Finding a (new) baseline

When I signed up for my first half-marathon years ago, the idea of creating a training plan seemed daunting. But slowly, the plan did come together, helped by advice from my BFF, and other runners who had half-marathons and longer distances under their belt.

Now, the plan for the next 18 weeks is starting to take shape. It’s not exactly a training block, but it’s not that different either — nutrition, strength training, good sleep habits, and regular workouts are common elements. And its been helped by the community I’m starting to build — run friends and colleagues who’ve navigated chemotherapy, along with new people I’m meeting through a support group I’ve joined.

This plan is a journey of discovering how I respond to this chemotherapy treatment — CarboTaxol — and what that means for moving my body.

First: The drugs

My bloodwork came back OK last Monday, so on Tuesday I had my first infusion. I arrived at the clinic for 8:30am, knowing it would be an all-day affair. Robbi, my nurse, introduced herself to me and my BFF. I filled in more forms — and wanted to redesign each and everyone of them, why are they so universally awful? — then the real work began.

Almost 90% of people have some reaction to these drugs, so each infusion is ‘pre-gamed’ with anti-emetics to fight nausea, as well as steroids and antihistamines. The net result is to make you both jittery and sleepy at the same time. For me, it also makes me chatty, and my BFF and nurse were the victims of that.

With the pre-game drugs on board, we started with Taxol, delivered over three hours. Taxol acts by stopping cancer cells from separating into new cells, blocking growth and causing cell death. Although it can trigger a laundry list of side effects, the one that worried me most is neuropathy in my hands and feet. To counteract that possibility, I spent the time with my hands and feet immersed in bags of ice, which sounds worse than it actually was.

Above: Two sides to the same chemo infusion day.

Taxol is also the culprit behind why I buzzed my already short locks even shorter on Tuesday. I’m oddly not fussed about losing my hair, and expect that to happen either just before or just after my second infusion. My scalp is already giving me signs that something is afoot, and now there’s less likelihood I’ll create tumbleweeds in my house as part of this process.

Above: Before and after. A #2 clipper left just my cowlick in the front to do its thing.

After Taxol was the Carbo drip, delivered over 30-60 minutes. Carboplatin is platinum-based treatment that works by damaging cell DNA to kill the cancer cells. Like Taxol, its side-effects are numerous, but the significant one is bone marrow suppression, lowering both white blood cells and platelets (Taxol contributes to low blood counts as well.) During each 21-day cycle, I may become neutropenic and/or anemic, making me both susceptible to infection and tired. This means I will be immunocompromised to some degree over the course of the entire summer.

Above: Taxol on the left, Carboplatin on the right.

Next: How it felt

Going into my infusion appointment, my highest anxiety was a potential severe allergic reaction to this drug cocktail, so I was both surprised and relieved I escaped that fate this time. Each infusion was uneventful, and I passed the time chatting with my BFF, and texting family and friends.

By the time I was done, I could recognize the steroid high that made me chatty and meant my normally creaky knees felt well-oiled instead. I had energy to spare. I had no nausea but had been warned it could set in after infusion so I gave myself a few hours at home before deciding whether to work out.

In the end, I went to the gym and spent 30 minutes on the treadmill listening to Kara Goucher and Des Linden giggle their way through the current episode of their podcast, Nobody Asked Us. It wasn’t a hard effort and I was pleasantly surprised by how good I felt. Still, I resisted the urge to push my pace into a run or extend the session past the time I had allotted.

Now: Finding the patterns

Anyone who has taken steroids is familiar with the downside, or crash, that follows once the drugs clear your system. After two good days with no nausea and a decent night’s sleep, I woke up on Thursday with stiff knees that progressed to bone pain, stretching from my hips through my ankles by mid-day. It’s an artefact of bone marrow suppression and overstimulated white blood cells. That evening I spent another 30 minutes on the treadmill — though it took some self-talk to convince me to make the effort — and discovered that exercise does indeed mitigate the pain.

By Friday, bone pain was ‘a thing’ and I found myself hesitating to put my feet on the floor as I got out of bed, because I knew standing up was going to hurt. Everyone is unique, and for me the pain ran down the outside of my calves and along the line of my IT band on both thighs. Both my knees felt inflamed and my hips felt tight. My ankles were reluctant to bend. I checked with the Oncology Pharmacy at the clinic, and then took Claratin and two Tylenol. Thankfully that did the trick.

Later in the morning, I joined some teammates for an online yoga session led by Athletes for Yoga founder Erin. Spending time on the mat eased me into a more comfortable state and I’ve earmarked a class to come back to for next cycle if I find myself feeling the same way.

Data nerd that I am, I’m fascinated that my Garmin’s Body Battery seems to track my symptoms. Whether it’s a reflection of two days of bone pain, or simply the cycle of my body dealing with treatment, by Monday my energy reserves bottomed out before recovering on Tuesday.

Above: When my Garmin looks like this, I rest.

The upside of better weather

I’m now 10 days into my first round and mid-cycle brings a whole new set of considerations. With lower blood counts, places like the gym are riskier, so I’m glad the weather has been better and I can opt outside to explore my neighbourhood. I’m an end-of-day runner and have been keeping that schedule since chemotherapy also makes you photosensitive — so I’m avoiding peak sunshine hours.

It’s lovely to see my neighbourhood exploding with signs of spring being here to stay — there’s the smell of magnolias everywhere on my street. For now, I’m finding joy in being able to continue to work out through this round of treatment. And if my energy remains high, I just might run instead of walk the next time I lace up my shoes and head out the door.