Isolating By Myself

I now have been totally isolated by myself, away from family and friends, for 10 days.  My wife drops food off and I wave.  We have a conversation for a bit from about 20 feet away.  Then she has to leave.  But it makes sense - she works in a hospital and it is too risky for me.  After 9/11 I was determined never to sit on the sidelines when something happened, and I became a volunteer EMT a little over a year later.  Unfortunately I have to sit this one out.

I am getting into my exercise routine again.  When my race got cancelled and I started to prepare to the isolation that was coming, dropped a bit on the training.  Swimming is off the table as gyms close down, but I am running and biking.  Bike is on indoor trainer.  Run is mostly treadmill, though on nice days, I try to sneak out - the only time I am outdoors.  When I do run outside, it is pretty easy to move 20-30 feet away the rare times I see people during the run.  Today I did a 3.19 mile run.

My breathing is okay, all things considered.  The exercise helps keep them clear.  I am waiting to see if I can go into a trial.  The virus is slowing the things down because they do not want patients coming in as an overall concept. Plus the trial I may get into requires a biopsy, which falls into elective kind of situation. There may be waivers for that.

 The kicker in all of this is that I was considering going back on FOLFOX instead of going for radiation in the hope in knocks everything down, with less risk in some respects compared to radiation, but I can't right now.

The trial is FOLFOX with an immunotherapy component.  My last chemotherapy cannot be FOLFOX, because if it is, then I cannot be in the trial.  So right now I am back to exercising and buying time.  Obviously I cannot maintain the status quo forever by this, but hopefully I can get an answer and/or things settle out a bit.  But it is going to be awhile before the virus is gone.

I have a feeling that I will not be really able to see family or friends for for months at this point.  The internet and technology makes it better.  And like everything else since the cancer thing started, I am just rolling with it and I am okay.

Who Needs Medical School? I Don't

Yeah, it is not pretty.

Once again, my Holiday Inn Express stay, coupled with 5 years of having scans, has made me qualified to read a scan.  Under the right circumstances.  And this time I was right.  But a little less correct.

I spoke with my oncologist today and she confirmed that things are spreading.  I basically had another big bloom The one thing I missed, however, is that one tumor is now close enough to my airway to be of concern.  (There is another one running a distant second in terms of being something of concern in terms of structural issues.)

She is now checking with the radiation oncologist to see if it can be radiated.  The location, size and potential scarring may make that a non-starter. 

Additionally, the third and fourth line chemos will not shrink anything, if they work at all.  Five years ago I had FOLFOX, and I asked about that.  Normally you do not go back on a cocktail once off it due to lack of efficacy.  But enough time has passed that it could be worth a shot.

One of the other issues with FOLFOX is that the oxaliplatin (“OX”) of the mix causes neuropathy.  By the end of run with FOLFOX I had trouble picking things up or feeling my feet.  I still have residual neuropathy 5 years later.  My oncologist thinks enough time has passed that perhaps the neuropathy may be at bay a bit.  But otherwise I recall FOLFOX being easier to deal with compared to my recent FOLFORI treatments.  I do not recall feeling as sick.

FOLFOX will be two week cycles – no three week cycle to make it “easier.”  I need to do an all out press to see if it works. 

Got into the pool yesterday. Hoping to get
into the pool one or two times more before
 shut down.

I am not looking forward to going back on chemotherapy.  I have been through it twice.  I know what is coming.  But I know once I get back into the routine I will get through it. 

A two week cycle is going to make #triathlontraining a bit more challenging.  I am pretty sure I can still get enough training in to be able to do sprint triathlons, though swimming may have to be dropped for awhile due to the coronavirus.  Due to the conditions of my lungs I am already “at-risk’ and chemotherapy will exacerbate it. 

The FOLFOX is kind of a long-shot, but at least I have a plan coming together for the first time since I was told that the FOLFORI stopped working.  It feels good that I am not just sitting idly by.

If things go well, I am also guessing I will get on a triathlon relay team or two. I am lucky to be surrounded by some great people :)

#iTRI4aCure  #EmbraceTheSlow 

Junior Radiologist Here - Not Pleased

I think I have been coughing more since I stopped chemo.  But I have allergies and tend to get upper respiratory infections now and again.  The last week or so I have been feeling like that maybe I had another respiratory infection and have not been training as much.  Resting.  A bit bummed because I was not training. 

So today, before a CT scan of my lungs, which is the first CT scan of my lungs since I stopped chemotherapy, I made sure to do a bike/run brick as part of my defiance (in my mind :) ) to my cancer.  About 13.6 miles on the bike and 1.2 miles on the treadmill.

A quick photo of the computer screen of two images from my 
last scan and the current scan.  Pretty much lined up to be at the 
same spot.  Looks clear as to what is happening.  

Then off to CT Scan.  I am not sure if I have ever stayed at a Holiday Inn Express.  I may have.  If I did, that would be the pinnacle of the medical training I have had in connection with reading a CT Scan.  That being said, I have some sense of reading the lungs in general after going through this 5 years.  I will still miss subtleties.  But today was not so subtle.

It is pretty clear that the cancer is having a field day in my lungs.  I am hoping that maybe I am reading it wrong.  That maybe the images are slightly off from when I tried to line them up.  But I know that is a bit clutching at straws.  

I really hope that the oncologist gives me a different take on it.  But the best I think I can hear at this point that this is considered relatively slow growing and I can go on a bit

longer than what part of me is thinking as the finish line.  

Tomorrow is a swim day.  I will be enjoying every lap.

Is Cancer A Chronic Disease? - Yeah I know...

Does Stage IV cancer that spread throughout the lungs qualify as a chronic medical condition?  Just curious....

"The CDC says early data suggests older people and people who have severe chronic medical conditions like heart, lung, or kidney disease are at higher risk for more serious illness from the novel. coronavirus."

I really do not want to concede any ground to #cancer.  It have not stopped this entire time.  And I am not saying the sky is falling.  And I am still not old (they said 60, and I am not even 60 in triathlete years😀)  But it does seem this is the time discretion is the better part of valor.

Will try to swim more (hopefully) before it gets bad in my area, but may be looking at bike trainer and treadmill for awhile in the not too distant future.

Corona Virus, Cancer & Triathlons

Reports of a new virus started up in December, 2019.  It was that time of the year, give or take a month, of when we all begin hearing of the current version of the flu.  We are reminded to get a flu shots and to wash our hands.  But this one was different.  This one was raising eyebrows and getting attention as it is spread.  The International Committee on Taxonomy of Viruses has it listed as the “severe acute respiratory syndrome coronavirus 2”, or SARS-CoV-2.  More often it is referred to now as covid-19 or simply coronavirus.

And in the day of the 24 hour news shows, coupled with social media (which was not quite like this when the first SARS came about), there was some ebb and flow about how dangerous (or not) this is.  For awhile it would be reported more on slow news days (i.e., non-primary days) or really grab headlines.  Kind of hard not to jump on a story where a cruise ship that is bigger than many cities becomes a huge petri dish.  Scares all of us.  And I have read too much on the internet from people spinning things one way or the other, including misinformation and straw man arguments.  On one side it is Kevin Bacon yelling "“Remain calm! All is well!” while the other side are binge watching Doomsday Preppers.

Reports of the mortality rate and rate of transmission is still not clear.  It seems to have moved quickly in terms of the number of countries infected.  And though, like the "normal" flu there is a tendency for older people, or people with compromised immune systems or other health issues (hello cancer), to have higher mortality rates, the overall rate can be as high as 3.4% according to the World Health Organization.  Lower end estimates are .2%  Which is twice the rate of the standard flu.  Which is a large number of people however you look at it if the transmission is not controlled.  

It has started affecting events - including in the U.S.  An Ironman event was cancelled it Taiwan.  A half marathon in France.  A conference in Texas.  Google and Facebook have cancelled events.  It is pretty safe to assume it will affect more events going forward.  It is not an easy decision for a promoter to cancel an event for a wide range of reasons.  But if canceling events, or flights or closing Disney for a bit helps break the chain of infection, it will happen.  If I was going to guess, it will happen.  I will be watching the pattern that emerges in the next few weeks in the U.S.

Please do not get me wrong, I am not expecting the end of the world.  Will Smith will not be the only person left, running around NYC trying to deal with mutated humans.  Other things, particularly proper hand washing, can help break the chain of infection.

I am going to keep on doing what I am doing.  Training.  Planning on going to the next race.  Washing my hands.  My upcoming races and travel plans are subject to change.