Live Through This
This article originally appeared on Womens Running
With a headlamp around her backwards baseball cap, Sheena Wisler began running The Bear 100-mile ultra in Logan, Utah, in the predawn darkness of September 29 as any first-time 100-miler should: focused, excited, and careful not to go out too fast. Her hot-pink socks and braided blond hair made her look youthful, which she still is at 34, while her strong physique and beaming smile showed she was ready and stoked.
But as she ran nearly effortlessly for the early miles, she couldn't help flashing back to her first time at The Bear two years ago, when she crewed for her husband, Ryan, at his first 100. Her body then was so thin and weakened by chemotherapy that she could barely lift his crew bag.
"I had all these torn emotions for how excited I was for Ryan," she said. "But also it was harrowing not to know, will I ever be in the condition to run even 10 miles again?" Running ultras and traversing mountains "makes me feel most alive, but I didn't feel alive, I felt like I was dying."
To restart running and feel most alive again--and to reach the start line of her debut 100--Sheena underwent a two-year medical journey that makes the struggle of any ultra seem relatively manageable, even privileged.
In the early miles of her race at The Bear, she had the chance to share that medical journey with two runners next to her on the trail. They happened to be doctors, an oncologist and an ENT specialist. Sheena also is a doctor--an OBGYN--who lives in Ouray, Colorado. Because they all work in medicine, they started talking, and she explained that in May of 2021, at age 31, she was diagnosed with Stage 3 rectal cancer and faced chemo plus numerous surgeries.
RELATED: Taking Time Away From Running Is Hard. It's Also A Huge Opportunity.
On top of the crushing cancer diagnosis, she received the heartbreaking news that she could never carry a pregnancy after receiving radiation treatment. She and Ryan had planned to start a family later that year. Before starting treatment, she underwent an egg retrieval and IVF cycle to freeze embryos, so they can seek a surrogate someday.
Then she had a chemo port placed. Over the course of several harrowing months, when she took a leave of absence from work, she went through 11 rounds of chemo and had multiple scopes to check her tumor.
In early December of 2021--after crewing her husband at The Bear--she underwent the biggest surgery: a lower anterior resection, which removed the tumor along with most of her rectum and part of her colon. That surgery revealed some cancer still present in her lower end and in some lymph nodes, even after that year's chemo, which Sheena said was devastating to learn.
"I elected to do more chemo, which was one of the worst days of my life. They were saying, 'I'm not sure it's going to help you or not,' but I said, 'give me the chemo, please.' That lasted for three more cycles, until I had to stop because I was getting neuropathy [nerve damage] in my feet and neck, which caused tingling and pain. My feet were pretty much trashed and felt like blocks of ice."
With her lower GI tract non-functional due to what had been surgically removed, she also had an ileostomy bag placed on her abdomen, to remove waste from her intestine, which she used until mid-March of 2022, when her lower "plumbing" that remained adapted to function adequately. Incredibly, she lined up for the San Juan Solstice 50-miler three months after the ileostomy reversal.
Sheena agreed to share her story--including sensitive details about her anatomy and treatment--in part because she's a doctor and runner, so talking about poop and other bodily functions doesn't faze her. More importantly, she said, "If anyone hears my story and thinks, 'Maybe I should get this symptom checked out, even if I'm not of age for a screening colonoscopy,' then I'm very happy to do this."
Racing with Scanxiety
While running and hiking through miles of aspen and pine forest at The Bear, in the midpack of the women's field, she remained on guard to troubleshoot problems that could derail her race. In particular, her lower GI tract might act up and spasm, sending her into the woods to cope with time-consuming repeated bowel movements, which happened during the 2022 San Juan Solstice 50 and caused her to time out at mile 40. In an instant, she could become nauseous, or simply too weak.
Worst and scariest of all--although she tried not to think about it--was the possibility that cancer could be spreading somewhere in her cells.
She gets screened for recurrence every six months, and her most recent scan showed no evidence of disease. She felt like she was out of the woods, but was she? She would find out soon after The Bear.
"Every six months, Ryan and I have a lot of 'scanxiety,'" she said. "This time, I pushed the scan off until after The Bear. I've worked so hard to get to this place that I told my oncologist, 'I'm doing The Bear no matter what, so I don't want to know any news beforehand.'"
"When you look at the data, most people who have recurrences have them about 24 months out, so this scan is terrifying," said Ryan, who's also a doctor specializing in internal medicine and also 34. "It's crazy, the timing of it coming right after the race, which is a huge celebration of life, and now we have to know this hard fact. It's probably the scan we sweat the most."
A New Young Doctor
I met Sheena in late summer of 2020, when I went to her clinic in Montrose because I needed a gynecologist. The first thing that struck me--even though I couldn't see her whole face, since we both wore masks--was how young she looked, with expressive eyes that crinkled from smiling. Being 20 years older, I couldn't help wondering, would she "get" me?
I showed her my perimenopausal period log, which included notes about how my erratic cycles affected my training and races. Her eyes widened and she exclaimed, "You're an ultrarunner!"
For the next 10 minutes, we spoke excitedly about running. She pumped me with questions about the 100s I've run and told me she ran her first ultra, the Arches Ultra 50-miler, that January, and dove into training for her first 100, Run Rabbit Run in September. But that race got canceled due to the pandemic. She was planning a Grand Canyon rim-to-rim-to-rim adventure and had big goals for training and racing in 2021.
We clicked, and I concluded that I had the best new doctor ever.
Because we have mutual runner friends, I found her on Facebook and connected. That was how I learned about her shattering diagnosis in May of 2021. The news hit extra hard because I had witnessed my brother-in-law, who was younger than me, get progressively sick from advanced colorectal cancer, which took his life that year. How could this cancer hit seemingly healthy people in their prime of life?
Sheena later explained the red flags that led her to get checked and diagnosed.
The Dark Months
Her 2021 began with getting COVID, which led to "an array of weird symptoms," as she put it, and may have exacerbated gastrointestinal troubles. She thought she probably had inflammatory bowel disease because of needing to poop with increased frequency and sensing inflammation down there.
"Running, to be honest, probably made me ignore some of the early symptoms, because I was like, 'all runners have GI issues,'" she said. "I wasn't concerned until I started having pain with bowel movements. I started thinking I might pass out" on the toilet because of the severe pain, which unknowingly was caused by a tumor partially obstructing her rectum.
The week she went in for a colonoscopy, she ran 40 miles and worked her shift. She planned which mountain to run on the weekend and picked out a swimsuit for her first beach trip since moving to Colorado from Louisiana, where she and Ryan went to med school. (They met in 2009 as undergrads at Louisiana State University during a prep course for the MCAT, when Ryan asked for her biochemistry notes.) She had no clue she faced life-threatening news.
But when she woke up from the anesthesia, she saw Ryan sitting next to the gastroenterologist. He wasn't supposed to be there, and his eyes were shedding tears. He broke the news: She had a mass so big that the scope couldn't pass.
"I just felt awful for Ryan, because he broke down," she recalled. "Then I had to call my parents, which was awful having to tell them. I was out of my body, thinking of my parents and husband, because I felt physically fine. My fight wouldn't come until later, with treatment."
She recalls the summer of 2021 as "the dark months, where I couldn't eat enough calories to be physically active. I'd just look at the mountains and cry. By September, I had to change my chemo regimen, because I lost weight too rapidly, and I started being able to force myself to eat. Right before Ryan went out to The Bear, I did three miles and couldn't move half a mile without having to stop and rest."
Ryan, meanwhile, continued to work full-time as a primary care physician, out of necessity, but he found time for longer runs on the weekends thanks to Sheena's mother arriving to help care for her.
At that point, The Bear 100 wasn't in his plans; new to ultrarunning, he had only run one 50K and one 50-miler. "I wasn't training for anything--I was reckless with my running. I'd fly down hills and push up hills. I was running just to get out," he said. Sometimes, Sheena would go with him and lie in a bed they put in the back of their 4Runner, so she could get outside and be near a trail.
Just two weeks prior to the 2021 edition of The Bear, Ryan found out that its wait list was nearly empty. Feeling some of that recklessness, he signed up and jumped into his first 100-miler with no deliberate training.
They determined that Sheena was well enough to travel with him because she had regained some energy and weight on her new chemo regimen. They headed to Logan, Utah, and Ryan finished the 100 miles in 32 hours, 43 minutes. (The race has a 36-hour cutoff.)
That race was a bright spot in an otherwise traumatic year. "In March of that year, my only grandpa died," said Ryan, "then in May, Sheena got her diagnosis; and then in November, my dad died."
"Double-Bagging, No Peaks"
Sheena then underwent the major surgery to remove the tumor and parts of her rectum and colon, and she restarted chemo in early 2022. Despite the surgery and treatment, she was able to run a bit during that winter by using a belt to secure her ileostomy bag and chemo pump around her midsection.
"I called it 'double-bagging' but no peaks involved," she joked. "The reality was, you get pumped up with steroids when you get chemo, so I felt the best those days and said, 'I'm going to go for a run.' Looking back, I'm so happy I did. Mentally, it felt wonderful."
To celebrate the end of chemo and her return to running in the spring of 2022, her Ouray running friends made her an ultra-style belt buckle with the saying, "Live through this, and you won't look back." On the first weekend of April--just two weeks after her ileostomy reversal--she and Ryan went to Sedona to run a small two-day trail race with a route of about 10 miles on each day. Sheena finished each day's route in a little over two hours.
She was on the mend, back to work, and back to training. The rest of 2022, she continued to improve. In June of this year, she went back to the San Juan Solstice 50 and finished it, which boosted her confidence and motivation for her first 100-miler at The Bear.
The Choice to Suffer
As is the case with many 100-mile ultras, Sheena's race at The Bear was going great, until it wasn't.
For the first half, she stuck mostly to liquid calories to reduce the need for "number-two" potty breaks. "My lower GI system did wonderfully. I was shocked," she recounted. "My first bowel movement came at mile 45, and then I had one more, and that was it. I felt incredibly lucky not to battle GI distress. But I did pack a small adult diaper, just in case."
Ryan began pacing her at mile 51 around 8 P.M., and in those early evening hours, a mix of nausea and fatigue made her energy plunge. By the time she got to the mile 61 aid station shortly after midnight, "I felt like I was going to pass out and vomit at the same time. I was lightheaded, dizzy, nauseous, and felt completely drained."
Ryan knew she needed to reset her system with rest and calories, so he coaxed her into the warmth of their parked vehicle and ordered her to eat and take a nap. Sheena resisted due to nausea and fear of losing time, but Ryan reassured her that they would not drop out.
RELATED: How to Recover Like a Pro
He was struck by the similarities between her nausea then and during chemo. "She said, 'I can't eat this because I feel nauseous,' and I said, 'You haven't thrown up; you can try.'" He persuaded her to force herself to eat, just as he did during chemo, when eating to prevent excessive weight loss was essential to continue treatment.
She slept for about 30 minutes and woke up able to nibble on some eggs and sip Dr. Pepper--her new favorite drink since chemo changed her taste buds and made Coke taste like chemicals.
Sheena's mom was at the aid station too. "Her poor mom said, 'Do you think she can't do it because of the cancer, that it's too hard on her body?'" Ryan recalled. "I showed her a guy lying passed out and said, 'Miss Tammy, he's going through the same thing. Everyone feels this.'"
Sheena left the aid station having spent about an hour and 20 minutes there. But her energy wasn't restored. From about mile 63 to 69, she said she moved in "a complete delirium state, falling asleep."
"She would tilt back, and I had to catch her a couple of times," Ryan said. "I shook her face, stretched open her eyes, told her to slap herself or pinch herself. I started singing, yelling. I tried everything. Her run was so pitiful at that point"--both he and Sheena laughed at this memory--"that I swear, I have patients in walkers who move faster."
Around mile 67, Sheena crawled into a bivy and passed out next to the trail for about 15 minutes. Ryan reflected on more parallels between this ultra and her cancer journey: Nothing prepares you for the mental darkness and fatigue. You make progress step by step, one aid station at a time, just as you move through cancer treatment one chemo cycle and one surgery at a time. You become part of a subculture and community that is hard to understand until you're a part of it.
She woke and made it to the mile 69 aid station, where she buddied up with two friends also in the race. Revived by their upbeat energy and the sunrise, she began to move better, mixing slow running with hiking and taking in more calories.
The low points she experienced "definitely reminded me of chemo," she said. "Mentally I kept asking, 'Does this feel as bad as a cycle of chemo? Nope, OK, keep going.' I'm choosing this, and yes, it's hard, but it's temporary.
"It's a privilege to be able to choose how to suffer. I hated not having that choice" after her cancer diagnosis.
At the final aid station, mile 92, she paused to dance a little with a funny crew that played music and wore costumes. "I was very happy because at that point, I knew we were finishing."
Her energy zapped by the heat, she nonetheless rallied to run and jump in the air at the finish line--arms up, heels together--with a time of 34 hours, 25 minutes. She glowed like a healthy, joyous, strong ultrarunner who nailed her first 100. Nobody would guess what she went through the prior two years.
The Dinner Date
Post-race, Sheena felt "on Cloud 9, so happy we got it done," but she faced another test 10 days later--the scan to detect cancer--and with it, a special date night that she and Ryan say feels both superstitious and cheesy.
Their routine for each six-month scan involves checking her result online as they're driving home from the hospital. If the result shows no signs of disease, then they go to the Red Lobster in Grand Junction and order the most expensive thing on the menu for dinner, and Sheena ceremoniously rips off her hospital bracelet at the restaurant table.
On October 10, Sheena and Ryan celebrated a negative scan at Red Lobster and tore off her bracelet during the lobster fest. The next day she posted on her social media:
"Incidence of rectal cancer at 31 years old: 0.0043%. Y'all, that means I'm 100x more likely to get into the Hardrock Hundred Endurance Run 2024 with a chance of 0.4%. I'll take the odds, lottery opens today, LFG!"
Colorectal cancer is one of the most common cancers diagnosed in the United States, and, although rare in young adults, the risk for developing it increases with age. The ACS recommends everyone begin colorectal cancer screening at age 45 or younger, depending on risk factors and symptoms.
Sarah Lavender Smith lives and runs around Telluride, Colorado. Her weekly newsletter "Colorado Mountain Running & Living" shares personal essays with practical advice about trail running, mountain living, and midlife grit.
For exclusive access to all of our fitness, gear, adventure, and travel stories, plus discounts on trips, events, and gear, sign up for Outside+ today.
