Inviting Gratitude, Gently

Since this week is the Thanksgiving holiday in the US, it’s a good time to revisit the practice of gratitude. I wrote some time back about my nightly practice of writing down three things for which I was grateful. It was a lovely way to close the day on a positive note, as I would always be able to jot something down, even if my day was difficult.

Nightly gratitude journaling started feeling forced, certainly not the point of the practice.

However, after a number of weeks of this, I found it harder to be consistent. I would skip days, and often on the days that I could find something to write in my journal, the process would feel forced. The more I had to work to pull out little things to be grateful for, the less meaningful they became. Eventually, and regrettably, I stopped the nightly practice altogether.

Apparently, this is to be expected. Psychologist Sonja Lyubomirsky and colleagues from UC Riverside found that journaling once a week was more effective for boosting happiness than doing so more frequently. I can see why this would be. Everyone has stressful days that can wring any semblance of happiness out of us. Yes, while I found something to be grateful for any given day, if the overwhelming feeling was that of negativity then I was simply going through the motions of trying to find something–ANYthing–to write down. For me, this waters down the effectiveness of the exercise.

But writing on a weekly (or less) basis allows me to focus on the most powerful feelings of gratitude, and those have a stronger uplifting effect on me. They last longer and evoke a joy that daily journaling couldn’t.

In my life, there have been times that have felt very dark and heavy. In the moment, I have not always been able to find anything positive in them. Take, for example, cancer. Those weeks around my diagnosis were literally the most terrifying of my life, because I felt that this situation could actually cost me my life.

Quite frankly, if someone had told me then that I should stop and think of all the things I was grateful for, I might have told them to go to hell. The intensity of what was taking place right then–the shock and disbelief, the despair, the sheer fear–was too great to let in any light. For someone to have suggested that I should essentially “look on the bright side” would have felt like they were dismissing the reality of what is cancer.

For me, the process of letting gratitude come to me was far more effective than trying to snatch it out of darkness.

But as I passed through those worst weeks, I noticed things that bobbed up to the surface that I could be grateful for, so much so that at times I was overwhelmed with gratitude for how events had unfolded compared to how things could have been. I still had cancer and my life was still upended, but I felt a sense of grace about it all.

So if were to give one piece of humble advice to someone going through desperate times, it would be to remain open to the possibility that no matter how dark things may seem right now, when you finally have a chance to take a breath, you may see that glimmers of hopeful light have been shining through all along.

Yoga Is For Every Body

As my interest in and personal practice of yoga has increased, I’ve noticed something peculiar about images of yoga. They send a message that you have to be young, slender and unnaturally flexible to be a “real” yoga practitioner. That seems daunting to anyone who doesn’t fit that mold.

I noticed something similar after I became certified as a personal trainer. I myself loved the feeling of strength and freedom I got from exercise; however, many people I spoke with were reluctant to go to a gym because they felt they needed to be in a certain physical condition before they even started. At the same time, they were daunted by the idea of striking out on their own. Even worse, in personal conversations with experienced exercisers and even other trainers, I found many would poke fun at those who were just starting out.

Come on, everyone has to start somewhere. An expert is just a beginner who stuck with it.

This is unavailable to me.

I thought yoga would be different, given the emphasis on one’s inner state. But I had to get over my apprehension about trying to fit an older creaky body into the unbelievable positions modeled by the yoga teachers I saw online. It was daunting. While I still felt strong, I seemed to lack that which yoga demanded. There were many poses that my old injuries and life-long inattention to flexibility would prevent me from doing.

I mean, google Flying Dragon pose and you’ll see why. Heck, it doesn’t even have to be as exotic as that. Go to Pinterest and search for yoga images – the results seem almost outrageous, with every yogini outdoing the one before them. Is that what we’re supposed to aspire to? I don’t see anyone even close to my age. Are they all in physical therapy? Or traction?

My spine doesn’t bend like that.

This is more my level: still challenging, but quite doable.

But this is yoga, right? There are quite enough poses that most everyone can learn and use to build a regular yoga practice, no matter what the images on the Internet suggest. More importantly, there are modifications for whatever your own body will allow. Can’t put your forehead on your knees in forward-fold? Then how about a ragdoll variation. Guess what, it’s still yoga.

That doesn’t mean that what those super-bendy instructors are doing isn’t impressive. But I view them much as I view someone free-climbing Yosemite’s El Capitan. With awe and admiration for their abilities. And then I delight myself by finally being able to touch my toes again, thanks to my yoga practice.

Look, Ma! No Libido!

This is a delicate issue that isn’t talked about enough. It’s time we brought it out into the open.

Based on the reactions that I’ve received from some health professionals, I believe that loss of libido is a highly underreported side effect of aromatase inhibitors, medications that are prescribed to suppress estrogen production in women who have or have had hormone receptor-positive breast cancer; aromatase inhibitors are generally given only to postmenopausal women. Sure, low libido is listed as a possible side effect on the informational insert that you get with the pill bottle, but its mention feels like an afterthought. The reality is, AROMATASE INHIBITORS STOMP OUT YOUR FREAKIN’ LIBIDO.

Why don’t we talk about this more? This may be due to the average age at diagnosis of breast cancer being the mid-60s, give or take. I’m willing to wager that many women of this age don’t feel very comfortable discussing intimate details of their personal life with (especially male) oncologists.

Couple that with the fact that as much as we’re trying to change as a society, postmenopausal women are still not valued very highly. Youth equates to beauty, and women continue to be judged by their appearance. Even the inhabitant of the White House has reflected the notion that an “older” woman wouldn’t be a fit companion for a high-powered man, presumably because he deserves “better”.

So let me stress, everyone deserves the opportunity to engage in meaningful intimate relationships. As we get older, sexual intimacy may not have the same prominence in our interactions, but it is still an important part of bonding.

This is a perfect example of a “quality-of-life” issue. It can’t be measured by a laboratory test, but it’s something very valuable. When the medical profession obsesses about breast cancer survival rates, and when the pharmaceutical industry develops even more-effective medications, those lives saved can be counted as numbers. But sadly, a drop in desire for intimacy, or a similar quality-of-life marker, can’t be measured in the same way and, therefore, doesn’t bear the same weight in decision-making.

Loss of libido can lead to a decrease in perceived quality-of-life

It rankles me when some of these complicated low-hormone effects experienced by women taking aromatase inhibitors are written off as simply symptoms of natural menopause, as if the cancer survivor is making a big ado about nothing. As someone who was premenopausal when originally diagnosed with breast cancer, and then chemically forced through menopause via chemotherapy and tamoxifen, I can assure you, none of this is what my body would “normally” be doing. The change from what I was to what I am is really striking.

I often think, if a medication could reduce the risk of cancer, but you would have to sacrifice your left arm for it to work, it probably wouldn’t sell well. But if the cost weighs heavily on quality-of-life, taking a toll on intimate relationships, that’s perfectly acceptable? Women who stop aromatase inhibitors are called “non-compliant”, as if they’re foolish and don’t know what’s good for them. But maybe doctors need to consider more than just statistics when it comes to treatment recommendations.

So why aren’t we forcing this conversation with more medical professionals? It’s easy to write prescriptions for medications. It’s much more uncomfortable to navigate the complexities of how intimacy suffers from them. The level of detriment will differ from person to person, as will the value of an intimate experience. While oncologists work to improve the length of our lives, as cancer survivors we need to apply pressure in the other direction, to make sure that their decisions are also informed by the quality of our lives.

~~~~~~~~~~~~~~~~~~

It’s important to note that while libido takes a huge hit from hormone-suppressing medications, it’s not even the main reason women stop aromatase inhibitors. There are other side effects that make the medicines difficult to continue. If you are having troublesome side effects, then tell your doctor as soon as possible. If your doctor doesn’t listen and doesn’t offer ways of alleviating your complaints, it’s time to find another doctor.

Sleep Peacefully, Sweet Aira

“[A pet is] a little tuft of consciousness that circles around a person like a moon around a planet, and completes their energy field making them more whole.”

Dr. Rachel Naomi Remen quoting a spiritual teacher, as related by Dr. Nancy Novak on the Nancy’s List email newsletter, November 1, 2020.

There are few reminders of impermanence as poignant as life transitions. I experienced this over the weekend as we said goodbye to our beautiful Siberian husky, Aira. I knew the time was coming and that it was right to let her go, just a month shy of her 15th birthday.

Retirement: living the good life in her “golden years”, in her own room. Lots of naps and loads of love.

Aira’s transition was gentle. My mother held and stroked her as she lay on her favorite rug in her bedroom in my parents house. She fell asleep quietly with the first injection, and after the I.V. drug was administered, passed into peace, surrounded by the people she knew and loved in familiar surroundings.

She now lies beneath the window outside her room, one of her favorite places in the yard to sit during the winter, as it was almost guaranteed to have a snow mound. She loved that. As the days became warmer, that mound was one of the last to melt.

In her younger days, bright with husky energy.

I remember the silkiness of the fur on the backs of her ears. And the unbridled joy she exhibited when she would get loose and start tearing around the neighborhood. And how she would roll around in freshly fallen snow in ecstasy. And how wonderful she smelled after rooting around in a rosemary bush. And how we would find a dog treat hidden in a shoe, under a pillow or anywhere else she thought was a safe spot that she could return to later for a snack.

Everything changes. Aira matured and calmed down. She followed us from Chicago to California, then due to stifling housing constraints in the Golden State, was welcomed by my parents in Connecticut, where she got a beautiful yard, lots of snow and unbelievable amounts of attention. Years after their three kids had left, my parents and Aira formed their own little family unit and went almost everywhere together.

My father’s health faltered and Aira, too, started showing her age. The last year brought on the most striking changes. Aira sprouted a fast-growing mast cell tumor on her shoulder. By the time it was removed, the mass weighed almost five pounds, and her prognosis was guarded. That was in April of this year.

Some weeks ago, my mother noticed a hard spot in Aira’s belly. As with the previous tumor, this one grew lightning fast. And unlike the tumor on her shoulder, this one was among her organs and taking a toll on her. This one was not coming out.

I would lie away at night, wondering how this would end. Had I known how blissfully she would transition out of this world, my heart would not have felt so heavy.

Newly arrived at my parents home in New England, looking forward to the cooler air and, after years of California warmth, SNOW.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~

I am Roman Catholic. When I was young, I remember a humble missionary priest speaking of how anyone could baptize someone with the sign of the cross and holy water. So, logically, I pilfered some holy water that my grandmother kept on a shelf and baptized our dog at the time, a good-natured chihuahua named Rudis.

Several decades later, when Aira was part of our family, I was already an adult (so I have no excuses), and as I was holding a small vial of holy water brought back from mass, Aira came to sniff at it. I thought, “Why not?” and baptized her.

I’m sure that I’ll be punished for this brazen transgression. And you know what? That’s okay. I hope that I’m banished to the place where animals go after they die, because I’d rather give up my spot in Heaven to spend eternity with my dogs.