February 2013, after being diagnosed with my third cancer in as many years, and on our middle child’s 13th birthday, I was admitted to the hospital to start chemotherapy. This new transformed cancer, Diffuse Large B Cell Lymphoma (DLBCL), was aggressive and required an intensive treatment regimen (R+ESHAP) that consisted of being hooked up to a chemotherapy infusion pump 24 hours a day for nearly 7 days straight. I was 54, had no other health conditions, and, having just abandoned my training to break my age group mile world record (4:25), was very fit. Therefore, my oncologist thought I could handle the treatment.
An unsuccessful attempt was made to insert an iv PICC line into the crook of my arm to thread up through the vein to a larger vein at the top of my chest. Besides being painful, this concerned me since I wanted to maintain the exercise routine that I had established in anticipation of needing chemotherapy, and thought full use of my arms worth keeping. Instead, a Hickman line was inserted into my chest, which was not much of a problem. However, finding a stationary bike was.
I asked my nurse if there was a stationary bike that I could use. I was surprised to hear that they had none on the oncology ward, and I was equally surprised to hear that in her 5 years of working there that no one had ever asked for an exercise bike. This was an MD Anderson affiliated hospital, and, at that time, MD Anderson was the #1 ranked cancer hospital in the US. I was disappointed to realize how little exercise was being used as a part of cancer treatments.
There were some bikes in the cardiology unit (exercise is a part of rehab after a heart attack) but I wasn’t able to use them because cardiology was in another building and that would require me to go outside to get there – not allowed. A patient coordinator then set about trying to locate a bike for me and her initial search found one in our building, in the basement of the psychiatric ward. In order to get to the bike I had to navigate some stairwells, so they reluctantly disconnected me from the infusion pump and gave me one hour to complete my exercise and to shower afterwards. I also had to be escorted and accompanied by a nurse (not the shower though), so off we went.
Arriving at the psychiatric ward was a bit surreal. In the small lobby there were two locked doors, one of them had an unsettling notice on it “Extreme escape risk”. I wondered about the patients behind those doors, each going through something different from me but also sharing something similar – the need to get healthy again. This was a sobering reminder that there were other debilitating things besides cancer, and that my health issues, although somewhat complicated and rare, in the grand scheme of things, were nothing special. I felt fortunate, I was beginning my recovery with a clear action plan, literally too, and with an understanding of what I needed to do and why. I wasn’t sure the psychiatric patients had as clear of a way forward, and I felt for them.
After buzzing for assistance we were given the okay to go to the basement where the bike was. Down more stairs we came to an old, small, gym. It was odd, with ceramic tile walls and bars on the windows, and most of the equipment had been abused and was in need of repair. The only decently functioning piece of equipment was an air-dyne bike, this is the type with big fan blades on the front wheel, which makes cycling at higher RPMs difficult, if not impossible.
Another problem was that the bike’s handlebars were connected to the pedals, this made the handlebars move backwards and forwards with each pedal revolution. I was not going to be able to use the handlebars that way because I was still sore from the PICC line attempt in my right arm. Plus, my left arm was also sore from the recent biopsy surgery that removed an entire lymph node in order to confirm my cancer diagnosis. A final problem was that there were no toe clips on the bike. For support, I held on with my left hand to a broken display console that was mounted between the handlebars. With no toe clips and a fan for a front wheel, this was going to be one interesting, if not difficult, ride.
For a moment I thought about the situation, me: chock full of tumors, in a psychiatric ward basement, chemotherapy drugs still coursing through my veins, and wanting to ride a dysfunctional exercise bike. I chuckled nervously to myself “Maybe I belong here”. Then I started pedaling.
As a runner, I broken 4 minutes for the mile, ran under 2 hours and 10 minutes for the marathon, and won numerous races around the world, but I never accomplished anything more uplifting than turning the pedals on that derelict bike. I rode that thing for 30 minutes while trying to control my emotions so that I could finish the workout and still have time to shower before being hooked up again to the infusion pump. The nurse was nearby texting on his cell phone, unaware of my riding predicament or of my emotions.
Prior to being admitted for chemotherapy I had been researching exercise and cancer treatments, and I had come across only one study, done on a small group of breast cancer patients, where someone had exercised during chemotherapy infusion. I had advocated that there be more studies on whether this could improve a patient’s response to chemotherapy – could exercise during infusion enhance chemotherapy and increase survival rates? I already knew that exercise was good for my quality of life, but now it was my turn as guinea pig. This added a different perspective to a study of this type, and it increased my respect and appreciation for patients who volunteer for research studies or clinical trials, they are heroes to me.
In the basement of that psychiatric ward, while riding a rickety old exercise bike, and with chemo drugs doing their thing inside me, I was alone with the enormity of that moment … and I was elated. Somehow this all seemed to fit for me – a bike, science, and faith, versus cancer – and I liked my chances.
NOTE: The hospital’s patient coordinator was able to locate a better bike in a storage room and they kindly brought it to my room for the remainder of my first chemo cycle. I was then able to exercise without being disconnected from the chemotherapy infusion pump. They also had the bike waiting for me when I started my 2nd chemo cycle (no pun intended) two weeks later.