It’s well documented that patients with cancer often encounter concerns relating to their body image. From changes to skin, hair, and weight, to losing breasts and gaining stoma bags, no-one wants to look like a “cancer patient”. For me, it was the drastic change in my legs that hit the hardest.
I was amongst the last of the population to come of age before the social media behemoth began dictating physical ideals to young women, plus I loved sport, so I was always more interested in what my body could do, rather than what it looked like. And what could my legs do? They could keep me going for long hours working as a doctor, keeping me on my feet up to seven days a week. They took me hiking in the Peaks and the Lakes. They were quite short, a little chunky towards the top (and would probably have benefitted from a bit of Pilates), but they were toned and strong. They also enabled me to run – along the river on my own, round the track with my running club, exploring foreign cities with my husband, and racing with hundreds of fellow enthusiasts. Running gave me a hobby to fit around unpredictable work schedules, a way to combat stress, and a level of fitness that allowed me to live my life to the maximum. I was never particularly speedy, but I used to get respectable times and loved the challenge of improving.
I had been running for a few years, gradually getting faster, when I entered the Manchester Half Marathon in October 2018. Months of training combined with fantastic support led to a personal best time – I felt fitter than ever and ready for anything. Fast forward six weeks and I fainted on my kitchen floor. Within hours I was sitting in Accident and Emergency being told I had Acute Myeloid Leukaemia and needed admission that day for urgent treatment.
My first cycle of chemotherapy was mentally very tough. As well as coming to terms with my diagnosis, I also had to deal with being suddenly confined to isolation in a cubicle for four weeks after leading such an active life. I knew that there was a lot of evidence showing the benefits of exercising when going through cancer treatment, and I had no doubt my baseline fitness had helped me tolerate the chemotherapy. I was desperate to keep moving and used a pedal exerciser in my room. The physiotherapists gave me some core exercises to do although I found a lot of them pulled at my central line. It wasn't much – I know patients having chemotherapy as an outpatient are often able to do more – but it was better than nothing.
As soon as I got out of hospital, I stepped up my exercise regime with daily walks. My first outing was on Boxing Day – it was cold, shaky and short. I was pretty devastated at what the onslaught of chemotherapy and 28 days in hospital had done to my body. But by the end of a fortnight I walking up to 10 miles a day and managed to part jog, part walk a Parkrun in 42 minutes.
My second cycle was pretty much the same – four weeks of isolation, trying to do what I could in my room, followed by a couple of weeks at home trying to build up my strength. I was a bit slower this time as my Achilles protested if I tried more than a brisk walk.
I came into hospital for my third cycle with much the same mind-set – to keep moving as much as possible in my room, and build on this when I went home. However, my neutrophils (white cells) did not recover after the chemotherapy this time. It meant that my bone marrow had gone into failure. Unable to produce red blood cells, platelets or immune cells, I was not allowed home and had to stay in hospital until my fourth and final cycle of chemotherapy, followed by a stem cell transplant. This was a huge blow, both psychologically and physically. I was worn out, fed up and very tired. I managed to acquire an exercise bike for my room and download some exercises from the Anthony Nolan website, but as weeks turned to months I just wasn't able to do anything except alternate between my bed and chair.
By the time I was finally discharged, I had spent five out of six months in hospital, with my final admission lasting 85 days in total. My haemoglobin level was just high enough to function, and I had lost a lot of muscle and strength. When I looked in the mirror I was the same weight, I had a great wig and I could fake eyelashes and eyebrows with makeup. But my legs looked alien to me. They were thinner, softer, with less definition; a symbol of how far I had been dragged away from my old life.
Beyond being told to walk as much as possible, I couldn't really find a lot of information about how I should approach exercise after a stem cell transplant, or a long stay in hospital. So I just walked most days, slowly building up my distances until I could do five kilometres. I had a few Parkruns under my belt before I got ill and had always said I would do some volunteering there if I had to take a break from running. So I started marshalling on Saturday mornings – it got me out of bed, outside and doing something useful! What really struck me, though, was the diverse range of abilities at Parkrun. Previously I had always been in the faster half of the field, but here were the beginners, the elderly, wheelchairs and whole families of runners that I never really got to see before. They didn't care about a finish time to put on Strava – they were just enjoying the exercise and outdoors. I felt such a thrill cheering them on, being back on the running scene and hoping I would be able to join these people soon.
So when I heard about 5k Your Way at a nearby Parkrun, I jumped at the chance. If you’ve not been, it’s held at various Parkruns around the country on the last Saturday of the month, for people who have been affected by cancer. It was just what I needed – I could participate in Parkrun, walking at my own pace without worrying about pushing myself too far or finishing long after everyone else. By the last 200 metres to the finish line I had to stop myself breaking into a run as I felt the familiar rush of exercise-induced endorphins and adrenaline.
5k Your Way was the confidence boost I needed. I felt ready to graduate from walking to a gentle jog, so I set off along the river at a pacey walk, with short bursts of gentle jogging. Apparently this is called “Jeffing”, after a man called Jeff Galloway who devised the run/walk method as a way to increase distance and reduce injuries for runners. It’s a principle used by the well-known Couch to 5k app, however I had avoided using this as I’d rather exercise based on how I’m feeling – my energy levels are still fluctuating far more than the average person and I was worried I’d overdo things by trying to stick to a generic training plan. I just base my jogging and walking on feel, with lots of recovery time.
I have also started back at my running club – whether popping down to help with a cake sale, going for a walk with similarly incapacitated members, or even venturing down to a track session to join in the warm up and pootle round in the slow lane. I’m meeting lots of new people who are sharing their alternate outlooks on running with me.
This Saturday I returned to 5k Your Way and got round in 40 minutes – a long way off my personal best but faster than after my first round of chemo. My legs are finally starting to take shape once again (fuelled by my insatiable cravings for protein!), and beginning to look like they belong to me. At 120 days since my stem cell transplant I am finally getting back to exercise, and whilst the long term effects of my treatment mean I am unlikely to get back to the level of fitness I had before, it doesn't matter because I can enjoy running again and optimise my health at the same time. As long as I’m mindful of my limitations I can set myself goals. Once my central line is out I will start working on my core. I am hoping to be able to continuously run a Parkrun by next year, and ultimately compete in the British Transplant Games one day. Watch this space!