Do I Worry About Getting Cancer Again?

I am asked now and then if I ever worry about getting another cancer. I have to say, most of the time, I really don’t. Oh, now and then I will get a little twinge in my rib cage that kind of reminds me of how I found the lymphoma seven years ago. When that happens, I will spend some time thinking about the possibilities, and worrying just a bit. But usually, I don’t think about it. There always seems to be other more pressing things to worry about, in any event.

Certainly there is no hard and fast rule about it, no prohibition of “double jeopardy.” That would be nice: “Hear ye! Hear ye! By decree of the emperor, it is hereby proclaimed to all that any subject who has survived one form of cancer will never be asked to go through this experience again! Let all subjects obediently follow this absolute ruling, under penalty of death!”

But alas, life doesn’t work that way. I know several people who have had multiple cancers. My sister-in-law Christine got breast cancer 20 years ago and ovarian cancer 3 years later. Talk about a double kick in the gut for a young woman, but she survived. My sister Ann got a new cancer while getting her third type of chemo for the first cancer – when that happens, oncologists are pretty sure that the chemo they are using is not going to be very effective. My TNT teammates Ed and Kristi have survived three and two cancers each, respectively. A former co-worker, Linda, survived one cancer and was killed by another about nine years later. Another Linda, a friend I met through First Connection, is on at least her third cancer, maybe her fourth – what a terrible time she has had. And a number of people that I’ve met through blogging are on multiple cancers. I’ve had to tell several folks that they are not getting their names written twice on my race shirt just because they got cancer more than once, so they might as well knock it off.

It seems totally unjust when a child gets cancer or when someone gets a second (or third, or fourth) cancer. Realistically, though, anyone who got cancer once is probably more likely to get it again than the general population is. For one thing, there was a reason they got it the first time: something in their DNA, exposure to some toxin or other environmental factor, stress hormones, immune system problems. For another thing, anyone getting chemotherapy and/or radiation is getting exposed to carcinogens. By example, I was told that by getting ABVD chemotherapy, my likelihood of getting a leukemia downstream would be from 1-3% higher than it would be otherwise. My friend Kristi’s thyroid cancer was almost certainly caused by the radiation that she received years earlier for her lymphoma.

I haven’t met a single person who, having cancer and maybe even getting something positive out of the experience, would volunteer to go through it again. I don’t know if I would want to meet such a person. I know if I had to go through cancer treatments again, I would dread the experience. But I also am not going to worry about something that hasn’t happened and may never happen. For all I know, my health may more at risk from scarfing down a bacon double cheeseburger than I am at risk of another cancer.

I do try to stay aware, eat reasonably well, and get some reasonable exercise. And I know I need to check in with an oncologist – mine retired two and a half years ago and I am way overdue to get a new one and have a baseline checkup. In fact, I am more than a year and a half overdue. I’ll get to it soon! Hmm, seems like I said that like a year ago. OK, I know I have to do it. And I will – right after I go eat a bacon double cheeseburger.

Something’s Afoot!

My left foot is feeling kind of miserable today, but that is because yesterday, I got my second injection of alcohol after that initial cortisone injection. The podiatrist believes that the neuroma, although still there, is getting smaller. He said that it generally takes three shots of alcohol, so I will still need one more.

I was asking him what a neuroma looks like. He said that the nerve running between the metatarsals is about the diameter of a strand of spaghetti. The pressure against the nerve as we run and walk long distances makes it react by growing material around the nerve to try to protect it, so it gets more like fettuccini. It is like a fatty and fibrous material, and the increased size means that there is even more space for the nerve and it gets even more irritated.

As he stuck the needle into my foot, he said “Tell me when it starts to hurt. That is the only way I know when I have reached the right spot for the injection.” He pushed the needle in more. A little more. Another quarter inch. “It should hurt soon,” he said, as he pushed the needle in a little more. ‘Whoa! Right there!” I said. He depressed the syringe and my forefoot felt flooded in pain for a little while. But walking out of the medical office, it just felt kind of numb, like part of my foot was missing.

Today, as is the norm based on my prior experiences, my foot hurts and I am trying to take it easy. It is not agonizing or anything like that, just painful in a strange kind of way. I have no desire to run today. Until I get back into running more or at least doing heavy duty speed walking for more than 7-8 miles, it will be hard to tell how improved the situation is. I did notice that it didn’t hurt much on my last long, tough hike, and that is really encouraging. I’ve been tolerating this for years and it just kept getting worse and worse, and I would love to have neuromas in the past very soon.

Running on the Last Day of Summer

I woke up early with things on my mind, lay in bed thinking uselessly for a while, and finally got up at 5:15. It was time for a run!

A run - that is not a typo. Yes, I know it has been weeks or even a couple of months since I ran. And you know, it felt good! I ran about 2 miles, a half mile at a time, while walking in between for about five minutes, for a total of nearly four miles. Running felt really comfortable – other than when I nearly sprained an ankle stepping into a little drainage gully in the dark as a car came by - maybe I need to do this more often. I could have run more distance at a time even, but I know that after so much time sans running, I could easily overdo it. My legs have felt a little sore all day – just a touch – and I am really looking forward to water aerobics tonight.

The stars (and planets) this morning were incredible. A few parts of my route were in total darkness, and for those parts, the sky was just amazing. I could not quite see the Milky Way, but there were thousands of stars twinkling away. I know so few of the constellations. The Big Dipper, pointing to Polaris and the Little Dipper, was easy to find, as is Orion. Venus shown brightly like a beacon. But other than that, they were just stars. I need to set a goal of learning a few more of the stars and constellations.

A few hundred years ago, I bet people everywhere knew most of the constellations, how they should appear at different times of the year, and how to find a route at night using them. Certainly sailors did, and overland explorers. They could not comprehend the GPS that we have today. Their livelihoods, and their lives, depended on their knowledge. We consider ourselves so advanced today, but in many ways our ancestors were more knowledgeable than we are. Going to Henricus City yesterday was an interesting reminder of how much we take for granted in our modern lives – and how easy day to day life is compared to a few hundred years ago.

I cannot believe that summer is over. It has just flown by. As we get older, and we realize that the very finite number of summers (or falls, winters, or springs) that we have remaining in our lives has just gone down by one, we realize how so very quickly life goes by – even on days when we wake up a little too early mulling things over. So remember to live, and enjoy, each day.

Light the Night Page is All Set Up!

As I mentioned a week or so ago, I am doing Light the Night for LLS on October 29. My fundraising page is all set up:

http://pages.lightthenight.org/va/Richmond09/ARitter

I've joined the Team of Faith's Hope. I am not going to go nuts with fundraising, but would love to reach $200 by a series of $5.00 donations. C'mon - five bucks! That's like a Chai Latte and a donut, and no calories are involved.

Plus you'll feel better! So "Gimme five!"

Recent Cancer Deaths

Thousands of people die each week from cancer, and their passing is only noted by their loved ones. But this week, there are a number of well-known people who died of various cancers. They represent all of the lesser known folks that also passed away from these terrible diseases. May they all rest in peace.

Patrick Swayze – Perhaps the most well known of recent cancer deaths, this great actor died after a two year battle with pancreatic cancer. His quick feet couldn’t dance away from a deadly foe that fights dirty.

Mary Travers – Of Peter, Paul, and Mary fame, she died of leukemia this week, just a few years after a bone marrow transplant seemed to turn things around for her. If I had a hammer, I’d smash cancer to bits.

Monte Clark – The former coach of the Detroit Lions died from bone marrow cancer.

Myles Brand – This president of the NCAA died from pancreatic cancer. He was tough enough to fire Bobby Knight in a prior job, but couldn’t out-tough cancer.

Keith Floyd – Dead from colon cancer, this chef was popular in Britain with TV viewers.

The Topics You Voted For

A few weeks ago, I conducted a poll on my blog about the topics you most want me to write about during the time period up until I start training and fund raising for my next event. I didn't get a lot of people voting, but here is a summary of what visitors to this blog voted for:

Humorous reflections on things - 75%

A survivor’s mind – what are we thinking and how is it different than before cancer - 62%

Inspirational stories about people I meet along the way or have heard about - 37%

Tales from past TNT events - 12%

Tales from my cancer experience - 12%

Ways to cope for people with cancer, their family, and friends - 12%

Training updates (I am not training for a specific event right now) - 12%

Reflections on TNT and the war on cancer - 0%

I appreciate everyone's feedback, and I will try to use these as guidelines for upcoming blog posts. For example, I'll try to write something funny (humor is in the mind of the beholder) at least every week or so. I like writing funny stuff, for this blog and in general (like the story of how I bought my first car, which is not on this blog - too long and doesn't really fit "racing for a cure.")

I know that I have not posted a lot about the second most popular topic (a survivors mind) and so I will try to pay more attention to that in upcoming months.

And while the three most popular topics need to get more attention, I will certainly write about the other topics at times as well - depending on what comes to mind at the time.

And of course, if there is something specific you want me to write about, send me an email or post a comment and I will try to accomodate you.

Thanks again to all of you who voted.

Things I’ll Need for Swimming

Based on my swimming performance, or should I say lack of performance, yesterday, I’ve compiled a list of some things that I’ll need if I get serious about this and decide to do a triathlon. These few things will really help with the swim portion of the race:

1. Swim goggles – My eyes will just be too irritated to not have goggles, but not wearing my glasses will be a problem. I have the eyes of a hawk – a blindfolded hawk, that is. Therefore, being able to see in the open water will be an issue because I don’t want to pay for prescription goggles. But for pool training, my extreme nearsightedness should be tolerable and I can figure out later how to navigate to the swim buoys.

2. A sleeker bathing suit – My beach and pool side bathing suit is not going to cut it, as it has too much drag. I may need to get something more like Spandex, although I don’t know if it is fair to subject the world to that. I have this vision of mothers covering their children’s eyes and women running away in horror.

3. A wetsuit – I won’t need that for a long time yet, but ultimately, I will need a wet suit.

4. An air pump to inflate the wetsuit – I sink like a stone, but I bet using an air pump to inflate the wetsuit will help a lot. I have this mental image of me looking kind of like a black Michelin Man, floating along the surface of the water like a gigantic marshmallow.

5. Flippers – Technically these are not legal for a triathlon, but I have a strategy to get around this that I will discuss later. Yesterday, they were the only thing that kept my feet pointing behind me.

6. Little hidden propellers for my flippers – I don’t think that these are legal either, but they would really help. I figure that I can find a craftsman to implant these in my flippers with an electric motor. Once I am in the water, I press this button in my wetsuit, little secret doors in the flippers open, and the propellers push me along. Who said that swimming is hard?

7. A snorkel – I swim pretty good under water but cannot hold my breath for a mile, so I figure a snorkel will really help with my breathing technique.

8. An inflatable life vest – If I develop a leak in my Michelin Man wetsuit, and it deflates, I will clearly need a backup plan to regain buoyancy.

9. A small echolocation device – Eureka! I just figured out how to find those buoys in the open water without my glasses. Problem solved.

10. Five one pound gold bars – I won’t swim with these, but I think they will be useful in having the race officials overlook the snorkel, flippers, life vest, and so forth. “Flippers? I don’t see any flippers.” “That’s not a snorkel – it is just a stick floating in the water. A moving stick. A vertical stick that is being pushed along rapidly with two little propellers.”

With just these few simple items, I feel confident that I can train for and ultimately complete the swim portion of a triathlon.

Like a Wildebeest in a River

You’ve seen the nature film: a herd of wildebeests in East Africa, throats parched after a long trek across the arid savannah, reaches a cool and thirst quenching river. Despite their suffering, they approach the river skittishly and with a great deal of caution. But finally, desperation for a drink overrides their fear and they gather at the bank and begin approaching the river's edge to drink. A log drifts slowly with the current, being moved along closer and closer to the thirsty animals. Just a log… No, wait – are those eyes? The last time I saw eyes on a log, it was an ent chopped down by orcs in “The Two Towers” as the army of cool tree people attacked Sauroman’s castle with Merry and Pippen.

In horror, you realize that this is no log. “Look out, wildebeests,” you cry out. “It’s a crocodile! Run away! Run!!!! One of you is going to die if you don’t get out of there!” The wildebeests ignore your lunatic ravings at the TV and continue drinking greedily. Suddenly, like a bomb going off in the river, water and wildebeests explode everywhere as a huge crocodile grabs one of them in its merciless jaws and begins dragging it into the deeper water. The wildebeest struggles in vain, going nowhere as it thrashes around in the river. Water splashes everywhere as the doomed beast fights to get away. Well, take away the crocodile, trade a swimming pool for the river, and I was like that wildebeest today, thrashing around in vain while attempting to swim with the local TNT Augusta half-ironman triathlon team.

I joined the team at 6:30 AM at the YMCA to give them a brief mission moment. I expressed my thanks as a cancer survivor for what they are doing, and then told them about the young girl with leukemia that I encountered in Nashville this past April. Then Coach Steve, a certified triathlon coach and an ironman triathlete, got the team started with their 1,500 meter swim, and told me to go ahead and get in the pool in lane one.

“Is there a kiddie pool?” I asked as I lowered myself in, only half in jest. He asked how long it had been since I swam. Well, if you define “swim” as moving around one way or another in the water, then not long at all. I am not at all afraid of the water and can swim, just not efficiently, and I have never been good at the freestyle. I got a mental block as a kid trying to learn it, and just ended up doing other self-taught strokes, but none of them well or long distance. Coach Steve said “Swim a lap down and back, and I’ll see how you do.” I started down the 25 meter pool, struggling quite a bit with my stroke but slowly moving along as the triathlon team cruised without effort down the other lanes.

I was glad to stop at the end of the 50 meters and get my evaluation. The coach told me that we would talk about my arm stroke later, but that the big problem was my kick. He said that my kick was actually hurting more than helping. I was kicking from the knee, and my feet were pointing down, actually brushing against the bottom a few times in the shallow water. Coach Steve gave me some shortened flipper things to put on and a kick board, and said to kick my way down the pool. Man, it was hard! The kick board kept sinking into the water and I had to keep putting my head up to breath. I kept stopping for instruction and advice. At one point Steve said “Art – I don't get it. You’re not moving!” I could have argued with him because I was pretty sure that technically I was moving – backwards, that is. But that seemed like a minor distinction. Every now and then I would get it more or less right for about 4 kicks, and I could feel the difference. I did another lap with the kickboard, trying to get it right – but more often than not it was pretty pathetic. I am pretty sure that a 90 year old holding a 25 pound iron weight instead of a kick board would have gone faster, and a lot more gracefully.

He had me get out and watch the other swimmers – how they held their feet, how their arm motion was, how they rotated their bodies, how they breathed. He had me get back in and try swimming another lap, and gave me some more instruction. I snorted some water at times and actually had to stop and stand up for a second to avoid choking a bit. In particular, I could feel that my left hand stroke was very inefficient. I ended my time in the pool by putting on a long pair of flippers – albeit a mismatched pair – and using the kick board for one more lap. I could really feel the difference because they forced my feet to stay up and pointed backwards. Now if only I could bribe an official and wear flippers during a triathlon. Seems fair to me.

I am glad I did this. It was frustrating to watch the whole team gliding effortlessly along for nearly a mile while I struggled badly for 1/8 that distance. But as Coach said, I have the endurance – I’ve done marathons (though not for a while). It is just a matter of technique and practice - and of persevering and not getting discouraged. So I think I need to get some swim goggles and start attempting to apply what I was taught today. It was very, very instructive.

One thing for sure – I won’t go swimming in an African river any time soon. The wildebeests would be totally safe with me in the water. And I'd be crocodile food.

Thank You, Augusta Half Ironman Team!

On Sunday September 27 in Augusta, Georgia, Team in Training Virginia will participate in the Half-Ironman Triathlon, sometimes called the “Augusta 70.3” because of the total distance involved. They will swim 1.2 miles, bike 56 miles, and run a half marathon (13.1 miles). To my knowledge, this is the first time that TNT Virginia will do a triathlon of this length. I know that Richmond has a big team, and there may be groups from the rest of Virginia as well. I don’t know everyone on the Richmond team, but I do know a number of them. Three of them were on my first TNT marathon team in 2005 – they did San Diego and I did Anchorage. I have been on teams with several of the others over the years, and known others from mentoring get-togethers. At least one of them is a cancer survivor, and a number more have lost a loved one in recent years from these diseases. Several of them hold the coveted TNT Triple Crown, having already completed at least one marathon, triathlon, and century bike ride for the Purple People.

So to those on that team in Augusta – from Richmond, elsewhere in Virginia, or any other chapter – thank you for doing this, for raising funds to fight cancer, for making a difference. As someone who has never done a triathlon – my triathlon in the mountains a few weeks ago doesn’t count – I am amazed at your hard work and achievements. As a cancer survivor, I am alive because people like you, decades ago, raised money to go towards Hodgkin lymphoma research. There will people alive in the future because of you.

Have a great time in Augusta, you awesome team! I am thankful for your efforts, and appreciate what you are doing. Here is my tribute to you.

"To the Half-Iron Women and Men"

You’re not made of iron, but of bone, blood, and muscle
You’ve got grit and pizzazz, determination and hustle
You’ve worked your butts off, you’re trained to a peak
Cause your upcoming adventure is not for the weak

For in less than two weeks, in the land of the peach
You’ll go seventy-point-three – no stroll on the beach
First, in a river, you’ll swim over a mile
Now I’d thrash around, but you’ll swim it with style

Then back on dry land, on your bike you will jump
And for fifty-six miles, the pedals you’ll pump
A half-marathon awaits when you’re done with that task
You’ll endure it, though tired, and the pain you will mask.

For many with cancer must do their own “tri”
And the outcome determines if they live or they die
First “event” might be surgery with much cutting and pain
And the loss of some parts with scars that remain

Next “event” could be chemo, they’re exhausted and sick
For many a month, since this treatment’s not quick
Radiation, with burning, is the final “event”
Leaving patients quite ill, so worn out and spent

Still others, to live, must replace their bone marrow
Surviving, or not, with a margin so narrow
For they may reject, with “graft versus host”
Cells so vital for life when they’re needed the most

With your heroic efforts and the money you raise
You are helping so many, earning thanks and our praise
On that day we survivors for you heartily cheer
As you race your hearts out for a cause we hold dear

So down there in Georgia, do your best and have fun
As you race for a cure while you swim, bike, and run
I’ve said it before, and I’ll say it again:
I hold you in awe, half-iron women and men!

Art Ritter
September 14, 2009

I Want You - To Vote!

A couple of week agos, I set up a poll asking what types of things you would like me to blog about in the time between now and starting training and fundraising for my next Team in Training event (I decided not to retire).

As of this post, only seven people have voted. Now, I don’t know how many people check this blog at least every week, but I know it is more than five. I seem to average about 10 – 25 visits a day, with less on weekends. So c’mon! Cast your votes.

I say “votes” because you can vote for as many of the topics as you wish. So let me know what you want to read about, and I will do my best to write things as often as possible that fit that subject area.

Unlike so many votes around the world, this one is not crooked or rigged. And it is totally anonymous – I cannot tell who voted or how they voted any more than I could do an Ironman triathlon tomorrow.

So if you are American, or from a democratic country elsewhere, exercise your right to vote! And if you are coming here from a country where you don’t have the right to vote freely and fairly, here on my blog you have that right – so exercise it!

So no excuses – vote for the topics you most want to hear about!

Thanks for voting! And have a great weekend!