September 14, 2014 posted by

Chemo Is Like Reverse Alpinism

Chemo Is Like Reverse Alpinism

Getting chemo is a strange experience. The goal, to kill your cancer with enough reserves left to survive, is a lot like high-altitude mountaineering. Only in reverse. And without the views. Instead of progressing upwards, the death zone is in a room. Beyond that, your life is 100% focused on survival. The similarities are eerie.

In mountaineering, the higher you go in elevation that harder it is to survive. In order to continually progress upwards, your day revolves around eating, sleeping, hydrating and temperature control, none of which you can do very well. Your body changes its chemical makeup. It’s constantly adjusting. You do your best to control it but it’s beyond your means. Survival is based on applied scientific guess work and luck. Breakdown is extreme. You become incoherent. Your hope is that you’ll summit before the damage is irreversible because the path is clear, at some point you won’t be able to go on.

Minus the adventure, this is chemo. You sit in a room, attached to a six-foot tube that poisons you, changing your body’s chemical balance and its ability to use nutrients, hydrate, sleep, etc. Your life revolves around eating for performance, hydration, sleeping, and temperature regulation, none of which you can do well. Luck is mitigated by constant monitoring. You’re poked and prodded to ensure “you don’t die.” The downside to which is that you can’t sleep. Over days you break down to the point of incoherence. You have no actual idea if it’s the drugs or lack of sleep, nutrients, and hydration. All you know is that it has to end because, at some point, you can’t go on.

Silly analogies aside, here’s what my day-to-day existence as a chemo patient looks like. It’s only round one. They say it gets worse, something I have little doubt is true. I’m not looking forward to round two. Then again, I’ve never met a mountaineer who looked forward to bivying at 26,000’ either. Some things in life are meant to remain fun only in retrospect. Is it fun? Well, no, but it certainly is interesting.

The Domicile

Here’s a vid of my abode. It’s kind of like a tent.

Chemo drugs are highly toxic. Nurses only handle it hooded and gloved. There’s a hazardous materials sign on the door. Walking into your room feels like stepping into an experiment. From then on, it’s pretty invasive. Like a low-altitude Everest, it’s a circus where you replace porters, guides, and highfalutin clients with doctors, nurses, PAs, aids, social workers and other hospital employees.


You’re not allowed to rest for too long, fearing something will stop functioning. Even when you feel good it’s treated like it may change at any second. And in fact is just might. You get hot, then cold. You swell. You deflate. Weight fluctuates along with your heart rate, blood pressure, and other vitals. Bacteria and other organic matter dies. You have very little control over any function. All in all, probably not unlike waiting out a storm at Camp V on Everest.

Minute by minute

Thought you’re constantly busy, days get mundane, go by slowly, and revolve around hydration. I force myself to drink every time I move, as you want to pee constantly. Peeing is how you regulate your body’s fluid and acidity levels. Again, just like spending days at elevation, I never go more than a few hours without peeing, nor would I want to. The more you pee the better you acclimate. So you drink, constantly, about as much as you can.

Eat often and eat well, about as much as you can force down. You’re on meds for nausea, which affect digestion and appetite, so it’s not easy. But you don’t eat for fun, you eat for fuel. Like a race, eating early and often is always the best protocol. Unlike when you’re actually racing, your body isn’t burning glycogen. Instead, the chemo drugs are thrashing your blood albumin levels. You need to replenish this. Your body’s protein needs essentially double.

It funny, people talk about “healthy eating” and, while it is vital that you consume something, you don’t have the control over it you’d think. It’s a sports nutrition template. You lose your ability to taste and all that matters is dense calories. You need energy of any kind, not necessarily salad. You consume anything your body won’t reject. “Healthy” food isn’t even a subject because, like during a race, your nutritional needs completely change. Biologically active foods, generally a good thing, are more or less a waste in the pool of chemicals that is your digestive system.  Lance Armstrong’s case, he eventually got so where all he could stomach was apple fritters. At least that’s something I’ve trained for.


who knows when weird training might come in handy?

When everything is working you try and be productive. When lucid, work emails always come first. I poke away at other work in between. Reading for fun is a struggle. As the week wears on, brain function begins to decline. The last few days are mired in fog. Concentration is weak. Whether the chemicals or simply the regimen, the end result is the same. Produce early because it will decline near the end, when life switches to minute by minute.



Exercise is similar. I trained hard the first few days, figuring it would get worse. It did. Near the end, easy stabilizer work and zombie-like strolls were all I could handle. They seemed essential, however, as much for peace of mind as muscle contraction.

Subsequent trips will follow a similar pattern. Hard work the first couple of days, followed by a lot of targeted stabilizer work. It’s definitely a good time to do mundane exercise, because everything feels worthy, not to mention “hard”.

Basically, the goal of this is to keep your body working. There’s no real use in “training” anything, since it’s all going to break down in the long haul, meaning I’ll be starting from scratch at the end. For this reason there is no use in putting any scientific training work into play. That is, until my stem cell transplant. At that point it will be time to strategically build my body into what I want it to be at the end of all this. That will be much more fun.

For now, however, the plan is to continue with reverse alpinism template. Just trying to survive, as pleasantly as possible, while never losing focus on the big prize above.


  • Sounds like a blast.

  • So fun. By the 4th cycle I may force myself to watch Lost Continent on repeat the entire time.

  • Phil got me to start The Crawling Eye. It’s a “climbing film” that Steve Tucker once told me was awesome and beautiful, or something like that. Of course, it’s the very first episode of MST3K. Completely rivaling Lost Continent, so far, though will take a few viewings to get through, for sure.

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