Strength – Frantic Shanti

The More Things Stay the Same, the More They Change

^{(Title image: Photo by Edward Howell on Unsplash)}

Maybe it’s time to talk about impermanence.

This is something that I have to remind myself constantly: just because things are a certain way now, no matter how set-in-stone they appear, there’s a high likelihood they will change.

I wish more people understood this. I’m old enough to have experienced a litany of changes in my life, some of which completely blindsided me, like cancer, for example. I was not expecting my entire life to get flipped on its back by one little lump and a subsequent scan. And yet, here we are.

That diagnosis brought a whirlwind of changes as I was assaulted with more medications and procedures that I had ever imagined possible in my life. And they came at me fast, one after the other. Recovering from surgery, dealing with chemo side effects, tearing through loaded weeks of radiation…and then, several years of endocrine therapy, which in retrospect threw me into what felt like the longest-lasting changes.

Those, I consider negatives. I tried to maintain my “normal” through them all, which meant consistency with my workouts and nutrition, just so that I didn’t lose myself in the mess of it. It felt like I was barely holding on with my fingernails.

Just when I thought this was the way it would be from now on, the light broke through.
(Photo by Sharon Co Images on Unsplash)

But…there was a flipside to this. Another change that I didn’t expect, but was actually quite positive: the realization that establishing effective coping strategies like meditation and maintaining existing healthy behaviors were the keys to eventually getting a handle on the negatives.

So everything bad that I thought I was stuck with—decreasing strength and endurance, low libido, thinning hair—all those things that we associate with old age and the relentless march of time gradually started turning around.

Again, impermanence smacked me on the back of my head.

So, there’s a lot I can write about this. I added creatine to my diet and over time it has had a significant impact on my workouts, in particular my strength. After years of watching my “gains” decrease, I could confirm that I was building strength up again at age 60.

My hair, which had been falling out, slowed that regression. Springing for better quality hair products helped, but so did moving to a quieter, updated apartment. The reduction of environmental stress, even in the presence of existing stressors of work and finances, had a dramatic effect. On top of that, becoming aware of the cyclical nature of my hair loss relieved anxiety about it. As did bucking the trend of “embracing” my gray (in my case, white) and instead welcoming light blonde back into my life.

But one of the most striking changes was the return of my libido. This is so delicate and important a topic because I am convinced that many cancer survivors-slash-postmenopausal women suffer in silence about loss of libido, no doubt due to the potentially embarrassing nature of the issue. Many of us were raised to not talk about such sensitive topics, and particularly not with male oncologists.

And all the hype about hormone replacement therapy for postmenopausal women…ah, but breast cancer survivors get locked out of all the positives associated with that…

The topic of libido deserves a post of its own. I will indulge this in the future. Suffice it to say, for me it was one of the changes that had the greatest effect on the current trajectory of my life because it was the one that (I had read? I had been told?) was irreversable and expected and I should just shut up and deal with it.

I thought this was the way it was going to be from now on. And I was afraid of the effect that it would have on my marriage.

Ah, but that beautiful concept of impermanence reminded me that I should never settle into expectations based on what came before me or what happens to others, because everyone has their own individual set of conditions. What a lovely awakening to the rest of my life!

Aging Muscle: After Cancer Treatment and Menopause [PHOTOS]

^{(Title image: Photo by Samuel Girven on Unsplash)}

This is a reality check to demonstrate how, even with the greatest of intentions and planning, coupled with a serious love of exercise, you can’t turn back time.

And that’s okay.

But first, the comparison. Taken from this previous post, here’s a photo right before I started chemotherapy for triple-positive breast cancer, April 27, 2017:

April 27, 2017: I was exercising with a vengeance

After finishing chemo, radiation and Herceptin, AND after two years of estrogen-lowering Tamoxifen and a year into Letrozole, I’d lost some muscle even though I was lifting as heavy as I could.

This photo is from December 11, 2020:

December 11, 2020: Still exercising with a vengeance, but…

While I was still working out hard, endocrine therapy and menopause took their toll on my progress. Interestingly, estrogen is not simply a “feminizing” hormone; in women, it also helps preserve both muscle and bone mass. Menopause puts the breaks on estrogen production.

This becomes worrying as we age because less estrogen means weaker muscles which can lead to a greater risk of falls and chance of bone fractures. Endocrine therapy, which is designed to decrease the estrogen in the body in order to lessen the recurrence risk of hormone-sensitive breast cancer, adds to the problem.

And more than seven years after the top photo, this was taken today before posting, September 23, 2024:

September 23, 2024: New phone, different lighting (sorry!), more wrinkles, same moles. I’m working hard just to keep what I have, but loss is inevitable.

I’m still lifting but the entire landscape of my workout routines has changed. I have to give myself more recovery time between strength training sessions. I am much more susceptible to injuries—seriously, I can tweak something by turning or stretching out in a weird way. I have neuropathy in my feet which makes getting up on my toes (such as in plank or doing lunges) painful.

We recently had an intense heat wave: for a week the temperature inside our apartment didn’t fall below 80F degrees, and during the day it climbed as high as 95F degrees (again, INSIDE our apartment). I managed to work out through a chunk of that week, but the heat eventually got to me. And recovering from that took almost another week.

So, the spirit is willing but the flesh is barely managing at times.

However, there is an upside to being 58 years old with a lifetime of fitness experience. I still love working out. Even tough training sessions are manageable because they feel like an awesome accomplishment, and I feel bouyed afterwards.

Even on the days that I don’t do a formal workout, I make sure that I’m moving as much as I can. Fitness is an integral part of my life, even though it looks different now than it did seven years ago. In the post that I reference earlier, at the very bottom I wrote about how yoga was becoming a larger part of my life.

And that’s continued. Through my yoga teacher training in 2022 and upcoming yoga4cancer advanced training starting in January 2025, this direction feels so right for me.

While I don’t plan to give up my gym sessions anytime soon, yoga has given me a path to physical and mental fitness as I age. I am gradually moving into a more meditative approach to exercise that is less about intensity and more about staying healthy by integrating mind and body.

Tall Like a Mountain: A Meditative Visualization

In dealing with anxiety, I’ve come to accept that while fearful thoughts come and go, I remain the same.

Visualizations have been helpful in realizing this. One of my favorites, the one made famous by Jon Kabat-Zinn, PhD — creator of the Mindfulness-Based Stress Reduction (MBSR) program — is the Mountain Meditation, and I value this visualization particularly because it is so meaningful in its description.

For this meditation, you settle into your seat and bring your attention to your body. Scanning your different parts, from your feet to your head. Feeling yourself breathe as you go. No need to change anything; you’re simply noticing sensations.

Imagine your ideal mountain…and then become it.

As you sit with eyes closed, shift your thoughts to a beautiful mountain, tall and stately. Imagine the details about it, it can be whatever kind of mountain you choose. Steep or gently sloping, rocky or carpeted with greenery. Allow the image to form itself: the mountain is stable, majestic and unperturbed regardless of the season or weather.

Then, once you have a clear picture of your mountain…allow yourself to become the mountain, settling into its form and taking on its characteristics. Feel yourself grounded in its stillness.

Sitting as the mountain, imagine the seasonal changes and the different weather that each brings. Through the snow of winter that blankets everything, the spring thaw as nature awakens and buds burst open, the summer teeming with life under the warmth of the sun, and autumn with its changing colors and cooler breezes that move you into a quieter state in preparation for the coming winter again.

All these bring wind, precipitation and occasionally harsh conditions whether they be cold or heat. But the mountain still sits as it always has, unmoving and unbothered.

And so you, as the mountain, also sit in the midst of different conditions. When you take on the garb of the mountain, you link with its strength and stability and unchanging nature from day to month to year. This meditation encourages us to see through the chaos of our everyday lives and find the persistent calm behind it.

This is one of my favorite meditations because it carries so much meaning. Below is a YouTube video of Dr. Kabat-Zinn leading a 20-minute Mountain Meditation:

Jon Kabat-Zinn’s Mountain Meditation

If you would like to read a version of it, PalouseMindfulness.com has provided their own adapted transcript of Kabat-Zinn’s Mountain Meditation in a pdf file. Alternatively, googling “mountain meditation” will also bring up a nice variety of recordings.

I encourage you to try this when you feel you need extra grounding.

This Is Your Arm On Drugs, Part II

While my previous post had focused on appearance, how I looked was a relatively small part of getting back to where I’d been physically. Much more important was the hit my strength and endurance levels took, and those don’t really show up in the photos I posted. While there’s not a huge change in muscle size, my strength did decrease significantly, not surprising given that I was going through cancer treatment. At the “height” of each chemo infusion, I had trouble walking, sometimes even lifting my head from the pillow. Movements required a lot of effort.

All that rest time affected my physical ability. I’d been told not to row (Concept2 erg) for four weeks after the lumpectomy on my left breast. That was tough because rowing is a form of meditation for me, the quintessential mindful movement — it was stress management that I desperately needed. I wanted to follow the rules so I stayed off the erg, but incorporated light weights into my “weenie” workouts. That helped, but I felt frustrated and weak.

Then, after those four weeks were almost over, I had my chemo port implanted on the right side of my chest wall, and again was told not to row for 3-4 weeks. Well, a week after port placement, I had my first infusion. ARGH! Sooooo, I wasn’t able to get back to rowing until I’d recovered from my first chemo.

My strength continued to increase after each of the first three infusions, which was gratifying. I’d gotten to about 2/3 of my pre-surgery strength training weight load. But after the 4th infusion, the fatigue started to catch up with me and I had to slow down. I was tired! To make matters worse, my bloodwork before the 5th infusion revealed an increase in the levels of two liver enzymes, ALT and AST. Chemo is hard on the liver, which works overtime to clear out the drugs from your system. If those numbers continued to go up, my 6th infusion would be delayed.

Now, you might think: what’s the big deal, waiting a week or two longer for the last infusion? Psychologically that would have been devastating. For me, getting through chemo was more than enduring its physical effects; the mental component was huge because of the stark contrast between my level of fitness previously compared to where cancer had knocked me down to. The dates of each infusion were seared into my mind, and I really needed chemo to be over.

My solution was to implement every means imaginable for decreasing liver enzyme levels. That included foregoing heavy lifting, according to my research. Anything, to finish on time. For the weeks before my last chemo, I was a green-tea-guzzling, dark-leafy-green-devouring, turmeric-supplement-popping, hyper-hydrated couch potato. Thankfully, my numbers went down and I finished chemo as scheduled.

The final infusion required the longest recovery. Once I got over the worst of the side effects, I could still only row 500 meters at a time at a harder pace, and my weight load and repetitions had dropped dramatically when strength training. While I was done with the hard chemo, I still had Herceptin infusions (and still had the port implanted, which got in the way) and those affected my heart, so I got tired more quickly. Not chemo-tired, but tired enough. I focused first on improving muscle endurance (lighter weights, higher reps) and then gradually increased the weight and dropped the reps to build muscle back.

There was a fire under my butt to get back to my version of “normal”. Ultimately, regaining strength was the easy part. The hard part was getting back to where I had been mentally, and even now I’m not sure I’m there yet. But who knows if I was in as good a state pre-diagnosis as I think I was?

My focus now is to train as hard as I can, stay as active as possible and not succumb to the weight gain that seems to afflict the average middle-ager. I guess I’m trying to find a “recipe” that will keep the cancer from coming back. It probably doesn’t exist, but seeking it is one way for me to maintain a semblance of control over something that is ultimately uncontrollable.