Another Oncology Appointment…and What’s Up With That Smell?

My oncologist appointment last week marked five years since completing my final chemo infusion (and for those of you keeping track, since I had that nasty chemo nail infection).

Lately, my oncological appointments run like this: my onc asks how things are going, I air all my grievances and we spend the rest of the visit agreeing that there’s no way to determine whether what I’m experiencing is chemo-related, menopause-related, or something that I was dealing with before but hadn’t paid attention to back before cancer.

Because there’s nothing like cancer to make you acutely aware of every twinge and creak in your body.

But that’s about it. We are running out of things to talk about. In this context that’s a good thing.

I used to lament “what could have been” had I not gotten cancer, not experienced chemo, not been pushed into menopause chemically and artificially had my estrogen levels squashed. But now, I know better. What happened, happened. And “what could have been” is pointless to ponder because it simply isn’t reality.

It took me a while to get to that place and I’m finally okay with it .

But there was something else different about this oncology visit…

I walked into the cancer center for my appointment and was hit with “the smell”. There is a distinct scent in the building, possibly the cleaning solutions used to disinfect the place or maybe a fragrance that is purposefully pumped in. I had mentioned it to my clinical counselor several years ago and she admitted that a number of people have said the same thing. The smell is familiar, given that after multiple appointments and infusions and radiation sessions, I’ve experienced it a lot and have made many associations with it.

But for some reason, this time it hit me hard and a wave of sensations washed over me. Not sure why my reaction was so strong, but I’d like to think that between my last onc appointment and this one, I’ve made the most progress in distancing myself from the frustrations of getting cancer and have actually moved on with my life.

However, that rush of emotions served as a reminder of everything that I’ve been through over these past five years. I thought that chemo was going to be the hard part. Turns out, it was the most predictable part: six trying infusions, but they came with an end date. The rest of treatment brought uncertainty and unexpected difficulties. I thought I was done after radiation…but the pills continued.

Looking back at this, while I’m technically not “out of the woods” and may never be, these last six months have felt different. Yes, I still have another onc appointment half a year from now, but I’m finally turning my face forward to the future instead of constantly looking back at the past, worried that those frights will catch me again.

Showing Signs of Stress

One of the benefits of doing a yoga teacher training (YTT) is that there are some interesting side effects that go far past learning about yoga instruction.

It also involves a great deal of introspection, sometimes uncomfortable, but always valuable.

Signs of stress are pretty universal and usually unmistakable.

What I found curious about myself was how, when I was stressed, I exhibited loads of visible signs of stress even if I was aware that I was doing it. It was as if I didn’t want anyone to mistake me for not being stressed when I was.

This made me wonder, was it simply habit? Or was I being a drama queen? Stress does affect me deeply and anxiety is hard for me to shake. It’s possible that I feared not being believed that I was suffering.

Perhaps I needed people to care that I was not okay.

But I came across a recent research article about this that suggested an even deeper reason. UK researchers Whitehouse et al. (2022, Evol Hum Behav) conducted a study in which it appeared that individuals displaying signs of stress came across as more likeable and more likely to elicit support from those around us.

This is curious because often in nature, showing “weakness” may result in a greater chance of being attacked. But apparently it doesn’t work this way in human society. The researchers postulated that signs of stress suggested that the individual might be deemed friendly and not a threat.

I can attest to the fact that seeing someone displaying anxiety immediately triggers a strong empathic response in me, no matter who the person is or what they’ve done. Having suffered anxiety myself, I am immediately drawn into what the individual might be feeling, projecting my own feelings onto them.

Yeah…don’t be this.

And it is very true that I’ve often gone out of my way to look more friendly, less scary, particularly when it comes to people smaller and weaker than I am (I’m 5’11”). I have a drive to appear less threatening. However, this does not necessarily benefit me–does the term ‘doormat’sound familiar? When you lower yourself far lower than is even remotely necessary, you’re not doing anyone any favors.

This explains a lot about my own life and it underscores the importance of being aware of your behavior and why you engage in it. When you run on autopilot you risk reinforcing negative self-beliefs and even generating new ones. Self-awareness is the antidote to that.

So that is what I’ve been musing about. YTT provided me with space from which to reflect on the ways that I behave and feel in certain situations. In turn I can use that information to make much needed changes in my life and get myself unstuck. How about you?

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Original research article:
Whitehouse J, Milward SJ, Parker MO, Kavanagh E, Waller BM (2022). Signal value of stress behaviour. Evolution and Human Behavior; DOI: 10.1016/j.evolhumbehav.2022.04.001

Reader-friendly version:
https://www.sciencedaily.com/releases/2022/05/220515113229.htm

Yoga Is For Every Body

As my interest in and personal practice of yoga has increased, I’ve noticed something peculiar about images of yoga. They send a message that you have to be young, slender and unnaturally flexible to be a “real” yoga practitioner. That seems daunting to anyone who doesn’t fit that mold.

I noticed something similar after I became certified as a personal trainer. I myself loved the feeling of strength and freedom I got from exercise; however, many people I spoke with were reluctant to go to a gym because they felt they needed to be in a certain physical condition before they even started. At the same time, they were daunted by the idea of striking out on their own. Even worse, in personal conversations with experienced exercisers and even other trainers, I found many would poke fun at those who were just starting out.

Come on, everyone has to start somewhere. An expert is just a beginner who stuck with it.

This is unavailable to me.

I thought yoga would be different, given the emphasis on one’s inner state. But I had to get over my apprehension about trying to fit an older creaky body into the unbelievable positions modeled by the yoga teachers I saw online. It was daunting. While I still felt strong, I seemed to lack that which yoga demanded. There were many poses that my old injuries and life-long inattention to flexibility would prevent me from doing.

I mean, google Flying Dragon pose and you’ll see why. Heck, it doesn’t even have to be as exotic as that. Go to Pinterest and search for yoga images – the results seem almost outrageous, with every yogini outdoing the one before them. Is that what we’re supposed to aspire to? I don’t see anyone even close to my age. Are they all in physical therapy? Or traction?

My spine doesn’t bend like that.

This is more my level: still challenging, but quite doable.

But this is yoga, right? There are quite enough poses that most everyone can learn and use to build a regular yoga practice, no matter what the images on the Internet suggest. More importantly, there are modifications for whatever your own body will allow. Can’t put your forehead on your knees in forward-fold? Then how about a ragdoll variation. Guess what, it’s still yoga.

That doesn’t mean that what those super-bendy instructors are doing isn’t impressive. But I view them much as I view someone free-climbing Yosemite’s El Capitan. With awe and admiration for their abilities. And then I delight myself by finally being able to touch my toes again, thanks to my yoga practice.

Musings from a Lockdown State

If there’s one thing that the COVID-19 pandemic has illustrated, it’s that all of us on this planet are inextricably interconnected.

In times of disease spread, this may seem like a bad thing, but it’s also an opportunity to pause and reflect that no matter where we live, we all belong to the same species. We are all vulnerable to the coronavirus, no matter whether someone is a high-profile lawmaker, a movie star, a famous athlete or the custodian at an elementary school.

So this is similarly a good time to think about the importance of sharing resources and considering the common good. I’m looking at you, Ms. “I’m-cramming-three-packs-of-toilet-paper-into-my-cart-even-though-the-limit-is-one.” C’mon, don’t be like that. Leave the stampeding to cattle herds. And the rebellious college students who feel the right to crowd beaches for Spring Break celebrations? Time to grow up.

We should be above that. And I believe we are.

As many hiccups as there have been, communities are adjusting to the changing situations at a breakneck pace. My university has ordered all “non-essential” personnel to work from home, within a week, we scrambled to move meetings online and eke out a research plan. Likewise, university courses are transitioning to an online platform, as is my kids’ high school. Restaurants have switched to take-out wherever possible. And my daughter joined her fellow fencers for a ZOOM training session with their coach last night.

This is not to say that this has been effortless. My daughter will probably lose her restaurant job, which means that she won’t have the income to continue fencing, as the classes are a financial burden on our family. But she has a place to live, food to eat and incoming college acceptance letters. Others are losing their livelihood and looking at a far bleaker future. Many of our favorite small businesses are suffering. Therefore, as much gratitude as I have for the ability to work from home and not face immediate financial consequences, I have great compassion for those who are struggling through what could be a long and difficult situation.

Blink and the numbers increase…

And this isn’t even counting the number of infected individuals, some with severe complications. These days, “hot spots” are less about internet connections and more about loss of life. Few saw this coming and we won’t see the end of it for some time to come. My heart goes out to COVID-19 patients, their loved ones and the uncertainties they all face.

At the same time, I’m concerned about a group with which I’m more familiar: newly-diagnosed cancer patients. Getting a cancer diagnosis is frightening enough; getting that diagnosis when the treatment for the disease puts you at significantly higher risk for succumbing to a global pandemic is unimaginably unfair.

This is painful, so I look for the bright spots in the world: the clothing designers distributing patterns for people to make their own masks so they don’t compete with hospitals for supplies, and the designers making gowns, scrubs and face mask covers for doctors; the local seamstresses who are firing up their sewing machines and using their skills in the same way; the alcohol distilleries and perfume producers who are switching to making hand sanitizer; the millions of dollars raised to support intensive care units. All this gives me hope that we are bigger than the virus and we’ll pull ourselves out of this.

Passing Days One Pill at a Time

I have beside my bed a 7-day pillbox. Since I avoid taking pills whenever possible, opting for alternatives to medication, there is only one lonely but mandatory pill in each little box corresponding to the day of the week.

That’s tamoxifen, a final remnant of breast cancer treatment that I’ll be taking for years to come.

I observe the passage of time by the disappearance of the daily pills. They mark the days that I work and the days that I don’t (weekends and Wednesdays). Sunday mornings the pillbox is full. The work week looms before us bringing early mornings and sleepy heads. Wednesday provides a brief respite with an extra hour of sleep and a day crammed with personal errands at home rather than office work. When Thursday rolls around and I return to my job, only the Friday and Saturday pills are left until it’s time to refill the box again.

Days melt into weeks, weeks into months. Make them count.

The weeks seem to go by more quickly as I get older. Time feels slippery and days fuzz into the background. Weeks pass into months as pills are consumed. I’m unsettled by the possibility that when my decade of tamoxifen ends, I’ll realize that I spent ten years waiting the pills to finish and missing what was going on in the moment. It frightens me into wanting to distinguish this week’s row of pills from the next, to make next week different from the last.

I pause as I plop a fresh row of pills into their designated boxes. Could I be kinder to those around me? React more calmly? Sleep better? Support the needs of others more? View my shortfalls with compassion?

Every morning I am able to get out of bed and place my feet flat on the Earth. That is something to be very grateful for, no matter how difficult my week. I represent the fortunate ones who have been given the opportunity to remain alive and present in “now” and appreciate every precious day more than the one before.

Survivor’s Guilt and “Noel”

After posting about missing the “downtime” of chemotherapy, I need to talk about how much of a privilege it is to be here writing that. I get to reminisce about the positives of being allowed to have no other job but to rest and recover.

Sometimes I complain about chemo brain, sometimes I wonder why *I* got cancer when those who take worse care of themselves seem to get off scott-free. I’ve left the initial fears about death behind me. Yes, my cancer may come back, but right now I’m in a good place with a good prognosis. My reality is that I will be able to enjoy this holiday season and focus on being with family, feeling physically healthy and “normal” again.

I have friends who are currently going through treatment. And you can bet that they would give anything to not have to be there, in the same way that I would have when it was happening to me. Some of my friends may eventually get to the place that I am now; for others, this may be the last stage of their lives.

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“All we have to decide is what to do with the time that is given us.”   ~Gandalf, The Return of the King

This is not lost on me. In fact, it’s something that I think about a lot. As we approach Thanksgiving, I am very grateful that I’m doing well, not even a full year after completing my last treatment. In addition to my gratitude, however, I carry a lot of guilt. One in eight women will be diagnosed with breast cancer during their lifetime. And many will be diagnosed with other cancers or other life-threatening illnesses. At any given time, there are so many of us going through the shock, fear and psychological and physical suffering of various treatments. How can I complain about my lingering discomforts when I have the pleasure of being here and experiencing them?

There are many things that could have been worse for me. But they weren’t. The more time that passes, the less I worry about why I got cancer and wonder more why I am one of the fortunate ones. As difficult as it is to put my cancer experience behind me and move on as if nothing happened, it’s even harder to do so knowing that I am leaving behind others who will not make it.

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I’ve met a lot of fellow cancer patients in the infusion room, some with metastatic cancer. There’s one in particular I cannot forget. I’ll call her “Noel” since I met her heading into the 2017 holiday season and her mother privately told me that she wasn’t expected to survive past Christmas. Noel was a friendly and sweet woman with aggressive breast cancer. We chatted about hair regrowth as mine was just barely beginning to come back, and she shared with me Facebook photos of what her hair looked like after her first breast cancer treatments were completed. Eighteen months later, the cancer had returned with a vengeance. Noel was divorced with two pre-adolescent daughters. Her mother told me that as Noel’s situation deteriorated, it also devastated her daughters, who were witnesses to their mother’s decline. Luckily, their father was very supportive and provided as much care and love as he could.

I was heartbroken as I left the infusion room that day. I don’t know ultimately what happened to Noel, although I expect the worst. Cancer is a horrible beast that ravages the patient, but also takes the family down with it. I think, “What a blessing to not have to go through that.” But that thought catches on my conscience. I’m still here; do I deserve to be?

Recounting this story a year later, that guilt weighs even heavier now. I feel an obligation to make good use of the time remaining.

Memories of Blood, Sweat and Tears

There are some odd memories from my chemo experience that stick in my head. It was such a jumbled, frantic time when I was struggling to get a handle on what I was dealing with. I was going through my first few courses of chemo when my daughter was diligently learning the dance steps to K-Pop group BTS’ song, Blood, Sweat and Tears. Lying on the couch in the living room as she followed the dance practice video, I became involuntarily familiar with the song and its accompanying dance moves. Because of the frequency with which I heard the music, I was convinced that either I was going to love it — or would get nauseated and anxious whenever I heard the opening bars.

I never developed an aversion to it. In fact, it remains one of my favorite music videos. Any associations that I have with the song also include knowledge of having endured the chemotherapy medications and emerged on the other side of treatment. That positive perspective gives me a feeling of accomplishment. I can watch the video without any “baggage”, which is a feat for things cancer-related. The surreal nature of the video, coupled with the fact that most of it isn’t even in English, reflects my disoriented state during treatment: colorfully dreamy, occasionally inexplicable and an escape when reality became “too real” to handle.

Cancer As Divine Justice?

It’s disappointing that I feel the need to post this disclaimer, but I would be heartbroken if someone misinterpreted this post to suggest that people with cancer are being punished by God, the Universe or whomever, for something that they’ve done. THIS IS NOT THE CASE and this post is not to be twisted into a perverted view of divine justice. I hope that’s clear.


One thing that I’ve grappled with throughout my cancer experience has been the WHY of it. I don’t like uncertainty and when I looked at the risk factors associated with getting cancer, there was no reason why I should have been saddled with this disease. Yes, I realize that life is not fair, and that these things happen for reasons that we don’t understand. But when you’re in the thick of diagnostics and treatment plans and all that good stuff, you don’t think clearly. Ultimately, there is a reason, but science has not progressed enough yet to provide a definitive explanation.

So, when science can’t answer, we turn to more primal explanations. Being a Catholic, I couldn’t help but think that this was some sort of divine justice. You’ve heard of Catholic guilt? On some level, I carry around a lot of it, more than my share. It’s propelled me to be as exact as possible in all things. When a police car drives by, I fear that I’m doing something wrong. I follow rules. I don’t lie. I keep my promises and hold secrets close. I care, perhaps a touch too much. In effect, I drive myself up a freakin’ wall.

Things had been going well, physically. At 50, I was strong, fit, remarkably healthy and free from a lot of the ailments that many women my age complain of. I had no weight issues, no food issues, loved to exercise and was so happy about that. My lifestyle supported good health and longevity. But then – WHAM! – cancer diagnosis. Maybe I was too happy? Perhaps I was smug? Catholicism makes a big deal of intention, as in not thinking bad things. Whether or not this is actually practiced by members of the faith is a different issue altogether, but that’s the idea. So I immediately thought that perhaps I wasn’t humble enough about my physical state? Despite the fact that I had truly worked for it, avoided indulgences like sugar and alcohol, pushed through discomfort to exercise, maybe my thoughts had brought on some sort of divine anger, and cancer was going to put me in my place.

That’s what I thought. And YES, I am a well-educated individual who understands that mutations in the DNA occur frequently, and the body takes care of them. But mine didn’t, so any reason that seemed to make “sense”…

Even then, I am not so arrogant to garner the attention of a deity. These days, there’s quite a bit of that going around, and I couldn’t hope to compete with the obvious examples that we see in political and entertainment spheres. So it really doesn’t make sense that I would get cancer for that reason. In that case, was my confidence in my good health particularly egregious and insulting to a divine power that I would get singled out?

These are the kinds of thoughts one has in the middle of the night when one has mixed up the order of their anti-nausea medications while that the body is fighting the effects of being slammed by an elephant-sized dose of chemotherapy.

Regardless, the thought processes continue…

Maybe this went so much further than some kindergarten-style retribution? Another cancer survivor had related that the disease was the best thing to ever happen to him. In the middle of chemo, I had a hard time appreciating that. But as the end of treatment started coming into view, I began to grasp what he meant.

Of course, being Catholic, my head went to…maybe this is some sort of odd divine blessing? I have no doubt that God has a sense of humor. I imagined him being bored and seeing me through a break in the puffy white clouds and – ZAP! – I get cancer while he runs and hides behind St. Peter, giggling. So maybe I was being pranked, but in a loving, benevolent kind of way?

Truly, this cancer experience has given me a lot of direction, a sense of purpose that I had lacked. Admittedly, this is imbuing an unchecked genetic blip with a whole lot of divine power. But take the God-figure out of the equation and look at it again. Choose your interpretation. Some random mutation? Or an opportunity to redirect my life in a positive way that benefits others?

Isn’t the latter a far better choice?

So, I’m Still Alive. Now What?

I spent much of 2017 focused on death and how to avoid it. When you’re smacked with a cancer diagnosis, time slows down. You only see as far as the next test results, holding your breath for a week at a time until you get news, followed by the next suggested steps. Your life becomes an “if-then” flow chart. Finally you get a concrete treatment plan, but that also limits your view of the future. Treatments are like stepping stones across a foggy river. You know the other side is out there, but you can only focus on the step in front of you, and for good reason. These are the most labored steps that you’ve taken since learning to walk. The process is exhausting, and wishes of “You can do it, you’re a fighter” are received with reluctance. Honestly, you don’t want to fight anymore. You want it to end.

Eventually it does. You’re done with treatments and have to deal with a future of ambiguity. The stepping stones then become scans and the space between them widens, allowing normality to seep in. Lingering side effects become fuzzy annoyances. Some days you forget you were a cancer patient. Having your hair grow back helps – a bald head is a constant reminder, but as the hair comes in, you look less chemo and more sporty. “Cancer” ceases to sound like a terrifying death sentence. Distance gives you perspective. You move forward.

And now…what? You are not the same person. Maybe it’s the fear and anxiety, maybe it’s the chemo drugs, maybe it’s the weeks of daily radiation, but something inside you is different. I describe it as a nagging urge to find a new dimension of life. Perhaps it’s another version of searching for my “why”, but it’s not a big leap to convince yourself that there was a purpose to your journey that goes beyond just the treatments. There is a feeling of inner wisdom that needs to be expressed. The most difficult part is figuring out how to do this in the time that you have left on this earth.