Sunday, February 13, 2011

Training for a Marathon

The Cancer Marathon.  It's not a running race. It's the race to have Meagan become disease free. Initially (after the true diagnosis of Stage 4 melanoma) it felt like a 100 yard dash. There was urgency - to understand, to cope, to make plans, to change directions, and to communicate and support. So every day was a sprint, and the training was to just flat out run as hard as I could. But in doing this, fatigue sets in - emotional, mental and physical. Sleep was hard to come by as I worried and would get up early to do research. But you persevere because you want to prevail. Then, after the whirlpool has sucked you down and you are gasping for air, you realize that it's not going to be a sprint, that it's going to be a long haul. This realization comes about after doctor consultations, evidence of speed of disease progression, and seeing the potential treatments stretching out in front of you (if this one doesn't work, you try another, if that doesn't work, you try another, etc.). So you have to live in the whirlpool, probably for a very long time. So what do you do?

I'm now trying to think of it as a marathon. That means preparing my mind, emotions and body. I started seeing a therapist right away, and that has been enormously beneficial. Just the ability to talk through scenarios and how I could handle things (talking to the kids, handling the upcoming scan news, supporting Meagan better) is super useful. It's like having a coach to deal with a situation that is unprecedented in your life. It's also really helpful to get feedback that you are doing the right thing. I ask all the time if I'm screwing up, or should be handling it a different way - I'm not there for him to just give me positive strokes - I really need the coaching - and so far the feedback is positive. In fact he is pretty darned amazed at how well we have coped and handled this individually and as a family. It's also a great outlet for me to express my feelings and fears and uncertainty, which is not necessarily what I can do with Meagan, because it would impair her ability to cope.

I also went on anti-anxiety and anti-depressant medication right away, at a pretty low level. I don't drink alcohol, so a little external calming is pretty helpful. It's enabled me to get a bit more sleep, which means I can function at a higher level during the stressful times. It puts me in a frame of mind that I can cope with the ups and downs of everyone around me responding to news. I think I've mentioned before this weird concept of re-traumatization. When the story gets told over and over (here are the scan results and what it means) to a series of family members or friends and I am the one telling it or overhearing it, your body definitely responds as if it was hearing it for the first time. So your cortisol levels shoot up repeatedly, and your body is in preservation and flight mode. Now this is just not at all good for longevity and the increased risk of a heart attack or stroke. So the medication has made a difference, I don't get that spike of high anxiety, and as a result, again, better ability to cope and play my role for the long term.

Then, the body - as this is a long haul fight - I realized I still needed to stay in shape, for health, stress, and attention shifting reasons. I'm not doing as much cycling even though I still love it. It's pretty hard to justify leaving my sweetie on a Sunday morning to go out with my team for 6 hours. Maybe when the weather is better and Meagan is away for a period of time with friends or family I'll head out for a longer ride. I have my bike set up on my indoor trainer so I can still crank out some minutes (around 30-40) a couple times a week and get my heart going. I am trying to do a somewhat regular class in yoga/tai chi/pilates at the new Magnuson Athletic Club I joined. I lift weights there 2-3 times a week. Plus we walk together and with friends. So the combination of all these, and making them a priority, has put me in a better physical state to stay high functioning. Of course we are eating darn well, and I've cut off caffeinated coffee (but do get caffeine from the matcha tea we drink together in the morning and the occasional pieces of chocolate bar (ok, maybe more than occasional, semi-regularly, but hey, the dark stuff is good for you). That's probably been the biggest shift - Starbucks and all the local coffee houses are definitely missing me.

I truly believe we will prevail. Everyday I find out more about new therapies and approaches to this nasty disease. We have a complete team looking out for our interests - from the medical staff to friends and family. By taking the long view, and preparing myself for that long journey, I hope I'll be able to be more effective and supportive for all I'm around.

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