Does Mindfulness Make a Difference?

Yes, yes it does.

I am AWARE.

What used to feel like a jumbled mess of emotions and sensations before, now makes sense to me. Intense feelings don’t come at me as quickly as they used to and there’s more space between a stimulus and my response to it.

There is a PAUSE.

I may still feel overwhelmed by circumstances when something unexpected happens, but now I know what’s happening and can pull myself out of it.

That doesn’t mean that I’m perfectly calm and don’t get frightened, anxious or frustrated. I do. You can see that in some of my posts, because I try to be very honest about what I’m experiencing in the moment. But no matter how deeply I dip into fear, I don’t stay there.

I can find the CALM amidst the CHAOS.

When things get intense, I know how to feel into my body. I recognize the physical sensations and I focus on releasing them. Smoothening them out. Breathing through them.

All those abilities were always available to me, but I resisted calming myself. I am aware that on some level I used to feel that anxiety was a necessary way to express my fear; that it was necessary to descend into fear to express my emotional state to others, so that I would be taken seriously. While it sounds odd to read that now, it was only through learning that I was able to soothe myself that I learned I didn’t need to commit to the torture.

I return to the PRESENT.

When I start thinking about fretful things in my past or fearing the possibilities of the future, I can now recognize that my mind has drifted away and I can pull myself into the present, feeling into my bodily sensations. I can break through the dark tumult that’s enveloping me. And suddenly, the noise is gone and I’m standing with my feet firmly planted in my room. I hear the birds and I find peace.

I know I am SAFE.

I have learned how to feel into my body to help it bring me back to the present and away from fearful thoughts.

I realize that there were behaviors that I engaged in during times of anxiety in the past, like pacing back and forth, that actually soothed my nervous system. Just as rhythmic rocking soothes a child. My body was wise and knew what I needed. When, years ago, the burden of my workload chained me to my desk and prevented me from movement, my anxiety skyrocketed and became almost unbearable. That was a clue, but at that point in my life, I didn’t know how to listen to my body.

Now I know what I must do to calm down and I allow myself to do it. But this change didn’t come about suddenly.

It takes PRACTICE.

Practicing mindfulness meditation when I am at peace allows me to build up the habit that carries me through difficult times. I practice daily. Somedays I can focus on my breath perfectly; other times I lose myself in thought shortly after I’ve begun. Regardless, I don’t give up. Even the “bad meditation” days are better than no meditation at all. Each session strengthens my mindfulness habit.

Every day. No matter what. It makes a difference.

Is It Metastasis or Menopause?

Ever get the funny feeling that something’s wrong?

Like things are a bit “off” but you can’t be sure? I’ve been dealing with that ever since I got off letrozole, an endocrine therapy for breast cancer with a reputation for being difficult to take.

As of this posting, I’ve been off letrozole for 117 days exactly–yes, I’m counting. I’m still shaking off side effects like stupid-crazy joint stiffness, but at least I can tell things have improved.

That’s not what I’m talking about here.

I’ve taken a few rides in the MRI tube already. Not in any hurry to repeat that.

Right now I’m having some “really intense” memory and focus issues. I’ve put “really intense” in quotes, because I talk in superlatives so that my concerns are taken seriously. It’s a bad habit, especially when speaking to an oncologist, because it’s a sure way to end up in an MRI tube. Again.

In the past, my oncologist suggested that my memory problems might have been related to anxiety and not the medications I was on. That’s quite possible, although it’s hard to tease apart “anxiety” and “med side effects”. I mean, simply being told you have cancer causes an immediate spike of the Stress-O-Meter. For someone as anxiety-prone as me, it’s like I’m constantly red-lining.

Now I’m off the endocrine therapy and my memory and distractibility seem to have gotten even worse. What I had before wasn’t like THIS.

It’s kind of like saying, “This hurts. I think I’m being hit on the head with a hammer.” But then you actually get hit by a hammer, and think, “WHOA, now THIS is being hit on the head with a hammer!”

If thoughts are beads on a string, my beads are dropping off at a constant rate, leaving me wondering what I was about to do three seconds ago. And getting distracted by shiny objects. Couple that with having to learn a complex new financial system for work (grrrrr, Larry Ellison), not having helpful documentation to do so and having to go through that while being mainly confined to my bedroom for over a year…yeah, it’s a mess.

I am not being rational and I know it. But I’m still on high alert and dialing my fears down is going to take time.

Because my breast cancer was HER2+–which has been associated with metastases to the brain–my anxious little self immediately thinks, “Wait, maybe this is cancer’s spread stealing my thoughts???” I think that I will forever be jumping to that as the first possibility.

That’s not completely unreasonable, either. According to “Medical News Today”, memory problems are listed as one of the symptoms of brain metastases, along with headaches, stroke, seizures, confusion, dizziness…okay not really experiencing any of those.

And the Mayo Clinic metastasis website asks: what are the most likely causes of my symptoms? So, I admit, a brain tumor probably isn’t, given all the other more likely possibilities: menopause, work stress, loneliness, lack of purpose…and *cough* listening to Twitch video streams while I’m trying to focus.

So really, these memory issues could be a completely normal effect of menopause, but in the cancer context the possibilities are frightening. It takes a lot of perspective to be able to look at what’s going on and realize that it’s not aberrant or dangerous. I feel like an idiot for jumping to the worst conclusions, but here I am…

It’s a survivor thing.

Mindful Games I Love: Meditating with “Playne”

I didn’t think I needed a video game to help me mediate.

In the description for “Playne” (on the Steam platform), the developer states that the game is designed to help you establish a meditation habit. While, I thought it would be uninteresting for someone who already had a solid habit, the reviews of the game were very positive and the concept seemed inviting, so I decided to give it a try.

After a week of meditation, saplings have emerged.

I had no idea that it would have such an impact on the quality of my meditation. While I often listen to ambiances (such as through the “MyNoise” app and website) and use guided meditations (“Calm”, “Insight Timer”) or similar auditory cues (“Unwind”), what I didn’t have was a visual representation of my meditation practice as it progresses over time. “Playne” supplies that.

“Playne” has three modes: Story, Sandbox and Evolve. This post is about the Story mode, as that’s the one most people start out with and the one I’m currently working on. Sandbox allows to you build your own meditation spaces and Evolve can only be unlocked after 100 days of meditation (I’m still in the 50s).

You have a small selection of meditations to choose from with the emphasis being on learning to sit with yourself.

The game starts out on a semi-barren island with only a tiny flame in a campfire, a stone lantern, several rocks and Sensei Fox to keep you company. There are both guided and unguided meditations to choose from and as you meditate everyday, the fire grows taller and seedlings sprout and grow. With consistency, you unlock different story chapters, which wise Fox relates, gain the ability to change the weather, and most importantly, grow the island into a beautiful meditation retreat. All it takes is patience.

There is a breath bubble to guide your breathing if you wish, and also a ring that serves as a countdown timer. Both can be turned off if they are distracting or unnecessary.

You are given the ability to chose the length and type of your meditation. In addition, you can regulate inhales and exhales (the length of which you can designate) with a breath bubble, keep track of your meditation time with a minute-ring, enable a journaling option (known as “thought pages”, which you can either keep or burn in the fire if preferred), and mark each instance that you become aware that your mind has wandered (as I enthusiastically wrote about here). There are different places on the island to meditate, and as you accumulate more days, you not only get more weather options to chose from, but also access to elements such as birds, fireflies, Aurora Borealis and butterflies. These are quite lovely and make your “Playne” even more inviting.

Be forewarned that there is the temptation to mark your progress and count achievements. I understand why, from the viewpoint of a game, this is necessary but it does go against the concept of mindfulness. On the other hand, I’m really looking forward to flowers and butterflies!

Now for the potential downside: As much as I enjoy all the offerings, there are a few parts of the game that seem antithetical to mindfulness meditation. The game keeps track of “effort”, you gain “achievements” and note your “progress”. As do other meditation apps/games, “Playne” maintains a record of your streak, and depending on your settings, if you don’t log in to meditate with “Playne” on a given day, you run the risk of having the flame in the campfire go out. While I know that this is done to encourage daily meditation, it is also somewhat problematic, as the whole idea of mindfulness is non-striving. I feel that too much emphasis on achievement in the context of a meditation practice goes against being mindful of the present.

Over 50 days into this, my Playne has grown significantly.

Being of a naturally competitive nature, I was reluctant to turn my practice into one where I would be clinging to achievements. Nonetheless, there are enough positives to this game, and it has benefited my practice so much, that I have been learning to let go. That in itself is a significant improvement!

Yes, it’s unlikely that I will risk breaking my streak, but that’s pressure I can live with.

Reservations aside, I am really impressed with the game. I will write about the Sandbox and Evolve modes when I get to them, and post more images as my “Playne” grows. Additionally, there is a virtual reality (VR) option that I am looking forward to playing with. For anyone starting out with meditation, “Playne” offers a solid platform from which to develop and maintain a consistent meditation habit.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

In addition to “Playne”, I am also using other mindfulness media on a regular basis (my favorite ones are here). That makes for a lot of checking in with electronics, unfortunately. I’ve gotten to the point where I meditate about a half-hour to an hour-plus every day. While it’s a priority in my life, there are days that it’s a struggle to find time for it all. Introducing “Playne” has added to this, and the last thing I need more of in my life is stress.

Sometimes I combine “Playne” with other apps to take advantage of the “Playne” ambiance while doing my favorite guided meditations. More recently, however, I’ve also used “Playne” as a way to emphasize unguided meditation, and that has allowed my meditation practice to mature and expand beyond the confines of a computer program and into the rest of my day. That is one of the greatest benefits of this program and the main reason why I have found it so valuable.

Endocrine Therapy: Getting to the Heart of the Matter

Looks like visiting a cardiologist after stopping aromatase inhibitors for breast cancer was a good idea after all.

The letrozole (aromatase inhibitor) that I’d been taking has been associated with cardiovascular effects, and since I was feeling progressively worse from the medication, I wanted to make sure that everything checked out okay.

With the improvement in surivorship comes an increase in the diseases that come about from cancer treatments. The longer people live, the more long-term effects take their toll.

It seems like the American Heart Association (AHA) agrees with my concerns. An April 26, 2021 statement by the AHA underscored the complicated picture of cancer treatments, in this case hormonal therapies for breast and prostate cancer. As stated in the article by Okwuosa et al. (2021) published in Circulation: Genomic and Precision Medicine, “As patients with hormone-dependent cancers continue to live longer, CVD [cardiovascular disease] has emerged as a leading cause of mortality and morbidity among survivors of these cancers.”

Ironically, breast and prostate cancers are some of the most common cancers in women and men, in addition to having some of the most effective treatments. The number is of breast and prostate cancer survivors is growing. Part of the success of treatment is expressly due to the development of hormonal therapies for long-term (5-10 year) use. At the same time, the increase in CVD problems is a result of this success, because as cancer survivors age they experience greater amounts of age-related cardiovascular events than do non-cancer surivors.

So, what do you do when the treatment that’s increasing your chances of beating cancer may also be increasing your chances of a cardiovascular event? Isn’t that one of the many problems with cancer? If your treatment works well, then that opens the door to having it work “too enthusiastically”, possibly with long-lasting negative effects.

It still comes down to healthy behaviors.

The AHA statement paper cited here stresses the importance of communicating with your oncological team about CVD risk factors and possibly requesting a referral to a cardiologist, having appropriate tests conducted (ECG/EKG, echocardiogram), and–in my opinion the most important thing the survivors themselves can do–modify lifestyle (diet, exercise, smoking cessation, etc.) to maximize your chances of a cardiovascular event-free survivorship.

While it may be frustrating to think of entering into an “out of the frying pan, into the fire” scenario with a potential leapfrog from cancer to CVD, nothing is written in stone. You can make an effort to protect yourself and avoid being a statistic. Focusing on healthy living will benefit you in many ways and is guaranteed to improve your life, no matter what your risks.

~~~~~~~~~~~~~~~~~~~~~~~~~~

Link to the AHA statement:
Okwuosa et al. (2021) Impact of Hormonal Therapies for Treatment of Hormone-Dependent Cancers (Breast and Prostate) on the Cardiovascular System: Effects and Modifications: A Scientific Statement From the American Heart Association. Circ Genom Precis Med,
DOI: 10.1161/HCG.0000000000000082

Link to a reader-friendly version:
People Taking Hormonal Therapy for Breast Cancer Have Higher Risk of Heart Disease, Monitoring Recommended, https://www.breastcancer.org/research-news/higher-risk-of-heart-disease-for-diagnosed-people-taking-hormonal-therapy

Grounding Through the Fingertips: Hand Steepling

Note: this is another grounding technique, by which I mean a way to retain focus on what is happening in the “now” rather than getting lost in memories of the past, which we cannot change, or succumbing to fears about what may happen in the future. It’s not a woo-woo magical technique. It’s merely being mindful about what is currently taking place so that you can respond appropriately and maintain your composure.

During acute stress, we need to bring ourselves back to the present quickly. By doing so, we are able to clear our heads of the “what-ifs” and “you shouldas” that cloud our thoughts at those times.

But what’s the fastest way to do that? For me, it’s definitely focusing on the fingertips. Each fingertip has approximately 3,000 nerve endings, more than any other part of the body (except the most intimate). When you touch something, all those nerves start firing.

You can take advantage of this sensitivity to ground yourself.

Channel Benedict Cumberbatch’s Sherlock and put your fingertips together.

This is what I do: I “steeple” my fingers (thumb against thumb, index finger against index finger, etc.) as if I were Star Trek‘s Mr. Spock contemplating a complex situation. The fingertip pressure immediately commands attention from my fearful mind in the same way that a boss displaying that hand gesture would command an employee’s attention. Taking deeper breaths, I rub my fingertips against each other in a circular motion. The movement enables the nerve endings on the fingertips to keep firing as the sensation continues. Or I can bounce my fingertips off each other, or keep them together but flex the fingers to create a pulsing motion.

Closing my eyes accentuates the emphasis on sensation and makes maintaining focus on it easier.

Yes, this seems so simple, but it’s also quite effective. By placing our focus on the fingertips, we take our attention away from more reactive parts of the body like the chest area, where the heart might be beating fast and ribcage expanding and contracting with rapid breathing. Feeling into those areas might only serve to reinforce the heightened emotions that we’re experiencing.

The hands lie further away from that commotion, and that distance between the chest and our fingertip sensations enables us, if even for a short while, to get some perspective. Think of it as the anxiety not being “in your face”.

We can use body sensations as anchors to help stabilize us through anxious times.

Sometimes, when I close my eyes, all I “see” is that sensation of fingertip to fingertip, as if it’s the only thing that exists. I can play with this, imagining that I’m holding something between my hands, and that the sensation I feel is actually the feeling of that object against my fingers. It can be a pane of glass or even a beach ball. It all depends on what my brain is willing to accept at the moment. It’s a relaxing mental exercise.

As with many things related to mindfulness, it’s helpful to practice this fingertip pose when we’re in a relaxed and meditative state to connect the sensation to a feeling of calm, enabling it to serve as an anchor when our emotional seas are rough. The more we practice, the stronger that association, and the more effective the grounding response when we use this technique in the midst of anxiety.

~~~~~~~~~~~~~~~~~~~~~~~~~~~

Fun fact: body language experts consider steepled fingers to be an expression of confidence. That might be the little boost you need when you’re navigating a stressful event!

Re-writing Your Life

When I look back at the past decades, I feel exhaustion sweep over me.

Negative events may seem like they’re never-ending.

Cancer was not the only negative thing to come up in my life. There have been quite a few horrible things that have taken place, and at times I get overwhelmed by the thought of them.

This is not where, at my age, I thought I would be, and that’s disappointing.

But I realized that part of this disappointment is the lens through which I view things. Granted, I’ve had my share of misfortune, but when my life seems to be sinking into bleakness, it’s time to do something about it.

This calls for a change in perspective.

So I have undertaken a project. I am writing out the story of my life, but with a slightly different bent: when I come across a negative event, I pause and consider whether I can find something in it to be grateful for. I write about how I overcame it, rather than how bad it was, or how unfair and so unlike what others have had to deal with. I place emphasis on the outcome to avoid getting mired in anguish.

A difficult person in my life? I’ve learned that I’m not responsible for their happinesss, only for my own. A disastrous financial situation? I’ve found that what I perceived as a terrifying outcome can be overcome, and there is a light on the other end and a path by which to maneuver through it. A frightening health crisis? I now know I have met head-on the most daunting disease I ever feared that I would have and somehow made it through treatment.

Re-framing your personal history, when you’re ready to do so, can open you up to a glorious new view of how powerful you are and what amazing things you have achieved in your life.

I am still here. Re-framing the bad stuff is work in progress and it’s not always easy to let go of my familiar, well-worn, negative narrative, but, yes, I am still here.

I’ve discovered that my life is a story of perseverence. There have been numerous hardships and it’s true they’ve left deep scars, but I am aware of how they may twist my attitude, which has removed some of their negative punch. While I may look around and wonder why things have gone a certain way, I also see what I’ve learned and how I’ve matured.

If you want to give this a try yourself, there are a few things to keep in mind:
This is something for you to undertake about your life, not to be forced into by another person, nor push someone else into.

This is not about looking through rose-colored glasses or feeling that your concerns are not taken seriously, nor is this a squelching of negative emotions instead of dealing with them. It’s a step to the side for a different view. This doesn’t mean that those events were not disastrous or those who perpetrated bad things don’t deserve punishment.

You have a right to be upset. You are heard.

Re-framing your life in this way means that you give evidence to the exquisite being that you are, and to the power that you have within yourself. If you feel as though you’ve been chewed up and spat out, be gentle and start slowly.

When you’re ready, invite healing by releasing the burden of negativity and, pen in hand, allow yourself to reveal your strengths.

Tripping Over Gratitude for the Little Things

“There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle.”

Albert Einstein

A few days ago, I was hurrying across the room to open the door for a workman who was coming to fix holes in our walls resulting from a plumbing emergency.

In our haste to make space for the workman, we emptied the contents of a closet (where one of the holes was) into the middle of the room that I was crossing, and as I scurried, one of those wayward closet inhabitants tripped me. I crashed onto the floor, twisting the joint of my left big toe and falling onto my right arm.

And this was after icing it as often as I could stand it. I’m a rainbow!

I tried icing, but I could easily ice only one body part at a time as I tried to work at my computer, and since I needed to be able to walk, the foot got preferential treatment. As a result, while the bruise on my foot looked terrible, I could put pressure on it and as long as I limped, was able to get around.

My arm was another matter. For the remainder of the day, I was wondering whether I had fractured anything. Rotating my wrist was excruciating, bending my elbow any amount was painful and even just having the arm hang down hurt like crazy. I couldn’t grasp things with my right fingers. The only non-painful position was if I supported my right hand with my left.

Why am I telling you this?

Because I’d written some time back about how I found it difficult to find gratitude for “little things” because doing so felt forced.

Well, that morning, I ate those words.

I remember the good old days when I could put on a sweater without pain. The opposite side of the elbow is equally colorful.

Because when I think back now of how wonderful it was to be able to open a jar of pickles by myself, or even raise a fork to my mouth, I get hit between the eyes with the concept of finding gratitude for everything.

I found gratitude for the fact that I fell on the carpeted floor and not onto one of my son’s tools (that he had left lying around — I need to talk with that boy), that I am still allowed to work remotely and can do so from the comfort of my bedroom, that we have a car with automatic transmission (no shifting!), and that we had enough bags of frozen veggies that I could easily rotate through as they thawed and keep icing.

The next morning, I experienced a tsunami of gratitude for feeling better, getting more mobility and being able to avoid a visit to urgent care. That one trip knocked some sense into me and reminded me that it is not nearly as difficult to fill my cup with joy for things I’ve been regularly taking for granted.

So, that trip I took helped me discover that I don’t need to wait for gloriously grand things to occur in order to feel gratitude. Multiple reasons for a grateful attitude are all around me, every day.

Clicking Back to the Breath

I’ve written before about being an imperfect meditator. There are days when the narrative running through my head is never-ending and refuses to be silenced.

However, I found something that helps while I was playing a meditation game called “Playne” (about which I’ll write in the future). One aspect of this game is that it allows you to mark the occurrence of a thought by clicking the mouse button.

As soon as you realize you’re not focused on your breath, you click the button, and the program makes a pleasant little noise.

The concept is similar to that of a meditation bell except you decide when the “bell” sounds.

As simple as this sounds, it has made a huge difference in my meditation practice. Not only does it help me recognize when I’ve drifted away, but that little sound is very effective at bringing me back to the breath. Instead of gradually floating back to breath awareness, I immediately wake up into the present moment.

It’s as if the sound plants a sonic flag at the point where realization hits and that speeds my return.

This is not unlike a meditation bell that sounds at regular intervals and invites you back into focus. However, the benefit from the sound in my meditation game comes from teaching self-awareness and presence, because I ring it when I myself identify the thought. In mindfulness meditation, we are taught to note the thought inside our head, but in my opinion, the sound helps it “stick”.

Over the past weeks, I’ve become quicker in releasing the thoughts and returning to the breath. The more I practice, the stronger the habit of regaining focus quickly becomes.

While it’s not feasible for me to hold all my meditation sessions within the confines of a game, I’ve found that there are other means of marking my thoughts. Clicking a retractable pen works similarly to the sound in “Playne”. The “click” is just enough to bring attention to itself without being disruptive

Something as simple as the clicking sound of a retractable pen can serve the purpose of noting a thought an d bringing you back to the breath.

Other gadgets that can work? Anything that delivers a distinct sonic note. Tapping a hard surface with the edge of a coin would serve the purpose. Or a hand tally counter that one might use to count people coming through an entrance. A quick search of phone apps reveals a number of tally counter apps if you don’t have access to the handheld mechanical device.

But it’s important to remember that the point of this is not to get obsessed about how many thoughts you had during a particular meditation. What you want is a little sound, like a gentle beep or click, to make you more aware of the thought.

Next time you are finding it hard to focus on your breath, grab a pen, a coin, open an app on your phone…even snapping your fingers may serve as your thought marker. It may be that little extra something that helps you back to the present all that more quickly.

Making It Through “Now”

My recent post, Just Show Up, about releasing the need to fight through breast cancer treatment, left out an important concept.

My cancer diagnosis was what I deemed the “worst-case scenario” from the viewpoint of everything that came before. The overwhelm was a tidal wave that caught me and spun me around. Disoriented, I struggled to breathe and find my footing, but it was too much and I was poorly equipped to deal with the news.

Taking on everything at once doesn’t help you keep it together, it tears you apart.

I went through the motions, stumbling through the appointments that now multiplied in number. There was so much information to wade through, decisions to make, upcoming treatments to fear.

Then a co-worker whose wife had been diagnosed with cancer some years before sat down with me and gently offered a valuable piece of advice.

I didn’t have to handle everything at once. Some the decisions could be made later. Each day would bring answers and more clarity. There was no need to load up on all the information. It didn’t help anyone get through these days, all it did was weigh them down.

The path through this entailed focusing on what needed to be done now, and then working on doing that and only that. Just taking that one easy step forward.

All that stuff in the past and the things to come, you can release them. Don’t carry that extra burden with you. Just focus on what’s happening now. And now.

Could you get through the last moment? Good.

Now just get through the next.

The Saga Continues…

I mentioned a few posts back that in addition to stopping letrozole (an aromatase inhibitor) which had originally been prescribed to me as long-term endocrine therapy for breast cancer, I saw a cardiologist. I was experiencing what felt like irregular heartbeats. Since arrhythmias have been associated with aromatase inhibitor use, I wanted to make sure that I wasn’t going from one problem to another.

The cardiologist I met with ran an EKG, listened to my heart and told me he really didn’t think I had any issues. However, he ordered an echocardiogram and a Holter monitor just to be on the safe side. I did both tests.

A week ago, I met with him to go over my results. He was pleasant as always, asked me how I was feeling–I was feeling great, actually, since I was pretty positive that I’d imagined any heart issues because I’d experienced little since I turned in the Holter monitor for analysis. So, if anything, I was a tad embarrassed for blowing things out of proportion. Geez, I’m such a hypochondriac!

That’s good, he said, equally pleasantly. “Because we found something.” Equally pleasantly.

Hang in there, baby!

I had not expected that. What I was expecting was, “everything looks normal.”

However, looks like there were some arrhythmias: supraventricular tachycardia and supraventricular ectopics.

My doc wasn’t concerned. He said that based on other data (72% left ventricular ejection fraction [LVEF]) my heart was healthy and strong.

Ooookay. But I was a little shaky that my concern about extra beats had been confirmed. Because I hate fearing that something’s wrong and finding out that I was right in fearing it! I’d prefer that it be all in my head.

Then we delved further into the echocardiogram. I shifted uncomfortably in my seat.

On the plus side, lots of things were normal. That’s good.

However, way back in early 2018, while I was receiving infusions of Herceptin, my then-cardiogram showed pericardial effusion (fluid where it shouldn’t be), but in a subsequent echo it had “fixed” itself. Well, that was back now. Also trace mitral and tricuspid regurgitation: my valves are a touch leaky. My cardiologist wasn’t too concerned about it. “Wear and tear,” he said.

But he also noted that I had a marginally “dilated proximal ascending aorta.” Right after which he noted that I was tall, suggesting that there could be error in the extremes. But neither one of us was 100% sure whether that was a change from the previous echo, based on how the report was written. And he questioned some of the values, saying that echocardiograms weren’t perfect or always accurate.

Get off one ride and right back on another.

At the same time, he wanted me to come back in a year for another echo. Just so that we can be sure that the dilation hadn’t progressed. “Then we worry,” he said.

I left the office with questions swirling inside my noggin and decided to do some computer research, which I immediately regretted.

First of all, “dilated proximal ascending aorta”, when googled, brings up a gazillion results about aneurysms.

ANEURYSMS.

I know I don’t have an aortic aneurysm. But I have to wait a year to see if the dilation progresses. That’s 365 nights of staring at the ceiling. And I have to make sure to remain calm and not harrass myself into elevated blood pressure, because that can put more stress on the blood vessel and dilate it even more.

Oh, and the supraventricular tachycardia and ectopics? Those are improved by exercise (um, yep, been doing that) AND by staying calm.

Try yoga and meditation, the websites suggest.

Okay, yep, been doing that too.

So where am I with all of this now? Obviously, I need to keep doing what I’ve been doing. But this really does underscore a couple of things:

1) Meditation and mindfulness are critical to our well-being. These are habits to establish now (yesterday!) and not stop. Ever.
2) Cancer casts a long shadow. You might be fortunate enough to earn the title of “cancer survivor”, but that doesn’t mean that it’s all giggles and rainbows afterwards. Cancer treatments are tough and while we’re furiously obsessed with doing whatever we can to minimize the chances of cancer returning (because that’s Job One), someone at some point needs to start thinking about what happens once the cancer is gone and we have to clean up after the long-term effects of the treatments.

Could my heart “issues” (I don’t know if they are serious issues yet) have been caused by Herceptin infusions, radiation to the chest and aromatase inhibitors? Yes, they could have. But could the fact that I am highly reactive and have a strong response to stressors played a role in this? Yes, of course.

Time is moving forward and I’m going to have to keep up.

And does it really matter? No, in all honesty it makes no difference. Whatever happened has passed. My only path through this is a calm heart and solid grounding on the Earth. I’ll know more about my physiological state in a year, which gives me another twelve months of daily meditation and exercise, and an even better appreciation of how my mind generates agony.

Maybe this is what I need to help me get better.