What Athletes Should Know About Cancer Part 2

If you're coming here from Amy's blog, welcome! This is part two of the two part blogpost on athletes and cancer.

Know how to support someone who is diagnosed

For an athlete diagnosed with cancer, the decision to tell others is difficult. They are afraid enough for their life, not to mention losing their friends, their sport, and their social network around it.
When they tell, the lay experts come out of the woodwork like termites- suddenly everyone becomes an armchair oncology expert, especially when it comes to nutrition. Resist the urge.

Don’ts
1. Don’t tell them about alternative treatments that you’ve heard of, or that you read somewhere about a study that showed some type of special juice cured cancer. Their LIFE is at stake here. If we knew the juice cured cancer, we’d all be drinking it.
2. Don’t imply that they did something to cause their cancer. Don’t try to figure out why. You’ll come off as contemptful or judgmental, not to mention what this does to your friend with cancer who is already overwhelmed.
3. Don’t freak out, look up statistics on their type of cancer, or give them information off the Internet. Let their doctors practice medicine and do what they do best- treat cancer. It might be hard to put yourself in their shoes, but try. If you had cancer, wouldn’t you want to choose the treatment that had the most evidence for success and rely on experts who have been trained specifically in treating cancer?
4. Don’t make assumptions, no matter how well-meaning you are, that they can “beat” cancer, tell them they are a “fighter”. Some people don’t want to hear this. If they do, then great, give them the support they want. Ask them what they want.
5. If someone is being treated for cancer, don’t recommend supplements or antioxidants to them. The chemotherapy is intended to kill cells. That’s what you want to do in the case of cancer. You want oxidative stress and free radicals. Otherwise you’re counteracting the chemotherapy.
6. If they are getting chemo, don’t give them fresh fruits or vegetables, fresh flowers or plants, expose them to pets or sick kids, and avoid going to see them if you’re sick. Their immune system is going to be weak until after they recover from chemo. This is not the time to bring them kale and chia smoothies unless their cancer doctors say it’s okay.

Dos
1. Go here and click on the body parts to get some basic tips on supporting someone with cancer.
2. If you’re finding yourself so freaked out by your friend who has cancer, examine your own reasons for your freak out. Do you have some of your own issues that are unresolved? Maybe this is a chance for you to get some counseling for yourself so you can give better support to the person with cancer.
3. Remember, it’s not about you. THEY have cancer, not you. You have your health. Use the abundant energy that you were blessed with to help them. Do some footwork, offer to do laundry, errands, things they don’t have the energy for. Walk the dog, clean the yard, shovel snow. Use some of your own precious training time to do something for them. That shows you care.

If you are diagnosed- it doesn’t automatically mean the end of your athletic career.

1. First, you’re going to panic. That’s normal. But I’m going to tell you this, as hard as it is, as an athlete, you need to take your lifestyle into consideration when talking with your doctors.
2. Even though your first impulse might be: “Cut it out of me and get it over with!”, what you do and how you approach surgery and treatment decisions can make a big impact on your ability to recover and resume your sport, and your comfort in doing so. Take your time, it will be worth it in the long run.
3. Don’t be pressured into choosing any one method of treatment. Make sure you ask the doctor how it will impact participation in your sport, and at the level you hope to achieve. Get a second opinion if you’re not convinced it’s right for you. If you can find a doctor who is an athlete, that’s even better.
4. Cancer is very rarely an immediate life-threatening emergency. You should take the time to discuss any decisions with your oncologists, breast surgeons, urologist, plastic surgeons, radiation oncologist, or anyone else in your care. For example: certain reconstruction methods may be better for some athletes than others. If you use your upper body a lot in your sport, make sure your doctor understands how important your sport is to you.
5. The way they approach radiation treatment, which chemotherapy they use, the type of surgery, and any reconstruction can make an impact on your ability to return to and recover your ability to do your sport. Prostate cancer treatments can also impact your comfort in returning to running and other activities.
6. Depending on what type of cancer it is, you might need some combination of surgery, chemotherapy, radiation, or other treatments. It’s not easy, it’s not fun, and it takes time. Athletes are known for not giving up, for having endurance, and believing in themselves. You can use these mental skills in coping with cancer treatment and recovery, plus the determination to come back.
7. Athletes also start out in better health than most patients giving them an edge. They are also more likely to be able to continue some form of exercise during treatment, which helps them throughout the process and in recovering faster.

It’s not over when it’s over, so don’t forget support afterwards

1. After cancer treatment it can take a lot of time and effort to recover. While athletes have an advantage, there is still a lot of physical, emotional, and even social recovery for athletes with cancer.
2. After treatment they have to regain their strength and fitness. They might be anemic, have lost muscle mass, or range of motion. They can feel abandoned by their workout buddies. Remember them. Don’t let your own athletic goals get in the way of being a friend to them. Make time even if it’s not in a workout, or offer to do an easy workout with them.
3. Don’t expect them to jump right back into racing and training. It can take a while, but often, they can come back, and sometimes, stronger than ever.

Cancer Harbors is an online service that is designed for people after cancer treatment, as a guide to recovering. It has special material and support for athletes with cancer, to help them physically and psychologically recover their strength and confidence. Emotional and social support, with coaching and guidance. It is for anyone, including non-athletes, who need help in the anxiety-filled year after they leave their cancer doctors behind. It’s a thoughtful way to support a friend who is going through cancer treatment, to give them the edge in recovering and getting back to the sport they love. It’s also a great way to learn more about cancer in general. To find out how to give a gift of Cancer Harbors, visit here.

What Athletes Should Know About Cancer Part 1

Athletes are great examples to others. We take care of our health better than most, we get plenty of physical activity, don’t gain unhealthy amounts of weight, tend to balance our lives, and have more positive attitudes.

We go outdoors, have more energy, and avoid unhealthy habits like sitting in front of the TV eating garbage. We set goals and achieve them, see the country and the world, and know how to have a good time.

When I’m not running, I’m an oncology nurse and cancer recovery coach. If I had a dollar for every time I’ve heard from a patient diagnosed with cancer, “I don’t understand how I got cancer. I ate organic foods, had a perfect diet, exercised, never smoked, avoided toxins, managed my stress...why did this happen to me?”… all those dollars would do wonders for my race bucket list.

The truth is, based on our current state of scientific understanding, we cannot absolutely prevent most cancers. Certainly there is a ton of evidence that exercise and healthy living can prevent chronic disease and make you more likely to live a healthier life and be more independent into old age.

I’m not saying it’s futile, or you should give up, sit on the couch and eat trash out of bag until you roll onto the floor in a sugar coma. I do want you to understand that being an athlete will not absolutely protect you.

We don’t do a very good job of educating the public about a disease that is likely to strike somewhere between one-third and one-half of us during our lifetimes. There’s a lot of misinformation, and that can lead to completely over-the-top, irrational fear.

What cancer is

Cancer is a wide range of diseases with a common characteristic: something goes wrong in the way the cells regulate growth, and results in uncontrolled cell growth. It happens at the molecular level, in the cell’s genetic material.

Cancer is not one disease, so there is no such thing as a single cure for cancer.

There are hundreds of different varieties of cancer, they all behave differently. That’s why they are all treated differently. What one person gets for cancer treatment can be completely different than what another person gets for cancer, even if their cancers started in the same part of the body.

Many people still equate cancer with death, and our society is in extreme denial when it comes to facing our mortality. Athletes often trick themselves into thinking their sport will give them immunity. Sorry to break the news, but your running shoes won’t protect you.

But the good news is, athletes are gifted with qualities that will often help them get through treatment and recover in a lot better shape than non-athletes. Determination, endurance, positive attitude, willingness to tolerate discomfort, and overall physical fitness are key qualities in achieving good outcomes during and after cancer treatment.

Fear and Judgment

Anyone can develop cancer, and it doesn’t mean you did something wrong. From what we know now, evidence seems to show that other than hereditary risk (mutations passed down in your family), and certain exposures and behaviors we know that are associated with cancer (like asbestos, smoking), it’s unpredictable. The older you get, the more likely it is that you will have it, and you might not even know it. Sometimes you might not even have to do anything about it and it won’t kill you.

Cancer does kill people, but not nearly as often as it used to. Sometimes it’s bad luck- some people’s cancers are undetectable until a very late stage. Don’t assume it’s the person’s fault for not getting screened. It’s important not to judge.

No one is saying you shouldn’t fear something that is potentially life-threatening. But a little knowledge goes a long way- in terms of early detection, managing anxiety, and coping in case it does happen to you or someone you care about.

Cancer concepts and misconceptions

1. Prevention. People confuse screening and early detection efforts with prevention. You really can’t completely prevent most cancers. Mammograms, pap smears, and colonoscopies don’t prevent cancer. They screen for it in hopes that it will be detected early enough to be treatable. By taking care of yourself, eating right and exercising, what you are really doing is reducing the risk, or likelihood, that you will develop cancer. Risk is based on statistics in the general population.
2. Early detection and screening. Squeamish is no excuse. Suck it up and get a colonoscopy. Don’t be so vain…believe me, they’ve seen plenty of butts, yours is no big deal. I promise you they won’t remember what yours looked like, even if you run into your doctor on the street.
3. Know your family history. If anyone in your family has cancer, let your doctor know. This is reason enough to make sure you do your screenings. If several people in your family have cancer, ask your doctor about genetic counseling. Really. It doesn’t hurt one bit and it might save your life or someone else’s in your family. (Counseling first, never jump into testing)
4. Learn about it- from the right sources. The National Cancer Institute (NCI) is a good place to start http://cancer.gov Don’t ask Dr. Google.
5. Use caution when reading online or ads. Here’s a great place to visit if you have questions about a study or claim you read: http://healthnewsreview.org Anything that says, “a study” showed… One study is not a body of evidence. Studies need to be repeated, on large numbers of people, put through rigorous trials on humans under strict conditions, study conditions and findings examined for bias by experts, and published in peer-reviewed scientific journals.

On to Part Two...

Like, Totally Tubular, Dude...

It's super hot outside today. We suddenly got this blast of warm air and a hot breeze along with it. I woke up at 3:15 am. Why, I don't know. But after trying to go back to sleep unsuccessfully, I decided to get up and get my run in. I wanted to get 15 miles with a tempo run of 5 miles, so I made coffee, and headed out to the Power Trail just as the light was filling the sky.

I have been working on more business stuff today. I finished the practice display for my booth at this weekend's Pink Boa 5K.

I am staying plenty busy, it seems like each week I look ahead at the following week and the calendar is clear, but by the end of a week, the coming week is jam-packed. That's a good thing. I will be ready for a break in July when I escape to Badwater and then later in the summer when we go to Manhattan Beach.

This morning I started out slow and stiff but after a few miles I was feeling good, so I proceeded south along the Power Trail and got a hair over 5 miles in 39 minutes and change, just under 8 minute pace again. I did 11.2 miles, so I need another 4 or so.

I need to finish running easy this afternoon so I'm waiting for the temperature to peak in the 90s, I need that heat training.

The neighbors behind us are replacing the fence between their yard and ours so I'm having to keep the girls in today, which is fine because they wouldn't want to be out in the heat.

I finally took a break and got some food, ate, and decided to check the mail. All junk, except for one thing.

The colonoscopy report.

I didn't get any phone calls, so that's a good thing. I had that little flutter of dread and fear in my gut that I always have after a mammogram, regardless. I opened the letter, hoping it would say, cleared for 10 years.

Denied!

Dammit. But I am still off the hook for 5 years. As long as I have no symptoms, that is.

The little polyp they removed was a tubular adenoma, those are the most common type of polyp, and they do have the potential to become cancerous. But it's out of me, and I can continue doing what I do, and eat lots of fiber, and go back in 5 years and hope there are no more polyps. They say that these polyps are more likely to be trouble if they grow to 2 cm or more. My little polyp (and I say that affectionately) was 4 mm.

This just confirms the importance of getting these screenings done. If that polyp was in there, and who knows how long it has been, and I didn't know about it, even at 4 millimeters, who knows how long it might take to grow to 2 cm, or larger. Who knows how long it might take to develop into cancer?

I could be walking around with colon cancer in a few years if the right set of cellular or molecular circumstances or triggers happened. Or maybe not. But I'm glad that thing is out of me, cute little polyp that it was, maybe I should give it a name. If it, or another one of it's buddies, wants to cause trouble, it will have to start from scratch.

As much as I found drinking the magnesium citrate to be the worst part of the whole experience, even worse than pooping a gazillion times in 12 hours, worse than having an impossibly sore butt for several days, I would gladly do it again in 5 years if it means I get to avoid colon cancer.

And it's another reason why YOU should not put off screening. Done with my public service announcement soapbox.

Back to running, I am planning to run with two different friends tomorrow, I should get lots of miles in. I run with Emma first thing in the morning and then with Cat at 9. I can still feel those hills from Horsetooth last weekend. The soreness is almost gone but it sucks to get out of the habit of doing hills. Next time I'll do some Rock Repeats, hopefully no rattlesnakes.

Time to go out and run. It is officially 90 degrees.

Done and Sparkling Clean...

You have GOT to experience this!

Anyone over 50 still hesitating on getting their colonoscopy done, I chicked you.

Yes the prep sucks. But the procedure itself, no problem.

I was scheduled for a 1 pm procedure and they told me to check in at noon. We planned for Morgan to pick me up at 11:45. She lives on the north side of town, and of course the noon train that goes along Vine Street held up traffic. I got a frantic text from her telling me she was stuck behind the train. I wrote back, no worries. It's fine.

Iris was pissed off all morning, She sat at the bottom of the stairs, giving me that look...the guilt look.

Morgan got here just a few minutes after noon and we arrived at the surgery center at 12:08. As it turned out, they were running behind too, so we sat out in the waiting area, talking, until after 1:00 when they took me back.

They weighed me and took me to a little prep area with a chair, gurney and curtain. They asked me a gazillion questions about allergies and then I changed into a gown. The nurse came back in and started my IV, and as we talked, I found out she works with one of my old coworkers. She did a good job with my IV, one poke, and started running some fluid into me, which was great because I was so dehydrated.

I waited for a while and then the anesthesiologist came in and talked with me, asked more questions, and then I asked him some questions about propofol.

One of the nurses I used to work with was there but she wasn't assigned to me, but I asked her to stop by so we talked for a little while, she seems a lot happier there at the surgery center. Later it turned out she was my recovery nurse.

The doctor came by and apologized for running behind, I didn't get taken into the procedure room until about 2 pm, but it seemed like the time went by fast.

When the nurse anesthetist came in, I knew we would be going soon. He asked me more questions and then wheeled me down to the room. He hooked me up to the monitor and put a nasal cannula on me. The doctor came over and talked with me, had me sign the consent, I rolled onto my left side and then the nurse anesthetist told me he would give me some lidocaine first to numb the vein because the propofol burns going in. I saw him attach the lidocaine, then I saw him attach the little syringe filled with the milky propofol. I said, "Good night" and watched his fingers push the syringe. Suddenly everything went fuzzy and gray, and that was it.

Next thing I knew, they were waking me up in the recovery area. The nurse brought me some crackers and juice, and once I was awake enough, she brought Morgan in.

I had a good prep, my colon was really clean. Damn, it should be! They did find one small (4 millimeter) polyp that the doctor said appeared benign and of course they completely removed it and send it off to pathology, so I won't have the results for a week or so. But everything else was perfectly clean and smooth. I got pictures, too.

It was amazing how fast I recovered and felt lucid. I got up with the nurse standing next to me to make sure I wouldn't fall over, and then I got dressed, she took out my IV, and I was sprung. Morgan drove me home and I came in the house to a vocal Buffalo greeting, and after hugs, headed for the food. I scarfed. I was so hungry. Then I took a shower.

Soon Dennis came home and we ate more.

I am hoping that the pathology results allow me to not have to come back for 10 years. I don't want to do this prep again anytime soon, and 5 years goes by FAST. But it was only the prep that is dreadful, not the colonoscopy itself. Someone has got to come up with a better way to clean out your gut.

Beer flavored laxative...you'd think one of the local breweries would get on that already...Fort Collins is the ideal place for that to happen. I can just see it now: New Belgium selling six packs of colonoscopy prep beer. What would we name it? Gut blaster? Butt blaster? Roto RootBeer?

I need a ton of sleep and probably a lot of fluids, and I'll be ready to go before the weekend. Looking forward to next week, hitting the speed again with Wheaties Boy.

This has been a public service announcement from Alene Gone Bad.

We now resume our regularly scheduled programming...

Word of Mouth: Top to Bottom

I have started running again, just a little. I've been working on doing about 8 to 10 miles on my feet each day, some dog walking, and then running small amounts. I feel great when I run. I'm a little slow but my legs don't feel bad. Yesterday I did 5 miles and wanted to keep going but stopped myself. The plan is 20 miles this week, 40 next, and see how it goes from there.

I plan to run the Houska Houska on May 26, which is a fun 5K. That week I will also do my first speed session again. I'm not going to push hard, it will just be interesting to see where I am 3 or 4 weeks post-race. And as of the first week of June I'd like to be back into training for this fall. I can't wait to get going again!

So the rest of this post is my public service announcement. If you're squeamish and can't bring yourself to put your big boy or big girl panties on, then by all means, move on to another post. If you think it's TMI, then I'm calling you a wimp.

I'm a 50 year old athlete, I run ultras, I've been mostly healthy all my life. I hope to continue that way. Some things you just never know if they're going to happen, but to the extent that you can prevent some awful thing from happening, I think you should. My opinion on this, and you might not agree, is that you have a social responsibility to control health care costs in your own life for the benefit of society in general.

By avoiding preventive care, your chances of having a serious health condition that needs expensive and drawn-out treatment result in increased costs that are spread to everyone. That's not fair. I'm not saying that everything can be detected early, because it can't. And no test, no screening procedure is ever fool-proof and 100% accurate.

Yes there are many tumors that go undetected, some cancers that often can't be caught early like pancreatic and ovarian, and I can't even tell you the number of women who had a mammogram come out "normal" and then within a short period of time later, found a lump that was beyond stage I. But those are generally the exceptions.

And if you are diagnosed with cancer or some chronic disease, it is not your fault (almost never! the exception would be if you willfully and knowingly allowed it to progress and then decided to wait to obtain treatment) and you deserve the best care that is available to restore your health, regardless of where you fall on the socioeconomic ladder. Knowledge is power and I am just saying that you have a responsibility to your fellow citizens not to bury your head in the sand if you have the knowledge and are able to access preventive care.

Having seen and administered the treatment for many types of cancer, I can tell you almost without exception, you are much better off detecting a disease, especially cancer, early, because the outcome and treatment are so much more favorable.

Yesterday I had an appointment with a dermatologist to check out my skin and lips because at my checkup this spring my dentist thought I had some sun damage on my lower lip that should be looked at. The dermatologist thought things looked pretty good, and advised against freezing off the few small spots on my cheeks, nose, and upper lip that are little pre-cancers until later on in the year, when I'm not having so much sun exposure, because it would leave white scars right now.

There were a few little rough spots on the edge of my upper lip, again, not too concerning, these are tiny little precancer areas. And the area of my lower lip that the dentist was concerned about, the dermatologist felt that there was nothing concerning at all there.

So I took care of the top half as far as cancer surveillance. Went to the dermatologist, had my mammogram, and now the not as much fun part: I scheduled the Roto-Rooter for the last week of May.

As an oncology nurse, I have to set a good example for readers. So I'm writing about colonoscopies. This won't be the last post, either. This is the PRE-colonoscopy blogpost. There might be a during the prep blogpost if I can get away from the can long enough, and yes I promise you I will wash my hands before I come back to the computer, there will be no virtual spread of disease and E. coli by reading my blog...and I also promise you, there will most definitely be a post-colonoscopy blogpost even though I anticipate I will have no memory of the entire procedure.

My intention is not to post graphic pictures or gross you out. The appearance of my inferior-most orifice will remain a secret between me and the gastroenterologist. But as far as the details of the procedure, if you're freaked out by the "EW" factor, then it's time to re-condition yourself.

I didn't get to have the colonoscopy appointment as soon as I wanted to, but I got it a week later, and still in May, with the doctor I wanted, so I'm content with that.

I wanted to get it done before Memorial Day because I want to return to full training but one more week won't hurt anything. I'm a little concerned about getting the anesthetic out of my system. They use propofol (yes that's the Michael Jackson drug) and from what I can tell about the pharmacokinetics (how the drug works, moves through your body, and is eliminated) it looks like it will be a good 48 hours before it's cleared. Until that time is over I'm not taking any chances. Two years ago when Dennis had his colonoscopy he broke his foot the day after, by slipping off the stairs. I'm convinced it happened because he was still affected by the propofol.

It kind of freaks me out to have them putting propofol in my system. We used that all the time for sedation for patients on ventilators in ICU. It's pretty freaky stuff. It wears off quickly, and it's this thick milky-looking liquid. I don't want it in my body. That is more of an issue for me than the scope itself. But I also know I don't want to be aware of or remember what they're doing with the endoscope, so I'll compromise.

What are the biggest fears people have around getting a colonoscopy that keeps them from doing it?

1. Embarrassment: exposing your butt hole to other people. Seriously. Everybody has one. (Some more than others)

Believe me, I don't remember the faces or other parts of any of the patients I ever was present with during their scope, and there were a lot. Even less so with your doctor, they do these day in and day out, they are busy watching the video screen of the inside of your colon, not paying attention to any personalized markings on your body. You won't run into your gastroenterologist in the grocery store and they'll think...oh yeah that was the one with the hairy butthole...

Now if you have a tattoo on your right butt cheek that says "Scope Me" or has the doctor's name, well, maybe they would remember that...but the room is dark so they might not even see it.

As far as the outside parts go, seen one, seen 'em all. Some have hemorrhoids, some don't. Unless you tattoo your hemorrhoids, they won't remember. That's about it...

What if you pass gas during the procedure? You might, but it's more likely to do that afterwards. But you'll be in your little recovery area and everyone else is out of it with anesthesia too. They won't know where it's coming from. Sort of like farting in a crowded, loud room full of people. And during the procedure, there is noise in the room and they aren't very close to the offending part anyway, they are focused on moving the scope and the video screen. You won't know, and won't remember. Everyone farts, you, your dog, your grandmother. Even gastroenterologists fart.

2. Afraid of pain: It's highly unlikely that it will be painful unless you already have some sort of serious GI disorder, and in that case they would medicate you. You will be lightly sedated, and the doctor can even talk to you during the procedure. Afterwards you will not remember it. But you will be able to let the doctor know during the procedure if you're having any pain. They can give pain medication if necessary, but usually it is not needed.

3. Afraid they'll find "something": If they find a polyp, they will remove it during the procedure. You won't even know. They'll slip this little wire around it and cut it off, take it out and send it off to the pathologist. It's done. Most of the time the polyps are benign and if they are suspicious, the nice thing is that they are out of there. Unless they find a major tumor, they are not likely to have to do anything else.

Sometimes they find a polyp that upon examination by a pathologist, needs to be followed up on with a repeat colonoscopy in 5 years, instead of 10 years. But since they took it out already, at least you have the peace of mind knowing that you've stopped the growth of a potential cancer and set it back. That alone is better than not knowing there is something growing in there, and finding it when it's already spread.

Wouldn't you rather know that you had a precancerous polyp removed and out of your body? At least you'll know you can do something about it in the future. And you'll know that the colonoscopy procedure wasn't that bad. It's a lot easier than waiting until there's a huge tumor that has spread to your liver and you need chemotherapy and surgery and possibly living afterwards with a colostomy bag attached to your abdomen. Believe me, a quick colonoscopy that you won't even remember is much more favorable.

4. Fear of complications: Unless you are in poor health, have advanced cancer, or already have some kind of advanced GI tract disease, it is very unlikely that anything can go wrong in a healthy colon. The scopes don't have sharp edges, the little tools they use are retracted inside the endoscope, and they are watching the entire procedure on video the whole time.

The doc I chose is one I actually know, and have conversations with if I run into him somewhere in the hallway or in town, and I know his wife too. But I feel totally comfortable because I've worked with him doing the procedure before and I know he does a thorough job. He's got a nice personality and you feel at ease around him. I won't be freaked out after the procedure if I run into him in the grocery store.

So that's my public service announcement for the day. I admit that yes I do feel a little icky about it. It's not something I look forward to. But I also know that it's better to get it over with, so I'm looking forward to being done.

The important thing to remember, other than GET YOUR COLONOSCOPY is, make sure you choose a doctor whose name you haven't tattooed on your butt.

Just Say No to the Taper Worm...

The taper is going as well as can be expected. I've been busy with work and other things so it's a welcome distraction from feeling like I need to bounce off the ceiling.

We took a trip up to the cabin this weekend to clear stuff out. We've decided to sell it, we aren't using it enough. We took the girls, they got a chance to hang out at their cabin hopefully before it sells. It's one of those "taper projects".

Iris knows where she is, as soon as we get over Kenosha Pass, she always goes crazy. We think it's the smell of cows, but it could be the scenery. This time there were no cows, probably too early for them to be grazing out there since the snow is not completely gone. As soon as we dropped down into South Park, she started getting excited.

On the way back the girls had to ride with all the junk we brought back from the cabin.

I was greeted by this nice piece of mail when I got home. One of those nice things about turning 50. Thanks for the pleasant reminder. Talk about the ultimate taper worm! I will have this done sometime this year, but I'm putting it off until AFTER the race.

Relentless Forward...

Motion.

photo credit: Kristi Mayo/mile 90 photography

I felt remarkably good after the race. Driving home was the hardest part, getting stiff driving the 10 hours home. But it was peaceful driving across Kansas, and I got a chance to do some thinking about my upcoming week. Lots of appointments, both business and personal, this week. I need to get a lot done, as next week is a big training week for me, planning on a lot of miles, my last chance for a high mileage week before Cornbelt.

I did have some swelling in my left ankle on Sunday night after the drive. I put ice on it and it had a chance to be elevated all night as I slept. I rode the bike for 2 hours Monday and then Tuesday was such a busy day I skipped my workout all together, not on purpose, either. I was just too busy. I ran 12 miles today and felt great. I don't feel like I ran a hard effort 4 days ago. We'll see what happens Friday, I'm supposed to get up and run speedwork with Wheaties Boy at 4:30 am. That's when he always runs these days, and it's why I haven't been running with him. But I need to.

I woke up this morning at 3 and could not get back to sleep, finally at 4 I just got up and started working. I had a busy day and hoped to take a nap if I got things done, but no luck. I kept getting things piled on. It was okay though.

It was a weird day all around. The weather was strange, somewhere between sunny and cold and cloudy, then rain. And I kept inadvertently running into people I needed to run into. Taking care of loose ends, without even trying. I guess the universe was helping me out today.

I had my annual appointment with the boob smasher at noon, I'm hoping that all goes well. I should find out in a week. I'll try not to worry and forget about it. I also went to the dentist before that to get my teeth cleaned. I do all the torture things together in one day and get them over with.

When I was at the dentist he noticed something about my lower lip- that it's got sun damage and he thinks it looks different than when I was there six months ago. He recommended I see a dermatologist. I'm not surprised, with all the years I've been out in the sun, and how hard it is to keep sunscreen on your lips. So I will do that, I need to get a referral for my insurance. I can just see them having to scrape off layers of my lower lip or something awful. But I'd rather get it taken care of now, get it over with, whatever I need to do, if anything.

Speaking of fun things, this year is the year for my first colonoscopy too. I'm putting that off until after Cornbelt though. I really don't want to do that either. I kept hoping they'd have a less invasive method by the time I turned 50, but no luck. I was also hoping they'd change the screening guidelines to age 55 for women. But no luck there either. With a family history of several different cancers, I need to stay on top of this screening stuff.

I'm just plugging away, each day, doing a few errands that take me in the direction of where I need to be. Some days I'm flying, some days my feet are stuck in cement. Even on the days I feel stuck, I'm still moving forward. But as long as I'm running, I'll be okay.

Fat Tax

Happiness is priceless, and so is good health.

Recently I was running with someone who told me about his family history of cancer. Because of his high risk status, he had his first colonoscopy at age 40. Everything was okay so he ignored the doctor's advice to repeat it in 5 years. After one of his friends died from colon cancer as a result of it being detected too late, he went for another colonoscopy. That time, the gastroenterologist found several pre-cancerous polyps and removed them. He gets regular colonscopies now and is aware of just how risky it would be to miss one.

No matter how healthy we try to be, no one is immune to cancer. Or if anyone is, we don't know about it and haven't figured out what genetic mechanism gives them immunity. There are a lot of things we can do to prevent cancer, or detect it before it becomes invasive.

All around us there are bad influences on our behavior. Advertising is a huge influence. Back in the days when cigarette smoking was glamorized, and there were no warning labels or high taxes on tobacco products, a higher proportion of people smoked.

I'm going to preface the remainder of this post with this warning: The Surgeon General has determined that reading this post will make people with a certain political philosophy apoplectic. Not a political party, but specifically, the anti-tax, anti-government mindset. Not naming names here, because it's not fair to generalize. But you individuals know who you are. You speak Palinese. (Sorry, let that slip out, I must have eaten too many beans last night)

You hear the word "tax" or "government", and you poop your pants. So if you're that much of a "Red" blooded American, take your Xanax now, put your diaper on, pop that mask on and crank up the oxygen, and strap yourself into the autopulse, 'cause you're gonna need it if you keep reading. I can think of a certain politician running a losing campaign for the Republican nomination who would have ear steam launching his big fat head up into space by the end of this post.

I get mad when I see people do stupid things that affect large numbers of people in a bad way. I've tried to stay away from politics but I also want to eradicate apathy. Running, any type of exercise, as well as health promotion, is political in our current state of obeseification. People need fresh air and aerobic activity, pumping blood with oxygen through your body helps your brain, heart, lungs, muscles, and every cell in your body.

If we don't start controlling advertising and marketing of all this bad stuff, young people are going to start out their adult lives with chronic diseases that will reduce their quality of life and years of healthy living. Not to mention making health care costs unmanageable.

I think we need more warning labels and fat taxes. I think we should tax television and bad food, to start. Electronic gadgets and TVs should come with a warning label: Too many hours of sitting on your butt watching this object can lead to obesity and premature death. Cell phones should come with a warning label: Use of this object can lead to sore neck muscles, obesity, motor vehicle accidents, traumatic injuries and premature death. Soda and snack foods: Too much intake of this product can lead to obesity, diabetes, cardiovascular disease, cancer, and premature death. Schools without physical education: The Surgeon General has determined that attendance at this school may cause obesity, diabetes, and early cardiovascular disease.

I don't watch television, but I catch snippets of it while I'm working, usually as I'm flushing someone's PICC line at work, they have the little TVs on while they sit and get their infusions. The advertisements for cars, especially big 4 wheel drive pickups, always show people driving a little too aggressively, just a bit too fast. So people think that is how they are supposed to drive on the streets, and through neighborhoods where the speed limit is 25 mph and there are young kids who play outside. Add a cell phone to that and you have a disaster waiting to happen.

I happen to love the idea of taxes to discourage people from spending money on things that are bad for them and drive health care costs upward. Cigarette taxes are great. But we should tax bad food at the same rate. You know the CEO of Nabisco or Kraft Foods doesn't have to lay out nearly as high a percentage of his or her income on health care as the average working person does. They are raking in the bucks from unregulated gluttony.

Every time you take a bite of those chocolate covered Oreo cookies or Ritz crackers, you are not only buying someone's next vacation home, you're also reserving yourself a future place in the dialysis unit, cardiac cath lab, or chemotherapy chair. And when health care costs and insurance premiums rise because of higher rates of diabetes, cardiovascular disease, and cancer, the average working person feels it a lot more. Fat is metabolically active tissue, it produces hormones like estrogen that can promote cancer growth. Insulin and insulin-like growth factor-1 are cancer promoters. Sugar causes us to release insulin. Obesity and metabolic syndrome can lead to insulin resistance, resulting in high levels of insulin in the blood.

And guess what? The CEOs of drug companies will be all too happy to take your money on the far end, too. And if they don't make enough profit off the drug you need, they might just stop making it (e.g. the current methotrexate shortage for treating leukemia in children, who didn't even have enough time to develop bad habits that contribute to cancer development over a lifetime). You don't think that's important? Go see Gab. I wonder what would happen if the drug company executives' children had cancer.

I don't know if my readers are aware, but there are quite a few serious drug shortages going on right now, for various reasons (e.g. "manufacturing and quality concerns") but mostly they seem to be coming down to greed. If the drug companies would invest instead of cutting back in these areas, there wouldn't be an issue.

Government regulation does help to prevent bad behavors from being promoted. People need real food and real exercise. People don't know about the benefits unless they are taught. Government is great at health promotion and education efforts. Efforts to prevent taxes and warning labels, and actions that strangle government across the board end up promoting greed. Greed is just another cancer, but it grows on our way of life. Look at the mess we're in, tell me that has nothing to do with greed.

Sounds like a job for a new government agency? The Bureau of Alcohol, Tobacco, Firearms, and Greed. Might want to get the U.N. involved, too.

Greed is a crime against humanity.