Friday, January 6, 2017

Little snippet of good news

It was three years ago today that I had my prostate removed due to stage 2 (Gleason Stage 3+4) prostate cancer.  The pathology from that day showed that the cancer was fully contained within the prostate and the amount of Gleason pattern 4 cancer (the more dangerous type) was very minimal.  In retrospect, I might have been able to put off surgery for years, although doctors want to treat people my age very quickly for prostate cancer, given the expected lifespan of a male in his early 50's.  In hindsight, especially with everything I know now, I would have have held off on treating the prostate cancer, but there are no do-overs.

Even though the final pathology report was good, and despite much more pressing concerns at the moment, I still need to have my PSA level checked every six months.  And, because I'm a testosterone user (it's only been in the past few years that prostate cancer patients have been allowed to use testosterone after treatment), the doctors are extra cautious about the PSA level.

So, this past Monday morning, I had three blood tests - a hemagram, PSA, and testosterone level.  First, and most importantly, my PSA remains undetectable at the 3 year mark post-op.  According to online nomograms, I have a 99% chance of not dying from prostate cancer in the next 15 years, and a 91% chance of being free of prostate cancer in 10 years.  My testosterone level is solid and my blood isn't too thick - something that can happen with high doses of testosterone -  higher doses than I use.

Doctors don't like to use the word "cured" with prostate cancer, and certainly not before the 5 year mark.  But, these test results give me some hope that I shouldn't have to worry about that beast again.  Besides, I have a bigger opponent these days.

Thursday, January 5, 2017

Minor setback

This week, for the first time since my radiation treatments, I was able to squat on Monday and not end up unimaginably sore for the next few days.  I even followed up Monday squats with deadlifts on Tuesday, plus some other work.  But, I noticed Tuesday night that I was struggling with my workout, and I blamed it on lifting heavier on Monday.

In reality, it turns out that I have a head cold - my first in a long time.  I'm not sure why, but for many years of my life, I have been prone to catching colds.  Two winters ago, before I started to feel sick from the liposarcoma tumor, I was amazed to catch a cold in November, December, January, February and March.  Those persistent colds led to a tough ski season.  It just isn't much fun to ski in the cold weather while sick.

In hindsight, I'm sure this was due to the cancer messing with my immune system, but at the time, it was very disturbing.  I've always heard that we catch fewer colds as we get older, mostly due to antibodies that we developed from colds when we were younger.  I can't cite any research on this, so I could be off base here.  But, I seemed to be going the opposite direction at the time.

But, after I started to get sick in April of 2015, and after the 5 colds in 5 months, this suddenly stopped.  I haven't had a cold right now in 20+ months.  So, I'm not going to complain too much about this one.  I would guess that I'm overdue.

Due to the cancer and having mild asthma, I get a flu shot every winter and I make sure to stay up to date on the pneumonia vaccine.  So, I'm sure this is just a head cold that will hopefully run its course in a few days.

Regretfully, that does mean a few days of rest.  I might be able to work out, if I really wanted to, but it wouldn't be fun.  So, I'm just going to wait it out.  If I'm not feeling better by tomorrow afternoon, I will skip skiing this coming weekend.  And hopefully, by Monday, I'll be right back to my normal training schedule.

I have just under 4 weeks until my next CT scan at Sloan Kettering.  If things go as expected, we will set a date for surgery that day, and I'm guessing I'll have surgery by mid-February.  So, my goal right now is to regain as much fitness as possible between now and the surgery.  My fitness has helped me in my recovery from previous surgeries, and going into surgery in good shape means I'm in better shape when I can resume training.

So, I really want to be training regularly right now.  But, I will use some discretion and rest a few days before getting back to my normal schedule.  I don't want to risk prolonging the cold by trying to train hard through it.

Such is life.

Thursday, December 29, 2016

A few good days in a row

Monday, the day after Christmas, I hopped on the treadmill for a 90 minute walk.  After our recent rain and freeze/thaw/freeze cycles, walking outside didn't seem safe, and it was a chilly day anyway.  The walk was pretty basic - a bit over 4 miles in the 90 minutes, but the aftermath was surprising.

I woke up on Tuesday sore all over from just walking.  I'm assuming that I'm still seeing side effects from the radiation, because every workout for weeks has had this effect.  Despite being tired and sore, I made it to the gym Tuesday night.  I started my workout with 10x3 back squats at 135#.  This is kind of pathetic, given that I lifted 320# recently, but it's what my body will tolerate.  Last week, one workout of squats at 113# destroyed me for the week, so even this level worried me.  But, it went reasonably OK.

After squats, we did an AMRAP of wall balls, light deadlifts and ring rows.  I have to admit that I really struggled through this and hated every second of it.  But, I finished, and it was one of those days where I was glad that I had worked out.  I rarely hate a workout, but this day was an exception.  Luckily, I stuck with it and completed it, even though it wasn't fun.

Yesterday, I wasn't as sore as I expected, so I returned to CF - my first time doing 2 days in a row since November.  We started with strict presses and push presses.  Then, we moved on to 3 x 5 minute working sets.  Each round had a "buy-in" of weighed box step-ups and DB shoulder to overhead movements, followed by max burpees in the remaining time.  Compared to the rest of the class, my burpee total was pathetic, but I did manage to get through it and keep moving.  The first round had 30 reps of each of the first 2 movements and I got 6 burpees.  The second set was 20, 20 and 16 burpees, and the last set was 10, 10 and 26 burpees for a final score of 48 burpees.  Most others had way more than 48 burpees in just the last set, and one person had a total of 170 burpees.  If I had done only burpees through the 21 minutes of this workout, with no rest and no other movements, I don't know if I could have done 170 burpees.  I have a long way to go to get back to where I was.  With surgery looming in February, I need to get myself back into decent shape quickly.

Today, we are expecting our first big winter storm in a couple winters.  I have to pick up a new part for the snowblower at lunchtime.  We are skipping CF so we can get home before the heaviest snow starts to accrue.  I am hoping to do CF tomorrow, at an easy level, before I ski all weekend.  The snow storm should really help the conditions on the mountain tremendously.

Thursday, December 22, 2016

Trouble finding my rhythm

Well, my wife would say I've always been rhythmically challenged, especially on the dance floor.  But, it's a different kind of rhythm that's eluding me, really since late September.  Late October is when my wife and I did the Ghost Train ultra, covering 45 miles in 28+ hours, but I started tapering for that event at the end of September.

Since then, I simply can't seem to find a consistency in my training.  Yes, I had three trips to NYC for treatment.  The treatment and aftermath of radiation cost me 3 weeks of gym time.  But, it seems that every time I jump back into CF, I trash my body so badly that I am left incapacitated for days.

This week, for example, we started the week with front squats and back squats on Monday night.  When healthy, I would do this workout at 185 pounds, a testament to my current weak front squat (My front squat PR is 305#, back squat is 375#, and I can only do 185 for mixed sets???).  But, after three weeks away from the gym, I backed way, way off, and did the squats at 113# - crazy low weight for me.

By Tuesday night, my hammies were sore, but I managed to walk on the treadmill.  By yesterday, I could barely walk, and I pulled my left hamstring during a warm-up at the gym, doing unweighted split squats.  I knew I needed to be careful on that movement, and I thought I was being careful, but I tweaked the muscle anyway.  So, I sat out the workout.  Today, I can barely walk again, so I doubt that I can do CF.  Even a walk on the treadmill will be tough, to be honest.

Every week seems to go like this.  No matter how easy  I go, I trash myself.  Then, I miss some days.  Then, when I return, my conditioning is even worse, and I trash myself again.  I can't seem to find a way to train at a moderate level so that I can find some consistency.

Squatting seems to be the core issue, and we always squat on Mondays.  Recently, squatting comes after a weekend of skiing, and by Tuesday, I'm shot.   I love to squat, and I want to squat at least once per week.  But, without some consistency, I can't do it without trashing my legs for days.  Right now, I haven't done CF even 3 times in one week since September.  I've been walking a lot, but walking is not proper preparation for CF.  So, my inconsistency feeds on itself, and I feel like I'm going backwards.

Between my trips to MSKCC last month and this month, the holidays, a business trip, and other family obligations, I simply can't find that rhythm.

Right now, I'm probably 7-8 weeks away from my next surgery, and I need to use that time to get stronger and more fit, so I'm as fit as possible heading into the surgery.  And, I'm not doing a very good job right now.  I must fix that!

Monday, December 19, 2016

Getting back to life

Last Thursday was a milestone for me.  After taking a sick day on Wednesday due to nausea and cramping, I ate lunch on Thursday.  It was the first time I felt good enough to eat lunch in a few days.  From there, each day has gotten better, although I'm still taking anti-nausea meds.

However, I'm no longer skipping meals (good or bad, I'm not sure), and I'm able to sleep through the night without being awakened by nausea.

I managed to ski both days this weekend, although I didn't cover much terrain on Sunday due to crazy weather.  I left my house early due to icy roads and an air temperature of 30F.  Driving was slow, and I had to use my alternate (longer) route to Sugarbush.  As I got close to the mountain, the air temperature went from 30F to 46F in a matter of minutes.  It started to rain hard and the winds picked up.

Only 2 hours later, the opposite happened, as the temperatures started to plummet again.  By the time I left the mountain, only 3 hours after I arrived, it was 36F and snowing.  On my drive home, the temperature dropped to 31F and it was 0F by this morning.  So, in 48 hours, we went from 0F to 46F to 0F.

Regretfully, the brief warm period and the pouring rain that came with it really destroyed our amazing start to ski season.  Natural snow trails that had been amazing are suddenly a mix of ice and dirt, and they are mostly closed.  The trails that aren't closed and that aren't groomed are now bulletproof ice.

Such is winter in New England (yeah, it's not technically winter yet).

But, the good thing is that I was able to ski 2 days in a row after a very rough week.  Last night, I even felt up to having a little Champagne as we decorated our Christmas tree.  We had waited longer than normal to put up a tree this year, wanting to wait until our daughter was home from Syracuse after her first semester as a freshman.

Tonight, I plan to do CrossFit.  It is a squat night, and after 20 days away from the barbell, I will lift very lightly.  My muscles might be strong enough to lift heavier than I will, but if I do that, I will be too sore to even walk for the rest of the week.  So, I plan to ease back into CF these next 2 weeks.

Lastly, speaking of CrossFit, members of our gym set up a fundraiser for my wife and me, to help us pay our transportation costs for my treatments at Sloan Kettering.  The response has been overwhelming in just one week.  At times, the kindness of others has honestly left me in tears.  I'm not sure what I've ever done to deserve such kindness, and I often say that it's my wife that people are supporting, rather than me.  I know that's not really true, but I have been touched beyond belief by all of the kindness we have received in the past 15 months.

While I would never say that I'm a religious person, the only word I can think of to describe how I feel is blessed.  We've had so much help from friends, ranging from a few great meals in Manhattan, a Broadway show, a night in the Waldorf Astoria with a high school friend (well, truly a lifelong friend), help from my brother, help from my skiing co-workers, and now, help from our gym friends (and others who have contributed so much).

I am reminded of a quote from Edgar Allen Poe's Mesmeric Revelation, and I'll finish with that:

"Never to have suffered would never to have been blessed."

Thursday, December 15, 2016

Radiation Aftermath - Tougher than I Expected

I finished radiation last Wednesday, 12/7.  I expected that the nausea would get worse for a couple days and then get better.  The radiologist told me he thought I would be back to normal by a week after treatment ended.  Regretfully, that hasn't happened.

I got home from NYC last Thursday evening.  I had been planning to work at home on Friday, but I felt pretty good, and I went to the office for the day.  That day went so well that I taught skiing that Saturday, and everything has been in freefall since then.

I got through the day of teaching skiing, but it took a lot out of me.  By 2:30 in the afternoon, I was done.  Simply depleted.  I had walked a lot in my ski boots, which is never easy, and a lot of that was on beginner skiing terrain - uphill and downhill.  I hiked up the beginner slope 4 or 5 times during the day.  By the time my FitBit told me I'd hit 10000 steps for the day, I was toast.

I had to skip a planned training session at 3:15. I was dealing with some nasty muscle cramps in the two muscle walls where most of the radiation entered my body.  I chugged a liter of water and this made things better, but not good.  I wanted to stay and have some beers with my friends, but after a short period of time with my friends, I had to head home.

The next morning, I felt so run down that I called in sick.  I slept in, did a little bit of winterization work around the house, tied some flies, and that was it.  The day was a wash.

On Monday, the nausea was worse.  I went to the office, but I couldn't even consider eating anything.  I did manage to walk on the treadmill at the gym while my wife trained, but 2.8 mph was hard.  I did this for 55 minutes, and I was exhausted.  On the way home, I had some medical MJ, and that controlled the nausea so I could eat some food at least.

On Tuesday, the nausea was worse, and the day was a repeat of Monday, except I napped at the gym rather than walking on the treadmill.  I had to use medical MJ again just so I could eat something.  Overnight that night, I started to get some abdominal cramping, and this led to me calling in sick to my day job on Wednesday.

On Wednesday, I slept a lot, tied a few flies, and I took a lot of pain medicine for the cramping I was dealing with.  I managed to eat a bowl of soup for lunch, I drank some ginger ale, and I ate some popcorn for dinner.

The cramping is slightly better today, but I still had to take pain medicine as soon as I got out of bed.  I had a medical appointment in the morning that I didn't want to miss.  That doctor was happy with how things are going for me, but the cramping and nausea are not his concerns.

So now, I'm in my office.  I couldn't drink coffee.  I haven't eaten anything.  And, with the weekend approaching, I'm curious if I'll be able to teach skiing or not.

Clearly, the radiologist was off a bit in his recovery timeline.  But, I've got the meds I need, and I just need to wait it out.  I was hoping I'd be training in the gym by now, but I'm far from ready for that.  So, I'll just continue to wait things out.  I'm probably already pushing more than I should, so perhaps a couple more complete rest days is what I really need.  I'd really like to ski this weekend, but my body's recovery comes first.

Thursday, December 8, 2016

Radiation done - long blow by blow of trip to NYC

I can't say that it's been fun, but my radiation treatments are now over, and I'm currently on the train back to Vermont.  I didn't do any formal workouts for the past 9 days, but the weather in NYC cooperated, and I walked anywhere from 11K to 25K steps every day in the city.  In my 7 full days in the city, I walked 108K steps - one of my best weeks ever, and well over 40 miles.

I got to the city last Wednesday, with radiation scheduled to start on Thursday.  The weather on Wednesday was rainy, but not horrible, so with my computer bag, a suitcase on wheels, and an umbrella, I walked from Penn Station to my room on West 63rd.  It's normally a 35 minute walk, but in the rain, and carrying so much stuff, I seemed to miss every light, and it took me 45 minutes or so to go 30 blocks.  I got to my room, grabbed a quick dinner, and then got to sleep.

The next day, I was up early.  I have my routine in NYC down pretty well for these extended stays with outpatient treatment.  I get up, get some coffee, and I get straight to work.  I did that the first day, and then headed to my first treatment mid-afternoon.  By cutting through Central Park, it takes me about 40 minutes to walk from my room to the hospital.

On that first day, I met with the doctor for a while and then did the treatment.  The treatment is kind of weird.  The radiation "machine" moves around a lot, going after the tumor from multiple directions.  They put me into a mold that we'd made the week before and an abdominal binder to stop my breathing from moving the tumor too much.  The tolerance for the tumor moving is 0.2 cm, so they crank that thing pretty tight.  They strapped me in, asked what music I wanted to hear (they use Pandora, and I just gave them a band to seed the Pandora feed), turn on the music, and 15-30 minutes later, I'm done.

That first day, I selected the Dead, mostly out of my excitement that Dead and Company have announced they will be touring again next summer.  I honestly felt nothing at all from the treatment, and afterward, I headed to one of my favorite watering holes on the upper east side - The Bar Room.  But, I had an empty stomach, I'd taken some pain medication before the treatment, and after just a couple cocktails, I felt like I'd had too much.  So, I headed back to my room, ordered a pizza, talked to my sister and my wife for a while, and got some sleep.

The next day was similar, although I did start to feel the nausea I'd been warned about.  Instead of taking Zofran for just the treatments, I started taking it every 8 hours - the maximum dose.  After Friday's treatment (David Bowie was my musical choice this day), I wandered downtown for a while - down 5th Avenue to Rockefeller Plaza.  It was a zoo - the worst pedestrian traffic jam I've ever seen.  Eventually, I'd seen everything I wanted to see and I headed back to my room, grabbing some food to go from the Whole Foods in Lincoln Center.

I got 11.5 hours of sleep that night, the first sign that fatigue would be affecting me.  And, I was pretty nauseous when I woke up, but after some Zofran, I was able to drink some coffee, although food seemed totally unappealing.  Around noon, I headed out for a long walk through the northern end of Central Park and eventually made my way to Penn Station, to meet my wife, who was visiting for the weekend.  I keep trying to spare her as much of this as I can, but she wants to be there for me, and I can't believe how lucky I am.  Thirty years after we said our wedding vows, and three years after cancer began to really test some of them, we seem to be doing better than ever.  Well, our marriage is doing fine.  My health is the real issue.

We walked back to our room, grabbed an early dinner, and went searching for a place to watch the B1G conference championship game.  We tried to go to a place that was hosting a PSU alumni group, but without a reservation, they had no room for us.  Yelp saved us and we found an Irish/sports bar in the Hell's Kitchen neighborhood.  When Penn State fell behind 28-7, the mostly Penn State crowd was pretty quiet, but things got boisterous as Penn State stormed back.  I was careful with alcohol - sipping beer very, very slowly, to not upset my stomach.  We even ordered some wings late in the third quarter, which turned out to be a mistake.

After the game, we headed back to the room and my wife fell right asleep.  I, on the other hand, was having serious nausea problems.  I knew that I didn't want to throw up spicy chicken wings, but I wasn't in control.  With great confidence, I can tell you that buffalo wing hot sauce in the nasal cavities is highly unpleasant.  Eventually, after getting sick, I was able to fall asleep.

Regretfully, the vomiting continued Sunday morning, and I sent a note to the hospital, asking if they could add some compazine to my Zofran and Ativan.  I probably should have had them page the radiation oncologist on call, because it took until Tuesday morning for me to get the compazine.  Luckily, the nausea calmed down on Sunday, and my wife and I had a great day.

We had a late lunch at Shake Shack, a NYC institution.  It was really good, although $5 for a basic burger, and a $5 Vincent Vega-esque milk shake was a bit pricey,   But, the food sat well, and we headed to Macy's.  I had forgotten how huge the Macy's is in NYC.  My wife wanted a new pair of dress boots, and they must have had over a 1000 options.  After one full loop of the second floor, I opted to just sit down, and have my wife text me when she'd found something, since I'm the one with a Macy's card.  Finally, she found something, I paid for it, we got my son a Christmas present, and we got out of there.

By now, it was getting dark, so we headed to Rockefeller Plaza to see the big Christmas Tree.  I quickly realized that the crowds were worse than Friday, so I started looking for an alternate way in, and luckily, I found one.  We got some photos, and then simply had to get out of the crowds.  By now, I was exhausted and my wife was thirsty, so we found a place for her to get a cocktail.  Then more walking towards the room, and I ran out of energy again, but this time, we were right at a Champagne bar.  My wife is a huge Champagne fan, so we dropped in.  It turned out to be some sort of event - women drinking Champagne and drawing a variety of models.  But, the models were in various forms of undress and in various BDSM gear and poses, so it was, uh, interesting.  After a little Champagne, we stopped at Whole Foods to get some dinner, and called it a night.

The next day, my wife was heading home and I had to work, so it was a low key day.  We had thought of going to Carnegie Deli, which is closing at the end of this month, but the nausea was too bad for me to consider it too seriously.

So, about noon, my wife headed to Penn Station. About 5:00, I headed out, planning to stop at the Dean and Deluca store on upper Madison.  I have been a customer of theirs for years, but I'd never been in a store.  I ended up buying one Christmas gift before heading to my 6:15 radiation appointment.  Everything lined up perfectly this night, and before the third Janis Joplin song was over, I was done.  I got them to page the radiologist to make sure I would get compazine, and then I was gone.  I picked up some beef chow fun at a popular Chinese takeout joint, and it was amazingly good.  In Vermont, I only get this dish when I make it myself, and I can only make it when I'm lucky enough to find the correct noodles.  This random restaurant's version was outstanding and it sat well in my stomach.

The next morning, my first goal was to pick up the compazine, and what a difference it made.  During chemo, Zofran had been the key to my nausea, but for some reason, during radiation, compazine made all the difference.  My Monday radiation went quickly, and my stomach felt great afterward.  (I requested Talking Heads on tuesday).  After I finished working for the day, I went to Rosa Mexicano by Lincoln Center for dinner.  I knew my stomach was a lot better if Mexican food sounded good.  And, this place was stunningly good.  Not cheap, but really, really good.

I told my waiter that the place would easily be the best Mexican restaurant in the entire state of Vermont if they opened a branch there.  And, I liked it so much, I made a reservation to come back the next night.

On Wednesday, I had to meet the radiologist before my treatment.  He was gushing about how well the radiation had gone, about how well they'd been able to isolate the tumor.  His attitude left me wondering if he thought things were in doubt beforehand and they'd just glossed over that piece of information.  I chose the Dead again, did the final treatment, and we were done.  I go back to see the surgeon and the radiation oncologist at the end of January.  We will likely set a date for surgery during that visit.

After one more trip to Rosa Mexicano, I got to bed early.  I got up early, packed, had some coffee, showered, worked a bit, and walked to Penn Station.  My train was a bit late, but not too bad.

And, that catches me up to right now.  While I still have medical appointments in VT, I'm done in NYC until late January and then a likely surgery date in February.

For now, I'm hoping the nausea calms down a bit more in the coming days.  I'm hoping I feel good enough to ski this weekend.