Sunday, July 25, 2021

A Good Day for Cancer?!

That spring day in 2007, when I first heard the word “carcinoma,”was memorable. Not just because of the diagnosis, but because of what happened after my appointment at Johns Hopkins. As I drove through Baltimore on my way home to Leesburg, Virginia, I came upon a horrible car accident. As the police directed me around the crash, paramedics were placing a sheet over the driver’s side of a mangled car. Someone was not going home.

Holy crap!” I thought, “That could me. At least with cancer I still have a chance.”

Then I remembered reading something that my running guru, Dr. George Sheehan, wrote about his cancer diagnosis. He was diagnosed with inoperable prostate cancer. His son, an endocrinologist, tried to reassure him, “People with prostate cancer usually die of something else.”

What his son said makes sense. Older people have other risks – heart disease from smoking, weakened blood vessels from untreated high blood pressure, diabetes from obesity. Many people die from heart attacks, strokes, and complications from diabetes.

But George decided right then and there: “I might die of prostate cancer, but I was certainly not going to die of anything else.” *

Likewise, I told myself, “I might die of breast cancer, but I certainly wasn’t going to die of anything else. What I can control, I will control.”

I chose the Sheehan approach. I kept running, had surgery, and worked with my medical team to help my body maintain an optimal state of health. Cancer was going to have to look elsewhere for help. I went about making myself the best body possible.

Was this a cure? No way. The idea of a cure leads many people to assume they are immortal, that they will live forever. Most people assume this. That’s why they smoke, don’t wear seat belts, skip a helmet while riding a bike, or drive after drinking a couple jumbo margaritas. Everyone thinks they are an exception, “It won’t happen to me. Death is a fact of life, but not in my life.”

listennotes.com

Twelve years after my surgery … I had an MRI which indicated one of my lymph nodes was “suspicious.” It could have been caused by anything, a cold, seasonal allergies or … “carcinoma.” My doctor suggested waiting a couple months and then repeating the MRI to see if there was any change. I agreed.

Then COVID came into our lives. On a spring day in 2020, my doctor called to cancel my repeat MRI. Mayo Clinic was canceling all procedures except for the most urgent and dire cases due to the COVID pandemic. “To be honest,” she said, “Your risk of death from COVID is much greater than from cancer. We will reschedule once we get a handle on this virus and can control its spread.”

How can I control my risk?” I asked her.

She answered, “Wear a mask, avoid groups of people – especially indoors, wash your hands, and continue exercising outdoors!”

Once again, I reminded myself, What I can control, I will control.”

carrienet.com

The word “carcinoma” is not a word anyone wants to hear. Many people describe the day of their cancer diagnosis as the worst day of their life. No one would choose to have cancer, nor to have their life put at risk. But if cancer or COVID or any other possibly life-threatening disease enters your life, remind yourself that you do have control of your response to the disease:

  • Will you accept the possibility that you might die or will you avoid thinking about that possibility and deny it exists?

  • Will you embrace your risk with a determination to exercise control over what you can control or will you downplay the importance of your life choices and decide to “just let what’s going to happen, happen?”

  • Will you actively engage with your doctors or will you ignore their advice because you think you “know better?”

Eventually I received both a mammogram and an MRI. The results were better than I expected, BI-RADS 1, meaning the image was “normal” and there is no evidence of a lesion or mass. This was good news as there is no obvious sign of cancer at the present time. So maybe I don’t need to have any more imaging studies? Oh, heck, no! I am in control of my appointments and my response is to continue with the scheduled MRIs as my doctor has advised me. Who knows what the results of my future MRIs or mammograms will be? No one. My best hope thirteen years ago was, and still is today, early detection. There is no vaccine to prevent hospitalization or death from breast cancer. The risk will always be present. It’s always there, sitting just outside the door. 

The word “carcinoma” may once again enter my life even though it appears I am “in the clear” – for now. I am aware of life’s fragility in a way I wasn’t before that memorable, “carcinoma” day. I control what I can by striving to take care of myself - my one, precious body and encourage others to do the same. Each morning I wake up excited, eager for what the day will bring. Every day is a “good” day when I simply reflect on the fact that I am still here.


* Sheehan, A. (2013). The essential Sheehan: a life time of running wisdom from the legendary Dr. George Sheehan. Rodale Books.

Thursday, July 15, 2021

That's Not Fair!

 
“That’s not fair!” 
“Yes, it is she broke the rules!”
We have been hearing those phrases a lot lately in the wake of the suspension and banning of several Olympic athletes. In fact, there is a list 15 pages long of banned athletes. Are all the suspensions and bans fair?
thesource.com

Sha’Carri Richardson won’t participate in the Olympics in the 100-meter race or the 4×100 relay. She was suspended for testing positive for a chemical found in marijuana. She smoked some marijuana after hearing of the death of her biological mother.

“Rules are rules,” and it appears Sha’Carri understands that. To her credit she did not give an excuse (blame someone or something else) for her bad choice but she did give a reason (explained her choice).

I want to take responsibility for my actions. I know what I did. I know what I'm supposed to do. I know what I'm allowed not to do, and I still made that decision.” - Sha’Carri Richardson 1

Marijuana does not enhance athletic performance. 2 So why the prohibition? Who is being “cheated” in this situation? 
 
 
Then there’s Caster Semenya, who was banned from running 400 - 1500 meter events in the 2021 Olympics because she did not meet hormone requirements. Caster is an intersex cisgender woman - her birth certificate says “female,” she was raised as a girl, but she has an XY chromosome. To compete again in her 2012 and 2016 Gold Medal event, the 800 meter, she was told that she would have to take testosterone suppressants, which she refused to do. 3
 
Obviously genetics and physical characteristics play a role in athletic ability. Olympic Gold Medalist swimmer Michael Phelps has a lung capacity that is twice that of a normal man. 4 Clearly, this gives him a competitive advantage, but is it unfair? Was he required to remove one of his lungs to “level the playing field” for the other swimmers? Where do we draw the line?
runnersworld.com

God made me the way I am, and I accept myself. I am who I am, and I'm proud of myself.” - Caster Semenya 5

In Caster’s case, she was penalized for something she had no control over, how she was born. She did not create her own body. Yet, she accepts her body, embraces it by being physically fit and active, and she addresses her situation in a way that honors her moral values - by declining to chemically alter her body. Is it fair to penalize her for how she was born or her choice NOT to ingest chemicals?

“But,” you might ask, "Isn’t it unfair to the other runners since Caster has a naturally higher level of testosterone?” Here is what Ajee Wilson, USA’s best 800 meter runner, has to say about Caster and “fairness.”

Throughout her career she ran in the shadow of Caster. Caster always won and Ajee consistently came in second. Once, after coming in second, again, Ajee was asked by a reporter, “Do you think it is good for the sport if Caster is allowed to run?’

Absolutely, I think she should be allowed to run,” answered Ajee

Another reporter asked a slightly different variation of the same question, to which Ajee, losing patience, replied, “I think everyone should be allowed to participate. I definitely think Caster should be allowed to to do what she loves.”

Then came, what I think is the most important question, “Do you think having her in the race helped push you?”

Ajee smiled and replied, “Absolutely!”

BINGO! The competitor in Ajee wanted Castor in the big races because the ultrarealist in Ajee cared more about getting the very most out of herself than about winning. And she was right to believe she was a better runner with Caster to vie against than without her.” 6
 

The reporters' questions and Ajee’s responses illustrate the two competing notions in sports that make the fairness debate so troublesome. First is the idea that the point of sports is the outcome — who wins and who loses. Winning is a fundamental part of sports competitions. Fans want to watch the best athletes perform. Sport competitions are BIG business. Everyone loves a winner and that’s why we have rules and everyone agrees to the same set of rules – in an attempt to create “fairness.”

The second notion is about “the journey” - everything leading up to the competition. Simply having the opportunity to train and compete creates “fairness.” Even recreational runners know that in order to better your performance you need to train no matter what genetics or physical characteristics you possess. The time, energy, and effort athletes must put in before a competition are worthy of our admiration. Putting worth your best effort is the most important aspect of sports, regardless of the outcome. 7

The tension exists, then, between whether we think sports are about the outcome ... or the journey - about winning ... or putting forth your best effort - about an individual achievement ... or a societal good. “Fairness” exists somewhere along this spectrum.

Finally, there was a time when "fairness" meant women could not run marathons, people with disabilities were excluded from sports, and professional sport teams were segregated. Now we are in a particular cultural moment which is redefining “fairness.” I have a feeling that rules will change and our concept of fairness will be reworked, once again.