is to be expected, but there is something there and I just have to wait out these next two months before I can determine if future plans are possible or not. For the time being, I can daydream what that might be like, whether that’s financial stability, life plans with Laura, more time with my son, and a wide open window of running progression where I can finally hit the ceiling of my abilities once again.

Here’s to hoping. But first, there are people to see and runs to complete. I may not be able to plan for a future, but I can plan for tomorrow’s run, and that’s something.

Indianapolis Monumental Marathon – Pace Report

Indianapolis Monumental Marathon – Pace Report

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Just a month before the race, I hadn’t even planned on running it. It was a marathon, for one, and I had not trained to race a marathon, but more restrictively, I had my surgery coming up at the end of October and so running a marathon wasn’t just out of the question, it wasn’t even a consideration for a question. Best case scenario post-surgery, I may have been able to take enough pain medications to see the runners I coach finish that morning. When my surgery was delayed, however, my schedule opened and I felt that drive to fill my days with as much excitement as I could while waiting, and it just so happened that my old coach was the pace organizer for the marathon. He was struggling to fill the quicker pacing duties and the seed was planted. I wasn’t sure I could commit to the task initially, but as race day got closer, and my long runs proved encouraging, I sent him an email and told him I’d run the 3:10 group in, confident I could overcome the obstacles of the marathon distance at 7:14 pace. But as I continued training, gauging the feel of 7:14 pace, I quickly discovered that running at this tempo felt overly restrictive and my body wanted to let loose with every step. And hey, if I’m going to run a marathon, I should just go ahead and push the envelope. I quickly emailed my old coach again and told him I was confident enough in my abilities to roll the 3:00 flat group in, but it turned out that both his 3:05 pacers dropped, leaving the 18 to 34 year old age group going for Boston Qualifiers unfulfilled. After a bit of arm twisting, I convinced him to give me the 3:05 position, leaving the 3:10 for someone else and deleting the 3:00 pace group, which was fine for the race. I didn’t fully grasp it at first, but a 3:05 finish is really crucial for a lot of runners as it is the biggest age group trying to qualify for the Boston marathon, which put a significant amount of pressure on me to fulfill the pacing role as best I could. Seeing as I had never paced a group before and, technically, had not run a road marathon in a race setting since 2010, there were a lot of unknowns I needed to psychologically prepare for before race day. But hey, YOLO, right?

I entered the start corral holding the red 3:05 flag at the top of a long wooden dowel, hoisted well above all the gathering runners as a signal to those trying to finish anywhere around this time. Some runners use the flag as a target, others as an anchor, and still others as a warning to get moving and stay ahead of the group. Immediately a handful of runners found their way around my spot in the first corral, introducing themselves, asking pace questions, or just calming nerves with friendly discussion. I assured them we would keep a steady pace and to allow me just a few miles to get in the rhythm of a 7:03 cadence. Admittedly, as this was my first pacing duty, I wasn’t sure what anyone expected of me beyond an expectation of consistent running pace. I knew my ultimate role was to metronome us to the finish and nothing more, but I also know some runners want or need discussion, distractions, encouragement, and other forms of support, and yet other runners want nothing but silence and the room to go inward and focus on their efforts. I decided I’d let the runners convey their comfort levels during the race and respond to each individually. The minutes ticked away, the standard pre-race rituals commenced, and we were ready to go. I took a few quick glances around and estimated about 10 to 15 runners were hanging around my hoisted flag as the race countdown began.

With an abrupt beginning that caught many elites off guard, we slowly moved towards the start banner and crossed the first timing mat at pace, myself hitting the start on the Garmin I borrowed from my girlfriend wrapping my left wrist for moment to moment pacing, and then the start on the timex wrapping my right wrist to calculate overall pacing at each mile. I was prepared.

We moved easily into the course and I tried to measure the freshness I always feel at the beginning of a goal race – reminding myself to run not how I feel at the start, but how I WILL FEEL at the end – against the runners passing me on the left and right as they pushed into the course, settling into their own paces and testing their training against the distance that would slowly wear them down. I let them go despite the competitive urge to match strides or second guess the incredibly slow effort we were rolling. If there is anything I’ve learned from my years of running, however, is the undeniable value of energy conservation and reigning in the fire that consumes one at the start of a race for saving it to burn to the finish. I kept this in mind as we ran towards the first mile marker.

We hit the first mile clock and where a wave of embarrassment and concern initially hit me when I saw how much slower we ran than the necessary 7:03 pace, I recalculated the 15 seconds it took us to to actually cross the start mat and realized we were dead on. 1 down. 25.2 to go.

I reminded the runners around me that we would still settle into a rhythm over the next two miles as we maneuvered through the downtown area in perfectly chilly air temperatures and under the shadowed gaze of our city’s humble skyscrapers, which annoyingly started playing games with the GPS signal to my Garmin, bouncing the pace readings between 6:40 and 7:30, neither of which were accurate. I ignored the watch and fought back the anxiety until I knew we would be out of the downtown area and the satellite signal would become more reliable. Our group was sizable and comfortable as we ran past the second mile clock, hanging just under pace by about 5 seconds. As is hoped for at this point, everything was very relaxed, so much so that conversation started between runners and myself. I tend to be a silent runner, not wanting to expend even the slightest bit of wasted energy, but I was confident in my abilities for the day and was wearing a new hat so to speak. One runner in particular asked me a number of questions and I shared some stories about races or little bits about the parts of downtown we were running through, but this proved too difficult for my liking as the runner was two stepping me, staying just a couple strides ahead, testing my resolve to stay on pace while trying to get closer for comfortable conversation. At some point I had to trail off the conversation and let him go at his own pace so I could keep everyone else on task.

We passed the 3 mile clock, then 4, and each time we sat just 5 to 10 seconds under the overall pace, a completely acceptable time for staying within a range that was not too fast or slow for anyone going for a 3:05 finish goal. Each clock we ran by gave me a boost of confidence that I was able to maintain this pace without getting out of control, that I could confine my intensity and competitive urges, or just not let the distractions around me pull from my task of bringing these runners home. I had a job to do and I was taking it very seriously. It seemed everyone else in the group was running relaxed and calm, but I distinctly remember the quickened footfalls and even quicker breathing of one runner in particular running clearly out of their comfort range, whether for a full marathon or half. I wanted to offer some helpful suggestions in backing off, but left that battle to fight themselves. Expectedly, that labored breathing dissipated soon thereafter.

We continued on through the miles leaving the city, rolling past 10k, then 7 miles, after which each I called out our overall time pacing, still holding around 10 seconds under goal. I was surprised how exciting this was becoming despite running a pace that had never threatened my past fitness, checking my watch against each mile clock we passed, my confidence surging with each readout that barely fluctuated more than a few seconds in either direction.

As a group we were like one body of runner, precise in our movements. There was an odd sense of power to all this, knowing I was controlling the efforts of these runners around me, with the potential to increase or decrease their cadence on command, effectively ruining their race with the slightest change in effort, and yet my job was to do neither, but simply run a concrete pace and never waiver from it, to be a visual and carry each one as far as they could possibly go at this effort, without thinking about their own abilities past the moment they were currently in. I’m not sure what a proper comparison would be for how I felt, but Laura likes to say I was a mama duck and all my baby ducks were following my lead. It’s an amusing analogy, but doesn’t exactly fit the intensity of the experience or the individual drives of each athlete.

Somewhere around 7 1/2 miles the half marathon course did an abrupt about face from the full and a few from our group separated, one of the runners thanking me for bringing him to that point. I exchanged a compliment and ran on, satisfied to have at least accomplished one successful pacing portion for the day, though this race had yet to even start, the inevitable fatigue of the marathon distance waiting much deeper in. I still didn’t know what was to come, but remained hovering between a necessary calm and focused intensity, like pulling a rope taught, but not too much, only enough to keep the necessary tension, as if I held it for myself to walk above. Or for the runners all around me to walk, knowing that if I let it go or pulled too tight, they would tumble off the side into disaster.

Our group moved ahead and I remained feeling strong in every way. I could carry on conversation if needed, but refrained from excess unless calling out our pacing at the mile clocks. We passed the eighth and ninth mile, now getting encouragement from the spectators lining aid stations and neighborhoods, families and kids still waking from their slumber, trying to find an excitement that would match the efforts of the runners. It was our fortune to be in the 3:05 group, essentially the first group to go by the spectators with a visual reference for our speed and mass. We became “The 3:05 group”.

“Go 3:05!”

“Yeah 3:05 pace! Good work!”

“Boston Qualifiers! Go 3:05!”

Our individual goals – mine to pace us in, and the runners around me to hit PR’s, qualify for Boston, or just run a successful race strategy – had become a little less individual and more a group identity. We weren’t just runners, we were THE 3:05. We were a team. And we received personalized encouragement from the people lining the course. It feels good to have a name, especially when the distance and effort conspire to take everything else away from you. There was a compulsion to stay with the 3:05 group once you had been identified, lest you fall away and lose the privilege and support of being “one of us”. The crowds continued to reaffirm the identity of our effort.

Up to this point our group was finding it’s comfort level, not just in our pacing, but placement and routine. We adjusted to the scattering at aid stations, to grabbing cups of water that splashed over the top and down our legs, to the fluctuation in pace that inevitably takes place when we break apart in those moments before regathering and falling back into rhythm. Personally, I had to make my own adjustments, whether letting runners get in front of me for the liquids, or holding back when I surged ahead to give them room. Pacing so many other runners also held other challenges I needed to assess and from which to adapt. I like to race alone, with enough space around me to feel uninhibited and free to adjust. Pacing, however, involves not only staying with other runners, but adapting to their need to be with you. What I learned during this experience is that some don’t just want to be WITH pacers, they want to be ON pacers. I quickly understood that although this finishing time might be expectedly unproblematic for myself, others would be holding on by a thread and feared the inevitable backsliding that can come with losing those around you. Admittedly, this threw me out of my comfort level. There were times I had one runner on either side of me, moving in perfect sandwiched syncopation at 7:03 pace, sometimes and continuously bumping my arm with the slightest tip of their torso, and despite our movement towards slower runners directly in front of us, I had nowhere in which to maneuver around the human obstacle. As you can imagine, this causes problems for staying on pace. As this congestion continued to threaten our pacing when moving towards fatiguing runners, I made the decision to give the course to the runners, literally jumping over the strides of a runner just in front of me and another just to the back in order to make it to the side of the course, right along the cones, sometimes completely outside the cones. I kept the 3:05 flag held high and let them take the course so that no one was inadvertently tripped up. This didn’t actually prevent some of the runners from latching onto my new placement like loosely applied velcro, but it was enough to give me the breathing room to avoid race ruining collisions and allow me to psychologically relax through the effort. After all, we were just passing halfway.

We ticked by the 13.1 mile clock, 20 seconds under overall pacing, feeling completely fluid and composed, just where you want to be in a marathon. Our group was still sizable, though I didn’t turn around to assess the actual number of runners following my lead. Some runners positioned ahead started to come back to us at mile 14 and 15, the effort beginning to erode their sense of pace and strength. More than a few caught sight of our red pacing flag hanging above them, calling out our 3:05 finishing time, and snapped them back into consciousness like visual smelling salts, their pace immediately quickening as they tried to put space between us. Others fell into our group and used our efforts to ease their own. The more the merrier.

At this point I noticed the casual atmosphere during the first half had shifted, the conversation cut short, almost to a halt, the breathing of those around me just a little more labored, footfalls repeating over themselves at a heightened cadence to remain in our seeming gravitational pull. I felt less a naive confidence from those around me and more a sense of composure and strength, whether fighting off the mounting fatigue or preparing for what the more experienced knew was coming.

Pushing into a portion of the course that was marked by short, but noticeable rises and descents in elevation, I concentrated in estimating my efforts to keep pace. The Garmin reading wavered in 5 second increments, intermittently slowing into 7:15 pace and confusingly dropping towards 6:45 too. I doubted the accuracy and held to the median, trying my best to keep the readings between 7:05 and 7:00 and despite each incline, the mile clocks read a flat line of tempo, our overall finishing pace holding at 30 seconds under 3:05. We were on. So on.

The race, however, had yet to start. Every experienced marathoner will only partially joke, “The first 20 miles is a warmup. The race starts with 10k to go.” Our group had seemed to have thinned out leading into the Butler College campus, the conversation now drifting to inadvertent bumping apologies and other quickened small talk or “thank you’s” to volunteers and cheering spectators. And then the first signs of faltering began.

I stayed just inside or outside the cones running the middle of the street, keeping the group congestion to a minimum, but a crash became inevitable. I didn’t see how it went down, but a break in the relative silence caught everyone off guard, a cone flipping to the side as a runner stepped right into it, tripping forward and catching himself in a forward roll as the runners around him darted left and right. I turned around to see him rolling back up to his feet and starting forward again, calling back, “Are you all right?!” but he was already composing himself and falling back in with the group. The other runners checked on him verbally and he confirmed all was good, staying right with the group, taking stock physically, and narrowly avoiding a race ending crash. A couple runners joked back and forth with him about adrenaline boosts and keeping things interesting, but we were all good and still rolling forward right on pace.

Everything, despite the trip up, still seemed stable, but looks are deceiving. The marathon distance does not forgive. If you have issues, whether physical or mental, weaknesses, also physical or mental, the marathon distance will bring them out of you. And it is at this point, around mile 18, most start to feel these said weaknesses. I wish I could say I was stronger than the marathon, but right then I noticed a dull pain on the outside of my right knee, which was a familiar, worrisome pain. It was the dull sensation that built into a run stopping “injury” during my benefit ultra run months back. It wasn’t the IT band issue I could manage in my left knee. No, that issue never even developed…this one was worse. I don’t belabor the difficulties I’ve had to manage from the effects of surgery and chemotherapy, but one of the worst for running might have been causing this concern deep into the distance. The neuropathy induced effects of my chemotherapy treatments have left the fronts of my feet relatively numb, causing me to instinctually search for proprioception and altering the way my feet land, putting stresses on my legs in ways I’m not used to. If there’s any injustice or unfairness in my cancer treatment as a runner (spoiler alert: there’s not), it’s the permanent damage to the area of my body I use most when running…my feet. Aware of this mechanical issue, I try to consciously run off my toes despite the lack of feeling, but longer distances wear on my resolve to do so, and in this is my own sort of personalized marathon obstacle. Refocusing again, I adjusted to the dull worrisome pain and tried correcting my feet to land flat and roll towards the big toes and not flex off the side, hoping to take the unnatural stress off the side of my leg. I went through a little bit of anxiety in the effort, formulating contingency plans if it grew out of control, hoped for the best, but ultimately calmed down and just let the pain sit there, convincing myself that our controlled pace would keep the pain growth neutral or slow enough to not become an issue before the finish. Whatever was to come, in the moment I needed to just keep running us on pace.

This deep into the run we had become completely separated from any runners lingering around us organically. If you were with our group at this point, you were solidly trying to run 3:05. Primarily men, I caught notice of a few women running with us, the shadow of a pony tail bouncing right next to me. I knew a 3:05 finish for them was possibly relatively more impressive than some of the others in our group and hoped they would stay with us as we continued through the 18 mile marker, 30 seconds ahead of overall pace yet again.

I was doing my job and feeling confident about it, while also preparing for the effort to come as the tension in the group continued to rise, like a tightening screw, ever so slowly. Just then a runner in the pack asked for our pacing. I repeated our 30 second margin and He called back,

“You’re doing great man. This is textbook pacing.”

Having never attempted this before, and for such an important effort for all the runners, I was bolstered in his confidence. In a moment of poor wording, I tried to respond with encouragement of my own.

“Thanks. We’re almost there.”

I tried to say this with a seriousness, not meaning “almost to the finish”, but actually, “almost to 20 miles, almost to the start of our race.”

As an experienced runner, I assure you, there is little we like hearing less than “You’re almost there”, when we absolutely aren’t almost there. If we’re 800 meters from the finish, THEN you can say “you’re almost there”. Until then, find something more appropriately encouraging. I had made an embarrassing amateur mistake and only hoped they knew what I meant or notched it up to marathon induced glycogen depletion. Whatever I meant, they knew what the score was.

We ran into the grounds of the Indianapolis Museum of Art, rounding a wide turn into a screaming group of spectators we had yet to visualize. The excitement and intensity filled me with an enthusiasm I was really enjoying, anticipating a Wellsely College like reception to propel our 3:05 group forward, only to be met with approximately 8 teenage girls in superhero costumes, somehow amplifying their voices to sound like a wall of noise. I caught myself verbalizing aloud, “Wow!”, in their excitement and volume as other runners drifted in their direction to exchange a line of appreciative high fives. I don’t know who those girls were, but they were doing cheering RIGHT. Someone give them an award.

That excitement couldn’t have come at a better time as we ran out of the IMA grounds, down an extended decline that wrapped around an off-ramp and into a stretch of isolated, slowly curving road that harbored not a single spectator. We were left to our own devices and the warning signs beating into us through our weighted footfalls and the sounds of our now audible breathing, heading right into the start of the true marathon effort at 20 miles. It was on this stretch we passed the first casualty of the day, an elite woman runner, who either blew up in the effort or was cut short by an unexpected injury, being tended to by a few cyclists. She was the first, but not the last victim of the day we would pass.

We ran by mile 20, now 45 seconds under overall pacing, still right on for the full 26.2 miles, the gain probably enabled by the ease of the last downhill cruise. I tried not to make an abrupt change in effort, but let my mind relax in hopes of an intuitive adjustment back to a subtly less tense stride. We continued on the long stretch of isolated course, the heat of the sun coming down on us without a break of shade. I began to feel the small tensions mounting, compelling me to strip off my thin glove liners in the heat and tuck them into the back of my shorts, instantly feeling a sense of relief and lightness as the air cooled my fingers. I had taken a few cups of liquid through the aid stations, a couple with gatorade instead of just water, but had yet to consume the concentrated sugars I brought for the ride. Taking a precautionary measure, I slowly pulled a GU packet from my waist pocket, hoping the caffeine would keep me mentally alert if the glucose had no noticeable effect, but the struggle of getting the thick sugars down without water proved too annoying for the effort we were exerting at the time and I abandoned the effort soon thereafter.

At this point it wasn’t that anyone was fighting a heart rate too high for comfort or form was crumbling under repeated impact, but the rope was now pulled tight enough from just the time spent moving forward that any extra effort or break in rhythm did not go unnoticed. These were the beginnings of the “tractor pull” effort of the marathon distance, where the closer you get to the finish, the effort seems to grow exponentially, threatening to kill your engine with the final line to cross still in sight. This is where the struggle truly begins.

We turned past mile 21, a full 45 seconds under finishing pace and pointed ourselves back towards the downtown push, now running through tree lined streets with spectators helping us eat up the distance with more 3:05 specific encouragement. Our group remained a sizable 8 to 10 runners, and the further we pushed on en masse, the more runners we found coming back to us, unable to sustain their expectations or overshooting their pace too early. We, however, felt like a machine without speed controls. When turned on, our gears rolled into each other without speeding up or slowing down, just stuck in perpetual motion. At times I would hear the sound of our footfalls all coming down in unison, despite our variations in stride length, like troops caught in lockstep, before those variations broke our rhythm back into the sound of a herd of pounding horses. We stayed together, a couple runners sticking to my side in what I perceived to be a gesture of desperate anxiety, while others stayed just off to the side in their comfort zones.

Running through mile 22, the recognition of “just 4 miles left” filled that emptying well of effort with a flood of encouragement and anticipation, and yet, also a significant portion of worry. This is where the race can come to a screeching halt, the wheels falling off, the fear of losing every gain made in the previous 22 miles so close to the finish. The weight of the marathon was upon us and the struggle was building. I sensed our group was thinning and the threat of race ruining fatigue was written on the backs of every solitary runner we moved towards and swallowed in our consistency, spitting out the back of machine of perpetual motion. The strength and intelligence of our pacing, however, became apparent with each of these runners we passed. The necessity of the controlled, measured effort was obvious, compelling everyone to stay together as we came up on mile 23, a mere 5k from the finish, and yet an incredibly, seemingly impossibly far 5k from the finish. Some clung desperately to our group, slowing drifting off the back, and yet, no one dared make a push ahead.

The course neared a turn into the long, drawn out stretch into downtown and towards the final turns to the finish, where the carnage of the distance was strewing out ahead of us. I called out to the group,

“One small incline over this bridge and then we roll all the way in!”, a seriousness and command in my voice I hoped would serve as a motivation to keep at it.

All conversation was over. Every breath was saved. Every stride measured.

Pushing down the straight away of Meridian street we could see the skyscrapers of the city center off in the distance, imperceptibly growing bigger with each step. The half marathoners intersected with us on the left side of the road and we passed by their back of the pack pace on the right, receiving encouragement when they saw us coming,

“Wow! 3:05 pace! Amazing!”

The same cheers from the spectators on the sidewalk compelled us closer with each step, the hardness of the asphalt reverberating through the cushions protecting our feet and jarring into quads talking back louder and louder. Runners were strung out ahead of us in broken lines of code, fighting their solitary battles to keep moving forward as we steadily and measuredly moved past them in unison. I looked back to see our group had broken into about 6 runners and I knew the pain was building, because I was feeling it myself.

I called out to anyone who could hear me, “Dig deep if you’re feeling the pain! Find someone close and stick with them!” trying to keep our group together into the last two miles.

Runners in front of us struggling to keep the pace they held this far were jolted into effort as they saw our small pack and the bright red 3:05 flag moving up on them. Some found the drive to push ahead while others were swallowed by our consistency and dropped off the back. The tension was now palatable, our group held on thinner and thinner threads, runners dropping all around us. We came up behind a woman, who pulled back abruptly, limping to the side and crying out about a lack of salt and a run stopping cramp. Her cry of disappointment was painful to hear, but we were on auto-pilot, unable to offer even the smallest gesture of sympathy in our concentration.

With each step I felt the wear on the soles of my feet, the building pain around the deadened nerves, and the almost screaming in my quads compel me to launch into a finish push, but had to remain reserved, turning over without a response to the call of intensity growing in my mind. My competitive drive wanted to let loose to the finish, but my responsibility to my pacing role kept me turning over steadily, swallowing up runner after runner after runner.

Looking just ahead I noticed a familiar singlet of my old team, the runner unmistakably struggling to make it in, having given in to the cascading of pace. We were moving smooth and knew this wasn’t going to change.

I yelled ahead, “PBT! Come with us! PBT! We’re going 3:05! Come with us!”, and saw him step into rhythm to be carried further towards the finish, wherever that may lie.

I checked my watch one last time at the 25 mile marker and hazily calculated a 30 second margin, encouraging the 5 or 6 runners still holding steady as we made the remaining turns to the finish. This was our final stretch. I could tell they were itching to let go as they started making small gaps on me as I tried to remain within pace. I debated going with them if I could be of final assistance, but decided to keep it on pace lest someone make a final move to get back with me if they had fallen off in the last two miles. It was hard not to go with their desperate, adrenaline fueled surge, but I kept it steady as best I could. As Laura put it, I let my ducks leave the nest and fly away!

We ran towards a line of spectators growing louder and increasingly populated with each turn towards the finish, when I suddenly caught cheers not only for the 3:05 group, but for me specifically. I did my best to acknowledge the support, while holding concentration to the finish, knowing I had executed my responsibility to it’s fullest. I heard my name called out again towards the last turn, rounded the corner and saw marathon president, good friend, and old teammate, Jon Little, leaning over the barrier,

“Yeah Spitz! That’s what I’m talking about! Are you on pace?!”

I yelled back through the turn. “I got ‘em!”

I won’t lie, the pain in my legs caught me off guard. I knew I could run the marathon distance and I knew I could maintain this pace, though I kept a reserved concern and respect for the ravages of the distance, but I honestly didn’t expect to feel this degree of wear fatigue in my muscles. And you know what, it kinda felt great. I hadn’t run an honest road marathon race since 2010, the potentials abbreviated by the cancer diagnosis during training for another go at the Olympic Trials in 2013, and so this pain was an acknowledgement of both my abilities and efforts. I was feeling not so much a pain as I was feeling accomplishment, effort, new boundaries, passion…my life.

I kept my eyes on the clock as I neared the finish line, runners just behind me making a surge to get under the 3:05 cut off time, and the group I had helped carry for 26.2 miles stretched out in front me, crossing the line in Boston Qualifiers, PR’s, and other individual successes. I got closer and closer, heard the announcer call out my 3:05 pacing, pulled the sign down close to my chest, and lifted a quick fist into the air as I stepped on the final timing mat, signaling to myself pride in holding 7:03 pace all the way to the finish without falter, completing the honor of assisting the ambitions of the runners I was assigned to serve.

Crossing the line and letting the wave of relief and success fill my body, I looked up to see race founder and director, Carlton Ray, greeting me with a huge smile, a strong embrace and compassionate kiss on the cheek. I met Carlton when I won the inaugural half marathon in 2008, and just after my diagnosis when I was the honorary race starter. He has always been an enthusiastic and compassionate supporter through my cancer experience and I have been so grateful for his inclusion of my presence at this race. Meeting him at the finish was an ending to the effort that carried an impact and importance I didn’t quite internalize in the moment.

I looked around and started catching eyes with the runners I had just run with to this finish, all of us pulling each other together as much as forward. We shook hands, gave hugs, thanked each other for the effort, and let the relief of accomplishment rival the smiles on our faces before going our separate ways since 26.2 miles ago. We had shared something genuinely special.

I began making my way through the finish chute, meeting Laura immediately off to the side to grab supplies, then getting my finish medal and seeing more friends working the chute. The people I started encountering around the finish area are too many to name individually without leaving someone out, but each one left me feeling increasingly grateful and humbled. I had yet to pause and gather my thoughts, understanding how important this experience had become.

I left the finish chute, composed myself with Laura, trying to get in fluids and putting on warmer clothing, then struggling to find my way back to the finish area to watch friends come in and look for the two runners, Marc McAleavey and Joseph Burns, I had coached to their first marathon, complete their own struggles and accomplishments.

And that’s when it all started to hit me, like I had outrun the impact during the race and it was just catching up, slamming into me from behind, catching me completely off guard. The enthusiasm, excitement and obvious difficulty of the runners coming into the finish was impossible to overlook. It was written on the smiles or grimaces spreading across their face, the form or falter in their stride, the cheers or struggles of effort they let escape without conscious intent. The marathon distance is no joke, no matter how you try to run it, and I had completed that, but I hadn’t just run a marathon. I had run the marathon in a race setting…despite cancer, despite the effects of chemotherapy, despite the effects of surgery, and despite the physical struggles of the marathon itself. It didn’t matter that I wasn’t RACING the marathon, it only mattered that I was a part of it, and in what is still a respectable time no matter one’s ability or current capabilities.

But even that wasn’t the impact that threatened to have me sobbing with emotion. It was the appreciation of those around me. I don’t pretend to assume people enjoyed seeing me run the race, but standing alone and remembering the cheers, excited faces and enthusiasm in their voices, I couldn’t help but recognize that people weren’t just happy to see me, they were happy FOR me…they were happy that I was running this marathon, that I was finishing, that I was completing my stated goal, that I was back in this race in one way or another. They were glad to see me out there as much as I was ecstatic to be out there. So many people, friends and strangers alike, have rooted for me ever since diagnosis and though I don’t like to make a show of my efforts or presume any sense of importance, I’ve graciously, if internally, appreciated the support from everyone beyond explanation. I can’t put words to how important it is to have everyone supporting me through the cancer experience, to hope for the best, and to then give an expression to the best outcome I can manage at this point by being out there running, for others as much as for myself.

I don’t know, maybe I’m reading into others sentiments, but watching those runners struggle to finish and the pride I was feeling for their efforts, despite knowing nothing about them individually, their struggles, their successes, I couldn’t help but feel as if others felt the same for me. I stood alone, looking down the road in anticipation of the runners I coached, feeling a mix of excitement, accomplishment, service and humility…and fought back tears of gratitude, for others, for myself, for everything.

Damn it felt good to be back, if only for these 26.2 miles, if only at this measured pacing, if only for these other runners. To experience the full depth of the marathon experience one more time…it felt so damn good.

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