Post-Cancer Comeback

Ghost of Igloi wrote:

Look at your schedule. I think you may need to add another rest day.

Def a good point, Igy. I sort of plunged into this, admittedly without a firm plan or schedule. I didn't do that entirely blindly; my thinking was that:

a) Anything and everything could possibly be more difficult than I could know ahead of time, so it wouldn't be possible to plan very far in advance, or to have a steady training schedule, and,

b) I would probably make rapid and significant gains in some areas (unpredictably though), so I would need to keep re-writing any plan, because some aspects of the plan would (likely) rapidly become obsolete, and,

c) Pretty much everything hurts, a little or a lot, more or less all the time; also I'm generally exhausted, a little or a lot, all the time. So it will be difficult to properly assess things like how many light days / recovery days / rest days.

(So far, it seems like all 3 of the above have been the case)

With the above guesses/predictions in mind, I have been loosely working from mostly walking to a mix of mostly biking with some, uh, 'running'; while taking days off more or less as needed, and increasing/decreasing exercise load according to how I've been progressing. Sort of like driving across the U.S. without a definite preplanned route: if I'm starting in Boston, and I want to end up in San Diego, I know that if I head mostly west and a good bit south I'll end up in the right part of the country.

Where I want to end up is strong enough and fit enough to run regularly (whether that ends up being 20mpw or 60+ mpw). With some significant improvements since starting out this spring, and with some significant challenges/limitations facing me at this point, I am putting some thought into what I should do at this point.

... well, that was more longwinded than I intended. Didn't mean to ramble

tl;dr - Yes, I should think about my approach and probably make a plan according to what's going on. Maybe more rest days and/or other adjustments.

So glad to hear this amazing story. Would love to hear more about his next Leadville effort, or any other updates.

Physiology, art, and science of training suggests some alterations to your schedule. Just based on your posts. Perhaps too much sameness, levels of stress constant. Easy days need to be easier. Quality days need to be increasingly stressful, of course within your ability to handle. My sense is you are breaking down because your stress in a week’s worth of training is too high, not the individual session. That said, your progress will be limited until you get a handle on the achilles issue.

Ghost of Igloi wrote:

Sub-8 Mile wrote:

Def a good point, Igy.

Yes, I should think about my approach and probably make a plan according to what's going on. Maybe more rest days and/or other adjustments.

Physiology, art, and science of training suggests some alterations to your schedule. Just based on your posts. Perhaps too much sameness, levels of stress constant. Easy days need to be easier. Quality days need to be increasingly stressful, of course within your ability to handle. My sense is you are breaking down because your stress in a week’s worth of training is too high, not the individual session. That said, your progress will be limited until you get a handle on the achilles issue.

Right, I hear you ... part of this is that I'm not even trying to have any hard or quality days right now -- just trying to get to a basic level of fitness. The more-or-less sameness in my 'workouts' is an attempt to stay on the easy-moderate end of things, and then I've been dialing it back on intensity or volume whenever I discover that something is too hard at any point. It's been a challenge to walk that line.

If we were to take a newbie or a guy/gal who's completely out of shape, we would probably say "Just do some easy jogging for a month or two, then we can get to actual training", or if he/she is REALLY out of shape, we might say "do a mix of walking and jogging for a month or two, then easy jogging for a month or two, and after that we'll get to actual training". This hypothetical person would probably start out with something like easy jogging just 2 or 3 miles every day, say with a day or two off each week, am I right? No easy/hard days per se, just trying to achieve some basic fitness to start.

That's sort of what I've been trying to do (is my approach wrong here?) except I can't even jog for 2-3 miles yet; plus with the added complication that sometimes things end up way harder for me than I would expect, due to the chemo-related bodily breakdown, extended time off, and long-term ongoing post-treatment effects such as exhaustion.

For example, I might THINK I'm about to do a 2-mi light jog, half a mile at a time with breaks, but my HR ends up being a bit high and I find myself tired for 2-4 days after. Yet it would have been weird to go slower. (Maybe I'm wrong about this ... it's just that it's already such a slow pace, at some point it would be a shuffle)

Still, it's difficult to go slower or to do even less. What, am I going to jog just 3/4 mi total, 1/4 mi at a time, at 12-min pace? Good lord. (That wasn't directed at anybody who is trying to give helpful advice; just expressing/venting frustration at my situation here).

What I'm attempting to do is more-or-less consistently easy-moderate days for the time being. I'm putting some thought into how to do that with respect to the Achilles and other challenges/limitations. If I had access to a pool and a gym (many reps with low weight, a la physical therapy) it would be great, but everything is closed due to COVID. I think I'm forming some reasonable ideas though - will post when ready.

Igy, thanks for your wise counsel. Anybody else who knows stuff, feel free to mention any thoughts. Thanks, everybody. I really appreciate the support.

Sub-8 Mile wrote:

For example, I might THINK I'm about to do a 2-mi light jog, half a mile at a time with breaks, but my HR ends up being a bit high and I find myself tired for 2-4 days after. Yet it would have been weird to go slower. (Maybe I'm wrong about this ... it's just that it's already such a slow pace, at some point it would be a shuffle)

4 minute intervals with 3 minutes active breaks sounds pretty much optimal. Science recommends high HR training, and if your medical practitioner approves then what is the problem? I do not see any problems with 3 days of recovery. Such training twice a week is ideal for physical improvement.

Semiler wrote:

Sub-8 Mile wrote:

For example, I might THINK I'm about to do a 2-mi light jog, half a mile at a time with breaks, but my HR ends up being a bit high and I find myself tired for 2-4 days after. Yet it would have been weird to go slower. (Maybe I'm wrong about this ... it's just that it's already such a slow pace, at some point it would be a shuffle)

4 minute intervals with 3 minutes active breaks sounds pretty much optimal. Science recommends high HR training, and if your medical practitioner approves then what is the problem? I do not see any problems with 3 days of recovery. Such training twice a week is ideal for physical improvement.

Thanks, Semiler. The problem in this case is that I wasn't actually trying to do a hard workout. I was attempting to do an easy/moderate workout. And if THIS was a hard workout (jogging at 8-10 min pace for just 1/2 mile at a time) then what on earth could I do for easy/recovery sessions during the 3-ish days in between?

(My exasperated tone isn't directed at you, Semiler. I really appreciate the input. Just a bit frustrated at my current limitations -- irritated that I can't (yet) just go for a simple 5-mi easy run or a 2 mi hard run; it would be physically impossible right now)

The thing is, I am at this time still physically under-prepared for hard workouts -- in terms of general conditioning, basic muscle strength, and redeveloping connective tissues. I'd never advise anybody in my condition to go out and hammer it twice a week, because they haven't yet done the weeks of easy running to get ready; for me, recovering from an extreme situation, I suspect this "getting ready" prep work may take months or possibly over a year. Right now it's too early in the process for me to start doing hard workouts; this would very likely lead to injury. Anybody agree/disagree?

After 3-4 months at it, I'm now working on a self-assessment, looking at improvements, strengths/weaknesses, what has worked and what has caused problems so far, and thoughts for moving forward based on where I'm at. Will post when ready :)

It seems to me that you like to compare yourself to the pre-cancer version of yourself. That is a very unfair comparison. I would recommend to forget about pace and distance and rather focus on improvement. Then you will gain a much more positive attitude about your efforts. You are able to run 2 laps in 4 minutes, and then repeat it four times over with a little breaks in between, after all you have been through. How can you have negative feelings about that? It is an accomplishment that cannot be overexagerated.

3 1/2 years in complete remission and running long easy runs are challenging. Requires too much recovery. Instead of focusing on my limitations I rather focus on what I can do and the improvement in physical fitness I have achieved.

My oncologist told me that her general advice would be to go gentle and be patient, but that she regularly observed that some patients didn't respect that advice, hinting at the option that her advice didn't reflect her personal opinion. At my last control she was very interested in the improvements I have made as she knows I only do hard workouts of the bad-to-the-bone category. When you are ready and what is the right intencity is something only you and your medical practitioner can figure out.

Excellent perspective -- thanks. Don't get me wrong; I am PUMPED about my progress. And I'm using pace & distance as measurements of where I'm at relative to last week, last month, last year (although you're right, I do sometimes fall into comparing my current self to my pre-cancer self. It's hard to not do that at all). Overall, I'm pretty positive I think.

My frustration is with the difficulty of getting reliably easy/moderate sessions. They are frequently are harder than I'd like, because my main focus at this time is to establish a basic level of fitness. So, while I'm thrilled that I can jog 1/2-mi at a time, I'd like for that to be easy or moderate if I'm going at 8-10 min pace, because it would be weirdly difficult to "jog" at, say, 12 min pace.

I'm not down on myself so much as I'm wanting to get over this temporary hump where everything and anything can wipe me out for a few days. I'll get there :)

But I do take your point, and it is certainly a solid point. Thanks, I really appreciate it.

Semiler wrote:

Sub-8 Mile wrote:

(My exasperated tone isn't directed at you, Semiler. I really appreciate the input. Just a bit frustrated at my current limitations -- irritated that I can't (yet) just go for a simple 5-mi easy run or a 2 mi hard run; it would be physically impossible right now)

3 1/2 years in complete remission and running long easy runs are challenging. Requires too much recovery. Instead of focusing on my limitations I rather focus on what I can do and the improvement in physical fitness I have achieved.

Well said. Thanks for bringing me back to earth with that.

Here’s my thinking re my progress with running & general fitness, and how to move forward.

Part 1 - Self Evaluation

Over the past 3 months, I have accomplished:

- Lost 8 lbs (need to lose about 12 more)

- Gained quite a bit of muscle, mostly in legs/glutes

- Started with walks of 1.5 mi @ 3.5 mph pace that would wear me out if repeated over a few days, and now built up to where those walks are super easy and I can bike for 30+ min at a harder effort and repeated over several days.

- Increased my running efforts from 1 min jogs with walking breaks, to being able to jog (albeit at a slow pace) for up to 1.5 mi without stopping.

- Getting better at ignoring the burning/stabbing phantom pain in my feet that flares up with each running step. Dangit.

- Improved my moderate ‘runs’ from 10-min pace to 8-min pace.

- Right now I'm guessing I could probably run a mile close to 7 flat if I really pushed it.

I have also made some mistakes, like some periods of too many hard days, not always taking enough rest days, and attempting hills (however lightly) when there is no way I should be doing hills yet.

I’m glad I reviewed that. I feel a lot better about my progress. I have a long way to go, and currently facing some challenges, but I can see that I am improving.

Here’s my thinking re my progress with running & general fitness, and how to move forward.

Part 2 - Current Challenges/Limitations

a) The bike has been great for building some muscle and getting in some aerobic work. But pedaling hard enough for long enough to get aerobic benefit is straining my knees, esp my left knee with an old meniscus injury. So I’m going to lay off the bike, except for super easy biking when needed for transportation, like at the pace of a beach tourist meandering thru town -- I won’t count this as training. With the removal of biking from my rotation, and without being able to go for a proper run, I should probably add walking back into the mix (I had reduced walking in favor of biking).

b) Running on trails is not the best idea at this point. With all the twists, turns, uphill/downhill changes, and minor obstacles such as rocks & roots, dizziness/disorientation can get the best of me. I currently have a broken hand and sore ribs to remind me, haha.

c) No hills yet! Need to do all the prep work to strengthen my Achilles first. Even slow hill repeats have resulted in sore Achilles.

d) Running, er … jogging needs to be somewhat limited for the time being, while I address the current Achilles issue. This will require calf raises (if soreness progresses more towards tendonitis, then it will need to be heel drops), proper full stretching with foam roller, and using a softly-rolling heel strike when jogging (I did this during an Achilles rehab a long time ago and it worked out well). No strides or even moderately intensive running/drills until calves and Achilles are properly strengthened.

e) Carioca drills seem ok; they are currently sufficiently challenging to be a great workout without overly engaging the sometimes-sore right Achilles. Too many or too fast can be (surprisingly) exhausting; I’ll have to perform the movements a bit slowly and keep the reps low.

f) Lots of strengthening is needed; I'm way too weak. I’ll work on this with stuff like bodyweight lunges, core exercises, and limited upper body work (don’t want to pack on the muscle).

e) I have to get better at taking enough days off, and at recognizing when I need a rest day. This can be challenging because to some extent I am in constant discomfort and always feeling a little (or a lot) exhausted, so it isn’t easy to realize that certain discomfort/exhaustion means it’s time for a day off. Especially given that pushing through all that is what gets me through every day -- how am I to shut it off selectively? I don’t know, but I’ll have to start figuring it out.

Thanks to everybody who helped me with parts of this.

Here’s my thinking re my progress with running & general fitness, and how to move forward.

Part 3 - Plan Moving Forward

Easy/moderate sessions:

- Easy jog, rolling heel strike for now, start with ½ mi @ 8-min pace and keep it there for a while.

- Carioca drills (8 x 100m); combines with the jog, this is just 1 mile per session and hopefully should be manageable.

- Lunges, calf raises, standing hip flexor exercises (slowly raise & lower the knee)

- Ankle walks (25m walking on toes, heels, outside of foot, inside of foot)

Harder session, 1x/week

- Long walk at approx 3.5 mi/hr (17 min pace)

- Squat-jumps

Rest Days, one or two per week

Also: Daily stretching, foam roller, core

------

I intend to do this for a few weeks, and then start slowly building up as appropriate.

Anybody have thoughts on this, or on the previous 2 parts posted above? Any input is great.

interesting thread. this is the kind of stuff that motivates me to still get on the boards everyday.

you mentioned doing some biking. have you thought about trying to work this in more for hard workouts that you can’t do yet? i’m thinking that it will help build the cardio without the injury risk. since you aren’t bike trained you won’t be able to do long hard bike intervals. but if you are on a stationary bike, doing all out 30 second intervals can work in the place of hill sprints.

i also just started experimenting with the app Elite HVR which uses heart rate variability as a measure of recovery. i don’t know much about it yet but started getting baseline data. once i get enough to be meaningful, i’ll do some research to see what all of it means. you just need a bluetooth hrm and the app is free. if i find the numbers correlate with when i think i’m recovered, i’ll rely on them to determine when i should back off. i tend to want to stick to a schedule and plow through a workout when i should not have. i need something to tell me no.

This is a really good idea.

Biking around on the roads lately seems to be straining my knees, esp an old left meniscus injury. Having dealt with this in the past, stationary reclining bike has worked well for me years ago.

I would LOVE to do some hard sessions as you suggest, and 30-60 min easy sessions for that matter, on a stationary reclining bike. I'd also love to get into the pool with a flotation running belt. But gyms are currently shut down, and I don't currently have budget to purchase a stationary bike (still recovering and unable to work full-time).

The other consideration is one of volume. As 'Ghost of Igloi' has pointed out -

Since a (perhaps surprisingly) low volume of work really wears me down at this point, if I were to do some good solid stationary bike sessions, it would probably significantly subtract from some other work that I'd like to focus on for now. So, great idea, and I'd love to do it, but not willing to make that sacrifice/tradeoff right now.

Brittle,

One of the ideas I use is a concept that came from the evil genius Salazar. That is “equivalent miles” which if you notice my posts, I call “Igy miles.” What you are doing here is coming up with a metric to quantify and track your cross training volume. For example, 30:00 on a spin bike, or 1,000 yards swimming is 3 miles. It does not matter if this is an accurate measure, it is just a way you can measure, and adjust your training loads. Remember you have essentially three main variables = 1) number of training sessions; 2) volume of training (a session and block of sessions), 3) intensity of session (or quality days in a period). Manipulating these variables will help you zero in on a structure. Good reference books are Daniels’ Running Formula and Freeman’s Peak When It Counts.

Igy

Sorry Sub 8:00, I meant the Brittle post for you.

moanswers wrote:

interesting thread. this is the kind of stuff that motivates me to still get on the boards everyday.

Glad to hear that this crazy story/thread is resonating out there.

I want to reach out to everyone and say:Thanks for the support, thanks for bearing with my sometimes long-a$$ posts, thanks for the encouragement. It really means a lot.

What I'm doing is hard. I'm wrecked every day. It could be worse (obviously I was supposed to be dead for sure); I could realistically have become both deaf AND blind, with lungs 2/3 full of scar tissue and god-knows-what left of my abdominal organs - plus, lots of people are way worse off than me - so I don't want to whine too much.

But this incessant loud screeching in my ears is maddening, and to be honest, kind of depressing. I wake up to instant exhaustion that grows over the course of each day. I dizzily fell down while jogging and broke my hand a week or two ago, but idc whatever, I got bigger fish to fry. I have a constant vague sense of pain that is everywhere and nowhere. And my feet, nerves damaged, have phantom pain; they fake-burn like heck when running. During the day, I keep taking off my shoes to convince myself that there's nothing actually stabbing my foot. Meanwhile, I'm pretty dumb relative to my previous self and I get mentally fatigued as the day goes on. Walking around, I crash into things because my sense of space is off.

This forum has really been an outlet for me and I appreciate it. I can't overburden those around me with all this; for them, it's been years. For me, I don't experience time in the same way any more and it's been like one long weird month or something. That along with my ears still ringing, I have the ongoing sensation that cancer etc has all just happened and is still happening. On the calendar, I am now 3 years cancer free but

OK. Pity party's over. 3 years cancer free.

Sorry - stuff really gets to me sometimes. Bit of a rough day. Thanks.

Oh, and F Cancer.

We are here for you Sub 8! I truly look forward to your updates. You are brave in your transparency and I thank you for that; there's something deep and meaningful for me in your posts. The emotions that come through as you reflect on your journey and share your struggles are refreshing and human. There's a reason you're still here. Keep up the good fight and thanks for bringing us along with you.

+100

I really look foward to these updates, hang in there!