Mighty Mouse

A Cancer treatment update for this week.  Again,  pretty damn boring,  which is a damn good thing.  Got thru my post Chemo infusion weeks,  with good blood counts (yea,  I plot them....  the Geek in me can't help it...)

Have now done my second round of the Mutated Mouse Antibodies.  As advertised,  with Rituxin,  the side effects are minimal.  After going thru a 7 or so hour first infusion protocol last week to insure there were no severe reactions,    this weeks mouse injection was down to about 3.5 hours,  as they know I am not reacting to it.  A bit tired on these days,  but may well be the IV Dexamethasone or IV Zantac (Benadryl) they give you before the Mutated Mouse stuff.  All those Antihistamines are for reducing the possibility of reactions,  and I'm sure that stuff can't help but make you feel funky.   One of those drugs also make it so I can hardly talk,  and fills my throat with gunk.  Fun!  At least two more of those sessions on tap.

Maybe My lack of issues with the Mouse stuff is because my Chinese astrology sign is the Rat.  Family familiarity?  Who Knows.

Since I feel so good,  I've been trying to get out & ride,  and the motivation to try and make up for almost a year of having to NOT ride hard is high.  Turns out,  that same year away from any kind of intensity on the bike has left me rather "slow".   Realized I need to back off and get some decent base miles in with my newly functional blood.  Let the Mouse stuff run it's treatment course first,    as I am sure that is NOT helping my aerobic potential right now.  So I have been trying to reel in the immediate expectations for fitness improvement,  and let all the drug nonsense finish up first.    That,  and turns out it's still kinda winter outside most days.  Seems easy to go do a cross race at 35 degrees,  but it is not as easy to get out & do that base thing at that temperature.  Been motivated enough to go do it,  so far at least.  

Going back to work now that my immune system is probably capable of withstanding the viral.  germ-ridden cesspool that is the modern workplace.   Seems like all that "work" time is going to cut into my midweek,  mid-day bike rides as well.  Bummer,  was getting used to having that time available.  Ah well.  

Enlightenment?

Remember when our "friends" in Colorado Springs decided to "fix" the Cross Upgrade/Category system a while back?  Seems like someone,  somewhere,  noticed that maybe,  just maybe kicking ALL the Cat 4 riders up to the 3's after doing 10 races was maybe,  just maybe,  not the best way to fix whatever problem someone,  somewhere,  dreamed up needed fixing.   Maybe,  just maybe,  the sandbagging or other imagined problem they were trying to fix was not worth the damage to a thriving grassroots cyclocross participation scene that seems to be doing so well in the U.S. right now.

How do I know that this bit of enlightenment may have taken place?  It seems that the USACycling rulebook sections that HAD just implemented the "10 & out" rule have VERY quietly changed.  No announcement this time,  the relevant rules just....  Changed.    Fortunately,  some people noticed,  and I managed to confirm that the upgrade rules did indeed change for next season.   The Cyclocross Cat 4 to Cat 3 upgrade stuff changed,  the higher category upgrade criteria and the road side changes did not.  The slightly lower  mandatory points limits remain for the higher categories.  The changes were made to the Cat 4 & BELOW levels for cyclocross only.   Wait....  BELOW Cat 4 you say?

Yep,  rather than force everyone to be a Cat 3 after 10 races,  they added Category 5 for new cyclocross riders.  Yep,  The lowly Cat 4 is no longer the BOTTOM of the cross gene pool.  They will have the Cat 5's to make fun of now.  

Here is the new Cyclocross upgrade rules verbatim:

1E6. Cyclo-cross Upgrades and Downgrades Cyclo-cross categories are upgraded similarly to road category upgrades using the system below:
(a) Requirements for upgrading:
5-4: Experience in 10 races is a mandatory upgrade. 
4-3: Voluntary upgrade with 10 points. Fifteen points or
two wins if the field had at least 30 competitors is a
mandatory upgrade.*
3-2: Voluntary upgrade with 15 points. Twenty points or
two wins if the field had at least 30 competitors is a
mandatory upgrade.*
2-1: Voluntary upgrade with 20 points. Twenty-five points
or two wins if the field had at least 40 competitors is
a mandatory upgrade.
*Juniors are exempt from this mandatory upgrade 

So what does this mean?  Well,  it certainly is less bizarre than what WAS going to happen.   Adding yet another group to find a race day slot for brings it's own problems to the table,  but also satisfies the real need for a "true beginner"/newbie group at the bottom,  allowing Cat 4 some more breathing room to be a long term home for the "recreational" or "not serious" racer.  I personally think there is a strong need for that in cross.  A 10 race & out limit on Cat 5 makes a lot of sense for a try-it-out-get-your-feet-wet kind of group.  After 10 races,  those who are hooked can survive or even thrive in the Cat 4,  making room for more newbies.  

Going to be a challenge to add that group to an already VERY full race day,  including a very likely and VERY needed women Cat 3 field.  Intel says it might go off with the older Junior races (15/16 & 17/18....).   Going to take a while to build a field of any size,  since only new cross licences will be granted that coveted Cat 5 card.  At least I don't see this actively HARMING participation & motivation,  as the original proposal certainly had the probability of doing.

With all the momentum and warm,  fuzzy feelings after Louisville worlds,  I feel a LOT better about next season,  and the continuing growth for Cross.

No More Waiting

Seems as if I have out-waited the Chemo side effects.  18 Days post chemo infusion now,  WELL past the drugs effect times,  and I never went off the cliff.  Never felt bad.  Had to HUNT for any symptoms.  Was pretty strange feeling SO good after getting those drugs,  sitting there just waiting for the truck to sneak around the corner & hit you.  Many days second-guessing how you felt,  second guessing every little ache or tired moment.  The expected crash never came to pass.    Had to ask the Docs if this was normal or not,  getting the drugs I did and NOT feeling like crap,  especially after feeling SO bad on my first visit to chemo-land 5 years ago.  In typically reassuring doc-speak,  it was,  "sure,  sometimes people have no effects,  and have differing reactions,  we really don't know why."

Whee.  Reassuring that the understanding of giving you such potent cytotoxins is SO well understood.  Especially when it's YOU they are getting pumped into.  Even started to wonder if I got the right drugs,  etc.  I REMEMBER getting something,  and seeing the name on the bag.   Cancer brain makes one have strange thought processes at times.  I DID get the drug,  and both my blood counts,  my obviously shrinking spleen (When you can FEEL your own internal organs,  that is a hint something ain't right....),  and my new found ability to actually push on the pedals of a bike with at least some limited authority

says it did SOMETHING.

Got over what fatigue I had,  and got over the dread of the NOT-arriving crash,  and started riding my bike again.  A mountain bike,  thank god.  Slow,  out of shape,  but can already just "tell" my blood is fixed again.  Was able to get my heart rate over 150 (and even 160),  for the first time in almost a year.  Actually feel like I can ride again.  A Pretty damn sweet feeling,  after having that taken away for so long.  I even Strava-ed the hell out of those rides.

Check it out,  158th out of 358 on the Heil/Wild turkey loop,  fresh off Chemo.  Better watch your sorry Strava/KOM Ass,  ya'll.  I'm BACK.  Oh,  and 11,  count 'em 11 Personal Records on all them there segment thingies on that loop (Maybe that had something to do with never me Strava-ing that loop before?  Nah,  I'm just kicking butt...)

Am I done with the medical nonsense yet?  Nope,  got a whole second set to start up on Valentine's day.  Some Mutated Mouse Antibodies that will hopefully kill off a bunch more of the Hairy little bastard cells that the Chemo did not get.  Lower "Minimal Residual Disease" is the intent,  with the hope that less leftovers to regrow means a longer remission,  and I want that.   An IV once a week for 8 weeks is the plan.  Eight full hours to get the first one in,  a very detailed infusion protocol to mitigate any adverse "reactions" to the Mutant Mouse cells.  That should be fun.

One more set of treatments to go.  At least these are not poison,  so SHOULD be low impact.  Of course after skating thru this Chemo,  now I worry the "benign" treatment will be the one to cause me grief.  We shall see soon enough.

I look to have some news on the Bike racing & Upgrade front coming soon as well.  Might have been a bit of a common sense outbreak down in the Springs.   Scary.

Waiting, waiting

One of the joys of anything to do with medical treatment in general,  and cancer treatment in particular, is WAITING.  Waiting for an appointment,  waiting for tests,  waiting for results.   For cancer it's always waiting to see what happens next.  With no "cure" for any cancer,  every one's experience is "Treat & Wait".  You treat,  you wait to see the results,  and for the real cancers (not like mine...) you wait to see if it spreads or comes back,  waiting for your 5 year "remission" time to come up.

Right now for me,  I am just waiting to see if I am going to crash after my chemo treatment.  It's now been 9 days since I finished up my Cladribine infusion.  Last time I did this,  about 1 to 2 weeks after infusion,  I went from feeling "pretty good" to feeling like absolute crap for 10 plus days.  Here I am at 9 days,  and for the most part,  I still feel really good.  No Crash.  Good,  right?

Well,  of course I can't shake the feeling that the truck I am expecting to get hit by is lurking around one corner or the other.  When it will appear and run me down is the question.  Then you start thinking "maybe I won't get the 'smack-down' this time".  That is a dangerous thought process,  as usually it's right about then the crash hits.  We shall see.

I did have an outbreak of one of those neat little things that chemo & a trashed immune system gets you.  Got a neat little outbreak of Shingles again.  One of those things you think of as an "Old People" disease,  one you will never have.  Turns out that after & during Chemo people are very susceptible to that little joy.  Since I had had a lovely bout with that 2 years after my last chemo,  I was able to identify  the outbreak,  get to the Doc,  and get a bunch of drugs going quickly.  A big dose of Steroids and Anti-Virals nipped this outbreak before things went real bad.  Neat thing about THESE drugs is it leaves me so hoarse I can barely talk.

A quick 'Crossin-Colorado "Public Service" announcement here....
If you ever had Chicken Pox,  and are over 50 years old or immune system compromised at all,  go get a Shingles Vaccination.  You do NOT want to have this shit.    Months of pain,  tingling,  itching, rashes and pain meds are not fun.  While learning that you can eat enough Vicodin week after week that you can adapt enough to do mountain bike races on the stuff (Performance enhancing?  not really....),  might be a neat little tidbit to learn about yourself,  I really advise against it.

So,  I wait.  At least I don't feel like crap.  Yet.

Am getting psyched for CX worlds this weekend.  Neat to cyber-stalk all the people you see every weekend in the masters races,  and then plan on having some folks over to watch the Elite Live streaming on Sunday.   Been fun reading about the Belgians and them having to travel more than 50 miles for a race for a change.  Poor Klaas Vantornout only has 3 bikes & 7 sets of wheels with him for worlds,  not his usual 7 bikes.   Big weekend.  Might even have a beer if I keep feeling like this.  (I hear there is even some "big game" later that day.....)

OK,  I realize that MAYBE everyone is done with the whole "Lance thing",  and MAYBE baseball can take some of the doping load with A-Rod,  but this little gem was too good not to share.  STELLAR  creativity.  Shot my drink out of my nose when I first watched this.  Can't help but make fun of the guy.

The descent

And NOT the fun,  rip a long mountain bike downhill kind of descent.

After a pretty much side effect free and feeling good Chemo infusion period,  the chickens are starting to come home to roost.   Ran with the Chemo Pump for the full 7 days,  with that timing out Monday AM.  Damn good to be rid of that thing attached to my arm.  Was starting to forget about it,  jumping up off the couch and the like,  then like a rowdy dog,  quickly coming to the end of my leash.  Getting that thing off is the first good milestone of the treatment process.

With no more need for the pump or any long-term infusions,  I also got to get rid of the PICC line.  Just as creepy as threading that thing INTO your chest,  removing it is pretty weird,  too.  As you can see below,  it is just a "Grab & Tug Firmly" kind of thing,  with a nice one hand coiling action on display as well.

PICC Line Removal from Dale Riley on Vimeo.

And yes,  you can feel it sliding out,  from about the shoulder down.  Nice.

Once I get rid of that,  and have a full load of Cyto-Toxins on board,  the waiting game begins.  Imagine KNOWING you will be hit by a truck any time,  but just not knowing EXACTLY when it will happen.  That is what happens with the Cladribine,  it takes a while for it to make you start feeling poorly.  PICC line & pump out on Monday,  still feeling good.  Blood work & a Doc visit on Tuesday.  Tuesday there was that "hmmmm.  do I feel the achy bones coming on?" thought in the morning.  At the Doc,  blood counts have plummeted,  as expected.  My White Blood Cell count went from ~5.4 to about ~1.7 over the week of treatment.  That drop is in reaction to killing ALL the Lymphocytes and Neutrophils in my blood,  both good & bad.  (The good ones grow back more & faster than the Mutant Cancer cells....)   My Neutrophils were down to 1.2K/uL,  just above the 1K "limit" where they start pumping you full of antibiotics to insure you do not get infected.

Thus,  they gave me what is basically EPO for the white blood cells (I know,  I know,  wrong kind...),  a drug called Neulasta.  Yet another Amgen drug,  described by the Chemo nurses as one of the "New Wonder Drugs" in the Leukemia pharmacology arsenal.   The intent is to boost production of the good lymphocytes and neutrophils,  keeping your immune system supplemented enough to not need to start the antibiotics,  or in most chemos,  stopping or delaying additional Chemo rounds.   For me,  it's more preventative.  This stuff has the side affect of generating "bone aches & pain",  same as the Cladribine.  OH,  and it happens to cost $10,000 dollars a dose.  (Guess it's still under patent...)  I am going thru the insurance dollars in a hot & heavy fury this time.  Thank god I HAVE insurance,  and good insurance at that.

Anyway,  it seems as if the Neulasta was the last drug I could tolerate,  as by the end of Tuesday,  I was on the Tylenol,  bones & Joints aching away,  and the nausea was peeking back in.  It all just got worse today.  Not sure if it is the real onset of what should be a solid week of ZERO fun,  or just the Neulasta.  We'll see soon enough.  Getting thru that will be the next milestone.  Had been able to even go ride easy for the last week at times.  That may well be over for now.  Oh well.

On a brighter note,  the media is no longer feeding like shark on the "Lance" debacle,  and coming up February 2,3 is the World Cyclocross Championships in Louisville  (no,  not the bowl of death but somewhere in Kentucky.   I am sure the Belgian contingent is excited to come visit us,  what with the "Lax gun laws & Methamphetamines".   Classic.

It will be streaming live for those who did not fly out to Loo-ie-ville and buy the $40 Tickets for the weekend.    I hope to have enough of a immune system to have some folks over to watch (Or even just to NOT be huddled in a ball whining like a little girl.  Yee ha,  here comes the fun stuff.

Off to the (other) races

My VERY non-Lance comeback to competitive cycling has begun (again...).

Started my treatment for the Hairy Cell Leukemia that had been slowly slowing me down till I was riding like a 2 year old on a strider.  Hairy Cell is a chronic cancer,  meaning that the treatment does not cure or kill it,  but only puts it in remission,  bringing the number of diseased cells down to a low enough level to prevent any symptoms.  Sad part is,  they then build up again,  quite slowly in the case of HCL,  but eventually you come out of remission and need treatment again.  In my case,  it looks to be 4-5 years of remission.  This is not NEARLY as long of a remission as I would care for.  A bit on the short side of median overall HCL remission times.  With only about 500 cases of HCL diagnosed a year in the US,  statistics are not good for my disease,   either treatment or duration wise.  This can make dealing with this "interesting" compared to the more common cancers at times.

So,  how does one put the fuzzy little bastards away for whatever time you can?   Treatment is VERY mild and tolerable by any normal cancer treatment standard.  The normal treatment is a single round,  5-7 days of a single Chemotherapy drug.  (Many chemo regimens now days use "cocktails" of multiple chemo drugs...).  Couple of weeks of feeling poorly,  reduced blood counts and you pretty quickly recover back to normal.  There is a newer treatment available now,  adding a "Monoclonal Antibody" 4 weeks after the Chemotherapy drug.  The intent is to eliminate MORE of the "residual disease",  killing more of the cancerous blood cells,  with the thought that this can lead to longer remissions by taking longer to "grow back".  Again,  the rarity of my disease rears it's ugly head in that there is only one small clinical trial of this drug combination with results so far.  At least that one small study seemed to show longer remissions.  With minimal side effects of the antibody drugs,  I opted to give it a shot,  again in the hope of getting more than the 4 years of remission before getting "slowed down" again.  Let's do this while I am "young" was my line.  Funny,  huh?

On Monday,  January 14,  I started my treatment.  A quick visit to the "Vascular Access Team" at Longmont United Hospital was first.  This was for the "PICC Line".  A "Peripherally Inserted Central Catheter" is a fancy IV,  one that you can go home with,  and allows multiple weeks of IV access.  This is a LOT less invasive that a "Port",  the other type of long-term IV access many chemo patients "get" to have.

Now,  mind you,  having someone snake a 45cm long tube into your "Superior Vena Cava" by way of your bicep is a pretty creepy "procedure".   Putting a "catheter" in your "Superior Vena Cava" via a "peripheral" is really just medical talk for cramming a tube in your arm and snaking it into your HEART.  What is weird about THAT?

Here is the nice nurse lady holding up a demo PICC line.  Yep.  in the arm,  over to the heart.  Sure.

This is my second PICC line now,  and in spite of the creepy-ness,  they are no more uncomfortable than getting a normal IV.  So in less than an hour,  you get a cool set of tubes hanging out of your arm.  And  you quickly forget that little purple tube goes into your chest. (sort of...)

Proper Access established,  run over to the GREAT folks at Rocky Mountain Cancer Center to get my dose of Cyto-Toxins going.  The standard HCL Chemo drug is "Cladribine"  .    I get about 50 mL or so (Not very much..) over a 7 day infusion.  Rather than the typical chemo experience of getting to go in to the "Treatment Room",  and getting endless IVs on some repeating schedule,  I can get my dose from an Ambulatory Infusion Pump,  a small pump I can carry around for that week.   This stuff is the other reason I can't get a regular IV.  It is SO nasty,  it can ONLY go in the high-volume veins near the heart,  a regular vein in the arm would get "cooked" from this stuff.  Neat,  huh?

All said & done,  I then get to tote this cute little setup around for the week.  I throw it in a fanny pack,  just for that '70s kinda fun vibe.

The pump pushes out 0.1mL of goop every three minutes,  with a nice little "Click-Whirr-Click" noise. Always reminding you it's going in.  Gives you the chance to remember what is going on and say things like "Die,  you fuzzy little bastards,  DIE!" to your own blood marrow.  Well,  at least **I** do things like that.  Maybe not all cancer patinets do.

Three days in as I write this,  and as in my last treatment,  I feel nothing yet.  Takes two or so weeks for THAT truck to run me over.   Always nice to know you are going to get hit.  Still feel good enough to go for a ride today,  even.  Just tuck your little friend in the jersey pocket,  let the IV tube dangle like a IPOD cord and go do it.  (Yes,  my chemo nurses did not think that was a good idea....  but then again they had no REAL reason NOT to.....)

Will finish up the week of hot pump action,  blood draws every 3 days, etc.  Then I will get ready for the crash.  Can't wait for that.  I'll keep the full blow-by blow updates coming as the fun unfolds.

Just as a side note,  I would like to personally thank Lance Armstrong for making the entire sport of competitive cycling look like a soap opera/freak show/TMZ episode.  ( I am SURE he reads my blog regularly...)
Oprah?  Really?  OPRAH is where you choose to come "clean"?

Good God.  Stinks like a herd of "crisis managers" and spin doctors to me.  Hmmm.  MAYBE Lance hired a herd of those kind of folks to polish the turd his "image" has become?  Nah.    At least it provides endless internet fodder and drinking games.  We'll be playing BingoSTRONG while watching that nonsense tomorrow night.  Should look just like this....


No matter what,  Thanks,  Lance.  You've done a GREAT job helping the sport you say you "love".  I really appreciate it.   Dick.

NO fun allowed.

As I ranted on and on about a few weeks back,  I see that we WILL be abiding by the new "rules de upgrade",  starting right..... about........... NOW.

If you watched the BRAC upgrade points (or were one of the lucky ones to get caught up...) you saw that anyone with enough upgrade points for the "new and Improved" 2013 upgrade criteria were bumped up a category in the last weeks.  Cat 4,  Cat3,  no one escaped "The Purge".

Some sniffing about revealed that outside of the points-driven purge,  the Cat 4 purge of the sandbaggers with (gasp) more than 10 whole races in the 4's are quite likely to see that same "congratulations!" E-Mail soon.  This would of course include those slackers who never came close to seeing the front 1/2 of a cat 4 field in that long,  sandbagging,  10 race cat 4 career.

Is upgrading on points good?  Yes.  Is preventing sandbagging good?  Yes.  Is it noble to want to challenge yourself against the best available competition?  Yes.  Is it a BAD thing to make Cyclocross Cat 4 a "true" beginner group?  No.  Is it right to force a back of the pack 4 into the 3s?  Hmmm..

Is it going to motivate those new riders,  JUST starting to REALLY get "into" racing,  where they might start to see the potential to see that front half of a race,  to taste even the potential of some small racing success,  get them REALLY hooked on this thing,  and then toss them into a big field of Cat 3s?  Probably not.

You may not agree with my ranting about what the "powers that be" that rule competitive cycling like Assad rules Syria,  decide for this sport.  You may not agree with my endless whining about the back of the pack viewpoint,  but I am not alone.  The slightly off base dudes at DrunkCyclist seem to share some of my love of the Colorado Springs Mafia. (See #3 in that link)

(graphic stolen directly from said Blog....)

Sometimes I just do not GET what the hell some of these things are supposed to be "fixing".  I just get frustrated by the complete lack of understanding for "Recreational Racing",  just racing for fun at a accessible level.  A level that takes maybe less commitment to training,  to a "bike racer" lifestyle,  yes,  maybe an "easier" level.  Can (and will??) many people get that satisfaction out of always racing to avoid DFL?  Sure,  but seems like a LOT more people might enjoy being even remotely "competitive" in results.  

Kona Loves Cyclocross from Kona Bikes on Vimeo.

I just do not see why catering a bit to that kind of rider would do anything but bring many more into the sport.  Not everyone likes to get their hind end handed to them week after week,  then get the "well just train more/get faster,  and you can play" treatment.  The more people you get,  and keep in the bottom of the system,  the better chance to get more of those elite riders the USAC caters so exclusively to.

Am I maybe over blowing this stuff (Again..)?  Maybe. (Probably..)
Will the Sport Survive (if not thrive..)?  Most Likely.
Might I be out of touch?  Likely.
Might I be completely wrong?  Also Likely.

Rant off.  Enjoy your New Year.  Watch/Go to Louisville for worlds.  Celebrate that "little accomplishment" for US Cyclocross.  THAT is a pretty cool thing.