Have a PLAN. Have a ton of PATIENCE. Be CONSISTENT. And most importantly, be ready for the plan to take a nose dive and know you’ll have to start again. And again.
And probably again.
Telling this story has been a constant teeter-totter of maybe I can inspire someone with my story and none of your business. For someone who gets paid to be on stage regularly as a fitness professional, I’m actually pretty private. The hope to inspire and encourage just ONE person has eventually won out.
My official diagnosis is ER-positive / HER-negative Stage 4 breast cancer. And trust me, that still bizarre to say. And honestly? That isn’t even the strangest news. Stage 4 cancer probably saved my life. I’ll get to that later.
My mantra though this entire thing has been Not Today, Cancer. Not today.
Here’s how it all went down.
“Hmmmmm… that’s weird, my sports bra must have been chaffing me on that run…”
As an athlete, and especially when training for a full IronMan competition, there isn’t a week that goes by that something doesn’t rub, chafe, ache, blister or bleed. And I had just re-hired my coach to train me for IMNC 70.3 in October, 2019. So when I saw this odd looking patch of skin on my left breast, I just thought, hmmm…better put some glide on it. Luckily, I had a doctor appointment within a couple weeks, and she wanted to biopsy it. Weird part? Totally clean mammogram. Yup. The good kind too. The state-of-the-art kind. Even on biopsy day they do ANOTHER mammogram. Guess what? Totally clean on that one too. Hey girls, take it from me, if you SEE something, SAY something. I have the kind of cancer that didn’t show up – until it did. So, a few days after the biopsy, just minutes before going on stage at a fitness conference in Chicago, I get the call. My brain said wait to answer until after your session, dummy. But of course, I don’t listen to myself. “Sorry to tell you, Pam, but it came back as cancer.” The rest of the weekend was a total blur. (I must give many thanks to my teammate and friend Javier Santin, who kept me somewhat sane and got me thru it all. And apologies to Marnie Rich and Emily Booth who must have thought I was a space cadet upon meeting me for first time. I’m not, as hopefully you now know!)
Tests. Tests. Tests.
What they don’t tell you is, it is not like the movies. You don’t get a diagnosis on a Friday, and on Monday you are bald and puking your guts out. (Neither of which ever happened to me, which is a total bright side). You undergo a TON of tests. PET scan, CT, MRI…a real alphabet soup of views of your insides. I learned that when they are looking for cancer, they find other things. And lots of times when they are looking for the other things, they find cancer. What they found, were threee tiny spots on my liver. Two of which looked pretty normal, one did not. So, I had to have a liver biopsy. Which, I highly recommend AVOIDING at all costs. OUCH. But not only did I get to do it once, they did not get a “significant sample” the first time so I got to go again. Double ouch. And subsequently, that came back as cancer, Hence the Stage 4 diagnosis. Still not the weirdest news, but I’m getting to that.
Oh yeah, did I mention I was training for another 70.3 Ironman? Press PAUSE.
This is where I departed from my original place of care, and went for a second opinion at The Cleveland Clinic. Which turned out to be the best decision I have ever made.
Remember when I said looking for cancer they find can find something else?
Well, they found them. Two aortic aneurysms, one ascending, one decending. Me. The lifelong athlete. The endurance gal. As you can see, the over-achiever that I am had to have not one, but TWO aneurysms! “You’ll eventually need open-heart surgery, it’s the only way to fix this kind.” No HIIT type drills. No heavy weight lifting. No spiking the heart rate. I can honestly say, that was harder news to take than hearing I had cancer. I went to the parking lot and lost it. I mean, fitness is my LIFE. Cycling is my PASSION. You might as well have just buried me right then and there. (And much thanks to my teammate Dennis Mellon who had to put up with that call from the parking lot!)
But thank god for The Cleveland Clinic. I turned everything over to them.
Here is where we get a plan. Finally. I work much better with a plan. Most athletes have a training plan – a blueprint for success when mapping out a season of races. Cleveland dug right in, calmed me down, added some clarity, and off we went. First, they determined two little pills was all I needed. Ibrance and Letrozole. No hair losing chemo sessions, no violent vomiting -it basically comes in those two little pills. That’s it. Easy. Only thing I can’t have is grapefruit. I mean, what did the grapefruit ever do to anyone?? Eventually I would probably need surgery, but let’s see if we can’t shrink those tumors. And they did. Big time! Then we took a look at the heart issues. Cleveland didn’t think the aneurysms were as large as originally detected, so open heart surgery wasn’t anywhere near in my future. Whew. get those second opinions, people. Don’t feel bad about switching care – it’s YOUR LIFE. And you know you only get one. Oh and another thing – don’t waste your time asking “why me?”. It’s exactly that- wasted time. Cleveland again and again assured me, BECAUSE of me, who I am, the exercise, the good shape I was in and my attitude, would all play the most important part of fighting this thing. Did you know Cleveland Clinic is the No.2 hospital in the nation, 5th in the nation for cancer care, and number ONE for cardiovascular/heart care for 26 consecutive years? Yup. This is my team. (U.S.News & World Report’s Best Hospital Rankings 2020-21).
Ironman 70.3 training back ON!
Here is where the plan and patience converge. I spent July thru October just re-focusing on getting back into better shape. I gave myself a goal of finishing that 70.3 in Wilmington, NC under 7 hours. I came in at 6 hours and 56 minutes. Most days I had to remind myself that I had cancer and heart issues. That’s how good I felt. You can live a life with cancer, and hardly miss a step. Hell, I bet most people reading this are going to be quite surprised. At the time of writing this and the world going thru a pandemic, the term “new normal” gets used a lot. Well, this is just my new normal. Get up. Take meds. Be a badass.
They say scars are just tattoos with better stories.
I guess I’ll have some great stories to last a lifetime.
I had surgery to remove two masses from my left breast. Amazing surgeons from The Cleveland Clinic (Dr. Stephanie Valente (breast disease) and Dr. Steve Bernard (plastic surgery) were able to not only save my girl, but use my own tissue to reshape it so I could avoid implants. (It’s real, and it’s spectacular:) The day after being released I was on the treadmill at the gym. Piece of cake.
March 2020. Bring on radiation. And a global pandemic.
The only issue I have had with insurance not wanting to pay for something, came down to follow up radiation. It was literally going to cost about 170K for both chest and liver radiation at Cleveland. Yikes. So, I opted to begin chest radiation at Roswell Park Cancer Institute in Buffalo, NY. They are close, and they were covered. Now, at this point I’ve pretty much skated thru having cancer. Dare I say, it was all pretty easy. I got 2 days into radiation and boom – corona virus hits NY State hard. So they put me on hold, but just for a day. The new normal was temperature checks upon arrival. The same questions every day. Enter one door, out another. No changing rooms. Hand sanitizer. Stay away from everyone. Ok. Cool. I can do those things. Pretty easy until about day 19 out of 21. Holy smokes…the skin burn is crazzzzzy ridiculous. Ouch. And I’ve had some pretty bad road rash in my day, but that sucked. So…exercising was back on pause. I did manage to teach some Facebook live Stages Indoor Cycling sessions, so thanks to everyone who put up with me, even though you probably had no idea my chest was literally feeling like fire ants had built on bonfire on it and were doing a some type of victory dance…ugh. But, due to my excellent health, it healed quickly.
May-Present (July 2020).
Cleveland did not like the idea that Roswell had suggested that liver radiation would probably result in a 3-5% damage to my kidneys. So my AMAZING oncologist, Dr. Halle Moore, suggested we look into Radio Frequency Ablation for the spot on the liver. Essentially, let’s zap it. Very specific. Pinpoint accuracy. And guess what? Insurance covered it. Go figure. So, July 14th, Dr. Erin Berber performed the surgery and here I sit, so far cancer FREE. I felt like a stabbing victim for a couple days, but hey – small price to pay. Two weeks post op and I did a small brick this am (bike+run) workout, and I have a small race in 8 days. I’m scheduled to compete again in October at IMNC70.3 Wilmington, but I bet covid has something to say about that…meanwhile, I’m still training.
And yes, there have been a couple of crap days. But it’s like riding a bicycle. If you look back (why me?) you’ll crash. And if you look sideways too many times (what if?), you’ll probably crash. You need to just keep looking forward. To keep going forward. Consistent, relentless forward motion. Don”t turn your head. Don’t look back. You’re not going that way.
You MUST keep in mind, that moments of weakness are just that – MOMENTS. Here is where the consistency of training has helped. Yes, you are going to have a bad run. A tough ride. But you get through it. And on the other side is strength. More strength. So keep moving forward.
There is something called survivor’s guilt, but I what I think about daily is survivor’s responsibility. To all those who have gone before me, that have had it much harder than I do, and to those who didn’t make it – we OWE them the honor of telling our stories. Of NOT feeling sorry for ourselves. And for never giving up. EVER. That is why I am also a supporter of Cleveland Clinic’s Team VeloSano. It is their annual ride and fundraising event that 100% of the proceeds go to cancer research. You can find more information about VeloSano and the great work they do here: https://www.velosano.org. In my next blog I will talk more about survivor’s responsibility. Look for it, if you are interested.
What has been the greatest lesson from IronMan training that has helped me the most? Perhaps it is the fact there is something oddly freeing when giving yourself over to something so big you can’t possibly sweat the small stuff anymore.
If you have stuck with the story this far, I only have one request. Please do not respond to this with an “I’m sorry”. I get where its coming from, but please – don’t. It’s like telling a marathon runner “You’re almost there!” at mile 21. Not productive. Sorry sits the bench. I ONLY WANT FIST BUMPS AND HIGH FIVES. TREATMENTS THAT KICK ASS AND A CURE. POSITIVE VIBES AND GOOD JU JU 🙂
One more thing. The only guarantee in life is there WILL be curves ahead. But isn’t that what keeps the ride interesting? Remember the things that have gotten you through difficult times before, and you’ll be ok. Have a PLAN. Have a bunch of PATIENCE. Be CONSISTENT with a great attitude. Find the bright sides. They are there. You may have to dig, but you’ll find them. I promise. Get a bigger shovel if you need to. They are there.
I absolutely must thank my spirit squad for the cheers, the well wishes and of course all the good ju-ju. Cameron, Laurel, Whitney, Javier, Dennis, Marina, Michael, Neil, Glen, Kristy, Ben – and all the Stages Crew – thank you!
Of course I am eternally grateful to the amazing Doctors and Nurses at Cleveland Clinic. You are truly the best in the world!
Thank you to my coach, Doug Bush of Endurance Factor, for all the “start-overs”. To my training partners, who always let me be a beginner, again. And again. Like, every two weeks (insert eye roll here…)
And to all my friends, and of course my family, who never ever once questioned that we would just crush this shit.
Postscript: My training partner Anna and I, 21days post liver Radio Frequency Ablation surgery. I officially came in 14 seconds under my personal goal! Ha! Best night of suffering and smiling!