franticshanti

Permission to Grieve

I feel like I write a lot about loss when speaking of my cancer experience. That may seem like a downer, but truly, cancer treatment is a complicated process in more ways that expected. Bear with me for a few…

There’s so much to lose: lose control of your life, lose your hair, lose your lunch, lose a lot of money, lose time at work, lose your libido, lose your overall quality-of-life. In more extreme cases, lose your spouse and your house. And unfortunately, sometimes lose your life. On some level most of us may feel some sense of loss.

Cancer is complicated because it can bring on a huge sense of loss.

I keep talking about this because it’s not something that’s fun to talk about. Most people don’t know what to say when they find out you have cancer. They’re hesitant to say something to “remind you” of the illness, as if you could forget. Relationships can become strained and awkward.

Interactions with cancer patients often turn into a “rah-rah” fest, with well-meaning friends showering you with “you got this” encouragement. But that’s not always what you need to hear.

I urge everyone who cares about the well-being of a cancer patient to allow them the opportunity to express how crappy things are. To simply listen and not contradict them. Because being insistent that it’s not okay to talk about anything negative creates an even bigger sense of loss for the patient.

Does this sound wrong? We’ve been led to believe that being positive is the only way we should be and that it’s no fun to be around those who are gloomy.

But consider this: would you go to a funeral and try to get the grieving family to “cheer up”? Would you try to tell them jokes and elbow them into smiling? I don’t think you’d be very successful and might be escorted away – at the least your invitation to the meal afterwards would probably be revoked.

Forgo the cheerleading and simply offer an ear and a shoulder.

We know that behaving this way is unacceptable, at least in most cultures (I can’t speak for everyone). Grieving is an important part of the human condition and not being allowed to grieve loss can be very stressful and lead to problems down the road.

So it is for the cancer patient. There’s so much more going on than simply increased doctor visits and medical procedures. Minimizing the impact that this has on their lives may range from feeling unfair to devastating.

Of course, every patient is different and their reactions will differ too. But I would urge loved ones to err on the side of caution, give their cancer patient the time and space to process and grieve and save the exhuberant “cheering up” for a time when the patient seeks that out.

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Ok, ok, the “loss of body odor” is one loss that’s not so bad!

Another Dual Focus Meditation: Engaging the Ears

In my ever-continuing quest to maintain my concentration during meditation, I’m constantly exploring different points of focus. My go-to still remains the breath, but I’ve written about sharing that spotlight with focus on sensations in the hands as part of a dual focus meditation.

More recently, however, I’ve incorporated more of the senses into my meditation practice (I mean, we have five so why not?).

Urban sounds can provide a constant din that can be used with the breath as a dual focus sensory practice.

In between the inhales and exhales, there’s space during which I’m notoriously susceptible to distractions. Lately, I’ve been working with sounds. I live in the city on a busy street and there’s rarely a lack of noise, so in the lulls between my breaths, my ears turn on and absorb the sounds transpiring outside my window.

The trick with sounds, however, is to allow them to simply be interpreted as tones and refrain from being drawn into naming them. A siren runs the risk of eliciting thoughts of “where’s the fire?” or similar scenarios. For this to work, it’s important to engage our “beginner’s mind” — our brains are quick to match familiar sounds with a story — and divorce the sounds from associations that we’ve made over the years.

If simply shuttling between breath and sound provides enough fodder for concentration, this might not be an issue.

In that case, street noise can be an effective anchor for its variability, its high tones and low tones, as the passing of cars may morph into ocean wave-like sounds.

Meditation music and meditative sounds abound on the internet. Hunt around and you will find a plethora of offerings to use as a focal point.

However, if urban noises are either too intermittent or too difficult to resist spinning tales around, there are many other options for ambient sounds that will work for purposes of meditation. It’s no surprise that platforms like YouTube have a gazillion listings under “meditation music” that may fit the bill. In addition, apps like “myNoise” (and website myNoise.net) provide customizable background sounds to help mask outside noise and maximize ability to stay focused longer.

As the body moves with the breath, sound will remain in the background allowing attention to organically cycle between the two. From personal experience, I’ve learned that juggling between feeling into sensations in the body (breath) and being aware of sounds coming through my ears results in really turning down the dial on my Monkey Mind, which seems to fade to the distance. This dual focus can close the gap through which mind chatter might otherwise intrude.

If you feel inspired, give it a try and let me know how it goes!

Two Simple Tips for Grounding Before Work

I wanted to share two little things that I do with my work setup to help ground me at the start of my day.

First, consider what’s in front of your eyes after your computer boots up? Choose a computer wallpaper to anchor you. Pick a calming scene, one that’s meaningful enough to tweak your emotional state. This is going to be different and personal for everyone. It might be random nature scenes, photos of people you care about, photos from places that you’ve visited, abstract images that you find peace-inducing and the like.

I have this image as my computer wallpaper and imagine how nice it would be to pet her when things at work get rough.

As an example, I currently have the head of a beautiful black panther poking out through lush green leaves as my background. The photo is highly detailed and when I look close at it, I am drawn in by the soft fur around her face, I imagine what it would feel like to scratch her behind the ears and “boop” her on the nose, even imagine her purring in whatever way panthers purr. This wallpaper allows me to slip away into big cat fantasies for a few seconds when I need a break, using all my senses to imagine what it would be like to interact with her.

It’s not just about finding the right image, however. While I currently use this panther as my grounding and relaxation anchor, if I go through a particularly stressful period of time where there’s a lot of anxiety at work, I will change the background to something different after the stress subsides.

Why? Humans tend to be visual creatures and we make strong associations that we’re not always aware of. If you’ve been looking at the same image while you’re close to having panic attacks, it’s time to change the image. Trust me on this one–it has to do with associative learning (think Pavlov’s dogs, except without the salivation).

I did this after going through cancer treatment. Done with chemo? Changed the background. Finished up radiation and herceptin? Changed the background. As much as I liked the backgrounds I was using, it felt great to get something fresh up on my monitors. It felt like a new start and I really needed that.

The second tip I have is equally simple and has the added benefit of being helpful in terms of computer security .

Find a phrase that makes you feel good? Turn it into the passphrase that you type every morning!

Change your password to a passphrase that inspires you or calms you. How would it feel to recite an affirmation or words of encouragement when you log into your work computer every morning? Make it so. It could be an expression of self-worth (iAM-D3$ervinG0fLoVe), a reminder to stretch (r0llY*ur$hou1d3rs) or any other positive phrase (th1s2$hallP@ss-Justbr3@the). It might be that little thing you need to give your day a teensy push in a positive direction.

For additional cyber-protection, stick in a word from another language –perhaps the sanskrit version of your favorite yoga pose?

The above tips are not earth-shatteringly novel concepts, but they are remarkably effective. Give them a try and see if they make your day a little more bearable.

Victims of Our Own Success: Premature Aging in Cancer Patients and What You Can Do About It

So this isn’t the kind of news you want to see. But there’s still hope…

A scientific journal article from 2017 (Cupit-Link et al., 2017, ESMO Open) describes the toll that cancer treatments can take on the patients subjected to them.

After being told you have cancer and deciding to proceed with the treatments that will offer you the best chance of survival…it’s disheartening to learn that many of those same treatments can accelerate aging, causing damage to your DNA, heart disease, hearing loss, cataracts, liver and kidney diseases, brittle bones, lowered immune response and other cancers (!) among other issues, depending on the type of cancer and treatment (see WebMD article).

The treatments that can save our lives from cancer may hasten our demise from age-related factors.

This is a problem resulting, ironically, from the success of treatments and extended lifespan of cancer survivors. Back when cancer was deadly with a low survival rate, no one was too concerned about the state in which survivors were left in; simply surviving the cancer was enough. Now that people are beating their cancers at greater rates, quality of life has become a much bigger issue.

While the most striking detriments are seen in childhood cancer survivors, accelerated aging occurs in most former cancer patients.

Doctors and researchers are taking note. At the time of this scientific article’s publishing in Dec 2017, there was already discussion on how to “de-escalate” cancer treatments as a way to decrease the amount of cellular damage to patients.

On a personal level, I chose an effective drug for my HER2+ breast cancer (Herceptin) over a more effective drug (Perjeta) that carried a risk of greater cardiotoxicity. I made that decision because although I was terrified of cancer, I was also afraid of what lasting effects the drug would have on me once the treatments were over.

Cancer treatments are strong but healthy living can help mitigate their negative effects.

But even if you didn’t have the opportunity to make such a choice, there’s still something that you can do. The authors of that 2017 paper noted that cancer survivors can take back some control over their health by adopting or continuing those healthy lifestyle habits that should sound familiar by now: not smoking, limiting alcohol, exercising regularly and eating a healthful diet.

To that, I would also add, managing your stress levels, the importance of which has been demonstrated on a cellular level, and getting optimal amounts of sleep.

Improving longevity is a hot field for research as scientists work to determine what aspects of one’s lifestyle show the greatest promise in keeping the body young. This topic is complex and new data is coming in on a regular basis, so I won’t delve into details here, but it stands to reason that being sedentary and eating a high-sugar, high-processed diet is not going to do you any favors.

Just as cancer treatments may have a negative effect on overall health, you can win back some lost ground by making healthy, informed decisions on diet and exercise. No one wants to limit their cancer treatment options, so this is one form of insurance that you can give yourself. No matter what else happens, a healthy lifestyle will benefit your quality of life. And that is an improvement that is yours to keep.

Making Space Through Breath: A Visualization

I’ve posted previously about the sensations I’ve experienced in the midst of anxiety, as if the stressor is right in my face, raw and unescapable.

Combatting this feeling has been my number one priority, since anxiety overtakes me before I even know it, triggering my fight-or-flight response. Once my sympathetic nervous system gets going, getting it “back in the box” can be difficult, possibly taking days, depending on the intensity of the stressor.

Anxiety can make us feel like we’re trapped and suffocating.

My current strategy is to create protective distance for myself in a very simple way. And it consists of visualizing an expansion of the space around my body.

It goes something like this: Imagine you are inside a deflated balloon. If you are experiencing tighteness in your head or chest, this serves as an effective analogy, particularly if your balloon is constricting you. Without letting your mind be consumed by the tightness, allow yourself to acknowledge the stressor that surrounds you.

Then, taking a deep breath in, exhale through pursed lips and inflate that space around you. Imagine how it feels to expand the balloon and release that clinging sensation. Feel the fresh air moving against your skin as the space around you continues to broaden.

Maybe you begin with the area around your head first, as if creating a bubble around it allows oxygen to flow freely, then move the expansion towards the torso, protecting and releasing the heart, lungs and other vital organs.

Or perhaps begin with the chest if that’s where the constriction feels greatest. Anxiety can squeeze your breath, so focus on mentally removing that weight from your sternum and ribs, visualizing an expansion of the free space around your chest with a deliberate slowing of breath. This takes some work, a back-and-forth between imagining space expanding around you and your breath taking advantage of the room that it has.

If your chest is mired too deeply in anxiety, turn your attention to your extremities, starting with the feet and hands, getting a foothold there and allowing the sensation of space to move slowly towards the center of your body.

The idea is to E-X-P-A-N-D the space around you, dispelling the feeling of closeness and suffocation that results in the wild urge to flee. Note that this is not avoidance of the stressful situation. You are acknowledging its existence…and then creating room so that your brain has space and time in which to think, to know that it’s protected from words and sensations and fearful possibilities. To know that it’s safe in the “now”.

Try this the next time you have a quiet moment. As with many of these techniques, it is helpful to practice in times of calm, to feel into what that sensation of space feels like. The more we practice, the clearer and more familiar that sensation becomes, and we can draw upon that feeling during stressful times.

Putting a Hold on Looking for Trouble

Last year at this time, I feared that I had heart issues based on what I had read about some of the cancer medications that I had been on, so I went to the cardiologist and they administered some tests. When I came back to the cardiologist to discuss results with the doctor, I was told that they had found “something” in the echocardiogram and Holter monitor readings.

But I still had questions, so I had a consultation with the cardiac nurse, who went through everything with me.

In the back of my mind, there’s a fear that my body is harboring serious health problems.

And it turns out that while they did find “something”, it wasn’t really anything out of the ordinary, beyond normal wear and tear. I was assured that my heart was very strong and healthy and I could continue to push through high-intensity workouts.

Still, it was recommended that I get checked out again this year.

But you know what? I’m not going right now. It felt like anxiety about the scans and then waiting for the results did worse things to my heart than whatever I might have been already experiencing.

I talked this over with my oncologist, who agreed.

The fact is, there are things that you need to get checked out, especially as a cancer survivor. But for other things, especially without a specific indication that there’s something wrong, you are simply looking for trouble. And if you’re looking for it, you’re going to find it.

Our bodies are not perfect. And the older we get, the more aches, pains and abnormalities we have. That doesn’t necessarily mean that there’s anything “wrong” that immediately needs to be fixed.

For now, I’m halting my search for trouble and taking the time to breathe deeply and just live.

Anxiety was the driver for me to get tests run. I was overreading about everything that could possibly go wrong–given the medications that I had been taking–and then rushing out to make sure that it hadn’t yet in the hope that I could rectify any budding issues.

And to be fair, there are still things that I could look at, still specialists I could contact. But perhaps I need to chill a bit…

…but perhaps I need to chill a bit. If it were to progress, would I stop exercising? Absolutely not. So then perhaps it’s best to take a wait-and-see approach for now.

All of this is so different from cancer, which drives us to seek treatment immediately. I am forever primed to worry about what might be happening in my body. But I also recognize this as a psychological side effect of cancer. I can’t let fear take over the rest of my life.

So for me, it’s time to stop looking for trouble, stop fearing for the future and simply relax and enjoy what’s happening in the present moment.

Holding Space: When the Thing to Say is Nothing

On the first day of my Yoga Teacher Training program, we did a curious exercise. Students were instucted to pair up and take turns speaking for about 15 minutes. During that time the speaker was to tell the other about their life. In turn, the listener was to say nothing. In fact, they were to make no facial expressions or give any response to the speaker. They were there simply to be present and witness to what the speaker was saying.

This was incredibly difficult for me to do. My partner was an amazing woman with a backstory that I was so driven to respond to. My usual MO in situations like this is to make little noises like “oh!” and “uh-huh”, and to nod along, raising my eyebrows, smiling…all actions to encourage the speaker. Containing that urge made me feel like I was sending a message to her that I didn’t care. I didn’t want her to think that she was boring me.

Sometimes, the greatest give we can give is our presence and undivided attention.

But the idea behind this exercise made a lot of sense. Too often, we can derail the thoughts of others by interjecting comments. Even when we are encouraging the speaker, we may inadvertantly be sending them off in a different direction than they had planned to go. Additionally, I realized that my need to show that I was interested about what they were describing was actually moving the focus on myself, rather than allowing the other to speak their truth.

This spoke to my own insecurities. In particular when speaking with people in positions of power, I will often watch for body signals and verbal cues that inform me as to what direction I should take my story. I recognize that I lack self-confidence, lost over the years by interacting with people who, in fact, did not value me or my thoughts.

Afterwards, my new friend and I blurted out how much we had enjoyed the other’s story and how difficult it had been to not show appreciation. But we also understood the value of this exercise.

I would not be quite so stone-like with a speaker in a future situation, but I will definitely be more reserved with the interjected “wow”s and allow the speaker to wind their own way through their story, allowing them to fully express themselves, giving them them gift of holding space for what they want to say.

Four Minutes of Hovering

Last week I had a 3-D mammogram. This scan marks a bit over five years since the diagnostic test that indicated I had a solid tumor on the outside of my left breast.

Heading into this appointment, I wasn’t particularly worried. Yes, I admit to having little heartbeat skips over “lumps” in my breast that aren’t really lumps: if you recall, I had felt something before my last oncologist visit; my doctor reassured me it was nothing.

I will never again hear the word “lump” and NOT think of cancer.

And because last August I’d had a chest MRI, a more sensitive scan than even a 3-D mammogram, it was HIGHLY unlikely that there was anything to be found in this mammogram.

But still, after the pictures were taken and the mammography technician left the room to consult with the radiologist, I got that all-too-familiar uneasy feeling.

WHY? I knew that the radiologist wouldn’t find anything. The technician practically said that out loud, since she was aware of my recent MRI.

But still.

I sat alone in the mammography room, breathing, looking at the clock on the wall and simply hovering. My attention was like a butterfly looking for a place to alight. I wasn’t holding my breath…but mentally, I had put the rest of my life on hold when the tech stepped out the door.

It took all of four minutes and the mammographer returned and gave me two thumbs up.

For four minutes, I had no plans for anything outside of the room I was in.

I breathed a sigh even though I had expected the good news. And while I wasn’t “freaking out” waiting for the response, it became apparent to me that I might always feel uneasy during that period of uncertainty.

I didn’t want that. I wanted to be completely unaffected, as if I had never had a bad experience and my heart was calm.

But hovering it was, because there are no guarantees. And as the gears of my life started turning once again, I remembered that there was no going back. All the negatives that have happened have happened and I can’t change that.

Eventually, years from now, my emotions may soften, but in the meantime, I’m just going to have to be okay with hovering for a few minutes.

100+ Breaths: Another Back-to-Sleep Option

Another stressful night left me wide awake at 3am again. Not fun when you’ve got a long day of work ahead of you.

I went to my tried-and-true tactic: several guided meditations which usually work to take the place of the worries swirling in my noggin. But this time it wasn’t enough. The voices were soothing but I wasn’t close to falling asleep.

So I came up with a simple impromptu meditation that kinda-sorta breaks the mindfulness “rules”.

So many numbers out there for me to count while I’m not sleeping…

I’ve been taught that one can count the breaths to help deal with the chattering “Monkey Mind”, and this can be done in various ways. For example, count each inhale as one and each exhale as two, repeating with the next inhale as one and exhale as two, and so on, never progressing further.

Or counting each breath cycle up to 10 (or any other preset number) and then start again at one. If your focus is lost at any point, start at one again, working your way back to 10, restarting at one if your mind wanders off again.

These types of counting techniques aren’t meant to get you anywhere. The number you reach doesn’t matter. What matters is that you make the breath counts your point of focus, giving the Monkey Mind something to do and keeping anxious thoughts at bay.

But for this particular 3am waking, I decided to try something else: count breaths without a stopping point. Instead of observing the breath without changing it, as is usually done during other mindfulness meditation practices, I counted during the exhale, consciously extending the breath as I thought the number. And as I focused on my breath, I kept track of the ascending numbers. This required a touch more concentration and yet was simple and boring enough to not excite my mind.

Inhale, exhale, eighty-six…inhale, exhale, eighty-seven…inhale, exhale, eighty-z-z-z-z-z-z-z…

Somewhere in the 70s and 80s the numbers started jumbling in my head and I repeated several, not being sure exactly where I was. By the 90s, my monkey brain was muttering. I remember getting to 100 and going past it, but my memory is foggy. Consciousness faded in the one hundred teens, I think.

As far as back-to-sleep methods go, this was not a quick fix, but I was too awake to try anything else. I counted for a good 20-30 minutes. I manipulated the breath, so as I mentioned, this practice didn’t follow the mindfulness meditation “rules”, although it did offer me meditation practice in lieu of spinning my worry wheels.

But in the wee hours of the morning when nothing else seemed to be working, it got me to where I needed to be: asleep.

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When the going gets tough, I’ve found counting to be one of the most effective last-ditch back-to-sleep methods, for me preferable to getting out of bed and going out to the couch to read or something. If nothing else, I get in some effective meditation practice. Additionally, this was not a night with a totally hyperactive Monkey Mind. My monkey was awake for distractible.

Note that as I was doing this, I lay on my side, bolster between my knees, white noise playing through my earbuds (yes, I’ve taken to sleeping with earbuds in!). I was in “sleep position” and keeping still, so the only “moving parts” were my brain and the expansion and contraction of my chest and belly.

And Suddenly, Another Freakout

Last week, I had a Pap smear. If you’re not familiar with what that is, you must be either male or blissfully young. In brief, it’s a test for cervical cancer, customarily done every 3-5 years.

I knew my results would come this week, along with other lab results. I was in a work meeting today when I noticed my phone was vibrating. It was my doctor’s office…and I was too late to answer the call.

Me: It’s probably nothing.
Also me: OMG I NEED TO CALL NOW!

The doctor’s office didn’t leave a message.

And that’s when I officially tuned out the meeting. A flood of possibilities came rushing in. My boss needed to talk to me but I was trying to suppress the growing urge to call the doctor’s office immediately.

The urge won. I called and left a message and went back to work, but my head was elsewhere.

The fact that there had been no message was extremely unsettling, because it made sense that if there were really bad news, the office would want to speak with me directly instead of leaving a voicemail.

And my reaction shouldn’t come as a surprise, because having been hit with a cancer diagnosis before, I’ve become hypervigilant. Like it or not, my brain wants to prepare for the worst so that I don’t have that horrible fall from thinking that everything’s just peachy to slamming into a nightmare.

It doesn’t help that I’ve read sooo many stories of women talking about being completely blindsighted by frightening diagnoses, and all of them saying that they thought nothing of the missed call from the doctor since they knew they were perfectly healthy, blah blah blah.

Of course, I know better than this. And at least I was aware of the hypervigilance, aware of my body’s reactions and aware that I was blowing things out of proportion. But it’s that uncertainty that is so difficult to take. Even though I know my response, I know why it happens and I know that chances are everything is ok…I want that certainty.

As it turned out, the call had come from the nurse assistant to let me know that my blood work results had come in. This was a relief, although I admit I considered it a defeat that I couldn’t be mindful and breathe through it all.

Then again, as a cancer survivor, I need to cut myself some slack. Getting slammed with a devastating diagnosis once leads to understandable echoes, no matter what test results I’m waiting for.

For now, I’m calm. Of course, my actual Pap smear results aren’t in yet. Those should come tomorrow or the next day. The nurse assistant told me that they’ll probably be normal (OMG, how can anyone say that????) and they’ll be loaded onto the patient portal…unless they’re not normal. And then they won’t be.

Guess whose heart will be fluttering for the next few days?

Not mine, because I’ve got it together.

Kind of…

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To be fair, I didn’t totally freak out over this. But scanxiety over test results is getting a little old, honestly…