Getting Old and Getting in Shape

This post has the potential to rival The Longest Post Ever, but it encompasses about six months of my life as opposed to six hours.

I'll start with something I've wanted to explain to all of my friends who are approximately my age and warily approaching or just past the big four-oh. That birthday, exactly one year ago, didn't bother me at all. It's just a number, I didn't feel any different, and I've never cared about getting "old" or having a bigger age. In fact, I had to be persuaded to have a party for my birthday (which didn't quite turn out the way I'd hoped) and basically, forty is no big deal. However, now that I've finished my fortieth year (actually, my 41st year for you math geeks), I have an announcement: If you can make it through the week of your 40th birthday without being diagnosed with CANCER, you've got nothing to complain about.

Obviously, during my recovery from the mastectomy and while undergoing chemo, I didn't quite feel my age. My body ached, I was tired all the time, and I seemed to be getting any ailment that could possibly exist. Knowing that there'd be a light at the end of the tunnel, I just plowed on through, waiting to be young(ish) again.

I know that the stereotype is that women doing chemo are bald and skinny because they're nauseous. However, I found that I was only eating comfort foods: cereal, pasta, breads, and uh, cookies. Add to that the fact that I was taking a steroid to make my body strong enough to handle the taxol, and I actually gained about 10 pounds during chemo.

I'd read many-an-article about how important keeping in shape is in keeping the cancer from coming back. Basically, studies and research have inconsistent findings about the kiwi and broccoli diet or the all organic lifestyle, but it is an absolute that being overweight or obese can increase your chances of recurrence. Though I indulged during the summer of awfulness, I knew it wasn't a permanent thing.

Early in my treatment, I was alerted to a fitness program at the YMCA through the national Livestrong foundation where they help cancer survivors get into shape. Knowing little about it but seeing that it was free, I signed up. After a few phone calls, I was enrolled in a class that would meet twice a week for twelve weeks, give me a personal trainer at each of those sessions, and tailor my exercises to the fact that I've been treated for cancer. Not only that, but the Livestrong program includes a free 3 month family membership, and since my body managed to grow the cool kind of cancer (breast cancer is very vogue these days), there's a grant to extend that family membership for a full year. October 2 was my start date for getting back into shape.

Between the end of chemo and the start of Livestrong, I began taking tamoxifen. Although I've alluded to it in other posts, here's my chance to explain how it has officially made me old. My breast cancer cells were classified as estrogen receptor positive, which is actually a good thing. (Best breast cancer ever, remember?) It means that the cells need estrogen to grow. This drug called tamoxifen can block estrogen from binding to other cells, thus giving any cancer cells that may be left in my body nothing to grow on. Dr. Kirshner, oncologist extraordinaire, actually told me that the tamoxifen does more for me than chemo and radiation combined. Unfortunately, tamoxifen, by cutting off my estrogen, put me into full menopause. But whatever. It was going to happen anyhow, and menopause is better than cancer.

Knowing that I cannot miss a pill or accidentally double-dose ("Uh, did I take my meds? I can't remember.  I'll just take one."), I bought one of those days-of-the-week pill boxes. Then I started taking the pills and the hot flashes began. It was the one-two punch of officially getting old.

Back to the weight thing. My first dose of tamoxifen was August 31. Starting then, I was gaining almost a pound a week by eating my normal, pre-cancer diet. I figured out, with the help of Google, why that may have been happening: Post-menopause, metabolism changes, so I was supposed to be eating like a 60-year-old, not a 40-year-old.

But hoping for an easy fix, I mentioned my weight gain to my doctors in November. A blood test for my thyroid was ordered because sometimes underactive thyroid causes weight gain. Results: overactive thyroid. I should have been losing weight. They repeated the blood test and got the same results. I was referred to an endocrinologist, who couldn't fit me in until February, so I was on my own with my weight gain for a while.

I thought that Livestrong, with the twice weekly meetings and my maintenance exercising a couple more times a week, would help out, but I continued to gain weight. In reality, Livestrong wasn't enough. The trainers, Elin and Al, were wonderful and knowledgeable, but the program is focused on strength and balance, and (sorry if I offend anyone) really geared toward older, less athletic people. I was a twice-a-day varsity swimmer through college. I've done a triathlon and numerous 5Ks. Yes, that was years ago, but my athletic body was looking for and needing more. I had to find something hard and go all-out!

In mid-December, up 18 pounds from when I was diagnosed with breast cancer, I asked a preschool mom/friend (Kristin) about some Facebook post she made about a Method 360 demo class. She explained that she and a trainer named Trish lead these classes that give you a full body workout (cardio, strength, core). I showed up that Sunday and gasped for breath, dripping with sweat for an hour. Absolutely perfect! The next day, I signed up for a 12-week program and committed to going to classes 6 days a week, sending Kristin and Trish daily food logs, and letting them measure my weight and body-fat every other week.

Those of you who know me well (or probably even those who only kind of know me) will have no doubt that I've gone all-in here. If I tell someone I'll be there 6 days a week, I will. If I have to send a food log, I will include the 3 M&Ms I ate this afternoon, no cheating. If a triathlon in June is mentioned, I'll register. (Actually, I'm now registered for one in June and another in August. Anyone have a bike I can borrow?)

It took me about 3 weeks of the daily workouts, but now I am not gasping for breath. I'm working hard and I'm really feeling fit. I'm down about 10 pounds on the scale (Trish says it's more like 13 pounds of fat gone and 3 pounds of muscle gained), but that's no longer the goal. I just want to stay in shape. Also, keep in mind that I'm not yet even back to my pre-cancer weight, though I'm more fit.

The sucky part is the diet. Paul and I have always agreed that a life without chicken wings is a life not worth living. We've said, "I'd rather die a few years earlier and eat what I want." Though I still agree with our sentiments, I have to refer back to the studies that show obesity can cause cancer to come back. If chicken wings cause me to be overweight, I guess I'll skip them. I'm sure I'll have wings, brownies, and McDonalds on occasion, but my daily diet has to be better than it used to be. For the first few weeks of this diet, I was hungry all day, but now I'm used to it and just accepting it, I guess.

So my endocrinologist appointment finally rolled around a few weeks ago and he did another blood test to check the thyroid. Now I'm actually showing the underactive thyroid that causes weight gain. His explanation is that sometimes our thyroid gland gets inflamed and becomes overactive (which would make sense because my radiation was pretty close to there), and then once the swelling goes down, it becomes underactive. I'm now taking a thyroid medication, another pill added to my days-of-the-week dispenser. We'll recheck the blood in a few months. Maybe thyroid meds will help me lose weight, too? I can wish.

When my parents were alive and I would get updates from my mom about her 60-something and my dad's 70-something friends, it was always about who had what ailments. In this ridiculously verbose post, I've mentioned my meds, menopause, my hot flashes, my oncologist, and my thyroid. I guess 40 is the new 60.

I'll end with a cool discovery I've made that'll help you young women in the future. Hot flashes are really quite uncomfortable. From summer when they started (menopause actually started temporarily with the chemo drugs) until December, I followed the generic hints: wear layers, have a fan nearby, use a cool towel or ice, etc. Literally, the very week I started Method 360, the hot flashes went away completely. Now, keep in mind that this is a very intense, boot-camp-like workout. Livestrong's 90 minutes of weights and stretching did nothing for the hot flashes. But serious exercise really does get rid of hot flashes. Now you know.

Now I'll Cliff's Notes this post:
- Chemo made me gain weight
- Tamoxifen cuts off my estrogen. Good at fighting breast cancer. Causes menopause
- Menopause made me gain more weight
- I started easy workouts with no effect
- Complete diet change and kick-ass workouts have had the desired effect
- I was diagnosed with hypothyroid
- I take pills from a days-of-the-week dispenser
- Triathlons in June and August

Happy 41st Birthday to me!