It feels like it wasn’t all that long ago that I had my five-year 3-D mammogram…and here I am with my six-year scan.
I’m writing this prior to the scan and will follow up with the results at the end of this post, but I find it useful to write while I am still experiencing the little uncertainties that come with scans. Like a Schroedinger’s-esque situation, I am both a cancer survivor and a cancer patient right now, since no matter how small a chance that another tumor will be found in my breast, survivor and patient are my only two possible modes of existence.
For my own sake, I try to release all expectations at this time. I don’t want to relax and tell myself that I’m sure that the scan will be clear, because the drop down from that back into “cancer patient” state would be too fast and steep, so I breath deeply and anticipate nothing. But that’s hard to maintain.
At the same time, just a few weeks after seeing my oncologist who skillfully performed a clinical breast exam and found nothing, it’s very unlikely that a mammogram would bring up anything life-changing for me at this time. In fact, if anything were found, it would be a tumor in its nascent stages that would be much easier to treat than the one I had in 2017. Or so I tell myself.
To be frank, it’s not locating another tumor in the breast that constitutes the scariest scary outcome. No, it’s the not finding a tumor in some other part of the body — perhaps a lone sleeper cell that evaded chemotherapy’s effects and circulated through my body before grabbing onto a vital organ and silently beginning to grow.
That’s the real bad news…but it would not be the news I’d get today.
This brings me back to that situation that all cancer survivors face: accepting that there are no guarantees.
For the next hours before my mammogram I will focus on work, think of nothing to do with cancer and take deep conscious breaths. As I sit in the waiting room I will gently distract myself, submit to the squishing of the scan and hang in the stillness of the present moment until I get my response…and hopefully go on for another year. Maybe.
So, I’m back now with the outcome that I was both hoping for and (to be honest) expected: All clear for one more year!
And even though I always play it cool before and during the scan, the difference in my state is really noticible after I get the thumbs-up sign. Those minutes of sitting and waiting for my results [note: as a cancer survivor, I get my answer on the spot, which I really appreciate] are a little uncomfortable — I float, trying to focus on my breathing. But to this day, even when I’m “not expecting bad news”, I cannot shake that tickle of unease.
And that’s just another part of being comfortable with being uncomfortable. Still working on it…
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.
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.
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.
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.
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.
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.
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.
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.
The doctor’s office didn’t leave a message.
And that’s when I officially tuned out the meeting. A flood of possibilities came rushing in. My boss needed to talk to me but I was trying to suppress the growing urge to call the doctor’s office immediately.
The urge won. I called and left a message and went back to work, but my head was elsewhere.
The fact that there had been no message was extremely unsettling, because it made sense that if there were really bad news, the office would want to speak with me directly instead of leaving a voicemail.
And my reaction shouldn’t come as a surprise, because having been hit with a cancer diagnosis before, I’ve become hypervigilant. Like it or not, my brain wants to prepare for the worst so that I don’t have that horrible fall from thinking that everything’s just peachy to slamming into a nightmare.
It doesn’t help that I’ve read sooo many stories of women talking about being completely blindsighted by frightening diagnoses, and all of them saying that they thought nothing of the missed call from the doctor since they knew they were perfectly healthy, blah blah blah.
Of course, I know better than this. And at least I was aware of the hypervigilance, aware of my body’s reactions and aware that I was blowing things out of proportion. But it’s that uncertainty that is so difficult to take. Even though I know my response, I know why it happens and I know that chances are everything is ok…I want that certainty.
As it turned out, the call had come from the nurse assistant to let me know that my blood work results had come in. This was a relief, although I admit I considered it a defeat that I couldn’t be mindful and breathe through it all.
Then again, as a cancer survivor, I need to cut myself some slack. Getting slammed with a devastating diagnosis once leads to understandable echoes, no matter what test results I’m waiting for.
For now, I’m calm. Of course, my actual Pap smear results aren’t in yet. Those should come tomorrow or the next day. The nurse assistant told me that they’ll probably be normal (OMG, how can anyone say that????) and they’ll be loaded onto the patient portal…unless they’re not normal. And then they won’t be.
Guess whose heart will be fluttering for the next few days?
Not mine, because I’ve got it together.
To be fair, I didn’t totally freak out over this. But scanxiety over test results is getting a little old, honestly…
I had an oncologist appointment last Thursday that marked four years of being done with chemo for breast cancer.
During my previous onc visit in February, I had been a mess: depressed, stressed and miserable with joint pain and a feeling that my endocrine therapy was taking away from me more than it was giving me. At that point, he let me stop the aromatase inhibitors.
Now, half a year later, I felt so different. My blood pressure was 118/83, much lower than the 130s and 140s systolic numbers I was hitting after stepping into the exam room on previous visits. I was peaceful and more hopeful.
We discussed all sorts of “survivor” things. The joint pain had mostly resolved itself and was no longer a hindrance to exercise, one of the things most important to me. My libido could have been higher and my short-term memory was often lacking, but he felt that could also be attributable to working and sleeping in the same room for the past year and a half, coupled with menopause.
Finally, my doctor noted that it was time for another chest MRI. Not the most comfortable of scans, but I’d done it once, I could do it again.
It was not until around noon of the next day that I suddenly plunged off a cliff. I was talking to my daughter and randomly mentioned my willingness to look after any pets she might have in the future when she’s living on her own, were she to travel for work, because where we lived now we weren’t allowed to have pets…
…and I was slammed by a massive wave of sadness and regret.
My thoughts zoomed back to my first chest MRI, stripped to the waist, lying on my belly, arms stretched over my head, frightened and painfully vulnerable. All my focus was on breast cancer and what other horrible realities the MRI would reveal. All I could think of was surviving my upcoming treatments.
That MRI meant that my life was on hold. There would be no progress in my career for the foreseeable future, and no chance of moving into a bigger place, one that would allow us to get a cat (note: I’m a dog person, but I would have been happy with a cat!). Animals have always been a part of my life, but our apartment rules prohibited them. I yearned for the chance to have a pet again. It seemed such a small thing to ask, but even that wasn’t available to us now.
That brief discussion with my daughter underscored a profound feeling of loss and despair. Cancer had robbed me of a lot of things in my life that others took for granted.
And as I sat there in the depths, I forgot that time does not stand still, things are always changing, nothing is permanent…and I have inside me everything I need to climb out.
Curiously enough, I had recently attended a talk on managing anxiety aimed at cancer patients and survivors. The counselor who presented the information was herself a breast cancer survivor and she told us a story of doing a follow-up chest MRI, which she found very stressful. Afterwards, she was asked by one of the cancer nurses what sorts of mental tools she had used while in the MRI tube to calm herself down. At that point, she realized that even though she taught these techniques to her patients on a daily basis, she had completely forgotten to use them herself!
I had been sitting in the darkness for a few minutes when I remembered her story. Most importantly, I remembered that I didn’t have to feel this way, that it served no practical purpose and that I wanted be happier. The only reason I felt like this was because these emotional plunges had been a habit of mine.
So I twisted a rope out of all those grounding techiques that I’ve posted about and pulled myself up.
True, I still didn’t have a cat. But I was able to take a deep breath and realize that at least I had a future. And that future might contain a cat.
If there is a time that I’m going to feel anxiety, there’s a good chance it’ll be during my yearly mammogram. This year it came around the same time that my oncologist gave me permission to stop letrozole (and there was stress preceeding that appointment), but also great fear associated with my perceived cardiac arrhythmias, for which I have several visits with a cardiologist lined up.
To top that off, a family stressor followed on its heels, which I won’t go into but one that portends difficulties in the future. This last anxiety-provoking event used the previous stressors as a springboard and exploded into something even bigger. I was primed for anxiety and it took me for a ride until I found the traction to dig my heels in and slow down.
The worst part is, none of this stuff will simply go away.
Often, when people speak of anxiety-provoking events, they’re described as stressful things like a tense meeting with the boss or college finals or tight work deadlines. Admittedly these are all nerve-wracking, but they are also time-limited.
Then we have something like cancer.
I remember listening to a talk about anxiety where the lecturer tried to give the audience perspective about what was really going on, and he asked: what’s the worst thing that could happen? “You’re not going to die,” he assured us. And it’s true: let’s say that you fail all your final exams, but you’ll survive, even if you have to retake the classes.
Cancer survivors can attest to the fact that we suffer a different flavor of anxiety. There is no deadline on our stresses. They are thick and cling to us, like caramel sauce on the inside of a coffee cup, thinned by the passage of time, but leaving a film on our lives. Our hope is to get past the two-year mark, then five. Ten, if we’re so lucky.
Often, we hear about the success of treatments only to realize that the success is based on the majority of patients lasting until the end of the study, which might have been only five years.
Having someone tell you that you have a 95% chance of surviving five years is, well, underwhelming, especially for those of us who had premenopausal breast cancer. I mean, yeah, I HOPE I can last five years.
So, what to do? If there were ever a time to practice non-attachment, this is it. For some of us (present company included), it is excruciatingly difficulty to release expectations–I want, even NEED, to be assured that everything will be okay and then rest easy with that.
But I promise you, clinging to the desire for things to be different only causes suffering. It also robs you of the joy of what you are experiencing right NOW–a beautiful sunrise, the softness of a pet’s fur, the richness of a cup of coffee, the coziness of a warm blanket. We are so wrapped up in fears of what the future holds that we miss the magic of what is before us.
Now is the only moment that exists, so truly, it’s the only moment that is real and certain.
Everything else is either history or what we concoct in our minds.
So this time of the year, I have to sit back and sense the Earth under my feet, feeling into how it supports me. This is what it feels like to be here now. No matter how many times I remind myself of this, I know I’ll have to do it again when the next stressor hits. That’s okay.
This isn’t the first time I’ve written about anxiety and it certainly won’t be the last. But practicing mindfulness, every time I go through this experience, I reign in my emotions a little earlier and start feeling better a little faster. When I look back at what happened I realize I’m making progress, and that’s what really matters.
That shouldn’t be surprising, given that it was my “scan-week” of the year, but even I was taken aback by how I’d felt.
For at least two weeks prior, I’d had that low grade, persistent anxiety simmering, the kind that you can *mostly* ignore during the day, but wow, does it rear its ugly head at night. I’d fall asleep, only to wake several hours later and then the mental battle of focusing on my breath vs. intrusive thoughts would begin. You’d think that by now I’d be better at shifting my focus, but meditation is always a work in progress.
Tuesday was my 3-D mammogram. That’s the one that verifies that I’m still in remission from breast cancer. Oooo, just a tad bit anxiety-provoking, but since I had seen my oncologist not even two weeks before and he’d already checked me out, I wasn’t overly frightened. I admit, it didn’t help that I couldn’t bring my husband for support (hello, COVID), but I felt positive going in.
And everything looked good. For that day it calmed my scanxiety.
But by Tuesday evening, I was frightened again.
This had ceased to be about breast cancer. Now it was all about my heart. I mentioned in a previous post that I’d been having little “heart episodes”. My blood pressure monitor kept signaling “irregular heartbeat detected” and my heart rate monitor would show funny spikes when I was working out. The app I was using for measuring heart rate variability (HRV) would show heartrates up to crazy numbers like 262bpm, and from time to time I’d get heart palpitations.
To complicate matters, the Herceptin I had been given for my triple-positive breast cancer is known for its cardiotoxicity and there are heart-related side effects associated with the endocrine therapy that I’d been taking for the past three years.
But on top of that, my heart would pound when I got anxious. No matter what I did, I couldn’t ignore it–I could hear it. And that pounding made me even more anxious.
That sounds like a never-ending loop right there.
Somehow I made it to Thursday and my cardiology appointment. The mere thought of having a scan that focused on my heart was anxiety-provoking but the medical assistant engaged me in conversation and kept my mind occupied. Even my blood pressure came out as in the 120s/80s (can’t remember the exact number), which was quite normal. She ran the EKG and went to get the doc.
So right now this story is running long, but the bottom line is that my EKG was perfectly normal. The cardiologist, an older man with a gentle voice and pleasant and calm demeanor, asked a lot of questions…and ultimately told me that he didn’t think my heart had issues.
But he suggested that we run a couple more tests: echocardiogram and 14-day monitoring. That way we could rule out anything serious.
And I, the one who hates scans and the anxiety they bring, felt so much relief that he was willing to humor me, so that I would definitely know if those “episodes” I’d experienced were real or not.
I have everything scheduled now. And wouldn’t you know it: I didn’t experience any weirdness all weekend. No perceived skips, no palpitations. I am rarely aware of my heart beating and no longer hear it in my ears.
So I had several days’ reprieve.
Sunday night I felt it again. Let’s see where this goes.
I had mentioned to my cardiologist all those technological gadgets that I had, my blood pressure monitor with irregular heartbeat detection, my heart rate strap that can measure R-R intervals, my watch that has optical heart rate monitoring capabilities. And he said, the new tech has its benefits but it can be inaccurate.
This time of the year is stressful for me because it’s the anniversary of my breast cancer diagnosis. That means it’s time for the scans that determine whether I can continue to consider myself “cancer-free”. Scanxiety, anyone?
This week is going to be a doozie, since I have my diagnostic mammogram on Tuesday followed by a cardiologist appointment on Thursday, the latter of which has become, ironically, the major stressor as I try to determine whether I’m suffering from “cardiac anxiety” or an actual arrhythmia (one of the possible side effects of aromatase inhibitors). To top it off, I get my first COVID immunization Friday, which brings its own stressors since I’m a bit “side effects-shy” these days.
Given all this, it’s a good time to talk about what apps I use the most to help calm my anxious mind. I’ve written about quite of few of them in my “Mindfulness Apps I Love” series, but here are the one I keep coming back to (all have generous free offerings; both Calm and Insight Timer have had major upgrades since I originally posted about them):
Calm This was the first mindfulness app I downloaded and it’s the one I’ve used every.single.day since March 13, 2017. I find the voice behind the app, that of Tamara Leavitt, very soothing. Since I started with it, Calm has added a number of elements featuring voices of celebrities, music, movement, classes, sleep stories, background sounds and other features that I haven’t even used.
What I use most: The curated “Daily Calm” meditations are my do-to first thing in the morning or if I wake up in the middle of the night with troubling thoughts swirling in my head — Tamara’s voice gives me something to focus on and shoos out the scary negative self-talk.
Why I like it: Because all the material is created specifically for the app, I always know what I’m going to get. It’s predictably high quality using a consistent format, and for me, it works. Also, once the meditation is done, the background sound continues and provides a soundtrack for drifting back to sleep or continuing meditation on my own, if that’s what I need. Finally, since this one was my first app and I ended up investing in a lifetime membership, I get access to everything it has to offer. If you’re not ready for such a loyal commitment to this app, you might not have quite as much to choose from.
Insight Timer This app offers a large collection of many meditations, music, classes and whatnot by a huge array of teachers. You need to search around because you don’t always know what you’re going to get, but if it’s out there, it’s in this app. I’ve played around with meditations that I might not otherwise just because they were available to try out. And now new, there are live events that include meditations, concerts, even yoga classes that you can join to help maintain a sense of community–so important at a time when so many in-person venues are closed.
What I use the most: I’ve settled on a handful of teachers with voices and styles that I prefer. Often, I use this app at the end of the day, when I’m trying to clear my head and settle into sleep, but it’s also great for any time when I want some guidance for settling down and am looking for variety.
Why I like it: OMG, the selection! Not only is there just about every type of meditation available (secular, sacred, shamanic and so much more–and now the app allows you to filter out the ones that make you, shall we say, “uncomfortable”), but there is a vast array of languages in which to listen. I speak a specific European language from a small Baltic nation, and yep, Insight Timer has a meditation in it. This is really worth looking into and most of everything is available for free–but donations in support of the app and teachers are very welcome.
Unwind This is an app that I recently reviewed here, and as I’ve gotten more into breathwork and vagus nerve relaxation, it has become invaluable to me. The combination of ambiances that you can select from paired with a gentle guiding voices that cues breath inhales, exhales and holds has made this perfect when I don’t want a guided meditation but I do want something to focus on.
What I use the most: Lately I’ve been opting for the “box breathing” pattern (inhale, hold, exhale, hold). It is perfect for calming my mind without straining my breath. I pair that with the “River Under Bridge” background ambiance that is a nice combo of gentle bird sounds with soothing running water.
Why I like it: Unwind has gotten me out of some anxious moments, specifically too-early wakings brought on by a racing heart. Instead of throwing in the towel and deciding that I’m just going to have to start my day at 4:27am, I’ve been able to lull myself back to sleep; again, the spoken breath cues provide guidance but are unobtrusive enough to allow drowsiness to set it. Additionally, Unwind is ideal for those times of my day that I need to eke out some head space and take a break from work pressure. Even a few minutes is enough to get my breath under control.
MyNoise I posted about this app in late January. It’s the most recent one that I added, but it is amazing! MyNoise consists of sound generators that you can manipulate to your liking, to create unique and changing background sounds for literally just about any mood or need that you can imagine! In addition to the app, there is a website (mynoise.net) that provides similar generators. Both the app and the site offer so much, but when I’m working on my computer, I’ll usually listen through the website since my eyes do better with the large screen.
What I use the most: I tend to prefer nature sounds with running water or else drones and more meditative music. My daughter, who is also a MyNoise afficionado uses the sound of medieval scribes to create an atmosphere conducive to doing college work remotely.
Why I like it: S P A C E. MyNoise creates space by masking unwanted ambient noises (busy street, noisy neighbors, etc.) and thereby provides breathing room and headspace. I have used this for mental breaks throughout the day, or for times when I feeled overwhelmed and need help staying present. There are no discernable loops in the sounds and because each sound generator is made up of different elements that can be manipulated by sliders, you literally can create a totally custom sound environment. It has to be experienced to be believed and it’s well worth experimenting with.
So, these are the four apps that I’ll be working with a lot this week as I make my way through scans, tests and immunizations. Each app has their own little something to contribute to maintaining my peace and I appreciate the portability of having such effective soothers in my hand, on my phone.
Yes, “scanxiety” is a thing. And I’m already regretting writing about it because it’s bringing home the fact that in a week and a half I have a mammogram coming up. It’ll be the first one since completely finishing my treatment almost a year ago.
You can google the definition of scanxiety, but any cancer survivor can offer their version. Mine is the unease that increases as I get closer to THE scan, the one that will pronounce me cancer-free for another year. Mercifully, I will have an unusually busy week at work which will keep my mind equally busy, and the rest I will have to power through with mindfulness and focus.
The unsettling thing about this is that for a short while, it’s a Schroedinger’s cat kind of situation. Around scan time, I am simultaneously a cancer patient and a cancer survivor. Prepare for the worst, hope for the best. It’s altogether unsatisfying.
This mammogram opens the door to the potential of letting cancer back into my life. And I am so.done.with.it. that having to consider what would happen if I had to go through treatment again evokes feelings of hopelessness and frustration. I don’t want to re-experience the steep let down that came with my initial diagnosis, after trying to reason myself into optimism.
Sometimes I play games with myself. Things like, “If I make it to the intersection before the light turns yellow, I don’t have cancer.” This is ridiculous, of course, but I can guarantee you that if I DON’T make it before the light turns, I’m going to be yelling, “Two out of three!”
Scanxiety differs from most life stressors, like a horrible job situation. I’ve had tough jobs with miserable bosses before. I also had the option of quitting. But I can’t say, “Screw this, I’m going to a different universe with better benefits.” I’m here and stuck living out some potentially nasty stuff, and possibly not making it through. That is simply reality and I have to be comfortable with it.
I struggle with the uncertainty that arrives hand-in-hand with scanxiety. Mindfulness teaches us to release expectations, and that is exactly what I’m trying to do. For me, the next week and a half will be a proving ground for how far I’ve come in my mindfulness practice. Perhaps looking at it as a challenge will put a neutral spin on the process of waiting.
No expectations means no anxiety, no let-downs, no shattered hopes and no “dying a thousand deaths” before I’ve even made it to the radiology department. I am not good at this, but I am light-years ahead of where I was two years ago, and I’m going to have to be content in that for the time being.