October 2023 – Frantic Shanti

Two Anxieties but One Breath

So, something occurred to me as I was dealing with stress about a work project…and then got news of changes that may require us to quickly move from the place in which we’ve lived for over ten years.

I am experiencing two different textures of anxieties. I’ve heard people discuss chronic and acute anxiety, but I would characterize the way I experience anxiety differently.

The first anxiety may wear you down but won’t require a complete change in your life.
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The first is anxiety about what may happen or anxiety about what has taken place in the past and I can’t change. That encompasses stressful events that you need to work through, like a job-related project, which requires holding on and managing. It’s more of a chronic type of stress even though it might be time-limited. There are things out of my control or, in the case or what has already taken place, there’s no going back. It doesn’t qualify as life-changing as it may intensify and relax depending on conditions.

The second, however, is anxiety about something that *is* life changing. Those of us who have been handed a cancer diagnosis know what it feels like. It means that the future will look dramatically different from what we expected it be. Other examples are a death of a loved one or losing everything in a natural disaster. A sudden involuntary change in your living situation. This requires letting go and radically recalculating what you’ve become very used to. It can be very difficult to do, especially for those of us who like stability in our lives.

The first anxiety is exhausting. The second is terrifying. Having experienced both, I can definitively state that the first anxiety pales in comparison to the second. In fact, in the face of the second anxiety we may actually let go of the first completely and wonder why it ever bothered us.

The second anxiety is more intense and will alter life as you currently know it.
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At the same time, as terrible as it may be, the second anxiety offers us a perspective and clarity that we would be hard pressed to accept as quickly any other way.

I do not wish either of these anxieties on anyone, but if there’s a bright side to them it’s that the same type of mindfulness practice that helps us deal with the anxiety of the first kind will also help when the expectation-smashing heaviness of the second anxiety hits.

Although you may still wake in the middle of the night, heart racing and wishing things had not changed, a consistent mindfulness meditation practice will provide you with the tools to smooth the jagged edges of rumination and fear, slowing the breathing and with it the heart rate, even in the presence of frightening thoughts.

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Of course, since this is a mindfulness blog in addition to being cancer-related, I cannot resist talking about one of the most effective techniques that I’ve found for calming myself: belly breathing.

Start by simply breathing deeply into the belly, as anxiety often results in shallow breaths. The deeper the inhale, the more air you will have for the exhale – try matching inhales and exhales in length. It won’t happen immediately. Give it time.

Create a breathing cycle and keep going. Establish a breathing practice and stick with it.
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Keep breathing into the belly, fully engaging the diaphragm, allowing it to drop and make space for your lungs.

As you do this, focus on the breath. The uncalm thoughts can still be there, but gently allow them to sit on the sidelines for now. I used to try to completely push them away, but they would bob back up to the surface like a balloon pulled under water, bringing the intensity of my anxiety back with it.

So let them be there…keep one eye on them if necessary but give your breath the main stage.

Once the inhales and exhales have evened out in length, insert a short pause between them. Breathe in … pause … breathe out … pause. Just a little stop to elongate the cycle. Consistently breathing into your belly.

Transition to full box breathing, where the inhales, exhales and pauses are all equal in length. If you get very comfortable doing this, for a little extra, try to make the exhales just a touch longer than the inhales.

Or if it gets tiring, simply try to make your exhales a little bit longer than your inhales and dispense with the pauses altogether.

Maintain this type of soothing, intentional breathing for a few minutes or longer, depending on how your body is responding or what your nervous system needs today.

Truly, you don’t have to do this perfectly or adhere to a specific count. Simply focusing on your breath and slowing your breathing will help immeasureably in making space for your thoughts so that you can back away a bit and survey the scene without feeling claustrophobic, no matter which anxiety you’re dealing with at the moment.

Cancer Survivorship Ain’t For Sissies

With all the focus on breast cancer during October, pushing us to be warriors and fight our way through this, the concept of survivorship can get lost in the fray.

We talk about cancer treatment and get very granular about the procedures, whether surgery, chemotherapy or radiation therapy. And those do deserve a lot of discussion as they can be difficult to endure. Some, like chemo, have an almost legendary reputation and it’s important to be able to separate fact from fiction.

After all the noise and attention associated with cancer treatment, survivorship can leave some of us feeling alone.
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Consider: how many of us, upon hearing that we have breast cancer, preoccupy ourselves with worrying about what life will be like five years down the road? More likely, we’re thinking about what treatment will be like and are hoping that we’ll be around when it’s done!

But with so many women surviving breast cancer, it’s important to talk about what happens after the dust settles and you realize you’re on the other side of the treatment that you had so feared. Is it really the “other” side?

So much of my blog has been devoted to the life after cancer. After I documented my treatment journey, I turned around to get hit in the face with all the stuff that I wasn’t expecting.

One of those was endocrine therapy. Women with hormone receptor positive cancers aren’t done when the “tough stuff” is over. Tamoxifen and aromatase inhibitors are a whole new round of treatment that can affect your hair, your libido, your joints and more. Some women get hot flashes and night sweats. Some experience weight gain. And these are medications intended to be taken for a number of years.

There may be body image issues. Breast cancer surgery can leave women looking very different from their pre-cancer days. Like it or not, breasts are associated with womanhood. Whether lumpectomy or mastectomy, with or without reconstruction, there is a new normal that needs to be dealt with.

By seeking support and relating your story, you help not only others who are dealing with something similar in addition to yourself.
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And then cognitive issues like distractibility, loss of memory and difficulty processing concepts may come up. To make things more complicated, these may appear after treatment is in our rear view mirror and our loved ones may simply not appreciate what we’re dealing with. The bodies and minds of survivors may change in a way that they are not prepared for. Because, how do you anticipate something like this?

Survivorship does not mean that you never again have to think about cancer or its repercussions. There will be adjustments to your expectations as to how your life will be from now on. It’s important that those around you understand that just because you are done with the major cancer treatments, things might not feel familiar or normal.

So we need to be having this conversation with those around us and making opportunities for affected women to seek help and support. There is no shame in being a survivor who is also struggling. While it’s true that we are “lucky to be alive”, it does not mean that we have no right to seek a higher quality of life.

Don’t be afraid to talk about it. ❤

Don’t Take Stress Sitting Down

About a year or so before I felt a cancerous lump in my breast, I was tasked with planning an academic conference, which I’d never done before. The project was running behind schedule, procedures had changed and I felt panicky and lost.

As a result, I was working seven days a week with most workdays lasting into the night. This was in addition to having to break in the early afternoon to pick up my children from school, then continuing work from home.

Everything was a rush and I had a constant lightheaded feeling.

When you have the least time to move is when you need to move the most!
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Most non-work activities fell by the wayside (Cooking? Cleaning? What’s that?). But the most pivotal of these was exercise. I’d been through highly stressful situations before but always had the opportunity to work off my anxiety. This time there was none of that.

Anxiety sat like a boulder in my stomach. I could feel my brain buzzing from the stress but couldn’t do anything about it. There was SO MUCH to take care of that my work-life balance was non-existent. There was only work, and this went on for weeks. My mental well-being plummeted, sleep was filled with night sweats…and the agony of not having the time to work out magnified my anxiety.

We know how bad sitting is for you physically, but not everyone is aware of the psychological ramifications of being sedentary, especially when it comes to managing stress. I found it so ironic that after my tumor was confirmed, the doctors estimated that it had started developing a year or so prior…during the time that I felt my life falling apart.

Stress did not cause my tumor. But it didn’t help my body counter it either.

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I personally am convinced that there’s no healthier, more positive way to tame anxiety than exercise. COVID’s remote work situation demonstrated to me that I feel much saner when I can stick a workout into the middle of my day, even if it lengthens my workday a bit, and the increased blood flow helps with my mood and productivity.

There is a Zen saying: “If you don’t have time to meditate for an hour everyday, you should meditate for two hours.” I believe that this saying also holds true if you substitute the word “exercise” for “meditate”.

Find movement that you enjoy and then stick it into your day.
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Obviously, I’m not suggesting that you do either for two hours. The idea is that when you are overwhelmed with responsibilities and stress, that is an indication that you need meditation AND exercise all the more.

Frankly, it’s also time to reevaluate your life priorities, but that can be difficult.

How to get more movement into your day? Based on the research* that I’ve seen, it’s best to take breaks about every half hour. That might seem impossible for some people and some work situations, but do the best you can. The last thing you need is more pressure on yourself.

Even just standing up and stretching is better than sitting glued to your seat. If you can walk around, take the long way to the bathroom. Hike up and down the stairs. Breathe deeply. Start there and you can add more later, keeping in mind that energy begets energy: the less you move, the harder it will be to get started; the more you move, the easier.

If you have time for a considerably longer break and don’t yet have an established training program, start by picking a rhythmic movement like walking, running, cycling or swimming and lose yourself in the rocking motion. Not only does that give you exercise, but the gentle back-and-forth is soothing for the nervous system.

Most importantly, make the experience a positive one.

My personal recipe for mind-happy exercise is: (1) indoor rowing (for the rhythm and cardio load), (2) strength training (with a focus on each repetition) and of course (3) yoga (for deep breathing and unwinding the stressed-out body). But these recipes will vary for every individual. What’s yours?

*I had a choice between getting my workout and meditation in or digging up these references. Guess which I chose? 😉 I’ll be back with the science in another post.

In the Midst of “Breast Cancer Pink”, Finding Stillness: A Meditation

As you’re probably aware by now, October is Breast Cancer Awareness Month. For breast cancer patients and recent survivors, seeing all that pink around can be a little stressful.

Yes, it’s important to maintain awareness that 1 out of 8 women in the United States will be diagnosed with breast cancer at some point in their lives. Those of us who have already been…well, it would be nice to forget about it once in a while.

One out of 8 is a lot of pink!
(Photo by Pawel Czerwinski on Unsplash)

So for this post, I want to offer you a very simple meditation. No prep needed.

Pause where you are right now and become still. Right where you are.

Notice how your body feels in the space that you’re inhabiting. What sensations do you feel most strongly?

The expansion and contraction of your ribcage with your breath?

The contact points of your body on the surface where it rests?

Perhaps a pesky little ache somewhere, in your joints, muscles or around an incision?

Tingling in your fingers or toes?

Are you gripping anywhere? If you notice tension somewhere in your body, very very slowly see if you can soften it. It’s okay if it doesn’t release completely – imagine that part becoming heavy and pliable.

And then see what other physical sensations make themselves known to you.

Stay with your body. There might be a lot going on in your mind right now, but that’s “up there” in your head.

Here. Stay down here.
(Photo by Tim Mossholder on Unsplash)

We are down here in your physical being. Feel the stillness that exists here, not agitated by your thoughts. It’s okay if there’s noise in your mind, like if you lived on the floor below a bustling office. All those workers up there, getting their stuff done.

You can hear them, moving about, speaking in muffled tones, keeping busy. That’s all okay. They can be there.

But we’re all hanging out in stillness down below, with distance between what’s going on here and what’s happening elsewhere. We have space.

How does it feel knowing that you have permission to be still? That you don’t need to drop everything and dash upstairs? The thoughts can wait. They’re not going anywhere. You have time.

Eventually, you’ll return to the hustle and bustle up there. But know that you can always take a break, come down into your body and sit in the stillness that is here.

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This October in particular is very busy for me. A big project at work, the holidays around the corner, prepping for guests while our apartment STILL awaits repairs. And then strange guilt that I’m not doing more yoga teaching. It’s a lot to manage in my head, all this piling on of responsibilities.

So that meditation up ^^^ there? Yeah, I needed that. ❤

Where Are You Getting Breast Cancer Info?

Since we are just at the start of October, aka Breast Cancer Awareness Month, I thought I’d go through some basics about getting information on breast cancer.

Let’s face it, as soon as you suspect that you feel a lump in your breast, feel a lump in your breast, have something funny show up on a mammogram and get called in for an ultrasound, are told that there’s something weird on the ultrasound and you need a biopsy, the biopsy reveals a tumor, as you’re in between any of the above, have a loved one go through this, or ANYTHING like the above really, you’ll have the urge to consult Dr. Google.

BE CAREFUL. When I asked my cancer surgeon about getting more info, she gave me a few websites and told me not to go anywhere else. These included:

National Cancer Institute (NCI)

American Ca ncer Society (ACS)

I was very surprised at the limited number of websites she suggested, but the reasoning made sense. You want to be sure that the information you’re receiving is accurate, up-to-date and vetted by cancer professionals. Both NCI and ACS can provide you with references to clinical studies to back up their information.

This was in 2017. I expect that you can find additional reliable resources now. However, as I discovered when I was looking up other sites, the Internet moves fast and what was once a good source may now be a broken link.

I want to stress: My blog should not be used as a source for making treatment decisions. I mean that with all my heart. I started my blog to relate my own experiences and research in the hopes of being able to provide the view of a cancer patient/survivor about what it’s like to go through a cancer journey.

I had been frustrated by not having an idea of what a lumpectomy looks like, no month-by-month photos of the process of hair regrowth, no good rundown of what to expect during my first chemo infusion, not understanding what that ‘chemo port’ thing was, having my medical team draw a blank when I asked why I had no body odor…and so many more things. So I decided to post photos and write about them in short, to-the-point posts.

But everyone’s experience is different. We have different backgrounds, different lifestyles, varying levels of risk factors and therefore different cancer journeys. The best resource that you have is your medical team. Make sure that you feel comfortable with them, get a second opinion if your treatment options seem inappropriate and definitely change doctors if you feel that yours do not listen to your needs.

Even though there are many complementary treatments you can try (I personally benefitted from meditation and exercise), do not use them as alternatives. Your best bet for survival remains conventional medicine.

Please seek out the resources offered by your cancer center. If you need someone to talk to, consult with whatever mental health support is available–this was also invaluable to me. This is not something you should feel you need to “tough it through”. You don’t have to prove anything. Just showing up for your treatments shows your strengh. Same thing goes for those providing care for you during this time, which can more more emotionally taxing than many are willing to admit. Look into support groups for both patients and caregivers.

Understand that you did nothing wrong. You didn’t deserve this.

And everything that I suggested above? Yes, check with your medical team even about my recommendations. The list of sites may very well have expanded by now but my admonishment to watch your step where your get your information for making decisions remains. Please, you are worth it.

As you navigate the experience that is cancer, whether your own or of someone you care about, please know that I am rooting for you, thinking about you and can’t wait to see you on the other side! ❤