Honor & Respect

Memorial Day - it's gorgeous here in NY! I will be taking care of some long overdue house chores and taking a nice, long hike. I hope your day is filled with friends and family - and fun.... Oh, and of course, some exercise. It should be easy to work in a little workout today - hike, bike, garden, Frisbee, canoe. Whatever it is that you enjoy; get out and enjoy it.

But this is also Memorial Day. At some point today, please take some time to think about what this holiday is about. It's not just about picnics and barbecues. Today is about honor and respect for those men and women who have lost their lives fighting our wars. Far from home, they have done their duty, done what they were told. Far from home, they have struggled and suffered. Far from home, they have died.

Whatever anyone thinks of any particular conflict or policy, these men and women are deserving of honor and respect.

And, to poach a phrase from my friend Wende's Facebook page, I hope we will continue to be a country worth fighting for. That is our responsibility, and possibly the best way to honor those who have fallen.

Julie

Top Of The Hill

I went for a run yesterday, about 3 1/2 miles. I went out at 2:00, right in the heat of the day. And it was HOT! It was well into the 90s with full sun. This may not have been the smartest thing I could have done, but it's what fit most easily into my day.

Where I live, there is nothing but hills - steep hills. I have learned to love running hills (I don't really have a choice), but some days are harder than others. On my usual route I have two really tough hills. One is a long hill, divided into 3 steep sections. The other is the final hill leading up to my driveway. It's steep, but mostly it's hard because it's the very end. I can see my mailbox; I know I'm almost there, but it seems to take forever, as though my steps don't move me any closer to my goal.

Yesterday, between the 90+ heat, sun, and hills, I was having a hard time! I was thirsty when I started, so I was already a little low on water (as I wrote in a recent post, thirst lags behind our actual need for water). Shortly into the run, I was parched. I tried to stay in the shade as much as possible, but there were some long stretches in full sun.

On a somewhat embarrassing personal note: there was a road crew out doing repairs - why do I insist on picking up my pace when I run past them?!? I was already parched and hot, why did I push myself to run faster? What do I care what these guys think - these old, fat guys who smoke every chance they get, and couldn't run 50ft? Oh, ego can be such a problem sometimes!

Then I hit the 3-part hill.... The third section is the hardest. It's shorter, but it's the steepest. I pride myself on running hills, but yesterday I struggled. I finally slowed to a walk for the last 20ft or so. I was devastated! I never stop on hills - I may run slowly, but I run! At the time, though, walking seemed a better choice than passing out. I think I made the right choice, but I was disappointed.

No matter what our goal is, we need to always be open to changing circumstances. I went out on a run that would normally be fun, but I found myself getting dehydrated and overheated. We need to be able to adjust our goals when necessary. We need to learn when to push and when to back off a bit and catch our breath.

I am quite capable of pushing myself. I've climbed more than one mountain, puking the whole way, but climbing anyway (it's what I do at high altitude - throw up). But I've also backed off when I knew I didn't have it or when I knew I might be endangering myself or others. The success of any race, climb, or life is often about pushing ourselves, but sometimes success comes from regrouping or even changing course.

Since yesterday afternoon, I've been thinking about my run and my walk. It seems like a pretty good analogy for cancer treatment (or any other illness/injury/recovery). The most important part of the story (other than sometimes my stupid ego gets me in trouble) is that I walked. I didn't stop. If I stop my muscles immediately start to tighten up. I may double over in exhaustion, making it much harder for my lungs to work. Both of these things make it more difficult for me to get started again.

However, if I just slow to a walk, I keep moving. My muscles keep moving - just more slowly - rather than stiffening up. I stay upright so my lungs continue to work more efficiently. And I keep my forward momentum, but allow myself to catch my breath.

I think this applies to getting through treatment, too. We have our goal - getting through our 6, 10, 12, however many cycles. We all have different experiences with treatment. Some people don't have much trouble at all, and others struggle greatly. But we all tend to focus on the finish line. All too often, I see people collapse, figuratively, afterward. It's so much better to keep going, even if slowly. Give yourself the chance to catch your breath, but keep moving forward. If you stop completely, you will have so much more trouble getting moving again. Walk, don't stop!

And better yet, don't be afraid to take a little breather in the middle. Don't be afraid to ask for help or go slowly (says the girl who foolishly runs faster past fat construction workers). Remember, success is not always about pushing yourself. If I had kept running the hill, but collapsed, I wouldn't consider it a very successful run.

Your goal isn't really getting through treatment - it's your life and all the good things in it. You're in it for the long haul, right? Learn to pace yourself. Sometimes you just need to push through, but sometimes a little break while still moving (as in walk, don't stop) is what's needed most.

Julie

The Health Of Our Care - A little help from my friends

There are around 47 million uninsured people in the U.S.

So, what happens when one of those people gets cancer (or some other life-threatening disease)? If it's someone we care about (and everyone has someone who cares about them), we hope they get the care they need. Because we like them and want them to be around and part of our lives, we hope that they will get the surgery and treatments that will make them healthy again, and deal with the financial mess later.

Getting that care and staying alive is expensive, though!

My friend Carolyn Baldacchini was diagnosed with breast cancer last year. She was uninsured, but understood that medical treatment couldn't wait. (Carolyn is the one who told me about HealthCareBlueBook.com, a great resource for the uninsured. I wrote about them in an earlier post.) But now, Carolyn has a mess of bills piled up - surgeons, hospitals, anesthetists, radiologists, oncologists, drugs..... Carolyn's friends are trying to help out with a benefit concert.

Carolyn and I go back to our Juilliard years. We're both violists and studied with the same teacher. She lived for a while in Italy, but now has a successful teaching studio in Summit, NJ, and is active in her church and community.

This Sunday, friends, some of Carolyn's students, and members of her church are going to be playing music to help her out. I had hoped to play, but unfortunately have a performance of Porgy & Bess at the same time.

The concert is Sunday, May 23, from 2-5pm, at the Unitarian Church in Summit. (4 Waldren Ave., Summit, NJ 07901 - www.ucsummit.org).  It's a fundraiser for Carolyn's medical bills.  It should be a lot of fun and a lot of good music. Suggested donation is $50 for a whole family, but basically whatever you can manage. It's all appreciated, and all goes to cover medical bills.

I hope some of you living in Northern Jersey can make it! Oh, and she's a great teacher! If you have a child who plays the viola....

Julie

Water, Water Everywhere

Hydration is important, but often overlooked. Lack of water is more likely to cause a quick death than any other single nutrient. Our bodies need water.

Most people rely on thirst to signal the need for water. Unfortunately, thirst is a lagging indicator; it doesn't kick in until you're already a liter or two low.

What does this mean for us as we exercise? We lose water through breathing, through the skin, through sweat, and through urine - a loss which can increase during exercise. If we're likely to be in a somewhat under-hydrated state because we're relying on thirst to tell us when we need more water, we're already behind before we start sweating.

Water carries nutrients to our cells and carries away waste. It helps us maintain a healthy body temperature. Our muscles and organs are about 70% water.

Staying hydrated during exercise will help us have a less pronounced increase in our heart rate while we exercise, and help us maintain our core body temp., avoiding overheating. It also reduces the glycogen usage of our muscles as they work - the energy needed to power them.

All of that means that water will improve our endurance.

Try drinking on a fixed schedule - not just when you feel thirsty. Don't try to drink a huge amount at once, especially right before you exercise. Try to drink around 2 cups of fluid an hour or two before you exercise. If you are doing some exercise that allows you to drink during, sip water as you go. After exercise, rehydrate. Make sure to replace any water weight lost during exercise - weigh yourself before & after to figure that out. Drink about 20-24oz. of water for every pound of water lost through sweat.

So drink, my friends - before, during, and after.

Julie

Coping with Cancer Magazine (p.16)

If you find yourself sitting in your doctor's waiting room this month, check out Coping with Cancer Magazine. I have an article, "Get Moving", on p.16 of the May/June issue, offering tips on starting and progressing with exercise during and after cancer treatment.

Julie

Thanks Mom!

Happy Mother's Day, Mom!

Many of you know my mom from my posts. I write about her with great pride; she's my shining example. She is the pushup queen, and the one who, at age 72, decided maybe she'd like to start running. In recent years, she's worked hard to take control of her health and fitness. She has been steadfast and resolute.

As all mothers and daughters do, we've had our less shining moments over the years, as well. But she is, in large part, responsible for who I am now. Thank you.

I like to think that the best qualities of each generation get passed on in a family. I come from a long line of strong, determined women. They were pioneer women. On both sides of my family, they were hearty women living and raising families in the Great Plains. They endured illness, blizzards, crop failures, and more. Everything they learned in their struggles and their joys they passed on to their children.

In my darkest moments during treatment - those days when I was sure I couldn't go on - it was generations of Olson/Goodale women who propelled me forward. I could feel the spirit of those doggedly determined women lending me their strength. My mother and grandmothers, and all those other women I barely or never knew would whisper in my ear to keep going, to get up and face the day, to keep putting one foot in front of the other - no matter how tired or frightened I may feel. And they reminded me to find beauty and joy wherever I could.

So, to my mother I offer my love and gratitude - for all of your help and support, for the strength you gave me, for all that you have passed on to me. Thank you.

Julie

What's Your Motivation?

 We all have our reasons for exercising. It's usually not enough to simply know that we need to exercise. Most of us need a tangible or immediate reason - a goal. Here's a list of a few of the reasons for exercising - some are mine, some come from clients:


* Climbing season (that one is obviously mine!)
* Get strong enough to play basketball with my son
* I want to shovel snow - I like it! (important since this person lives in Chicago)
* My grandson
* I'm determined to get back on my bike
* Carry my groceries
* Triathalon
* Have enough energy to enjoy a shopping trip
* Get out of this chair!
* Cook Christmas dinner for my family
* Lose some of this damn chemo weight
* Breast cancer! (since exercise reduces risk of recurrence, this is a BIG motivation for me)
* I'm tired of being tired
* Get back on my feet
* I think I'd like to run a race. Do you think I could?
* Walk without a cane
* 20,000 ft. (again, that one is mine)
* I just feel better when I exercise
* To hold my son

What's your motivation?

Julie

Milestones and Reflection (a little off-topic)

I've been thinking about cancer milestones lately, and then, unexpectedly, I hit one today.

I've been thinking about it in part because I'm approaching 9 years. It's suddenly hit me that somehow, I've become an old timer at this. I'm the one with seniority, even among women much my senior in age.

Then today I saw my oncologist.  I was feeling mildly anxious about it; I always do. No, that feeling doesn't really go away. A visit with the oncologist never feels "routine". It does get easier, but I doubt it will ever feel like going to the dentist for a cleaning.

Everything checked out just fine. And then it happened: a milestone. I don't have to see him for a year.

That may not seem like much of a milestone, but it sure feels like it to me. For almost 9 years, I have visited him every 3 - 6 months. This may not be typical of most cancer patients, but I tried various drug therapies and took part in a drug trial, so had more frequent followups.

I've graduated! A full year between onc. visits! Initially I felt positively giddy, but that gave way to reflection.

My oncologist has had quite a profound impact on my life. We've now known each other a long time. And besides being fond of him because he's worked very hard to keep me alive, I like him. I find him oddly amusing. We talk about all manner of things, often not at all related to cancer. Actually, we often talk about skiing, and what's not to like about that?

But reflection went beyond conversations I've had. I spent much of the day thinking back over the last 9 years - the affect of cancer in my life, the hard-fought successes, and the costs. I'm finding it strangely overwhelming, and I've only been bumped to yearly followups. I still have followups with all my doctors. Cancer is still a part of my life. I am still and always will be a cancer survivor.

What's it all mean? I don't know. Idiot drivers are still annoying and dangerous, and should be taken off the road. If I don't sleep well, I'll still be cranky. Mean people still suck. Tomorrow will still come - with or without me. And I'll still go for a run tomorrow, and lift weights the next day. And then...and then...and then.

Julie

Come On Ladies, Do You Really Need More To Convince You? - new analysis shows exercise after breast cancer reduces breast cancer death by 34%

There have been numerous studies in recent years which have shown large improvements in breast cancer outcomes from exercise. On this blog, I have written about the Nurses' Study, the HEAL Study, and a study on exercise and breast cancer by Dr. Friendenreich and colleagues, among others. They've all shown significant improvement in breast cancer outcomes for women who exercise regularly. However, the studies measure exercise in different ways, some include nutrition differences as well, and they look at different outcomes.

Now, researchers in Saudi Arabia have done a meta-analysis of the existing studies. Their results were published in the journal Medical Oncology.

And what they found is encouraging - or alarming to anyone just sitting around on the couch. After analyzing 6 different studies, they found an overall decrease in breast cancer deaths of 34% for women who were physically active post-diagnosis. Active women had a 41% lower death rate from all causes.

According to the authors, Drs. Ezzeldin Ibrahim and Abdelaziz Al-Homaidh, "The results are encouraging and it showed that physical activity being relatively convenient, easy, and affordable risk modifier that may be able to change breast cancer outcome for millions of women. The demonstrated benefits may be equal or higher than most of the currently available interventions."

I've downloaded the study and have been poring over tables and graphs (I guess I really am a bit of a geek). Besides the big, headline numbers, there are some additional, interesting points.

Regular exercise appears to decrease the risk of developing primary breast cancer by 20-40%; but for post-menopausal women, the numbers change to 20-80% reduction in risk. Additionally, for each additional hour per week of exercise, the risk of developing breast cancer decreased by 6%. (So encourage the women in your life who haven't had breast cancer to get moving!)

For those of us who have already been diagnosed with breast cancer, physical activity before diagnosis appears to have little effect on breast cancer outcome. In examining the studies, the authors found that intermediate or high physical activity prior to breast cancer diagnosis did not affect breast cancer deaths, but did show some benefit for overall mortality.

The demonstrated benefit comes from post-diagnosis exercise. All levels of physical activity lowered the risk of dying from our disease by 34% compared to women with low activity levels. That's all levels - moderate to high - which means you don't have to be a super athlete to reap the benefits.

The key here is that it's post-diagnosis exercise! That means, my breast cancer-surviving sisters, that we cannot sit around feeling smug because we used to be active. What we did before cancer doesn't appear to help us much after cancer. It's moving after cancer that can save our lives.

And I mean that quite literally. A 34% decrease in risk of breast cancer death is as good or better than a whole lot of the treatments we go through.

So doll, do you really need more convincing?

Julie