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I observed here a while ago that I am a big one for anniversaries. But tonight I’d like to discuss something a little different. How do you know you have reached a milestone? What sorts of benchmarks have you set for yourself in terms of recovery?

I didn’t make enormous progress in the skills that were assessed at the start of the 12-week Livestrong program and at the end. These included measures of balance, flexibility, and strength; fortunately for me, I started out fairly well on all counts and so had relatively little to improve. However, you’d better believe I’m happy when I’m able to increase my weight or my reps on the workout machines, or up my time on the elliptical.

I do have a bit of a competitive streak, and always have, going all the way back to 4th grade when we had arithmetic flash card drills around the classroom. That’s another story, since I always wound up losing somehow to one particular boy—after beating everyone else first. But I’ll refrain from that digression. I raise it here only to note that some time later I learned that it’s far more satisfying to compete against myself. At this juncture setting and surpassing some workout goals seems to be a healthy way to meet those ego needs while getting stronger and more fit.

Outside of my exams and consults, which measure my health in entirely different ways, it’s not easy to tell how much I’m getting “better.” I can, however, look back to my stamina and mood during significant events of the past two and a half years to gauge how far I have come.

Two years ago last weekend, I attended one of the performances of the community choir my husband conducts. I traveled down with friends so that we wouldn’t have two cars to drive home afterwards, and even so I could not make it through the entire afterglow. I was still undergoing chemo, and I had recently lost all my hair. It hurt to eat some things, and I was crushingly tired after a certain hour no matter what.  It’s a relief to realize how far I’ve come along since then, an awareness reinforced this past weekend when I not only attended the group’s performance and the afterglow, feeling more than well enough to be sociable, but drove both ways as well.

The performance seasons for this choir offer another reminder of my progress, because the concert season of the fall of 2010 was my husband’s first one as director there, and my first one singing with that group. We were both so terribly tired after that weekend of performances in early December—which followed four days of extra rehearsals with the orchestra that is not-so-fondly known as “hell week—that it was a minor miracle we made it home safely following the party. I was already seriously symptomatic, and in retrospect I can see that I was terribly scared about what was wrong. I did get even sicker before diagnosis and treatment, and my recovery has not been a straight-line ascent. But I am definitely better than I was in December of 2010.

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Summer vacations this year will provide another means of comparison for me. In July of 2011, not yet through with chemo, I traveled to rural Virginia with my husband and daughters for my oldest nephew’s wedding. The trip down was simply awful. It was brutally hot, and we were all out of sorts just from that. We had to break up the trip because I did not have the stamina for 9-10 hours in the car at a stretch, and we stayed at my sister’s on the way. Unfortunately, the temperature didn’t drop much below 80 that night, and my sister’s house did not have working AC or decent air circulation. Thus by the time we reached our destination, we were all on our last nerve. The only saving grace was that by some fluke we had wound up with a Cadillac as our rental car (our own beaters being far from reliable enough for such a trip) and so we had comfy seats and wonderful cool air as long as we were on the road.

I had a meltdown at the rehearsal dinner, feeling beyond weary physically and feeling great anxiety and grief about perhaps never seeing my own daughters’ weddings. My nephew's father had died some years before of cancer, so that reminder hung heavy for us all. And that was before we’d gotten our disconcerting news about my chemo failure and the lung mets. I did manage to pull myself together, and for the most part I think we all wound up enjoying the wedding weekend. But that was definitely another low point.

The vacation season I had last year demonstrated significant improvement over the adventures of 2011. When my husband had a few days off, we went camping fairly close to home. We didn’t have an ambitious agenda, other than enjoying some quiet time apart from the usual routine, but I was far more able to enjoy the moments as they came and went, rather than worrying about what had been or what might lie ahead. In part that’s a function of my improved physical health, and I should not be disingenuous about that influence. It’s also an indication of my increased ability to bracket my awareness of being under threat, at least for a little while at a time.

My experience at NN12 was also a good test of my recovery to that point. Traveling on my own was tough, no doubt about that, and I needed every minute of sleep I could get. But I was far more able to keep up with the pace of the event than I expected I would be, and that was definitely heartening. I suspect that NN13 will be challenging in new ways, but I’m grateful not to have to plan as carefully as I did last year for bail-out time. We’ll see how well my expectations match the actuality.

I haven’t mentioned the possibility of decreases in health and fitness along the way, though I’ve also experienced some of those (and continue to do so). Of course, other factors complicate the process for all of us, as this example illustrates. An acquaintance of mine has been struggling with a serious case of colon cancer (which unfortunately has recently recurred). After her first chemo treatments, feeling miserable and depleted, she asked her oncologist how long it would take for her to feel back to normal again. He replied, "About 10 years." Once she recovered from hearing that blunt assessment, she pointed out that she would then also be ten years older, and thus presumably not as fit as she was when all this began. He acknowledged that, but then reminded her that it would be better to be ten years older after all.

The most frustrating chronic after-effect I have to cope with, apart from fatigue, is related to my current treatment. I have not yet gotten a good handle on my weight, which has increased by about 20 pounds over the past 20 months since I’ve been on hormones. I feel as though that’s a sort of time bomb waiting to release other negative effects, so that’s one major motivator for me to increase my exercise goals.

I’ll go on the record here with my fitness objectives for the summer and fall. Currently I’m getting to the gym twice a week, most weeks, and doing 17 minutes of cardio each time. I’d like to nearly double that cardio time in the next six weeks, so that in another thirteen weeks after that I have a good chance of getting close to the target of 150 minutes per week. Specifically, here is my plan. To add about 5 minutes per week will get me to about 64 minutes/week by mid-June. To double that again would mean adding another 64 minutes, which will take about thirteen weeks at a rate of 5 extra minutes per week. Then I’ll be about 22 minutes short of the goal of 150/week, which I would hope to meet with another four weeks of incremental progress. If I can do it more quickly, I will; I’d like to get to that level before the fall rains arrive. Simple enough in theory, right? I’ll keep you posted about how things are going. Even holding the line at my current weight, rather than gaining a pound a month on average, would be helpful, though I am hoping for some loss.

And now it’s your turn. How do you assess your progress? Has it been even or sporadic? Has some recurrent event helped remind you of where you were compared to where you are now, as my husband’s concerts do for me? Do you have particular goals for yourself? Please do share as you are comfortable. And of course, this is always also an open thread for anything else that’s on your mind and heart.

Monday Night Cancer Club is a Daily Kos group focused on dealing with cancer, primarily for cancer survivors and caregivers, though clinicians, researchers, and others with a special interest are also welcome. Volunteer diarists post Monday evenings between 7-8 PM ET on topics related to living with cancer, which is very broadly defined to include physical, spiritual, emotional and cognitive aspects. Mindful of the controversies endemic to cancer prevention and treatment, we ask that both diarists and commenters keep an open mind regarding strategies for surviving cancer, whether based in traditional, Eastern, Western, allopathic or other medical practices. This is a club no one wants to join, in truth, and compassion will help us make it through the challenge together.
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Originally posted to peregrine kate on Mon May 06, 2013 at 04:45 PM PDT.

Also republished by Monday Night Cancer Club.

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