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.

Gotta be prepared, ya know?

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…

Five Years Down and Moving Along

I had another oncologist appointment last week. This one was a milestone, since it officially marks five years since my breast cancer diagnosis.

Five years ago, I was told that with triple-positive breast cancer I had an 85% chance of survival…but there in the fine print was added “five-year survival”.

Delays in routine care due to the pandemic have resulted in more late-stage diagnoses.

With advances in treatment for HER2-receptor-positive tumors (HER2 being the third marker in “triple-positive”), that percentage has improving. But it’s still interesting to note that there’s a finite end to what reliable survival info your doctor can give you, since it’s hard to run longitudinal studies with a large group of participants.

In any case, my oncologist was happy to see me alive and kicking. With the pandemic, women voluntarily and/or involuntarily delayed preventative care, and as a result, there has been an increase in the percentage of women presenting with advanced-stage breast cancer (from UC San Diego Health). Given how far treatment itself has come, this is a distressing statistic because it means that we have effective treatments but patients are not getting them soon enough. So perhaps, for him, I was a five-year treatment success in the midst of all of this.

My oncologist’s concern now is less that my tumor will recur and more that whatever conditions were responsible for the first tumor might result in a brand new one. He still checked me over carefully. My bloodwork looked good with only a lower white blood cell count (“that may never recover,” he’s said in the past). I have no headaches, my bone pain has significantly decreased and other long term physical side effects from endocrine therapy have just about Sudisappeared.

Five years post-diagnosis I’m turning down another path, one that I would have never explored had it not been for what cancer made me face.

I’m still dealing with things like distractability issues, but that could also be due to menopause and the pandemic situation and maybe just the march of age in general. I’ve noted before that it’s hard to pull apart all the factors to identify a single culprit.

My oncologoist remarked that I looked like I was doing well, that I exuded a positive “aura”, and while I’m sure he didn’t mean that metaphysically, the truth is, I feel like I’m finally moving forward in my life again. This coming weekend I start a three-month yoga teacher training course that will move me down a new path for the future.

I still plan to keep posting weekly during this time. We’ll see how it goes!

What If It Isn’t?

“Supposing a tree fell down, Pooh, when we were underneath it?”
“Supposing it didn’t,” said Pooh after careful thought.
Piglet was comforted by this.

A. A. Milne

So, I felt a “lump” under my left nipple, what I refer to as my cancer-side. It wasn’t the same kind of lump that I remember from cancer but when I thought of how I’d describe it (mass, thickening, etc.) I came up with cancer-sounding descriptive words.

This “lump” was also way bigger than my tumor had been.

I think I feel “something” and –BAM!– my mind takes me to worst-case-scenario land.

Now you might think that I would reason with myself. I’d had an MRI in the late summer that showed nothing. A real lump that big would have shown up.

Again, it wasn’t a lump, it was a “lump”. But in the back of my mind, a film starting playing…

I was writing letters to my friends on how much I had appreciated their friendship. Practicing how to tell my kids that I wouldn’t be around to see them graduate from college. Posting my final thoughts here.

It sounds sooo melodramatic but my brain is like a motor boat left unattended with the engine running. And it’s just heading away on its own on a course that no one plotted.

Why do I “go there”?

There is a part of the brain called the Default Mode Network (DMN), which is the area that is more active when you’re at rest and otherwise not focusing on anything. There is a nice “plain-English” explanation here (from an accompanying article to meditation teacher Jon Kabat-Zinn’s Mindfulness course on Masterclass.com). It describes the role of the DMN in “self-reflection…social evaluations…memories…envisioning the future”. And it also notes that problems within the DMN can predipose people to a variety of cognitive issues, including anxiety.

Start my motor, cut me loose…and off I go.

This would explain a lot about my personal default mode.

The article goes on to describe how meditation can “keep the mind from wandering into stressful territory, like reliving traumatic events from the past or anxieties about the future.”

Well, it’s good that I’m meditating, then. But I’ve already put a lot of practice into panicking. I’m an expert hand-wringer. I have a lifetime of experience helped along by a series of anxiety-provoking events. Meditation is chipping away at my hypervigilance, but it’s a slow process.

The main thing that has changed, however, is that now I’m more aware when the motorboat putters away. It used to blindsight me and before I knew it, I was hit by a tidal wave of anxious sensations (tightening, gripping, nausea…). I didn’t realize that this habit of automatic thoughts was driving my anxiety.

Now, when I start down the road of “what if it is…”, I can stop and ask, “what if it isn’t”?

And that comforts me.

When I Can’t Keep Images Out of My Head

When I first started my mindfulness meditation journey, I was taught to use the breath as the point of focus. It is a reliable anchor, always there to return to when you inevitably drift off into thought. It is a stable grounding force that keeps us present.

But there are times when it’s hard to focus on the breath. Perhaps when the mind is especially busy. At those times, I switch to other bodily sensations, such as tingling in my hands or pressure from contact with the surface that I’m sitting on. I wrote a post about moving between two points of focus to help the mind maintain concentration without wandering off. That helps too.

Some days my monkey mind is particularly loud and attention-seeking.

And sometimes my chattering “monkey mind” calls for a switch to an auditory focal point such as gentle music, singing bowls, nature sounds or even simply street noises. Those will keep me present as long as I don’t fall into the trap of making stories about the sounds.

But some days are extra tough.

I tend to avoid meditating with my eyes open. Doing so only reminds me that I need to clean my desk or vacuum the carpet (“guilt-guilt, blame-blame”). However, I am a very visual person with a vivid imagination, and opening my eyes immediately grounds me if my thoughts get too pervasive when my eyes are closed.

Sometimes a thought will trigger an uncomfortable and anxiety-provoking feeling simply because a seemingly-innocuous scene has been associated with a disturbing event. The scene flashes before my eyes andbefore I know it I’m down a rabbit hole. Monkey mind is activated.

While staying with bodily sensations would be preferable, some days there are too many opportunities for my monkey mind to run away with me. It can get exhausting and counterproductive to “dodge” these visuals. Yes, we are “supposed to” let the thoughts pass by us without getting caught up in them. But there are days when they agitate me too much and throw me off track.

Tree!

So I’m cutting myself some slack and turning the “problem” into the solution. On those difficult days, I focus on an image of my own choosing. Something that I can visualize clearly so that it keeps the monkey occupied while at the same time keeping me away from troubling scenes. You could argue that I’m “avoiding” the thoughts. But I see this differently–I’m giving myself a little break from them.

What works best for me? An image unencumbered by potent associations–this is different for each person. A tree, for example, works for me. It might be a thin white birch tree or as majestic and meaningful as Yggdrasil. The tree itself doesn’t matter as much as that I choose it according to what suits me and what soothes me. I can focus on its rough bark, veiny leaves and thick canopy and the sensations that these things evoke to keep away from creating stories.

And if this results in greater concentration, I have the option of hopping back to the breath. Or not.

This might not seem like an earth-shattering revelation. There are relatively popular mountain and lake meditations, so this concept is not new. But with all the emphasis on feeling into your breath in an effort to calm the thinking mind, sometimes it’s simpler to not worry about the “shoulds” and instead see what your own self needs to help it let go and settle into peace.

Still Not Stinky: Chemo & Body Odor 5 Years Later

After finishing chemo for breast cancer and noticing that I had no body odor, I decided to write a post about it because the Internet was silent on the topic. Apparently, I wasn’t the only one who’d come up empty. A number of you commented that you’d noticed the same thing and similarly found no explanation.

Well, five years after my initial diagnosis, maybe 4.5 years after finishing chemo, I still can’t locate info on the Internet about this.

If I do find the odd article about cancer and body odor, it’s about the exact opposite: smelling bad as a result of the disease or certain medications. Not what I’m looking for.

Hey, Internet! Is there really no one looking into this?

It is quite weird that I can’t even find anything in the US National Institutes of Health PubMed database, so I would suspect that chemo-related loss of body odor is not on the radar of researchers. Well, it’s certainly not on my oncologist’s radar because he said he’d never heard of it and didn’t think it could be attributed to chemotherapy. Personally, I can’t imagine how it could be from anything else.

I’m going to pester him about it again during my next appointment. Usually armput odors are caused by bacteria. As an article from the Cleveland Clinic explains, odor is produced “when bacteria on the skin break down acids contained in the sweat produced by apocrine glands, which are located in the armpits, breasts, and genital-anal area. The bacteria’s waste products are what produce the smell.”

And NPR ran a story on researchers looking into what the worst bacterial offenders are, noting, “When the bacteria break down the sweat they form products called thioalcohols, which have scents comparable to sulfur, onions or meat.” The greatest culprit? Staphylococcus hominis.

So then maybe the chemo stops the production of thioalcohols? Or chemo wipes out the S. hominis living on our skin? I’m surprised that no one is researching this in the context of chemo patients, because it seems like it might have some health implications. We still don’t know all the side effects of chemo drugs and it would be useful to start a conversation about this one.

If you’re experiencing this, please tell your medical team. They might simply not be aware of what’s happening.

I’m not saying that I smell like a bouquet of flowers, but according to my husband, there’s no “sweaty pit” odor.

And you might be wondering what my current experience is, almost five years later. Even though I departed the realm of the completely-odorless about two years after completing chemo, I still have very little body odor. And it’s not like I don’t give it chances to fester since I work up a good sweat when I exercise. Note that my left armpit, which was thoroughly irradiated, exudes almost no noticible odor. My right armpit doesn’t smell very much, but sweat that gets on, say, a sports bra will start making the fabric stink the next day. (Let’s just say that I’ve been testing this out.) The skin in the armpit itself? Minimally, and that’s with no deodorant, although I do wear it anyway.

Certainly, the six weeks of radiation therapy on my left side would likely have an effect, and so it would make sense that there’s a difference in odor between both armpits.

Still, the “natural” (and unfortunately overpriced – yeesh!) deodorants do a very good job of fragrancing my armpits because they don’t have to work very hard.

So the mystery remains. I’m going to keep digging into this as it’s likely there’s a disruption of our skin microbiome involved, and given the popularity of that research (see microbiome and armpit odor info at drarmpit.com), someone may be looking into the connection between chemo and body odor in the future. Until then, I’ll just remain happy and relatively unstinky with fingers crossed that it continues.

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Many thanks to my very patient husband who played along and agreed to smell every place I pointed to. I’ll revisit the odor issue during the summer just in case…

Lovingkindness When It’s Hard

Lovingkindness (n.): a tenderness and consideration towards others (Oxford Languages)

Sonder (n.): the realization that each random passerby is living a life as vivid and complex as your own (Dictionary of Obscure Sorrows)

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One of my goals for 2022 is softening my views of difficult people.

This takes some mental calisthenics. There have been individuals in my life that have impacted me in negative ways, and trying to see around that is usually met with a great deal of internal resistance on my part.

But when we hold onto hurt, we sully ourselves, not to mention completely (and possibly unfairly) writing off the person whom we view as the cause of our pain.

There have been people in my life who seem to go out of their way to be cruel.

I need to stress that giving difficult individuals a second look to examine their internal motivations does not mean absolving them of all responsibility for their actions. What they did or said remains that and their role in your pain is not diminished. But in letting go and softening our own reactions, we heal ourselves and decrease the impact that the individual’s actions have on us.

What has been working for me is one simple thing: to pause and imagine what pushes people to be uncharitable. In my experience one of the main motivators seems to be fear. We all have our own ways of dealing with this emotional state, some of us may retreat and tremble (this would be me), others may lash out and attempt to control the situation that way.

I’ll go out on a limb and say that many of those in our lives that we perceive as “evil” may be running away from something. And their inability to deal with their fears and shortcomings makes them very pitiful indeed. The more thoughtless and controlling and misery-inducing an individual seems to be, the more fear they may well have bubbling under the surface.

If we can step back a bit, we can mitigate their power to upset us, because that’s when we see their behavior in a different context.

Let me offer an example: One of the most toxic bosses I ever had would go into “tyrant” mode, judging immediately and harshly, seemingly unable to manage her employees without bullying them. There was intense tension when she was around and I felt like I was never good enough, something that affected me deeply.

Difficult people may be fighting their own inner demons.

But I soon learned that she made everyone feel that way…and also that she was locked in an unhappy marriage and had little control over her personal life. So she established (and overestablished) control where she could. She hired young employees who would work for lower wages and greatly increased her profits, although it also resulted in a significant turnover because the conditions were psychologically distressing.

I dreaded work so much that it was only a matter of months before I resigned my position. I got myself out of there, a decision I never regretted. And I stress this because if a situation is bad, even if you can find some sympathy for the perpetrator, it never means you should stay there and take the abuse.

But understanding what a difficult person is going through can offer some balm for your soul as you shake off the effects of the negativity. Naturally, this is far easier to do from a distance, but it can also help create some emotional space for you if you cannot put physical space between the two of you just yet.

And in the context of a lovingkindness meditation, this makes it much easier to bring that individual into focus and offer them kindness and compassion for what they are experiencing.

It may help to consider this: true power comes not from expressing your dominion over others; it comes from understanding the reality of the situation and making the choice to respond with compassion.

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In the case of my former boss, upon searching for her recently, I was shocked to learn that she had founded a charitable organization to help children in need. All those profits that she had amassed had gone to a very good cause, as she now worked exclusively on a volunteer basis.

I’m so happy to have seen this giving, caring side of her. Wish she’d been able to show it to us.

And I sat there, staring at her photograph on my computer screen. That was her, certainly decades older, but different from the way that I had remembered her. So much more complex a human being. And instead of scoffing at the “old person trying to get into heaven”, I was filled with joy. Inside that being that I had only known as a tyrannical boss was a genuine caring person who was finally able to express her true loving nature.

Nothing could have made me happier.