A Run Down Memory Lane

 

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I just got back from the coolest trip. I met Zeynep Madak-Erdogan on twitter a year or so ago (thank you #bcsm!), and when I saw that she was a breast cancer researcher at the University of Illinois, we quickly bonded as I told her about my time there. In the months since, she has asked me to work with her on a few different projects, and she even invited me to come to campus as the Cancer Community @ Illinois starts a new cancer research advocacy group!

I’m going to get some of the “official photos” soon and I’ll share a little of the more science-y stuff I did there, but until then, the fun stuff! Zeynep and the rest of the cancer working group set up a great itinerary for me, but she was sure to ask if I wanted her to arrange any specific meetings. My only request was dinner at Papa Del’s, which apparently made me one of the cooler campus visitors and showed my UIUCroots to anyone who hadn’t already heard I was an alum. We drove around campus, and seeing the buildup of research park on the south farms where there used to be nothing but sheep was probably the biggest change. Fortunately (or unfortunately?) there are still some farms on the other side of First Street, so I immediately recognized the familiar smell of spring on the South Farms.

My other request was a slightly later start on the second day so that I could get in a run to visit some of my old haunts. Of course, as a student, I wasn’t a runner, so roller blading or taking the Red bus would have been more accurately nostalgic way to get around campus, but I enjoyed taking my new habit to my old stomping grounds.

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Of course I had to snap a quick picture with the Alma Mater and on the Quad, which like the Union and much of campus, were as I remembered them. (My apologies if this one is upside down. WordPress and I can not agree on how to make it right side up on all devices. Agh!) At one point, we were noticing all the new hipster food trucks near the Beckman Institute and I commented that the only food truck in my day was the weird smelling silver truck outside Noyes Lab. When we walked past that spot moments later, Derald’s Catering Truck was still there, as if it had never moved, save to get a snazzy new paint job on one side!)

imageThis is the entrance to one of the new buildings on campus– the Carl Woese Institute of Genomic Biology. Besides the cutting edge science that goes on inside the building, the art of science is prominently featured throughout the building with temporary themed exhibits. These three sculptures outside the building show tRNA at three different stages.

imageGreen Street looked different, too, with many high rise buildings towering up over the familiar streetfront stores and restaurants. But IGB is probably one of the shortest new buildings on campus, built only a few stories high because of its proximity to the Morrow Plots– the oldest continuously planted experimental cornfield in the United States. And as all my fellow Illini friends know, you can’t throw shade on the corn! (OK, it’s a long video, but gives you the whole story of the Morrow Plots and why the Undergrad Library is underground. The song starts at around 8:30.)

I had a great visit and especially enjoyed my run down memory lane. Stay tuned for some pictures of me dressed like a grown up and being all professional and everything to find out why I was actually there!

 

My Rock ‘n Rollin NED-iversary

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I know it’s a little overdue, but I thought I should show you how I spent at least the first few hours of my NED-iversary. Since Emma Clare had to be in Leesburg super early for a gymnastics competition, as soon as I fixed her hair, I kissed everyone goodbye and headed to take the metro downtown. It was a great day for running, and I was expecting lots of music and mayehm along the course. The Rock ‘n Roll series didn’t disappoint– bands most every mile and lots of people cheering, some from their stoops while drinking their (morning) beer! Besides all the water stops, there were plenty of people handing out water, champagne, beer, and even barbecue! But what really distinguished this half from the Nike half I did two years ago was the hills. Oh, the hills. The Nike course was so flat that the slight, barely distinguishable incline was the only “hill” I can remember. This course, on the other hand, had not only a steep hill that was over a half mile long, but lots of other decent hills, too. And of course, that one just before the finish. Awesome. But I ran this one without having to give myself any pep talks, and even made it up all those wretched hills, finishing two minutes faster than the last (much flatter!) half, so we’ll count that a win!

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I even got my first real medal! I love the Tiffany necklace I earned at the last race, but there is something pretty cool about a big, heavy medal!

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Not to be outdone, the rest of my family had a pretty good weekend, too! Emma Clare came home with four medals from her gymnastics competition, Turner finished out the basketball season with a celebratory medal, and Clay earned a special achievement medal at work on Friday! What a wonderful weekend for our family.

Name That Bib | Rock and Roll Half Marathon

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According to the website, as I sit and type, there are just over 4 days and 9 hours until the Rock and Roll Half Marathon for which I am registered. I can hardly believe it was six whole months ago that the idea to run this race was hatched as I ran with a friend through the district on a lovely, warm Columbus Day. As we talked it out, I went from a little ambivalent about the prospects to downright convinced that I should register for this race. Held on March 12, the race is just one day short of marking three years since I had my bilateral mastectomy. Though technically, the chemo had already killed the cancer in my breast, we didn’t know for sure, so that is the day that I officially consider myself to be cancer-free. Now here’s a little cancer speak technicality for you. People really “in the know” don’t like the phrase cancer free. Because really, you can never know. If you would have given me a form to fill out on September 15, 2012 and asked me to describe myself as either a cancer patient or cancer free, of course I’d have picked the latter. In fact, that wouldn’t have been accurate, I just didn’t know.

So in the cancer world, my status is technically NED for three years– No Evidence of Disease. There’s probably no cancer there, but we don’t know for sure– it could just be too small to detect. But as far as we can tell, there is no evidence of cancer. Which makes March 13 my NED-iversary. Catchy.

That’s all background for the question I have to pose. Back in October, I was stopped in my tracks by the option to personalize my bib. The only thing that fit in the character limitations that marked such a celebration was “cancer free.” But even without the hangup of cancer free vs. NED, I didn’t have the confidence to put that on a bib I wouldn’t be wearing for another six months. A lot can happen in six months. But nothing happened! I’m still just as NED as I was in October. Back then, I decided not to personalize it, leaving myself the option for a custom job with a Sharpie on race day. So, friends, help a girl out. What should my bib say? I’m leaning toward (NED)3, but knowing that people sometimes cheer for you based on the name on your bib, I’m not sure I want to be known as Ned. Makes me think of Ned Flanders, and then words like okely-dokely start popping in my head… Comment here or on Facebook, all reasonable (family friendly!) options will be considered! And the countdown is on– 4 days, 9 hours, one minute…

 

Running, Motherhood, and Breast Cancer

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I won’t rewrite the whole post here, but be sure to check out my new post on the Cure Community page. It’s a little bit about running, but a lot about the realities of being a mom with cancer, all inspired by the Melissa Etheridge song, I Run for Life, which randomly popped up on a Spotify playlist a few years ago. (Kleenex alert: Mom, you might want to skip this one. You know, the realities of having a child with cancer and all…)

Summer Writing | Women’s Running Magazine

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I can hardly call it writing, but the next summer project on my list just showed up on newsstands! The first thing I did when I got a request this summer from Women’s Running magazine was call Sally to make sure that I was right– this is a legit magazine! Like one you can buy in stores and everything! They asked to feature me in their “Bloggers on the Run” series for October. Because breast cancer. Ironically, they took the text from some interview questions they asked me, and there is no mention of breast cancer in the piece! But since it’s sprinkled in between pictures of women showing off their pink running gear and pages of ads featuring pink ribbons, I’m guessing anyone who’s interested will make the assumption. I didn’t really get to share anything new or shocking, but it was fun to see my face (on a bald head, no less!) in a running magazine (who’d have ever guessed?!?) and perhaps it will give a runner facing chemo the confidence to keep on running. Head to your newsstands and check it out or read it here! (I picked up my copy at Barnes and Noble, since the selection at my local drugstore was too small to carry anything not related to home decorating or fashion and makeup!)

Road Trippin’ | Seatbelts and Mastectomies

imageSo it turns out that seatbelts and mastectomies don’t always mix well. A couple of years ago, fresh off my mastectomy, I found this little gem at an auto parts store and found that it really did help me be more comfortable. It’s hard to believe that it’s been over two years since that discovery. Since that surgery. I’d hoped I might “grow out of it,” but I still have some nerve issues that make a seatbelt cutting between my breasts (especially on the driver side) irritating. It’s not that big of a deal driving around town, though I find that I pull the seatbelt away from my chest instinctively at this point most of the time.

As we headed out on our first long road trip this summer, I knew comfort was going to be key, so I put on a loose comfy tee and a pair of running capris, and we set out. I quickly figured out that a loose tshirt and a seatbelt, even with its cushioning, was a bad combination for me. By the time it was Clay’s turn to drive, I thought I was going to come out of my skin. It took nearly my whole shift as passenger to get comfortable again, and then I had to shift back to the driver’s seat.

Thankfully I had taken along a sports bra or two in case I wanted to get in a run (ha! It was WAY too hot!) and so I put that on for the ride home. The difference was HUGE! I don’t have to go for a lot of support, but the way that a sports bra creates sort or a flat surface keeps the seatbelt from getting between my breasts and irritating me.  While I still pulled the seatbelt away reflexively, I was actually comfortable even when didn’t.  I’m not convinced that I need a sports for actual sports (though it feels too weird not to wear one!) but apparently, they’re my new must have for road trips!

On Remembering and Carrying On | September 11

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I wanted to go for a run downtown yesterday. Really, I wanted to park near the Pentagon and run across the Memorial Bridge onto the mall. But, figuring that security around the Pentagon would be crazy, I decided that wouldn’t be the best plan. My second choice was to park in Rosslyn and do a similar route coming back through Georgetown and the Key Bridge. But since I couldn’t find anyone who could spend the morning with me, and frankly, I had other things I should be doing, too, I settled and headed out on my normal neighborhood loop.

I’m sure there has been a cloudy September 11 since 2001. Yet I feel like every year, I look up to a bright blue, cloudless sky and think how amazing it is that every year, the sky looks just the same. In 2001, I headed into the lab super early every morning, so by the time the first plane hit the World Trade Center, I was finished with my morning’s work in the tissue culture room and came out to see the image on my labmate’s computer screen.  After a brief chat, we carried on with our work, but gathered back around the computer as word filtered down the halls that the second tower had been hit. I fielded the call of a friend who was supposed to be relaxing after defending her thesis the day before but was instead frantically looking for the work number of a friend who worked in the World Trade Center.  Finally, I remember running across the hall to stand next to the desk that would eventually be mine to look out the window into that crystal blue sky, watching smoke rise from the Pentagon before we were eventually sent home.

Somehow, every year on September 11, I feel compelled to run. Because I can. This year I wanted to go downtown, run past the same skyline I saw looking out that window. I wanted to run across the Key Bridge, remembering the fully armed National Guard troops who welcomed me across for weeks as our city struggled to return to normal. I was a little disappointed to “just” be running my normal loop. Yet as I ran the lovely wooded trail along the interstate, I could see the flags placed on the overpasses every year by the Arlington County Fire Department in memory of that day.  I saw the cherry blossom-themed sign pointing towards downtown.  Crossing over the interstate as I headed home, I could hear the hum of traffic and the rumble as a metro train passed under me.  The sky and the flag, so beautiful. The traffic, so blissfully normal. The day will not be forgotten, yet we have carried on.

And as for that run downtown, there’s always next year. (At which point my St. Louis Cardinals-loving eight year old would tell me I sound like a Cubs fan!)

Gettin’ My Groove Back | Running After Cancer

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I managed to run all through chemo. I didn’t go as fast, or as far, or nearly as frequently as when I was in top shape, but I had cancer. So I was winning. Then surgeries started creeping in, and I LOVE my plastic surgeon, but he’s a stickler about limiting activity after surgery. The six week ban on anything that causes you to bounce or break into a sweat probably isn’t necessary, but he wants to ensure the best outcome possible. When it comes to plastic surgery, I’m all for a good outcome, so I obliged.

We all know that breaking a habit is far easier than starting a new one, so at the end of each six-week doctor imposed hiatus, it took a while to get back into the groove of a regular morning run. And then as soon as I’d gotten back in the swing of things, I’d need another surgery. Training interrupted by surgery has kind of been my go-to excuse for the last two years. But just this week I realized that my most recent surgery was in June of last year. That means I’m almost a year surgery-free! Which is awesome. But also, that fact makes my go-to, perfectly respectable excuse completely pathetic. There’s no reason I should be sleeping in far more days than I’m getting out for a run.

Enter the plan to get back my groove. It is a multi-pronged approach:

  • Run with a friend: Accountability helps. And so does companionship. Last week I made Emma Clare run with me before Turner’s baseball game. I have a neighborhood friend who I run with before the kids head to school– our plan is twice a week. (When life doesn’t get in the way.) And then Sally and I have decided to resurrect our chemo runs, meeting in Old Town once a week or after a shopping outing, and have even added a third friend to that mix.
  • Make a goal: I’m completely out if I don’t set myself a goal. But with a (reasonable) goal, I’m a fierce competitor. So I’ve got a couple of friends in on it, and we’re doing a minimum of three runs a week and reporting back. I kind of wanted a mileage goal for myself, too. I decided on a May marathon– not that I’m going to run a marathon at the end of May (ha!) but that I’ll run a total of 26.2 miles in the month of May.  I’m off to a pretty strong start, though, so I am thinking I might need to up that goal…
  • Power through: This is the hardest. The weather yesterday morning was perfect for a run, the trails were packed, and the trees were lovely. And my run was abysmal. I’m not fast, so it doesn’t bother me to get passed. But yesterday, I got passed by a guy running in a cotton tee and dockers. (Hard to tell myself that he passed me because he puts in a lot of miles when he’s running in a pair of chinos.) Also, I got passed by a woman at least twenty years my senior, who, based on the fact that both knees were taped and she had a terrible gait, was running in a significant amount of pain. Hard to keep going after grandma limps by. The one lucky break? One of the top candidates for neighborhood gazelle joined the path quite a bit ahead of me, so she can keep saying with conviction that she’s sure I’m not that much slower than her. Nevertheless, I finished the run and was determined today would be a better day.  I had actually set up two running dates. First one got cancelled last minute because my partner’s dog hid one of her shoes. She never did find it! Second one cancelled due to that partner’s stomach bug. (Apparently, it’s not a great thing to be my running partner!) Thankfully, though, I powered through and went out solo. The music was great (thanks, Spotify!) and I spent some time thinking through a phone call I have later today.

So after a few false starts, I managed to make it a respectable week. What about you– how do you get your groove back and restart a cast off habit?

On Being Med-Free | Tamoxifen and Long Term Breast Cancer Treatment

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Forgive the old picture, but I don’t have any current pics of my meds.  Because I don’t have any meds.  Which is sort of a blessing and a curse.  It’s great that I don’t have to remember to fill a prescription and remember to take a daily pill.  It’s really great that I don’t have to deal with side effects.  What’s not so great, you may be wondering? I’m not actively doing anything to help prevent a recurrence.  If you know someone who’s had breast cancer and finished her treatment, odds are good that she’s taking a pill every day for the next five or ten years, and so it’s an obvious question to wonder why I’m not.

And this is where we go back to the science.  Remember when I explained about how my breast cancer is called triple negative? (Yep, if you look at that post, I used the same picture! Sorry!) Pathologists look at three main receptors when classifying breast tumors: ER, PR, and HER2.  Since my tumor didn’t have any of the three, I am considered “triple negative.” Tumors that express ER or PR are considered hormone responsive, and they make up 60-70% of newly diagnosed breast cancer cases.  These tumors use estrogen to grow, which means that shutting down their ability to use estrogen can shut down tumor growth.  No tumor growth means your tumor won’t kill you.  Obviously, hormone-targeted therapies have made a significant impact in the management of hormone responsive tumors.  There are several ways to manage hormone responsive tumors long term.  Tamoxifen is the most commonly known, and it acts as an anti-estrogen in the breast and effectively shuts down estrogen signalling.  Other drugs (raloxifene, toremifene, and fulvestrant) work in a similar manner.  Aromatase inhibitors halt the production of estrogen (letrozole, anastrazole, and exemestane) and can also be used to starve the tumor of estrogen.  (Fun fact– a woman’s body uses testosterone to make estrogen using an enzyme called an aromatase, so aromatase inhibitors prevent that conversion).  In premenopausal women, ovarian ablation (with drugs like gosserelin or leuprolide) can be used in conjunction with aromatase inhibitors, and have recently been shown to be very effective.  These treatment regimens are long term– five years used to be the standard, now some studies indicate ten years is even better– and are not always tolerated well.  Like any treatment, some women don’t have many side effects, but for some women, the treatment causes significant quality of life issues leading them to choose to stop treatment.  (This is certainly not a decision to be made without talking to your doctor! I’m just saying that it happens, good or bad…) Most women deal with some side effects that fall into the undesirable category, but are considered a reasonable trade off for the reduction in risk of recurrence.

All of that is to say that at least 60-70% of women treated for breast cancer benefit from long term hormonal treatment.  But for those of us without hormone responsive tumors, there is no reason to take the meds.  Our tumors don’t use the estrogen, so blocking it won’t help us.  And herein lies the blessing and the curse.  I don’t have to take daily meds and deal with the side effects, which is awesome.  But I’m also left in the position where there is no medication that I can take that will reduce my risk of recurrence, and that’s a little less awesome.  I’m just going to count on the fact that the chemo did its job and keep running, running, running.  (I do wish it would warm up, though.  It’s a little cold and icy to enjoy running right now!) I can’t take tamoxifen to help me, but exercise has been shown to reduce recurrence risk.  And so I will run.  As one triple-negative friend put it: “Running is my tamoxifen.”

For a more complete discussion on hormonal therapy for breast cancer, check out what this fact sheet from NCI (National Cancer Institute).  It’s complete and not overly technical.