The Longest Miles
How did I get from cancer to a half marathon? Let's just say it's been a journey.
If all goes as planned, by this time most of you read this I will have completed the Knoxville Half Marathon. Now, before you get all excited, I did not actively sign up for this race. I signed up for the 2020 version of this race, and then Covid and cancer and cancer treatment happened, and I had to ask the race director twice if I could defer my registration. January me didn’t feel like asking again and decided it was a problem March me would just have to deal with.
When I was originally training for this race in the Before Times, I was in the best running shape of my life. Running pace is a deeply personal thing — my fast is someone else’s slow, and my slow is someone else’s fast — and I’ve never had any delusions of becoming an elite runner, but I was finally running fast by my own definition after more than a decade of making the most marginal of gains. I had been putting in extra work on the strength training side and, in addition to the usual long training runs, doing the kind of running workouts that are designed to make you faster, and whatdayaknow? I got faster.
Unfortunately I did not carry that speed into the early days of the pandemic. Around the time the half marathon was postponed on account of Covid, I was dealing with some sort of upper respiratory issue that came with a heavy dose of shortness of breath and fatigue (*shrugs*), so I decided to take a break from running. And then a couple of weeks later I fell down the stairs and severely twisted my ankle, for which I got no treatment because the entire world had shut down. I was just starting to load test my ankle again when I found the lump in my boob. Fun fact: The tremendous pain that prompted me to feel up my boob to see what was going on in there manifested during a run. Running, as it turns out, really is good for you.
I cried for about three days straight when I was diagnosed, but the thing that may surprise you is that I wasn’t really thinking about the suddenly very real possibility that I might die a whole lot sooner than expected. That would come eventually, but the weirdly beautiful thing about being in shock is that it sometimes protects your brain from going places it cannot at that time handle. Instead, I thought about how healthy I was, or at least how healthy I thought I was. I’d run enough half marathons that I’d lost track of the count! I’d done three half Ironman races! I’d ridden my bike 31 miles up a mountain with a 4,500-foot elevation gain! There is no way on God’s green earth that a person who can do all of those things gets cancer!
A quickish origin story for you: In 2008, I was sedentary and doing Weight Watchers, hoping to shed some of the pounds I’d rapidly gained after college. I decided to do the Couch to 5k program, even though I didn’t really have any specific interest in running. Running was a thing that it seemed everyone else did, so I figured if I wanted to be more active I should do it too. Plus, finish lines held a certain allure, and it seemed like there was a 5k almost every weekend, so I reasoned I’d have no problems finding motivation.
Deana, our delightfully bubbly WW leader, asked our group one day what physical activities we loved as a kid. My answer was a no-brainer — I was usually on my bike or in the pool. "So why not do those things now?” she countered with. Deana had just rediscovered hula-hooping and had brought her new hoop to the meeting for us all to play with. I used to be really good at keeping a hula-hoop above my hips but discovered it was a skill I’d left behind in childhood. Still, her point was made. Even if I wasn’t good at it anymore, I had fun trying. I’d probably have fun on the bike and in the pool too.
This was one of those pinprick moments in time that you look back on and realize how it was actually a major turning point in your life. I had done one 5k by that point, and I wondered if there was such thing as a 5k version of a triathlon. All I knew of triathlon was Ironman (the championship in Kona version — I had no idea there were dozens of other Ironman races or even a half-distance version) and Escape From Alcatraz. Both seemed infinitely crazy to me. I went home and Googled “5k triathlon” and learned, yes, there is such a thing. It’s called a sprint, and there were about a half-dozen of them scheduled in Knoxville for the summer of 2009. I Googled “Couch to Sprint Triathlon” and found a handful of free training programs on the internet. I would need to get a bike. I would need to start swimming laps at the gym. “This is crazy, right? Right?” I said to myself. I decided to do it anyway.
My first triathlon, the Springbrook Sprint in August of 2009, wasn’t pretty. I hadn’t done a great job of sticking to the training program, and I finished maybe third from last. I’m pretty sure they’d already done the awards ceremony. But I didn’t care. I found myself high on the adrenaline of having finished a triathlon. I signed up for another the next spring. Two years later I joined a triathlon training group. “I want to not finish at the back of the pack,” I told the coach. His response was, “To get faster at sprints, you need to do longer races.” I signed up for an Olympic-distance tri, which is roughly twice the length of a sprint. It scared me. Again, I was one of the last finishers, but I was even more stoked. I got faster at the sprint races that all of a sudden had become training workouts instead of my goal races. Two years later, one of my training teammates and I talked the rest of the group into committing to a half-distance Ironman — that’s a 1.2-mile swim, 56-mile bike and half marathon. I’d never even done a half marathon at that point. Again I was scared, but by then I had gotten hooked on testing the waters of what seemed impossible. I had come to realize that if I put in the hard work and trusted the process, I could do the things that scared me. This knowledge would come in handy later in my life.
I tell you all of this not to #humblebrag about my athletic accomplishments, though I am damn proud of every mile and minute of training I’ve done and every finish line I’ve crossed. I share all of this to stress that none of this came naturally or easily. I had put in hundreds upon hundreds of hours over the course of years and years and years to get to where I was in 2020. And then cancer threatened to take it all away from me faster than I could say doxorubicin. When I cried so hard in those first few days after my diagnosis, this is what I was thinking about.
The doctors stressed that my level of fitness would serve me well in managing the roller coaster that is cancer treatment. Looking back, I absolutely believe that to be the case. Though my blood counts dropped as expected, they never reached the danger zone where you’ve run out of blood cells to fight the chemo and/or radiation that’s fighting your cancer. I had plenty of unfun side effects, but I never made any unscheduled trips to the hospital. If cancer treatment can go smoothly, then I guess I was Christopher Cross carried by a dream and the wind.
Still, treatment is hard. They make you sign waivers before you get your first dose of chemo acknowledging that the thing that is supposed to kill the cancer that’s trying to kill you may also kill you. Part of my four-drug chemo protocol included the lifetime maximum dosage of Adriamycin, a Kool-Aid colored drug nicknamed the Red Devil because it’s so toxic to your heart and has such awful side effects. (I’ll wait while you Google worst chemo.) It’s so toxic, the nurses have to wear hazmat suits when they administer it to you. It makes your pee red for a couple of hours.
My medical team encouraged me to continue to be as active as I could because it would help me rebound faster after each chemo round. Two days before my biopsy, I had done a seven-mile hike in the Smokies that included a two-mile uphill section with a 1,000-foot elevation gain. I hauled ass up part of that climb after hearing and seeing a rattlesnake that was lounging on the side of the trail. (Yeah, I had no idea there were rattlesnakes in the Smokies, but there be rattlesnakes in the Smokies.) With that hike as my baseline, I figured I could still do, what? 20-mile moderately hilly bike rides? Three- or four-mile runs? No. After my first few rounds of chemo I couldn’t walk upstairs without getting winded, so I stuck to slow walks and threw in some short, flat bike rides once I was off the hard stuff and on the “easier” chemo.
I wasn’t sure when running would be back on the menu. No one can give you any sense of what’s reasonable to expect of your body during and after cancer treatment because, as it turns out, every case of cancer, every treatment and the way every body reacts to it all is different. The most specific prognosis I got was from my radiation oncologist, who cautioned me that I’d likely feel treatment-related fatigue for up to six months (he was not wrong), but as far as running? “If you can do it, by all means, do it!”
I did a few sessions of run/walk intervals here and there in the latter half of my active treatment, but I didn’t try running in earnest again until April, a couple of weeks after I was fully done. I opted to follow Couch to 5k again, hoping that would ease me back into it. The first few weeks have you doing very short run segments — we’re talking 60 seconds at a time — followed by longer walk segments. Those weeks were fine. But when I got to where I was supposed to be running 20 minutes without stopping, I found myself gasping for breath and squealing from the pain in my chemo- and menopause-ravaged joints. And as long as my lungs and joints were barking that loudly at me I couldn’t outrun the voice in my head saying, Maybe this is it and you’ll never be able to run again. I threw the training plan out the window.
But I still kept chipping away at my own pace. I told myself to stick to a mile or two at a time, to go as slowly as I could while still propelling myself forward and to walk when I needed to. My body never has handled running in the Southern summer heat well, but I was convinced that the only way I was ever going to get better was to keep running in the Southern summer heat. I hated it, but I didn’t feel like I could quit.
As the weather turned to fall and the Mercury finally started to drop, things got better. I could run without choking on the air. I could run without getting flushed. I could run three miles without stopping. I could run and still walk the next day. I could run a little faster. I could run and actually sorta, kinda enjoy it. By November, I was up to four miles. In December, I covered a 10k distance for the first time since my early 2020 training. I felt great. Game on, I told myself in January.
In those early days of my diagnosis when I was crying all of the time, all I wanted to do was get through treatment and get back to my regularly scheduled life. I did not want to pass go, I did not want to become a pink ribbon-encrusted caracature of a cancer patient. Every one of my early-stage cancer people who is reading this now is smirking and/or nodding emphatically because they were there too at one point, but they all know the secret — there is no picking up where you left off. Yes, you survived, you can check that off the list. Now please enjoy a few years of near-constant anxiety over the potential for a recurrence with side dishes of sadness, anger and PTSD.
We don’t do a great job as a society of acknowledging how very scary the survival part of being a cancer survivor can be. But there’s something else that we don’t readily acknowledge, and that’s this: That even in surviving cancer, you experience a litany of tiny deaths along the way. Some of those deaths are visable, like when you lose your hair and your eyebrows. Some can be profoundly sad, like when you lose your ability to conceive children. Some may seem superficial but are annoying in a nagging kind of way, like how my big toenails no longer fully connect to my toes. All serve as a constant reminder of just how much cancer has taken from you.
I have thought about this on every single long training run I’ve done in advance of tomorrow’s race. I’ve done the Knoxville half three or four other times, so my training routes are well-worn and familiar to me, and my brain falls into a routine of assessing how I’m doing based on what it knows. The last time I ran up this hill, I bounded up it. Now I have to walk. … The last time I did this route my pace was 9:50 per mile. Now it’s 11:15 … The last time I ran this far, I felt good. Now I’m suffering. Yes, comparison absolutely is the thief of joy. I’m living it with every stride in my running shoes. But YOU go through chemo, a mastectomy and radiation and then tell me if you can stop yourself from thinking about what cancer has stolen from you. Tell me you can just be happy that you survived without mourning what you’ve lost. Tell me you can focus on only the positive. Just don’t be upset when I don’t believe you.
I almost quit training for this race after a long run in February. It was my first serious foray into the meaty hills that make up the midsection of the race. Early in my run while poking up the first of the grueling hills, some dumbass college kids hung out a car and made barking noises at me. I was already in physical pain, and it was enough to make me cry when I got to the top. This isn’t fun, I thought, so why am I putting myself through it? I wasn’t out to prove anything to anyone, not the very least me. After all I’ve achieved and all I’ve been through, I think I’ve satisfied the “prove it” requirements of this course. I didn’t really want to ask for another race entry deferral, but my pride wasn’t too bulletproof to do it.
Here’s where I drop my heaviest truth bomb on you: Deep down, I know I keep pushing myself to run farther and faster because I’m trying to outrun the cancer. I don’t like saying this out loud because I know how irrational it is. I couldn’t outrun, outbike and outswim cancer before. There is some evidence that physical activity can increase the odds for long-term cancer survival, but it’s not like this specific half marathon or any after it is the thing that will keep the cancer at bay. It’s certainly not keeping the anxiety at bay. And yet, I keep notching miles in hope that the next one will somehow magically secure my future survival.
I bargained with myself to do one more long run before deciding whether to quit. I told myself I also had to retool my approach to see if it helped. No more trying to run the whole way, run/walk intervals were now the de facto approach. I had to eat better the night before and run earlier in the day when it was cooler and more comfortable. If, after trying these things I still was miserable, then the race would be off for another year.
I suppose you can guess what happened because I’ve already told you that I’m aiming to complete the race tomorrow. I don’t know if it was the intervals or the Yassin’s chicken shawarma I had the night before or the chance encounter with my beloved training buddy Bill along the way, but I was firing on all the cylinders I have left in my body on that subsequent run, so I decided to stay the course. Unfortunately, unseasonably warm and obscenely windy weather have made all the runs I’ve done in Knoxville since pretty miserable, so my batting average on having good runs is … well, let’s not talk about it. I already have my misgivings about how tomorrow is going to go. Let’s not make it worse.
I saved one piece of information so that I could end this on a higher note. I don’t want you to think that I’m solely dwelling on what I’ve lost from my pre-cancer self or that I’m failing to recognize the progress I’ve made or how much I still stand to accomplish (insert requisite “assuming the cancer doesn’t come back” here).
I visited my parents in suburban Memphis two weekends ago. I had been trying to make at least quarterly trips to the motherland before the cancerdemic hit, and this trip was an effort to get back to that and also to go through some boxes of stuff my Mom has dutifully stored in the attic for more than 20 years. This trip coincided with a prescribed 12-mile training run, the longest run of the entire 12-week plan. No problem, I thought. I’ll take my shoes with me. I’d done a handful of long runs in Germantown previously. It’s pretty flat compared to Knoxville. Maybe I’d have at least one more good run before I started tapering.
My Mom informed me a few days before I made the trip that the Germantown Half Marathon would be happening the Sunday I was there. I had already planned to run on Sunday to avoid the snow that was coming the day before and to give my body an extra day to recover from a nasty cold I’d been fighting that week. The race route almost perfectly mimicked the route I was planning for myself. The wheels in my brain begain to turn. The race was only one more mile than I was scheduled to run. There would be water stops and port-a-potties along the route. And a medal at the end. “This is crazy, right? Right?” I said to myself. I decided to do it anyway.
I told myself all I had to do was get my 12 miles in at a comfortable pace. Stick to my run/walk intervals for as long as I could, and if I had to walk that final mile because my body wasn’t yet ready for it, so be it. The finishing time was irrelevant.
It was 28 degrees at the race start, which is pretty close to ideal for me. My parents came out to cheer me on, and I love having supporters. Did I mention it was flat? I faithfully stuck to my run/walk intervals all the way to the very end, thanks to some well-timed encouragement from another runner at mile 12. I finished that race, and I finished it faster than I could have imagined if I had allowed myself to imagine how fast I might finish an impromptu half marathon less than a year after finishing cancer treatment. It wasn’t even my slowest half marathon ever! I was elated. I could run a half marathon. Cancer didn’t take that away from me.
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