Hamster Power and Cancer Awareness

“Mummie… Mummie… MUMMIE!!!”
“Sigh… what is it Timmy?”
“Mummie, why is that strange man running uphill shouting ‘Hamster Power’?”
“I don’t know, just keep a safe distance”

Timmy’s quandary will be resolved by the end of this post, but first, September is prostate cancer awareness month, and OMG, I can’t believe it’s already been 11 months since my diagnosis.  Suffice to say I’m doing much better than the unlucky minority that don’t survive their first year past diagnosis.

Generally I’m doing exceptionally well, with a couple notable footnotes.  First and most annoyingly, my hot flashes are getting worse, and starting to interfere with things such as sleep.  I’m either uncomfortably cool, or hot and sweaty, and seem to be losing the ability to spend any time feeling pleasantly warm.  It’s a problem to be solved, but so far I haven’t found a simple solution.

The other footnote is that my blood pressure seems to be inching up.  This is a very common side effect of my medication, and it’s something to keep an eye on.  It’s also a great example of something that for most people changes slowly over years if not decades, but when you’re battling cancer these changes can happen in just a couple months.

Most of this is due to treatment to suppress testosterone, and not the disease itself.  Let me try to explain how prostate cancer treatment feels.  Imagine for a moment you’re a healthy and relatively young man.  You think about sex frequently.  You’re active and loud and brash, sort of like this:

Tommy Shaw is an excellent guitarist, but Ted Nugent is on a whole different level.  Anyhow, now imagine that you find yourself in middle age and without testosterone.  Sex is no longer a pre-occupation.  You feel more sedate somehow.  You’re still upbeat and enjoy smiling, but it all somehow seems a bit weird, and like your body is speaking an entirely different language:

Prostate Cancer Awareness

Semen.  Specifically, semen with a slight pink tint.  That was the first sign that something was not right in my body.  I had a PSA screening test about six, maybe eight months earlier that came back at 2.0, completely normal.  Prostate cancer is a slow growing cancer and with a low PSA this couldn’t be cancer.  Must be an infection.  This symptom didn’t repeat itself so the infection must have cleared up and I went on with life.

A few months later, the start of my urine stream had a slight brown tint to it.  I wouldn’t have noticed except that the first drops landing in the urinal looked different.  Gonna have to keep an eye on that.  Oh look, it went away for weeks.  Now it’s back again.  Sigh.  I looked up urologists on Google, but the ones I found on my first try seemed to be vasectomy factories.

Eventually, I found a urologist near the office that had good reviews and made an appointment.  Around this time, that niggling running injury turned into back pain that made sitting very uncomfortable.  On Friday whenI had my appointment, I got the dreaded DRE.  “Digital Rectal Exam”.  This is the reason why men sometimes seek out women urologists for their generally smaller fingers.  I had a nodule on the right side of my prostate, better get some blood and schedule a CT scan.

To make a long story short, my PSA had gone from a happy 2.0 to a “worrisome” 216 in 13 months.  The CT scan and a subsequent bone scan showed widespread metastases.  The biopsy report indicated “intraductal carcinoma”, which is a rare form that is very aggressive and doesn’t output much PSA, and thus tends to avoid the screening test until it’s way too late for a cure.

A quick word about survival statistics: They apply to populations and not individual patients.  Prostate cancer has about a 90% five year survival rate.  But, 90% of prostate cancers are caught when removing the prostate is curative, and the five year survival for those cases approaches 100%.  It’s the unlucky 10% like me that have advanced disease at diagnosis that account for nearly all the deaths within five years of diagnosis.

My personal message to you is not a simple “get screened and everything will be okay”.  Screening is important, but the PSA test is far from infallible, and failed me miserably.  You must also be on the lookout for symptoms that indicate something is wrong and further investigation is warranted.  Back aches are a plague of middle age, but they can also be a symptom of metastasized cancer.

The other part of my message is to be aware that tomorrow is not guaranteed.  Screening tests aren’t perfect, and neither are doctors.  A careful balancing act is required here.  It is wise to get screened for cancer and be aware of symptoms that aren’t right, but on the other hand you can’t live your life worrying that every ache and pain is a potentially fatal symptom.

It’s something I still grapple with.  I just finished telling you about how I ignored the early symptoms of my cancer.  Do I wish I went to the urologist sooner?  Definitely.  Would it have made a significant difference in my diagnosis?  Probably not.  There would have been the advantage of starting treatment sooner, and I may have been able to skip the radiation treatment to my spine, but that’s about it.  I’m convinced my cancer was widespread before I had any symptoms.

Let’s go back to those survival statistics one more time.  Have you seen the long term survival rates for prostate cancer?  Virtually nobody with my diagnosis is reaching the age of 100.  Despite all the millions spent on research, death continues to be our number one killer, and I’ve reached the limit of how much cancer awareness I can write about without getting silly.

Hamster Power

It was finally the day.  I went out the door and ran and walked my way through two states, four towns, 650 feet of elevation change, and covered 12.7 miles.  It was my longest run in over three years, and it felt great, at least for those of us that enjoy sore feet, aching muscles, and heavy breathing.

This was only four days after getting injected with “hamster juice”, which is my new term of endearment for Xgeva, the bone strengthener produced in genetically engineered hamster ovaries.  Hamster juice is intended to help my bones heal from the damage caused by the cancer, and is what allows me to continue running.  Of course, the running further strengthens the bones, so it’s a very synergistic combination.

In a way, it’s a bit silly to push my running to the next level while the side effects of a hamster juice injection are at their peak.  On the other hand, I’m finding that getting out and moving while the body is under duress due to other issues eventually leads to bigger gains in fitness.  I honestly was pushing through the joint pain and fatigue by shouting “Hamster Power!”, but of course my vocal cords wheren’t engaged, so it was a whispered shout.

This route starts with a long uphill stretch, with a payoff at the top of the hill.  There are several horse farms with pastures that provide a view of hills and mountains way off in the distance.  At one farm they were setting up folding chairs for what looked to be an impending outdoor wedding with a view.  It’s just one of the ways that you can run the same route repeatedly, and it’s a little different each time.  It’s why I enjoy running outdoors instead of on a treadmill.

From the view it goes downhill for the next mile and into New Hampshire.  I skipped a walk break or two and glided down the hill to gain back some of the time lost on the uphill section.  My toes were taking a pounding here as they repeatedly slammed into the front of my shoes.  At the bottom I stopped to tighten up the laces.  That reduced the toe pounding, but tight laces can lead to foot cramps.  Longer runs leave less room for errors in mundane things like how tight you tie your laces.  Okay, still a couple more hills to get over.

Cranking up one of the last real hills, I started thinking to myself “Keep those feet turning.  Keep moving.  Go Forward.  Move Ahead.  It’s not too late, to whip it!  Whip it good!”  Did I mention I get silly on long runs?

After the hills the road gets lumpy.  It’s never flat, there’s just an endless series of short ups and downs.  Not quite high enough to be called hills.  Not enough to get into a rhythm.  Just enough to make the route a real challenge.

At about mile 11 the endorphins really started kicking in.  I was going to finish this route for the first time in years.  Fuck the cancer.  I whisper-shouted “I FEEL AWESOME!!!”, and then sucked in a bug on the subsequent inhale.  Gag, cough!

After my free protein supplement from mother nature, it was mostly downhill back home, and nothing of importance happened.  I finished my run feeling tired and sore, but not really any more tired and sore than I would be after running a dozen miles years ago.  The problems I’m having with sore feet and inhaling bugs are running problems, not cancer problems.

A few days after that long run, I took a run/walk/hike in Vermont.  That went down an all but abandoned stretch of road, past a couple abandoned houses, and ended at a field next to what appears to be a well maintained but off the grid house.  I honestly don’t know if the field is owned by the house, or is simply part of Jamaica state forest.  But since there was nobody at the house, I “trespassed” onto the field which has one of the best mountain views in the area.

I wish I had my camera to capture the view.  However, the lack of a camera didn’t stop me from posing for a few photos that weren’t taken. I was really hamming it up.  I hooted and hollered, for real as there didn’t seem to be anybody around for a mile in any direction.  I was feeling great from the run, and such antics only improved my mood further.  I did handstands and cartwheels.  I used yoga powers to levitate.  Nobody was around to confirm or deny these claims.

Such silliness keeps me from dwelling on other aspects of my situation.  About the hot flashes, somewhat disturbed sleep, and increasing blood pressure.  About the unlikeliness of celebrating my 100th birthday.  About how my mom probably won’t be around for that birthday if I do reach it (who knows, maybe she will live to 130+).  For a moment, I’m just a guy enjoying the moment.

Because really, at the moment I’m doing very well, and I’ve shown a new found ability to deal with things as they come up.  When I get entirely absorbed in a run, or in a video game, or even a problem at work, it shows some ability to not worry about things that haven’t happened yet and don’t need to be dealt with until they happen.  If I can do that for a moment, perhaps I can do it for another moment.

Epilogue

The seat belt sign had just been turned off as the plane banked into a turn to head east for Europe.  Timmy gazed out the window at the tree covered mountains and hills that lay below him, and saw a field with a strange man jumping up and down on a rock.  “Mummy, there he is again!”

The Wapack Water Stop

In this post:

• Pain Update
• The Wapack Water Stop
• Baystate Training Update

Pain Update

In my previous post, I set up an epic battle between myself and that nagging pain in my back and hip which was largely blamed on too much enthusiasm in my running.  What I sort of didn't mention was that running is only a partial contributor to my condition.  I'm also cutting and splitting firewood, and lugging a chainsaw into the woods to cut a trail on our property.

All this bending and lifting and generally using a good portion of my bodily strength in odd positions also takes its toll on my joints.  Holding a chainsaw to cut fallen trees on uneven terrain is a form of backwoods yoga.  It's both a sign of my continued improvement, and also a source of pain and stiffness when I do eventually find my new, improved limits.

So take my whining with a grain of salt.  It comes from a place of pain and fatigue, and my brain isn't always good at remembering all the things I did leading up to the pain and fatigue.  Happily my wife is pretty good at remembering and reminding me how I got into such a state.

Wapack Trail Race Water Stop

Due to various life events, it's been a few years since I've been able to help out at the Wapack trail race.  For those who aren't familiar with it, it's a small but very challenging race that runs out and back on the Wapack trail over four mountain peaks.  About 18 miles in total, with nearly 4,000 ft of up hills and an equal measure of downhills.  I've never actually run the race, but I have run the whole course in shorter sections.  This year I got the call to set up the water stop in the middle of the trail.

Access to this section of the trail is very limited.  In the 9 miles between Windblown ski area and the Mount Watatic parking area, there is only one spot where it's possible to drive a vehicle right up to the trail, and that involves travelling over half a mile of gravel road that is no longer maintained.  A week before the race, I was in the area and scouted out the road.  It had some pretty significant washout:

The basic problem is that it's a narrow road and only half washed out, so one side of my truck has to ride on the portion of road that's still in reasonable condition, while the other side bounces along in the bottom of the washout.  This makes it vulnerable to any high spots in the transition between normal and washed out road.  It was still somewhat passable, but in spots I had to choose between scraping the bottom on the middle of the road, or scraping the running boards on the side of the road.  There were more heavy rains a few days before the race.  I feared further washout may have occurred.

There were two ways to deal with the situation.  One would have been to get a bunch of people together on race morning and carry the 10 gallon coolers full of water on foot up the half mile of steep gravel road.  10 gallons of water weigh about 80 lbs, plus the weight of the empty cooler.  The other way would be to assemble a few volunteers the day before the race with shovels and rakes and implements of destruction, knock down the offending high spots on the road, and use the material to fill in the worst of the low spots.  Suffice to say, we chose the option that involved implements of destruction and use of 4WD-LO.  And so it was that 30 gallons of water was delivered on time on race day to the water stop.

You can add shoveling and raking gravel as well as lifting 80 pound, 10 gallon water coolers into the truck to the list of things I'm doing and then forget about when I complain about pain.

As for the race itself, there was an exciting back and forth battle for the win between a guy who was better up the hills vs a guy who was better on the flats.  They came into the water stop together, and seemingly took a brief truce to refill their water bottles and drink some Gatorade.  That is until the guy who had been a few steps behind coming into the water stop decided to resume the race without warning, causing the previous leader to toss his partially consumed water cup and rush off in pursuit.  I found it rather amusing.  The third place runner came by a number of minutes later.

There's also an interesting anecdote about the leading woman runner.  She took her time re hydrating, and carefully placed her empty cup into the garbage can nearby.  While this was happening a male runner came by, grabbed a water cup on the run, gulped it down, and tossed it on the side of the trail.  The leading woman picked up the tossed cup off the trail and put that in the garbage while sighing something about "Boys!", before casually running off to resume her race.  I expect she went on to win ahead of all other women in the race, and she seemed like she was just having a casual morning out in the woods.

While the race went on I found myself increasingly fidgety and wanting to be in the race.  This race has been on my bucket list for years but I've never been in good enough shape to dare to enter it.  Usually, I get over-enthusiastic in my spring and early summer training, develop over-use injuries, and then put my dreams of the Wapack trail race and fall marathons on hold for another year.  It may be time to make a more determined, more deliberate attempt at this race next year.  It sort of feels like it's reached the point of now or never.

Let me describe fidgety.  When fellow club member Paul came by the water stop for the second time, we started to talk, and rather than hold him up I chose to run about a half mile with him.  Paul is not only running the race, he's also the race director.  He was helping with the road repair the day before the race, helped with race setup the morning of the race, ran all 18 miles and 4,000 feet of elevation gain of the race itself, and helped to clean up afterwards.  He's in his late 60s and I was running pretty fast to keep up with him for that half mile.  I can't wait to be almost 70 so I can have his level of energy.

After jogging back to the water stop, I then ran the same section with Chris, another fellow club member and host of the runrunlive podcast.  After the last runner had gone by, I ran the same section a third time to retrieve a length of yellow "CAUTION" tape we had previously strung up at a fork in the trail to prevent runners from going the wrong way.  In all, my step counter claims I covered several miles working a stationary water stop.

One final anecdote from the race:  One runner came into the water stop with his jaw hanging open in surprise.  How did we get the truck up here?  he asked, after introducing himself as the director of the spring Wapack and Back race.  "Magic" I said, and then went on to tell him about the crew with implements of destruction that was working the previous day.  It seems the spring race chose the option to carry water in on foot.  He was very thankful that they might not have to do that again next year.

After all the runners had gone by, we broke down the water stop and drove to the finish line to partake in pizza and snacks while watching the runners come in.  I had hoped to help with the post race cleanup, but my body had other ideas.  After hours of boundless energy and enthusiasm, I was reminded that my last chemotherapy infusion was less than six months ago.  There is an emerging pattern that if I go well beyond my limits, I will still get what feels like chemo side effects.  So I left before all the runners had finished to go home and lay down for a few hours.

Baystate Training Update

After a few hours of laying down, I felt well enough to get out and go for a six mile run.  As mentioned previously, I signed up to run the Baystate half marathon on October 20th to celebrate the first anniversary of my cancer diagnoses.  All indications are that I will crush this race, but it's likely I'll be taking a nap afterwards.  Not too shabby considering all I've been through in the past year.

Yesterday I woke up at 6am, and was out the door at 7:15 for a 10 mile run and couldn't dilly dally because I had to be back home and cleaned up in time to dial in to a 10am meeting.  (side note: If you're over the age of 50, you can refer to video conferencing as "dialing in", because I am old enough to remember and have used a rotary dial phone).  This was sort of a dry run for race day where I'll have to be up early, drive myself to Lowell, and be ready to race at 8am.  Waking up and running weren't a problem, but there may be some digestive issues I'll need to address.

After my previous post, I expected to have to cut back on my running pace and mileage and focus on strength training exercises for a few weeks.  In reality, I did cut back my pace and mileage for about a week, and did my strengthening exercises once, maybe twice.  After that, I went out and ran 33 miles in a week, which also including some time spent working in the woods with a chainsaw.

Let's put that in perspective.  Prior to this year, I hadn't run 30 miles in a week since 2015.  I've had seven 30-mile weeks so far in 2019.  I have to go all the way back to 2013 to find a week where I ran more than 33 miles in a week.  When I talk about running the Wapack trail race and marathons in the not too distant future, it's not a pipe dream or bluster.  It's simply looking at my current running performances and assuming I'll continue to improve if I keep training and avoid injury.

I'm running better than I have in years.  My Garmin is producing hard data to back that up.  The fact that I'm doing this while continuing to put all sorts of chemicals into my body to fight cancer just blows my mind.  I'm as curious as anybody to see how far and how fast my body can eventually go.