April 2023 – Frantic Shanti

Things I Wish I’d Known About Breast Cancer, Part 1

Cancer, perhaps more than any other disease, has a formidable reputation that precedes it. Because of this, cancer “lore” can affect your expectations of treatment effects and anticipated prognosis if you are unfortunate enough to receive a diagnosis.

There were a number of things that I didn’t realize about breast cancer that might have made my experience, if not better, at least slightly less harrowing. Here are a few of them, in no particular order:

1. Breast cancer research remains more highly funded than that any other cancer (source: 2019 Northwestern University estimate) and is therefore the best-studied type of cancer. As a result the treatment plan is solid. While this does depend somewhat on the type of breast cancer you have (Triple-Negative, Triple-Positive, Hormone Receptor-Positive, Inflammatory, etc.), the fact remains that there is great interest in “saving the boobies”.

We are living in an era where research in breast cancer is churning out valuable findings at a break-neck pace.

Your treatment plan has likely been well-tested with ample positive outcomes. Combine this with the tendency for this cancer to be diagnosed at earlier stages due to the relative ease in finding a tumor (I mean, you can feel the lump even if it’s not very big), survival rates tend to be very good. Understandably, that might not be very comforting at the time that you’re hit with the news that you have breast cancer, but it is a blessing that you’ll appreciate later.

2. Getting breast cancer is not your fault. I struggled with this one for a loooong time. If you’ve read some of my earliest posts, you know that I not only had a hard time getting my head around my diagnosis, but also a lot of anger about everything I did that was considered “protective” that seemed not to make any difference.

The reality is, as much as we do know about cancer, there’s still a lot we don’t, which means you can be doing everything right — even “perfectly” — and still be diagnosed with breast cancer.

The message I got from cancer-prevention campaigns was that there was so much you could do to avoid the disease. I checked off all those boxes and thought that I was at very low risk. I was “the fit one”, the vegetarian, a dutiful breast-feeding mom allowing myself no indulgences — the last person you’d imagine this happening to, but it did.

I felt ashamed about the diagnosis, even feared that I would be accused of lying about my healthy habits. I was terrified that my healthy lifestyle had somehow backfired. While this sounds ridiculous now, feeling so out-of-control about my own health was demoralizing and depressing.

3. A healthy lifestyle goes a long way in making recovery easier. While I felt dejected about not being able to avoid breast cancer, my exercise and dietary habits helped me recover from treatment side effects faster and not gain weight afterwards. And as I learned later, by maintaining an active lifestyle, I was significantly decreasing my chances of cancer recurrence. I wrote about those findings in this post.

So all my efforts were not for naught. Word to the wise: if you don’t exercise regularly, start now. If you do exercise, keep going!

4. There is light in dark places. I must stress that cancer isn’t some “great” thing that happens to you and it carries with it big side effects and an ever-present risk of death. I lost two friends to breast cancer who were both diagnosed about the time that I was and they were far too young to die.

But given that I had to go through this, I had the option of “sink or swim” when it came to how I would view my experience. Eventually I found the light in the darkness of the cancer tunnel, but it did take a number of years and many ups-and-downs before I was able to appreciate the lessons that the disease taught me: being able to accept and live with uncertainty, identifying a clear purpose in my life, finding gratitude in small things, even coming to grips with my own mortality. These lessons were difficult but also valuable, and I admit that I wouldn’t have learned them if I had not gotten cancer.

Perhaps some of the most important of these were identifying that I had suffered from anxiety for a good part of my life and understanding how it had shaped my decisions. Yes, it took cancer for me to realize all that! This led to incorporating mindfulness and meditation into my daily routine.

And that is a very positive thing indeed.

“Detached”: Time-Out in Third-Person

As an addendum to my post where I wrote about using third-person language in meditation to help keep distance between yourself and your thoughts, I wanted to revisit this method for everyday life.

While in that post I alluded to using third-person descriptions on stressful days, it’s really worth emphasizing the utility of creating space throughout the day.

To sum up that post, I mentioned a mindfulness technique suggested by meditation teacher Jeff Warren in which when we find ourselves being swept away in thought, we describe what’s happening in “third-person” language and play the role of an observer.

But as I said in that post, why limit that to meditation sessions? In fact, you could argue that it is even more important to bring that type of gentle detachment to the things that ordinarily set us off in our daily lives, whether it be with family, at work or anywhere.

I would say that so much of my anxiety has stemmed from an inability to maintain perspective about the trigger. Noticing when I’m getting carried away and then describing the situation as something that is happening to another person — similar to the way a newcaster might report on an event in a calm, informative manner — helps loosen its grip on me.

The ability to step back and detach from the situation is kind of the name of the game in terms of reducing stress levels, isn’t it?

By narrating the circumstances around your stressors, we make space: “FranticShanti felt a little ill when she saw that the letter in her mailbox was from her landlady. She expected this to be about a rent increase…and she was right. Another $200 per month.”

Third-person language gives us the space we need to tackle our stressors without getting pulled into them.

That telling offers some space. It doesn’t change the situation, simply presents what’s happening in an unemotional manner. Then following up with some trouble-shooting helps soothe my agitation: “This will require a review of her finances, but as she calculated with last year’s rent increase, she can still absorb this additional amount. Things will probably be okay. She takes some deep breaths and feels into her hands and feet.”

Not only can you calmly describe the situation, but you can describe yourself engaging in self-soothing techniques as you work out your next steps.

It is quite effective in slowing down racing thoughts, particularly if you’re in a place where you can speak out load, as hearing yourself describing things can be even more grounding.

As with other simple grounding techniques, this may seem a little contrived or simplistic, but it might be just enough to bring you out of your head and into the here and now — cool, calm and collected.

Such a Fragile Life

I’m not going to post the post I’d written for today.

Something else came up and it really made me think about how we are teetering on a slim ledge between “everything’s ok” and “the end is near”.

Last Wednesday, I cut the inside of the roof of my mouth in the soft palate. Or maybe it was a burn? I didn’t pay much attention to it because this happens from time to time, it’s not that big a deal and it seems to heal quickly.

Except this time it didn’t. Granted, I ignored it a tad too much and wasn’t as careful as I should have been about what I was eating. I felt loose skin rub off around that area.

In a second, everything can change. [Note: this is not my car.]

It started hurting more and eating became more painful. At night, my mouth dries out even when I’m sleeping with closed lips. My tongue feels like sandpaper against my palate and because of where the wound was, my tongue was irritating it.

Friday, I realized that if I spoke a lot without a break, my tongue would abrade that sore area even more. Saturday, I told myself that I should be doing warm salt water rinses, but kept forgetting to do so.

Sunday, my head hurt upon waking although the area felt kind of better? But when I tried eating and drinking as normal (albeit avoiding that side of the mouth), the pain seemed worse.

Or maybe it was my perception of that pain? For me, it’s so hard to tell. I vacillate between ignoring a dangerous situation and imagining the possible worst; it feels like I could talk myself into/out of anything.

Before I was diagnosed with breast cancer, I had been aware of the lump in my breast for six months, but kept telling myself not to freak out and that it would probably go away on its own.

Maybe it’s really bad, maybe it’s not bad at all…I dunno…

Spoiler: it didn’t, and although the tumor was still Stage I-sized when I finally went to the doctor half a year later, it had already invaded the tissue outside the milk duct in which it originated. [To be fair to myself, there was more to that decision, which I won’t go into here. I wasn’t a total idiot about it.]

And then after completing all of my chemo rounds, one of my fingernails looked like it had a bubble underneath it…which I ignored for several days (actually, it became impossible to ignore because the pain was increasing), figuring I’d wait because it was probably just my nail coming off, which sometimes happens with chemo.

Except that it wasn’t. It was an infection. But instead of going to the ER immediately, I waited another night because it was the weekend and I figured I’d call my oncologist in the morning.

That night was worse than any night of my life. I barely slept because my hand was on fire and in the morning there was red line running down from my finger into my wrist.

At that point, I was probably closer to death than I had been throughout my entire cancer experience.

My point is, I was able to “reason away” any immediate responses and ignore striking red flags for fear of blowing things out of proportion. I didn’t want to look like a hypochondriac. It was hard for me to fathom that the situation was as dangerous as it ended up being.

But our lives are really so fragile. After going through cancer, I realized that something could be going on inside my body, silently, that could change me irreparably — even kill me — within a very short period of time. And it could be happening right now.

What a tenuous hold we have on our existence here. How often do we forget that? And why aren’t we more careful with ourselves?

Such a short tenure on this Earth. Where do we put our energy? Too many spend so much time being horrible to each other and the world around us. And most of us don’t appreciate what we have until it’s too late. Some of us never appreciate it at all.

Take a deep breath, hug the ones you love (that should include yourself) and enjoy this moment.

I’m going to go rinse with salt water…

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A little update: I made a doctor’s appointment for early tomorrow morning, after which I realized — through diligent image googling — that I probably had a massive canker sore. It’s not likely to kill me but it’s doing a good job making me miserable.

And if I’m wrong and it’s something worse…then that’ll be next week’s post.

Creating Space with Third-Person Language

I’ve had some up-and-down weeks this year and have been working on making space in my head to lessen the impact of anxious thoughts.

I recently heard a wonderful suggestion by meditation teacher Jeff Warren (via his Daily Trip on the Calm app) about creating more mental room for yourself. He encourages describing what’s happening in the third person when thoughts come up during meditation.

Like many suggestions to help with mindfulness, this seems surprisingly simple, but so far I and everyone else I’ve recommended it to have found it to be very effective.

Making space is good for more than avoiding viruses…

It goes like this: I am sitting in meditation focused on my breath (or any other chosen anchor) and a thought pops into my mind. I say to myself, “There goes FranticShanti thinking about X topic again”.

Suddenly I feel a *whoosh* as I’m pulled back out of that scenario. And instead, I’m observing myself having that thought. Hearing myself describe the situation as a bystander has a calming effect and creates a sensation of safety and distance.

I’m still staying present and noticing what’s going on around me, but recognizing that this thought is happening to the person who is known as me — instead of allowing myself to get sucked into it, along with all the associated emotions — expands the amount of mental space I have.

It’s kind of like looking through a window at a situation instead of being there in the room with it. Not nearly as scary or immersive.

Looking at things through a protective buffer makes even scary situations less threatening.

Likewise, throughout the day, describing a stressful situation in third person helps us remember that there is always space around us that can serve as a buffer from unsettling thoughts. It can even help us handle anxiety-provoking situations as it also provides an opportunity to describe a potential ‘solution’, as if you were to give a friend some advice on how to deal with it.

Imagine saying, “[Your name] just realized that there’s a deadline they forgot about, so they’re reshuffling their schedule to accommodate the task.” That’s much more productive and grounding than screaming, “AAAAAAAAIIIIIIIEEEEE!!!” in your head.

So, I’ve started using this in everyday interactions when I feel myself getting swept away by worries. It’s been an effective way of bringing myself back into the present, to what is real and actually here, and it serves to reframe what is going on in my life.

This sort of method brings stressors down to a manageable level, allowing for perspective. And we can all use a bit of that.