No Pass No Play

Back in the 80’s when I was in high school the governor of Texas tapped businessman H. Ross Perot to head a team tackling education reform.  The group issued a recommendation called No Pass No Play which led to requirements for public elementary and secondary students in the state to achieve a grade of 70% or higher in all subjects in order to participate in school-based extracurricular activities such as football, drill team, and band.

I was reminded of No Pass No Play just last week when discussing Herceptin with my oncologist.  Herceptin is the primary drug being used to treat my specific Her2+ breast cancer and also happens to lead to an increased risk of heart failure.  Cardiac surveillance is therefore customary for patients treated with Herceptin and back in August I had a MUGA scan to measure my baseline Left Ventricular Ejection Fraction (LVEF).  It turns out that a healthy diet and plenty of exercise are good for the heart:  my LVEF is 77, a number at the very highest end of the normal range of 55-75.

Now almost a quarter through my year of Herceptin treatment, I will return for another MUGA scan on Saturday.  Dr. Semien reminded me that if my LVEF drops below the previous measurement by more than 15% (i.e. if it drops below 65), she’ll stop the Herceptin until my heart recovers.  While starting with a healthy heart obviously lowers the risk for heart failure, if the LVEF changes it can only go down because it’s already so high, regardless of whether I’m on Herceptin or not.  So I have to keep plugging away, exercising every day whether I feel like it or not (and fortunately I usually do), just so I can keep up the good fight against cancer. No Pass No Play.

This all brings me to today’s Top 6 List of ways to keep me moving.  Over the past eight months since diagnosis and even throughout surgery, chemo, and recovery, I have managed to exercise every single day without exception, though on some days a bit less than others.

  1. No Pass No Play (Low LVEF = No Herceptin)
  2. Exercise with a friend — There’s nothing like socializing to make the miles pass quickly. More effective, however, is the underlying responsibility to someone else.  How could I consciounably no-show when my exercise buddy is waiting for me outside in the cold and dark?  I can’t, so I go.
  3. Start early — Busy schedules don’t get in the way if the day doesn’t start until after exercise … before the kids wake up, before breakfast, before anything else.  Sure, I sometimes work out later in the day, but it’s much harder to get going when my brain’s not too sleepy to argue.
  4. Set goals —  In 2011 the list included various shades of running/swimming/biking faster and farther and completing whatever running races that came my way.  More recently I’ve been eyeing a local mini triathlon, though first I have to get over the idea of swimming in cold, murky open water.
  5. Start out small — If it’s one of those days and I really just don’t feel like moving, I make myself get out of the house to walk around the block.  Inevitably, this turns into a few blocks, then the neighborhood, and without really thinking too much about how much I’d rather be inside sitting on a couch I’ve already walked a few miles.
  6. Anything counts — If I’ve violated Rule #3 or if I’m just feeling under the weather, I cut myself a little slack.  A two mile walk is always better than nothing.

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