Training for Lung Cancer | Jul 5 2023

It was a beautiful Monday morning when we set out on a long training ride. There was only one problem: my breathing was off. I could tell about 5 minutes into the ride. My lungs usually feel stiff when I get started, but after some slow deep breaths and a few juicy coughs, I can usually dig in. The right lung is scarred, from radiation (fry that tumor, baby!) and serious pneumonitis. The lymph nodes at the center of my chest, too. So it’s a challenge to lovingly command my body to work through this very real set of physical constraints. But it’s worth it to see the progress. My speed has increased on flat terrain. And, hills that once felt impossible feel much less awful– my muscles respond more readily, more smoothly; I’m not as intimidated. What’s a shocker is that I’ve only just discovered I’m carrying a fair amount of new fear about all this bicycling stuff. Fear is one of the unexpected side effects of lung cancer, I suspect. Last week, I made a new rule: if I feel afraid about riding, I need to do it.

Which bringsus back to Monday. Fifteen minutes into the ride, the relatively level road had me pushing hard to hold a pace that was 2-3 mph slower than only four days earlier.  When I breathed in, the center of my chest, around the sternum, didn’t move easily; I couldn’t find the bottom of my lungs. By that I mean, when I take a deep breath, I can usually feel both lungs expand from my belly, up through the sides of my rib cage and into the top of my chest, just below the clavicles. Not Monday. At only a couple of miles in, this did not bode well for what was supposed to be a 45 mile ride.

Mark usually rides ahead– he’s always been faster. He’ll circle back periodically to find me, or wait at an intersection. “I hear you breathing hard,” he observed Monday as I pulled behind him at a red light. “Yeah, I’m having a hard time warming up,” I said. He gave me A Look. I pulled out my inhaler, which I typically use only at the start of exercise. “Let’s see what happens,” I responded.

When we finally turned off of busy main roads and into rolling farmlands, things had not improved. Willamette Valley terrain can include challenging short climbs; even after the inhaler boost, I’d begun to dread encountering them.  Finally, at the shady entrance to a vineyard, I signaled a stop and pulled out my inhaler again. That was the warning flag. “The symptoms are either going to ease,” I told Mark, “or we’ll need to make an emergency plan….Unless you think I’m being an idiot.”

I offered that because right then, I no longer had perspective of whether I was safe or not. One part of my brain was screaming reminders of what my first pulmonologist had said, 30+ years earlier. Never forget, he scolded when I confessed a reluctance to call him, you can die from asthma. Dr. Richard Green, the NYC schools chancellor, had just died of cardiac arrest due to asthma and my doctor used Green’s death to drive his point home. The part of me with the long history of asthma reasoned that with all the rescue inhaler stuff floating in my lungs, I could watch and wait a bit longer. Typically, I’d go with that voice of experience. But there was a newer voice in the mix, and it was very, very tense.

I’d only started to hear it over the course of the past month, as I added more hill climbing to my rides. The first time, it had left me puzzled and a little annoyed– I needed to concentrate on riding, not talking myself down from a sneak panic attack.  The third or fourth time up a steep hill near home, the fear sounded as shrill as fingernails across a chalkboard. I had no idea what was causing it. But Monday, on the side of that road, I realized in a flash that it was the voice of New Me, a lung-cancer-bicycling-me, not Old Me, who could push the rules just a bit and know I’d be OK.

Mark looked concerned, but didn’t think I was being an idiot. I think now he was responding to the what Old Me would have said. He’d learned to trust Old Me, you see. He has yet to be formally introduced to New Me. (Maybe that’s why I still felt uneasy as we began to ride again.) I settled into a slower pace. High cadences draw more on the cardio-vascular system but are ultimately more efficient than lower cadence riding, which is more muscle-powered. I was riding more slowly to help my cardio system, but even more so because it felt like I had the weight of a dozen people riding with me, a committee exploding with conflicting views.

You don’t need to be doing this, you know.

You don’t need to ride to Multnomah Falls.

Most people with lung cancer don’t do this kind of thing.

Maybe you can’t do that ride to the Falls.

You probably can’t.

Think of the elevation.

The miles are double today’s ride….

Then, from the back of the pack, a small question: But what if you can? I bless the Peloton instructor who says that like a mantra. I heard it Monday and I worked hard to turn my focus to the road, the trees, the alternating gold and green patches on the distant hills. For the first time that day, I was outside of my fear-head.

Miles later, we stopped at the entrance to the public park and lake we’d planned to ride around. My breathing had eased but still wasn’t 100%. I’d already exceeded the inhaler’s usage maximums, and while decades of life with asthma have left me with a pocketful of rule-bending to draw on, I wondered if the wisest course wouldn’t be to find a shady spot and wait for Mark to circle the lake, ride back to the car, and come to get me.

We talked for what felt like a long time. The lake was beautiful, my lungs were easing, and with that, fear was diminishing too. I wanted to do the ride. Ohhhh no, bad idea. You could just wait here for Mark. You probably should, you know.

Blah blah blah, I told myself. What if you can? Finally, Mark and I agreed we’d move ahead, checking in periodically. We were prepared to switch to Plan B at a moment’s notice.

And then we didn’t have to. I took each of the crazy-long hills slowly. Mark waited for me at the top. “OK?” he’d say, or “Go?” Yes. And sooner than I expected, we’d ridden the entire circumference of the lake. We stopped in a shady spot for a long lunch. When I’m having asthma, I keep telling doctors I never wheeze, I cough and I can’t get a full breath. By our lunch break, I’d stopped coughing.

We decided to find a return route that took us through countryside rather than a busy multiple lane road. For the most part, we succeeded. Afterwards, Mark confessed that Southwest Spring Hill Road and Southwest Fern Hill Roads had him worried. Usually, hill in a road’s name means exactly what it says. With the temperature climbing into the 90s, we were both relieved we’d gotten t​he no-hills part of each road.

46.2 miles, bay-bee. Training for Multnomah Falls? You bet. Maybe even more important: new training ground for living with lung cancer? (Jeez, aren’t we done with that yet?) (No, silly, we’re not. Obviously.)

Most important, here’s a cake I delivered today. The kiddo’s favorite things were listed as race cars and soccer; his favorite color was rainbow. I told the AI image generator, Dall-E, to make a picture of a race car driving so fast it spewed rainbow exhaust and soccer balls in its wake, then I had the image printed in edible ink on edible paper. The squiggly stuff on top of the cake is icing. I had a blast with it.

Thanks for reading. Here’s hoping your day has a few rainbows tucked away, preferably with rainbow frosting.