I never really liked running anyway

I’d always joked that I didn’t really like running. There was some truth in it. I loved how fit it made you, I loved how you felt after you’d been on a run and most of all I loved Parkrun – those free, weekly, timed 5k runs that take place in hundred of locations across the UK every Saturday morning. Since finishing treatment for primary breast cancer in February 2016, I’d also run a half marathon, a 10-mile run and a 10k and for a while I even trained with a running club. You don’t do all that if you genuinely don’t like running – but I always found it hard and I wasn’t a natural.

Then in March I got a pain in my spine and my right hip. I followed it up and it turned out I have secondary or metastatic breast cancer.

As well as there being cancer in my bone marrow and in three vertebrae, there is a lesion in my left-side rib area and there are “areas of less significant scattered bone disease”. As for my right hip, while there are no obvious signs of cancer in the hip itself, the pain I get there may or may not be related in some way to the diagnosis. Either way, that’s where there is most pain.

I suspected my running days were over but I hadn’t put it to the test. I needed to find out one way or the other.

Last Sunday morning, I plucked up the courage to give it a go. I put on my running kit, including for inspiration the Parkrun t-shirt I got for having chalked up 50 runs, and set off for Tooting Common at the end of our road. I went as slowly as I possibly could without it being considered fast walking. It didn’t help. It took just a few steps for me to know it wasn’t going to work. I’m not going to exaggerate; the pain was nowhere near excruciating but I just knew my hip couldn’t take it. My back, I could feel, would also start hurting soon.

I waited a few minutes then tried again. It still hurt. I tried once more, and that was it. I limped to a secluded spot on the common, sat down in the shade of a tree and proceeded to shed a bucketload of tears – of anger, frustration, sadness and self-pity.

So now I know for sure. Barring some weird reversal of the crap that’s going on inside my body, my running days are in the past. I guess I knew they were but I think I had to go through the motions. Maybe on some subconscious level I knew I needed a good, cathartic cry.

So much for getting a century of Parkruns. I made it to 86, which is pretty damn good. For those of you who may be thinking of suggesting I limp or walk the course 14 times just to get to 100… the answer is a big no.

It’s strange. On one level, I’m really disappointed but on another I’m already over it. Maybe I really didn’t like running that much anyway! More likely it’s because I know I have no choice. Or perhaps sometimes a good cry is just what’s needed to help you move forward. I’ll continue volunteering for Parkrun every now and then as I’m so grateful for what it has given me over the past three years. It was a key part of my recovery from my treatment for primary breast cancer and I’ve made new friends through it and had such fun. I ran all but one of my 86 Parkruns in the past three years, most of these on my home course on Tooting Common. I started it in earnest in April 2016 – six weeks after I finished radiotherapy – and never looked back.

On the positive side, I’ve restarted treatment. I had to have a short break as the drugs made my neutrophil count drop during the first cycle to below the level that was judged safe to continue with treatment. Neutrophils are the white blood cells that fight infection. Pharmaceutical intervention was needed to get them back up to the required level but we got there and here I am, back on track with Cycle 2. I have blood tests next week to check to see how things are going.

There’s clearly lots going on inside that I’m not physically aware of. But what about the things I am aware of?

Well, it sometimes takes some careful manoeuvring to get out of bed in the morning without too much pain. This is mainly due to the pain in my ribs – where there may also be cancer – that sometimes develops overnight and to the discomfort in my hip, which gets worse overnight, regardless of what’s causing it. My back is not generally painful but can start aching if I walk a good distance.

My hip hurts every time I get up from a seated position and take my first few steps. The pain generally wears off as I start moving about but a few people have commented that I sometimes walk with a slight limp.

The level of pain I have in the morning gives me a sense of how things will go over the course of the day. Overall I’m glad to say the pain seems to be diminishing.  I either take no painkillers (that’s the most common outcome at the moment), over-the-counter strength painkillers or prescription painkillers. The problem with the strongest ones is that you’re not meant to drink alcohol; the pain has to pretty bad before I take those!

The pain is at its worst by far in the days following the monthly Faslodex/fulvestrant injections and the Zometa/zoledronic acid infusion. Getting the injection in your buttocks verges on the painful side of uncomfortable and your glutes hurt like hell for a couple of days afterwards. The Zometa and the fulvestrant can – and do – cause bone pain for a couple of days afterwards too. Painkillers are most definitely needed then.

Also, I swear my hair is getting thinner by the day. Thankfully diarrhoea – a serious concern with the Verzenios/abemaciclib tablets I’m taking – has not been a problem. I’m not saying it’s been non-existent but it’s not been a problem.

I already knew tennis was out. Now it seems running is too. There’s still the cycling; I rode 62k yesterday, in glorious sunshine, the furthest I’d ridden since starting treatment in late May. I’m paying for it now as I’m absolutely whacked. Thankfully I’m not working today and, as Wimbledon is on, I have an excuse just to sit on the sofa and do very little other than watch amazing tennis on TV and finish writing this!

The question now is whether cycling is enough or do I need to seek out something to replace the tennis and running? Swimming anyone?

Legal doping and Hank Williams

I can personally attest that blood transfusions do indeed improve your cycling performance! Unlikely as it seems, I have become a legal doper.

I had some scheduled blood tests done on Monday with a view to starting my second cycle of treatment after seeing the consultant the following day. When I saw the consultant, however, she told me my haemoglobin level had fallen even further since my previous appointment. It was clear that a blood transfusion was the obvious option to help combat the anaemia that the low haemoglobin level was causing – even to me who’d been in denial as to whether it was necessary.

The secondary breast cancer I have is in my bones and bone marrow, with the latter affecting my body’s ability to produce the required amount of red blood cells. Red blood cells contain haemoglobin, which transports oxygen around the body.

A transfusion would mean I didn’t feel as tired as I’d been feeling these past few weeks. I’d been finding that if I went up the stairs too quickly, I had to stop at the top to get my breath back. I couldn’t rush anywhere – it was taking half as much time again as it usually did to walk to the the tube and from the tube to work. On Thursday, therefore, I spent the whole day at the hospital having two units of red blood cells transfused.

You’re meant to feel the effects of a transfusion pretty soon after having it. I therefore decided I owed it to myself to do Parkrun on Saturday morning. Parkrun is the free, weekly, timed 5k runs that take place in hundred of locations across the UK every Saturday morning. I’m a massive fan and while I haven’t run for months, I’m keen to start doing Parkrun again if I possibly can. However, I had a pretty strong feeling that even if I had the energy to run for 30 minutes plus, my back (there’s cancer in three vertebrae) and hip (the pain there may or not be related to the diagnosis) wouldn’t cope for more than a few hundred metres. So I knocked that idea on the head.

Come today, though, I decided I’d aim for a proper bike ride. Since May 19, I’d only been out on my bike a few times and I hadn’t cycled more than 10 miles. You get out of the habit pretty quickly so I did have to psyche myself up for it. Also, we were at a wedding last night (nails painted accordingly!) and this morning I wasn’t exactly raring to go. It was a beautiful day, though, so eventually I forced myself out the door.

Off I cycled to Richmond Park in south west London, did three laps then cycled back home, stopping only at lights and junctions and to take photos of the beautiful fawns in the park. I cycled almost 35 miles in total and surprised even myself. In fact, I would have done a fourth lap had I not wanted to make sure I got home in time to watch Andy Murray in the men’s doubles tennis finals at Queen’s. In the end he didn’t play until much later on so I could have gone ahead and done the extra lap.

Painwise I felt almost fine the whole ride – no hip pain, no back pain, and just a little pain in my left ribs (where it’s likely there is cancer).

I can’t say for sure but I really don’t know whether I would have been able to do that ride at the start of this week. I’m not sure I’d have attempted it. Of course I’m aware that even with the transfusion, my haemolgoblin will still be below normal levels, but it’s all relative.

As well as having a transfusion, I’ve also had to take a temporary and hopefully short break from treatment. I’m disappointed but the blood tests had also shown that my neutrophil levels had fallen during the first cycle to below the level that’s judged safe to continue with treatment. Neutrophils are the white blood cells that fight infection. We’ll do some more blood tests tomorrow and hopefully we’ll restart treatment on Tuesday. The break in treatment has also probably led to me feeling less tired as one of the drugs I’m on can also lead to anaemia.

I’ve written many times before that I had in effect resigned myself to being diagnosed with secondary breast cancer at some point. I was at high risk of it happening and that’s precisely what has occurred. Accepting that it might was part of my coping strategy.

I even had a headline planned for the blog post I would write if it came back. It was “The f***ing f***er’s f***ing back and I’m f***ed”. In the end, though, I decided not to use it. I went for the much plainer and much less crude and bleak, “It’s back.”

While the first part of my unused headline captures perfectly how I feel, I hope it’ll be a good while yet before the second part becomes a reality. As the wedding last night and today’s bike ride show, there’s still plenty of world out there to enjoy and plenty of wonderful people to enjoy it with. In the end, we’re all f***ed, aren’t we? To paraphrase the late, great American country singer Hank Williams, none of us is getting out of here alive.

Cycling challenges and lowering expectations

I’d been doing so well in terms of cycling to radiotherapy before I came down with this infection (It went downhill from there).

I’d first cycled on Day 4 (In the end, the wig ditched me). By the end of Day 7, I’d ridden to three sessions and had driven or been driven to four. Car 4 – Bike 3. Things were getting interesting. At some point during the third trip on the bike, I got the idea that it would be fun to aim to cycle to more radiotherapy sessions than I would drive to. At that point I had nine sessions left so it really wasn’t a tough target; I had plenty of leeway and I thought it might give me an incentive to cycle if I was feeling a lethargic or just plain tired. Then the infection took hold and while the goal is still achievable, it’s only just.

I’ve now had 11 radiotherapy sessions. The car has increased its lead over the bike and is winning 7-3 (I’m discounting from the car vs bike/me “duel” the session this past Friday when, for good reason, I used public transport). I came out of hospital last Wednesday and while I have been tempted to cycle on the odd day since then – particularly on Thursday, when it was such a beautiful day – I haven’t done so. I know I like a challenge but I’m not stupid and I knew I had to take it easy to give my body a chance to get over the infection.

So we’re at Car 7 – Bike 3. With just five sessions left, the best I can aim for is an 8-7 win. But a win is a win. To get it, I’ll have to cycle to radiotherapy every day this week. No pressure there. I’ve almost finished my course of antibiotics, I’ve had a very restful few days and so I’m up for trying. It’s a shame that on a couple of days the weather forecast is really not good.

Perhaps I should do as a friend suggests and just let it go. She could be right. There will be plenty more opportunities for cycling challenges. However, I’ve lowered my expectations over a good few things these past months, and as this is my final week of hospital-based treatment, there won’t many more of these particular types of challenges. I may be setting myself up for failure, but I’ve got to give it a go. I wouldn’t be being me if I didn’t.

I’m off to get my bike.