Chemotherapy

With my first surgery complete, and the discovery that my lymph nodes were clear, my oncologist was finally able to give my cancer stage: 2A, which based on size of the lump and the fact that zero lymph nodes were impacted. It's conearly-stagely stage cancer, which is a relief, but wasn't going to exclude me from having to undergo chemotherapy. It's the only treatment available for triple-negative breast cancer, and starting chemo sooner rather than later gives you the best shot of achieving good outcomes.

I don't really know what that means for me, exactly. Given that my lymph nodes were clear and that I had a mastectomy, I'm not sure what they are expecting to find at the end of treatment. I'm still going to have to keep my fingers crossed that I won't have a recurrence - I understand the five-year mark is a good goal to reach, as it will be unlikely I will have a recurrence if it doesn't happen within five years. So... fingers crossed, I guess.

My oncologist described the chemotherapy regimen I'd be undertaking - eight rounds, spaced out every two weeks. The first four treatments would include adriamycin and cyclophosphamide, followed by four rounds of taxol. He also described the common side effects and when I could expect them:

1. Hair loss would begin within the first few days of treatment. I could expect to be completely bald within two to three weeks. 
2. Nausea and vomiting would be the worst two to three days after treatment. 
3. Constipation and fatigue would be ongoing.
4. Some patients also see weakening of the heart, called cardiomyopathy. 
5. Compromised immune system: Chemo doesn't differentiate between cancer cells and healthy cells, and knocks out your white blood cells, which are key in fighting infections.

So I would have to stay away from notoriously "germy" places like:

• Gyms
• Buffets
• Disney World

Guys, you know how much I love Disney, right? My annual pass expired in August - it's the first time I haven't renewed it since we moved down to Florida. And the months of October, November, and December are extra magical as Disney preps for the holidays, so I'm sad to be missing out.

I had also been planning on doing a Disney Halloween-themed cruise to Bermuda with some friends and family in October. Disney Cruises are my absolute favorite vacation, and I had been planning this particular trip with the family since June of 2017. Since the trip was planned for the time right in the middle of chemotherapy, I had to back out of it. Glad the rest of the family still went, though. Wouldn't want my cancer to get in the way of their fun. 

Anyway, as much as the side effects all sound like a blast, I forced myself to look forward to treatment. I understood time was of the essence. The only problem was that I had to be completely healed from my surgery before starting since chemo could interfere with the healing process and put me at increased risk of infection. 

So my oncologist and I set a tentative start date for chemo for August 16, about one month after surgery, to allow time for healing. My husband arranged to be home from work that week so that he could go to that appointment with me... and when the time came, we bravely marched over to the doctor's office together.

Only to have him take a look at my surgical scar and determine I wasn't ready to begin. He postponed treatment one more week, which was unfortunate because Ben would be back on the road for work. And again, I knew starting sooner rather than later was important.

But now that I know how much the side effects kick my butt, I guess I'm grateful that I didn't start on the 16th and got to enjoy my 38th birthday on August 20th pretending to be normal. 

Happy birthday, blog

Just stopping in to wish the blog a happy 2nd birthday. Look at how far we've come in two years!!

That's sarcasm, people. For all of this "learning" and "discovery" I've done - not just in the last two years, but since I started half marathoning five years ago - I've gone pretty far fucking backward. I've really just traded one set of unhealthy signals I had five years ago for another much worse set today.

Yeah, remember this? I don't think I'm even moving pebbles anymore. And my writing has kinda gone to shit. 

And I am just so goddamn tired of getting advice from so-called experts who know nothing, Jon Snow. And speaking of Jon Snow, maybe that's part of my problem. Why is all of this expert advice I'm getting coming from dudes? I really gotta rethink my "resources" page because none of these resources have actually helped me get anywhere close to my goals and maybe it's because it's all "expertly" crafted by men using research on other men to the benefit of future men and NOT ME.

I probably just offended 2.53% of my readership. Sorry. I know at least my husband will forgive me. Bear with me for a sec, though, this is not a gender issue.

Here's the truth. I've been steered wrong by female docs too.  Female coaches with specific expertise in my problems charge too much. Holistic health professionals in my area that accept my insurance are hard enough to find, and females are nonexistent, but at this point I'm thinking none of these "professionals" really know what they're doing anyway and they're all just throwing spaghetti. Or zoodles, and those are NEVER going to stick.  

And every success story I've ever read online must be totally fake because how is it that I can do what they're doing and not improve? They're either lying to me or not giving me the whole story. Don't give me that "unique snowflakes" BS, we're not THAT unique. Otherwise, what's the point of even doing research and sharing stories? I should just shut this down right now, right?

The thing that is working for me right now is chemical and short term. Why didn't anybody tell me about this option years ago? Why did I have to fight with this for so long and only have this offered to me after I went asking for something else New Doc couldn't actually prescribe me?

I don't know. Maybe I did have the right answers in my younger days. I don't have time to keep getting it wrong here, people. Hurricane Ethel could take this all away from me tomorrow. No, there's not actually a Hurricane Ethel right now, but while we're on the subject, let's start a petition to change the way they name hurricanes because I hate having to tell people I've been beaten up by an Irene, Sandy, and now an Irma. How about Hurricane Vader? Hurricane Palpatine? Even Hurricane Death Star would work. Seriously, you could get enough villains out of the Star Wars universe to get through a few hurricane seasons just fine.

When exercise becomes unhealthy Part 2

I was investigating a dip in traffic to the blog this week and discovered I inadvertently changed my privacy settings. Way to go, Nicole. It was a particularly bonehead thing to do given I'm still trying to rebuild an audience after killing RttDS last January. So if you're here, I am very grateful you're still sticking with me. Thanks.

Yesterday, I introduced the moment I started seeking new answers to problems that had been building throughout my entire life. I had been juggling a restrict/binge/purge cycle for years, and prior to 2012, I had tried unsuccessfully to end this through therapy. I think part of the problem was that I wasn't willing to stop the intense exercise - I was only focused on the "binge" portion of my problem. Here are some things that were happening to me that should have clued me in sooner that I was overdoing it:

1. Loss of menstrual cycle: I didn't start journaling until about 2010, so I have fuzzy timelines on this, but I had been taking hormonal birth control up until 2009. I stopped because I figured taking hormones for 10+ years was a bad idea. Shortly after I stopped the BCP, I stopped getting my cycle regularly. I likely would have lost my cycle sooner - BCP was artificially keeping it going. As I shared in this post, it came back late 2015 after I stopped the running madness.
2. Compromised immune system: Like I said yesterday, I was sick all of the time in 2012. It was particularly bad that year because I faced lots of stressful events then, and wasn't doing myself any favors adding in the extreme exercise. But even in the years following, I'd find myself feeling run down frequently. Since 2015, I've had less of a challenge fighting off infection.
3. Night sweats: TMI? About once a month, I'd wake up in the middle of the night absolutely drenched. It could be the middle of the winter, it didn't matter. This was the absolute WORST because a. Gross and b. There was no chance of me going back to sleep when this happened. I never tied the hormonal chaos my body was going through back to this, but given that it hasn't happened in a few years, I think it's safe to say the intense exercise was connected.
4. Compulsion: While not a physical symptom per se, I feel like it's important to address here. Exercise was *the* thing my life revolved around. All social engagements were prioritized around my training schedule. I was even late to my bridal shower because I needed to hit the gym the morning of, and my husband wasn't ready to go to the gym with me on time, but I just would not cut my run short. It's no longer the end of the world if I miss a workout these days.
5. Lack of improvement: Remember I said yesterday one of those overtraining signals is still hanging around? This is the one. The thing is I DID get faster and I DID lose weight when I began half marathon training, even though some of the other problems above I had already been experiencing for a few years. And things kinda evened out for me in 2012... and then started to get worse, and haven't improved since. 

Things are supposed to be getting better now, damn it.

BONUS SYMPTOM: Anxiety. I don't know whether to include this here or not. It COULD be related. I can't ignore the fact that it certainly peaked in 2012 while I was training for two half marathons, but there was a lot of other stuff going on. I've experienced it less intensely over the last few years, but I think there are other things in my life besides my running and eating habits that are contributing to that as well. 

I've noticed my anxiety has increased since I started the meds. I confirmed with New Doc this week that bupropion acts like an amphetamine. "That can be a bit uncomfortable for someone with anxiety," he says. Gee, doc, ya think?! He's changing my script, although the lower dose has more of an immediate release. We'll see how that goes.

Anyway, I share the above in the hopes that it can help you or someone you know to figure out if you have an unhealthy relationship with exercise. There are plenty of other ways your body could be yelling at you to slow down, but the biggest thing is that you've gotta be in a place where you are willing to listen. Something about living through a natural disaster like Hurricane Sandy finally got me to listen and start looking for answers. Gotta live our best lives now because tomorrow is not promised.

When exercise becomes unhealthy Part I

Hurricane Harvey had me thinking a lot about my experience during Hurricane Sandy in 2012.

2012 was kind of a crazy year for me. I had started a new job in November, 2011, so I was still learning the ropes in 2012. I ran my first (and still my fastest) half marathon in April. I was planning a wedding, got married in June. I then left that job I had started in 2011 for another one right after the wedding. Oh, I ran my second half marathon in September. And then I went on my honeymoon a week later. While I was away, my grandmother died, which was pretty hard on my dad's side of the family. I began another serious job search. So... yeah. A lot happened.

Right before Hurricane Sandy, I was hit with an infection. I had a nasty abscess under my arm - I used to get these frequently in college, but hadn't had one in about ten years. I had attributed the abscesses to being overweight, and figured they were a thing of the past since I had dropped about 20 lbs and kept it off. So I was very surprised to see one return. Maybe it had nothing to do with weight, and everything to do with stress...

In any case, I went to see a doctor, who suspected it might be MRSA and gave me a powerful antibiotic to fight it. I didn't get better, though... I got worse. For two and a half weeks, I suffered, and woke up one final morning covered in hives. Turns out I was allergic to the antibiotic they gave me.

Between that experience and a glimpse into the "End of Days" that was Sandy, I knew something had to change. I began to question what my existence had become.

1. Why was I getting sick all of the time? Even before the MRSA problem, I was always frequently feeling run down.
2. Why was I job hopping all of the time? Before 2013, I hadn't held the same job in a calendar year since 2005. Anxiety wasn't the whole reason for that, but definitely a major part of it from 2011-2013... coincidentally around the time I began training for half marathons.
3. And why could I show so much control and delayed gratification in so many facets of my life - exercise, finances, volunteering - but could NOT get my eating disorder under control?

So I can pinpoint that late 2012, right after Sandy hit, is when I started to look into unconventional approaches to solving my issues. Because "diet and exercise" weren't really getting me anywhere I wanted to go. My initial search lead me to read Wheat Belly by William Davis, and I started my first public blog in 2013 about my experience trying to kick wheat and gluten grains from my diet. Spoiler alert: it failed.

Now, what's the most logical next step to take when one has trouble restricting one item from his or her diet? Why, find an even MORE restrictive diet, of course! In 2014, I found Paleo and started reading things like Mark's Daily Apple and It Starts with Food (aka the Whole30 or Whole 9 Life). Yet what drew me to these resources was not so much the attention they gave to food, although food featured prominently... it was the information they provided on living a healthy lifestyle.

And that nudged me towards the fact that I needed to quit running cold turkey.

Which is why I started this blog in 2015. Because I wanted to stop running... except I didn't want to do it until after I got a sub 2 half marathon. So here I am, still running, and maybe that's a dumb thing to do.

But maybe it's not.

Because it's easy for me to look back NOW at all of the signals my body was giving me in 2012 (well... from 2009 to 2015) to stop running so HARD, start eating more, and maybe take a break once in a while.

And I'm not getting a single one of those signals today.

Ok, I lied. One is still kinda hanging around.

And I'm not 100% sure what to do about that. 

Tomorrow, I'll share what those signals were in the event you are experiencing any of them... so that maybe you can recognize if you might be in the run/eat/repeat cycle, and get some help getting out of it sooner rather than later.

I sense much fear

Birthday transgressions aside, I've been sticking to what I believe is a perfect diet for over a month now. I should be on top of the goddamn world.

But here's where we stand four weeks after starting medication to get me out of the run/eat/repeat loop:

• I'm tired. I sleep just fine, but I can't seem to shake this general feeling of fatigue. I constantly feel like I need a nap. When the weekend rolls around, I should be ready to go bang down Disney World's gates, but it doesn't sound nearly as much fun as curling back up in bed does. And I didn't think it was possible, but every run seems to get slower than the last.  
• I'm cranky. I am always on edge. Poor Ben can't wait for another business trip to get out of the path of Nicole the Lion. Part of the problem is that I feel like my anxiety has been jacked up a thousand fold, and my impending doom is always around the corner. So wouldn't that make you a little testy too? 
• I've lost 0.0 pounds. This is the cruelest twist of all. I am talking to the tenths of a pound here, people. How can I not binge, eat cleanly, exercise sensibly, and have nothing to show for it? 

Sanity is overrated anyway.

Fact: I had mentally prepared myself for painfully slow weight loss when starting the drugs. No, for realsies. Here's why:

1. I am 100% certain that undereating and overexercising got me into this mess years ago. So I am super paranoid now about making sure I track every last calorie in My Fitness Pal, and I'm eating towards the high end of what someone my height/weight/activity level should probably be eating.
2. I had been taking supplemental thyroid medication for over a year, and stopped last month. My timing is great, isn't it? Now, because I had been taking this medication for a while, my brain said "sweet, I don't have to worry about telling Mrs. Thyroid to do anything anymore," and checked out of that business. Even though I titrated down my thyroid medication dosage to the best of my ability, I figured there would be a period of time before my brain realized she's got a job to do again. From what I had read, it usually can take two weeks to a month. 

So I knew it would be slow, but to not see any progress after a month is fucking depressing. And I just don't know what to do at this point. I don't want to mess with calorie intake just yet. Fortunately, I do have a follow-up appointment with New Doc this week so maybe I can get some guidance. I've been considering going back to Dr. Paleo too, for the sole purpose of getting some quick bloodwork done to see exactly what's going on thyroid-wise, but maybe I'll give it another week or two. 

I understand solving 20+ years of disordered eating takes time, but here's the reality of the situation: I've wasted my best years on this... thing. This fixation, this obsession, whatever you want to call it, with being an athlete. No. With having an athletic body-type. And I've put off other goals. I can't concentrate on other things I want to achieve. I start other "projects," but always come back to THIS. I can't do it anymore because life is just going to pass me by. I need to be done with it. I can't accept that what I am now might be as good as it gets for me. And that I very well may have missed my window to get a sub-2 half marathon. 

So... not seeing any progress is pretty scary for me. 

I found an old birthday e-card I received from SparkPeople that I saved because it had this quote in it and it's so right: What matters most in life is often viewed as peripheral to the things that we focus on. Passion takes a backseat to production, wellness to working, and balance to busyness. The old adage that 'life is not a dress rehearsal' is so true, and yet we act to the contrary by putting off what is truly important or indulging in things that are not...

Logical Nicole knows the above is true. So why am I still drowning in this ridiculous fear?

Twenty-One Days

Hey, I've been gluten/soy/dairy free for three weeks now. Not sugar-free, though. There's some sugar in the almond milk they use at Starbucks, and I enjoy an occasional latte now and again. I also like a little bit of maple syrup in my chia pudding, but that doesn't really count, right?

The above isn't exactly a super feat of willpower, though. I've done three or four Whole 30's at this point, so I've been here before. 

Nope, this is no big deal.

What IS a big deal is that today marks three weeks of being binge free. I can count on one hand the number of times this has happened in recent memory: earlier this year when I started Never Binge Again and around this time last year when I first heard of NBA. There have been more two-week stretches here and there, but even when I was doing Whole 30's, it was still possible to binge on compliant food like nuts or Larabars. 

So twenty-one days binge free means I can celebrate better habits formed, right?

Not so fast. We all know it may very well take more than 21 days to form better habits. And I'll never lose my healthy dose of skepticism that once I stop taking the two types of medication I'm currently on to silence my addiction, it's going to come back roaring more loudly than ever. 

I can't seem to find much on the interwebs about what happens after binge eaters stop taking these meds. Plenty of success stories for people who are currently using them, sure, but I want to know how they fare after. There's also case studies from people who have used them to treat other addictions, like smoking or alcoholism. I am hopeful because they seem to be successful, but I can't ignore the fact that food is a completely different beast than cigarettes or liquor. I can't just quit food entirely.

I can just live in the moment for once, though, and enjoy what it feels like to be free. So what if I got here in an imperfect way.

I don't have to worry about what might happen later. Because I can always use the present moment to be healthy when it comes to my food choices. And I'm doing the legwork now to be ready to come off the meds in the right way. I have to remember, I'm on the lowest possible dose of each, with so far no need to increase my dosage. 

And I can finally celebrate a binge free birthday (yes, I've got another birthday approaching this weekend, even though I told those silly birthdays to stop coming around years ago). A really excellent birthday gift would be some news about runDisney's Tinkerbell Half Marathon. Something tells me that's not going to happen, though... maybe if I use the Force...

I'll be doing my long run in South Carolina this weekend so I can be in a better spot for the eclipse on Monday. A long road trip... not having access to my own kitchen... this would have been quite challenging in the past, and I'm curious to see how I'll handle it this weekend. But I'm pretty sure it will be easy for me now.

Inner Workings

So I'm one week into a new regimen of taking two types of medication - a low dose of an anti-seizure med and an antidepressant - to help end my eating disorder.

What if I told you.... I take both pills?

For the last ten years or so, I've really been strongly against taking any type of medication, even avoiding aspirin for headaches if the pain wasn't unbearable. Even last year, I was hesitant to start up thyroid medication when I learned my thyroid was working sub-optimally, but gave it a go because I thought that might be playing a role in my binging, and the thyroid meds didn't contain much in the way of chemicals (just naturally desiccated pig thyroid gland). But after a year of taking higher and higher doses of WP Thyroid until I hit the max and never seeing better results, I decided to wean myself off of those meds, and I took my last 1/2 grain of WP Thyroid this morning.

So I didn't take the decision to go hunting for help from conventional medicine lightly, but when it comes to binge eating or bulimia or whatever the hell plagues me, the pendulum swings just seem to be getting wilder and wilder in my life. One month, I'm "cured." The next, I'm so far off the rails, it's scary.

I want equilibrium. I want balance. And then I'll achieve my goals, like finally getting my sub 2 half marathon.

And um, guys... the meds are kinda working.

Let me explain to you the inner workings of my brain before last week:

Inner Pig: "Oreos."
Nicole: "Um. We don't eat that stuff anymore."
IP: "Oreos."
Nicole: "We're kinda busy right now."
IP: "Oreos."
Nicole: "I don't really want Oreos."
IP: "Oreos."
Nicole: "I have to run tomorrow, and I can't be sick and bloated for that."
IP: "WE'RE GETTING GODDAMN OREOS."
Nicole: "Eep. Ok"

That's literally how it works for me, and as I understand it, for most with binge eating disorder and other types of addictions. There's an internal argument, a power struggle that takes place until my rational, logical self takes a back seat and something else takes over for a while until I find myself knee-deep in a pile of oreos, wondering how this happened and feeling guilty as hell, and the only thing that is gonna make me feel better is running the junk out of my system, only my body is wearing down and I can't run like that anymore.

And here's how it's worked since last Friday, like almost immediately:

IP: "Or-"
Nicole: "SHUT THE FUCK UP."

Who's in control? Me.

Also, the meds give me a potty mouth.

And that's it. I eat three normal meals, mostly things I've prepared myself from fresh meats and veggies, and have an extra healthy snack if I have worked out, which has been most days this week. I also have dinner at the table with my husband - it's worked out really nicely that he's not traveling this week for work to get me into the habit of sitting at the table to have meals.

And that's exactly what I'm looking for... building good HABITS around food so that in a few months time, I can eliminate the meds and be a normal human eater. I also believe that - because I won't be eating the things that suppress thyroid function like gluten and dairy - I'll be helping my body out in that respect, too.

I've got hope again. Haven't seen you in a few months, friend. Glad to have you back.

Insert Clever Title Here

I kinda spazzed out last night at kickball. There were a few things working against me:

• New medication
• I woke up early yesterday to get in a 5 mile run, since I wasn't certain kickball was going to happen (we've been rained out 80% of the time this season). The rain did not work in my favor this time, however. 
• We had a double header... against the same team, who is pretty good
• Our (2) games didn't start until 8:30 pm... and usually I'm in bed and winding down around 9:15pm, so I really didn't want to be there

It doesn't help that every week, we're always fighting to get enough women to play on our team. We always barely eek by with the required 5 minimum, which means that every single one of us is playing the field every single inning, while the guys get to rotate in and out, and the ladies never get a break. Don't get me wrong, I like to play, but I think I'm going to need to take the next season off to really focus on half marathon training. I'll try to find someone to replace me as short stop.

Running went well yesterday.

No it didn't. It went more like this:

Minus the whole stripping part.

I did find this article about running form interesting. It appears my natural stride is what's going to be most efficient for me after all, and I don't really need to give it much further thought.

Weird dreams continue. Last night, there were a few different ones, but the one that stands out most vividly right now involves me being part of a focus group at work reviewing new commercials where we fired the guy who has been acting as our spokesperson over the last few years... and replaced him with an animated version of him and used his voice. Pretty sure we can't do that. Also, the commercials were nonsense.

I'm so tired today. Here's to a much-earned rest day.

Right Life

Today's day 5 on the topiramate/bupropion combo, and I have to say the side effects have generally been minimal and not unpleasant. Except for the weird dreams.

Strange things happen when I go to sleep these days. 

Last night, a nice gentleman named Vlad showed me how they made blue breastplates at Epcot's Norway pavilion for Disney's army. Two nights ago, OJ Simpson was running for mayor of St. Petersburg, which I hope is not prophetic considering we do have a mayoral election coming up, OJ's daughter lives here, and he did mention living in Florida once he gets out of prison.

Speaking of living in Florida, I've lived here since July of 2015. When I first got here, I felt like I was finally living my "right life"... no more commuting, more time to dedicate to running and my other passions, and - yes, still feeling pressure to perform at work - but pressure I could alleviate with a quick look out of my bayview balcony. (I temporarily lived in a condo overlooking Tampa Bay when I first got here. So awesome.) Well, here I am two years later, and I'm not really feeling that "right life" feeling anymore.

Surely, I'm missing my waterfront property. 

Ok, I know it's more than that. I really think I'm just not in the right line of work anymore. I've been in my role for 4.5 years, with my company for about 10. But I'm afraid to look elsewhere. I do love my company and there are plenty of reasons to stay with them, but I think it may be impossible to land another job with my company as a remote worker, and moving back north is not an option for me right now. 

Besides, I really love working from home. I can think clearly. I can be here to let in contractors when needed. I can do other things with my life besides drive myself to and from work. Yet I believe it is going to be very difficult to land another work-from-home job, and this article agrees with me. 

And yet I fear I might be forced to look elsewhere in the coming months. 

All signs point to the fact I should find a new role that gives my life meaning and purpose, especially as this month I will enter my late 30's which is mid-life crisis territory. But I hesitate because I'm not sure the benefits of finding meaningful work outweigh the stress of having an office-based job again.