Anxiety – Page 4 – Frantic Shanti

“So, What Should We Talk About?”: My Six-Year, End-of-Chemo Appointment

A little over a week ago, I had another oncological appointment. This one marked my six years since completing chemo for triple positive breast cancer.

Honestly, at this point, the conversation between my doctor and myself has turned much more social. There are not as many pressing matters to discuss. My bloodwork is normal and boring. I don’t have side effects to speak of, at least not any that I can attribute solely to cancer treatment (hello, menopause, ugh). And even my oncologist is openly positive about my future.

Wow, have things changed.

Six years ago I was dealing with the effects of a nasty fingernail infection that landed me in the ER (be forewarned before clicking that link: it was pretty gross!). But for this appointment, I was asking my doc how HE was feeling.

Our conversations have become pleasantly mundane and I enjoy catching up with him. Also, I am panicking less.

As a cancer survivor, I do not like surprises. When my doc says to schedule an exam, I’m going to do it fast!

Much less. Even when I do lapse into micro-panic, I have accompanying moments of calm. That is a definite improvement. At the same time, cancer is cancer. So when my oncologist noticed that I hadn’t had a pelvic exam this year, he told me I needed it. And then before our appointment ended, he repeated that I should get one.

For a brief instant, my emergency alarms went off.

Maybe it was the fact that he repeated himself and seemed very serious about it. After six years of hypervigilance, I still get unnerved by slight shifts in tone of voice. I think that’s hard-wired in me, seared in via anxiety, even though my days of being a hot stress-mess are behind me.

It’s so tempting to wipe my hands off and pretend that everything is normal, but cancer teaches us that some nasty stuff might be lurking under the surface of, “I’m sure it’s nothing”. My days of innocent ignorance are gone.

So, yeah, I’m fine. Still no recurrence of a cancer in my breasts. Probably not anywhere else either. I’ll remain optimistic and look forward to seeing my oncologist in six months and chatting again.

But I’m going to schedule a pelvic exam soon.

Managing Expectations: A Reflection

As I sit at home waiting for the stormy remnants of what used to be Hurricane Hilary to pass by, a bit of reflecting…

There is a saying attributed to Buddha: “The root of all suffering is attachment.”

While there is much that can be and has been written about this, I’d like to bring it down to something very concrete in my life.

It seems so simple, this letting go of our expectations. But we humans are hard-wired not to do that!

One of the wonderful attributes that we as humans have is the ability to plan. Yes, that’s been evidenced in very clever animals, but humans take it to a whole new level.

Where that incredible gift fails us is that in the process of planning, our goals and expectations become very real in our minds, and if they don’t play out as we had anticipated…well, sometimes we don’t deal with the disappointment well.

For instance, in such situations I experience stress and anxiety. Others may react with anger and frustration.

Regardless of the outlet (whether handwringing or yelling), it’s safe to say that the outcome is not pleasant for anyone. And yet letting go is hard when we are really counting on the expectation being realized. Or perhaps even worse, when we get lost in thoughts of how things could have been.

Consider this scenario: let’s say that following a leak in our apartment and subsequent slow repair process, two months later our water-damaged kitchen cabinets haven’t yet been replaced.

But wait, I get word that the cabinets are coming finally coming in this Friday, August 25th and will be installed the following Monday (28th)! Expectation established! And it’s not a small one because most of our kitchen and the entire dining room have been sitting in the living room area for over eight weeks.

Oh, how difficult it is to sit with what’s happening in the present moment — we’re always looking to see what’s up ahead or somewhere in the past. The greatest peace I’ve ever felt is to simply be here.

WOW, do I want this to get fixed! We have a house guest arriving on Wednesday the 30th who is supposed to sleep in the living room. Weeks ago, when she arranged to visit, I was sure that all the repairs to our apartment would have been done long ago. But now, between the cabinet installation and her arrival, I don’t have a lot of time to clear out the mess and get everything back in its place.

I cannot let go of the need for everything to go smoothly. But while I’m struggling with the burden of that need, I’m simultaneously living through the stress of, “oh no, what if it doesn’t work out that way???”

So there you go, a double-whammy. All this because although I know better, I latch on to how I want/need things to be. Either expecting perfect success or total disaster.

Letting go will never be as easy to do as it is to talk about. But in my brightest moments, I am able to step outside the confines of my thinking, move out of myself and get perspective on the present situation, accepting that I cannot predict and shouldn’t expect too deeply. That’s when I experience the highest level of calmness.

And then, as will happen, I forget and sink back into my small, highly personal mind, where I once again cling to having things be a certain way.

From a Safe Distance

It’s hard to believe that six years ago I was a week and a half away from my final chemo infusion, in the thick of being a cancer patient with no idea of what tomorrow would bring.

Cancer survivorship used to be a whole lotta “looking over your shoulder” for the next thing to hit.

I also thought that I’d live the rest of my life, however much or little of it there was left, in fear, always looking over my shoulder to see if cancer was close behind. In fact, after my active treatment was over, I expected that my anxiety would increase because I imagined that whatever had triggered my tumor growth would again be unleashed and ready to attack my again.

And when I had to stop aromatase inhibitors early due to side effects, I envisioned even more terror because I wouldn’t have the medication’s protection anymore.

None of this suggested that I would have a very pleasant future. Either I would get cancer again…or I’d be consumed by worry over getting cancer again.

Reality turned out to be quite different.

The more (1) I practiced being present, coupled with the (2) increasing distance between my last dose and today, the easier it has become. Now, that might sound like a no-brainer, but it was news to me.

And I don’t know exactly when I turned the corner on my fear but it was probably after the worst letrozole side effects ceased and I was able to reflect on and accept that cancer happened and now I was moving past it.

It took years to get to that point, but it would have probably come sooner if I hadn’t convinced myself that I’d never get there.

And how are things different now? I don’t think of cancer every minute of every day. And when I do think about it, it doesn’t seem as daunting.

I realized this after meeting a cancer survivor who works at a store that I frequent. She revealed that she’d just received her three-year “all-clear”. The relief on her face was unmistakable.

And it struck me that I used to have that incredible sense of gratitude too. And I still kind of do for a short bit, but it fades quickly as I turn my focus to the rest of my daily responsibilities.

Yes, I am still seeing my oncologist twice a year, having annual 3D mammograms AND the occasional MRI, so it’s less likely that something’s going to sneak up on me. But the concern is no longer as all-encompassing because it doesn’t feel as likely.

Of course, I could be kidding myself. Even after six-plus years I know that every set of scan results is a door to either “no evidence of disease (NED)” or “we’ll get you in to see the oncologist ASAP”. So far I keep going through the NED door…and it keeps opening onto a bright day.

In the midst of taking things for granted, it’s nice to stop and think about that.

We’ll See What Happens…

As the saga of our building’s leaky pipes continues, this experience reminds me of some of the best advice I received for getting through my cancer treatment.

How could cancer relate to a plumbing emergency? In how I perceived the news and possible outcomes. My cancer diagnosis was terrifying because I had grown up understanding that the disease meant difficult treatment and a real possibility of death. Now that I was dealing with cancer, I was jumping to conclusions, driven by FEAR.

And the leak in our unit? That meant a huge disruption in our lives as workmen enter and our belongings are piled together. But even more so, FEAR of the future, as we didn’t know the extent of the damage and whether we’d be able to to keep living here.

Getting a first glimpse of restoration. Lost some ceiling, light fixtures and a lot of kitchen cabinets.

The thought of moving brought anxiety about higher rental rates, dealing with belongings after nine years in the same apartment, even simply fear of change and uncertainty.

But that best bit of advice that I mentioned above? I found that it applied well to this situation also. And it goes like this: don’t try to tackle everything at once; take it bit by bit.

When I was diagnosed with cancer, the experience was nothing if not overwhelming. So many new terms, treatment options, possible outcomes. It was too much to handle. Someone I worked with suggested that I deal with things on a day to day basis. Not obsessing about the future, only what I needed to get through for today.

This was not easy for me, as being FEARful came naturally to me. But I understood what he was saying, even if I struggled to actually follow this advice at the time.

As with cancer, so with plumbing. My mind had already “gone there”, struggling to afford another unit (this is an older unit with rent lower than other places around us), staying up day and night to pack. Ending up in an even worse situation with inconsiderate neighbors…

But reality was not like that.

Behold, the FORCE AIR 2000EC! This monstrosity is the heart of the asbestos abatement operation. The workmen couldn’t fit it back in their truck so we’re babysitting it for a couple of days. Also, it looks like it was built by orks, but that has nothing to do with anything.

Within a weekend we had moved much of the kitchen and dining area. And really overhauled our possessions — even something as complicated as draining our 20-gallon fishtank and relocating its inhabitants to my husband’s office was not as difficult as anticipated.

I had time. I had time to move things, I had time to reorganize, to declutter, to stop and think about what was next. I had time because it wasn’t all happening at once. Stopping and breathing and noticing all the space around gave me space inside my head.

Discussions with our landlady suggested that we would take it one day at a time. No one was throwing in the towel yet…

…and even if the worst case scenario happened and we had to move, there were other places that were available (all with air conditioning, which we don’t currently have), and the rental cost would have been similar to what we pay now. In some cases the places were newer and most allowed pets (!), which I’ve been longing for.

All of a sudden, things didn’t look that bad. The options seemed promising.

Taking it bit by bit gave back a sense of control. All those fears slowly fell away.

And now, I find myself hovering with acceptance. Not landing on an expectation that THIS or THAT will happen. I don’t know what will happen and I’m finding a comfortable place to simply hang here, not gripping or holding on or needing for anything to be different.

We’ll see what happens…

Mindfulness 101: Noticing the Qualities

The main reason why I started a meditation practice was because I had been diagnosed with breast cancer and was, to put it mildly, freaking out.

As a naturally anxious person, the diagnosis blew the roof off my ability to cope and plunged me into a nightmarish situation. Anyone who’s ever dealt with severe anxiety will tell you that nothing is more important than making it stop.

Over the years, my anxiety gathered enough power that it was able to blindside me. Cancer anxiety practically wrecked me.

When my radiation oncologist recommended mindfulness meditation, I felt empowered by the thought of gaining control of my runaway anxiety without the need for medication.

I was hoping meditation would enable me to sit in peace in the midst of chaos. But I imagined that as feeling no stress, as in, being numb to anxiety-provoking stimuli.

That simply doesn’t exist. I wanted to not experience any stressful situations, but there is always stress. We can’t change that. Mindfulness meditation was only going to help me change the way I reacted to it.

So here I am, more than six years after initally starting a daily meditation practice and guess what? I still have stress, I still feel anxiety.

However, what did change is that I can define it now. When I become aware of agitation and anxiety, I know to pause and bring attention to how it manifests in my body.

What does it feel like? Tightness, heat, rapid breath?

Where does it show up? Face, temples, chest, stomach?

Is there a color or sound or smell associated with it? Does it have a “texture”?

Does anxiety have an odor? Next time stop and take a whiff.

I can relax my muscles, sink into the earth, breathe deeply and notice the qualities of anxiety. By pulling apart what is happening, I slow time down. Instead of being hit by a locomotive full force, I walk around the train cars. I can notice how I feel as I pass through the experience.

Is it pleasant? No. Does it always work immediately? No. However, I can see it coming, and as a result, I relax into it. It is the awareness of the anxiety that helps me through it, not a numbness to it. This leads me to acceptance of the situation instead of bracing against it.

On one level, it’s a little discouraging to still be dealing with the unsettling nature of stressors. But I am heartened by the empowerment that mindfulness offers. I have evolved enough that I know I don’t have to go back to being thrashed by the whirlwind. I can sit inside it and watch it swirl and pass through. Every time I do this, it gives me more confidence for the next time.

Is this something that might help you too?

Things I Wish I’d Known About Breast Cancer, Part 2

This post continues what I started in the last post…a few things about breast cancer that I wasn’t aware of at the time of my diagnosis. Knowing the following would have made things a little less stressful:

1. Lumpectomy is a relatively uncomplicated surgery. I wish someone had explained this to me because I was a total wreck going into surgery (which happened to be the only surgery that I had ever had up to that point, making everything 10 times worse). Although I had decided against a full mastectomy, I was still so afraid of what a lumpectomy would entail, what I’d look like and how long it would take me to recover from losing a chunk of flesh.

The reality was…I was back at work the next week. No drainage tubes, no need for heavy analgesics — just a couple of ibuprofin the night after surgery because skipping coffee that morning resulted in a headache, but that was it. It was even hard to tell that I’d had my lump excised. Wish I could go back to my earlier self and tell her not to worry.

Stethoscopes are emotionless. Oncologists can seem to be too, but that’s by design.

2. Doctors are not in a hurry to give you good news. I think there’s a general feeling among medical professionals that there’s so much that can go poorly during cancer treatment that your doc isn’t going to go out of their way to pump you full of optimism. They probably practice keeping an emotionless face as they deliver all sorts of news, both good and bad. As a patient, however, I watched every flicker on my oncologist’s face for an indication of how things were “really” going. I feared that there was something he wasn’t telling me.

It wasn’t until perhaps a year or so later when I was expressing my fears to him about possible abnormalities inside my body that he uttered the phrase, “but you have your health”…and I was taken aback because I had never heard him sound so positive. It was almost a shock to hear him confirm that I was actually considered healthy.

3. Don’t expect things to be the same as before. Accepting that part of your life has changed will make it much easier to go on. This took me a while to appreciate because I was expecting to get back to doing and feeling everything the same as before my diagnosis.

But chemo (and eventually, age) pushed me through menopause, and I had to come to grips with, say, a high-intensity interval workout requiring more recovery time and that I had trouble remembering people’s names. Once I got to that point of acceptance, life after cancer treatment became easier, although it did take a number of years to get there.

4. Hair takes a while to grow back in. The reason I created posts with photographs that illustrated the cancer journey that my hair went through (here and here) was because I could not find good photos on the internet documenting the process. I did see images of a woman a few weeks after stopping chemo with little stubs already visible, but that was not my experience and it made my anxiety over my slow regrowth even worse.

Walking around with no hair was getting old and I was getting more desperate by the day to see evidence of sprouts!

If you’ve ever googled your chemo drug name + “hair loss”, you understand the fear: the first search result is usually a law office gathering info on behalf of cancer patients whose hair never grew back!

It took a number of months before my folicles woke up and actually started growing. I remember the moment that I finally saw growth on the front of my head and it was as if the heavens had opened up and divine light poured out onto me. Seriously. I would have avoided a lot of stress if someone had just told me that it’s gonna be a while.

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Ok, ok, to be fair, my oncologist did urge patience with the regrowth but I was a jumbled mess of nerves and was feeling overwhelmed. All the internet propaganda about both (1) other women having much faster regrowth, or (2) other women never getting their hair back terrified me. Note to self: when feeling desperate, stay off the internet!

“Detached”: Time-Out in Third-Person

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

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

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

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

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

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

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

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

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

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

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

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

Creating Space with Third-Person Language

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

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

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

Making space is good for more than avoiding viruses…

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

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

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

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

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

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

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

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

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

Just One Day

If you had one day to live, how would you live it?

I pondered this question last week as I was trying to calm myself down before teaching my first official public yoga class, while also juggling emotions about certain events at home over which I had no control. Read that as: anxiety.

And in the midst of this all-too-familiar emotional turmoil I felt myself being consumed by my thoughts. And yet, if I had only one day left on this earth, I can’t image that I’d let myself get mired in everyday worries. My perspective would immediately snap into a megawide view of everything that exists in the world.

Never was I so aware of every palm tree…

It would be easier to see the beauty everywhere. Consider this: when I returned to Southern California after four bitterly cold years in a Northern climate, I noticed every.single.palm tree. I was so aware of everything that I had missed during my years away and appreciated every ray of warm sunshine. Other cares temporarily fell away as I was filled with gratitude to be back.

If I had only one day to enjoy the world, I hope that I wouldn’t spend it lamenting over little things. I would sit with my face to the sun, smell the breeze, take deep breaths and appreciate the here and now. Accepting that I had only 24 hours, I imagine that I wouldn’t be ruminating about something a co-worker said to me in passing or how I really should be cleaning the bathroom more often.

So interesting that it would take facing the end of my days to begin truly appreciating them.

So how about this (and this was what I meditated on last week in the midst of nervous feelings), why not imagine the feelings of that last precious day every single day? Stop and feel into my feet on the ground and the air in my lungs. There is so much wonder all around us and what a pity that it takes a drastic event to experience a perspective shift.

It feels so glorious to be alive.

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Don’t get me wrong, the shock of knowing that your end is near could be devastating. So if you’d like to use this idea as a meditation prompt, perhaps consider if you were on vacation in a paradise-like location and if your plane were leaving in a day, how would you enjoy your remaining time there?

Finally Normal: My Six-Year Oncological Visit

I hit another cancer journey milestone this past week: my six-year oncology appointment.

Like my last few appointments, this one felt commonplace and unintimidating…and if the nurse had let me sit down for a couple of minutes after coming into the exam room, my blood pressure would have been lower. As it was, the reading was not that far from normal.

For the first time since cancer, my bloodwork is all normal!!!

One other thing that was strikingly normal: for the first time in six years, since all the cancer madness began, all my bloodwork, both Complete Blood Count (CBC) and Comprehensive Metabolic Profile (CMP), was completely normal. Nothing that would suggest a year’s worth of cancer treatment in the past.

This is so curious because for years, nothing felt normal.

Now everything is.

Ironically, it was my oncologist who was experiencing illness and I had to switch my appointment time so that he could get to his doctor.

I was hit by the realization that everything that had felt out-of-control and hopeless six years ago no longer existed. I was the one who had kept the idea of cancer alive in myself. I still defined myself as a cancer survivor because perhaps I needed some way to justify what I considered to be my shortcomings, as in, “I used to be able to do this, but…”.

This was a battle I fought in but only memories remain. In the present moment, there’s only silence.

Returning to the cancer center for this appointment felt like I was visiting a battlefield from a war that I had fought long ago. The echoes of battle cries…just the wind. The clashing weapons and falling bodies…not there anymore. This may sound like such an overly theatrical description, but that’s exactly what it seemed like.

This doesn’t mean that I’ve got the rest of my life figured out. There are still so many unknowns, including an increased chance of cancer recurrence — and I still need to schedule this year’s mammogram, something else that slipped my mind as I was basking in the idea of being “normal”.

But that tortured soul who, on top of all the other stressful things going on in her life, was hit with a cancer diagnosis…she doesn’t exist anymore. If I’m so unfortunate as to have the cancer come back, she won’t be experiencing the aftermath.

I will. And I feel like I’m so much better equipped to handle all that uncertainty than she ever was.

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I still call myself a cancer survivor. But it’s only one of a long list of “skills” that I have on my resume.