South Dakota: Day 1 & 2

As I mentioned previously, Dr. S and I ventured to the Black Hills of South Dakota for a vacation with my family. While there and during our drives to and from the area, we were able to fit in a few adventures.

Day 1
Our first day consisted of a long 10 hour car journey from the Twin Cities to Custer State Park where my family was renting a lodge. Leaving at 6am, we drove southwest through Mankato and down to I-90, which we were on basically the whole rest of the way. A few coworkers warned me that the drive would be boring and that as much as you think you don’t want to, stops at Wall Drug and the Mitchell Corn Palace would be a much needed break. Dr. S and I were hellbent on not stopping at these places - and we didn’t! We fought off the thousands of signs for Wall Drug successfully. (We were quite happy once we were past the town of Wall and the signs for Wall Drug ceased.)

I honestly didn’t think the drive was too bad. Southwest Minnesota seemed to drag on a bit - lots of windmills, grain silos, and trains hauling grain - but things got much more interesting once we crossed the border. The landscape became drier prairie, with much fewer trees. We also were not expecting the dramatic river valley of the Missouri River and the change of landscape thereafter. We were both captivated by the rolling prairies and grasslands of western South Dakota. Neither one of us had ever seen ranch country before. As I-90 swept just north of the Badlands, we could see little glimpses of that landscape as well. We were gawking all over the place, which at times was a bit dangerous considering the interstate speed limit in South Dakota is 80 mph. It certainly made the drive go quickly however. By 4pm we were settled into our room at the lodge.

Day 2
The one activity that was an absolute must for Dr. S and I on this trip was the hike up to the lookout tower on Black Elk Peak (formerly called Harney Peak). We broke in new hiking shoes, bought a new backpack (and Camelbak) for Dr. S, and read up on the hike beforehand. Looking at the weather for the week, the very first full day of the trip was the chosen day. Not too hot and no chance of rain. Besides the two of us, a handful of my family also decided to do the hike.

Before I get too far with detailing the hike I should mention the wildlife we saw not even a mile down the road from our lodge. Custer State Park is home to a huge amount of animals (which I’ll list on a later post) but the most iconic is the bison. The park hosts a nearly 1500 head herd that roam freely. (There’s fencing and cattle guards to keep them in the park). Sure enough, our first full day in the park we venture out and see a bison nearly immediately. The car traffic was stopped to allow a bull bison to just nonchalantly mosey down the road. We slowly rolled past and snapped a few pictures. Quite a way to start the day!

Switching back to the hike… We were using the shortest and most used way up to Black Elk Peak, which starts at Sylvan Lake. This apparently is the most popular place in the park by a long stretch, because it was packed with people and we had to hunt for parking spots. With that said, if you visit the Black Hills and want to do the hike up to Black Elk Peak or do anything else by Sylvan Lake, either do it super early in the day (which we should have done) or avoid the summer tourist season.

With a large gain in elevation and a round trip of 6 - 8 miles (depending on which source you were using), we knew the hike would be manageable but challenging. (The final distance of course ended up being around 8 miles.) What we weren’t prepared for were the effects of being in a higher altitude. The trailhead near Sylvan Lake is roughly 6000 feet. Black Elk Peak is at roughly 7250 feet. All of us in the hiking party live below 1000 feet. Quite a big change for all of us. On the way up, we weren’t getting physically tired, but cardiovascularly tired. Our breathing was more labored and we needed to take breaks for water and rest even though our leg muscles weren’t taxed in the slightest. The need for breaks was (mostly) fine however because it allowed us to take pictures and just soak in the awesome scenery.

Once (finally) at the top, Dr. S and I basically ate our small packed lunch right away. It was food first and then exploration. The views from the top were of course spectacular but so was the mountaintop itself. How the Civilian Conservation Corps ever were able to build the lookout tower so far into the wilderness and on this craggy peak of the Black Hills was just amazing. All the members of my family sampled the various viewpoints of the tower and a few of us hiked over to the nearby peak. This is the actual highpoint (and thus the top of the actual peak). I joked that it “was the highpoint of trip” and that “it was all downhill from here.” Groans all around.

After a good amount of rest, we headed back down the trail. The hike down was waaay faster than going up of course, but Dr. S and a few of my family members were just blazing back down. They started just moments before the rest of us but we never caught up to them the whole time. I found out it was because Dr. S really had to use the bathroom (the trail was far too busy for doing business in the trees) and the others with her had just been to Colorado a few weeks prior so the altitude wasn’t affecting them as it was the rest of us.

Once everyone was back down, we reunited with our vehicles and headed back to the family lodge via the Needles Highway. The Needles Highway is a curvy, switchback laden road that runs north-south in Custer State Park and runs through or near some of the tallest towers (or needles) of Black Hills craggy rock. There are also a few one-lane tunnels through the rock. It’s very scenic, but for the person driving it’s also a bit hellish. It’s not really a two-lane road but like 1 - 1.5 lanes wide depending on the section. This isn’t so bad when the people driving at you are considerate. When there are entitled idiots on vacation thinking they get to use the whole road for just themselves...well, you get the idea. The views were great though and we did get to see some wildlife. I did however need a few beers once we got back to the lodge (one for the hike, two for the drive on the Needles Highway).

Needles Highway wildlife - a very scruffy mountain goat

Ups & Downs

Dr. S and I were in western South Dakota for a family vacation two weeks ago so I have a few posts coming from that, but I first wanted to post a running update I meant to post before heading on the trip.

My fitness comeback continues and so does my progress with running. For over a month now I've been running my two mile routes without any walking. I've now even done a handful of three milers without walking. Mostly my pace has been slow, at or even slower than the pace I've run for marathons. I hit what felt (and still feels) like a turning point however on my June 22nd run.

For the first time since I started running again, I was able to run a pace below 8:30 per mile. Granted this was only for 2 miles but it made me feel fast-ish again. Dropping below an 8.30 pace just gives me that little bit of belief that I’ll get there, running will become easier again, and little by little I’ll get faster. Eventually I’ll drop below an 8:00 per mile pace, then maybe 7:30 per mile, and who knows what else. Until then, I’m supremely happy with my 8:30 pace.

I was (literally) brought down to Earth though on the following day’s run. My legs were feeling the previous day’s efforts and I was pushing them too hard. I shuffle-tripped and came crashing down. This was in the crosswalk of a roundabout so luckily no cars were around. Regardless however, I tuck and rolled beautifully right into running again without missing a beat. I had a scraped up knee and a few bruises but mainly it was my pride that got hurt. Like I said, I was just pushing tired legs too hard, but the lingering post-chemo neuropathy in my feet may have played a part as well.

Since then I’ve gone on the South Dakota trip (where I only ran once, really slowly). I’m trying to get back into a running rhythm again as well as continuing my to form a new habit of running first thing in the morning. I’ve typically been an afternoon runner, but I’ve realized that life and hot summer weather often likes to interrupt those late afternoon / early evening running plans. Thus, I’m waking up earlier in the morning and getting in my miles before the day heats up (figuratively and literally). My brain and body are still getting used to the idea of waking up at 5:30 and then running by 6:30, but they’re coming along. It only gets better - easier, faster, farther - from here.

My Cancer Adventures: The Finish Line

This is a few weeks past due, but I’m now officially done with cancer treatments. My last zap of radiation was back on May 22nd. (It’s worth noting that this was 6 months exactly from the day I got my diagnosis, November 22nd.) Even now weeks later however, the idea of being done with treatments still hasn’t hit me. Life is (basically) back to normal again but neither myself nor Dr. S know what to think of it. We’re readjusting and catching our collective breath. We really plowed through life in the 7+ months from mid-October on - lots of appointments, chemo fun, me sometimes working 6-day weeks, etc. That driving ahead kept us mentally/emotionally on top of everything, but we’re feeling it now. It’s now a point for both of us to slow down and really enjoy the lives we call normal.

The only appointments I have now are for 3-month check-ups. I’ll have one in July with my chemo doctor and then one in August with the doctor I had for radiation. The July check-up is the bigger one as I’ll have the multitude of blood tests done, hopefully get the OK to have my port removed, and hopefully get the even bigger OK that I’m still cancer free.

Since I really didn’t post much during radiation treatments, I’ll share some pictures of the experience. (If pictures are a thousand words, this will make up for my lack of writing, right?) So first up is a picture of my mask for anyone curious. You can’t really tell here, but it’s very detailed. There are indents for my ears, perfect bumps for my brow ridge, and even a bump for my port. I guess it makes sense since it was molded to me and fits like a glove.

How tight did it fit? Well enough to give me the previously mentioned “waffle face.”

Sometimes after treatment I would stop for coffee or, for later appointments, lunch. A huge tip of my hat to the baristas and food service workers that never said anything about my “waffle face” appearance - even though I could totally tell you were wondering “What the hell just happened to this guy?”

I Ran

For the first time in 6 months, I ran. It wasn't fast, it wasn't pretty, and it was interspersed with lots of walking, but today I ran.

For the last few weeks I've been doing lots of walking to slowly get my body more active again. This week though a switch seems to have gotten flipped and my body was itching for more. Today was a beautiful day so I decided to give running a go. I didn't push, I just tried to get my legs used to the feel of running again. My body did have to strain, but in that good exercising way - something I haven't felt in a long time. I could be sore tomorrow, but it will be the best damn feeling ever.

Now in case you are confused by the title of this post and are looking for A Flock of Seagulls here you go:

My Cancer Adventures: They Call Me Mr. Waffle Face

As of today I’m 9 treatments into my 20 of radiation therapy. Time just seems to be flying (so much so that I haven’t kept up with posting). I have a bunch of random thoughts/remarks so out come the bullet points:

• As I mentioned previously, a common radiation side effect is fatigue. So far it’s really just been the fatigue of waking up early in the morning and then driving a half hour to my appointment (most of my daily treatments are in the morning at 7:30 so I wake up at 5:30). In terms of real fatigue, I have none so far. In fact because my body is now basically recovered from chemo, I’m bounding with energy.

• While the getting to and from my radiation is a wearing daily annoyance, the experience while I’m at the clinic couldn’t be better. The radiation staff is super friendly (just like everyone has been) and the treatment barely takes 15 minutes. I just lay motionless on a table for that time so it can be quite relaxing. I guess it’s forced meditation/relaxation time. I mean my head, neck, and shoulders are strapped down by my mask (rather tightly) so yeah, it really is forced. Oh, and I’m laying on a hard carbon fiber table. And the arms of a big machine are rotating around me. And I’m getting hit with radiation. Ok fine, it sounds extra weird but I find it relaxing.

• Yes, my mask is rather tight. It's supposed to be of course, but it took some getting used to the idea of not being able to open my mouth to mumble or breath. I can just barely swallow if spit builds up in the back of my throat. I can breath out of my nose just fine, but I make a point in the morning to blow my nose, have a menthol cough drop, and drink lots of tea to ensure my airways are clear. Additionally the mask leaves a nice imprint on my face - mostly on my chin and forehead - for a while afterwards. The nickname for this by my clinic’s techs is “waffle face.” I've taken it a step further by giving myself the alter ego of “Mr. Waffle Face.” So basically for about 15 minutes after treatment I'm like a lesser known Dick Tracy villain.

• At one of my appointments last week, I had the extra fun of also getting my port flushed. When a port isn’t in use (I haven’t had chemo for just over a month now), it needs to be flushed to it doesn’t clog up and get infected. The flushing literally took two minutes but wow, I really didn’t miss having my port accessed. I didn't miss the now revolting smell of sanitizing solution (I associate the smell with chemo and nausea) and I really didn't miss the jab of a needle in the sensitive port site.

• During all this radiation running around, I've also started a new job. (Let's just throw everything into upheaval!) Basically right at the time I was diagnosed with cancer, I started working two part-time jobs (20 hours a week each). In one of those jobs I'm staying with the organization, but starting a new position. It could be worse, but scheduling new job training on top of the radiation schedule (and the other job still) is just another extra thing. Considering I often worked 6-day weeks while on chemo, I think I can manage this however.

That's what I have for now. I don't expect too much “news” in the short term. It's just the relatively easy (compared to chemo) daily grind of radiation therapy.

My Cancer Adventures: Goodbye Chemo, Hello Radiation

Yes, you read that right. I’m officially done with chemo. My PET scan came back negative for any active lymphoma cells. So for those keeping track, I was able to get away with (yeah, I’ll put it that way) 4 rounds (or 8 treatments) of chemo instead of the 6 rounds (12 treatments) that were initially planned. I didn’t ask, but it seems like my lymphoma died off better than expected.

Now I move on to radiation to be extra sure the cancer cells are wiped clean. According to my chemo doctor and my new radiation doctor, ABVD chemo followed by radiation is a tried and tested method for treating the classic form of Hodgkin’s. I’ll have four weeks of radiation, going in to be “zapped” every weekday morning. Yesterday I had my radiation consultation where I was also fitted for my mask. (Watch the video below from my mask manufacturer and this will make more sense.) This mask keeps me in the same position for every single treatment so the radiation always hits the intended spot every time (and not something else). They warned me that getting the mask made would feel really weird and it did. I thought it would feel more like plastic being stretched across my face but it felt more like a mesh of extra stretchy spaghetti and not so much like plastic. It was weird. It’s also pressed right down on your face, so luckily I’m not claustrophobic.

For those wondering, radiation treatment is pretty harmless. I’m not radioactive or glowing afterward. Other parts of my body aren’t really affected either. The treatment is basically a just a beam that’s slightly more powerful than an x-ray that’s also pinpointed to a specific spot (for me, this is my neck/shoulder area). I really just have a few possible side effects. Because of the proximity of my problem area to my throat, I could have some irritation to my esophagus - basically a dry throat and trouble swallowing. At the spot of treatment, I’ll also have some skin irritation. I’ll just need to apply lotion and keep it out of the sun. Lastly I may have some fatigue, especially toward the end of treatment. This shouldn’t be as bad as the fatigue from chemo however.

Lastly if your mind has gone to me replicating the Spiderman origin story, you’re not alone. I thought of that basically immediately. Besides the logistics of training a spider to perfectly sit on my neck, the radiation isn’t strong enough to do anything that super. Well, I mean it does of course treat cancer - which is pretty damn super if you ask me.

My Cancer Adventures: A PET Scan Primer

In case anyone ever wondered what it's like to get a PET scan, it's a lot of hurry up and then wait. While preparing for my most recent PET scan, I thought I’d write out this quick run through of what the process is like:

Step 1: Technically, the first step is to fast for at least 4 hours. As I had a 9:30 appointment the other day, I woke up early to have breakfast at 5am and then went back to bed.

Step 2: Drive to the hospital, check in at the reception desk, sit in the waiting room, and wait to be called back to the PET scan area.

Step 3: When first in the PET scan area, you get weighed and then get to choose one of two lovely medical grade lounge chairs.

Step 4: Sit in your chair, get your finger poked, and have your blood sugar measured.

Step 5: If your blood sugar level checks out, you then get a small IV injection of what is basically slightly radioactive sugar water. This makes things stand out on the scan.

Step 6: Then you wait for 45 minutes for the sugar water to flow through your system. Hopefully you've brought something to do or read because there's no wifi.

The lovely waiting area view.

Step 7: After the 45 minutes, you're all set for the scan. Well, ok, they have you go to the bathroom first. Once you're on the scanning table you're there for 15 minutes and there’s no chance for a potty break.

Step 8: If you wearing a top with snaps or zippers (metal), you'll have to take that off and put on scrubs. (It will mess up the scan.) With a metal button on my pants, they always give me the option of changing into scrub pants or just pulling my pants down to my knees and covering up with a blanket. I just do the blanket method as it's easier. I also take anything out of my pant pockets at this point. My phone, keys, etc wouldn't mess up the scan since it's below my knees (it only scans your knees up) but it's a precaution so those items don't fall into the track of the moving table. Apparently people have gotten their keys stuck.

Step 9: You lay on the table flat on your back with your arms back above your head. It's a pain for me to get comfortable and still be able to fit my arms through the opening of the scanner. Still it's not as bad as my first scan which happened right after my surgical biopsy and I had very little arm flexibility. My left arm was completely asleep at the end.

Step 10: Basically you just lay there for 15 minutes as the table moves back and forth. You can close your eyes, but you don't want to move. Putting yourself in into nap or zen-like state is definitely recommended.

Step 11: Once the 15 minutes is up, the moving table will be back in the starting position and the tech will announce that you can move and relax. They'll check that the scan came out alright and then you're free to go. You know, once you pull your pants up or change out of your borrowed scrubs...

And that my friends is how a PET scan works. I believe this in now in order:

Does NBC still do these?