When You Suffer From Post-Cancer Chronic Fatigue But Can Still Bust Out A 30 Minute 5K
Just because you suffer from post-cancer neuropathy and chronic fatigue issues, doesn’t mean you can’t push yourself and get out there and kick some ass. You’re looking at a guy who just a few years ago struggled to run more than 2-3 blocks at a time because of terrible chronic fatigue issues, now coasting into the finish line in 30 minutes in a 5K race, and feeling great while doing it!
Every day that I’ve woken up since cancer, and every moment I’m alive, I feel this low-grade burning and aching sensation throughout my body, and it’s because of the chemotherapy that I went through many years ago. Chemotherapy induced peripheral neuropathy (CIPN) be thy name, and my primary symptoms have always been chronic fatigue issues. It took me nearly two years after my cancer treatments to notice this, long after any pain from treatments and surgeries were gone, and basic physical rehab was completed, that this low grade aching and burning in my body was a “new normal” that wasn’t ever going to go away.
I had a choice of either BEPx3 or EPx4 chemotherapy for my Stage IIB good risk testicular cancer back in 2011. I was seen at Memorial Sloan Kettering Cancer Center in NYC, and was personally in favor of doing the RPLND if I needed one. MSKCC favors the EPx4, which also reduces some of the risk of doing the RPLND surgery because Bleomycin isn’t used, so that’s what I went with. But that extra round of Cisplatin exposure compared to BEPx3 really did a number on my entire nervous system, and there’s not a day that goes by that I don’t “feel the burn”. I’ve just gotten used to it, but long-term studies have shown that testicular cancer patients who do BEPx3 tend to have a lower cumulative burden of morbidity than EPx4 patients, with the extra exposure to Cisplatin being the primary culprit. BEPx3 patients also have a very slightly higher but statistically insignificant cure rate, but it’s always been within the margin for error, so the two protocols have been considered equivalent.
It’s water under the bridge to me at this point, but this is why I generally recommend the more universally accepted standard of BEPx3 for good risk testicular cancer patients, despite having done EPx4 myself. It’s literally a matter of picking your poisons, and with my luck I probably would have been one of the ones that made it into the medical studies with terrible side effects from the Bleomycin drug.
All that matters is that I’m here, so I have no regrets, and what’s done is done.
My Chronic Fatigue has Been a Long road that’s difficult to maintain
I’ve come a long ways. For my first few years after cancer I woke up everyday just happy to be alive, but never felt like I had anything more than a half tank of fuel for the entire day. I really suffered physically in the aftermath of cancer, and emotionally. I “looked fine” but it felt like I had aged several decades, and it was demoralizing barely being able to keep up with my young family. Only I could feel this, and I struggled physically for years.
Related: Running From Cancer
I refused to accept that this was how I was going to feel for the rest of my life, so I took up running and pushed myself hard. I could never run more than a few blocks at a time for years, but my body finally responded and “rebooted” itself, and I’ll never forget the day when the chains came off and I finally managed to do a 5K run in 30 minutes, and without even needing any walking breaks. I was so overwhelmed with joy that I wept for 30 minutes in my back yard and texted a bunch of friends who knew of my struggles all too well. I’ve never been a good runner and probably never will be, but in that moment I finally felt alive and like I had just discovered the fountain of youth, thanks to years of running and pushing myself hard.
Back in 2015, the day the chains finally came off and a day I’ll never forget!
Trying to keep myself in good physical condition has always been my weapon against my chronic fatigue issues, but it’s very much a damned if you do, damned if you don’t affair. If I don’t exercise regularly, I’ll fall out of shape and feel like total crap. My energy levels will plummet and a lot of other things can tend to go south. If I do exercise regularly, I’ll be exhausted from working out and pushing my limits. But regular exercise serves to push those limits outwards and helps me to feel better and like I have more energy on average throughout each day. It turns out that keeping my body in “30-minute 5K ready form” is a pretty good fitness baseline for the point at which I’ll feel like I have all the energy I need and almost like a normal person.
Now about maintaining that…
Life Always Seems to Get In The Way
Our lives over the past few years has been crazy and chaotic, with so many twists and turns. We’ve had to take on a disabled family member full-time who has special needs, had to move into a bigger home that needs a lot more upkeep and maintenance, and got a dog just for good measure. I’ve also never been busier at my job, and have never had to travel more for work than I have in recent years, all at the same time. It all adds up and really takes a toll, and also tends to obliterate any attempts at maintaining a fitness routine. The past few years have been a blur, and it’s so easy to completely fall out of exercise and fitness routines or just not exercise at all, but I can’t allow that to happen. Every time it’s the same thing. I’ll feel fine for a few months after not exercising, but eventually my body falls flat on its face, I have no energy, no libido, no nothing, and just feel like a miserable lump.
The first part of 2019 was a great example. Despite a strong start to the year with a great new gym opening just down the street from our home, between March and April I was so busy at work and having to travel so much that I didn’t even make it at all. Between urgent business trips to one place or another, and then back-to-back week long trade shows in different time zones, by the time this busy period was done my chronic fatigue set in so hard that I almost couldn’t move through most of the month of May. I’d never felt so awful in my life, but forced myself to get moving again.
5K RACE TRAINING
It’s been our tradition to make our first beach trip of the year on Father’s Day weekend. We go to Rehoboth Beach, DE, and one morning a few years ago we woke up and strolled outside to see runners everywhere and a 5K race going on! We had no idea, but I had been into running, and William was still pretty young but wanted to race too, so we decided we’d do it the next time we came.
That was last year, but it always seems to be the same thing. A crazy work and travel schedule, and hardly any time to train or get to the gym. In fact, last year around this time I had actually quit our previous gym because it was too expensive and never had time to make it! I had also been traveling so much for work that I’d actually developed bilateral ear infections, so ran last year’s Rehoboth Beach 5K still on antibiotics and a steroid pack, and could only hear out of one ear. William and I both ran in the 32 minute range, but little did I know William was a little sandbagger and had so much more than the pace we had trained at, so this year it was on. :)
My first training run in May was a not too bad 34:24, and then I followed it up with a 33:15, and a 31:31 that I was really pleased with, but then things went downhill with a 32:53. I was struggling and couldn’t progress at all.
Detox Your Life and Get Enough Rest
I came to realize that my body was totally hooked on caffeine and dysfunctional without it, so that was the first thing to go. It was painful, but I went with just water for a week. A disastrous 37:09 run during that time, along with another that I aborted after a mile, serves to illustrate just how powerful an effect caffeine addiction can have on us and how awful withdraw is, but I felt so much better afterwards. I also cleaned up my diet and cut out all of the junky foods, went with a high protein breakfast, and usually a homemade wedge salad or something non-carby for lunch. I’ve always had a low metabolism, and can typically skip dinner and be just fine so long as I eat properly and the right foods during the day. I kept getting into the gym, on the elliptical, on the fitness bike, into a few spin classes and the dreaded stair machine, and also did some weight training. Before I knew it, I was back in business with a much better 31:14 the week before our race that actually felt good to run, and like I had more.
Another thing you can’t overlook is getting enough sleep. Our bodies need rest, and mine especially does whether my chronic fatigue has been acting up or not. Between all of the business travel, bouncing between different time zones, eating terribly and almost literally living on caffeine, and more than one hotel bed that was just plain rotten, massively disrupted sleep patterns and not enough rest was probably the biggest single contributor to my chronic fatigue meltdown the month after all of this craziness.
If you’ve just been through cancer treatments, don’t underestimate how much sleep you might actually need - I needed 9-10 hours per night my first few years after cancer! Turn the TV/computer/phone off, put the books down, and just rest. Even today, I can’t do the 6-7 hours of sleep per night that I could when I was younger, and before cancer. A solid 8-9 hours is what I need, and anything less than that will eventually catch up with me.
RACE DAY AT REHOBOTH
I wasn’t expecting much on race day not because of a lack of training or a good final run, but rather because of some mild food poisoning or a stomach virus that both my wife and I managed to pick up a day or two before our race. There’s always something! But as the race got going, I felt good, my pace was good in the 9:30 range, and just kept going. William tends to struggle on hills, but if there’s an actual race and his adrenaline gets flowing he takes off like a little rocket ship, and Rehoboth Beach is a flat course so I knew he’d be fast (he’s about 2 minutes faster than me on average).
William coming into the finish in the 28 minute range! He’s fast!!
And his old man 2 minutes behind!
I had to take a few very brief walking breaks, but other than that I was stoked with my sub-10 minute per mile pace, and ended with a chip time of 30:24 which was awesome. A 30 minute and change 5K! Hallelujah! And William, who’s only 10, did a 28:05! We were both pooped afterwards, but really pleased with our runs and our times.
Exercise Can Be a Big Mental Boost
Whether it’s running or any other activity, exercise can be a huge confidence booster when you’ve worked hard and struggled, but then see positive improvements and better results. That’s exactly what I felt getting back into my 30 minute 5K zone, and it’s encouraged me to stick with it and keep going for other races my son and I will do in the fall. Life is way too short to spend it feeling awful. I’m finally close to the state I need to be in, my work won’t be quite as hectic this year (that hasn’t been the case!!!), and our new gym is right down the street, so there’s no excuses for me. Let’s see if I can keep it together this year, finally hit my goal weight, and get a timed 5K run in under 30 minutes. If this big old barge that suffers from chronic muscle fatigue can do it, you can too.
See our full Rehoboth Beach Father’s Day 5K 2019 Race Photo Album here.
William and I ran the Seashore Striders Rehoboth Beach Father’s Day 5K for the second year in a row, and this is our third timed race together. William (10) did great and set a new personal best of 28:05, and I ran a very solid 30:27. We were both really happy with our results, and then proceeded to stuff our faces with all of the delicious food at Rehoboth Beach. We’re going to keep training through the summer for some fall faces to stay on top of our game. :)
When Will I Do More Than a 5K?
People have asked me when I’ll do more than a 5K, and the answer is not any time soon. For starters, I don’t have anything to “prove”. Just being able to do a 5K in 30 minutes or less is a huge accomplishment for me, but there’s not a doubt in my mind that I can do more, and eventually I’d like to do at least a half marathon (13.1 miles) someday. But for someone like myself where the chronic fatigue issues are always lurking, it’s a lot more time to train, and a lot more time away from my family that I just don’t have at the moment. I can disappear and get a quick 5K training run in and nobody will ever know I’m gone, but disappearing for hours on end while doing half or full marathon race training just isn’t in the cards for me at this point. When the time is right, and other demands in life subside enough to free up the time, I’ll make it happen, and you’ll be able to read about it here. :)
Have I Mentioned How Important Regular Exercise Is for Cancer Survivors?
Actually I have, more than once, but I need to practice what I preach too!
Actually, I have mentioned how important exercise is for cancer survivors a few times below.
Post-Cancer Fatigue and the Importance of Exercise
Running from Cancer
Regular exercise isn’t just important for cancer survivors but for anybody. My post-cancer chronic fatigue issues were pretty heavy, and the only way to keep my body up and running and to have any energy at all was to push it hard. I don’t think my running story is all that special or glorious, but all things considered, finally being able to do a 5K run in under 30 minutes after years of pushing myself might as well have been like completing a full marathon for me. Some personal heroes of mine, like my friend Jonathan Barr in the UK, kept doing regular 4 miles runs or walks during treatments, and then ran the full 2015 New York Marathon just 10 weeks after EPx4 chemotherapy in only 5 hours and 5 minutes despite being in his 50’s! It was great to meet Jonathan and his lovely wife Lauren who is also a runner at the original Testicular Cancer Summit in 2017. Couple goals and fitness goals all in one!
Don’t miss Jonathan’s amazing post-cancer running story here: Defying All Odds
Meeting my personal fitness and couple goals heroes, Jonathan and Lauren Barr at the original Testicular Cancer Summit in 2017. This is the guy who ran a full marathon just weeks out of EPx4 chemotherapy!!!! Simply amazing!
Anyways, to say that 2018 was a disastrous fitness year for me would be a gross understatement. A combination of my job being totally out of control busy with numerous fires to put out every single day, and then having a new dog to care for at home left absolutely zero time for exercise. Even if I did have time to exercise, I was approaching 50% travel for work at times throughout the year, all of which continually threw wrenches into developing any sort of fitness routine, and you always tend to overeat or just not eat properly while traveling for work, especially when your company paying. While I managed to do some running and a few 5K races with my son William, who’s 9 years old and kicked my butt both times, in general I felt like total crap in 2018, the pounds piled on, and my energy levels plummeted, and I was back to struggling for every bit of energy I could muster just to get through the work day, with nothing left for anything else.
Our first Father-Son Father’s Day 5K at Rehoboth Beach, DE will be a new tradition for us. We both did 31 minutes, but William kicked in his afterburners at the end when I was huffing and puffing and beat me by just under 20 seconds!
For our second 5K of 2019, we did the Rockville 5K which runs right through our neighborhood. I just never had time to really train and did another 31 minutes, but William hauled and did a low-29 minute time. He’s a natural! So proud! :)
A big problem was the fact that the previous gym I was a member of was a 20-30 minute out of the way roundtrip just to get to. If you’re trying to make it to the gym for a solid workout 3-5 times per week, that adds up to over 2 hours of time in the car just getting to the gym and back, which is time I simply didn’t have. I managed to figure out that I did have time exercise, but not time to get to the gym also, so I very sadly discontinued my gym membership and just pounded the pavement with running and walking in my neighborhood, and then quit that too when the weather turned too cold. My neighborhood community center has a decent set of exercise equipment, but with zero ventilation in the room and flickering lights that bring on migraines, it’s truly a miserable experience working out in that small room. I could never commit, and so I fell completely off the fitness wagon for a few months, and of course the chronic fatigue hit me hard.
Luckily for me, a fantastic brand new gym has opened just a few blocks away that’s less than a 5 minute drive for me now, not really out of the way at all, and at a fraction of the cost of my previous gym. I got in on opening day December 31st, 2018, and I already felt a million times better after just the first workout, and after a solid week in the gym I’m already feeling like I’m back to my old energetic self. The fatigue has all but vanished, I’m sleeping better, I have plenty of energy in the morning now, and am no longer struggling for energy at all.
The new Onelife Fitness in Rockville is fantastic, and just a few blocks away. I’m not endorsing this gym over any other. The best thing about this gym to me is that it’s very close by and I can get to it without losing any time.
It’s funny how our bodies work and how counterintuitive they are. If you sit around all day or never exercise, you’ll feel fatigued and like you can’t move, which discourages you from moving at all, and only makes the fatigue worse! Get your ass into the gym and get a solid workout in, and all of a sudden your body is charged up and you feel like you can conquer the world. Well, maybe that’s a bit of an exaggeration, but it’s a night and day difference for sure.
Check out some photos of the new gym! This place is sweeeeet! The pool will be opening sometime later.
I know it and I’ve lived it, and I cannot allow life or work schedules to interfere with my physical health and getting regular exercise ever again. If I have one New Year’s resolution for 2019, it will be that, oh and lose the 20 pounds I managed to pickup and get back down to my goal weight (again). There’s a lot of “best things” that I’ve done for myself as a young adult cancer survivor and best practices that I can and have passed on, but surely regular vigorous exercise is at the very top. Maybe a lot of people can get by just fine without ever exercising, but I cannot after cancer. Regular exercise is what keeps my chronic fatigue issues at bay, and I can only go so long before my fatigue issues will start to rear their ugly heads again and my body starts grinding to a halt.
You don’t have to run marathons like my friend Jonathan. Just get out there and get moving and do whatever you can do. Your body will thank you for it, and it will be a huge boost in mental confidence as well when you can do just a little bit more each time, cancer survivor or not.
Happy 2019!
StevePake.com
Post-Cancer Fatigue and the Importance of Exercise
By far, the biggest physical challenge I've faced after cancer, is that of chronic fatigue. After months of being poisoned almost to death by harsh chemotherapy drugs, irradiated trying to nuke cancer cells out of existence, or having our bodies ripped apart and then sewn back together, our bodies are just plain tired.
By far, the biggest physical challenge I've faced after cancer, is that of chronic fatigue. After months of being poisoned almost to death by harsh chemotherapy drugs, irradiated trying to nuke cancer cells out of existence, or having our bodies ripped apart and then sewn back together, our bodies are just plain tired. They take a beating fighting cancer, there’s tremendous amounts of healing and rebuilding that needs to be done, and all of that requires a lot more rest. I went from being just fine on 6-7 hours of sleep per night before cancer, to needing at least 9-10 hours after. Anything less, and I would struggle badly throughout the day. My stamina also plummeted, and I had to very carefully balance the amount of physical activity in a given day, or else I'd simply run out of gas. This wasn’t an easy thing to manage while trying to live the best life that I could after cancer, while keeping up with my busy family of four!
A year or two after my cancer fight, and long after the pain from surgeries and various complications had finally subsided, I took notice of another type of fatigue. I realized that I had continuous low-grade aching and burning throughout my body that I never felt before cancer, and that it never really went away. Everybody thought I looked great, my hair and color had returned, and I had managed to lose a bit of the weight that I had picked up, but only I could feel this low-grade aching and burning in every single muscle in my body, and my continual struggle for energy despite the years that had passed. I never felt like I had anything more than a half tank of gas for the whole day, no matter how well rested I was. My body felt like it had aged at least 30 years, and I was formally diagnosed with chemotherapy-induced peripheral neuropathy by my GP. My oncologists told me that my neuropathy symptoms had improved to as good as they would get by this time, and that there was little hope for further improvement. I refused to accept that, and went to see my "other doctor."
My wife just happens to be a neurologist. She commonly sees older patients who might have had cancer a few times, some of whom have neuropathy problems so bad that they can't even stand or walk anymore. I was horrified. My wife encourages her patients to exercise, as that encourages nervous system regrowth and repair, but it’s a slow process that can take a long time. Few of her patients comply. I did.
For the next few years, I dedicated myself to a near daily program of exercise. I walked, or ran, or did whatever I could do on a given day. I gave up going out to lunch with my co-workers, as lunch was the only time I could truly exercise and push myself. It took everything that I had to get going in the mornings, and I was too exhausted from my day to exercise during the evenings. Progress, if you could call it that, was slow. It seemed like I was going nowhere, but I was happy for whatever incremental gains in strength and stamina that I could pickup. I'd wanted to give up so many times, but exercise always made me feel better, and there was no way in hell that I was going to spend the rest of my life feeling like an old man. I was a determined Scorpio on a mission.
Some tips. Our bodies have been through complete hell fighting cancer. Listen to what they’re telling you, and give them the rest that they need. Respect their limits, but keep pushing for more. Be patient, but persistent. Never give up, never lose hope, and find the support that you need, especially from other cancer survivors who know exactly what you're facing. Never underestimate the resiliency of our bodies to heal and recover. Our bodies are amazing, but need prodding and encouragement! Give that to them. Most of all, never stop believing in yourself.
I could never run more than a few blocks without having to go down to a walk, until one day I could. Then I could never run a full 5K in better than 30 minutes, until one day I was able to do it! Then, I couldn't do that consistently, until I could. I never could have imagined a time when I'd be able to exercise hard 5 days per week and feel fully charged each day, until today that I do! This progression has taken years, and not months as it might have for normal people, and might not have ever happened had I stopped believing in myself and quit!
April 1st, 2015 was the first time I was finally able to run a 5K in under 30 minutes, after over two years of pounding the pavement. I was so happy that I cried, as it represented the heavy chains of post-cancer fatigue coming undone, and physical freedom and energy that I hadn't had in years.
Five years after my cancer diagnosis and after so much hard work pounding the pavement and hitting the gym, I finally feel 30 years younger, and have all of the energy that I need again. I've been so happy at some of these milestones that I've cried, just being able to do something simple like jog behind my kids learning to ride their bikes, after a busy full day. I can see clearly now how my body has slowly but surely been coming back to me after all of these years. I couldn't be happier, finally having my rightful youthful energy back again, and having my confidence back knowing that I can do whatever I set my mind to. Never give up, and never stop believing in yourself. Cancer knocks all of us down, but keep getting back up.
All charged up from a workout at our local gym on a beautiful Sunday morning in the Spring of 2016, and ready for the day!
StevePake.com
Running from Cancer
This is the story of my 4 year long fight to reclaim my body after cancer, from barely being able to walk unassisted and having so many complications, setbacks, and headwinds, to finally punching through and running 30 minute 5Ks, and all that I've learned along the way.
This is the story of my 4 year long fight to reclaim my body after cancer, from barely being able to walk unassisted and having so many complications, setbacks, and headwinds, to finally punching through and running 30 minute 5Ks, and all that I've learned along the way.
I'm a 4 year survivor of testicular cancer, who to this day still has daily struggles with muscle fatigue and weakness, and other symptoms of chemotherapy-induced peripheral neuropathy that have become permanent. I took up running as a way to push back hard against this. For years I couldn't run more than a few blocks at a time no matter how hard I tried, but I persisted, and today I'm able to run regular 30 minute 5K's. This is my running story, and the story of my physical recovery after cancer!
For years after my cancer fight, I would struggle with my body physically. Prior to cancer, I could wake up at six in the morning and be into work by seven, work straight through lunch and be home by four, work out hard for an hour, pickup my kids by five, run around and play with them all night and go to bed by 11 or 12, and then wake up no problem the next morning and do the same thing all over again. I was invincible. I had unlimited amounts of energy, and my body could do whatever I wanted, whenever I wanted, even on very little sleep. But after cancer, those days were long gone. Four rounds of chemotherapy knocked me down hard, and then the RPLND surgery knocked me down even harder. After cancer I would struggle to even get out of bed by seven, and would be plagued with fatigue issues throughout the day. Even simple motions and movements would feel strained, as if I had just lifted a ton of weights. And rather than being able to stay up until midnight every night if I wanted to before, now I would be dead tired as soon as I came home from work, and crashing hard at only 9pm. I had been in nearly the best shape of my life before cancer, but would find myself in the worst shape of my life after.
I started a new job just weeks after my cancer fight had come to an end, and my new co-workers were greeted by a ghostly pale fellow with just fuzz for hair who could barely stand up straight, walk down the hall or balance himself without holding onto something, nor make it up a flight of stairs without wheezing for breathe. And then, things just got worse when I developed terrible shooting nerve pain that I would suffer from for hours out of the day. I couldn’t sit still for any length of time without it flaring up, and co-workers would be startled when I would suddenly double over in extreme pain. And then I found out that one of my kidneys was near failure. A lymphocele from my RPLND surgery had formed directly adjacent to and was pressing up against the ureter of my left kidney, almost completely blocking it and causing hydronephrosis. I was experiencing organ failure, which also explained why my creatinine numbers had shot straight through the roof. Lovely! When a fine needle aspiration and alcohol schlerosis procedure didn’t resolve it, I ended up having to get an incredibly painful and uncomfortable kidney stent placed for about six months, which made it difficult and uncomfortable to even move at all. I felt like I was going backwards. I was happy just to be alive, but my physical experience was one of constant struggle, and my quality of life wasn't anywhere close to being what one would call good.
Many of the struggles I faced with my body were due to chemo-induced peripheral neuropathy (CIPN). Platinum-based chemotherapy agents melt away testicular cancer tumors, but are notorious for causing nerve damage and all sorts of other damage throughout the body. There wasn't a single day that I woke up after my cancer fight feeling like I had anything more than a half tank of fuel for the whole day. I was constantly tired and felt weak, had burning and tingling sensations in my arms and hands, had numbness issues and could barely feel my feet, in addition to pain issues and problems with reflexes and balance. Doctors told me that these symptoms would improve to as good as they would get by a year after treatments had ended, and so I just endured all of this for a year. But that year came and went and then some, and by the end of 2012 my body was far from "bouncing back." It was stumbling and face-planting more than anything, and far short of a full recovery. My heart sank when it became clear that many of my physical struggles were likely to become permanent issues, and I became incredibly distressed.
Here I was, a young guy just into my mid-thirties with so much of my life in front of me, and two young kids and a busy family to keep up with, yet I was still struggling so much physically and in tremendous amounts of pain every single day. These were supposed to be the prime years of my life, yet in so many ways I felt like a decrepit old man. I never stopped being happy that I was alive, but this was neither the life that I expected nor that I wanted after cancer, and my quality of life just wasn't there. I didn't know what to do anymore. Nothing brought me more happiness and joy than my family, but every year my kids would be getting a little bigger and a little faster, and I feared one day they would just leave their "old man" dad behind, who could never go anywhere or do anything too strenuous, because of all of his issues. I had beaten the damned cancer, but felt like it was still getting the last laugh in some cruel way, and I hated every bit of this.
My awesome kids have always been my top priority. I was terrified that one day they'd just leave their decrepit "old man" dad behind.
I had more than a few friends that were into running, including many cancer survivor friends that I had only just met in the past few years. I had even run a bit myself many years ago but had given it up, but now found myself incredibly inspired by all of my survivor friends’ fundraising efforts for various cancer charities, and how hard they worked. I had been walking for general exercise which helped a lot, but thought maybe I needed to push myself harder, and so I decided to give running a try again. As to be expected, I couldn't run very far or very fast at first and just ran whatever segments on my walking route that I could. All it took is a little bit of running for something incredible to happen, though!
The next evening, the first full day after this first run, I was settling into bed for the night and about to drift off to sleep when suddenly I bolted upright, wide awake and in shock! My God, I told my wife, I hadn't had any nerve pain that day! I hadn’t had any throughout the day, and the 20-30 minutes of thrashing nerve pain and muscle twitching that I typically had to endure my way through before falling asleep each night didn't happen either. It hadn’t gone unnoticed by my wife, either. This was just as painful and disheartening for her to watch as it was for me to experience! When there’s so much love there’s also transference, and it’s like every stabbing shot of extreme nerve pain was hurting her also, and she felt powerless to do anything about it. We were both speechless! There was something about the intensity and impact of running that literally gave my nervous system a good workout, and that also seemed to calm it down. I had been on godawful drugs like Lyrica before, which did help reduce my nerve pain issues, but not without making me feel like I had been hit by a bus. My wife begged and pleaded with me to take it because of how painful my nerve pain episodes were for her to even watch night after night, but I had sworn pills off entirely. Every single pill I ever took always seemed to have more side-effects than the relief they provided, and just seemed to make things worse! If simply running was all it would take for me to finally live a pain free life, without any rotten pills and their nasty side-effects, then by God I was going to do it! I was instantly hooked on running.
The Many Benefits of Running
It didn't take too much running to realize other physical benefits as well. I had also been suffering from occasional periods of low testosterone, and my hormonal levels in general just seemed to be swinging all over the place. I wasn’t a consistent person anymore in terms of mood. The stress of cancer survivorship no doubt had something to do with that, but swinging hormones did too! When I’d have a testosterone level dropout, it brought with it very depressive moods, and bouts of feeling just completely miserable, directionless, highly irritable, and asexual that could last days if not weeks. If I woke up one morning having had these symptoms the day before, or with the very obvious symptom of not even needing to shave, I would force myself to get out for a run that day no matter how awful I felt. I’d go as hard as I could, and without fail I would always feel much better the next. Just walking had never managed to perform a magic trick like this with my body or my hormones, but running could.
Around the time I started running at the tail end of 2012, I was also falling into a very bad place emotionally. A fellow cancer warrior friend had just died of his cancer, and a few others had experienced recurrences of theirs. I had a very bad recurrence scare myself where I thought for sure that my cancer had returned, and that I was going to die. I had been in a complete panic, went to sleep in tears numerous nights, and had the fear of God in me. I had a few extra tests done as a precaution when I went in for my follow-up and everything turned out fine. My body was fine, but the emotional floodgates had opened. Tons of repressed memories and unexpressed fears and emotions from my cancer treatments that I had unknowingly kept bottled up inside of me for nearly two years, suddenly started coming out. I fell into a depression and began experiencing extremely bad post-traumatic stress. I was so afraid, and didn’t know what was real and what wasn't anymore. I was so charged up with anxiety and adrenaline almost all the time, and it would burn me up inside emotionally sitting still. Running gave me an outlet for all of this pain and energy. When you’re in such a deeply distressed state, there’s something very primal about running specifically, outside and with the wind on your face and not on some wretched treadmill, that just helps to release that energy and bring a sense of calm back.
Perhaps most importantly of all, the time I had mapped out in my day for running, typically over my lunch hour, also gave me the time that I needed to help sort out my life again. I realized the need to completely reset and rebuild my life from scratch after cancer, but when would you ever find time to sort life out again like this with a busy job and family? Running wasn’t just exercise for me anymore, pushing back against physical challenges. Running became an important appointment that I needed to keep with my mind, body, and soul. My time for running was the only time of the day where I wouldn’t be dealing with work or family or anything else. It was time just for me, and my time for running quickly became sacred time for me.
Just as Stuart Scott described his post-chemo workouts as his private ‘FU cancer’ time, my lunch time runs became my own private FU cancer time as well. All of the anxiety, the pain, and the fear that I had been experiencing, I dumped it all into my runs, pushing myself as hard as I could. I’d commonly sprint the last quarter mile muttering FU cancer under my breathe, and sometimes aloud. I didn’t know who I was nor what I needed anymore after cancer, and running was the time when I would sort all of that out. I never listened to music. I held very deep soul-searching dialogs with myself, and challenged my beliefs and assertions about everything. Slowly but surely I began to understand who and what I really was, what my needs really were as a person, the true origins of so many of my troubles and sources of pain, and also, what I could do about them. As a running mentor of mine had said, “Sometimes, running is the only thing that make sense.” I didn't understand why or how in the beginning, but indeed, running just made sense. Running was just the release that I needed, and it was something that I could do easily every day, even if I mostly walked and just ran a little.
Damned If I Do, Damned If I Don’t
As beneficial as running proved to be for me, it was also incredibly frustrating. I could never run more than a few blocks at a time without it feeling like my entire body had slipped into neutral and just couldn’t go anymore, no matter how much I willed it forward. The few times I really pushed it and forced myself to run through a solid mile if not further, even after many months of trying, I suffered terrible physical breakdowns in the aftermath. My speech slurred, and I could barely walk or lift my arms, and my entire body would feel limp. One breakdown was so bad that I nearly had to call my wife to come pick me up, because I almost couldn't coordinate walking anymore. When I finally managed to stagger back to my house, I had to have her help me up the stairs and into our bedroom, and there I crashed at 7pm, absolutely spent and completely dead in the water. I still couldn’t move when I came to the next morning, and had to have my wife bring me the bedside commode that I had last used when going through chemotherapy, because I couldn’t even get out of bed to go to the bathroom. I didn't make it into work until nearly lunchtime that day, and for the next several days I would struggle like I never have before physically. I could barely get in and out of my car, struggled to turn the steering wheel at slower parking lot speeds, and even typing and speaking were challenging.
I didn't know what was going on at first and nearly applied for a handicapped parking permit, but in the grand scheme of things I knew that this wouldn’t have done me very much good anyways, that I was probably pushing myself too hard, and that I needed to manage my body better. I was forced to accept that my body just couldn’t maintain a solid run if my life depended on it. I wasn’t out of breathe, my heart wasn’t beating out of my chest, and my muscles weren’t exploding. I had put my nervous system in distress, and was formally diagnosed with chemotherapy-induced peripheral neuropathy around this time by my primary care physician. Typically, nervous system fatigue would be one of the final stages of fatigue for runners, but instead it was hitting me first and before anything else. My nervous system was clearly my weakest link. It just couldn’t keep up with the rest of me, and I had to learn to accept this and live within its limits.
I had set a goal for myself of being able to do a 5K run in 30 minutes or less, which is considered to be a very basic starter goal for runners, but for me it felt so impossible. Friends of mine picked up running and could quickly achieve blistering times well below a 30 minute 5K that I could only dream of, while I had to limit myself to a 50/50 mix of either walking or running on certain segments of the course that I had mapped out through my neighborhood. Typically, I could walk/jog a 5K in 34-36 minutes, but some days I could barely even walk one in 40. The best I could do a 5K run was in 33 minutes and change, but not without these terrible physical breakdowns. I was disheartened by how limited I was, but learned what those limits were, and to stay within them. I had to very carefully budget my amount of physical activity in a given day, balance that against the amount of rest I had gotten the night before, and just be happy that I could do anything at all. In time, I learned very well what I could and couldn’t do in a given day. My quality of life improved tremendously when I was able to find the right balance for myself, but I was still frustrated at feeling so limited, in stark contrast with the practically unlimited energy and strength I had had before cancer.
Beyond the frustration of not being able to run well at all, there was the complete misery of the cold winter months. Cold weather never used to bother me, but suddenly after cancer it would bring on tons of aches and pains that I'd never had before. I would feel so stiff, almost like I couldn't move, and would feel completely lousy all the time. Especially around the winter solstice, it honestly felt like my body just wanted to pack up and hibernate for a few months. Chalk it up to a bit of aging, yet more neuropathy symptoms, or other strange effects from chemotherapy that nobody really understands, but the winter months had become a thoroughly miserable experience for me. Alas, running helped with all of this too! Once again, and without fail, and no matter how awful I was feeling, if I forced myself to get out for a run I would always feel so much better. My aches and pains, my mood, and everything else would improve, and I could actually feel reasonably human so long as I kept running a few times per week. Winter seemed to put sand in my gears, but running helped to keep my wheels greased and my body moving.
Not once have I ever actually looked forward to running. It’s how I knew I would feel after running that’s always kept me going, along with the time for prayer, meditation, or sorting out whatever awful thoughts have been running through my head. One doesn’t need to try too hard searching on the Internet to realize how beneficial regular exercise is for not just our bodies, but also our minds. I never stopped running, and I never stopped pushing. I was happy to be living pain free, and to have far better quality of life than I did before, and without needing any stupid pills. I was content with the incremental gains in strength and stamina I had managed to pickup, and was accepting that that’s all there might ever be. Time for running was sacred to me and far beyond achieving any particular time, but I still wanted that 30 minute 5K. In an aft corner of my mind somewhere, not being able to get anywhere close to that still frustrated me. It’s not like I was demanding that my body carry me through a half or even a full marathon at the blistering paces some of my friends were putting down. It was just a 30 minute 5K, and not being able to get close to this was a thorn in my side.
The Huge Breakthrough of 2015, After Two Years of Running
I would walk or run a total of over 300 miles per year in both 2013 and 2014, and not one of those miles were easy. I had to push myself hard and fight with my body through every single last one of them. But suddenly in 2015, everything changed. I had given myself a break from running in any real quantity from the end of 2014 and through the first few months of 2015 due to an injury, and mostly just walked. My first real run of 2015 came not because I felt my body was ready yet, but rather because of post-traumatic stress. As I rolled into work on Monday, March 16th, all of a sudden I started having terribly nervous and anxious feelings. I’d felt something building through the weekend, and couldn’t think or concentrate at all. Right as I was wondering what in the hell I was being spooked by, I started having visual flashbacks of going through chemotherapy, complete with the smells, the sounds, and the awful feelings. It turned out that that day was the day that I would have been starting chemotherapy four years ago. I hadn’t given this milestone even a single conscious thought, but here my mind was recalling it. It’s like my sub-conscious was remembering, and was spooked fearing that we might be going back. I’d been through ordeals like this more than a few times, and knew that today was just going to be one of those days where I had to run. I always hated forcing a run on an injured body. It was risky and I could re-injure myself which would set me back months, but when you've got post-traumatic stress knocking, you've just got to go take care of business.
I might have gone a little above and beyond my normal self-protective 50/50 walk/jog limit that day, but I generally stuck with my program, and then had a genuine "HOLY SxxT!" moment when I looked down at my running watched as it beeped for the 5K and I saw a 32:52. I had never gone that fast before, ever. It was a new personal best! I hadn't done any serious running in months and wasn't at all conditioned up for it, and even when I was before I still couldn't do better than 33 minutes without causing a nervous system crash. I was so worried that I nearly texted my wife a “crash warning”, when I knew I had overdone it and was going to be in trouble later, but I made it through the rest of the day just fine, and managed to get up the next morning under my own power, too. I was shocked. I thought it was a fluke and that maybe it was just the adrenaline from post-traumatic stress giving me a bit more of a tailwind than I had expected, but I hadn't been that spooked. In the grand scheme of post-traumatic stress episodes, this ranked as merely a two or three on a ten scale, just a little blip. I had had far worse episodes of post-traumatic stress and gone a lot slower, and so I knew this couldn’t be correlating directly with amount of anxiety or adrenaline present. I went running again a few days after that 32:52 to see if it was a fluke or not, and managed an even better 32:25 without any anxiety fueling the run. On top of that, I noticed that it felt different to run now, too. I didn't feel my whole body slipping into neutral and straining after a few blocks of running as I always had in the past. There was no longer a low-grade burning or straining sensation all over my body, but rather a more strictly muscular type fatigue just in my legs as I ran, which would be the more normal order of things. Something clearly was different now.
Finally across the plateau and closing in!
It was surreal. Almost out of nowhere, and after two years of pounding the pavement feeling like I was going nowhere so many times, I had just set a personal best 5K time for myself, yet felt like I was sandbagging and had so much more to give! I had no idea what was happening or what had changed, but it was an incredible feeling. Two days later, I decided to get serious and allowed myself to run freely, and without the self-protective restrictions I had placed on myself before. It’s good to push yourself every once in awhile just to see what you can do, and the tears started flowing when I saw a 30:24 at the 5K, with an overall pace of 9:48 minutes per mile. It was then that I finally realized that somewhere, somehow, I had rounded a huge corner, and that my body wasn't nearly as limited anymore as it had been. I didn't just reach but rather smashed right through my preliminary goal of being able to maintain a 10:00 minutes/mile pace. For the very first time, hitting a 5K in 30 minutes wasn't just a fantasy and something to dream about being able to do someday far into the future. Now it actually felt real and achievable, and all I had to find was another 8 seconds per mile.
Chasing That 30 Minute 5K
The next run I went for a few days later, I wasn't feeling it. I felt fatigued and couldn't run through the first mile, and decided to back off and "only" ran a 33:14. This was still a time that would have absolutely flattened me just two years ago, but now it was a "slow" time for me. I didn't allow myself to feel even the least bit discouraged, and simply kept at it. My, how far I’d come! On Monday, March 30th I went out and ran a 30:57, a 9:58 overall pace which I was happy with. It wasn't a PB, but I knew I was headed in the right direction and just kept my head down. It had taken me two years to cross this seemingly impossible plateau, with muscle fatigue and nervous system issues fighting me at every step. For all I knew it might take me another two years to cross the next one, but all I needed to feel was that it was within reach, and just kept running.
Two days later on April 1st, 2015, April Fool's Day of all the days and the start of Testicular Cancer Awareness Month, I just felt good. I had built my body up a bit with these previous few runs, but my family and I were headed off for a week long spring break adventure the following week. This was going to be my last opportunity to get a run in for over a week, and there was no way in hell I was going to lose the momentum I had built up without trying to make this happen. I wanted it so bad that I wasn’t just tasting it, I could smell it too. It was a picture perfect early spring day, and if ever there was a day where all of my biorhythms or whatever you want to call them were all in peak alignment, this was the day. I felt good and well-rested, hadn’t had hardly any of my usual fatigue in the morning, and just felt primed to make this happen.
As I stretched and set off on my run, everything felt good. None of the body slipping into neutral nonsense down the first damned block, no muscle or other fatigue, and I just felt like I was in the groove. I ran through the first mile, listening very carefully to what my body was telling me, and it told me to just keep on going! As I crossed through to the second mile, the thoughts started flowing. All of that classic motherly advice came back, that if you put your mind to it you can accomplish anything. For the longest time, my mind had been the only willing participant in my running endeavors! I remembered Stuart Scott writing and speaking so much about about Coach “Jimmy V” and his famous speech at the 1993 ESPY awards, and to “Never Give Up, Don’t Ever Give Up!” You can call me a lot of things, but a quitter isn’t one of them! As I crossed into the third mile, I recalled how Lance Armstrong wrote that his final few tour stages almost felt effortless as he was closing in on his first Tour de France victory after his cancer fight. Unless you’ve been living under a rock you know that Lance was juicing, but so was everybody else at his level. I wasn’t, but here I was running further and faster than I ever had before, and it was almost feeling effortless! I took only three very brief walking breaks of 20-30 yards tops on this run, and only on particularly tight sections of my course that would almost slow me down to a walk anyways, and then got right back into a run. I needed to maintain at least a 9:40 pace to hit the 5K in 30 minutes. As I rounded the last tight corner and broke into a run, headed towards my finish line a quarter mile away, my eyes lit up when I saw a 9:38 pace still on my watch! I knew I had done it, and wouldn’t even need to sprint the last quarter. I had it in the bag! I could just coast myself in, and the only thing I needed to do was not trip or get hit by a car!
Down this final stretch of road, the tears started flowing at full force. All of the memories of so much pain and frustration with my body, and all of the misery started releasing themselves. Every single day for the past four years I had felt like an old man, tired and fatigued, and struggling to get through each day. I was always happy to be alive, but it had always felt like I was dragging heavy chains around that were slowing me down, and holding me back from living my life to its full potential. After two years of pushing so hard, I was finally busting through these chains! All of the days I was so frustrated and hurting, all of the days that I just wanted to quit and say to hell with it all when I felt like I was getting nowhere, and all of the sacrifices I had made, this bittersweet moment made it all worth it. As the 5K passed and my watch beeped, I managed a 29:44 at a 9:33 pace! Victory at last! I crashed through my goal with more than a few seconds to spare, and I was over the moon.
A bittersweet victory at long last, smashing right through the 30 minute mark on a picture perfect early spring day! I laughed, I cried, and I reflected, just soaking in every second of this great moment after struggling so much for so many years!
Unlike the past where big moments came and went without really registering, I took time to soak this all in. Rather than rushing to the next appointment or task, I relished every moment of this. I sat, I laughed, I cried, and I reflected. I took selfies and sent messages to a few select friends who knew of my struggles, and who I knew would be able to share in my joy of this great personal victory. I didn't feel like an old man anymore. I felt 20 years younger than I had been. I felt like someone that had been told they’d never be able to walk again, and after years of trying finally proved everyone wrong. And even better, I made it through the rest of my day just fine, chased my kids around at the park and on their bikes that night, and still managed to get up under my own power at six-thirty the next morning. My dedication to running had become my fountain of youth that helped me turn back the clock. Running had not only been key to getting my mind back, it had finally helped me get my body back as well.
What I’ve Learned
Never Give Up, and Never Stop Believing in Yourself - The same attitude that's seen me through so much emotional trauma and turmoil is the same attitude that's seeing me through my physical challenges as well. Never give up, and never stop believing in yourself! I had to change course numerous times dealing with mental health issues, and the same has been true in dealing with my physical challenges. I've failed numerous times and ran my body straight into the ground, but I never quit! I kept getting back up again, and kept trying different things until I finally found a way to exercise that gave me all of the benefits I needed, but wouldn't run me into the ground.
Patience and Persistence - I learned to be patient with my body, and also forgiving. I learned that it wasn't fair to compare myself to friends who hadn't even had cancer, weren’t dealing with hormonal swings, and who hadn't been through chemotherapy and experienced all of the nerve damage that I had. Rather than obsessing over what I couldn't do, I learned to appreciate and accept what I could, and simply kept at it when I found the right balance of what I could do without breaking myself. Numerous times and over and over again my body told me no, but I persisted with my running and was relentless. There's only one time that I actually ended up curling myself into a ball in my bed instead of going running, because I just felt so awful that day. Not only did I feel terribly guilty, but I didn't get any of the benefit of running that I always did after a run, and vowed to never fail myself like that I again.
The Resiliency of our Bodies - As I pounded the pavement month after month, little did I know that my body really was responding to what I was putting it through. Little by little, and at a rate far too gradual to ever notice, my body was improving and slowly but surely coming back to me. Maybe it would have made some of this recovery on its own, but the benefits of running and exercise are very well known. I don't think there's too many out there that would argue that all of this exercise hasn't helped to encourage and accelerate such a wonderful physical comeback! Never underestimate our bodies ability to heal and improve themselves, even long after doctors say the window for healing has closed!
The Importance of Priorities - If you're told that you're at high risk for a heart attack or some other life-threatening condition unless you start exercising and make other lifestyle changes, I think most people will suddenly find the time that they never had for exercise, out of fear of death. In my case, my body just wasn't coming back to life like I had expected it would, and I wanted so badly to not just live, but to live without pain! My family is no different than any other busy, two-professional, two-child household, with work schedules to manage, rigid kid drop off and pickup times, and zillions of after school and weekend activities. It mattered not. I just had to make the time. I could barely get my body moving in the mornings, and by the evening it was already on a solid downward slope. As much as I had enjoyed going out to lunch with my new co-workers almost everyday, and as supportive as many of them had been, I had to give that up. My lunch hour was the only time of the day when I could get a good solid workout in, with that boost and all of the other benefits that I needed. Never hesitate to do what you feel you need to do for yourself after cancer. Self-care and self-preservation should be the top priority. As the saying goes, you can't love and care for others until you can love and care for yourself. Making self-care my top priority in life helped me to heal both physically and mentally, and in turn allowed me to once again be the husband that my wife loved and needed so much, and the father that my children needed likewise.
Now I can be "that dad", jogging through the neighborhood and trailing behind his kids as they ride their bikes. I took this photo after running a 5K over lunch that day at a pace would have flattened me in years past, and still had the stamina to be active with my kids that evening! The power of exercise!
Taking Up Running is the Single Best Thing
that I Ever Did for Myself After Cancer
I used to think that runners were crazy, and wondered what on Earth drove them to want to torture themselves the way they do, pounding the pavement week after week. Even the well known satirical website The Onion parodied this in one of their brilliant video skits, but I get it now. I so get it. When you're fighting cancer, you always have a ton of appointments to get to, and medical professionals become a big part of your support network early on. The stress and anxiety during a cancer fight doesn’t let up once you’re on surveillance, though. It only gets worse, yet you lose all of the active support from the medical system that these appointments provide while actively fighting. Running became appointments that I had with myself, to help rehabilitate my body, relieve stress and anxiety, and to soothe my soul. My running time has become sacred to me, it’s been that good of an outlet, and now it's just hard-coded into my schedule. Taking up running is the single best thing that I ever did for myself after cancer.
A fitting bumper sticker that I saw on a parked car as I was wrapping up this essay, along with a pair of 13.1 and 26.2 stickers. I couldn't agree more! Who knows what's next for me, but I know that as far as I've come and as hard as I've been willing to keep pushing myself, that anything is possible!
StevePake.com
Special thanks to all of my runner friends, but especially to my friend and two-time testicular cancer survivor Alex Hohmann. Not once was I ever made to feel even the slightest bit discouraged by any of my runner friends, but Alex especially was such a great source of encouragement, guidance, and moral support, in addition to just plain being an exceptional human being and role model. Alex has been a wonderful mentor, and is one who leads by example. The world needs more people like Alex. I actually bought my trusty Garmin Forerunner 110 GPS running watch off of Alex when I was just getting going, and he was upgrading to something fancier. Thanks to all of the support I received from Alex and all of my runner friends, and a whole lot of blood, sweat, tears, and dedication on my end, now I finally feel worthy of wearing it!