Article from the Metastatic Breast Cancer Network - 9/13/11

13 Facts Everyone Should Know about Metastatic Breast Cancer

1. No one dies from breast cancer that remains in the breast. The lump itself is not what kills. The metastasis of cancerous cells to a vital organ is what kills.

2. Metastasis refers to the spread of cancer to different parts of the body, typically the bones, liver, lungs and brain.

3. An estimated 155,000 Americans are currently living with metastatic breast cancer. Metastatic breast cancer accounts for approximately 40,000 deaths annually in the U.S.

4. Treatment for metastatic breast cancer is lifelong and focuses on control and quality of life vs. curative intent. (“Treatable but unbeatable.”)

5 About 6% to 10% of people are Stage IV from their initial diagnosis.

6. Early detection is not a cure. Metastatic breast cancer can occur ANY time after a person’s original diagnosis, EVEN if the patient was initially Stage 0, I, II or III and DESPITE getting annual checkups and annual mammograms.

7. Between 20% to 30% of people initially diagnosed with regional stage disease WILL develop metastatic breast cancer.

8. Young people DO get metastatic breast cancer.

9. There are many different kinds of metastatic breast cancer.

10. Treatment choices for MBC are guided by hormone (ER/PR) and HER2 receptor status, location and extent of metastasis (visceral vs. nonvisceral), previous treatment and other factors.

11. Metastatic breast cancer isn’t an automatic death sentence. Although most people will ultimately die of their disease, some can live long and productive lives.

12. There are no hard and fast prognostic statistics for metastatic breast cancer. Everyone’s situation is unique, but according to the American Cancer Society, the 5 year survival rate for stage IV is around 20%.

13. October 13 is National Metastatic Breast Cancer Awareness Day. To learn more about it as well as resources specifically for people with metastatic breast cancer see www. mbcnetwork.org. We appreciate your support on October 13 and throughout the year.

300 Marathons/Ultramarathons - 8/31/11

My 300th marathon/ultramarathon is scheduled for this weekend at the Woods Ferry 24-Hour in Chester, SC. I hope that I have not jinxed myself by counting the chickens before the eggs hatch (or something like that), lol. With my luck, a root could grab my toe and snap my ankle before I get the minimum 26.2 miles for the race to count. Nevertheless, I am so excited. I'm trying to remember if I was this excited when I hit #100 and #200. I remember my 100th finish, but I had to look at my spread sheet to jog (pun intended, lol) my memory of which race was #200. All I remember about #200 is that the target race kept moving because I DNF'd several races in 2008. That year, the bone pain in my hips and back slowed me down immensely, and I missed several cut-offs for races. This year, I have been very careful to schedule races that I was more likely to finish than not to finish, so that the target race wouldn't change too much. My last two races, however, really frazzled my nerves.

The race director for the Marquette Trail 50K in Marquette, MI threatened to cancel the race because enough entrants had not registered. I had already sent in my registration, but more importantly, I had already bought my plane ticket. That was the biggest expense. The goal of hitting #300 was inconsequential, because I could always find another race. So, I sent out a desperate e-mail to all of the runners in my address book asking them to consider running the race and to also forward the e-mail to their running friends. From the replies, no one I knew was going to make it, but a few weeks later the race director sent out another e-mail stating that enough runners had registered to have the race. Whew!

Then, the week of the race, a 9-hour cut-off was posted on the website. I have not run a 50K in under 9 hours in over a year, and it was on a much easier course, the Gator Trail 50K in Lake Waccamaw, NC. I went to the race any way, and to my surprise, my running buddy, Henry (WI), was at the race. Bless his heart! When I told him of the cut-off imposed for the 50K (even though the 50 milers had a 13 hour cut-off), he said that he had not seen the update on the website, and as far as he was concerned, if the course is kept open for the 50 milers for 13 hours, we should not be pulled. Well . . . we missed the cut-off for the aid station at 10 miles by 30 minutes, but the volunteers did not say anything and we surely weren't going to say anything, so we continued. We also missed the cut-off by an hour for the second aid station at 18 miles, but the volunteers were gone, leaving fluids and snacks on a table for us to help ourselves. Henry said that he was going to keep me in his sight and make sure that I finished. I felt so sorry for him because I was so slow and really struggling to keep up with him. I told him several times to go ahead because he would have no trouble making the 9 hour cut-off. He refused. Right before the finish line, after 11 hours (2 hours over the cut-off), he turns to me and says that we have to cross the finish line together. It was almost a week after the race before the results were posted. Both of us were listed with official finishing times, completing #298 for me.

Timmy's Challenge Marathon in Cairo, WV lived up to it's name when I received an e-mail from the race director stating that the early start would not be officially timed because of the chip timing system that he was using. An early start meant a 9-hour cut-off, and the regular start had a 7-hour cut-off. The Blister in the Sun Marathon (#297) was completed in 7:35:15, so I was in a panic. I decided to go to packet pick-up early and talk with the race director. I wanted to make sure that if I took the early start that I would be given an official finishing time and listed in the results, because there was no way that I could finish in 7 hours. He assured me that I would get an official time, but that I couldn't use it to qualify for Boston (hah!), that I would not be eligible for awards (another hah!), and that early starters would be listed after the regular starters, even if an early starter had a faster time (again, hah!). I was fine with the rules and proceeded to the start line with 26 other early starters. In the end, the race director made two separate finishers' lists, one for the regular start and one for the early start. The early starters are not listed on http://www.marathonguide.com/, but both finishers' lists are on the race's website, so the race counts as #299.

For 299 marathons/ultramarathons, I have 299 stories, but I won't even attempt to recall all of them here. The plan is to run eight 7.75 mile loops at the 24-hour this weekend, which will give me 62 miles, but really, anything over 4 loops (31 miles) will be great. After this weekend, I will have run 125 ultramarathons and 175 marathons for a total of 300. This number is minuscule to my running buddies. Henry completed #743 at Marquette. That number is obsolete now, of course, because he's already run one or two more races since then. Larry (TX) has 600+; Jim (CA) has 735+; Eugene (CT) has 400+; and Eugene (IL) has 341+. I really am the "newbie" when it comes to the number of endurance races completed. Because some of my running buddies are not members of the running clubs that are accumulating endurance runner statistics (Marathon Maniacs, 50 States Marathon Club, and 50 States and DC Marathon Group), I don't have access to their published completions. Running buddies, Terri (SC), the race director for the 24-hour that I'll attend for my 300th, Fred (OH), and Rob (TN) are super runners who have been doing this for decades, and there's no telling how many finishes they have. Furthermore, their finishes are primarily ultramarathons. They rarely run marathons. I am not even worthy of being in such a group of elite runners, but like the true running buddies that they are, they tolerate me trying to be like them.

I ran my first marathon in 2001 at the Country Music Marathon in Nashville, TN. Doing the math over 10 years, that would average about 30 endurance races a year. However, that's not the break down at all. In 2001, I only ran one other marathon and that was the Rocket City Marathon in Huntsville, AL. I shaved off a whopping 40 minutes from my first marathon and thought that the trend would continue. Needless to say, I was a little naive in the early days about marathons, lol.

In 2002, I ran the Country Music Marathon almost an hour faster than the year before and also added the St. Jude Marathon in Memphis, TN. In 2003, I was diagnosed with breast cancer, and chemotherapy proceeded to slowly kick my butt into inactivity. I missed the Country Music Marathon because I was too sick to participate. I remember lying on my couch and watching the news coverage of the race on television, crying my eyes out. During the spring and early summer, I work a part-time job. Weekends are optional when we get a little behind on projects, but since I couldn't run the race, I got up off the couch and went to work a 7-hour shift and was sick the whole time. I was still upset about missing the race, but at least I was making money to fund future races, so it was all good, lol. Later that fall, after chemotherapy, the mastectomy, and radiation, I managed to complete my only marathon for the year at the Louisville Marathon in Louisville, KY.

In 2004, my ultramarathon career began. I completed 10 ultramarathons, which included my first 50 Miler at the JFK 50 Mile Run in Boonesboro, MD. After 16 miles of the Appalachian Trail and 26 miles of the flat, dirt/gravel canal path, I remember running the last 8 miles of the rolling, country roads. I felt like a winner, and I didn't know how I found a last burst of energy to pass so many people. Then I saw the finish line, and I cried my eyes out. I was so happy to be there and to still be able to run after my trying time with breast cancer the year before. In addition to the ultras, I also ran seven marathons that year. I finally had 10 states completed to join the 50 States Marathon Club and the 50 States and DC Marathon Group. I also signed up for the UltraList. I never post to the UltraList, but I love reading the e-mails every day that I get in digest mode. I have learned a lot about ultrarunners, ultrarunning, gear, nutrition, and races from the UltraList. It's just a great source of information.

In 2005, I ran 47 marathons/ultramarathons in 41 different states. I earned 10 stars (Titanium Level) in Marathon Maniacs, becoming Maniac #245 in 2006. The club has an unbelievable 4000+ members now! Prior to 2004, I did not realize that it was possible to run more than three or four endurance races a year without becoming injured or burnt out. Larry (TX) explained to me that if you are already trained to run a marathon, why not just keeping running marathons instead of taking time off, reducing your mileage, and having to retrain all over again? It made sense to me, but I'm also very gullible. Those in the 50 States Marathon Club and Marathon Maniacs were out there every weekend, and I didn't want to miss all of the running parties. Nothing fatal happened in 2004 with 17 endurance races, so I stepped up my game, put on my big girl panties, and ran with the other megamarathoners.

There was a lot of adventure in 2005. I had my first DNF in December at the HUFF 50K in Huntington, IN. I had finished the race in 2004, but by the end of 2005, my body was just tired. My ITBs flared in both legs and with a foot of snow on the trails, 19 degree temperatures, and a 30 minute late start because I overslept, I was miserable, hurting, and behind the cut-offs after the first loop of the three loop course. Because I could not even complete the 2nd loop before I would have gotten pulled at the next aid station, I was coaxed into dropping from the race. I went to the car and cried. If you noticed, crying is a common emotional response for me, whether happy or sad, lol. I was on a schedule, so when I started having the ITB problems in the weeks prior to HUFF, I continued to run. I finished the Holualoa Tucson Marathon in Arizona (the race director was the elite ultrarunner, Pam Reed, who came and talked with us on the bus that took us from the finish line to the start line) in my slowest marathon time up to that point, 6:08:54. The next weekend was even worse, dragging the left leg for the last 16 miles because I was in so much ITB pain and finishing the Kiawah Island Marathon in South Carolina in 7:13:42. So, when I got to HUFF the following weekend, my body threw in the towel.

That year was also the year that I did 4 doubles, Saturday and Sunday races. The Mad City Marathon in Madison, WI and Lakeshore Marathon in Chicago, IL was the first double. I finished Mad City in 4:38:37 and then Lakeshore in 5:51:17, because the last few miles of the Lakeshore course were not marked well. A first time marathoner and I ran off-course right into downtown Chicago before we found our way back to the course. It turns out that there were also two 25 mile markers on the course. Part of the problem was that the race director had moved the start line the morning of the race and had not compensated for the extra distance on the remainder of the course. There really is no telling how much over the marathon distance we ran that day. Needless to say, there was so much uproar from runners on http://www.marathonguide.com/ in the comments section for this race that the 2005 edition was the last Lakeshore Marathon.

The second double was Marathon to Marathon in Storm Lake, IA and Swan Lake Marathon in Viborg, SD. I was told at the Swan Lake Marathon that I was seen on the news coverage of Marathon to Marathon because I was running in the vicinity of the Governors of Arkansas and Iowa, who were also in the race. I didn't even remember any news cameras on the course, not to mention that I was running the same pace as the Governors, lol. I had missed the news coverage because I had driven to Viborg after the race and probably went straight to bed after dinner and a shower.

The third double was the New Hamsphire Marathon in Bristol, NH and the Maine Marathon in Portland, ME. I finished the New Hampshire Marathon on Saturday in 4:58:51, and the Maine Marathon on Sunday in 5:01:51, my closest finishing times for a double.

The last double of 2005 was the Breakers Marathon in Newport, RI and Mystic Places Marathon in East Lyme, CT. I hated the old Rhode Island course and started the race late because I couldn't find the start line. My finish time with the late start was 5:20:08. In contrast, I absolutely loved the course for the Mystic Places Marathon and had a negative split for the weekend with a 4:34:36 finishing time.

I took a couple of weeks off from running at the end of 2005, hoping that my ITB problems would clear up. On January 8, 2006, I was scheduled to run the OC Marathon in Newport Beach, CA. It was my 38th birthday, and I was to finish the 50 states circuit at that marathon. I really didn't believe that I would be able to run a step, but with the help of my running buddy, Charlie (CA), I was able to finish in 5:17:15 with very little pain. That was my sign to register for more races. I ran 52 marathons/ultramarathons in 2006, the most races that I've run in a year. I did my first 50K double in December of that year: HUFF 50K in Huntington, IN in 8:03:12 and Recover from the Holidays 50K in Huntsville, AL in 8:09:49. I also ran my worse double by time in December: Rocket City Marathon in Huntsville, AL in 4:51:51 and the next day, Otter Creek Trail Marathon in 7:22:51. In August of 2006, I ran my 100th marathon/ultramarathon at the Silver State Marathon in Reno, NV, where I learned that running through sand was hard and no fun at all. I crossed the finish line with my running buddy, Albert (CA), who was also finishing his 100th marathon/ultramarathon. This year would also yield some age group trophies for me. In the France to Germany Marathon in French Lick, IN, I won second place in my age group with a time of 4:46:41 and in the Andrew Jackson Marathon in Jackson, TN, I won third place in my age group with a time of 4:41:24.

Although 2006 was a great year of running, the first half of 2007 was my best running. I completed 48 marathons/ultramarathons that year. I finished my first 100 mile race at Rocky Raccoon 100 Mile in Huntsville, TX in 28:22:08. I had my best Rattlesnake 50K finish time in 8:01:26, a race that I've finished six times. I also ran my marathon PR at the Andrew Jackson Marathon in Jackson, TN in 4:20:02, taking home the second place trophy for my age group. In the second half of 2007, I was hampered with back and hip pain that I thought was from running too much and too often. I went to a chiropractor for three months (and later a physical therapist for a few weeks), decreased my running during the week, and continued running my scheduled races on the weekends. It wasn't until January of 2008, when my hip and back pains increasingly became worse that I found out that the pain was actually my breast cancer returning, but this time the cancer was in my bones.

In 2008, I still ran a lot of races (completing 45 marathons/ultramarathons) but at a much slower pace. With the pain, I just couldn't train like I had become accustomed, and I was gaining weight because of it. It was all I could do to make it to the start line. That year, I ran my first 100K at the Bandera 100K in Bandera, TX, one of the hardest courses that I have run because of the rocks and ascending/descending of mountains. The race director gives you 24 hours to finish, and I finished in 21:21:35. I also returned to the Rocky Raccoon 100 Mile, finishing in 29:28:07, an hour slower than the previous year. This was the year that I began running a lot of timed events, completing my first 24-hour race at 24 Hours Around the Lake in Wakefield, MA with 69.52 miles. The race was on concrete, and the balls of my feet had never been so sore after a race. Also, #200 occurred in 2008 at the 12-Hour Adventure Trail Run in Triangle, VA, completing 39 miles. My second 100k was at the Wild West 100k in Lowell, MI. There were only 3 females in the 100K. My running buddy, Terri (SC), and I stuck together for the whole race. She was 2nd overall female, and I was 3rd overall female. The overall awards were huge gold painted horseshoes with a star in the middle that I absolutely loved. I also managed to finish two more 100 milers that year, Heartland 100 Mile in Cassoday, KS and Mother Road 100 Mile in Elk City, OK.

In 2009, I started this Blog with the intention of having a place to talk about my running adventures. Unfortunately, it has slowly deteriorated into a "How to Live with Metastatic Breast Cancer" chronicle. This post is probably the most I've written about running in months. So, let's get back to that.

I finished 38 marathons/ultramarathons in 2009. I ran the Bandera 100K for a second time in 20:43:43. I also completed the Umstead 100 Mile after taking a 50 mile finish in 2008. My momma travelled with me to Hawaii for the Kona Marathon, her very first flight ever. I ran 80 miles at the Tour d'Esprit 24-Hour Run in Memphis, TN, promptly and literally passing out a few minutes after I sat down for the awards ceremony. I woke up surrounded by paramedics. Someone had removed my glasses, so I couldn't really see. Ice packs were being placed on my head and neck. Someone was lifting and propping up my legs. And a running buddy, Harry (MS), had to accept my award for me because all of these people would not get out of my personal space, lol. I had placed 2nd overall female. After I convinced the paramedics that I was fine and that I didn't need a trip to the hospital, I remember kicking myself later that day because the first place female had also run 80 miles, but she had run it in a faster time. I had time to run at least one more mile, if not two, which would have given me the overall female win. But I had a goal of 80 miles when I started the race, and when I reached it, I stopped with about 40 minutes left on the clock. The lesson learned here is that, in a timed event, you run until the clock stops, lol.

In 2010, I was becoming very discouraged from all of the pain in my back and hips, side effects from the various treatments, the weight gain, running less, racing poorly, and fighting cut-offs. I don't know how many DNFs and DNSs I had, but it was a lot. I managed to finish only 24 marathons/ultramarathons last year. I did complete the Philadelphia 100 Mile and Mother Road 100 Mile, bringing my 100 mile race total to seven. The month of June saw no race completions at all, while I had two weeks of radiation to finally give me a break from the pain. I finished several timed events last year, because they were less stressful for me. There are no cut-offs, and you just run what you can. I saw my first overall female finish ever at the Badgerland FX 24-Hour Run with a 24-hour PR of 80.5 miles. It's not my fault that only one other female was in the 24 hour! A win is a win, and that's coming from someone who isn't competitive at all, lol.

This year, I've already finished 23 marathons/ultramarathons, so I will have more completions this year than last year. As I perused my spread sheet, I remembered something about every single one of those 299 races. It just goes to show you that it truly is about the journey and not so much about the destination. And what a great journey it's been! I've been to places that I never would have seen if not for a race. I've overslept. I've run injured with ITB and achilles problems. I've missed planes. I've been bumped to later flights and left wondering if I'd make it to the start line in time for my race. I've gotten lost getting to races and leaving races. I've gotten lost on some race courses. I've fallen on the trails many times. I've seen bears and snakes, which are not my favorite things to meet on the trails. I've run with some wonderful people who have become great friends. I've done well in races and just as poorly in others. But no matter what, I am always thankful that I'm still out there.

I talk to God a couple of miles before I cross the finish line of my races. I thank Him for allowing me to do what I love to do. I thank Him for the volunteers, the race director, the safe travels, the food that nourished my body over the weekend, and the weather, whether it was cold, hot, rainy, snowy, or whatever. And I thank Him for the beautiful courses that I run on, roads or trails. There's always a pretty sight for my eyes and soul. I thank Him for a job that pays me well enough to do these races and that gives me free weekends to do them. I joke about quitting, but I don't think that I can. I don't know if and when I'll ever get back to being able to train like I should, so that my race times can improve. I get so frustrated from the cancer pain and the side effects from the treatments, but as long as I can run, walk, shuffle, or hobble in the races, with my running buddies, life is good. I love this sport. I really, really do. I hope that God allows me to see #400, #500, #600 . . . .

A list of all of my marathons/ultramarathons is on my Marathon Maniacs page:
http://www.marathonmaniacsdb.com/Maniacs/MyMarathons.asp?ManiacId=245

A list of the Mega Finishers in the 50 States and DC Marathon Group is here:
http://www.50anddcmarathongroupusa.com/megadivision.cfm

A list of the Ultramarathon Finishers in the 50 States and DC Marathon Group is here:
http://www.50anddcmarathongroupusa.com/ultras.cfm

A list of the World Megamarathon Ranking (300+) is here:
http://www1.vecceed.ne.jp/~ageo/fullhyak/%82Q%82O%82P%82OYL%81@%20World%20Mega%20Ranking%20rev2.pdf

We Have the Same Name - 8/3/11

We have the same name. We both wear prescription eye glasses. We are about the same height and complexion. When I was bald, she was losing her hair. Now that I have hair, she has none. I had a mastectomy. She had a double mastectomy. Cancer was only found in one breast, but she had the other breast removed as a precautionary measure. She has a family history of breast cancer. I do not. I'm only three years older than she is. She has two kids, ages 5 and 13. I have none.

Her oldest child understands that she is sick. He tells her often that he loves her, and she happily returns the sentiment. "He told me that his love for me is as big as the sun," she proudly said.

I laughed. "That's a lot of love," I told her.

"I told him," she continued, "that I loved him as much as I love God." She has a lot of faith. "I believe that it is all going to work out," she said. "I'm not giving up my faith. I pray every day." She made me a believer. I told her that prayer does help, and she nodded enthusiastically.

Her breast cancer was discovered when she was pregnant with her youngest child. She prays for another six years to see her oldest become an adult and her youngest become old enough to understand what is going on with his mother.

She has metastatic breast cancer to the bones, liver, and lung. So do I. We see the same oncologist in a cancer treatment center with several oncologists. We often are in the treatment room together, although we've never had the opportunity to sit next to one another and talk. Since we have the same name, a few months ago, one of the nurses joked about getting us mixed up. I threatened to sit next to my MBC sister and really confuse her. The nurse laughed and agreed that would really throw her off.

Our treatment protocols are different. I ran down my list of treatments since my second diagnosis in 2008. She, on the other hand, could only recall having Tamoxifen, one of the drugs I was also given initially. "I got 2.5 years out of that drug," she said. I barely got a year.

She had radiation to her hip. Her pain is better, but she has been having bowel troubles ever since then. Her stomach is visibly puffy. I also had radiation last year to my left hip. The pain is much better, and I am having no residual side effects. I'm beginning to see that even with the same disease, we are having much different experiences.

"I would feel so much better if we could get my bowel problems under control." I asked if there wasn't something they could prescribe to make it better. "Stool softeners," she said. They are treating the symptom, not the problem, and she is miserable. Although I had bowel problems from the chemotherapy for the primary breast cancer in 2003, I have had no bowel problems since I started treatments for my metastatic diagnosis. I feel sorry for her.

She is hooked up to an oxygen tank. I am so grateful to still be able to huff and puff our pollution-filled natural air. Sure, I complain when I can't get enough air into the lungs, and I get dizzy from lack of oxygen, but I can still breathe on my own. She can not. How in the world would I pull the oxygen tank over some of the hilly, rocky, and rooty trails that I run on? She can't run. I'm guessing that she can barely walk. I would die if I could not run/walk/shuffle along on the trails and roads. Again, my heart is breaking for her. How is she mentally handling all of this?

I am called back to the lab for vitals, blood work, and a urine sample. Both of us had scans this morning, so we'll see the oncologist for the results, and then proceed to the treatment room for chemotherapy.

My oncologist tells me that my scans from this morning look good. The liver and lung tumors are stable. My blood work and urine are good. My oncologist gives me another prescription for antibiotics because the nails are now oozing and smelly. Other than that, we will continue with my treatments. I am blessed to be in a state of stability. I realize that my situation could be a lot worse.

Unfortunately, the treatment room is overcrowded as usual. When my MBC sister comes into the treatment room later, she finds one open seat on the other side of the room. I have so many more questions for her. I guess I'll have to wait to talk with her again. I only get my 30 minutes of Avastin today, but she is there much longer than me. I leave with heavy thoughts about the sister with the same name as mine.

Make her feel better. Solve her bowel problems. Shrink her puffy stomach. Answer her prayers and give her another six years with her kids. While I'm asking, give her another 60 years. Let her see both kids become adults. Let her see the grand babies that will hopefully come sooner rather than later. Take away her cancer. Give her beautiful hair. Take away her oxygen tank and allow her to fill her lungs naturally. Let her walk effortlessly. And if she so desires, let her run on the trails and the roads, exploring the beautiful scenery around her. Let her live.

Green Thumb - 7/6/11

My oncologist is not happy about my green thumb. She says that she has never seen the nails turn green. Sure, Taxol does a number on the fingers and toes and causes neuropathy, but my situation is so serious that she makes the hard decision to take me off of the Taxol. To be clear, the whole thumb is not green. The nail and the skin closest to the nail are lime green. The thumb is very sensitive to the touch and is swollen. My other nails are undergoing the same fate. They are all in some shade of brown, indicating the nails are dying and starting to separate from the nail bed. All of my fingers and toes are neuropathic - tingling, painful, or numb. I had long ago cut down the nails as close to the skin as possible to lessen the pressure on the nail beds, but it appears that this action has done little good. Because of the chemo, the nails aren't growing as fast as they would normally, which is a blessing.

I have mixed feelings about stopping the Taxol. My last CT scan showed continued regression in one of my liver tumors. It's down to 10 millimeters from 16 millimeters. Initially, it was 19 millimeters, so that sucker is really shrinking. The lung tumors are stable, and there doesn't appear to be any new bone lesions. That means that seven months of chemotherapy is working. I really don't want to stop just because of neuropathy. I've been in so much pain from the mets in my spine and hips in the past four years that the pain in the fingers and toes is minimal in comparison. I do drop things because of the numbness, and I need to go shopping for pants with no buttons. Anything that touches the fingers and toes causes pain, or in the case of the numb digits, a tingling sensation travels through the nerves. And the green thumb is really grotesque. Even with all of that, I would still rather be on the Taxol. What if the tumors start spreading or growing again? Technically, Taxol has not failed me yet, so as soon as the neuropathy is under control, maybe I could go back on it. In the mean time, however, my treatment options are so limited that my oncologist offered no replacement for the Taxol.

I'll still get all of the other drugs: Avastin (chemotherapy drug that enhances the effects of Taxol by cutting off the blood supply to tumors); the clinical trial drug, Everolimus (I still think that I'm getting the placebo); Zometa (helps to build new bone tissue); Lupron (injections to keep the ovaries shut down); and Aranesp (injections to help build up the red blood cells). Without Taxol, I no longer need the IV bags of steroids and Benadryl. Eliminating the steroids should allow me to finally calm down enough to get some quality sleep during the night. Of all of the drugs, Taxol is the most important, and as proven from the neuropathy, the most toxic. Because of the green thumb, I'm back on more antibiotics. My oncologist also wants me to soak the nails in warm water and baking soda several times a day. I'll lose the nail on the thumb, but maybe by stopping the Taxol, starting the antibiotics, and soaking the nails, I'll be able to save the others. The real reason for stopping the Taxol, of course, is to save the nerves. Having permanent nerve damage in the hands and feet would really suck.

Avastin is still spiking my blood pressure. I am now on a double dose of the blood pressure medication. By eliminating Taxol, my blood counts should start coming back up so that I'll be less tired and breathing better, and the eyebrows and eyelashes should finally start to grow back. Avastin is used as maintenance and doesn't really attack the tumors like Taxol. The best we can hope for is stability with no progression. Regression is almost impossible without the Taxol. The best thing about all of this is that I now only have to go to the cancer treatment center twice a month instead of three times a month.

As a side note, I'm down to essentially no running. I just can't get enough oxygen into the lungs to sustain a run. Trying to breathe in too much oxygen too fast only results in dizziness. My stamina is gone. I could literally fall asleep while I'm walking. A power walk is a struggle, but I've been moving my legs every day. I hesitate to say walking because three miles an hour is really pushing it for me. I'm hoping that working this hard has some kind of training effect. Maybe when I'm able to get back to running, it won't be too difficult to get back into shape. Regardless, I do what I can, and I try not to stress about what I can't do. I am still "racing", but it's all for sanity reasons now. I'm sick and tired of being sick and tired, so I need some type of normalcy in life. Racing does that for me. I am so grateful to all of the race directors who put on timed events or who have very, very generous cut-off times for the distance events that allow me to finish.

I've also tried to decrease my calorie intake, losing about five pounds over the last couple of months. I'm not running, so I really should have made adjustments some time ago. Hopefully, I'll be able to shed a few more pounds throughout the summer. I have several cute little sundresses that I would love to squeeze back into. My face had become so bloated from the steroids, so when a good friend of mine recently commented that my face was thinning out some, she really made my day. It's the little things in life that are so special.

You Don't Look Tired - 5/10/11

"Did you have treatment today?"

"Yes," I responded without going into details. Because I arrived at my office in the late afternoon on a Tuesday, my co-worker should have known the answer to the question before it left her lips. I have had chemotherapy three out of four Tuesdays a month for the past six months. The routine has not changed. She knows this, and she still asked the question. We were about to embark on another one of our cancer discussions.

"So, when do you get tired?"

I almost didn't answer the question, but then I gave her the benefit of the doubt. Maybe she was just curious. Maybe she was concerned. I don't mind answering questions of curiosity or concern. I would rather people ask me about metastatic breast cancer than for them to assume something about the disease that is incorrect. With breast cancer as prevalent as it is, women and men should gather as much information as they can about the disease. I won't force it down anyone's throat. I rarely bring up cancer in daily conversations, unless I'm asked. It's like with running. I won't initiate the topic, but if asked, I'll talk about it until the person's eyes glaze over. However, with this person, I know that it's not about curiosity or concern. I was going to let it slide one more time.

"I'm always tired," I answered. It was short, stated nicely, and to the point.

"You don't look tired," she said simply.

At that moment, I wanted her out of my office. I stared and typed at my computer, hoping she would say what she had to say, get the blunt message that this conversation was over, and then leave my cubicle. I'm sure she didn't mean to be insensitive, but I think she was trying to get a more detailed explanation out of me, and I was not in the mood today.

She's done this to me before. In 2003, the chemotherapy "cocktail" that I was on made me very ill. I was nauseous mostly all day and every day for three months before my mastectomy and then three months following my mastectomy. My stubbornness would not allow me to vomit. I learned early on that slipping in very small meals throughout the day when I wasn't feeling too badly helped me a lot. Those rare moments when I thought my body would not rebel were the best times to sneak in some Sprite, a cracker, or some tomato soup.

In 2003, the conversation went similarly to the one above:

"When do you get sick?"

"I'm always sick."

"You don't look sick."

I mean, how am I suppose to respond to that? Maybe she thinks she's complimenting me in an off-handed manner. Maybe her statement is synonymous with, "but you look good," which is what I normally get from other people. Or maybe I was reading her wrong. Maybe I was being overly sensitive.

She is the type of person who comes to work when she doesn't feel well and proceeds to tell everybody in the office what is wrong with her on that particular day. She's had so many illnesses since she's worked in my office that I'm surprised she hasn't keeled over by now. Don't get me wrong. I don't wish her any ill will. I know that she does it for attention. I even play into her little game. The game gets old, but I won't say to her what she says to me. She really does look sick, hobbling when she's had a foot problem, a back problem, or a shoulder problem. Her eyes look tired and sad when she has a headache or her allergies are bothering her. But just because I don't profess to the office my health condition on a daily basis like she does, doesn't mean that I'm not ill or that I'm not tired. When asked, "how are you," I will not go into a long dissertation about how I'm feeling. I have to be caught off-guard, in a talkative mood, and with a person that I trust before I do that. I will only do that with a true friend or family member who I know really cares and is concerned. Someone who is just asking so that they can compare illnesses will not get the same answer.

I don't want to burden my friends and family every day with what's going on. Metastatic breast cancer is a chronic illness, just like, for example, diabetes. On a daily basis, a diabetic deals with blood sugar levels, what to eat, what not to eat, when to eat, when to take insulin, when to exercise, etc. I'm sure he or she doesn't work diabetes into every conversation and with every person that is encountered every day. There are a couple of diabetics in my office, and although I will ask how they are feeling occasionally, I have never said to them, "wow, you sure don't act like your blood sugar level is through the roof." Wouldn't THAT be inappropriate?

Whether I want to believe it or not, whether I appear sick or not, or whether I look tired or not should not be the determining factor about my situation. I am sick, and I am tired. I accept it, and I go on, but I don't give in to it. I am not going to mope around like I lost my best friend. I'm going to come to work showered and dressed professionally. The thin hairs on my head are going to be brushed neatly. I'll wear cute earrings to try and detract from my bloated face (a side effect of the steroids). And when someone asks me, "how are you," my standard answer is: "I'm good. How are you today?"

In general, I believe that people are decent. They want everything to be well in your world. No one wants to hear about a co-worker, friend, or family member who is having a bad day, a bad month, or, bless their hearts, a bad year, especially if they are not in a position to do anything about it.

So, let's get back to my co-worker. Does she think that I'm lying about my health because I don't look sick to her and I don't seem tired to her? What is she really saying? Does she want me to look as bad on the outside as I feel on the inside? Is that validation and justification for her? Is it a case of her just not really knowing what to say to a cancer patient? Does she really mean, "despite everything that you are going through, you look very well?" I don't get it. It makes me angry, rustles my feathers, and rubs me the wrong way because I don't get good vibrations from her when she says these things.

Maybe the next time she asks the question, I'll go into great details about how I've been feeling for the last six months. I should tell her that the skin hurts to the touch when I lose hairs from my head, eyebrows, legs, arms, arm pits, pubic area, and crack of my ass. I should tell her that the fatigue is really causing some quality of life issues for me now. After I take a shower, I have to sit down on the toilet for a few minutes, to keep from passing out on the floor, because I feel like I've exhausted that last bit of energy from body. I should tell her that getting out of the bed in the morning is a process. I have to sit on the edge of the bed and wait for my body to adjust. I wake up tired. My legs are weak. I'm dizzy. I'm breathless. The mile walk from the parking lot to my office takes me about 20 minutes, and I'm huffing and puffing loudly and quickly the entire time because it's a gradual uphill journey. I have to go slowly, because otherwise, my legs feel like lead from lack of oxygen. I get dizzy from trying to take in too much oxygen at once.

Maybe I should explain to her that it's truly a miracle that I can continue to do my races. I should tell her how I struggle with the pain in my hips and back from the cancer, the nausea, the breathlessness, the dizziness, and the weakness in my legs that inevitably come during the races for hours and hours. I should tell her that I shouldn't be out there and that I have to take special care of myself so as not to burden the race director or other runners with my fatigue and sickness. I should add that, even though I am physically incapable of completing the races in a decent time, I'm mentally feeling really good about myself because, regardless of the setbacks, I'm still out there on a beautiful day (even if it's cold and rainy) and on a beautiful course (with the endless hills, stream crossings that wet my feet, and roots and rocks that hurt my neuropathic toes). I'm having fun with my wonderful running buddies and doing what I love to do. Maybe I should tell her that it empowers me and gives me hope, that I'm trying to be tough, and that I'm showing cancer who's the damn boss. Do you think she'd be interested in hearing those details?

Or maybe she wants to hear about the day after my races. I can finally sleep, because the energy is totally depleted. I can finally eat and drink because my stomach is growling and I am thirsty. I am incapable of doing anything besides sleeping, eating, and drinking, but I finished another race the day before and I'm totally ecstatic about that small accomplishment. I feel like I have a love hangover, and I can't wait until the next weekend to do it all over again. She doesn't run, so she would probably not really understand trashing a dilapidated body and feeling damn good about it afterwards.

Maybe I should tell her that my tongue feels numb, that I have no taste buds, and that the mouth sores are painful. I love spicy foods cooked with peppers, onions, garlic, herbs and spices, but it all irritates the mouth sores. Besides, I can't taste them, but it doesn't prevent the food from setting my mouth sores on fire. We should talk about not being able to get enough food in my body because my stomach feels full all the time, and yet, I can't seem to lose any weight. While we're at it, we should talk about the extra 30 pounds that I have been carrying around over the last four years, from not being able to run as much as I would like, and because I can only do what my back and hips allow me to do. Let's talk about my raw throat and raspy voice that occurs for 3 or 4 days after treatment or when I've been huffing and puffing for too long. How about I tell her it hurts to button my pants, to type on the computer, or to pick up a spoon or fork to put food into my mouth because of the neuropathy in my fingers? How about the toe nail that I lost and the pain I feel when my toes touch the top of my shoes? Hey, here's a good one - my bleeding nostrils. It is really grotesque in the mornings, tapers off during the day, and picks back up during the night. Blowing the blood clots out and then having a runny, bloody nose for the next few hours is really exciting. We could get into the constant coughing and resulting phlegm, but that's just as nasty. I do not dare leave home without tissues.

Let's talk about the debilitating headaches that I'm still having. The neurologist has ruled out cancer involvement, but I'm still having them. Let's talk about the hot flashes that I have every hour, all day long, since 2008. They are a side effect from every treatment that I've been on for the last three and half years. During the day, they're irritating to say the least, but at night, I wake up every hour, tossing the sheet and comforter, grabbing water from my bedside, and fanning myself until it goes away. Then I'm cold and wet, and I pull the covers over my naked body and sleep for another 55 minutes or so until the next hot flash occurs.

Let's talk about the steroids, that keep me wired, even though I'm tired. I can't focus for long periods of time, and even though I want and need quality sleep, I rarely get it. Let's talk about my high blood pressure, a side effect of the Avastin, one of my chemotherapy drugs, and the high blood pressure medication that I have to take that doesn't seem to be working. My low blood counts (red, white, and platelets) are worth a few minutes of discussion, thanks to the Taxol, another one of my chemotherapy drugs. Let's talk about the hip pain that I still have. Some times it's a dull roar and at other times it's screaming murder, but make no mistake about it, it's always there. Let's talk about the tracks in my right arm because my left arm can't be used for blood draws and contrast injections for the scans due to lymph node removals in 2003. Several veins in my right arm and hand have been blown. The veins are swollen, painful to the touch, and slow to heal. My arm is in multiple shades of black and blue.

I really don't want to complain, but since I'm telling her all of this, I may as well tell her about my mental state. It's really hard dealing with all the little problems from the cancer and the treatments. Some days I don't know if I'm coming or going, because so many things are going wrong at the same time. How can I issue a technically sound permit to my facilities if the tips of my fingers are hurting from typing the permit conditions on the computer, while a hot flash is occurring, sitting in a pool of sweat, and then five minutes later, I'm shivering from the cold, and then I unconsciously swallow and the back of my throat throbs from the pain, or my tooth accidentally touches one of the sores on my tongue? When I get up from my desk after working for more than a few minutes to go to the printer to retrieve a document, I have to slowly stand up and stretch the hip a little before I walk away because the pain is begging for attention. But before I walk away from my desk, I feel a stream of blood running from my left nostril, so I grab a tissue to blow, and out comes a couple of blood clots. The once white tissue is now completely soaked with bright red blood.

It's close to lunch time, but my stomach is not growling from hunger pangs. It's still full from the orange juice or green tea that I had for breakfast, even though I know that's not enough to sustain me until dinner. And then what should I have for lunch? It doesn't matter. Nothing I eat has flavor to it, and after a few bites of food, I have to push it aside until my stomach opens up some room for the remainder of the meal or until the mouth sores stop hurting. And I'm tired. I want a nap so badly, I want to cry. But, even if I laid my head on my desk for a few minutes, it will be time for another hot flash, which will wake me up.

I may not look sick and I may not look tired, but there's enough going on in my body that I know that I'm not a well person. I don't want sympathy. Am I suppose to go through the day, disheveled, moping, cursing, placing the back of hand onto my forehead, walking around the office stating, "woe is me," hoping that someone will see me and ask me "what's wrong?" Should I proceed to waste 30 minutes of their day with bad news? That's not me. Sure, I'll tell it to the Blog all day. That's the purpose of the Blog, to listen without judgement. But I'm not going to burden and alienate my co-workers, friends, and family about how I'm feeling on a daily basis. Let's just assume that six months of chemotherapy is cumulatively tough on my body and leave it at that. When I say I'm tired or that I'm sick, regardless of how I look on the outside, my co-worker should not be flippant and say that I don't look sick and that I don't look tired. She has not earned the right to discredit how I feel. I should tell her that. I should ruin about 30 minutes of her day telling her how sick and tired I really am. But, you know what? This person has known about my Blog for years and will periodically ask about how to assess it, but I doubt that she's even read one post. That says to me that she is neither curious or concerned. What in the hell is she expecting from me?

Delano Park 12-Hour - 3/12/11

Sunshine! I had been waiting on it all week. An office mate and I decided that the reason we felt so "blah" was lack of sunshine. On Thursday, I told her that I was losing my permanent tan, and that this weekend will put me back on track, lol! I came back from Decatur, AL with a slight tan line from my watch being on my left wrist. I'll take it. Bring on Spring!

Last year at the Delano Park 12-Hour, I managed 46 miles. This year, I only did 36 miles. I could have done a little better if not for two naps that totaled about 90 minutes, but I still would not have matched last year's distance even if I had stayed awake the whole time. No biggie. I was just happy to be outside moving in the sunshine. The best part of all was spending the day with my running buddies.

The course is a one mile loop on smooth, crushed gravel throughout the park. Even though there are a couple of risers, I still consider it a flat course. It's a great race to push for a 12-Hour PR. The one aid station at the start/finish area was fully stocked. I couldn't take full advantage of it, however, but I did enjoy two slices of cheese pizza, a couple of mini-powdered donuts, a few chips, and Mountain Dew throughout the day. After the race, we had the awards ceremony and dinner at a local church, and among other things, they served salad and a veggie lentil soup that was delicious.

My running buddies were awesome as usual! There are no words to describe Fred (OH). He finished the Rouge-Orleans 126 miler the weekend before Delano, and he still ran 51 miles on Saturday. He will probably double this distance at the Howard L. Aslinger Memorial 24-Hour Endurance Run this upcoming weekend. I will again have the opportunity to witness a great performance as he laps me over and over again. Fred is training for the Self-Transcendence 10-Day in New York next month. He usually runs about 500 miles in that race. I can't even imagine the physical and mental fortitude that accomplishing that feat will take. Fred is truly an inspiration and a sweetheart of a man to top it off. Check out Fred in action below in the long black tights.

Andy (FL) was there. He wanted to run a 50K and call it quits so that he could have dinner with his family. He finished the day with 33 miles. With upwards of 500 marathons/ultramarathons under his belt, he is a remarkable runner. Since he was on a mission, I did not chat with him as much as I would have liked, but we'll see each other on the trails and/or roads soon. Below, Andy is passing through the aid station and timing area on the right. On the left, several of the relay teams had set up their tents to hang out while waiting for their runners.

I have a new running buddy, Steve. He says we've met before, but neither one of us could remember which race it was. We shared some early laps together getting to know each other. He splits his time between Little Rock, AR and Chicago, IL. He and his wife are trying to sell their home in Chicago so they can be together, but she still works at a job that she loves, while he's decidedly retired. He is such a treat. His goal was "40 miles or 4 o'clock, whichever comes first". He was right on, too. He ran 40 miles in just under 10 hours (the race started at 6:00 a.m.) and then called it a day. I am genuinely impressed!

I spent most of the day with my running buddy, Gene (IL). We have run too many races to count together over the years. I know that if I can keep up with Gene, it's going to be a great day. Again, I had decided that I was going to take some time off from racing this year. But that decision causes me such mental anguish. At Delano, I was like a kid - talking and joking with everybody, running when I felt like it, walking when I couldn't run, and singing (making a "joyful noise" as stated by Fred (OH) as he passed me, lol) and dancing to my MP3 player the few times that I was alone on the loop. I miss racing every weekend. The last few months I have only been racing, on average, two weekends out of the month, but I wanted to be out there more. Gene, who is 75 years old, ran 32 miles at Delano. That's an amazing accomplishment, even for someone half his age. He never complained. He talked and joked with several runners throughout the day. He ran happily. Gene runs mostly ultramarathons now and needs North Dakota to finish his circuit of an ultra in all 50 states. He kicked my sorry a$$ into gear and taught me a valuable lesson on Saturday. I will do what I can and be grateful for it. I will no longer whine about what I can't do, because there's a whole lot that I still can do. So, I will "just do it". Because of Gene, I have registered for four more races that I know I can complete (two 24-Hour races, one 12-Hour, and a 30 Miler that has no cut-off). Thank you, Gene, for helping me to see the light!

I am always a little concerned when running buddies drop from the racing scene. I had been asking around about David (GA) because I had not seen him. He was no longer on Facebook and his Blog had been removed from the Internet. To be honest, I feared the worst. But David was there in full force. He's been running but has not been racing as much so that he could spend more time with his family. He is a noble man and has his priorities straight. We walked several loops together, but when he was running, he was really moving, and he finished with 51 miles. We both were so happy to be at Delano on Saturday. I could tell that he missed the ultrarunning scene, because the feeling was mutual. I'm looking forward to seeing him in some future races, now that I know that he is getting along just fine. Unfortunately, I didn't get a picture of David, but below are the "pear trees" along the course that remind me of David - tall, beautiful, and majestic. I don't think David cared too much for the smell of the bloomed trees, but I took in a deep breath every time I passed the trees. They smelled wonderful to me.

My running buddy, Tammy (MD), ran a very impressive 69 miles to finish second overall female and sixth in the entire field. She was happy, smiling, joking, talking, encouraging, and taking many pictures in the process. She was a running machine in her pink attire. "Wow" is the only word to describe her performance.

Heather (AL) has new purple hair, and she looked great out there, finishing the race with 49 miles and the female master's win. Rosemary (KY) is fantastic in every race she enters, one of my favorite 100 mile queens. She even slowed down to walk a few loops with me. I enjoyed her company, and I'll see her on the roads and/or trails again soon. We've run a lot of races together over the years. Well . . . she's always way ahead of me, lol, but she is a kindred spirit. And she rocked 46 miles at Delano!

John (AL) and Fred (TN) each ran a 50K. John is young and fast, so I think he was just doing an easy training run. He walked a little with Gene and me and told us about his work trip to Australia. Fred broke his leg a couple of years ago at the Chattooga 50K in South Carolina, but he is back at it and looking strong in the process.

In addition to the 12-Hour and relay race, Delano has a 50 mile option (with a 12-hour cut-off, of course). Vikena (GA), who was always encouraging when she passed by, Perry (GA), and Scott (GA) ran excellent times in that race. It must be something in Georgia's water, lol.

Running is a great sport that allows you to compete with the elites. I was in awe as the elites lapped me too many times to count. I enjoyed watching them going for their goals. Jamie (CO), Dink (AL), Robert (AL), Liz (GA), Beth (GA), and Susan (GA) are elites whose running careers I follow on a regular basis. It was a pleasure to run "with" them on Saturday as well. And one of these days, I'll have the courage to go up to them (before or after the race, of course) and talk with them.

As a side note, good vibes from Delano spilled over into my health. I had chemotherapy today, after being off for two weeks again because my blood counts have been too low. My CT scan on Friday showed regression in my liver. A 19-millimeter tumor in my liver is now down to 16 millimeters. The lung tumors are stable. My bones are showing no new lesions but a lot of new scar tissue, which is a good thing and means the Zometa is still working. Stability, regression, and a beautiful day with my running buddies at Delano. Tiger couldn't have asked for more.

Black Warrior 50K - 2/19/11

I love my legs. They are long for my 5-ft and 3.5-in frame. And thanks to chemotherapy, hardly any hair remains on them. In the past, the thigh muscles bulged in the right places, the hamstrings had long and thick muscular ridges, and the calves were tight as a drum. Long gone are the beautiful muscles that I worked so hard over decades to maintain. They moved fast at the 2007 Black Warrior 50K in 7:32:39. They moved slow this year in 10 hours. They started one hour and 30 minutes sooner than the remainder of the field, and time wise, they will still be listed as the last finisher of the race. I like to say that my legs enjoyed the trails longer than anyone else's legs, lol.

And what a beautiful trail, even with all the roots, rocks, stream crossings, small ups and downs, and horse poop. It's a runnable course, if your legs are in shape. My legs are not. My legs don't lift like they once did. They are like dead weights. They try, but after a while, fatigue sets in. And then they do what I call a shuffle. My feet barely clear the ground, and I pump my arms to propel my body forward. It's wasted energy, I know, but I can't help it. Oxygen doesn't get to the leg muscles to make them work. I feel like I'm running at altitude. I huff and puff trying to get air into the lungs, but the air gets caught some how, and it doesn't make it down to the legs. I have to be careful, because now, the dizzy spells are pretty frequent throughout the day. The fight to breathe makes my throat raw. My high-pitched girlish voice turns into a raspy, male voice. I always wanted more alto in my voice like Gladys Knight, but this sound that comes from my throat is not what I had in mind. I now wish I had that irritating high-pitch back. I can't get air through my noise either, because of the small blood clots that I blow out periodically. I always have a stuffy and runny nose these days. I carried wet wipes with me to take care of this problem during the race. The blood clots are really bad in the morning and then they taper off during the day.

I miss running. I really do. When the field caught up to me, I watched as runners who had taken the regular start, cruised by me as I stepped aside on the single track trail. I did not want to impede their progress. Some spoke as they passed. Some were silent as they concentrated on the task at hand. I truly envied them. Even in my running days, I did not move as effortless as they did, but at least, I was running. Now, I am so embarrassed by my awkward movements that when someone comes along to pass me, I discontinue my shuffle and walk instead. The shuffle is a pitiful sight, but if I'm walking, maybe the other runners will think that I'm taking a little break from the running. The walk and the shuffle are about the same speed at 3 miles an hour, so it really doesn't matter which one I do. When I am breathing comfortably and no one is in sight, I shuffle again. I am so very, very tired and wonder how I will ever make it to the next aid station, not to mention the finish line. And after a few strides down the trail, I am back to huffing and puffing and then I walk for a long way.

I should quit. I know I should. It's not fun any more. It's not fun to struggle at something you love. I've always said that when I stopped having fun at running, I would quit and take up another hobby. But that was before I knew that it would not be an easy thing to do. It's difficult to break an 18-year habit. I'm having a hard time giving up the idea of running. My legs were made to run, but they can't now. No matter how hard I push them, they will not lift. It's the cancer and the treatments for the cancer that are trying to force me to quit. I think if I was quitting for any other reason, it wouldn't be such a difficult choice. I feel like my hands are being forced, and I don't like being pushed in a corner. I always come out fighting. It's the Tiger in me. So I struggle on, shuffling when I can, walking when I can't, and most of the time, huffing and puffing for air. I have to keep going. I just have to. Cancer can not be the reason for quitting.

My right hip has been hurting again, so my shuffle is more of a Quasimodo move. It looks like I'm dragging the right leg behind me. But my most recent CT Scan on Monday was stable. Stable. If stable was on Facebook, I would "like" it. I have been waiting almost four years to hear that word. The little bit of chemotherapy that I've been able to handle (and stay on) has been working. In almost four years, this was the first scan that showed no progression. Stable gives me hope. After stable, maybe regression will follow. After regression, maybe I will get to dance with NED (no evidence of disease). I am assuming that we are on the upswing. I am so grateful. Black Warrior 50K was my reward (and punishment) to my body and mind for doing so well.

Keith, the race director, allowed Andy (FL) and me to start the race early. I kept up with Andy for the first 8 miles, before he found his groove. He has been having back problems, but he says that he does better if he starts off really slow so that his back warms up and then he increases his pace. Other than that, I was alone most of the day. The weather was a little warm. Everyone wore shorts and short-sleeved shirts, while I sported long tights and a long-sleeved shirt. I tied my jacket around my waist and stuffed my gloves into the pockets when it became too warm, but I was pretty comfortable all day. Another runner asked if I was hot in all of my gear. How do you explain without getting into a deep conversation about your health issues? I usually say that I'm just not running as fast as everyone else, so I'm not overheating at all. But for some reason, I wanted her to know that I was cold most of the time because of the chronic anemia. But maybe she didn't understand the symptoms of anemia, and I just confused her. I should have just stuck with the lack of speed answer. It was also the truth.

I didn't eat a lot at the aid stations, although they had plenty of food. My stomach feels so full these days. I eat a lot of small meals throughout the day, but I'm not losing any weight. Nothing tastes good to me. The chemotherapy has killed the taste buds. A potato chip tastes the same as a cookie. I'm just going through the motions of chewing and swallowing. I drank a lot of Mountain Dew to combat some of the fatigue, but it didn't last long. A mile or two outside of an aid station, and I was dragging again.

I am still waiting for the nail on my right big toe to fall off. The nail has partially separated from the toe bed, and it's dark and ugly. It hurts on some of the down hills as it hits against the top of the shoe and feels even worse when I stumble into a root or rock. The tips of my fingers underneath the nails, which are a light purple, are really sore some days, too. Today is no exception. I squeeze my hands into little balls to calm the tingling sensation throughout the day.

Emotionally, I was happy. I was amazed that my legs were working. It was a good feeling. I was out in the forest, enjoying the day, shuffling when I could, encouraging the runners who passed me, joking with the horse people, and giving them the right of way on the trails. They were all very courteous to us runners who were invading their trails for a day. They were impressed that we were running 31 miles that day. Ten hours passed quickly. Despite my struggles, it really was a beautiful day to be out on the trails. I would rather be here than at home on my couch with my feet up watching senseless television.

At the start of the race, we are on a dirt and gravel road for about 2.5 miles before we hit the single track trails. At the end of the race, we run that same road again down to the finish. Towards the end of my races, I always have a little talk with God. While I shuffled and walked the last 2.5 miles to the finish, I thanked him for allowing me to arrive safely, for a beautiful day, wonderful trails, friendly volunteers, Keith for allowing me to take an early start so that I would get an official finish time, and Andy for keeping me company for the first 8 miles. Most of all, I thanked Him for allowing my legs to move 31 miles that day. And then on that lonely dirt road, after 10 hours, after willing my body forward, exhausted from the effort, the tears flowed uncontrollably and I cried. I'm still here, I told God. Thank you, God, I'm still here.