Sunday, April 20, 2008

"Only" is a relative word for runners

The 112th Boston Marathon is tomorrow. Thirteen years ago, I ran the marathon with my friend Diane.

Well, I didn’t actually run the whole thing. I took her to the starting line in Hopkinton and then drove downtown to meet her four miles from the finish. She correctly estimated when she would reach that point, and then I jumped in and ran with her to the finish, so that I could provide support. I wasn’t the only one doing that kind of thing.

Once I started trotting along with her, I wasn’t really sure what I do.
“You’re doing great,” I said. “Just a little further to the finish.”
Diane looked at me out of the corner of her eye.

“I can’t really talk right now,” she said.
So I stopped my blathering and ran along with her. Later, she said that just by quietly running alongside her, I had helped a lot. At the end, someone threw a mylar sheath over me and congratulated me. I felt a bit like a fraud. Diane had run 26.2 miles, and I had run only four. We laugh about it today.

“Only” is a variable word for runners.
One person’s shorter run is another person’s long run.
So where someone who does longer distances might say, “I ran only six miles this morning,” the listener who was pretty pleased with having squeezed in a three- or five-miler before work might feel diminished. There is a hierarchy of “onlys.” I think people use the word because they kind of feel they should have gone further.

When I bought sneakers from the skinny “real” runners who worked in the runners’ shop, and they asked how far I ran each week, I told them, “Only about 30.” I felt I had to apologize.

Joan Benoit Samuelson, two-time Boston Marathon winner and a pioneer in women's distance running, tells interviewers these days that while she used to run 120 miles a week, she's down to 70 or 80 because that's all she can do. (Kind of a variation on "only" 70 or 80.)

I did increase my mileage when training for a half marathon in Hartford; after I ran it in 2002, I felt kind of wimpy at having “only” done the half, as the people doing the whole looped past me.

When I was in the hospital receiving chemotherapy for leukemia, I walked up and down the Pike, a corridor at Brigham and Women’s Hospital. When I had my two stem-cell transplants and couldn't go off the pod, I did 44 laps back and forth in front of the nurses’ station, because someone had estimated this was a mile.

It was all I could do. Some days I was happy that I could even do that. Other days when I thought about what my old self could do, I felt kind of down. And when I came home, weak after the treatments and the hospitalizations, I could barely walk to the corner, and the word “hill” assumed a new definition for me and was now just a small incline.

I could only get to the corner.

Tomorrow, as the Boston Marathon takes place, I will go into town for an appointment at the Dana-Farber clinic. I will have my blood drawn and have a check-up afterwards. If I feel well enough, I might take a walk afterward. But it will only be for a mile or two. I hope that soon my “only” gets longer. In the meantime, I have to remember to be patient with myself.

Wednesday, April 16, 2008

Hair do's and hair dont's

They say my head has a very nice shape. I figure I can repeat this, since it does not amount to bragging. I really had nothing to do with it. In any case, I’ve been told that I looked good bald.

This is a good thing, I guess, because I’ve been bald quite a bit on and off over the past five years. Since getting diagnosed and treated for leukemia, going into remission for almost four years and then relapsing (arrrgggghhhhh!) and going into remission again last year, I’ve watched my hair fall out, grow back in, fall out and grow back in (2003) and then fall out and grow back in again (2007).

Actually the shape of my head is not really perfect. When I was a junior in high school in New York City in 1971, I left a party for a late-night bike ride with my boyfriend, my first love. We had not really sealed the deal, but we were about to. He pedaled and I sat on the handlebar as we headed down Fifth Avenue to Washington Square Park. We got off the bike and leaned it against a bench, and then we kissed in the warm spring night. He threw his faded red jean jacket on top of us as we stood there hugging. (I’m not sure what this accomplished – he was 6 feet 5 and I’m 5 feet 9, so we weren’t exactly hidden from view, but for just a few minutes, it did feel like we were the only ones in the park.)

On the way back to the party, I accidentally stuck my foot in the spokes of the front wheel. The bike flew up, flipped over and landed on my head, almost in slow motion. Blood gushed out onto Fifth Avenue, and my boyfriend put me in a cab that took me to the nearest hospital. He followed with the broken bike and held my hand while I got stitches in my head. Then we went back to the party. The throbbing in my heart eclipsed the throbbing in my head.

The incident left a little bump. Sometimes I touch it to remind myself of a city night filled with promise, when a bike landing on my head (and my concern over what to tell my parents) was the worst thing that had ever happened to me.

I had long hair that I often wore in a ponytail. When I played tennis or jogged, I pulled it through the back of a baseball cap. I never got my old hair back after cancer. When it grew back, I didn’t let it get long again. I kind of wanted to, but everyone advised against it. They said it looked better short. I know other women who share the dilemma: In wanting your old hair back, you want your old life back. But you can’t go back to the old life, and, with a combination of regret and acceptance, you follow everyone’s advice and stick with the fashionable shorter hair. Sometimes it's like I have a phantom limb, and I shake my head as if to get my hair out of the way. But sometimes I feel kind of cool, and I put on dangly earrings and hold my head high.

Tuesday, April 15, 2008

Bone marrow transplants bring new birthdays

Today is my half birthday. I am six months old.

Most people know it as tax day, and for me it’s that too. But it is also a kind of marker on my leukemia journey. Six months ago, I got my second bone marrow transplant. It was Oct. 15, 2007 – my new birthday. Actually, it was my second new birthday, making a total of three birthdays in all.

Aug. 24, 1954 was my real birthday.
My first transplant, on Sept. 18, 2003, marked my “new” birthday.
I had hoped it would be the end of leukemia for me. I got what is known as an autologous transplant, using cells collected from my own bloodstream after I went into remission. I received these cells back intravenously to repopulate my bone marrow after my third, and most intense, round of chemotherapy depleted it.

I took a long time to recover, including a year at home while my weakened immune system grew stronger. I was always afraid of recurrence, but as time went on I became more confident. When I passed the two-year mark, I felt especially good. That is the point at which the disease is extremely unlikely to return.

But as I discovered in August, 2007, unlikely does not mean impossible. I felt great and was back to my usual self – working full-time, doing yoga, lifting weights, and running, biking and playing tennis. I was nearly four years “out.”

My doctor saw the signs of trouble in a routine blood test, and then he performed a bone marrow biopsy that showed the leukemia had returned.

I found it nearly impossible to comprehend, and immediately began to wonder if I had done something to bring this on, or if, conversely, there was something I had not done but should have. My doctor said it was nothing I did, or didn’t do. It just happened.

An article that I recently wrote for the Dana-Farber Cancer Institute's website, headlined "Baby Steps and Beyond," tells the story. Short version: I had to go through chemotherapy and transplant again. This time I had an allogenic transplant, using marrow from a donor. The idea is that donor marrow is insurance against the leukemia coming back; the new cells recognize invading cells as foreigners and attack them in a way that my own cells were unable to.

Recurrence, of course, is a whole new ball game.
Physically, it was probably easier the second time around. Mentally and emotionally, the story is more complicated. You feel more fragile, more vulnerable, yet you have the benefit of already having learned coping skills from the first time around.

You have to take time to give thanks for the progress made by medicine and for the progress you have made. I am not yet allowed to know my donor's identity, but we have exchanged anonymous cards. He is 53, a father, and lives somewhere in the United States. That's all I know about him, except that he is extremely generous, and that he gave me a second chance.

So on my six-month birthday, I send him thanks, wherever he is.

Thursday, April 10, 2008

Anniversaries that resonate

We remember where we were, what we were doing when major events occurred. Our memories provide texture, fill in the gaps, anchor the big events.

A big one for most of us baby boomers is the day JFK was shot. I was in grade school in New York, and they sent us home. Not totally comprehending but knowing it was very bad, I watched the events unfold on a black and white TV. I sat on the floor in our parents' room, my eyes wandering from the televised images to the speaker at the bottom of the set. The dog had chewed it, and my mother had covered the hole with a pink silk rose.

Then of course there is Sept. 11; most everyone remembers where they were. I was running, and got home on time to see the second plane hit.

On a personal note, I piece together the events framing my hospitalizations, with anniversaries marked by whatever else was happening. Family and friends weave the fabric too.

St. Patrick's Day is a marker for me; more specifically, the St. Patrick's Road Race that takes place in Holyoke, Mass., the day before the area's big parade. My cancer journey began five years ago when my fatigue in running the race sent me to the doctor who diagnosed leukemia.

On April 7, 2003, I went to Boston. I would spend two days at my sister and brother-in-law's before being admitted to Brigham and Women's, the partner hospital of the Dana-Farber Cancer Institute. On April 9, 2003, my chemotherapy started.

That April 7 was tough for my three children, who fill in around the event with other memories. Ben remembers that he was supposed to play his first varsity baseball game. Snow was forecast, and the game was canceled. Actually it was just cold and damp when I left that morning, and it didn't snow until much later in the evening.

The present adds other layers, drawing attention away from the past.

April 7, 2008. Five girls, including Katie, wear Red Sox shirts to softball practice; Katie is one of three wearing a Papelbon shirt in honor of the charismatic closer who helped last year's team win the World Series. (So? The shirts were bright and cheerful, that's all.)

April 8, 2008: Ben, who covers sports for a newspaper in New Jersey, comes home for a couple of days and sits in his old spot on the couch to watch the Red Sox home opener, held on a beautiful baseball day on which Boston beats the Tigers, 5-0. Bill Buckner makes a surprise appearance to throw the first pitch, and the crowd gives him a standing ovation. It is his first visit to Fenway Park in more than a decade, and his eyes tear up. Buckner, who had 2,715 career hits, was blamed for an error in Game 6 of the 1986 World Series, which the Mets won. He tells interviewers that he forgives fans and the media for what they did to Buckner and his family. (I remember watching that fateful game while Ben slept upstairs in his crib, before life threw me curveballs.)

April 9: 2008: Katie pitches a no-hitter, and I watch her softball team win their game in the finally-warm spring sun. Later, I stop overnight outside of Boston at Diane and David's (my sister and brother-in-law) before heading to Maine to pick up my son Joe from college in Maine for his April break.

Diane and David don't eat much dessert, but they know I do, and they buy me a really good brownie. I savor the treat along with their conversation.

April 10, 2008: It's a sunny, glorious day again. When I get to Bates, students are lying in the sun, walking around in flip-flops, tossing frisbees. I can't believe I am old enough to have a second child in college. I am grateful that I am alive to see him coming out of his dorm, wearing, as usual, his Red Sox hat. We give each other a big hug. Then we laugh and talk almost the whole time during the three-and-a-half-hour drive back.

Monday, April 7, 2008

Tennis: The Agony and the Ecstacy

You can't get a runner's high in tennis, but you can get in the zone or close to it.

Tennis has bigger highs and lower lows than running. Many of the things that make running beneficial can hurt your tennis game. For example, letting your mind wander during a run is very calming. In a tennis match, you will lose the point if your mind has wandered off to what you're going to eat when you go off the court, or where you're going afterwards, or any number of benign or even self-destructive thoughts.

My highest high during a United States Tennis Association (USTA) league match occured in August, 2003, when I competed along with my team in the regional district championships, held that year in Portland, Maine. I still needed one more round of chemotherapy and my stem cell transplant. I had a fungal pneumonia which was being kept in check with an anti-fungal drug; lung surgery, the only way to get rid of it, was scheduled for later in the month after my platelet count had risen enough to stem bleeding during surgery.

Still, I felt well enough to play, and my doctors had given me permission. Out on the court with my partner, Donna Young, I was free from the pressure to win because I had no expectations other than being able to hit the ball and enjoy being out of the hospital and on the court. I had so much fun that I forgot to fret in my normal fashion. We got in the zone, and won the match 7-5, 7-5. On the court there were just the two of us playing, but it really was a team effort.

The lows can be something else, especially if you are as prone to obsessing as I am. Years before at another District competition in Providence, R.I., Donna and I had been ahead 5-2 in the third and decisive set. The other team crept up on us, one game at a time, and we panicked and tensed. Instead of playing our regular game, we played not to lose. Lose we did, and we spent the rest of the weekend, and actually weeks after that, hating ourselves and analyzing where we went wrong.

I've been re-reading Ian McEwan's novel "Atonement" in advance of seeing the movie, and I remembered a chapter from his novel "Saturday" in which he described his main character's thought process during a squash game. That chapter really resonated with me for the way in which a game, which is supposed to be fun, can assume out-sized proportions. Henry, a successful neurosurgeon, is losing to his opponent, Jay, another doctor:

"The constant change of direction tires him as much as his gathering self-hatred. Why has he volunteered for, even anticipated with pleasure, this humiliation, this torture? It's at moments like these in a game that the essentials of his character are exposed: narrow, ineffectual, stupid -- and morally so. The game becomes an extended metaphor of character defect."

I also recently reread Timothy Gallwey's book "The Inner Game of Tennis," in which talks a lot about the zone. He writes that when a tennis player is "in the zone," "He's not trying to hit the ball, and after the shot he doesn't think about how badly or how well he made conact. The ball seems to get hit through a process which doesn't require thought." He likens it to peak experieces in which people feel at one with the experience and, in the words of psychologist Abraham Maslow, "free of blocks, inhibitions, cautions, fears, doubts, controls, reservations, self-criticisms, brakes." He quotes Phil Jackson, coach of the Chicago Bulls, describing "the zone" in his book, "Sacred Hoops": The secret is not thinking. That doesn't mean being stupid; it means quieting the endless jabbering of thoughts so that your body can do instinctively what it's been trained to do without the mind getting the way."

Gallwey offers suggestions for stopping the mental chatter. First, it boils down to changing your definition of a good match from one in which you have to win, to one in which you played great and had a good time, no matter what the results. (Yeah, yeah, yeah, easier said than done.) He also offers useful techniques along the lines of others who counsel the benefits of mindfulness.

Breathe. Focus. Be aware of the present. Keep your eye on the ball.

In tennis as in life.

Thursday, April 3, 2008

After setback, recapturing the runner's high

Most runners didn't need to see the research to know that the runner's high is real. Last week, the New York Times published a story proving it to be true. Researchers studied distance runners, but I think that shorter runs get those endorphins going too. Sometimes just the fact of having run does it. You can let things slide, knowing you've gotten your run in. I once had a serious relationship with a man who didn't get it when I attempted to fit my run (or tennis match) into the day against all odds. "I need to run," I'd say. "You don't need to run," he'd say. "You might want to run, but you don't need to." But I did need to, underscoring a point that many of the "addicted" already know: You need to be in a relationship with somebody who gets it (or you need to be alone).

When you get sick, or injured, you miss the calming effects of your runner's high.

In 2003, calm was hardly in my vocabulary while I battled cancer. I received my chemotherapy in-patient at Boston's Brigham and Women's Hospital, where I was confined for weeks on end. I felt a little better when I discovered that, at least, I could do some kinds of exercise almost every day, except for when I just felt too sick to move. I did some exercises in my room, but preferred getting a change of scene by walking up and down the Pike, a hospital corridor connecting offices marked by Turnpike-like signs.

This was my new landscape. I took the elevator down to the Pike and got on at Exit 1, walking down to the end, Cardiac Surgery at Exit 9. Places I passed included Mammography near Exit 4, the Blood Donor Center and Plastic Surgery between Exits 5 and 6, Pain Management Center (which I could have used!) just before Exit 7, and Thoracic Surgery at Exit 8. There was plenty to look at on this main artery where doctors, patients, visitors, hospital personnel and med school students walked, often at a fast clip that I envied.

At the end of The Pike, I stopped to do runner's stretches or catch my breath, before turning around and heading "home" to my room.

I wore a mask and gloves to protect myself from germs, and most of the time pushed my IV pole, which was my nearly constant companion.

I cannot say that this "exercise" gave me a runner's high, but it did distract me. I'm sure it helped me physically, but I wasn't in much shape to do anything when I got back home after my treatment ended with a strong blast of chemotherapy and a stem cell transplant. In fact, back home, my definition of a hill now included just a tiny incline on the sidewalk, and I was out of breath just trying to walk to the corner.

I wanted my runner's high back, and although I eventually did get it, the path was arduous. First walking, then walk/running, then finally running is a long process. I told my children, not "I'm going for a run" or even "I'm going for a jog," but rather, "I'm going for a trot." On frigid days when I couldn't get outside, I ran up and down the stairs. Before going outside, I would linger at the door for a long time, procrastinating with one more stretch. It took months to regain my stride. You can't get a runner's high when you're working so hard. Sometimes I asked myself why I was doing this, but I already knew the answer. It was because I would only feel like myself when I was running again.

Wednesday, April 2, 2008

Runners and their Races

The photo at right is of me finishing 
the St. Patrick's Race in the 1980s.

Most runners have a race they feel is their own. The St. Patrick's Race in Holyoke, Mass., a challenging 10K, is no more my race than it is that of the approximately 2,500 runners who run it every year a day before the city's big St. Patrick's Day Parade. But when people mention the race, I say, "Oh, that's my race." It's not because of my speed. I'm not especially slow, and not especially fast, but I am committed. I think my best time was 52 minutes. I'm not one of those people who keeps a log of race times. I look it up every year, but I never write it down. I have lost count of how many times I've run it, but it's probably around a dozen.

I started in the 1980s with friends from the former Holyoke Transcript-Telegram, a good little newspaper that lived and breathed the race, the parade, and the colleen coronation ball, which I remember as being the time when my strapless bra fell down around my knees during a dance. We went to the race for the fun, the festivities, the camaraderie and the challenge. At that time the race was longer by about two miles, following the hilly 
road that cuts through Holyoke Community College. They lopped 
off that extra challenge to attract more participants.
I took a break from the race after each of my children was born, and 
each time felt that I had finally come back when I could do the race again.

After my leukemia went into remission, I ran the race twice -- last year and the year before. For reasons that I will explain later, I couldn't run the race this past Saturday, when it attracted a record-breaking number of participants, more than 3,000. I did, however, go for a little jog at 1 p.m., the time the race started.

Our area has two big races: St. Pat's and, the Saturday after Thanksgiving, the Talking Turkey race, six miles around a beautiful reservoir also in Holyoke. My friend was raped at that reservoir, and for her, running that race was proof that she was stronger than her fears.

Similarly, when I returned to St. Pat's, the race that led me to the discovery that I had leukemia, I felt like I was facing some kind of demon and also celebrating a rebirth. I was nervous, excited and scared, all at once. Most importantly, I was a runner, not a patient. And when I finished, at a little over an hour, my mixed reactions showed me that I was thinking like a runner, too.
First came the exhilaration of crossing the finish line. Then came the critical thinking.
"I feel pretty good," I thought. "I could have gone a little faster. Well, maybe next year."

Tuesday, April 1, 2008

Lance Armstrong and me

I'm like Lance Armstrong.

Just kidding.

Since it's April Fool's Day, I thought it was a good time to get that out of my system.
I do have some things in common with him, though. We both ride a bike and we both fought cancer. Sports helped pull us both through. Running, and tennis, are closest to my heart, and it was through running a road race at just about this time five years ago that I learned I had leukemia. My time was about 10 minutes slower than usual in Holyoke's Saint Patrick's 10-K in March 2003, and, thinking I was anemic or just plain run-down, I went to the doctor.

Blood tests and a bone marrow biopsy revealed the shocking news: I had Acute Myelogic Leukemia, a fast-moving blood cancer. The race led me to the discovery while I was otherwise still pretty healthy, and put me in good stead to withstand the rigorous chemotherapy that followed.

Two years later, when I was back on my feet, I was planning to run the same course again. I was back at work as a reporter for a regional daily newspaper, and my managing editor called me into her office. I had just gotten into work, my hair still damp from my morning run. My editor wanted me to write about running the upcoming race, to explain all the feelings it brought up and to talk about how exercise had helped me get through my treatment.

"It's like Lance Armstrong," she said.

I'm not sure, but I might have rolled my eyes.

"The race is a metaphor for life," she said.
She said my story was compelling like Armstrong's, but more accessible. Not everyone can fight cancer and win the Tour de France. It was easy to admire Armstrong, but not to identify with him.

I had written about my road back to fitness in an essay for the Lives page of the New York Times magazine (4/3/05) I wasn't sure I wanted to be all over the front page of our reginal daily newspaper, but my editor thought it would help a lot of people.

So I wrote about how exercise sustained me through my long hospitalizations (one as long as six weeks), as I rode a stationary bike in my room and walked the hospital corridors dragging my IV pole. I wrote that exercise helped me take it one step at a time and distract me from pain and fear of death. I wrote about getting a bone marrow transplant, and about the year I spent recovering at home.

I was glad that I did it. The letters poured in, surprising me with the effect that my story had. Later, I will share some of them. I'll also share thoughts about getting back on your feet after serious illness and setback, through finding something -- in my case, sports -- that helps you get outside of yourself. I welcome comments and shared stories.

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