Note to Self

Heading into Thanksgiving is probably not the time to start closely paying attention to the calories consumed.....

OK, maybe it is a good time. But I am seriously reconsidering doing any Christmas baking this year.

Online fitness tracking

I've discovered www.fitday.com

Your BMI: 25.58

A BMI between 25 and 30 is considered overweight.

The healthy weight range for your height is between 107.8 lbs and 145.6 lbs.
Your weight is 3.4 lbs above the healthy range.

I've put in all my information, with a goal of weighing 134 pounds by February 8, 2009. (We're leaving on a cruise that day) :)

It has the potential to either inspire me or piss me off. WE shall see.

Oncology Rehab - Day 6

I want to quit.

I resent being a "cancer patient" again.

Recently I got into a cyber-argument with someone (someone who is dying of metastatic cancer...... so I wasn't really arguing, but more on the receiving end of her anger) about whether it's appropriate to use the word "cure" in relation to breast cancer.

I don't think it is. She thinks those of us who are NED ("no evidence of disease") are an ungrateful bunch who should consider ourselves "cured" until further notice. I'm paraphrasing. And I don't begrudge her her anger. She's had a piss-poor deal thanks to cancer, and it sucks and I wouldn't trade my survivor guilt to be in her shoes for a minute.

But it got me thinking ALOT about how cancer has changed me, and whether she is right - should I say I am "cured" because there are no tumors to find anywhere? It seems, to me, to be disrespectful to those who will die of breast cancer to say, "Well, I'm cured." For me, if there is no cure for ALL, there is no cure yet.

Not that I don't realize how lucky I am. Because I do. I really do.

But anyway, all of this was rattling around in my head when I got to rehab yesterday. So I was in a pissy mood. I don't want to be a cancer patient. But I don't feel whole - and wonder if I ever will. Maybe when the scars fade, or when I don't take a handfull of pills every day in 2012. The girls could tell I was in a bad mood. Mainly because I told them.

So I did 45 minutes on the treadmill. I remember now what shin splints felt like back when I was dancing in A Christmas Carol. Then I pushed through as much of the weight training as I had time for before the forced relaxation.

(For the record, there is little if any yoga in this program, which they advertised, and which I was excited about).

So the very kind woman who supervises these rehab sessions tells me "you just HAVE to stay for the meditation. I picked out this CD just for you." So what could I say? I assumed the position, and they tucked me into my warm blankie........lilac-scented eye pillow in place..... and the droning began.

I don't know who the woman is who does these meditation CD's, but her voice is like nails on a chalkboard. And guess what - you saw this coming - it was the "Anger" Affirmations from Day 1.

I removed my eye pillow, parted with the warm blanket, and stealthily sneaked out the door.

Ah, freedom!

Screw you, cancer.

Onc Rehab - Day 5

So Friday was Day 5 of oncology rehab. I am 1/4 of the way through the program, and don't have much to show for it so far.

I hate that effing NuStep machine. I also hate how I jiggle when I walk. Although I guess it is better than it was.

Weight is still holding steady. We calculated my resting heart rate at 85, which is "poor" on the fitness charts. I'm going to investigate what, if anything, needs to be done about that. As I mentioned back in the day, chemo is cardio-toxic, so it's not surprising that my resting heart rate is higher than it should be. But I expected it to be better than "poor" after 14 months of steady workouts. I guess I should try and find out what it was 14 months ago and see if there has been improvement.

It just seems like somebody should be scanning or doing whatever heart tests to make sure chemo doesn't give me heart failure. I hate that we, as patients, have to be so proactive. Otherwise they just put you on the assembly line and pat your head as you go by..... it's infuriating.

I was a slug over the weekend, although I have to think that chasing kids, doing laundry, and running up and down the stairs 100 times a day must count for something.

I only did 20 minutes on the treadmill this morning. The dog at my PB&J that I had ready for my breakfast, so I was running on an empty tank.

OH, and an interesting new development: Coke and Diet Coke make me sick to my stomach. What's that about?

I'm still fighting off the cold I've had for a month. I've had two rounds of antibiotics for an ear infection, and my right ear still isn't quite right.

OK, It might have been a slight exaggeration to say "follow me, it'll be fun." :)

Follow Me

If you look to the right, right under the bunny ears, there is a "follow me" option. I think you have to be a blogger member to do this, though I'm not sure about that. Anyway, right now I have zero followers, and that is pathetic, so if I don't get some followers soon I'm going to remove the widget.

Meanwhile, I worked out - 30 minutes of cardio each day on Wednesday and Thursday. Back to onc rehab today.

I'm not losing any weight, but (and this may be my imagination) I seem to be less like a bowl full of jelly lately.

Follow me. It'll be fun.

Onc Rehab - Day 4

Monday I did 30 minutes of cardio on my own.

Then back to onc rehab on Tuesday. 25 minutes on that damn NuStep. My resistance was set at 5, and I think that was too high because my back hurt when I was done.

I did most of my weight training and some crunches, and then was running short on time, so worked in only 11 minutes on the treadmill at the end. It really should have been 20 minutes.

Then back to the gym this morning for 35 minutes on the treadmill.

The scale isn't budging. But it's not going up, either.

I need to do a food diary and have the dietician look at it. But I've had this damn cold for over 3 weeks, and food has not been appealing........ so my guess is I'm not eating enough. I recently switched my breakfast from oatmeal to a scrambled egg with biscuit and a slice of bacon to up my protein after my morning workout. I suppose I could do without the biscuit. But the biscuit is the best part....

Oncology rehab - Day 3

I realized I haven't posted a recent pic of me. Here I am on Halloween. I dyed my hair red about a week before Halloween, and so far only 4 people have noticed.... so it either looks really bad or really natural. Who knows.

Oncology rehab Day 3 went well. I am fighting off a cold I've had for three weeks, but I still managed 30 minutes of hard cardio and all the weight training. Holding steady at 149 on their scale.

Going to these sessions has reminded me how "lucky" I am. I'm by far the healthiest, thinnest, probably fittest person there. I almost feel like I stumbled into the wrong gym. Unfortunate, of course, but I guess if that's what it takes to make me feel better about myself, so be it. I'm getting an attitude adjustment if nothing else.

I guess this is one of the "benefits" of getting cancer when you are young and otherwise healthy: you bounce back a lot faster. If you get to bounce back at all, that is.

In between thoughts

So apparently somebody is still reading the blog. I've learned that some of my YSC sisters are following along, and would like more detail about oncology rehab. Some cannot find such a program in their area, and some just cannot afford the copay required, so they are doing it on their own.

Have I mentioned that I think the U.S. health care insurance system sucks? I've been very fortunate that cancer has not bankrupted us. Not true for all. I will be curious to see if President Obama has any luck improving the system.

That being said, I continue to be amazed by the quality of care I have received in Alaska. I feel like I live in the boonies, but some people in the lower 48 cannot find oncology rehab or even a decent plastic surgeon. I've had both.

Some things I have learned so far at onc rehab:

Cardio, cardio cardio. They have doubled the amount of cardio I was doing on my own. I was doing 20 minutes a day. They are asking for 40. Not only is cardio your ticket to losing the weight, but the heart needs to recover from chemotherapy. Remember, adriamyacin is cardio-toxic. And most young women with breast cancer get the Red Devil. My resting heart rate is about 85, and should ideally be down in the 60's. Also, maintaining a healthy weight is important in avoiding recurrence.

Calculate your target heart rate (different for everyone) and work hard enough to get to it. If you don't get it up there, you're wasting your time on the treadmill.

They took me off the elliptical machine and put me on the treadmill and the NuStep. Although all are cardio, the elliptical is not weight-bearing, and I need weight-bearing exercise, they said. They didn't say why, but I assume it is to both build strength and for strong bones - osteopenia and osteoporosis are both hazards of early cancer. Or, from the treatment, I suppose. I'm a little unclear on how a treadmill is "weight bearing" but whatever.

When you get to weight training (after that 40 minutes of cardio), exercise each side separately. I learned I can lift 20 more pounds with my left leg than with my right. So by working both legs together on the leg press (for the past year), my left leg probably was doing more work the whole time. The goal is to balance them out.

To calculate how much weight to lift on each machine, they had me do the exercises one repetition at a time, adding weight until they found my "max" for each side. Then they took 1/2 of the max of the weaker side, and that is where I am starting my weight training. So for example: I could lift 50 pounds with my right leg, and 70 pounds with my left leg on the leg extension. So I am starting both legs at 25 pounds.

To improve balance and work my core, I am lifting hand weights while standing on Dynadisks. Dynadisks are round, squishy disks that rest on the floor. It makes lifting a 4 pound weight altogether more challenging, because you are trying to maintain form while not falling down.

I managed 30 minutes of cardio on Wednesday and Thursday this week, and go back for more onc rehab on Friday.

Oncology rehab - Day 2

I showed up. 149 pounds.

5 minute warmup.
20 minutes on the treadmill at a good clip.
15 minutes on something called the NuStep, which looks like this:



It was evil.

A bunch of weight training and crunches.

The physical therapist actually told me how "lucky" I am to have implants, because as I get older, they will have so much support under my pec muscles.

Whatever.

Oncology Rehab - Day 1

So I had a bad attitude.

I was driving to my first oncology rehab session, and I was pissed off. I wasn't sure why. In retrospect, I didn't want to immerse myself in cancer again. I knew going to this class that I would be participating with other cancer patients - many of whom are closer to treatment than I. And I was right. There were people there carrying oxygen tanks. Women with no hair. Generally, people who looked wan and tired and, well...... they looked like cancer patients. And I sooooo don't want to be a cancer patient any more.

And even though I've been hitting the gym hard, 3-4 times a week for the past year.... they still had to take my blood pressure before they would let me get on a treadmill.

Then...... oh no, don't walk too fast! 3.0 miles per hour for the first 5 minutes. I felt myself becoming more and more uncooperative by the minute. But I was also happy to see a friend there, and catch up with her. (Thanks, Jeannie, for referring me to onc rehab in the first place).

After 20 minutes on the treadmill - which is facing the windows and a beautiful mountain view - I moved on to weights and range-of-motion exercises. I learned that I can lift 20 more pounds with my left leg than with my right. Interesting. I learned that my balance is not so good. I learned that even though my range of motion after bilateral mastectomy is good, it could be better. And today - two days later - I'm really feeling that workout, so obviously they knew what they were doing.

The last half hour of the two-hour session consisted of a little yoga, and a guided meditation. Normally I'm into that sort of thing, but when they put on the meditation CD I was surprised to hear that the meditation/affirmations had to do with "anger management." I thought - what the HELL? Do they just assume that every cancer patient is angry? My blood pressure started to go up again, and as I listened to the CD I realized: Surprise. I am angry.

I'm angry about what cancer has done to my body. In a million little ways, and a couple of big ways. I'm angry that I didn't get the big epiphany that I had hoped was coming with a potentially terminal illness. I'm angry that of the hundreds of wonderful young women that I have met because of cancer, I will probably live to watch more than half of them die - and I'm angry that that very fact makes me one of the lucky ones. And yes, I am angry because some people didn't show up for this like they could have.

So apparently there is still work to do.

19 more onc rehab sessions. I'll keep you posted.

Oncology Rehab - Who Knew?

So for the past year I've been trying to pull my body back together all by myself. Meanwhile, the oncologist bitches about every 3 pounds I gain (she sees me every six months). Despite working out 4 days a week on my own, I have not gained back all my strength or lost any of the Tamoxifen-weight I have gained. I am sick of doctors telling me Tamoxifen does not make you gain weight - because every young survivor that I know has gained at least 20 pounds on it.

So guess what - if you are fat, you have a higher risk of cancer recurrence. But they give you drugs that make you fat. Go figure.

By way of reference, I weighed 135 pounds at diagnosis in December 2006. All reports are this was a good weight for me, (although I preferred my 126 pounds from the pre-Nathan era).

After two surgeries I was down to 118 pounds from the stress of it all. Although I love being that thin, nobody thought I looked good.

I managed to maintain through chemo though I never really weighed myself.

Then, in AUgust 2007, I started TAmoxifen. It took me awhile to catch on.... but I finally realized I was gaining about a pound a week. I managed to head it off by stepping up my workouts, but I couldn't lose anything.

I quit weighing myself daily when I hit 150 pounds last week.

And then I discovered this: Oncology Rehabilitation

Improve and enhance your quality of life during cancer treatment and recovery through a prescriptive exercise rehabilitation program. Our comprehensive 10-week program combines aerobic exercise, muscle strengthening, relaxation techniques and range of motion exercises. We also incorporate mind and body healing through guided imagery, meditation and use of affirmations. A licensed physical therapist and registered nurse, both with extensive experience and training in oncology rehabilitation, supervise the classes. Each participant will receive an initial assessment, individualized plan and exercise prescription in addition to the 10-week group classes. A physician referral is required to participate in the program.

Our program also offers lymphedema services using complete decongestive therapy techniques and garment fitting by our certified lymphedema therapist.
The program welcomes participants at any time- from their initial cancer diagnosis through survivorship. Staff RN and Physical Therapists are available Monday - Friday between 8 a.m. - 5 p.m..

And guess what. Insurance pays for this.

So why, I ask, did my oncologist not refer me to this program? Who the Hell knows.

I had my initial assessment yesterday, and I start my twice-weekly classes on Friday.

Many thanks to my boss for understanding my additional 6 hour absence each week to make this happen.