The Boy in the Bubble

Or maybe I should say the Man in his Man Cave.    From jetting around the US to a self-contained bedroom/bathroom, my world has gotten pretty small pretty fast.  But in the context of what I’m going through it truly doesn’t matter.

This week’s blog starts with the first phase of treatment called Induction.   The first phase of Induction is the actual chemo therapy treatment.    As I mentioned last time, the goal of the chemo is kill off all the white blood cells that have gone rogue.  In my case it’s the neutrophils, the little guys that protect the body from infection.    To do this they put me on two chemicals that target those cells in what they call a ‘7 and 3 treatment’.  For 7 days you are on one of the drugs for 24 hours a day while the other one is pushed through your IV once a day for the first 3 days. 

Speaking of IVs, the Friday the chemo was started (the day after the bone marrow biopsy), they do a small operation to put in a PICC line.  Way cool.  They use ultrasound to locate a vein in your upper arm then they make a small incision and thread a plastic tube into the vein, up your arm and into your chest.  The arm end is held in a snap mechanism that they can then attach the IV tubes to (I have two dangling from mine).   Given the amount of times I was stuck to give blood or receive fluids up to this point, this makes life so much easier.  Kind of like having and outside faucet vs having a plumber come to your house every time you need to use a garden hose.

PICC line is in, the prep drugs are being pumped in and by the evening Friday they hooked me up to the chemo drugs.    Lots of questions at this point…If the chemo is only on for 7 days, why am I in the hospital 30+?   When will I start feeling bad?   What are some of thing that will happen to my body as a result of the chemo?

The reason for the long hospital stay is to assure your body has recovered enough for you to leave isolation and face the germs of the real world.   You are not cured after Induction, but treatment from there will depend on your type of AML (which you will likely know sometime between day 7 and day 10 after the bone marrow biopsy cytogenetics are complete).   The measure for going home in my case will be the rate I am able to create good neutrophil white blood cells and platelets.   It would not be good form to get all the way through Induction and then succumb to the common cold or a cut while shaving when you get home.

I asked the question of when I will start feeling  bad and when will I start feeling better a half a dozen times but I kept getting the same answer…You start feeling bad around the end of chemo (day 7) and It will get worst through about day 18body .  You should turn the corner and start feeling better by day 21.  However, every patient is different and your mileage may vary.   The last 9-10 days of the 30 are to allow your system to recover to the point of producing enough blood cells to protect you.  Oh Yeah…and they have a nice going away present for you just before you leave the hospital….another bone marrow biopsy.  

 

Here are some of the challenges and body changes you can expect as a result of the

-          Spiking Fevers

-          Mouth sores

-          Rashes (reactions to the meds)

-          Water weight gain…swelling

-          Nausea and Vomiting

-          Loss of hair

-          Constipation followed by bouts of diarrhea

-          Excessive Nose bleeds

-          Extreme Fatigue

-          Change in sense of taste

-          Reactions to transfusions

Most of the items on the list come and go at random times, usually just when you are starting to feel better.   Mouth sores, rashes, nausea, and hair loss however come and stay like a bad house guest. 

Some of these will start during the chemo phase but most come after when you are in the “Dead Zone”.  The dead zone is my name for the 2 weeks after the chemo when your body continues to kill off the bad cells and the system hasn’t “rebooted” to start generating new good cells.  This is also the time when there is the greatest chance of run-away infection and nonstop bleeding.  

For me, the first few days of chemo were uneventful.  You are on a cocktail of anti-viral, anti-fungal and anti-biotics while they wait to see how you are going to react to the drugs and the chemo.   My biggest problem is a couple of cyst like sores that formed on my back near the biopsy site  that have swollen up into what looks like little purple volcano’s surrounded by a bigger circle of red inflamed area.  Pretty uncomfortable when trying to lie in bed or sleep on my back.   My back/backside has become a curiosity for a variety of doctors and is getting more views than a new baby Panda at the National Zoo.    So far it has stumped the Oncology and Hematology DRs, the Infectious disease DRs, and the Wounds Dr. (I didn’t even know they had such a specialty).  Over the course of the week it continues to get worst.

By day 4 of the chemo I’m feeling the effects.  My weight has climbed 17 lbs, my appetite is pretty much gone and a mild stomach problem that I had before (Gastroparesis) has taken over the digestive system and I burp regularly as soon as I put anything in my stomach  (100-150 times in 10 minutes).   The nurses have taken to looking for a bull frog under my bed.   We’ve now added Gastrointestinal DRs to the long list of daily visitors.                          

Days 5-7 are more of the same.  As my system becomes less and less able to protect itself, we substitute drug cocktails.   It’s a combination of trying to find the right antibiotics to deal with the back,  the right anti-viral and anti-fungal drugs to fight off any potential external infectors as well as  drugs that can help the stomach and digestive system so you can keep the energy up and the fluids (and other stuff) flowing through the system.  Everything gets measured…what I call the “Goes-intas” and the “Goes-outas.  Privacy (or the lack there of) takes on a whole new meaning.

As you might expect, the body doesn’t take to kindly to being flooded with poison and then a variety of compensation drugs and this is where the symptoms mentioned above begin to appear.  I broke out in a rash, first on my neck and head and then spreading to my feet.   More adjustments to the drugs and some creams to help with the rash.  The “volcano cysts” on my back are getting worst, more drugs for that.   A lot of the drugs are administered as liquid IV so my fluid retention has gone up.   Weight is up over 22lbs from when I walked in the door a week earlier so there is also a drug to help me flush fluid from my system.  By the way, that last drug is called Lasix, pronounced the same as the corrective eye surgery.  When they first told me I was getting a Lasix treatment I marveled at what a full service operation they had where they would fix my eyes as well as my blood. 

As chemo winds to a close (day 7 of 30+) I’m still in good spirits, still getting in 60-80 minutes of walking a day,  and only dealing with 4 or so of the dozen potential unpleasant symptoms.  Of the 4 jobs I have…Eat, Drink, Sleep, and Walk…..eating and sleeping are the ones that need some work.   Walking presents some interesting challenges as I have to maneuver Olive Oil around a hallway full of portable computer stations, nurses, techs and other patients.   Keeps things exciting,

If you have questions feel free to post them on the blog site and I will try to incorporate the answers into future blogs.

Next time we will take on week one of the Dead Zone. 

Running may have saved my life

That’s a pretty dramatic statement but before we get into that, let me set the stage for the blogs over the next couple of months.   One of the goals when I started blogging on running the Boston Marathon was to give an insider’s view of what it is like to train for and then run the world’s oldest and most elite marathon.     Over the years I’ve had the opportunity to share the experience of running Boston in a range of situations including some crazy weather that almost cancelled the race as well as witnessing the bombing at the finish in 2014.   The one consistent piece of feedback I’ve received is that the blogs help to give the reader a sense of being there, of seeing the race from the inside out rather than through the eyes of the media.    This new journey is far less interesting and far more personal but for those that are interested I hope to provide that same insider’s view of life fighting cancer.     I don’t intend to go into a lot of medical detail (I’m not that smart and frankly find some of it really boring) but I’ll give a layman’s interpretation of what is going on.  I apologize in advance for the areas where it may not be medically accurate but I can promise it will be emotionally honest.

First question I get is “How did you find out you have Leukemia?”    It’s not as if you wake up one morning saying   “I think my white blood count feels low, I think I’ll go have it checked.”  I’m not a big fan of going to doctors so it would take a lot to get me to set up an appointment.  In this case what triggered me picking up the phone was a couple of slow runs where I struggled to get enough breathe on hills.  I could have just chalked it up to being tired, after all I had been ramping up the weekly miles and had just finished my first 17 mile run of the season.   Monday morning I call the Dr. Office and she squeezes me in for Monday evening.   We have a nice chat, she checks vitals, does an EKG to check the heart, does a lung capacity and blood O2 check, puts me on a nebulizer (basically breathe through a tube blowing mist for 10 min to open airways)  and takes some blood for testing.   Initial prognosis is asthma/restricted airway.    

During the day Tuesday and again on Weds they call to get more blood.  They didn’t provide a lot of info, just an acknowledgement that my white blood count (WBC) was low.   Weds midday they told me to head to the ER at the hospital for another blood test and consultation.    Late afternoon I met with the Hematology DR for the first time and she filled me in on my status.   White Blood Cells come in different types and have different roles.  In my case the Neutrophils, whose role it is to fight infection, were almost nonexistent (average is 3500-5000…I was 84).    Being totally naive of what this meant, I asked if we could treat it quickly because I have a marathon in 6 weeks.  She just stared at me and then she used the “L” word.  You could have knocked me over with a feather.    To be sure they needed to do bone marrow biopsy Thursday morning and given the fragile nature of my immune system they were checking me into isolation immediately.

Thursday morning I get a bit more information about what is going on.  In a very simplified explanation (because I’m just a simple guy)  there are three key types of cells in your blood…red blood cells which carry the oxygen around the body,  platelets that help you clot so you don’t bleed out when you have a cut or bruise,  and white blood cells to help fight infections.   All of these are generated by your bone marrow.  Effectively some of my WBC (the Neutrophils) had gone rogue.  They multiply at a faster rate and hang around longer but don’t function to help the immune system.   In addition they crowd out other cells like the red blood cells and platelets.  The net effect is lower immunity to colds or illnesses, longer time for cut or bruises to stop bleeding or heal and lower level of O2 in your blood from the fewer RBC.

It was the lack of O2 during my running that triggered the DR visit.   Lucky, cause either of the other two symptoms could have been fatal.   I guess you could say running saved my life.

The next question I get is “How did you come down with it?”   There’s no good answer to this question, for Leukemia or most cancers.  In my case it was a chromosomal change in my Neutrophils.   I suspect I will never know why.

“What is the treatment?’   It starts with a bone marrow biopsy.  Basically they stick a long needle into your hip bone and first extract some fluid from inside the bone and then core out a piece of the bone.   Definitely not something you want to put on your bucket list.    The result of that test gives them the basic info of the type of Leukemia you have which in turn set the protocol for treatment.   The results come in two stages…first the diagnosis of type (mine is AML Acute Myeloid Leukemia) the second is an understanding of the amount of chromosomal damage (cytogenetics) which determines the complexity of the downstream treatment.   

All forms of AML have the same initial treatment called Induction.   Leukemia is not treated with radiation since the problem is in the blood so the goal is to eliminate all the bad white blood cells and then hope that when your system starts recovering you will generate good cells (kind of like rebooting a computer).  They do this with chemicals that effectively wipe out your immune system but in the process it also lowers your platelets and red blood cells as well.  Thus the reason you are kept in the hospital isolation 30+ days as even the smallest cut, infection or virus could be deadly.

My Induction started Friday the 4^th.    Milestones are measured from this date.  In the next installment I’ll give a perspective on what it was like handling the chemotherapy.

God bless

A journey of a 1000 miles begins with one step.

Relative to my decade-long quest to complete 10 Boston Marathons in a row, it has been more like a journey of 8 million steps.  Like most journeys of this length, I didn’t start out with the idea I was going to do this for 10 years.  Initially it was a way to remember my son’s life, give something back in his name and for a long while, an avenue to deal with the grief.  The roads and the wind gave me a shoulder to cry on.   Over time the idea I could make an impact with the donations became the bigger goal but I needed a bigger challenge to grab attention and get support.  

There are about 20,000 elite runners who qualify and get accepted into Boston each year.   A little over half are men and less than 10% of those will be in my over 60 age group when we toe the line at the start.   At the end of the day there will be less than 900 runners age 60 – 64 who will finish. I would guess less than 20% of those will complete it more than 2 years in a row.   If I could avoid injuries, fight the weather and stay healthy for 10 years, if in the process I could run fast enough to requalify and get accepted into the race, and if I could actually finish all 10 in weather that would range from 40 degree days to 90 degree days, and include rain, hurricane winds and a terrorist bombing then truly that would be an accomplish worthy of asking people to fund the efforts of Help in the Nick of Time.  This has been my goal since starting the charity 7 years ago.

OK, enough history, let’s turn to philosophy.  Pretty much all of us have heard or maybe used the phrase “A Journey of a 1000 miles…blah blah” from the Chinese philosopher Laozi. It’s a timeless phrase you can use  for just about anything that involves a challenge (quitting smoking,  going to the gym, losing weight, getting to college, building a career).  It has the added benefit of making you sound wise and experienced.   Works great on a long road trips when your 8 year old asks “are we there yet” (Gaze off into the distance and with a thoughtful voice say “the vacation of a thousand miles begins with one step).   Totally derails the kid’s thought process.  

OK…what has this to do with my training for Boston this year?  The journey of 8 million steps is almost over.  For the last nine years, while I thought I was on annual quests to get to and finish the Boston Marathon, in truth I was on a decade long journey of healing and discovery.  That journey is about to end. But not at the finish line of the Boston Marathon.  Last week, during my 17 mile run it was clear I was struggling to keep my normal pace.  Within a couple of days I knew the answer, I have Acute Leukemia.

Am I angry?  Not yet.  Probably still in denial.  I’m waiting for the first guy who says “When life gives you lemons, make lemonade”.    Then I’ll go postal.  Sometimes when life hands you lemons you just want to throw them at someone…..starting with the guy who said “make lemonade”.

So now my life has totally changed.  For the next 30 days I’m stuck in isolation as they pump my body full of poison to first kill all my white blood cells and then watch to see if good ones or bad ones come back.  Unfortunately the chemo kills off the production of red blood cells (which carry your O2) and your platelets (which handle blood clotting).   So avoiding germs because I have no white cells to fight infection, no cuts or bruises because I have no platelets to stop the bleeding and limited exercising because I can’t get a lot of O2.    In my new world I’ve traded my 17 miles running for 17 laps around the hall pushing my new best friend….my intravenous tree we’ve named Olive Oil.   I also have a machine that does leg massages to keep the blood flowing.  We call her Helga.    You can tell that loss of red blood cells are affecting oxygen to the brain as well.

Now instead of looking like one of the zombie extras from the walking dead shuffling down the road on my runs, I’m one of those hospital zombies shuffling down the hallway pushing my IV pole, nodding to all the nurses and trying not to flash my backside through my custom tailored hospital gown. 

For the next 30 days or so I plan to change the blog over to my new journey.  When I feel up to it I’ll post info on what is it like to be on this journey and much like the running, give some of the emotional highs and lows.  For those of you that don’t care to follow this info just let me know and I’ll take you off the distribution list.   I fully understand…neither one of us signed up for this trip.  

I also want to thank all of you who have supported me through the years.  Words cannot express my gratitude or the gratitude of the people we have helped.  That effort will continue regardless of what happens.

Stay well and God bless!

Dave

Marathons are like presidential campaigns…only shorter

In a less than lucid moment the other day I was toying with the idea that I might try an ultramarathon, a race longer than 26 miles.  Nothing crazy like 50 or 100 miles but maybe a 50K (about 31 miles).    The next day I found myself 5 miles into a 15 mile run on a 2 degree day with a 30-40 mph head wind and as I scrape the ice off my mustache and eyebrows a more rational version of myself decided to reconsider.   Instead, I decided that I should consider joining the presidential race.   

Like most candidates I built my list of pros and cons on why I would be qualified to run.
Pros:

-          Like the other candidates I have the stamina to travel long distances on a regular basis.  But where they need jets and buses I can save the environment by running.

-          I can be tenacious to the point of stubbornness when I know I’m right and everyone else is wrong…which is most of the time.

-          Like the other candidates, I have strong opinions on what we need to do to fix the country but no specifics on how I would get it done

-          I’m willing to party with just about anyone so I could be right at home with both parties. 

-          I have lots of experience debating.  Frequently  it involves whether to get out of bed to go running on cold mornings or  whether to stop or keep going on long runs.  

-          Campaign stops are like water stops…you stop for a bit of refreshment, some high fives with supporters, tell everyone you’re doing great and then off again till  you reach the next one.

-          I have 4 grandchildren (and 2 on the way) so lots of experience kissing babies (and cleaning up messes).

-          I have lots of people who support my races in the past.  Why not this one?

Cons:

-          I’m not much into mudslinging (but I could challenge other candidates to a Mud Run)

-          Fund raising…I don’t mind asking for money to help others.  Couldn’t get there for myself.

-          I have limited experience in politics (can’t decide if this is a Pro or Con).

-          Despite being a legend in my own mind, my ego isn’t big enough.

-          I’m not a very good liar

-          I think the Pope is a good guy

Despite the long list of Pros, and the overwhelming amount of encouragement I’ve received, I’ve decided that the race,  which will last over a year and a half, is much too much like an ultramarathon.  Instead, I’ll be sticking to shorter races like the marathon and focus my fund raising on making one small corner of the world a better place. 

I do wonder what it would be like if the presidential campaign season was limited to less than 3 months like other countries.   Since we call it a race, let’s have the  candidates compete in a Mud Run together as a way of seeing their true personalities.  Who will be the trash talkers before the race even starts.  Who would be the ones helping others over/under obstacles along the way.  Which ones would run around the mud pool, crawl through it or just throw it at others.   Which candidates have the staying power to complete the race and which ones drop out when the going gets tough.      It may not be the best way to pick a candidate but it would surely tell you a lot about them.  Worst case, it would shorten the campaign season and save a boat load of money.    

 Clearly I have too much time to think while I’m running. 

Till next time…

Second Efforts, Second Chances, Second Winds

In 2003 I ran the San Diego Rock and Roll Marathon with my daughter Heather and her roommate Abby.  It was their first marathon and they brought the old man along to keep them company.   Somewhere around 20 miles it became clear Abby was struggling, at one point mistaking one of the bands playing along the route for a water stop.  We got her into a medical tent and they worked on her for about 10 minutes, pouring salt packets into her mouth and giving her water.    Shortly after, as the medical team was arranging for a ride to the finish, Abby pops up off the cot and declares she’s going out to finish the race.    And we did.

Five  years before in 1998 at the mature running age of 11 year old, a  boy named James Bonnett completed the same marathon in 3:28 winning the under 19 division.  The next year in the Across the Years 24 hour race (where you run as many miles as you can in 24 hours) he finished second running just over 101 miles.  Over the next years he was a phenon among the ultra marathon crowd placing high in the ranking of a number of 50 and 100 mile races.    By 2010 at 24 years old he couldn’t run a half mile.   Down on his luck, separated from his wife, and in a job he didn’t like, he decided to try running again.  His first day out he couldn’t make it around the block.   Three years later he won one of the premier ultra marathons, the Zane Grey 50 Mile run.

In the 1972 Olympics a Finnish runner Lasse Viren,  running in the 10,000 meter race, tripped and fell clearly ending his chances of winning a medal.  He got up and not only finished in the medals, he won the gold and set an Olympic record.   He went on to win the gold in the 5,000 meter race as well.

In 1996, a few years before James ran the San Diego marathon, I thought I had run my last Boston Marathon.    I had been away from marathon running for almost a decade but I had signed up for the 100^Th Boston Marathon because…well..because it was the 100^th and I wanted to be part of the experience.   It was a great experience but definitely not anything to write home about in terms of performance.     With that under my belt I was done with Boston.  Or so I thought.

I’ve learned a lot from running over the years.   Like how to pace myself so I don’t burn out, how to deal with the frustration of injuries when you least can afford them,  and motivating yourself to get out of bed  for that long run on a single digit winter morning.  I’ve also learned that help often comes when you least expect it, like the popsicle someone gave me during a 90 degree Boston Marathon, or having your sister join me to get me through the tough miles at the end of a race.  Or a friend running with you and sharing your grief after the loss of a child. 

 While running has given me a lot, it’s greatest lesson have been in teaching me to deal with life’s challenges and knowing that second efforts can lead to second chances.

It’s the reason I started Help in the Nick of Time.  To find a way to give people who are struggling a little bit of a second wind, a little boost  to help them see the other side of the near term troubles and to help them help themselves to find a way forward.   Our efforts are modest but to the people they help they mean the world.   Showing them a second effort can lead to a second chance.  For the support you have given me over the years I can’t thank you enough.  

So while I thought I was done with Boston 20 years ago, life had other ideas.   This is my second effort to give others a second chance.   A goal worth running for.

Could it possibly be a decade of Boston Marathons?

There are not many things I can say I’ve done for 10 years in a row.    Sure there are the standard things like spending the holidays with your children, or making sure you get away with your wife for some one-on-one time.    But even those were challenged over the last decade, life sometimes just seems to get in the way.

So it is with no small measure of surprise that I find myself beginning my efforts to complete my 10^th Boston Marathons in a row.    There is no intended bragging here.   I couldn’t have made it this far without a lot of help along the way.  In fact I’d say it’s the support of all the friends and family who sent words of encouragement (if you can count calling me insane as encouragement),  home remedies for injuries, Christmas gifts of winter running gear, and most of all donations for the charities which have been a core of what keeps me going.

Someone asked me the other day if I was getting tired of running marathons.  “You’re over 60, when are you going to start acting your age”?    Given that we supposedly get more senile as we get older I figure I am acting my age.   Who knows, if I get a little older and crazier I may start looking at Ironman Triathlons.

For now I’m content with just being able to get out the door in the morning and put one foot in front of the other and at the same time knowing that my efforts are helping to raise funds for families in need.    I guess I’ll stop running when I stop caring.

So come along with me for another year and I promise I’ll do my best to make my trials and tribulations along the way as entertaining as possible. 

Stay tuned…the ride has just begun.

Every year is unique…this one was no different

As much as I like to believe that after running 18 Boston marathons that the next one will be easier, it isn’t.   It could be age or it could just be nerves but for some reason I can’t put into words every 

marathon morning carries both excitement to be there and nervousness at what’s ahead.  

For those of you that have read previous year’s blogs of race day you know that often what defines the day is the weather.  I’ve  run in the remnants of a hurricane with winds so strong they blew over the porta-potties (nasty).   There was the year the temperature hit 90 degrees and they considered canceling the race.    Spectators brought out garden hoses and ice to cool down the runners (you’ve got to love Boston spectators).    There was a year when it snowed the day before the race and runners were standing in muddy slush in the staging area before the start.  While there have been perfect sunny 50 degree days sprinkled in over the years this was not one of them.

I had the luxury of staying with the Burnett family the day before and it was perfect…great food, great company and a warm bed.    When I left for Boston the next morning to catch a 6AM bus to the start the temperature was in the 30’s with the promise we would warm up to a toasty  mid 40’s during the day.  Rain would start late morning and continue throughout the day with winds picking up as we got close to Boston (in our face of course…we wouldn’t want it to get easier).

   

Hopkinton is a small town so they close down the roads into the area by 7AM.    Buses pick up runners in Boston for the hour trip out to the start staging area, attractively called the athlete’s village.    Picture several sports fields with a large white tent in the center, hundreds of porta-potties lining the perimeter and 10’s of thousands of runners milling around looking for a way to stay warm and burn off nervous energy.      Security is high since the bombing 2 years ago including scanning all runners entering the village and restrictions on what you can have with you.    In prior years you could keep a bag of clothes with you and as you left the village to head to the start you could have your extra clothes and personal items placed on a bus that would meet you in the finish area.  With the changes in security this was no longer possible so what you wear or carry with you either travels the 26 miles with you or gets discarded at the start.  You see some pretty creative outfits as people wear old clothes and cast offs to stay warm before the race (more on this later).  State Police, National Guard, canine units and swat teams are all there to help assure the safety of the runners.   They were polite, supportive and ever vigilant.  It felt good to have them there.

Last year’s marathon was one of the largest fields as a result of the bombing the year before.   This year’s 30,000 runners were a step up from the normal 26,000 and as a result there was an additional wave added to the staggered start.    The wheelchair racers go off first (you do not want to be running in front of a wheelchair racer on a downhill).    The women elite runners go off at 9:30 followed by the elite men and the first wave of 7500 runners at 10 (and yes, most of us are sitting around since 8AM waiting for the start).  There are 8 corals/wave and runners are staged in corals based on their qualifying times.  Corals are a good name for the process of packing the runners into the starting areas.    To get to the starting corals you have to walk almost a mile from the athlete village (because of course you need a warm up before running 26).    On the way, athletes are peeling off all the warm outer clothes they brought and tossing them to volunteers who are filling thousands of trash bags that will go to charities.   A nice way for runners to empty their closets and the needy to get some warm clothes.

Wave 2 goes off at 10:25, Wave 3 at 10:50 and Wave 4 at 11:15.   By the time Wave 4 leaves the elite runners will be past the half way point.    I was in Wave 3 and as I headed down to the start it began raining.   One of the tough decisions is deciding what to wear.  With the cold and the rain this year it was an easier decision…hat, gloves, nylon wind pants long sleeve shirt and a light rainproof windbreaker.   To stay warm and keep the rain off while waiting for the start I wear a designer trash bag over my outfit.  Very stylish.    One last run to a porta-potty and I’m ready.

I knew going into this race that I was not going to run fast enough to requalify.  I have been injured off and on over the last 4 months and there was no way to get the kind of performance training in that I would need.   My strategy was to go out slow and try to avoid aggravating any injuries in the first half of the race and then take the second half based on how I felt.   The rain didn’t change any of this for me; I just made more wet sloshing sounds as I ran.

  

There are no better crowds than the Boston Marathon spectators.   Rain didn’t matter…they were out there cheering like always.     You have to love the creativity, like the guy at around 16 miles with the sign “1 million inches travelled, 660,000 to go”.  Or the people who normally hand out orange slices or ice, switching to hand out hot coffee and tea.    There are a number of places along the route that play music, live and recorded.    This year one was playing the Boston Red Sox theme song Sweet Caroline by Neil Diamond.    As if to pile on the pain, it stuck in my head for the next 5 miles.    And then there are the Wellesley girls.  You run the gauntlet of a quarter mile of hundreds of screaming college girls with signs reading “kiss me I’m …” (you fill in the blank; it gets more creative every year).    I swear some of the old guys just run the race so they can stop there and get a little lip.

My immediate goal was to make it to 16.5 miles where my family was waiting for me.  My twin grandsons at 4 haven’t missed a race since they were born.    Having survived that far, my sister Terry jumped into the race to run the last 10 miles with me.  She was terrific.  It was like having my own concierge.  She would get me water,  pass me jelly beans and at time run in front of me to help block the increasing wind.    She even tried at times to hold a conversation with me.   I think I managed to grunt an occasional answer.     From 16 to 21 is a series of up hills that come at a really bad time (the last of which is the famous Heartbreak Hill).    The wind had picked up substantially (20 mph) as we got closer to Boston and was particularly brutal among the hills.    You know it is windy when you go to drink at the water stops and the water blows back in your face. 

From beyond the hills it was the normal grit your teeth, find somebody tall to run behind to block the wind and just count off the last 5 miles.    It turned out to be one of my slowest marathons but then again I was just happy to have made it through uninjured.     It will go down as a memorable one not because of the race itself but because of the people who supported me along the way.  Not only the ones that were able to brave the cold on race day, but also the ones that sent words of encouragement and donations to Help in the Nick of Time.

To me those are my heroes.

That which doesn’t kill us makes us stronger

Yeah, right.   Who cooks up this stuff?   Clearly not a marathon runner. 

Actually it was Friedrich Nietzsche.   He also said “It is not a lack of love, but a lack of friendship that makes unhappy marriages.”  I can relate to this one.    Pam and I are coming up on 40 years next month and she is still my best friend.  She says it is because nobody else will put up with me and as far as she is concerned I’m still on a trial basis.    I think I’ve finally softened her up and this could be the year she decides I’m a keeper.

I think a more appropriate saying for a marathoner would be “That which doesn’t kill us leaves one hell of a scar”.      Marathons are never pain free at least not for me.   How painful they will be is a function of four parameters:  how many injuries/battle scars you carry into the race, how soon the pain starts during the run, the degree of the pain, and the recovery time.     It’s a sad fact that the earlier you have a problem in a marathon, the slower you are going to go and the longer you are going to be out there dealing with the pain.   It is why experienced marathoners know to hold back for the first half of the race.   The only thing worse than being half way and knowing you’re already cooked is knowing it at 10 miles.  It makes for a really long day.

Anyone who knows anything about marathons has heard about the infamous “wall”; the point in a marathon where a runner crashes.     Runners describe it as “someone hoisted an elephant on my shoulders” or “my shoes were suddenly made of cement”.     I’ve been there and it’s not pretty.    The science behind this is pretty straight forward.   By the time you get to 18+ miles you have pretty much burned through all the carbs/glycogen you have stored in your body.   At this point you need to start burning fat instead.   There’s just one problem….well maybe three.  You need oxygen, water and glycogen to help burn the fat.   It’s wall time.    You are now sharing your oxygen with your fat burning oven and your muscles are screaming for more.    You also are syphoning off some of your body’s already depleted water supply to burn the fat.    The equivalent of eating a mouthful of peanut butter covered pretzels without anything to drink (try it…I dare you).  

If you happen to be running the Boston Marathon it is at this point that you realize you are in the midst of the 5 miles of Heartbreak Hill.    It’s one of the reasons the Boston Marathon is considered one of the toughest. 

Of course the “wall” isn’t all physical, there is a strong mental component as well.    I love the Yogi Berra quote “Baseball is 90% mental and the other half is physical”.    As the body seizes up and the pain increases, the mind struggles to keep the body from stopping.    In the end it’s not typically the body that fails, but the will to keep pushing the body.  I guess that is the rational side of the brain. 

Despite a couple of dozen marathons,  and knowing better, I went out too fast last year and spent the final 10+ miles fighting with myself to finish.   In a week I’ll get another chance to do it right.  But this year injuries will rob me of any chance of finishing under the qualifying time for next year.    Instead this will be a race with the goal of avoiding the wall, staying healthy and finishing (preferably before dark).

Nietzsche had one quote that I think marathoners can relate to. 

“To live is to suffer, to survive is to find some meaning in the suffering.” 

One week to go!