Post Prouty Post

Today was my first ride following the Prouty which was last Saturday, July 11. As I am in Watertown for a few days, I took advantage of the flats - what a relief after the hills of NH and VT - and rode out to the Minuteman Trail, following it all the way to Bedford (gateway to Billerica, I am told) and back. Seriously, I was so happy not to have to ride up any hills. It was like rowing with a tailwind in both directions! Although I look a little worse for wear, or sweat, finally a photo without a helmet and shades, haha.

Back to the Prouty. If it weren't for Saiya joining me for the ride, those 100 miles would have kicked my behind. Either that, or it would have taken me at least half as long again to complete. As much as supporting the Norris Cotton Cancer Center was a goal, learning the ropes of a long, well-paced ride and managing the rest stops was "operation critical" for me for the upcoming Pan-Mass Challenge. I learned a lot and am now much more confident heading into the 192-miler.

SAG stop #2, our first - pretty fresh.

Panorama of SAG #2 - water refill, portalet, and some food.

I have to say, the ride itself was fairly uneventful, which turned out to be a very good thing. Lessons learned - put ice in your water bottle when you refill it, temperatures climbed from the low 50s (note to self - buy arm warmers) up to the low 80s (ice!), and keeping cool is/was very important. Eat at the stops - watermelon is cold and wet (good), pbj squares (or nutella-banana squares even more tasty for some fats and protein), and potato chips (salt, mmmmm). All the stops were the same in terms of the food, yet we still eyed everything as if we were standing in front of a full refrigerator trying to decide what to select as though something new would suddenly appear or we had missed something. Regardless, it all tasted good which goes to show that when you're hungry, even a mini cliff bar tastes pretty good.

Saiya changing her flat tire.

The 100 mile route took us from Hanover, north to Thetford and Orford, then swung east in Haverhill to Wentworth before working our way back to the Connecticut River in Woodsville, NH. From there, we crossed over into Wells River, VT, and proceeded south till we recrossed over at Lyme, NH, and back to Hanover. Not too far along into VT, Saiya finally slowed down - she actually came to a stop - a flat tire, bummer. This also drove home the importance of being prepared. We had spare tubes and CO2 so we were fine, but no pump (mine was sitting with an extra shirt I had planned to bring and didn't). I did have cash and my phone, and Saiya thought to bring an ID with her. Smart!

After the ride was over, everyone who had participated gathered under the tents for food and socializing. It was great to catch up with the rowers (the US Women's National Team, Dartmouth College sophomores, and plenty of Upper Vallery folks and a sprinking of CBC-ers) who had done a 20-mile piece earlier in the day, as well as countless walkers (5k and 10k), golfers, and other cyclists (20, 35, 50, 77, and 100 mile options). Although we lost track of time and missed signing up for  massages, we still managed to get back on our bikes for the mile and a half ride back home. And, following much needed and welcome showers, headed out for dinner.  

Now, I am looking forward to only a few more long rides between now and when we head west to spend the night in Sturbridge, MA, for the start of the PMC. I'm riding for a lot of folks this year. Team Muri is in full fundraising mode. Click here if you want to help kick cancer's behind and find a cure. I'll be doing my best out there, too. On to Sturbridge!

Post ride, pre-food.

Still a good time for a photo op!

PMC & Prouty Training

Although long overdue for an update, I finally feel like I've caught my breath since the collegiate rowing season ended this spring on May 17. Wrapping up the fiscal year, getting on top of recruiting, and sorting out my first year of head-coach coaching seemed to take at least as much time as I could provide. Once we were off the water, I continued to have fun traveling to regattas to recruit and/or to work as a referee (always fun to don the blue blazer and pick up the flags). At the same time, all of my post-season travel has had a homecoming feel to it of sorts. NEIRAs were in Worcester where I'd been for so many years for the Men's Eastern Sprints each May. Then, USRowing Youth National Championships took me back to Sarasota FL, where after training camps for so many years, I got to see the race course in action. This was particularly exciting as I had first seen it when it was only in the planning stages. Equally exciting but involving far greater travel and a slightly shifted venue was a quick trip to the UK in June for the Henley Women's Regatta. I hadn't been there since the Royal Henley in 2003. Not only is rowing a small world in a social sense, it further appears to be a small world in a physical sense as well with past, present, and future all overlapping.

With the end of the season and the true arrival of spring, another opportunity presented. I finally took my bike training outdoors to continue preparing for the Pan-Mass Challenge. A wonderful friend connected me with the Upper Valley Women's Cycling Club. I have to say I have loved every minute of every mile. I've included a few photos of my training rides below - the first one is from my very first group ride. I was very nervous, more than I had expected. For one, it had been decades since I did any kind of training ride. To calm my nerves, I kept reminding myself that the group promised rides at all levels from beginners to hard core. But as I got on my bike and cycled over to the meeting point, the whole reason for the training ride became one of those cascading triggers that can catch me off guard - I'm training so I can ride (ok) in the PMC (still ok) to raise money for cancer research (ok, a great cause) because I am a cancer survivor (stops being really ok for a while). Before I knew it, I was really working hard at holding it all together. Fortunately, the mile ride to the meeting point didn't give me enough time to totally come apart at the seams, and sunglasses and group introductions gave me the opportunity to put it all back into perspective. Once the group pulled out to begin the ride, however, I did choke up a couple more times, but then the fun of being in a group and the incredible scenery took over and I was fine.

With only 25 days to go till the PMC, I am also getting ready for the Prouty here in Hanover NH. It is a ride supporting cancer research and patient services at the Norris Cotton Cancer Center at Dartmouth-Hitchcock where I had my radiation treatment. Aside from raising money for a great cause - defeating cancer, I'm also looking forward to riding 100 miles in one go this Saturday, July 11. (The actual course is 96.7 miles, but it will top out at 100 if I include riding to the starting point from home and back again.)

The PMC is August 1-2. I'll be riding with long time friend and supporter-extraordinaire, Saiya Remmler. We may or may not officially be Team Muri, with or without official uniforms, but Saiya is the ringleader and a major source of inspiration to me so I am all in. We will start in Sturbridge MA, on the August 1, and finish the next day in Provincetown, 192 miles later. The link to my PMC page is www2.pmc.org/profile/LM0272. My goal is to raise $5000, 100% of which will go directly to the Dana-Farber for research and treatment.

My first ride with UVWCC (middle rider) - in sneakers since 

I couldn't find my shoes.

On another group ride, this time sporting my Long Beach 
RA cycling top!

Post-rainy ride in Watertown MA.

On my Connecticut River
Short Bridge Loop > 20 miles.

Panoramic view of the bridge in Lyme crossing the Connecticut River into VT - Hanover to Lyme and back.

One year blogversary

I've been on a team training trip for Spring Break the last two weeks. Sometimes, it is better than it sounds, but most of the time it's pretty great in that we a) get to be out of the cold, and b) focus on only rowing without the distraction of having to work around classes. In general, everyone is more relaxed, coaches and athletes alike, and we can really get down to rowing.

On a trip like this, there is some forced downtime between practices, and the days tend to run into and over one another. Saturdays and Sundays are just like any weekday, and none of the weekdays are distinguishable from one another either.  With as much internal focus as I could muster, I forced myself to remember my sister's birthday as well as the anniversary of Max acquiring us as his humans. I thought I had all the major dates covered, so I was a little surprised to see a Happy Anniversary cupcake in my inbox one day. "We hope it was a great year and look forward to sharing many more." It turns out, I hadn't really missed anything - it was congratulations on the one year anniversary of my first attempt at this blog. Although my first post here wasn't until March 30, I had set up another account before that. 

Confirming that date for myself meant going back to read that first post. I had to stop before the first paragraph. Having just made it through all the one-year-ago-todays - that week of appointments finding and biopsying the lump, the confirmation of cancer, and the medical team meeting during spring break 2014, and all overlapping with the one year out follow up appointments left me a little more worn thin than I expected. 

As squirmy as it made me to reread part of it, I'm still glad I did it, and I'm even more impressed that others followed so closely. For me, keeping this journal has been a tremendous help and source of control. (Thank you GM for the recommendation!) The amount of introspection required to write a post keeps me centered and on track. I highly recommend some similar form of a journal of what's going on should you find yourself in similar shoes. Aside from keeping folks up to date, it allows me to get things off my chest, and to clear my brain of dwelling on the negatives as much. 

So happy anniversary to the blog. Happy anniversary to me! I am looking forward to sharing a good year ahead!

Kicking cancer's behind

Today is my first check up with imaging since the end of treatment. My mammogram is in the morning and I'll meet with my surgeon this afternoon. In between, I have lunch planned with a friend. It's a great day to confirm the kicking if cancer's behind. 

Surprisingly, I slept well last night likely due to the pleasant distraction of the Dartmouth Friends meeting in New York City which had me traveling the last two days. It was good to be tired and to be able to sleep! And, to keep busy or at least occupied. 

On a day like today and the days leading up to it, I find myself reflecting on where I am now. We just adopted a rescue which falls squarely into my thinking now - why wait. Is there ever a perfect time and who knows what tomorrow will bring. (It brought us Brady, a wriggly 6 month old french bulldog.)

I also think about my friend who goes in today, too, for an 18 month check up, my friend who confided in me over the weekend about his newly diagnosed cancer and when he will tell his children, and my friend who has more testing the end of the month before starting a clinical trial. I'm thankful for all my friends who are survivors. 

And, I am still feeling pretty lucky. I got this message from one of my athletes this morning, "GOOD LUCK LINDA!!!!!!!!!!! I hope you indeed have kicked cancer's behind!!!!" That's the plan, H, that's the plan. 

A quick reminder about my "on the bike" effort to kick cancer's behind more broadly. I'll be riding in the PMC to support research and finding a cure. You can help too by visiting my donor page at http://www2.pmc.org/profile/LM0272

Thank you!

OK, off to confirm the demise. 

PMC - take one

I was gently reminded that it is time for a post - thank you B & K.

Cutting to the chase, I am doing well. By mid-January, not only did I really and truly have a full head of hair, I finally actually felt good. Finally and for a change, if I felt tired or worn out, it was more likely due to not getting enough sleep (staying up too late and/or getting up very early) or doing a full-throttle work out. What really clued me in, though, was an impromptu session of "Hit the racket ball and run," an energy and frustration burning game of distraction my assistant coach and I have taken up on occasion. I could run and sprint and swing for the ball and not feel like I was in cement without enough oxygen. It was a very happy moment!

Workouts are going well. Physically, the power came back fairly quickly. It was also the last aspect of training to diminish even if I can only measure it anecdotally. At this point, I feel like my endurance is still improving, and I'm up to that uncomfortable and unfortunate point where any extra gains really start to take a lot more effort and time. NOT that I am complaining.

As for the hair, on my head it is still short, but I've been keeping it that way. Even though it has all come in, it still doesn't quite feel like my hair. I think there's a bit of a wave to it though it's not long enough (less than an inch on top if the clipper measurements are to be trusted) to notice. I've just been enjoying the easy care that comes with super short hair. Pro-tip - no comb necessary, just smooth it down with your palm. By now, all the rest of the follicles all seem to be back on their own rhythm with hair naturally falling out when it is supposed to and being replaced on the same schedule rather than 100% on or off. When my hair started coming in in full force, I felt a bit Yeti-like. It seemed like every hair follicle kicked into action at the same time and I went from being hairless to nearly fuzzy. Thank goodness that phase has gone by.

Day to day, I am taking my tamoxifen without fail. I'm not a fan of the hot flashes, at least not the few that cause me to break out into a full body sweat, but again, I am NOT complaining, at least not too much. This sure beats the chemo!

Burying the lead, the real news is that I have signed up to ride in the Pan-Massachusetts Challenge, which from their website is an annual bike-a-thon founded in 1980 that crosses the Commonwealth of Massachusetts and channels 100% of rider-raised dollars to the Jimmy Fund supporting treatment and research at the Dana-Farber Cancer Institute. Although I received treatment at Massachusetts General Hospital and Dartmouth-Hitchcock Medical Center, I absolutely benefited from prior and ongoing cancer research. You can follow me and support my ride here on my paceline page as I support the PMC's mission to find a cure. I'll be sure to keep you up to date.

So far, February has been pretty good. The Patriots won the Super Bowl     and Hanover has less than two feet of snow while Boston is close to 6 feet ❄ ❄ ❄ ❄ ❄ ❄ ❄ ❄.

Happy New Year, 2015

Just another Thursday, not even a new week, but the turning of the daily calendar today brings in a new year, a powerful symbol for a new beginning, a fresh start, for many. And, with my own reflections I am compelled and honored to offer thanks for the past year. I am thankful for so much and for so may people who helped me get through last year.


A big thank you goes out to my immediate community, Cambridge Boat Club. I can't count the number of emails, cards, meals, rows, and general boosts that I got (and still get) from fellow members.

I ran out of magnets and then fridge space very early on. Outside the club, there are also many non-members and non-rowers keeping me strong. The texts and tweets and retweets and various electronic check ins (ongoing!) mean a lot. Reminding me I'm kicking cancer's ass goes a long way!!!

Thank you, too, to my many far flung friends who, some I see often and others it has been years, sent me messages and even care packages (Seattle and the Pacific Northwest get mad props on care package per capita), across the pond, and in between.

Thank you to my two teams - the lightweight men of Harvard and the women of Dartmouth. You kept things normal and let me focus on being me. My former colleagues at Harvard - other coaches and non-athletic folks as well - were downright amazing through all my treatment, too, making it possible for me to carry on every day.

The greater rowing community will never cease to amaze me. Forgoing the politics of pink, I, and it seemed the majority of rowers I know, were awash in it. Here are a few of the many highlights. As I've mentioned before, I am happy to let people support me. Thank you for every last bit of it.

Thank you to the survivors and friends & family of survivors for sharing your inspiration, comfort, and, mainly, for having survived. While I wouldn't wish this on anyone, knowing survivors was and continues to be a huge part of my strength.

With respect to treatment, I am lucky to have a truly amazing team of doctors and medical staff beginning with day one and finding the lump to seeing me through all of the treatments at both MGH and Dartmouth-Hitchcock. Within this team, I have to also include all of my friends and friends of friends in the medical profession - I love Boston - who helped me navigate and control this process, right down to setting up this blog. How do I have so many doctors among my friends? #lucky

I thank my husband for having to be tough when neither of us wanted to. Even if he can't handle medical jargon without feeling faint, I know that it means that he cares, and I know I can always count on him for everything else (other than taking notes during medical team meetings).

(notice my full head of hair)

And, Max, our ridiculous French Bulldog. He doesn't know and never could, but he's a good cuddler and a tremendous source of hilarity and entertainment on a daily basis. He also helped us out again with our holiday greetings this year. Fortunately, we were able to keep it at a PG-13 rating. ♥ 

Thank you for following me and being part of my Support team. Happy New Year!!!

XO - Linda

Post game (after treatment)

Today was my first post-treatment (survivor) appointment. Going back to November, suffice it to say, I got over not being seen by medical professionals everyday very quickly after my final radiation treatment. Celebrations abounded. Cupcakes were baked (and consumed), my colleagues took me out to lunch, and then on the weekend more cupcakes were produced (by my team). I even got a diploma (really, these are for the kids) for completing my treatment with such a good attitude. Tears were shed frequently, but that seems to be my m.o. these days - emotions are dialed up a bit for both the happy and sad spectrum. 

It took about four and a half weeks for my skin to look normal again. What I hadn't noticed until two weeks post was the small patch of affected skin on my upper back, mirroring the treatment area around my collar bone - that radiation goes right through. The skin looked tan more than anything else, but it was the itchiness that tipped me off that anything was going on. 

Back to the present, today's visit was with my medical oncologist. The visit included all the standards - vitals, blood draw, physical, exam, and arm measurement. Weight, temp, and BP all normal. Blood draw will show how my liver is doing (should be fine, but confirmation will show nothing has changed with the tamoxifen); it takes a few days for results. After the exam (skin check, palpitating, listen to lungs), my doctor said, "perfect." (yay!) I also had my arm measured, adding to the periodic comparison before and after surgery, looking for lymphedema and any other changes in size (none).

My next visit at MGH is with my surgeon in March and will include imaging. Then, I will be on an every-six-months schedule. Prior to that, I will be enrolled in a follow up survivors group at Dartmouth-Hitchcock. (It would have been at MGH, but that's a little far for a commute.) Looking forward to that, really!

Little by little, and some days more, I am embracing this whole survivor business. From having people think it's a bad-ass hair cut to only feeling tired from a lack of sleep or a hard workout, it's pretty good! And, the extra time each day - remarkable, not to mention the improved availability of mental bandwidth for things other than cancer. 

Last 2

Down to the last two treatments. Hard to believe this phase is wrapping up, as well. Once you get to single digits, I was told by a friend who's been on this path (same but different), it would go quickly. That seems to be true.

All in all, I'm still feeling very lucky. I've had a great team here in NH building on my positive experience at MGH. I feel like everyone has been invested in taking very good care of me. Except for a few days, my whole time in Hanover so far has involved the daily Monday through Friday trips to Dartmouth-Hitchcock. It will be quite odd to finish treatment and not see my therapists every day and my doctor and nurse for the weekly check ups. Good for me, but still odd. Already, I have to keep to myself from making the turn into the hospital when I drive by. I will certainly enjoy getting back the time lost each day!

Next up will be coping with the end of treatment. Another friend, also in the club, referenced the PTSD after treatment. He sent me a link to an article, but this PDQ from the National Cancer Institute (cancer.gov) spells it out simply,

"Some survivors  of cancer experience trauma-related symptoms similar to symptoms experienced by people who have survived highly stressful situations, such as military combat, natural disasters, violent personal attack (such as rape), or other life-threatening events. This group of symptoms is called post-traumatic stress disorder (PTSD) and includes avoiding situations related to the trauma, continuously thinking of the trauma, and being overexcited."

"People with histories of cancer are considered to be at risk for PTSD. The physical and mental shock of having a life-threatening disease, of receiving treatment for cancer, and living with repeated threats to one's body and life are traumatic experiences for many cancer patients."

"Fear of recurrence and the anxiety of being a survivor" are particularly significant.

However, there is good news for me! Protective factors: "Certain protective factors may decrease a person's chance of developing PTSD. These include increased social support, accurate information about the stage of the cancer, and a satisfactory relationship with the medical staff." Check, check, and check! Thank you, everyone!

Count - Ah, Ah, Ah

I'm in single digits now for the remaining radiation treatments. After this morning's, there will only be 5 more times on the table. As Count von Count would say, "Five, Ah, Ah, Ah."

First of the follow up appointments will be in December with my medical oncologist at MGH (bloodwork, etc), and again in March with my surgical oncologist (more imaging). I'm already slated to start (Nov 1) daily tamoxifen which is a hormone inhibitor, specifically an estrogen agonist, and specifically targeted for me since my cancer is hormone receptor-positive. I'll continue to have 6 months check ups and will probably be on tamoxifen for five years, though that will be under review as well.

More immediately by the end of last week, and more clearly this week, the skin in the treatment area - essentially the upper right quadrant of my torso from my sternum to my side and from just below my breast up to just above my collar bone - looks like I've spent a little too much time in the sun on a topless beach. Two places are a little harder hit. Under my arm, there is a patch of skin that is a darkish not quite purple color and it's also starting to get a little raw. The only other suffering spot is across my color bone which looks like a small rash has developed. Since the friction of clothing doesn't help, and I'm already using special ointments (Jeans Cream and Aquaphor), we've added Mepilex patches to protect those areas. Mepilex is this really cool silicone foam dressing that sticks to my skin but doesn't use an adhesive. I can take it off and put it back on multiple times.

If you want to see a photo of the skin and the patch, you can click here. The uncovered skin looks like a shadow, but that's fairly accurate in terms of color. Just below that, you can see one of my treatment tattoos (slightly enhanced by a sharpie each day by the therapists). And, about halfway up the darkened skin, you can see a small horizontal scar which is where the sentinel lymph node was removed. The second photo shows the Mepilex dressing. This is completely safe to open at work, and I am not exposed, shall we say, at all.

5k

5k yesterday, 2k tomorrow - exceeded all expectations!

2k or 5k?

I'm behind again in terms of posting, but only because things have been busy in a good way. Here is the evidence of my 2k reception (to oncology and radiation) at Dartmouth-Hitchcock.

I'm including it because tomorrow is a big 5k day, the Head of the Charles, a 3 mile head race in Cambridge. I'm rowing again this year with my friend CB. Sometime last March, she did the calculation - 16 weeks for chemo, 6 and a half weeks of radiation, a little time for surgery, "you'll be ready for the Charles." And, she meant I would be rowing with her. At that time, and it still is, about being in the boat together. Over the spring and summer, it was good to think about it on some of the really tough days. Last year, we trained a lot and had a great race day, setting a new course record. This year, despite the surprise move to Hanover last month, we've still had a few rows together - not quite as many as last year - and still continued to train in our singles mainly, just not side by side. It should be a good run down the course. Steering, while still challenging with the buoy line and 7 bridges, should be less stressful since we have no crews in front of us. #poleposition

It's also the first race for my new team. We're in the Club 8+ on Saturday and the Championship 8+ on Sunday. It's exciting and nerve wracking all at the same time. I can't wait. Race day is always a good day. Green Means Go!

Lastly, since it's getting late, an updated photo at a friend's request. It shows my hair which has grown in to a good length, and I'm getting ready for tomorrow. Photo pinched from Anne. Not sure why my eyes are closed, but you get the gist. 2k or 5k? Why not both. 

Slide Control

This week went much better than last week in terms of mentally tolerating the daily radiation treatments. Getting and staying on one (and the right one) machine helped a lot - the initial set up and re-set up were over with so the visits were much shorter. On the first day there was music, I asked if we could keep it on and they said I could pick anything since they have Pandora. Now, as soon as I walk into the treatment room, I pick my music. Even though it will only be for about 4 songs, I have discovered this is my saving grace. One of the techs asked what I wanted to listen to, what was my favorite music. I said I didn't want to listen to my favorite music and then associate it with the treatment. Nora Jones was on the air when I walked in which seemed fine by me - at least it wasn't muzak, Country Western, or some angry 80s rock ballad or even worse heavy metal. Instead, it turns out I have selected Easy Listening (read that nice and slowly for full effect). Nora was followed by Frank Sinatra and that worked for me, too. The music is a nice distraction.

Anyway, here is the chain of events for anyone following along. The whole process takes roughly 90 minutes from my office in Alumni Gym, more on Mondays when I meet with my radiation oncologist. Walk to car, drive to hospital (park for free - score). Go down two flights to the radiation treatment center (room 2K is the radiation/oncology reception area - I kid you not). Swipe in at the bar code reader with my tag (left) and then wait to be called. A few minutes later, and some number of pages into the home decor magazine of the day, I get called to go to the gown changing area where I put on my non-drafty gown (arms through two sleeves then it wraps around from the back and it loops over my right arm, very nifty). Move into 2nd waiting area. Get called into the treatment room, remove the gown (these things will never wear out except from washing) and hop onto the treatment table where they place a bolster under my knees, the custom head pillow is already waiting (not soft at all, hard plastic), and I wedge up against a stop (like a seat but you are lying down) built into the table to keep me from sliding around. As I reach my arms up over my head to hold onto the handles to keep my them and me from moving, the techs remark my tattoos with a sharpie to better see the alignment marks. They use those marks to determine how much to pull on the sheet underneath me to slide me into position. Sometimes, they'll lift my arms to get them in the right place to align me as well. At that point, a red light shines onto me as part of the process. The reflection in the glass of the rotating X-ray disc above me shows an alien looking red patchwork of veins with very small spacing projected onto my bare chest. I can't think of the movie where I've seen this effect before, but it should come to me. On X-ray day, they take a few images at each of the three treatment stations and compare my alignment. This past Wednesday, they re-measured how far each of my sides is from a designated point to make sure I haven't changed in size. Finally, if it isn't an X-ray day, that's it - they leave the room and let me know it's time to start the treatment.

The treatment is delivered through the X-ray machine which looks like a disc from my vantage point, maybe a couple of feet in diameter. It is on an arm which allows it to move in with nearly complete freedom of movement. It usually starts on my left near my elbow aimed at what seems perpendicular to my right breast and then there are a few zaps - I can hear the X-ray machine whirring when I am being radiated. After a those bursts, the disc rotates around me and to the right - next up, I believe, is the supraclavicular region. At this point, I can just see the edge of the disc in my peripheral vision. One or two more bursts, and the final rotation to my right occurs. I can't see where the machine stops because my head is turned up and to the left to keep my chin out of the action. The final two bursts are completed, and then the red light goes out signaling I am done and free to move - relief for my arms, and I can cover back up again with the gown. The total zapping time is about a minute or so and the time from first to last zap is about four minutes. Pro tip - make sure to wait till they remove the bolster and lower the table before disembarking or you'll make the techs nervous.

Then, I'm on my own again to head back to the gown area, apply some of the skin cream to the treated area, get dressed, and head out. Remembering which floor I parked on is the next major hurdle, and then I can drive away. It's that simple. The whole process (despite my whining) really is how my assistant coach would say much wow.

9 down, 24 to go.

Radiation Domination

Today marks day 2 of radiation therapy. 

All in all, a tough day. A dear and loved friend lost her dad early this morning. The side effects of his chemo became too much, but in the long run, how doesn't matter as much as the fact that he is gone. I'm thankful to have some hilarious and good, over the top memories of him - who else builds a pole vault pit in their backyard for fun, but my heart aches for her knowing what that kind of loss is like. It also, it almost goes without saying, cuts a little too close to the bone. 

Yesterday's first radiation visit, delayed from Monday due to a broken water pump, was literally painfully long. The lying still isn't bad. I actually don't mind that at all - it's a challenge I enjoy and can keep my mind on. I don't even have to hold my breath. It's not the molded headrest to keep my chin out of the works. It is as hard as a rock and if I hadn't been there for the taking of the (my) head impression, I'd wonder who sat in for me. It's hard, unforgiving, and has a ridge that digs into my scalp. But I've been told it's the right one - I asked. But wait, there's more. As I lie on the table with my head turned up and to the left, I have to keep my arms above my head. Therein lies the rub. The way my arms rest, particularly my right arm, it goes numb within seconds. The other one takes a few minutes. Today's shorter session was bearable with much counting and trying to focus on something else, anything but what was going on, but yesterday's session which included many x-rays and consultations and adjustments was excruciating both in duration and actual discomfort. I've been told that after today it won't take as long to set me up. I can only hope at this point. 

Adding insult to injury yesterday, I found out after my treatment that I am on a back up machine. Part of my plan in moving my treatment out of boston and waiting till now to begin was to ensure continuity - I would only be on one machine and only have one doctor. Toss that one out the window. Once the water pump situation is resolved, I'll be moved to the right machine. Finding out after the fact really irritated me. 

Not much positive to report here - a sore right neck, shoulder, and elbow, a tendency to numbness and aches after the contortions, and a general feeling of sadness as a result of the procedure. Lying on the table, naked from the waste up, feet strapped together, and arms stretched out over my head is a very exposed position physically and emotionally. Being blasted by a high dose x-ray has me asking is this really all they can do? Which leads down the rabbit hole of how bad is this if this process is part of the cure. And, finally, each session reminds me of this sickness. Even though these treatments are shorter than the all-day chemo infusions, which I would never want to go through again and would not wish on my worst enemy, at least I could distract myself. There is no distraction I've found when you're naked and exposed like this. Not yet, anyway. I find this part of the process quite depressing. Somehow, I have to reframe the focus, like I did with the chemo and its side effects, that this is going to make me better, that it is working, and it will all be worth it. It's like I tell my team on the tough practice days - you can choose to have a bad attitude or you can choose to have a good attitude. 

31 more sessions to go. I can do it. 

Pause drill

Quick update.

Radiation did not begin today as scheduled. I got a call this morning a couple of hours before I was supposed to show up. Coming, as it did, during a very densely packed HR new-employee orientation, I lost my perfect excuse to escape. As best I could understand, a water pump, possibly in the radiation machine (really?), was not working. I've been rescheduled for tomorrow at 5:00pm. In a fortunate turn of events, since that is normally smack in the middle of practice, tomorrow is an Ivy League Rest Day which enough on the team lobbied for. #sororityrush #earnedmytrustalready

Rapid fire update.

• It's been over a week since I sliced open my boat on the submerged part of a tree on the Connecticut. Ugh. 
• I shaved my legs for the first time in nearly 5 months. Slightly more pleasant than above.  #sharperblade
• Max is nearly as excited when he sees a golf bag carrier as when he sees a deer. Or, a skunk. 
• A week of DVW in the books!

Doctor-Doctor-Doctor

I returned safely from the Amsterdam and the racing on Labor Day. Results were, for the most part strong, though many of the athletes were affected by unfair conditions on the course. Even for an outdoor sport, it was a tough go watching so many athletes in a position of having so much out of their control despite the countless hours of training and devotion to technique. It was heartbreaking to watch whether you've been there competing at that level or not.

After my day of rest, it was time to dive into a series of doctor's appointments which would close the loop post-surgery and pre-radiation as well as set me up for the transfer of treatment to Dartmouth-Hitchcock. Tuesday, first up, MGH and my radiation oncologist. We went over my pathology report which had been updated in the form of "final report." Pre-chemo, I was originally diagnosed as T2 N0 where T indicates the size of the tumor (between 2 and 5cm) and N indicates what is found in the nodes (0 means none, clear). Following the chemo and surgery, I am now T1 (the tumor shrank to under 2cm) and N1 (one positive node). As planned, this indicates radiation therapy in my future - once a day for 6.5 weeks, Monday-Friday, or 33 treatments. What we discussed was where to have the treatment which boiled down to my right breast where the tumor was removed, under my right arm to get to the remaining lymph nodes, and above my right collar bone where the lymph nodes under my arm drain through. Short term side effects include hair loss at the site of radiation (not like chemo where I lost all my hair), skin issues (discoloration, loss of suppleness, burning, peeling, rash), and fatigue (mainly toward the last few weeks and likely less intense than with the chemo). Long term side effects could be lymphedema (swelling of my arm due to damage sustained by the lymph system) and brachial nerve damage (resulting in loss of control and strength in my arm), as well as an increased risk of skin cancer at the treatment site and other tumors/cancer in general. Both of the major long term side affects which could wind up affecting my arm are less for me because of my age, good health, and fitness/exercise. The best long term side effect is that overall, the radiation lowers my chance of recurrence of breast cancer by 30-40% such that I will have a less than 5% chance of recurrence over 25 years. That works for me!

The next day, Wednesday, early in Hanover, I met my radiation oncologist at D-H. We also went over my pathology report and agreed on the same treatment plan. This precipitated a radiation planning meeting for the following Monday. Afterward, it was great to then have a whole day in Hanover to get going on the transition to a new job in a new town, but at the end of the day, another 126 mile drive back to MA.

Thursday, day 3 of doctors, I met with my surgical oncologist at MGH to close the loop on the follow up team meeting - I had met with my medical oncologist right before going to Amsterdam but at that time the rest of my team was on (deserved) vacation. From my my surgical follow up, it was confirmed that the incisions were healing well and that the scars and puckering would continue to fade and smooth out. None of that bothers me and since nothing is terribly sore anymore and is healing well, I am very happy.

Time at home Friday-Sunday allowed for some socializing, some packing, some work from home, and some rowing before heading back to NH for Monday's early morning radiation planning meeting at D-H. Monday involved going over the treatment plan again and essentially staging a simulation. My radiation oncologist marked the treatment area with a sharpie and some indicator beads that would show up during the CAT scan. The three sites within this zone are basically my entire right breast, under my right arm where the lymph nodes are located, and the supracavicular nodes (think just above the really bony ridge of your collar bone). This would enable the team of nurses and technicians working with my doctor to line me up properly and plan for the correct dosage of radiation. It turns out, my surgeon placed (microscopic) clips where the tumor was removed which makes if very easy to see where I need treatment - these clips show up on this kind of imaging but are way too small to feel. After positioning me just so, I was marked, literally tattooed with 4 tiny dots - two on my sternum one each above and below my breast about 4" apart, and two others on my sides one each under each arm about 1/3 of the way above the lower sternum mark. They really look like small, dark freckles. One more trip in the CAT scan allowed them to adjust my chin out of the way. I'll have to look hard left for the treatment. Each treatment itself isn't very long, maybe a minute or so. And, just like an X-ray, I will not be able to feel the radiation therapy even though this amount of radiation kills fast dividing cells which is not at all like the lower amount you get at the dentist's office or to look at a broken bone - that amount does not kill your cells.

I will begin treatment on September 22 and my last day should be November 5. I would be starting a week sooner, but decided to wait out for my doctor's return from the annual American Society for Radiation Oncology Conference Targeting Cancer (I think I have that right).

Finally, I became especially aware of the time frame of all of this when I got a call from my old mammogram provider reminding me of my 6 month check up. (I won't be going since my next one is scheduled at MGH 6 months from now. Sometimes, it is hard to believe this all began 6 months ago, that it is over 2 months since my last chemo, and that I am feeling as good as I am today. Beyond that, life is the general craziness that ensues at the beginning of every new school year as the returning students come back to campus and the new ones arrive for the first time. Throw a somewhat bossy/needy dog into the mix, two brand new coaches, a first practice in only a few days and you've hit the nail on the head on the level of the excitement going on around me.

Amsterdam, The Netherlands

Three and a half weeks past surgery, almost a full 7 weeks post-chemo, and 11 days since my last post and I am doing well. The follow up with my medical oncologist was uneventful. The pathology report showed clean margins on the tumor which measured a little over 1cm in the biggest dimension. There was a micromatastasis in the first sentinel lymph node but it is no cause for concern. Any others were likely zapped by the chemo which is what it was meant to do. Both of those results mean no more surgery and no more chemo. Onto radiation!

In the meantime, since my last post, a lot has been happening. The CPET went well, as well as could be expected especially if you are a rower who has ever done a VO2 max test. The technician set up the erg for me and we picked a 12' piece with shifts each 2' to step up the watts in a linear fashion. I made it a little over 30sec into the final shift, and from the data it looked like I had definitely peaked and plateaued (good for providing the desired information). If I heard correctly, I was on the order of 165% of my predicted (age/height/weight) capacity. I'll have to look up what it was 15 years ago, but only when I'm feeling particularly secure, I think. While the technology may have improved to measure and record data, the actual test wasn't any easier to do. With a plugged nose and having to breath in and out of a tube held to your head with a neoprene mask, not to mention more than a half dozen or electrodes, it was quite the set up. Sorry, no photo. I remembered too late. I'm not as fit, understandably, as I was before the cancer treatment, but the outcome of the erg piece honestly wasn't as grim as I had anticipated. 

My hair is definitely growing back now. The peach fuzzy hair I shaved off has been replaced by about 3mm of normal looking, dark hair on my scalp. On top of that, just as I was down to the last eyelash on each eyelid, the barest fringe of eyelashes became noticeable. At roughly the same time, the light hair on my face returned. I no longer feel weirdly naked and exposed. And, last but not least, my eyebrows have just started to grow, too - they look faintly colored in, but are more and more noticeable every day. Eyebrows certainly add or convey a lot of expression that is notable more for its absence. Still waiting on some nose hair to fill in and help with the filtering system, but this is an excellent start, for sure. It only continues to get better from here on. 

Post surgery, I have also resumed rowing and running - the week off following surgery was tough without exercise but definitely the right thing to do since I was physically tired and needed to protect the surgical sites, and I'm glad I toed the line. This week, in Amsterdam at the World Championships, I've been able to bike (in the gym or following practices along the race course, a fun but frightening peloton), run, and erg with some regularity which is nice. It certainly helps to have a physical release at these kinds of events. I'm tired at times, sure, but mostly that is a combination of jetlag, cellular recovery, and being a hardworking coach. 

I do have some really big new in the plus column for a change. I have a new job - I know, I'm dropping the bomb late in the post. I am now the Head Coach of Dartmouth Women's Rowing. Bet you didn't see that coming. Neither did I. But when I got a call about the position mid-July I thought why not explore the possibility. It turns out  liked what I saw on my interview, but tried to think practically about it being a viable option. Then, after what seemed like too long of a time to get a good phone call, it came in the form of an offer, and I said yes! Now, when I get back to the US, I will have two major tasks in front of me. Arranging for radiation to be moved to Hanover (that shift is actually underway) and getting up to speed seriously fast with Dartmouth - a new assistant coach, learning more on who my new team is, and finding a place to live among other tasks. 

Until then, back to the racing, writing some emails, and more when I get home. 

P.P.S.

Post Post Surgery

Once again, I am past due for a post so here is another very brief update. And, again, as last time, no news is good news. 

First off, feeling much less sore from the surgery. The swelling and general discomfort has been replaced by a somewhat normal looking bruised area on my right breast, as if a bruise can look normal. The steri-strips are still going strong on both incisions, there and just below my underarm. The stretches and exercises for shoulder mobility and to prevent tightening around the surgical areas have been effective if not poorly written. Give me a specific amount of time and number of reps, and I'm happy. The vagueness of 3-4' total, 15' per day, or "stretches for any time of day," really needs to be rewritten. 

Tomorrow, I am going in for a CPET,  a Cardiopulmonary Exercise Test designed to determine my baseline prior to radiation, or as it says in the pre test instructions it will "evaluate my exercise tolerance ... to maximal effort." Uh oh. Good news - it will be done on a bicycle, treadmill, or indoor rower. 

Thursday, meeting with my medical oncologist, and, I hope, reviewing the final pathology report which is due out on Wednesday (tomorrow). This is the precursor to getting set up for radiation treatment to begin in September 

Lastly, my hair is definitely on the return. I had nearly a true 1/4" of very wispy, extremely fine hair starting to appear on my head which is what I had expected timeline-wise. I did shave it off this morning, however, because it was fairly patchy and growing unevenly - not a good look. I'm ready, however, and will wait for the real stuff to start growing back. And, yet, at the same time, I am down to a total of 19 eyelashes evenly split along both upper lids. Fastest growing returns first.

Post Surgery

Surgery went well yesterday! Two boxes checked, only radiation left to go, probably starting in September.

poster on my door early Wed AM

It was a long day. It started out very well with a good row on a beautiful morning on the Charles, and the fantastic poster (left) taped to my front door before that. I didn't have enough time to make it over the HOCR course twice, but still managed to get in 10k - no complaints. I was a little dry (dehydrated) since I wasn't supposed to drink or eat after 10pm the day before, and was only allowed 8 ounces of a clear beverage up to 4 hours before my procedure. Banking on them meaning the surgery (noon) but not sure if the wire insertion counted (10:30), I drank those 8 ounces during the beginning of the row which still kept me good for either deadline.

The row was followed by a thorough cleansing with Hibiclens Antimicrobial Soap. On Monday, Tuesday, and Wednesday, I was instructed to wash my "body gently for five (5) minutes," which helps with the "prevention of surgical wound infection." It was pink and not unpleasant smelling, but it didn't lather up very well. I had to laugh because the washing instructions also included a line about not shaving the area of my body "where surgery will be performed." These must be generic instructions and not geared toward someone with essentially a total loss of hair. That was followed by patting dry with a clean towel and donning comfortable clothing - a pair of DHA sweatpants and an old, white button down (no pullovers or t-shrts was the recommendation, go with buttons).

2 gowns, 2 socks, glasses - that's it

After arriving at MGH just before 8am, I checked in and waited about 40' to check in with a nurse - when had I last eaten or had anything to drink, when had I bathed with the soap, when had I used the bathroom, what pills was I taking and when, etc. I passed that test, fortunately, and then got to change into two gowns - one opening in back, one opening in front. And my vital signs were ok - BP, temperature, HR. These questions were asked almost every step of the way. The one question that really made sense was their asking me what the procedure would be - they knew, and I knew, but it is a way to make sure everyone REALLY knows what's going on. As part of the checking in process, an IV line is inserted. Usually, I am a what they call a good stick. But, I was dehydrated which means my veins were not as veiny as usual. The first attempt into the back of my hand went in and then came out, but was still under the skin - not the ideal location to receive IV fluids. Attempt two went well and into the vein in the crook of my elbow. Pro tip - any time you're going for a blood draw or to make a donation, make sure to be super hydrated - it makes the needle going in so much easier.

Next step was having the wire localization (not much thicker than a human hair) set up to mark the

nuclear radiation warning card

tumor so my surgeon would know where to make the incision. I got wheel-chaired to imaging in another wing on another floor for this procedure They weren't as forthcoming about this procedure as I had anticipated, or maybe I just underestimated it. The wire is inserted during a mammogram with a little lidocaine. I was going to be under compression for so long (5' each direction), that they provide a chair to use. After the first compression, they switch the orientation by 90 degrees. But that wasn't all of the prep. A doctor from nuclear medicine showed up with a radioactive trace that indicates where the sentinel lode is located under my arm, again, so my surgeon could tell where to make the incision. That was injected after the wire was in place. Let's just say it stings a lot and it is nearly a dead-center, frontal assault. Ouch. Do the math. They gave me a little business card as verification that I will be radioactive until August 2 in case I get stopped in one of the tunnels, by a police officer, or at the airport. Then, I was ready for surgery, and got wheeled back to the waiting area back upstairs where I watched tv for about 45 minutes (old rerun of the Gilmore Girls - nearly all daytime tv is pretty bad and CNN was going to be too much).

After taking away my glasses so they wouldn't get lost during the operation, they wheeled my gurney to just outside of my OR (41), the Induction Room. The waiting area is the hallway, literally. If you've seen the Fugitive with Harrison Ford, picture the area where he looks over the little boy with the chest films. A hallway. That's it. And they call it the Induction Room. Lame. At this point, they covered my head with a shower cap style hairnet. Seriously? What did they think was going to fall out and contaminate the incision? At least, I had as many warm (135F) blankets as I wanted. Then, the same list of questions from the Anesthesiologist plus a few more about past surgeries. I was able to name drop (it couldn't hurt) and made sure to let him know that my HR would be about 40-45 while I was under and that that is normal for me (so that I wouldn't be over medicated trying to get my HR and BP up to the sedentary level). It was then that I found out I would have a tube inserted into my trachea - ugh - standard operating procedure, as they say.

Finally, it was noon. Right as I was being wheeled into the operating room (very bright lighting, especially compared to the hallway), they started me on some relaxant and after moving from the gurney to the operating table under my own power, that was all I can remember till I came to in the Recovery room. As I understand it, my surgeon inserted some blue dye that wouldn't filter out of the sentinel lymph node so that when she made the incision at the radioactive site she could also see the first node which would be blue. That node and the second one were removed and sent to pathology while she continued and made the incision at the end of the wire. The tumor was then removed (with clean margins, they check for that), and then the bulk of the surgery is putting everything back nicely (cosmetic) and making nice seams. I am peeing a pale blue, and that could last for a few days. The nodes are clear of cancer, but it will be 7-10 business days before the full pathology report is back.

After coming to in the recovery room, where I finally got something to drink (ice water) and to eat (saltines and graham crackers), I was home around 5pm.

My throat is still sore today when I swallow, slightly more noticeable than the soreness from the surgery which is easily managed with some ice and tylenol or ibuprofen. And, I'm convinced that some of the soreness is from being in the contortionist positions required by that mammogram yesterday. Walking around is allowed for now, more brisk walking approaching a week out, and then I can ride a stationary bike one week out, and rowing can commence two weeks out.

Homeward Bound

No post in a week again, but I have a good excuse this time. Yesterday, the World Rowing Under-23 Championships wrapped up after a busy five days of racing, a total of nine days on site. Both of the boats I was coaching had very good results, from a gold medal to an eleventh place finish in highly competitive events.

Up next is a busy week. Today, I am flying home. Tomorrow, I wrap up the final visit at MGH for a fatigue study associated with chemo and breast cancer. Then, Wednesday is the big one - Lumpectomy Day! Phase two, as I see it, will be over and done with before I (almost) know it. While that may be in part due to jetlag, I'll take it!

This past week has been my first third week of a cycle and I have to say, what a difference. Even with the fatigue I felt at the end of the 8 weeks of Taxol, I have felt noticeably better this week. Noticeably!!! I worked very hard and long hours at the regatta and I didn't feel nearly as wiped out as I had the last few weeks at home, particularly week one following Taxol 3 and 4. I even got exercise 6 out of the last 8 days, and it wasn't a struggle - not any more than one would expect in an un-air-conditioned gym anyway. It is really heartening to me how good I feel, although there is still a way to go. 

Two physical updates of note. The purple fingernails from the nail bed attack of the Adriamycin are just starting to grow out long enough to clip. The base of my fingernails looks normal again, and at the last clipping, I had a little collection of faintly purple slivers of nails. Number two is that I have the tiniest amount of peach fuzz-like hair on most of my scalp. It is barely noticeable, but I the right light - a hotel bathroom with a half dozen mirrors and at least as many light bulbs - it just shows up. This doesn't mean the chemo isn't working, it's merely a part of this whole, weird process. However, it will still be a while before real hair starts to grow back. 

Finally, for those of you who we're wondering, and if you were wondering you probably had already guessed the answer, yes, the Head of the Charles guaranteed 2x entry is in. Time for the callouses to develop - let's go skin, step it up, at least by October. 

Varese, Italy

Alive and well, and coaching at the Under-23 World Championships held in Varese, Italy! Day 14 never felt so good, especially staring down something new - Day 15! 

Here I am, hard at work today setting up the boat for the lightweight men's double scull. It has either been raining or about 75% humidity AND over 80F. Keeping the sun off. "Tomorrow is forecast to feel cooler than today." Not much is more fun than this - seriously. #iloveracing

Thank you for the photo, Allison (c/o USRowing)!