Community Spotlight: Patricia Tirona
Patricia Tirona is a veteran runner. She’s the Co-Captain of the New York-based running team, The Dashing Whippets. She’s a 9-time marathoner including 2 Boston and 4 New York City marathons. She is a huge San Antonio Spurs fan. She loves hot wings, sushi, tacos and bourbon, is a huge Marvel fan-girl and creates music playlists for EVERY scenario (although she trains almost exclusively to rap). Patricia was recently diagnosed with breast cancer.
Her story is one of grit and perseverance, which are traits inherent to most runners, and highlight the importance of community. Patricia is as strong and inspirational as the running community at large, and we wish her all the best in this fight against this wretched scourge that human beings should no longer have to be fighting. She wanted us to emphasize a critical component in this piece: the incredibly important role in maintaining a high blood cell count, boosting immunity, and fighting off side effects for patients who have been diagnosed with cancer, particularly breast cancer. She has started a Strava group for people who want to train through the disease together called Chemo Champions, which you can join here.
How has your schedule changed (or not) with respect to getting treatment? Have you tried to continue running, and if so, can you share the experience?
The first four rounds of chemo consisted of Adriamycin/Cyclophosphamide, which pose a cumulative effect as treatments progress. Adriamycin aka “Red Devil”, known for its bright red color, is “pushed” slowly through the IV via a syringe. The progressive nature meant that the side effects of nausea, fatigue, immunity breakdown would worsen with each round of chemo. Typical amongst chemo patients is to feel little side effects the day of, more the day after, even more the second day after, and usually worst by the third day which could last into the fourth day. I was given two types of drugs to manage the nausea, both of which came with their own side effects, and opted to take the milder of the two only on the night after treatment.
I usually felt okay the day after, rough the second day after, and back to normal with some fatigue the third day. As far as training this meant I could work out the day after but had to wait for this small, self-timed immunity-boosting Neulasta pod, which is attached to my belly via a tiny catheter, to inject itself 24 hours post chemo. The first day after chemo #1 I ran 8 miles with Katie! Over the course of about 7 weeks, 3 rounds, the side effects remained predictable. No lasting effects by the third day meant feeling normal enough to work out the week after. Typical was hitting anywhere from 20-45 miles a week. But as the chemo effects accumulated I felt easily winded like I was running at altitude and stopped often. 60-Minute elliptical hill intervals while binge watching The Punisher and Supernatural, eventually replaced running. I tried to keep up a workout schedule of 4-6 times a week. My running paces dipped to slow times even at max effort but it was still wonderful to get out there.
As warned, the fourth round and last of the AC knocked me on my ass. The day after felt okay and I did another hill interval elliptical workout but the second day after was the worst fatigue and nausea I’d ever felt. The altered taste buds, another common side effect, meant that after any given treatment cravings changed leaving me struggling deciding what to eat. I couldn’t get off the sofa, had no appetite, ordered 2 medium thin crust Domino’s pizzas I slowly nibbled on but couldn’t make a dent in, watched around 11 episodes of Bates Motel, and had throbbing back and leg aches, typical of Neulasta. I worked out very little after the fourth AC treatment and then I caught a sore throat and cold to boot — struggled through some elliptical and cycling at the gym while running mileage was down to practically nothing. Silver lining: my pesky Morton’s Neuroma is non-existent due to the imposed rest. That’s something at least.
What are some of the things keeping you motivated through this process?
My mom, friends on DWRT, the running community, my cat, continuing to work, and yes, my love of basketball and the San Antonio Spurs have kept me sane.
At the time of the initial biopsy I was told I wouldn’t have to undergo additional treatment after the left breast mastectomy since no cancer had been found in the lymph nodes. It was a perfect and sunny prognosis — texted and basically told a small circle, “Hey guys, at least I won’t have to do chemo or radiation!”
Early September, surgery to remove and partially reconstruct the breast was a breeze and I was up and walking the next morning, eating well, and managing the pain. Forever grateful to the teammates who filled my room after surgery and those who visited me days after. My mom never left my side and was in good spirits. Then the oncologist came in and delivered what would be the hardest blow during this process. During the surgery they found cancer in a few lymph nodes which meant I’d need chemo then radiation. Chemo, hair loss, nausea, and fatigue — everything I arrogantly assumed I’d sidestepped. The next few weeks were spent in and out of doctor’s offices. Being given my treatment schedule was like being handed a marathon training plan. Timelines were established, do’s and don’ts given, and details laid out: 4 sessions of AC every two weeks, 12 sessions of Taxol every week, then 3 months of daily radiation. Since then the 12 sessions has been amended into 4 sessions every 2 weeks assuming I can handle the aggregated dose. Early October was the target to begin.
Friends and family reached out in a steady stream. Whenever anyone asked what they could do, I told them I needed them to act normally around me. We could even make jokes about it. It was imperative to spend the time in the company of good people so the hours would pass quickly. Favorite hangouts include cooking dinner at home for people, going to the movies (Thor Ragnarok was the best!) and watching basketball at home or at bars. Recently taco night with some Whippettes in our new taco shorts was just what the doctor ordered.
Many teammates knew someone who had cancer or had experienced it themselves. Elizabeth Miller, whose own baby boy was diagnosed with a rare form of eye cancer, could not have been more supportive, informative, and cheerful. Caitlin Jones ran the LA Marathon a month after her own surgery to remove tumors. They shared their personal experiences and it was comforting. I was neither unique nor alone.
Melissa, a friend and fellow DW who accompanied my mom and me during the first session of chemo, unbeknownst to me, started a fundraising page to help offset the costs of treatment, and more specifically, the cold capping therapy, a short-lived attempt to save my hair. I was hesitant to go public with the diagnosis but the cat was out of the bag when I saw someone mistakenly mention the fundraising link on Facebook. I was in the middle of that first session when I saw this. Of the handful of times I have cried during this, I cried the most when I saw the kind and encouraging messages on the fundraising page. Over the next several days they’d raised over $9,300. The support was humbling.
My second session occurred a few days before the New York City Marathon. Bad enough to defer my own marathon until 2018 but to miss cheering would have been devastating. I spent the day prior making cheering signs with my teammate, Katie, while the Great British Bake Off played in the background. I was exhausted and falling asleep by the time we sat down to eat our dinner. Happily the morning of, all the symptoms were gone. What an incredible day! Teammates and other runners inspired me with their stellar performances and PRs. The hard work it took for all of them to slog through their training plans, make daily sacrifices, and then execute on race day was awe-inspiring and motivates my own journey. Elite athlete Gabriele Grunewald who trains at top levels while battling through recurring cancer is even more proof of how indomitable a runner’s spirit is. Superheros apparently wear lycra and running shoes.
My chemo began just around the time of the beginning of basketball season. The season is 82 games long and ends with the finals around June. Breaking down my treatment schedule with the NBA timeline is helpful. I’ll be nearly done with it at around the time of the All Star game. While radiation winds down around the finals, my own tough season will be nearing its end. On the nights I stay at home alone, being able to relax by myself with a game on, Spurs or otherwise, is a luxurious distraction. The cancer is the furthest thing from my mind as I immerse myself in the pace and incomparable beauty/athleticism of the game. At the time of the diagnosis I started a basketball blog to write symbolic pieces paralleling my love of the game and the struggles of players/teams with my own: https://sentimentalfan.wordpress.com/.
You noted that you’re a part of some community groups on Facebook. How have those groups been beneficial to the process?
My teammate, an oncologist, explained exercise’s crucial role in maintaining a high blood cell count, boosting immunity, and fighting off side effects. He has been a champion of my activity and is my go-to for advice. After each panicky message with me saying “I saw this thing online that happened to this woman and no, what about me…oh my god?!” his usual response was “Stay off the internet!” Thankfully I found a Facebook group which shared his sentiment about working out and not panicking at everything I read.
I belong to two Facebook groups. They couldn’t be more different from each other. One is called “Fit Sisters Fighting Breast Cancer” and it’s filled with fit women who refuse to let chemo destroy their workout routines – many working out as much as 6 times a week. I’ve befriended some members and keep up a regular correspondence with them. We compare fatigue, diet, and workout notes. Every day the feed is filled with flexing gym selfies, healthy meal pics, and photos of smiling women sitting in the hospital hooked up to IVs captioned with comments like “Can’t wait to get to the gym tomorrow.”
We banter about how we dislike the misconception of cancer/chemo patients as fragile creatures to be babied and handled with kid gloves. I’ve received great advice on how to deal with possible lymphedema, extreme swelling at the site of lymph node removals. I had seven removed in my left arm and was told I’d never be able to lift to the degree I was prior to my mastectomy, lymph node removal. There is one woman in this group who had even more removed in both arms and she posts gym selfies one year post surgery saying she’s almost up to 60% of her prior weight load! She recommended an industrial grade compression sleeve which I promptly purchased online. As soon as the chemo is done I hope to find a physical therapist that specializes in controlling lymphedema so I can get back to lifting. I might have never known this was a possibility but for this group.
When I made the decision to shave my head and give up on the cold capping it was because these women confirmed cold capping wasn’t ideal for people who sweat/work out because of the stress it places on the follicles — shedding was inevitable despite best efforts. Confronted with the choice of attempting to keep hair or run, the decision was easy. I remember walking calmly by myself into the local barber shop, telling them my situation, watching the barber go in the back and wash his hands. He shared that he had also shaved his sister’s head before she began chemo a few months ago and she was doing great in anticipation of her lumpectomy. It was about as peaceful and life-affirming an event as something like that can be. If not for the support of the women in this group I would have likely cried hysterically saying goodbye to my hair. Also, after some inquiry within the group, most women reported growth started 2 weeks after the last session of chemo with at least an inch of length one month after chemo ends! For me that means a head of hair arrives in February.
The other Facebook group is not workout oriented and includes many heartfelt posts of panic, sadness, and requests for support. Many in this group suffer greatly after each session of chemo and it’s a reminder that my fitness base, particular stage of cancer, support system, and overall lifestyle have equipped me to manage the side effects and maintain as normal a life as possible under the circumstances. Of course everyone handles side effects differently but countless medical professionals advocate even the lightest form of activity as being a huge benefit to managing side effects. Even a body in motion with cancer can stay in motion.
Where will we see you next race-wise?
The 2018 Brooklyn Half! By the time this rolls around in May it will be around 3 months past my last round of chemo. The next 4 rounds of Taxol chemo I’m about to undergo are usually far milder in terms of side effects than the AC infusions so I hope to even resume some speedwork.
Are you sharing your training at this time? Is there anywhere where people can keep track of you?
I am working with DWRT coach, Chris Forti, to help me tweak the Whippets training plan as I work myself out of the fog of chemo’s effects. It will be imperative to have accountability that involves hitting paces and completing reps. Managing the chemo’s effects is a secondary goal. Getting in race shape is now my primary goal.
I have a private account on Strava. (In case you were wondering the name “Oldmanriverwalk” is Tim Duncan’s nickname. Timmy is a retired San Antonio Spur and the greatest Power Forward to ever play basketball.)
Who will we see in the Western Conference NBA Finals this year? Will the Warriors be back on top?
Spurs vs Warriors! I’m mildly terrified of Harden and the Rockets but assuming we get past them I have to remain optimistic about our chances with the GSW. Zaza Pachulia better keep his foot far away from Kawhi. I’m still not over that dirty ankle play. Time is passing quickly and soon enough it will be playoffs time. I’ll be at my favorite sports bars, wearing my Manu or Kawhi jerseys, pitchers of beers flowing, eating wings with friends and yelling at the TV without a care in the world — well, okay caring that the Spurs win.
Recently a depleted Spurs roster overcame a 23 point deficit to beat the Thunder. Coach Popovich said the Spurs experienced “an attitude change from ‘poor me’ to ‘screw you’” during the comeback. Pop’s cantankerous words spoke to me — apt for my current situation, but more importantly, next year in November I’ll be telling 5th Avenue ‘screw you.’
Thank you, Patricia, for sharing your story. Our thoughts, our prayers and our running steps are dedicated to your recovery. Kick Cancer’s Ass.