“Seventeen minutes slower ...” In August, 2010, I was 17 minutes slower in the Cherry Creek Sprint Triathlon – an 800-meter swim, 12-mile bike ride, and a 5k run – than the previous year. Seventeen minutes slower was a worrisome change for me.

Before you mistake me for a lean, mean, athletic machine, let me intro­duce myself. I am a 71-year old woman who is a little overweight, a strong swimmer, and a power walker. As an athlete, I am truly a turtle, but tri­ath­lons are perfect for athletes like me. The cross training of triathlons is gentle on the aging body, and I experience great satisfaction in complet­ing a multi-sport event. Plus, I was a coach for the Roaring Fork Tri­athlon team – a fun, supportive group of women.

Triathlons have been my summer project for the past 20 years.

In the summer of 2010, I was dismayed by my slower time, so I performed a self-assessment. I had been get­ting slower since early summer, and no matter how hard I trained, I tired sooner, even noticing shortness of breath. Another oddity I noticed was that food tasted different; I no longer liked familiar foods.

I decided that it was time for me to visit my long-time family physician. He listened carefully, performed a thorough exam, but found nothing notable. What he did not say was, "You are just getting older." Instead, he ordered a panel of blood tests and consulted a hematologist. More blood tests and urine tests followed. That summer, my family physician saved my life.

Undoubtedly, you remember when you were first diagnosed with multiple myeloma. For me, it was August 22, 2010. My husband and I sat in disbelief and ignorance in the oncologist’s office. I was slower in the triathlon because I was seriously anemic. My hemoglobin was so low that the doctor was surprised I was able to complete a sprint triathlon.

Even though I am a masters level nurse, I knew nothing about multiple myeloma. Nothing. Both my husband and I heard little of the doctor’s words after he mentioned the word “blood cancer.” We learned later that this was a natural response. On that day, we stepped through an unseen doorway into cancerland.

Two days later, I began a new school year in my job as a professor of nursing. On the same day, I started treatment. As a nurse I can compartmentalize well, so I continued to teach each day, swallowed the Revlimid (lenalidomide) and dexamethasone (Decadron) pills, and began the myeloma journey.

The side effects were troublesome to me. I experienced fatigue in the afternoon, along with bouts of dizziness and constipation. In the past, I had not paid much attention to my bowel habits. That all changed when I was admitted to the hospital overnight for a bowel obstruction after two weeks on these drugs. It was painful and scary. I learned that I had to pay attention to bowel patterns and manage changes. I also learned that constipation and diarrhea are often part of the myeloma treatment.

In September, after one month of treatment, I received more bad news. My form of myeloma was categorized as aggressive because I had the chromosomal abnormalities t(4; 14) and del(17p).

It was time to travel to the University of Colorado Hospital in Denver to meet with a myeloma specialist. Denver is a 3.5-hour drive, in good weather, over two mountain passes. We would view this mountain drive as another stage in the triathlon of cancer.

The day was filled with tests: a PET scan, a bone marrow biopsy, a bone scan, skeletal x-rays, and additional blood tests. After a thorough evaluation, the myeloma specialist recommended an autologous stem cell transplant, sooner rather than later, because my myeloma cells were aggressive and at risk for defeating simple chemotherapy. I was 66 years old at the time, hitting the upper age limit for this treatment regimen. However, the specialist believed that I nevertheless was a good candidate for an autologous stem cell transplant because I was healthy otherwise and in good physical shape.

The fall of 2010 remains a blur. I continued to teach, glad to focus on being someone else besides a cancer patient. Like a triathlete, I planned for each stage of the upcoming treatment plan as a different event: inpatient induction chemotherapy, stem cell harvest, and finally the transplant.

The gift of 20 years of tri-training is that I knew how to set goals and break them into manageable actions. My first goal was to remain healthy throughout the induction therapy. I walked regularly, ate healthy, and lived each day with positive intent.

Induction chemotherapy consisted of a potent combination of drugs called the VDT-PACE protocol. On days 1 through 4 of each treatment cycle, I would receive Velcade (bortezomib), doxorubicin (Adriamycin), etoposide, cyclophosphamide (Cytoxan), cisplatin, and dexamethasone, administered as infusions at the hospital, followed by three weeks of rest. At minimum, I would lose my hair, become immunocompromised, and feel weaker.

In November 2010, my adult sons and I entered the large University of Colorado Hospital for my first round of induction therapy. A surgeon implanted a dual-chamber port under my chest skin so that all the intravenous drugs could be administered more easily. That procedure was neither painful nor scary.

The first overnight hospital experience was a bigger personal challenge than any athletic event in my life. Once my sons left, I became afraid. I was in a strange hospital in a strange town. I was a patient and not a nurse.

To calm myself, I turned to a familiar strategy used in tri-training: visualization. I visualized my safe bedroom at home, focusing on slow breathing. Breathe in, breathe out, to the count of four. My fear diminished. This strategy proved to be a powerful tool for me to use over and over.

As I revisit the fall of 2010, the schedules, plans, and goals were my valiant attempt to control this disease and its attack on my body.

In December 2010, I was bald but hopeful. I had survived one round of the inpatient induction therapy with the help of my tri-sisters, friends, and family. They were a band of angels building a circle of love around me. They provided me with meals, cards, hat parties, and infusions of positive energy. I embraced my baldness with colorful scarves, walked daily, and continued to teach.

First event down in the triathlon of cancer, and I was still coping.

Around the same time, my long-time girlfriends and I signed up to participate in the 10k Winter Sun Race in Moab, Utah, for the fifth straight year. The second round of induction therapy was scheduled for the week after the race. I thought a weekend of laughter and good company was a perfect way to prepare for the second hospitalization.

I walked the course slowly and was the last person to cross the finish line. I was happy despite a nagging cough that bothered me the entire weekend.

By the time I arrived at the hospital for the second round of treatment, the cough had worsened and I had chest pain. After a chest x-ray and CT scan were completed, I received the awful news. “You have fungal pneumonia. Go home and get better.” My fantasy schedule dissolved with a cough and a fever.

Slowly, I did get better. My job was more understanding than I was. Substitute teachers were hired for a longer time. Painfully I learned that everyone is replaceable.

I had to apply another lesson from triathlons to my life with myeloma. When your original plan falls apart, you create Plan B. In triathlons, I have experienced flat tires or choppy waters that interfered with a successful race, but did not prevent me from finishing it.

Even though the next stage of treatment was delayed, I couldn’t give up; I had to adapt.

Plan B meant resting more and paying closer attention to my body. Like every one of us, I re-learned that I could plan and set goals, but not control the outcome.  So I focused on each day instead, celebrating small successes.