“I wish all of my patients asked how hard the could exercise,” said the doctor. “Most people, when they get to this point, won’t get out of bed.”
Last week my haematocrit dipped below 30. It’s been hovering around 27 ever since. While this is my chemo plan’s “by design”, it’s not an ideal scenario for doing stuff. When asking the doc how much I could safely push he said, “About as hard as you want but it’s going to be like exercising at 20,000 feet.”
Alas, more alpine analogies. They do make sense in a “death zone” kind of way. Chemo puts you into the death zone. It’s killing all cells in an attempt to weed out the bad ones. I can see how it’s hard for people to exercise when you feel like dying. In alpinism, you keep going because there’s an obvious survival element. Maybe doctors needs to start pitching it that way to patients, too.
the recently less obscure object of desire and, above, iris excited about finishing a section of trail.
“The only people I see get through this unscathed are those who continue to force themselves to workout,” said the pulmonary nurse testing my lungs. “It’s true when you’re going through chemo, and even more important when it’s finished and you’re re-building your body.”
looking down from the new trail.
She is perplexed by my lung deficiency. While my vital stats, heart rate, lung capacity, VO2/max are great, I lack the ability to push out air properly. This has been a problem for as long as my lungs have been tested, and is probably due to all the treatment I had for asthma as a kid (which was probably fairly Draconian way back then.) We tried some drugs but nothing changed it much. “You’ve probably just adjusted, since it doesn’t’ seem to be affecting you,” she said before adding, “one of the most messed up breathing patterns I’ve ever seen was on a professional mountain biker. Our bodies can adjust to all sorts of things that aren’t supposed to happen,” which leads me to another point.
The type of exercise you do during chemo doesn’t mater much, as long as your pushing your body. It’s not like we’re training for anything specific. You’re not going to set personal records during chemo. You’re exercise to keep your vitals functioning. You need to work you heart, strenuously enough to promote hormonal cascades. While this is the goal of all training, you would normally specify it for what you want your body to do, like run fast, lift a lot of weight, or change body composition. In this situation, all you’re trying to do is maintain body composition as much as you can, so all you need to do is put your body to task. Hormonal releases will accomplish the rest.
This will be completely different than what happens post-transplant, at the end of my treatment. At that point my body will be broken down and, basically a clean slate in which to work with. My training will then become extremely targeted. I said it before, but this aspect is one I’m looking forward to. Not many of us get (want perhaps a better word) to rebuild our body during middle age. It’s a completely different topic that what’s being discussed today.
Exercise is counter-intuitive to many people. Because it breaks tissue down, causing short term pain, some avoid it as much as possible. But in a pain and pleasure world, this is one of those things you have to get around. We are mammals, and thus need movement in order to thrive. It’s a very simple scientific principle but it’s even harder to relate to during cancer. Unfortunately, that’s when we need it the most.
We back off on exercise when we’re sick. This makes sense because exercise tasks your immune system, as does being sick. But “sick” usually reference to an ailment you’ll recover from naturally. Cancer is a different template. It’s there until it’s gone. A lifestyle, if you will. When you stop exercising in life, your body slowly dies. You don’t want that scenario when you’ve got cancer to fight off. You’ve got to keep moving.
Of course you don’t move well at 20,000 feet. You have to stop and catch your breath every few uphill steps. You can’t do what you do at sea level and, unlike alpinism, you don’t acclimate to cancer (although your body does recover). Therefore, your exercise scale is all messed up. You’re not sure what you can do, or should do, because it feels like you can’t do anything. And, unless you fully accept it like I’m trying to do, exercise isn’t very fun. But you’ve got to do what you can.
finnegan in the evening light.
I’ve turned to trail building. It’s not the kind of thing I usually spend too much time on because I’d rather be doing stuff on or at the end of the trail. But someone’s got to do it, and since riding and running on trails is pretty much out, as is climbing at the end of them, I’ll spend my time getting exercise and doing public service at the same time. In the last week I’ve done about 10-12 hours of trail work. I’ve accomplished what I probably could have done in 2 or 3 hours if I felt normal. But that’s just fine. I outside, working as hard as I can, accomplishing something useful, and helping my body fight cancer. As the Eiger Sanction credo goes, we shall continue with style. Now I need to train. Where’s George?