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Last year I ran two marathons. It was my first real attempt at to take on any kind of endurance challenge. For me marathon running is both terrifying and exhilarating. You get to the start and wonder – did I train enough? Did I do enough speed work? Run enough hills? Log enough miles? Drink enough water? I secretly love the training, the hours of running, in the heat, in the cold, with the dog. I loathe the last 2-3 weeks before race day where you cut back on mileage to prepare. I get bored, and crabby. I’m really fun to be around during that period.

Having had cancer myself, when I signed up for my first marathon, I considered doing so with an organization that raises money for fight cancer. However, though it may sound silly, I wanted to make sure that I could do it first! So this year I will be running the Marine Corps Marathon through the DetermiNation program in order to raise money for the American Cancer Society.

I am on the hook to raise $1275, which is no small chunk of change. Honestly, I would love to raise more. Please help me with this goal. I will be thanking you every mile.

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Today’s run was a fucking revelation. It was the prize for every step I’ve slogged through, every hour on the treadmill, every run I didn’t feel up for and did it anyway. For the past two weeks or so I’ve been cutting my miles back, in order to give myself a little rest before the big push during the 26.2 miles of the marathon. This is usually referred to as tapering in the running world. Very often when someone tells you they’re tapering, this is quickly followed by a reference to “taper madness”. After weeks of training, and ideally peaking your mileage towards the end of of your training cycle, squeezing miles in around your already busy schedule and then going out for 3-4 hours on the weekends all of a sudden, you’re not doing that. You have weird blocks of free time and you’re supposed to be resting those muscles a bit. This free time increases as the specter of the marathon comes closer.

This is not a formula conducive to maintaining one’s sanity. You begin to wish you had a hobby. One of course, which you’d probably have to drop during your next training cycle, so… you see the problem. For me with this free time, inevitably I end up reading more which is nice. However, I also seem to veer towards reading books about running, which makes me want to run, which I’m not supposed to do. This pisses me off and just fuels the fire of my already shit mood. For anyone who has had to deal with me on any kind of personal level for the past two week, allow me to offer my apologies now. Clearly all the blame lies on the taper.

With the Richmond marathon just a week away I realized on Friday that my running plan for this week probably had me logging too many miles. At the last minute I had to rethink my training for the weekend which lead me to shorten my last long run and skip another run entirely. This also didn’t make me feel particularly good. I was planning to do my long run on Saturday but was feeling kind of tired, so I pushed it off until today. Today’s run confirmed that this was the best decision. It took me about a mile and a half to warm up but once I did I found myself running faster than I typically do. I’m a slow runner. I enjoy the distance and try not to beat myself up for logging 12 minute miles. But today, I watched my Garmin report my time and I was shocked when I saw numbers that indicated I was running miles in the 9 or even 8 minute range. I maintained this for about 4.5 miles of my 6.5 mile run. For me this is race pace – like short race pace for a 5k or 10k. While I don’t expect to be able to run the entire marathon like this, it does make me feel confident that can pull down a better time than my lackluster 5:13 at Pittsburgh this past May.

I felt like a million bucks this morning, dodging strollers, and racing through intersections just before the light turned. It felt better, really than any monetary figure I can pin on it because I was running. This was no jog, no training run, no run just to get those miles logged. It was a beautiful thing.

So, I believe in the taper. I believe that sometimes you need to feel like you’re going backwards in order to make progress. I believe that I will rock the house during the Richmond marathon, because really, when you’re running you’re biggest challenger is yourself. Oh, and I also believe in getting new running socks a week prior to the race! So, I’m ready Richmond! See you next weekend!

This morning I ran in the Global Race for the Cure 5K. It is the first time that I’ve done this particular race by myself. I admit to feeling an odd sense of entitlement when I am running in it. I find myself entertaining thoughts along the lines of “get out of my way with your stupid stroller,” or “why the hell did you stop dead two steps in front of me – you signed up to run and we’re a quarter of a mile in,” or “I know that you didn’t just throw an elbow right into my survivor shirt just to gain a whole step in front of me, asshole.” It feels like my race. I had breast cancer, so all of you, really you’re running for me. I own that shit. At least that’s the weird twist my brain puts on it when I’m out there. It’s always crowded. It’s always blisteringly hot, even though it starts early. Honestly, were it any other race, there’s no way I’d do it every year.

But I got up early. I ran to the metro for a warm up, rode down to Chinatown and jogged over to 7th. I had considered doing the “Parade of Pink” because they move to the front of the race line, though I think that would make me feel like I was on display in a weird way, but I got there a little too late. I did hear the official announce the Survivor of The Year, which made me wonder how the competition plays out for that annually, considering the nature of the honor. It’s funny if you think of it in the right context. Honest. So, instead I walked over towards the start line and noticed that there were signs placed where the parade of survivors would go so I meandered over and squeezed myself in before the actual parade came.

It’s so big and such and event that the time you spend waiting at the start gets tedious.You are bored. Everyone around you is bored too, and when there is any indication that you’re going to get to move, the crowd converges in on you from all sides. It’s a little frightening. So the gun went off after I listened to half of the playlist I had prepared for the race and the crush made its way across the start line. The first hard turn is not long after the start line, and the crowd is still thick. So it’s kind of annoying because I felt as if I was getting pushed more towards the sidewalk the closer I got to the turn. The crowd stayed heavy until the first mile when the heat really starts to get to everyone, and some runners succumb to improper pacing at the start. I started out fast for me, somewhere around a 9 minute mile. I felt good but knew the heat, and that thick cotton survivor shirt that I actually wore right out of the race packet like an idiot, would eventually get to me.

Mile 2 was uneventful. The sun was brutal and as I approached mile 3 I discovered the benefit to starting out in the back of the pack – I was missing the freak sightings which make this kind of thing amusing. My pace had slowed a bit, but I was still running sub-10/mile, I was getting passed, but I was also doing my own share of passing, however there were no pink flamingo hats, only one tutu, and no big teams, feather boas, anything. All I could do was repeat my “make it easy, make it light” mantra in my head, turn up the Gnarls Barkley, and wonder how much of a disaster it would be if I tried to take off my shirt for the last half mile while running instead of finishing wearing the equivalent of a  soaked cotton towel. Next year, damn the gun time – I’m running in the back of the pack, just because it’s more fun!

When the finish line became visible, I checked out my Garmin and sure enough, it looked like I was going to come in sub-30 minutes. If it happened, this would be the first time that I’ve ever done that and it was my goal for the race. Sure enough, my official time was net- 29:33. 29th/258 bc survivors, 786th woman to cross the finish and 147/856 in my division. For me this was not bad, not bad at all. Still, next year I’m going to run at the back, just to try and get the full experience.


day 5

Originally uploaded by l@in.

Recovery has been both better and worse than I anticipated. I think I already mentioned that the implant was removed (and reinserted!), which resulted in the increased level of pain that I’m experiencing. And again, the drain didn’t help (although, I know not having it could have been disastrous.) However, I am feeling better quickly. My range of motion is pretty good and while I’m not trying to lift anything of any significance, I can pick up a glass or a plate in my left hand and carry it a short distance without an issue, which is nice. I’ve even been able to knit small projects! I listened to my Dr.’s exercise mantra, “you can walk”, and did 30 minutes on the treadmill today at a really slow pace. It’s better than nothing, and I’m so happy we were able to get that before the surgery.

I’ve done this enough that I feel like I kind of have a system. I try to do whatever I feel compelled to. If I feel like laying down, I do. If I feel like I need more pain meds I take them (and if what I feel I need seems unreasonable, I know there’s a problem). If I think I can tackle some house work I try and if it doesn’t hurt, I do it, and if it does – forget it. It really helps that I’ve been able to work from home this week, and can hang out with the laptop in bed if I need to.

And if I’m hungry, I eat. This is probably the most complicated thing for me because I do love to eat. I’m also trying to be healthy for many reasons, one of which is because I’m, of course, concerned about the cancer returning. So I try to eat healthy, exercise, and do all the things you’re supposed to do to stay in optimum health. Did I mention I love to eat? And I love sweets? I know when I’m exercising a lot, I feel like I can cut myself some slack, but now that I’m struggling with a 28 minute mile (ugh! it hurts just to type), I don’t really have that luxury. So I stocked the freezer with pasta sauce, chili, and soup, and Joanna has been great about getting me out of the house to find yummy healthy things with the occasional flake (like a delicious chocolate cake from whole foods). I am looking forward to being able to handle the damn blender again – I miss my green smoothies!


lunch smoothie

Originally uploaded by l@in.

The other day 1L asked me some questions about my smoothie making. I thought they were pretty good so I thought that I’d just write about them here, instead of responding on my flickr stream. I didn’t really start making smoothies until the cancer thing was really under control. I wanted to eat more healthfully which was something that I’ve been trying to work on for the past few years, but my health issues really kicked this into high gear. I started reading about people who were using nutrition to combat cancer, mainly macrobiotics. I feel like I’ve made a lot of progress, but it’s an ongoing thing. Joanna and I did a week of raw eating last summer. I’d definitely like to do that again. I don’t think I could do it all the time but I think it’s a good break from normal eating and gets me back into eating more fresh, unprocessed foods. I still eat too much sugar and sweets in general. That said, the last time I saw my doctor, he said my cholesterol was in a really healthy range and I’d lost some weight, so clearly I’m doing something right.

Anyway, 1L asks:
“I’ve been thinking about juicing for a while now, and I’ve got a couple questions for you, if you have the time:
-Where do you find your smoothie recipes, or do you just make them up and experiment?
-Did you buy a special juicer or blender? I don’t have either right now, but was looking to buy a blender with some BB&B gift certificates that I have.
-Do you transport smoothies to work for lunch, or just drink at home?”

At first I looked for smoothie recipes online. I think I found a lot on raw food blogs. It might have been through Kris Carr’s Crazy Sexy Cancer documentary that I really started to consider juicing and green smoothies, using kale as a base for the smoothie. After I made them a bunch, I just started throwing anything in. Now I’ve started to experiement with more vegetables. The other day I put leftover broccoli in it, and today some fresh carrots that need to be eaten. I’ve discovered that pretty much everything works. Also, if you’re drinking it right away, ice is a good thing to add for texture and temperature.

I usually try to throw a little bit of fruit juice in too, but not too much and I use water as the liquid base. Though, if you’re looking for protein, all fruit and a little yogurt or milk is a yummy smoothie. I think the weirdest smoothie I’ve ever made was when I was recovering from surgery and got a really big protein craving. I put a banana, milk, and a few tablespoons of peanut butter in the blender with some ice. It was pretty good.

I use a plain old Oster blender that I’m pretty sure I got in college to make frozen drinks. It’s not special. I don’t think it was the cheapest model I could get, but I don’t think it cost more than $40. You could get something nicer, and it might work better, but right now this one is working for me.

I used to only drink smoothies at home but I was chatting with a friend recently who said that she’d been taking them to work for lunch. I peppered her with questions and she said that it separated a little, but a little stir fixed that. It was fine in terms of temperature if she put it in the fridge right when she got to work. She said that she just put whatever fresh or frozen fruit she had on hand and sometimes used yogurt and it always worked out fine. I tried it the other day; I made a smoothie, popped it in a drink bottle with a straw and froze it. I took it to work and let it sit on my desk and it thawed out in about four hours and was yummy and slushy. This way I don’t have to make the smoothie in the morning, because I’m really lazy and unless I’m working from home, it won’t happen.

30th annual meeting of the San Antonio Breast Symposium occurred in mid-December. The goal of the symposium is, “to provide state-of-the-art information on the experimental biology, etiology, prevention, diagnosis, and therapy of breast cancer and premalignant breast disease, to an international audience of academic and private physicians and researchers.” Interesting and innovative research comes out of this symposium every year. Some of the research that I found especially interesting this year:
A research group based in San Francisco has found a way to discover “lethal cases of DCIS (ductal carcinoma in situ) from ones that will never become life-threatening”. This could potentially prevent other other women in my situation from having a mastectomy or even a lumpectomy, which would be amazing.
new approaches to detecting early stage breast cancer and DCIS using high resolution MRI
the use of telemammography in rural communities
inaccurate application of the clinical breast exam (CBE)
High incidence of brain metastases found in patients with HER2 positive metastatic breast cancer
Survival outcomes in pregnancy-associated breast cancer

There’s lots of other interesting research presented at the symaposium. Abstracts and poster information is available at the site.

To whom it may concern,

I am writing to relay my experience at Washington Hospital Center on the December 20th-21st.

I was scheduled to have the 3rd step of my breast reconstruction with my plastic surgeon, Dr. Susan Otero, after being diagnosed with breast cancer in 2006 and undergoing two mastectomies at another hospital in 2007. Prior to my surgery date the WHC staff called me for my pre-op check-in and were also very attentive during the check-in process at the hospital. I was very pleased with the treatment and care I received prior to surgery and post-op during my recovery. Three nurses in particular, Birdie, Claudia, and Joan provided me with very high quality care. I was very pleased with the treatment I received in recovery.

However, the first major problem came when my initial recovery nurse, Birdie, called repeatedly to find me a room. My surgery was over between 2-3pm, and I recall being fully awake and able to be moved to a room around 5pm. Around 8pm I was moved to a different, larger recovery area and put under the care of Joan and Claudia, and told that I would be moved to my own room soon. After over a four hour total wait, I was finally transferred to my own room around 9:30pm.

By this time I had missed all the meal times and was hungry and tired and wanted to be in my own room, which should have been much quieter than the hustle and bustle of the recovery area. When I finally got to my room I was checked in and asked about getting food of some kind. I was told that the meal times were over. I pressed the issue as I was very hungry, not nauseous in any way, and definitely feeling up to eating a small meal. I was told that a boxed lunch could be ordered for me. In the interim, my nurse brought a large cup of juice.

Around midnight no food had arrived and it had been about four hours since I had received pain medication. Around 12:30 when my nurse, Jillian, came into my room I told her that my pain was increasing and asked for more pain medication as well as lozenges for my throat which was very sore after being intubated. She said she would order the medication and told me that no meal had been brought. She eventually found some cereal and milk for me, which was kind of her, as the food that was ordered apparently never arrived.

At approximately 1:30 I received throat lozenges. Around 2:30am I still had not received any more pain medication and my incisions felt like they were on fire. It was almost impossible for me to rest. I had not been seriously uncomfortable post-op until around midnight when I had asked for the medication and as I stated before, had been very well cared for. In recovery I was asked about my level of pain and the nurses responded appropriately. Therefore I went from being very comfortable to being in an unacceptable amount of pain for an extended period of time even though I knew that my surgeon had ordered Vicoden for me during my recovery in the hospital. I paged my nurse. She said that the drugs hadn’t arrived from the pharmacy yet but if they didn’t arrive in 10 minutes she would go check on them herself. About 15 minutes later she came with the pain medication, apologized and she told me that it would probably take me two cycles of drugs to really feel better since the drugs I had received so much earlier were almost completely out of my system.

Around 6am my surgeon arrived and told me that I would be discharged that day, which I had expected. My nurse followed shortly thereafter and brought another round of medication. I was feeling much better by then and was awaiting breakfast since I had yet to really eat anything. When breakfast did arrive, I discovered chicken broth, jello, and more juice even though I had already eaten solid food and had requested a vegetarian meal. I was not able to eat any of the food that was brought for me. I paged a nurse and a tech arrived. When I told him about the problem, he got the person who was delivering the meals and explained the situation. The delivery person said that he had an extra breakfast and would bring it to me. It never arrived. By this time I wasn’t surprised and simply wanted to get out of the hospital so I could recover properly.

I am amazed that I was able to receive both the best and the worst care I have ever had in a hospital at the same facility in 24 hours. My diagnosis has necessitated six surgeries in the past 14 months and I have never had to wait so long for medication or food in any hospital – especially things prescribed for me by my doctor and/or things that I could have had at home. I would have fared far better if I had left the hospital and gone home after my time in the recovery area, which is unacceptable. I am at a loss as to the reason why I was not able to get the medication prescribed for me, in the hospital. Considering that during previous recoveries in other hospitals I had serious issues with nausea and required far more pain medication, my experience at WHC does not make me feel confident that it could provide me with a level of care that would keep me well and comfortable. If it was so difficult to get the medication specifically prescribed for me, I can only assume that if I became nauseous or needed a non-prescribed drug right away there was no way I would have gotten it.

While I appreciate the kindness and dedication of the majority of the WHC staff which I came into contact with, overall I am appalled by my experience there. As portions of the WHC were rated among the US’s best this year, I have to believe that I experienced huge flaws in an otherwise well-functioning system. Nonetheless, I consider my experience to be unacceptable and I feel I would be remiss if I did not relay the details of my situation in the hopes that the system can improve and others can enjoy at least a modicum of good quality care that was missing in the majority of my experience at WHC.

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