Month: November 2022

“Scatterbrained”: Yeah, Chemo Brain is Real

After a few years of wondering what the heck is going on with my head, I joined a Memory and Attention Adaptation Training (MAAT) class generously provided by my cancer center (which I’ll be posting about on a later date).

This is gratifying on two levels: first, that I can learn new strategies for dealing with the memory issues and distractibility that have been plaguing me since finishing breast cancer treatment five years ago; and second, and perhaps more important to me emotionally, that what I am experiencing is REAL. It’s officially termed Chemotherapy Related Cognitive Impairment (CRCI) or, informally, chemo brain.

I’ve been told that “you’re imagining this” (I’m not) or “you’ve always been like this” (I haven’t) or “just focus harder” (I AM!!!) or even “this is just an excuse” (Argh! No!), coming from people who have been annoyed by my memory lapses.

Chemo brain spends a lot of time just wandering around without an idea of how to get anywhere.

My brain isn’t lazy. As a matter of fact, it’s the opposite problem. My brain is too busy.

In the MAAT class, we learned of a study from the University of British Columbia (UBC) by Kam et al. (2016, Clin Neurophysiol) that examined what happens inside those brains that suffer cognitive impairment from cancer treatment, even years later. In that published study, the experimental group consisted of nineteen breast cancer survivors. All had undergone chemotherapy for early stage breast cancer and had subsequently self-reported cognitive issues.

Researchers at UBC compared these survivors against twelve (non-cancer) control subjects in a task that required sustained attention. All the participants’ brains were monitored via electroencephalogram (EEG) both while working on the task and while at rest.

The results were vindicating for me and, I’m sure, for others experiencing this. Normal brains cycle through periods of focus and periods of “wandering”. However, as the UBC researchers stated in a summary of their results (published here): “We found that chemo brain is a chronically wandering brain, they’re essentially stuck in a shut out mode.”

This was true even when the breast cancer survivors thought that they were focusing. Furthermore, the survivors’ brains exhibited activity even when they were instructed to relax.

Great. We know that chemo brain is an undeniable fact for some cancer survivors and can last for years — in this study, up to three years. However, for me and some of the people in my MAAT class, it’s been five years and we’re still dealing with this, which is frustrating. What can be done about it?

When anxiety and chemo brain collide, you get a confused goat tangled up in a rope. That would be me.

It won’t come as a surprise — anxiety makes everything worse, and that holds true for chemo brain too. As mentioned above, I’ll discuss this in greater detail in a later post, but basically, a main focus of the MAAT class is learning to handle stressors in an effort to relieve anxiety.

So now that I know that what I’m experiencing is a real thing, a large part of combatting it is what I’m already trying to do — mindfulness, meditation, yoga and similar sensible self-care. And while it might seem aggravating that even with all that practice I’m still dealing with this, I’m actually bouyed by the fact that every bit of mindfulness helps. The reality is, I’ve made a monumental amount of progress from where I was when I started, five years ago.

And that keeps me going. Where would I be if I wasn’t trying?

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References:

Reader-friendly summary:
“‘Chemo brain’ is real, say UBC researchers”, UBC News, Apr 27, 2015, https://news.ubc.ca/2015/04/27/chemo-brain-is-real-say-ubc-researchers/

The published study:
Kam JWY, Brenner CA, Handy TC, Boyd LA, Liu-Ambrose T, Lim HJ, Hayden S, Campbell KL (2016) Sustained attention abnormalities in breast cancer survivors with cognitive deficits post chemotherapy: An electrophysiological study, Clinical Neurophysiology, 127, 369-378. https://doi.org/10.1016/j.clinph.2015.03.007
Please note that the above study is not available free online at this time. For a pdf free of charge, contact one of the authors (email address next to their name at link above) or your local university library. Due to copyright issues, I am unable to distribute the full document myself.

A Gentle Meditation for Finding Peace at Thanksgiving

For those of us in the United States, Thanksgiving presents an opportunity to gather with family and close friends and share a festive meal.

However, this holiday can become complicated in a time of polarized views. Coming on the heels of another political election, togetherness with those of strong opinions might be, to say the least, uncomfortable.

Put another way, the battles will be epic, the indigestion will be legendary.

So for everyone who is anticipating shifting restlessly in their seats this week, I wanted to offer you a short meditation.

Listen closely. On the surface you might not like what you hear, but there may be deeper messages that speak to the vulnerability of those who seem the most belligerent.

Listen. If you listen closely enough, you will hear the real reasons that your family members believe what they do, particularly if their views seem hurtful or unfair. It often has something to do with fear or an unfulfilled need and often comes from a place of vulnerability.

You will chose how to approach this. But I can assure you that arguments are pointless. There will be no “winner”. Just resentment and an even stronger resolve not to change their minds. Don’t plan on pulling a “zinger” that will convert everyone to your way of understanding. Not gonna happen.

Observe. Instead of reacting to statements that you feel are wrong, watch the body language of those around you – it will show you the state that they are in. Clenched fists, hunched shoulders, unsmiling faces, repetitive movements – all these belie discomfort. Are people enjoying their food or unhappily shoveling it down?

Take a step back to help you see what’s really going on. Everyone at the table has a three-dimensional life with their own desires, joys and sorrows. In the time of heightened emotions, it’s easy to forget that.

Smile and find something that everyone can agree on.

Breathe. Don’t get sucked in. If someone asks you what you think about a contentious topic, smile and compliment Aunt Gladys’ stuffing. How does she always make it so flavorful? You woke this morning salivating, thinking about having it for dinner.

It may sound contrived, but if you can find a sincere compliment to express, you can change the direction of the conversation and relieve tension. But please, be sincere.

This is not a dishonest deflection of attention. This is finding that one thing that everyone can agree on and focusing on it. It’s like lighting a spark and then blowing on it gently to help it grow into a warm and cozy fire. Everyone benefits.

This is mindfulness at its best. Every person has something within them that wants to be loved and respected, even if they don’t feel they deserve it. Sometimes those who seem the most cantankerous feel the most wretched inside. Remember, at the end of the visit, you will get to leave, so why not leave having spread a little joy and goodwill?

At the least, you will have made Aunt Gladys smile.

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There is a lot going on in the world that is worth fighting for. Thanksgiving dinner is not the place to do that. And perhaps the peace that you impart over that meal will eventually soften hearts and open minds.

Fighting My Way Out of a Paper Bag: An Analogy

I wanted to share a little technique that I’ve been using to give myself perspective. It’s quite simple: I have a small brown paper bag pinned to the wall above my desk.

The bag is there to remind me that most of the things that are upsetting me or stressing me or just taking up headspace in the moment are transient issues that fit into that paper bag. The REST of my world remains outside that bag and unbothered by whatever is going on in there.

The trick for me is to not get sucked into that brown bag. When that happens, and it does, I’m suddenly whirling around with all the daily stressors and emergencies-of-now, and that’s all I see. My entire experience becomes those anxiety-provoking elements and my stress levels skyrocket.

When stress levels are high, it’s easy to get sucked into a space of high anxiety where you see only those stressors, forgetting that the rest of the world is outside.

It takes a lot more effort to fight my way back out of there than to stay outside in the first place.

At the same time, it’s so easy to follow all those stressors right into that bag. For me, that’s the path of least resistance, even a habit.

But when I lean back and take in the entire picture–the time-limited nature of what’s bothering me and the fact that in a couple of weeks it’ll be gone–my view broadens and I am reminded of what else is going around me right now, in this moment.

Right here, where I feel my feet planted on the ground. I smell the scent of lemon wafting up from my diffuser. I’m aware of sounds from the street below and sunshine coming in through my window.

Perspective. All of these things tumbling around inside the bag will pass. And, yes, perhaps more importantly, new ones will bubble up and take their place. I can’t stop that and I have to accept it. But I can take a deep breath and stay in the bright light of the day instead of darkness of that little bag.

Yogis, Find Your Own Balance

I am a newly minted registered yoga teacher (RYT-200), having passed my Yoga Teacher Trainer (YTT) final exam in mid-May 2022. When I tell people I’m a yoga teacher, they naturally assume that I am extremely flexible and have impeccable balance.

But, no.

Yes, yes, when I’m warmed up I can touch my toes with straight legs, even put my palms flat on the floor…but in yoga practice, I prefer to keep a slight bend in the knee in forward fold. My balance is a little wonkier and I’ve been known to wobble and trip my way around a corner if I’m moving quickly.

I enjoy a deep yogi squat because I’ve been practicing that pose since childhood, but neuropathy pain in my feet prevents me from holding my back heel up high in lunges. So my abilities are spotty.

The gift of yoga is that it is available to all.

When I took level 2 yoga classes, part of the prerequisite for my YTT, I would regularly lose my balance in some of the moves that the younger class participants easily nailed. It took more brain power and concentration to keep my body steady (possibly chemo brain played a part). I’m sure other students would have been surprised that I was in yoga teacher training.

I mean, WHY would I even consider becoming a yoga teacher?

Because I want people to know that yoga is for everyone. While I’ve ranted about this before here, going through YTT classes really underscored the fact that, at least in the United States, yoga practitioners tend to be very homogeneous: young, white, female, flexible, affluent.

Come as you are. Nothing special needed.

This is particularly disappointing because there are other populations that would benefit greatly from establishing a yoga practice and arguably might need it even more for their well-being. Slowly, yoga is being made available to “the rest of us”. But it’s going to take a while.

So I urge you, seek out yoga in parks and free classes at the Y. Explore YouTube for gentle beginner yoga videos so you can practice from home. You don’t need the burning sage, expensive yoga pants, organic cork blocks or trendiest mat. You just need to show up, follow along with the poses and breathe.

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To be fair, my balance and flexibility have improved significantly with regular yoga, and that’s my point: I didn’t need to be super flexible to begin. No one does. But if the message that yoga studios and fellow yogis are sending is that you already need to be able to strike a complicated advanced pose, think of all the people who won’t even consider starting.

And I have learned to seek out modifications for those yoga poses that throw me off center. The old self-conscious me would have thought that made me a failure. But I know better now.

Because I know I can do the most important pose very well: sit quietly and breathe.

Namaste ❤