Begin Again

Not so much of a bell ringer anymore.

Spring doesn’t get nearly enough love.

Summer is warm and wonderful, fall is crisp and colorful, and winter is…fun if you lean into it (and get the right gear for it), which I’ve learned to do. Mostly.

But spring, whenever it finally arrives in New England, brings so much hope, potential, and possibility, and I am feeling it this year.

That is, of course, in large part because after 11 rounds over eight months, I am done with chemotherapy — at least for now.

This was the big decision I was grappling with a few weeks ago: whether to stay on the chemo regimen I’ve been on (which is working so well!), or switch to “maintenance therapy” as recommended by my team (and beyond).

It’s a choice that came with plenty of emotions, a bit of agony, and an eventual game-time decision during New York City Half weekend (which was such a good weekend, OMG).

Maintenance therapy is still intense and aggressive. It involves infusions every three weeks, a shot every four weeks, labs every two weeks, daily pills, and lots of routine monitoring, along with scans every three months.

My first new-to-me treatment was last Tuesday, and it was a weird day.

I decided to go alone — something I haven’t done in a long time. But I felt like I should. Like I had to prove to myself that I could do this. What I learned was that of course I can do this. But I don’t have to, so why should I? Everything is made better with a friend close by. I’ll consider reenlisting the Support Squad for appointments going forward.

Everyone in the infusion center was so excited when they learned that my IV bags would be filled with Herceptin, Perjeta, and Zometa — not Enhertu (the chemo I was getting).

“You have to ring the bell,” they exclaimed.

I had no interest in ringing that bell. Again.

It’s different for me this time.

And I did that already, in September 2024, to celebrate the culmination of two surgeries, four rounds of chemotherapy, and a year of immunotherapy. I did the whole “I’m cancer-free” thing, and it was kind of a shitty day, if I’m being honest. (Stories I will share if I ever throw in the towel and do a “burn it all down” episode!)

I rang the bell, and a few months later, the cancer came back, and spread. I was cancer-free for what felt like five minutes. It was a glorious, hopeful five minutes! But it wasn’t enough time. And while I appreciate the kindness and encouragement from the staff in 3K, I’m not touching that bell again. (I love hearing other people ring it, though, and I will cry and celebrate every single ding!)

So last Tuesday was weird.

Because so much was changing. I wasn’t getting chemo! I knew there would be side effects I was likely to experience (and oh have I!), but it wasn’t chemo.

I was still there, though, doing all the same things. The port access with Carol and Haley, the medical oncologist visit (mine is currently on medical leave, so I met with a new-to-me oncologist, and if I’m being honest, it didn’t go great!), and then straight to the infusion center where everything (the smells, the saline) still triggers me and makes me feel sick. (“Anticipatory nausea,” they call it.)

I burst into tears when the oncologist told me the infusion would take “four to six hours.” No one, at any point, had told me that, and I came prepared for a quick hour-long session. Not a full day in 3K. It rattled me, and I couldn’t quite recover.

I finished the day feeling totally and completely drained.

I didn’t sleep for the next few nights. The hot flashes hit me hard, and my whole body ached (bone and joint pain are common side effects). Nothing compared to chemo, but a new journey with new side effects to wade through and make sense of (and hopefully adjust to).

But then, Annie and I went away for a few days, on a little ski trip with friends. We stayed in a cute cabin on the river, the ski conditions were great, and the kids and adults all had a blast. I was so happy the whole time.

I went away for a weekend two days after getting treatment for Stage IV cancer.

I felt happy, calm, content, and alive.

I know it’s totally cheesy, but I have given myself full permission to live with Extra Cheese from now until forever. To celebrate everything. To make little moments into big deals.

And…

I’m nervous, about so many things.

I’m nervous about this treatment not working. About finding out at my next scans (in May) that the cancer has grown or spread. About having to go back on chemotherapy. About making the wrong decision.

I’m nervous about survivorship.

For the past year, life has been so hard, but I have truly been given so much grace. People have been so unbelievably kind and understanding. I’ve been slow to respond to calls, texts, and emails, and no one is mean about it, because I have cancer.

Now, I’m worried about the expectation of being thrust back into Real Life.

I’m worried that because I’m not in chemotherapy, I should be fine. I should live as though I’m not still in treatment, because it’s not chemo. I’ve been really lucky, in a way: Because of this shit diagnosis, I’ve gotten to be on the receiving end of and to bear witness to some of the best in humanity. I have been consistently blown away by the support I have received throughout all of this. My gratitude knows absolutely no bounds.

At a time when the world is so ugly and so divided, I’ve seen so much good on a personal level, and it has given me hope in a greater sense: that the good will eventually outweigh the bad, because there is more good than bad. I have to believe that.

So I don’t know what happens next. I know I am so excited to get to enjoy Boston Marathon weekend without being in the middle of chemo. I’m excited for my hair to grow back! I’m excited to get to make plans without doing the mental math to figure out where I’ll be in the chemo cycle, and how I’ll feel during said plans.

To quote the legendary feminist Jessie Spano: “I’m so excited. I’m so excited. I’m so…so…scared.”

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This week on the Ali on the Run Show:

• Why Did You Run Your First Marathon? Was this a filler episode, perfectly slated between an emotional week and some very busy ones (Boston incoming!)? You bet. Was it also really wholesome and sweet and fun? Hell yeah. Thank you to the 950+ of you who submitted stories about your first marathons. I genuinely loved reading all of your responses. Thank you for contributing, and for letting me share your stories.

Ali in Boston: The big spring weekend is coming up quick! Here’s what I can tell you about where you’ll find me during Boston Marathon weekend:

• On the cover of the official program — a very cool surprise by the B.A.A. team — which is wild, and everyone has been so nice about this and excited about it! I’m feeling the love!

• Friday, April 17: Hosting a panel at the Expo at 1 PM with Amanda Vestri and Annie Frisbie. Free to attend, no tickets required. Just show up and hang out with me and two of the top Americans in this year’s Boston pro field!

• Also Friday, April 17: Ali on the Run Show LIVE at WBUR CitySpace. Doors at 6 PM, show starts at 7 PM. The show is sold out, but you can get on the waitlist or, if you’re not in Boston, we’re introducing the first-ever Ali on the Run Show LIVEstream! (It’s very cool that this sold out without us announcing the special guest yet. Hints: She’s been on the Ali on the Run Show once before, she’s very funny, she’s stunning gorgeous, very talented, and a heck of a marathoner.)

• Saturday, April 18: Ali on the Run Show LIVE at The Track at New Balance, start time 1 PM. Guest announcement and ticket information coming soon. Free!

• Monday, April 20: Find me at the finish line all day long. Forever here to be your hype girl!

Watching:

• Still Love Story (today is the finale; mixed feelings!), Shrinking (very close to being a perfect show), and Summer House (again, watching the dissolution of Kyle and Amanda’s marriage is hard to watch, especially if you’ve experienced anything similar; I have So Many Thoughts after this week’s episode). Nothing new, but I sure do love all three.

Listening to:

• Jessi Draper on Call Her Daddy. I haven’t watched Secret Lives of Mormon Wives since Season 1, but I’m chronically online enough to get the gist of what these women are up to. Listening to this brought up a lot for me, I will say that.

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SPONSOR SHOUT OUTS

I am so grateful for the wonderful brands and partners I get to work with on the Ali on the Run Show. Supporting them = supporting me!

• Shokz: Click here and use code ALI for $10 off your next purchase.

• Lagoon: Click here to get my favorite pillows (I sleep on the Otter every night), and use code ALI for 15% off.

• New Balance: Click here to shop New Balance’s latest releases for the season.

• Oofos: Click here to check out the new Club+ line. Comfy and supportive = a dream!

And so…

Take good care of yourselves. Take good care of each other. Be the good. Spread the love.

(You’ve got this. You’re doing great.)

Love,

Ali