Wednesday, the day after my last post, I not only felt well enough to work all day, my wife and I did 25.3 miles on the tandem that evening. Unfortunately, the weather turned bad yesterday, and Friday I had the day 8 gemcitamine IV, and felt really bad the rest of the day.
I felt better yesterday, with only a major headache left over, so I took a pain pill, and went for a 25.1 mile ride. That’s 63 miles for the week, not too bad I think, since it’s February and I’m being hammered with chemo.
Friday, February 15th was my 22nd wedding anniversary. I celebrated the occasion by spending 6 hours hooked up to an IV, receiving chemo drugs. This time, they used gemcitabine and cisplatin. I must not have felt too bad when I got home, because I finished installing my new carbon fiber seat on my Roadster, then did a short test ride (nasty weather getting close, didn’t want to wait).
Saturday, the day after chemo, I still felt pretty good, but the weather was way too nasty to ride. Sunday was better weather, but I started to feel sick, and had to bail after just a 13 mile ride. Monday, I went to work, only to leave and come home after four hours. Today, I lasted just 30 minutes at work, and had to come home. I finally seem to have figured out that one of the two anti-nausea drugs they are giving me is making me sick. Sheesh……. not only are the chemo drugs bad, the anti-chemo drugs are bad.
Well, my first attempt at chemotherapy did not go well. I had an allergic reaction to the first chemo drug they tried: Taxotere. 15 minutes after they added it to my IV, I started getting serious chest pain, broke out in a cold sweat, got dizzy and felt like I was going to pass out, and when my blood pressure dropped to 70 over 40, they quickly wheeled me to the emergency room, where I spent the rest of the day on saline solution to flush out the Taxotere. I go back next Friday, for another try with a different chemo cocktail. I can hardly wait.
Peggy, Steve, Ken, and Rick joined me on my 53 mile Kennedale – Briaroaks route today. We left Sonora Park around 10:00 am. It had already started to warm up by then, and within a short while, it was truly a beautiful day for riding. This is mostly a quiet, scenic route (with a few crazy drivers thrown in at the beginning and end), and the roads were great, as was the company.
The only part of the ride I didn’t enjoy too much was the downhill rough curve I tried to take too fast at mile 33. I was on my left side and skidding, instantly. It’s the first time I’ve ever gone down at speed on the Corsa, and another reminder of the need to pay attention at all times when riding. I knew this curve was rough, and had always slowed down for it before, but just didn’t think this time.
I knew I had some serious road rash on my left butt cheek, but I had no idea how much of the rear of my tights was gone. They should never have let me go in the Subway after the ride…..lol. I have road rash all the way across my rear, so I must have finished the slide on more than just my left side. The road rash on my left forearm and thumb are less severe.
We ended up with 52.3 miles, at a 14.3 mph average, and did 2,355 feet of climbing. It was my first ride of more than 25 miles since my surgery. I’ve developed consistent exercise induced asthma since the surgery. It happens whenever I ride hard. I start my chemo next Friday, and I’m betting I’m the only patient in the chemo room with road rash from a bicycle crash.
Today’s route
Can I keep it?
Fedex delivered box 1 yesterday, and box 2 today. It’s a Performer Roadster carbon fiber and aluminum lowracer. Actually, with a seat height of 15 1/2 inches, it’s too tall to really be called a lowracer. I guess quasi-lowracer would be more accurate. The seat and bottom bracket height are both over 1 1/2 inches taller than Performer’s specs show them to be. The bike is made with two different sets of wheel sizes (559 and 406 or 622 and 451), and the fact that mine has the bigger wheels may explain this discrepancy. The seat and bottom bracket are 2 1/2 inches taller than those on a Baron.
I bought mine from Steve Delaire at Rotator Recumbents. Like China Mascot, Performer builds excellent frames, but has been known to install componants that are poorly chosen, mismatched, or just plain wrong. I figured Steve rigging it would eliminate most of that, and he did a nice job. I asked him for an OC setup, and the riser and handlebars he installed work really well on the bike. The idler setup he used seems excellent, too. The only booby trap that escaped Steve’s eagle eye was the rapid rise rear derailleur paired with a Sram Rocket shifter. For those who haven’t used a rapid rise derailleur, they shift backwards from every other derailleur you’ve used. Paired with the Rocket shifter, 1 is the smallest cassette cog, 9 is the biggest. I might could get used to that except for the fact that I have the same Rocket shifter on my Corsa, and having the same shifter work backwards on one bike from the other isn’t going to work.
I did my first 25 mile test ride this afternoon. Slow speed handling on the bike is outstanding. On my first try, I did a turnaround on the narrow Joe Pool dam road, without unclipping and without sitting up. I have yet to wobble on the bike. It came with the standard heavy FRP seat that Performer and China Mascot use. The seat seems too large for me, and isn’t that comfortable. Still, even with the seat I’m not too fond of, the bike’s ride is surprisingly good. On the rough Joe Pool dam road, it was at least as good a ride as my Corsa. I have a carbon fiber seat ordered for it. I won’t be able to really fine tune everything until I receive that seat. With pedals and seat pad, the bike weighs 26 pounds (unofficial bathroom scale weight). The carbon seat should lower that by 2 pounds.
As tall as the bike is (relatively speaking), it may not be as fast on race day as I’d like. But, I can already tell it’s going to be a blast to ride.
Starting with that ride on the 5th, I’ve now ridden 10 days in a row. I pushed it a bit today, and averaged 17.2 mph in a 25 mile ride on Joe Pool dam. That’s pretty encouraging for me, considering the lung tissue I’ve lost, and the fact that it’s only been a little over 3 weeks since surgery.
But it isn’t all good news. The biopsy from the lung surgery found one cancerous lymph node. That makes my cancer stage 2 rather than the stage 1 it was thought to be, and drops my 5 year survival odds from 80-90 percent to 40 percent. I can raise that some by having adjuvant chemotherapy, and my surgeon has referred me to an oncologist. I won’t be able to start chemo until 6 weeks after surgery.
I also seem to have developed exercise induced asthma, whenever I ride. I never had it before, and my research finds no link between lung surgery and exercise induced asthma, but I found an old Albuterol inhaler and tried it, and it seems to help a lot, so I’m saying it’s asthma. I’m bringing it up to my primary care doctor next time I see him.
But for now, it feels good to be riding.
This afternoon, starting from my driveway, I rode 9.8 miles in the neighborhood on the Nimbus, averaging a blistering 12.9 mph. Why bother blogging about such a short and slow ride, you ask? It was my first ride since losing the upper half of my left lung to surgery on December 20th. They removed 40 staples from my side yesterday, and after a few minutes trying out the stationary bike, I decided I could ride. It felt great to be back on the bike.
I’ll be going back to work on January 18th, but I’m not supposed to do any lifting until February 1st. I plan on just riding easy for a while, and not pushing it until I’m a lot further along in the healing process.
I was released from the hospital this afternoon, and am home. We usually have our Christmas gathering on Christmas Eve, but posponed it until this afternoon this year.
I am feeble, and have a Frankenstein incision from the middle of my back all the way around to just under my arm, with 40 staples in it, but it’s still great to be home for my family gathering. Merry Christmas, everyone!
I was admitted to the Dallas VA Hospital on Wednesday, and had surgery Thursday afternoon. They did a wedge resection on my upper left lung, and after the pathologist confirmed it was cancer, removed my entire upper left lung lobe, as well as a bunch of lymph nodes. The lymph nodes will be biopsied, and if they are cancer free, then the surgery was a cure.
They had me walking a lap around the Thoracic Intensive Care Unit on Friday, and cyclist that I am, I asked for and got bonus miles, walking a second lap.
I was moved from TICU to a regular room last night. I will probably be here another couple of days.
I had no symptoms that really alerted me, but looking back, there were hints. The first was in June, when I experienced asthma like symptoms during a 128 mile ride. I wasn’t wheezing, but was short of breath, unable to breathe in my usual amount. This would have not been noticeable on my couch, but was VERY noticeable on a 128 mile bike ride. I had to stop and catch my breath on the one significant hill on the ride, became exhausted much sooner than usual, and was barely able to complete the ride. When I got home and told my wife, she thought I should go to the ER, but I couldn’t bring myself to tell a doctor, “Doc, I’m so terribly sick that I could barely complete a 128 mile bicycle ride.” I also had bronchitis for three weeks in August. I’ve always been bronchitis prone, but hadn’t had it this bad in years.
I probably should have posted some of this story about how it got diagnosed before, but here’s my story up to now. It starts with a thyroid nodule. It wasn’t cancerous, but ended up leading to the discovery of my lung cancer. It was the spring of 2006 when I noticed a lump on the lower right front of my neck. It was much lower than my Adam’s apple. I had a checkup with my regular doctor coming up, so I mentioned it to him, then. He said it was likely a harmless thyroid nodule, but referred me to a thyroid specialist. I traveled to the Dallas VA Medical Center to see this specialist. I had no idea then of how many times I would make this trip in the upcoming days.
The thyroid doctor ordered an ultrasound scan to measure the nodule, then an FNA (fine needle aspiration) for a biopsy to check it for cancer. None was found, and the doctor said the nodule should just be checked annually for growth. She did say, however, that an umbilical (belly button) hernia I’d had for a long time needed to be repaired, and I had surgery in January of this year for that. It was my first surgery in many years.
In the spring, another ultrasound scan was done on the thyroid nodule, and it was determined that there had been quite a bit of growth. Another FNA was done, and when it was inconclusive, another procedure was done, where the neck is numbed, and a much larger needle is used to extract biopsy samples. Just before he gave me a shot to numb my neck, the doctor said, “I don’t know if I should numb you or not. A long distance cyclist like you would probably like the pain.” I was NOT very reassured by this. There was still no cancer found.
I thought all this was to determine whether or not to do surgery on the nodule, but I was mistaken. The doctors had already decided to surgically remove it; they were trying to decide whether or not to take my left thyroid gland, as well. Thyroid nodules are common, and very low risk when they’re small and on young people, but when you are older and the nodule is bigger, and especially when it has a growth spurt, there is a very high risk of thyroid cancer. Thyroid cancer is among the least deadly of cancers, but it’s still cancer. If there is cancer on one thyroid gland, the risk of cancer on the other thyroid gland is so great, they remove them both. Since they didn’t find cancer in my thyroid nodule, they only wanted to do surgery on the right side.
I agreed to let them remove the thyroid nodule, and they scheduled surgery for September 29th. I was scheduled to race in The Texas Time Trials on that very day, so I asked them to reschedule for the next available date. They scheduled me for surgery on November 15th. Two weeks prior to that, I did all my pre-op appointments, which included a chest x-ray. They spotted a shadow on the x-ray, so faint they weren’t even sure if it was anything more than an x-ray glitch (properly called an artifact). When they went back and reviewed the pre-op chest x-ray from the umbilical hernia surgery, 10 months earlier, and saw the same shadow on it, they knew it wasn’t just an artifact, and ordered a CT scan.
When they called to tell me of my CT scan appointment, they only told me that my chest x-ray had something suspicious on it, and they wanted to take a closer look. It was 8:15 pm on Wednesday, November 14th, the evening before my scheduled surgery, when the surgeon called and told me my surgery had been canceled, and he was pretty sure I had lung cancer. It was a 2.8 centimeter SPN (single pulmonary nodule – anything less than 3 cm is a nodule, 3 cm or bigger is a mass). He called back the next day to tell me he wanted to admit me to the hospital on Sunday, November 18th.
Since the doctor was already supposed to operate on a thyroid nodule, and here I was with a cancerous nodule in my lung, he figured the thyroid nodule was probably cancerous, too, and that I might also have cancer in lots of other places, as well. With me as an in-patient, he knew he could get quicker test results and consultations with other doctors, to determine what, if anything, could be done for me. He didn’t share all that information with me at the time, but with the tone of his voice, he might as well have.
I was admitted, and violated with various tests. The first consultation the doctor wanted to do was, understandably, with the pulmonary (lung) doctors. It wasn’t until my second day in the hospital that he was able to do this consultation, and as soon as he did it, everything changed. The pulmonary doctor took one look at the CT scan, and told the thyroid surgeon that it was not a metastatic tumor from some other cancer, it was NSCLC (non-small cell lung cancer), and was the primary tumor, and as small as it was, it was probably the only cancer I had. He recommended that the thyroid doctor release me from the hospital, and turn my care over to the pulmonary doctors. I was released that evening.
My doctor care went from fast and furious to a snail’s pace. The pulmonary doctors seemed to be in no hurry. It was two weeks later when I had my appointment with a pulmonary doctor, who told me the SPN was well contained within the upper lobe of my left lung, that my lymph nodes showed no signs of cancer in the CT scans, making the cancer likely Stage 1, and that surgery to remove that lobe of my lung should be a slam dunk cure for the cancer, with a 90 percent chance of it not recurring. He told me with a straight face that I would notice no difference with that lobe of my lung missing. I’m no doctor, but I immediately knew better than that. Your right lung has three lobes; your left has two. A couch potato might not miss half of his lung being removed, but a serious cyclist was sure to notice his VO2 max being surgically reduced that much.
My research, though, had already told me that surgery was the best way to attack early stage cancer, so I agreed to the surgery. I asked about thorascopic surgery, which is much less invasive than open thoracic surgery, and he told me the VA only does open thoracic surgery for a lobectomy. I considered trying to get the less invasive thorascopic surgery. There were only a few doctors doing this type of surgery for lobectomies in the country, so I would have to travel, and even then, most would not guarantee not to change to open thorascopic surgery, once they got inside. Using a thorascope for a lobectomy is very difficult, apparently. The surgeon has to get all the way around the lung to remove lymph nodes to properly stage the cancer, and not many have the skill to do that with a thorascope. And if there are any complications, you get opened up anyway. So, I agreed to the open thoracic surgery at the Dallas VA Medical Center. If I had known then what I know now, I would have done whatever necessary to try and get the thorascopic surgery, instead.
I came in for a pulmonary function test the next week. A pulmonary function test checks your lung function to see if it’s good enough to give up a lobe of your lung, and still have enough lung function to get by. Not surprisingly, my pulmonary function was in the high-normal range, and the woman who administered the pulmonary function test said it was the first time she had seen a high-normal range on a lung cancer patient. I was to end up being a freak to many of the medical people I saw.
I waited for my surgery to be scheduled, and called when mid-December rolled around and it still hadn’t been scheduled. After my call, they called back to let me know my surgery had been scheduled for the day after tomorrow, December 20th. Wish me luck.