Weight and energy: asked and answered

July 10, 2017

Hi, Tracy.
I had the shock of my life a few days ago (my recent life, anyway) when I got on the scales and was approaching 220, the weight I endured a few years ago before I took off 35 pounds. That led me to have an e-mail exchange with my oncology PA:

Asked:

 It's been 90 days. I'm still having hot flashes and night sweats, and I understand that this is probably normal. I am trying to drink lots of fluids, because once the hot flashes pass their greatest intensity I end up drenched with sweat.
I have two questions:
1. Does the treatment I had contribute to weight gain? I'm finding I am moving toward my greatest weight, and I'm not sure whether this is due to lack of discipline, or whether  this is naturally due to the effect of the hormone blockers, radiation, etc.
2. Is there a good strategy for regaining stamina? A little while ago I went on two short hikes (3 miles, 500-foot elevation gain) two days in a row, and my energy level was low. I had to stop a lot and rest, and then plod along slowly. But a week later I went on the same hike and had all sorts of vim and vigor. I'm wondering whether it was because I took a 30-minute nap in my car and then chugged a Mountain Dew (sugar and caffeine) before heading out. Based on that experience I'm tring to stress my body with a hike that takes a bit of work, and then rest 2-3 days to allow it to recover before challenging it again. Do you have any thoughts on this?

Answered:

Hello there. I hope you are enjoying your summer despite the hot flashes. 

1. Weight gain can occur with lupron injections (reported <13%). It usually occurs when men take it for a longer period of time but I have seen it. You may need to see how many calories you are taking in and how many you are burning. I am not an expert in calculating any of this. If you write down everything you eat and the amounts you can often see that you might be taking in more that you thought.

2. The testosterone blocking effect is leaving your body but it can take time for you to continue to recover your stamina. I am glad to hear you are hiking. I think it is important to do a little exercise every day. The nap and then the caffeine in the Mountain Dew most likely did fuel you short term for your hike. On the days where you are not hiking, walk 1-2 miles per day to keep your body moving. It does not have to be strenuous, just keep moving daily. Some days hikes go well and others not as well. Don't give up. Listen to your body and slow down if you need to. You are out there and that is good. 

That's all she wrote

Having read this after an afternoon of hiking at Flaming Geyser State Park, I said screw it and had a mug of whole milk and two pieces of Jessie's Key Lime Pie -- with meringue.
Love,

Dad

90-day energy report

June 30, 2017
Hi, Tracy.
It's been 90 days since my radiation treatments and the taking of hormone blockers. I'm still having hot flashes and night sweats, and they can occur several times a day. But I seem to be getting strength and stamina back -- intermittently. And I'm also having a problem keeping weight off.

A week ago I hiked Twin Falls. The elevation gain was only a few hundred feet and I hiked only about 3 miles. But I had to stop several times due to fatigue. Then the following day, Saturday, I hiked it again, and again I was quite tired. As a measure of my stamina, when I was in shape, I could sustain a heart rate of 148 beats per minute. On those two hikes, the best I could do was 128, and only for short periods. This is the same speed limit I reported here June 12.

But almost a week later, I visited the Twin Falls again, this time hiking 5 miles and reaching greater elevation. And throughout most of the last I had great energy. (I also had a 30-minute nap in the car just before hiking, and a 16-ounce can of Mountain Dew, giving me a sugar and caffeine shot.) There were a couple hot flashes, but only a couple. And that night I went to a dance class without taking a nap first.

That was yesterday. Today I rested at the condo and had a long nap, but at the dance tonight I found my legs tired and my energy level poor.

My emerging theory is that I need to exercise to keep from back sliding as well to improve my condition, but I also need a lot of rest afterward to let my body recover from the stress it hasn't endured for some time.

I also need to eat more moderately. I am closing in on 215 pounds, five below my maximum weight. More than 10 years ago I took off 35 pounds from that top weight, and lately I've been putting it back on. I want to return to 185 pounds if possible, and that will be my goal for the summer.

Love,
Dad

128 bpm

June 12, 2017

Hi, Tracy.
I'm back from my travels to the Banff-Canmore area of Alberta, Canada. Magnificent scenery.  As I said in the prior blog, when I was there I found myself exhausted with minor hikes, and then realized it was because the elevation there was about 5,000 feet higher than Seattle. Makes a difference. At the same time, however, my heartbeat at rest was as low as 46 beats per minute. That was a surprise.

Yesterday morning it was 48 bpm. I would have expected it to be lower than the Canmore rate, because I was at about 400 feet above sea level. But I'll settle for 48 bpm, because that still puts me in the top 3 percentile.

A new metric

A bit ago I walked to the waterfront and then came back uphill. My heart rate got to 128 bpm and I had to stop for breath. This is a new metric to keep track of, because it marks a new boundary. When I was in hiking shape I could trudge along with at least 20 pounds on my back and my speed limit was sometimes as high as 148 bmp -- and sometimes in the upper 150s. So the fact that 128 bpm is now my new speed limit shows how far I have to go to full recovery.

Love,
Dad

Short, challenging hike

June 7, 2017

Hi, Tracy.
Today I went on a hike that was surprisingly difficult. My traveling companion, Valerie Vessey, and I have been staying at a time share in Canmore, Alberta, Canada, and we drove to Banff National Park to see Moraine Lake. I wanted to hike there because of stunning photographs I had seen of that location, and because I wanted to build up my stamina.

Moraine Lake in Banff National Park

The hike was short, but surprisingly difficult. I had to rest along the path that lead to the headwaters of the lake. Afterward, when we climbed up on the moraine at the opposite end of the lake to get the "$20 view"  (the view that appeared on Canada's $20 bill), I climbed a staircase that just wore me out. It could not have amounted to more than 200 feet, elevation gain, but I had to stop and rest a couple times.

Later, I learned from a park employee that the lake was at an altitude of 5,000 feet, the elevation of Denver, the "mile high city," and I realized the elevation change from Seattle may have been the reason.While I didn't hike well, I believe the effort will have a positive impact on getting me back in shape.

Before we left the park, we talked with an individual who was directing traffic who told us he had just been watching a young female grizzlie bear which had just disappeared over a knoll. He shared information about the nature of the bears and how park staff co-exist with them -- including entering their dens to tag the young while the adults are away!  Afterward we drove up to look at Lake Louise before heading back home for dinner. We plan to do at least one other hike before we return to Seattle.

Addendum: June 8

At mid morning I took my pulse with amazing results: about 46 bpm. I don't get that. It's extremely slow, I'm at 5,000 feet, and I haven't exercised for months.


Love,
Dad

More rebounding: Little Si Again

Memorandum: May 30, 2017

Today I'm not writing a letter to Tracy because Tracy was part of the event. The two of us climbed Little Si, the first real hike since I climbed Little Si on April 11. Last time it took four hours to reach the top; this time it took two hours. My knees were a little weak, and I was tired afterward, but I'm encouraged. Normally what takes 90 minutes took only 120 minutes. The day was a cool 60 degrees or so and I was able to complete the hike with a minimum of eating and moderate water. I had hot flashes and had to rest at times, but this was a triumph compared to the difficulty of just climbing from Alaskan Way to the Condo via Madison Street. My pack weighed under 20 pounds.

In June I hike the Canadian Rockies near Banff. I feel up to it.

Recovering stamina

May 21, 2017

Hi, Tracy,
This week I'm starting to focus on restoring stamina. Yesterday I hiked 2.6 miles round drip to Recreational Equipment Inc. to use up a rebate coupon to purchase camping supplies. The climb up Denny Way isn't that long, but I felt myself worn down by the walk back home.

And last night I went dancing with a friend. I found myself surprisingly weak and sitting out several dances. Before the evening was over, I was soaked with sweat. I think the weakness from my treatments has discouraged me from getting enough exercise, and that this has led to a decline instead of a recovery from the radiation and hormone-blocking treatments. So I believe it's time to stop recuperating and start exercising.

June 4-11 I plan to be hiking in the Canadian Rockies near Banff. Between now and then I'm going to try to get in a small hike every day to recover my stamina. And when I return from Banff I intend to hike regularly the remainder of the summer.

Love,
Dad

Collateral damage: $237.44 light bill

The May light bill is three times the level of the previous year.

May 13, 2017

Hi, Tracy.
Just when you think the story is winding down, another shoe drops.

Most of the effects of the Lupron shots and bicalutimide pills, as well as the radiation treatments will have worn off by the end of this summer, but a collateral effect has shown up in the form of a humongous bump in my City Light Bill.

What's that got to do with cancer treatments? It's the "manopause" I've undergone as my internal symptoms responded to hormone blocking and radiation effects. You know that I've had hot flashes followed by cold sweats, but I haven't told you how I coped with them. First of all, in February and March I spent most weekdays around the house, and I wasn't gone hiking on the weekends. That was coupled with a lot of time spent at the computer -- sometimes dawdling, sometimes being creative, and sometimes spent on a class on Web design, well after the radiation treatments ended.

That was matched with chills that I alleviated with help from my space heater -- and hot flashes, which I mitigated with a small table fan. Sometimes I would turn off the space heater, take off a wrap, and then turn on the fan because I became chilled. Sometimes I would turn off the fan and turn on the space heater -- or grab a wrap.

Electrical heating and cooling affects your usage of electricity. When my electrical bill arrived (the image at the top) the tale was told. My electric bill had tripled over the prior year. It probably didn't help that this was a record year for rain.

Love,
Dad