Lifestyle

Adoption of positive health behaviors (e.g. diet, exercise, stress, alcohol, nicotine, recreational drugs)

Acceptance – Nutrients, Perfectionism, Photo Ark

Acceptance – Nutrients, Perfectionism, Photo Ark

 

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Dear travel buddy!

How is the summer treating you so far? If you are able to go outside, please protect your skin. In addition, for those undergoing active cancer treatments, please explore with your cancer provider if these could increase your skin sensitivity. On the other hand, if you are watching the summer pass by from the side of the pool, or even inside, then please know you are not alone! I am sure there are many other persons, including myself!, who prefer or are in need (for e.g. physical reasons) to stay on the side-line, which may result in feeling like an outsider.

But what are we trying to “fit into”, really? And who defines or decides who does or does not fit? This makes me think of Hans Christian Andersen’s  Ugly Duckling story about a swan’s egg that ended up in a duck’s nest! Other ducks gave the “ugly duckling” a hard time, because he appeared and behaved differently. But when the ugly duckling encountered other swans, his perspective changed. His self-image and confidence improved for the better: he wasn’t ugly after all! The humbling experience also led to a silver-lining insight:

He felt quite glad that he had come through so much trouble and misfortune, for now he had a fuller understanding of his own good fortune, and of beauty when he met with it. [Source].

For me the morale of the story is that trying to ‘fit in’ may not be the best approach, because it has a moving target of which the standards are driven by the constantly changing societal norms and pressures. Furthermore, striving to fit in may force us to portray ourselves differently to the outer world than we feel on the inside. This facade may result in us losing touch with our inner values and principles, and drain our soul.

This is valid for every person, but perhaps more so for cancer survivors who may not always be able to conform to society’s expectations. Their bodies may have been disfigured. Dysfunction or disability may interfere with one’s ability to climb the career ladder. Cancer treatment related infertility or financial difficulties may ruin one’s ability to create the picture-perfect life.

Instead, pursuing acceptance and belonging may be a healthier approach, although it still requires effort (as does every meaningful relationship!). But this pursuit may be easier to sustain, because it is ideally based on authenticity and thus may allow you to remain more true to yourself. But determining where you belong starts with you finding the “new you” and accepting this “new you” in the post-treatment phase!

Life is a journey….enjoy your personal rediscovery, frank conversations with your loved ones about your (likely altered) abilities/needs/wants, and the expansion of your social circle with more people who ‘like you just the way you are‘! [sorry – I could not help myself as a Pittsburgher].

Together we stand strong! Please find below a few things for education and entertainment!

Learn and Think:

Live and Feel:

I create and maintain this platform on my own. Please help by nudging me if you encounter technical problems.

 

 

Weight – Nature Therapy, Survivor Story

Weight – Nature Therapy, Survivor Story

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Dear co-traveler!

How have you been? I hope you were able to spend the Holiday weekend making new memories, doing the things you love (including doing ‘nothing’!?) with people who are meaningful to you. If you had to work, then I would like to thank you for your service – and wish you happy preparations for your next Holiday weekend!

This week, I will share a bit about my weight challenges. I know I am not the only one! As we age, maintaining and losing weight might become (much?!) more challenging than when we were younger. In addition, some cancer treatments can also lead to weight gain, directly or indirectly.

And that brings it back to me! I have gained quite a bit of weight in the aftermath and it seemed that my weight was only going up and up, seemingly independently of what I tried. I tell my patients general principles that I have shared with you before. Even though I am a physician who is supposed to know how to do this (“do as I say, not as I do!”), I realized there is still a lot I need to learn and I may need a little help!

Everyone is different, and so everyone needs to find the tools that work best for them and fit best with their personality/lifestyle. And that may take some trial-and-error efforts. In the current time and age, there are so many different help tools out there. I wish for you that, with patient persistence, you will gracefully find what works for you. But at the end of the day, motivation and ability are crucial.

In terms of motivation, the following proverb says it all: “You can lead a horse to water but you can’t make him drink”. You cannot force someone to accept an offer or opportunity. The timing has to be right and only you know when you are ready.

And last but not least one’s ability is crucial. Your motivation may be on target, but you may be hindered by factors such as your physical or financial abilities. Your body may not (yet?) allow you to move or eat the way you would like or even need to. We all have to find and accept that happy medium that is different for everyone and can vary over time.

For now, I think I have found strategies that seem to be able to help me turn the course, resulting in my child-like excitement (in sharp contrast to my family’s speechless response) when the scale showed a long-desired drop in weight, even if it was only 0.2 lbs! It’s the little things that matter – babysteps!

Please keep in mind the following key concepts:

Until the next time! In the mean time, please find below a few things for education and entertainment!

I create and maintain this platform on my own. Please help by nudging me if you encounter technical problems.

Learn and Think:

Live and Feel:

All Goes the Way It Should Go – Dementia, Metformin

All Goes the Way It Should Go – Dementia, Metformin

team-spirit-2447163Hello you! How have you been?

I am back online after a brief silence! I had to prioritize my time/energy for work and family, while dealing with and healing from an unexpected, sudden, and fixable health issue. All should be up and onwards now!

There is really never a good time to be sick. But we often cannot control its timing, forcing us to:

  • Initiate emergency contingency plans (for childcare etc.),
  • Ask for and accept help (at work and home),
  • Improvise, and then the hardest step of all, at least for me,
  • Let go, go with the flow, stop rushing things along, and trust that all will be what it will be. I reassure myself by reminding myself that everything goes the way it should go, whether I like it or not, whether I know the reason or not. And so, I try to accept and make the best of any situation.

Now, I have a refreshed appreciation for every day that I don’t need to visit the hospital, see a doctor, or am held back by health issues!

I am grateful for the loved ones, friends, and colleagues, who took time out of their lives to provide support (whether via text, phone, or in person). It takes a village to travel through life – together we stand strong!

Learn and Think:

  • Cancer Survivors May Have Lower Risk for Dementia. Cancer survivors may report post-treatment brain fog, which is a usually mild and transient cognitive impairment. As far as know this is not a precursor for the development of dementia. In contrast, researchers have found more evidence of a puzzling phenomenon: cancer survivors seem to be a bit protected against dementia.

Live and Feel:

“Life is short. I think that you find your own way. You have your own rules. You have your own understanding of yourself, and that’s what you’re going to count on. In the end, it’s what feels right to you. Not what your mother told you. Not what some actress told you. Not what anybody else told you, but the still, small voice. Beyond that, I don’t know. And it’s the not knowing that’s the good part. To me, mystery is the most beautiful thing—the fact that you can’t figure it out—that’s it for me. That’s for sure.”

To Eat or Not to Eat…That’s the Question….

To Eat or Not to Eat…That’s the Question….

We all need (and want to!) eat. Food keeps us alive, but more than that….the activity of using our senses (taste, smell, see, touch) and eating is important to our quality of life and a significant part of socialization with our loved ones and friends…..

It can be rather confusing to know which food products, combination of foods, and preparation methods to pursue that will result in not only improved health, but also, and more importantly, do no harm! Searching for recipes and trips to the grocery store may become a time-consuming process that you dread. This can be overwhelming if you have one, or perhaps even several medical conditions that require a special diet. Education to make more sense of food labels has been provided by e.g. FDA, NIH, and the Academy of Nutrition and Dietetics. Your PCP may be able to connect you with a local (oncology) dietitian for advice (or you may be able to find a registered one here). Cancer centers may provide free access to a dietitian, and depending on the indication, your health insurance may also help in providing coverage.

Eating out can also become an adventure and a challenge. Fortunately, many restaurant menus are becoming more attuned to these dietary needs and are working to offer greater transparency by including nutritional content for calorie counters and those with food intolerances and allergies.

To put this into some perspective, although we have made great strides in the medical field, we still face the challenges of much that remains unknown, confusing, or even contradictory. New study results often raise more questions than they answer, which may be due to multiple problems.

Two examples:

  • An early 2019 publication made headlines by stating that “among US adults, higher consumption of dietary cholesterol or eggs was significantly associated with higher risk of incident CVD and all-cause mortality in a dose-response manner”. This publication has been heavily criticized. Two articles may help provide perspective and allow you to make your own informed decisions. One is an article by the New York Times and another one by the American Heart Association (the latter predated the above mentioned publication, but nevertheless still provides valid points).
  • The intake of vitamin supplements seems to have drastically increased, since popular trends suggest that they “may help, but do not harm’. However, this perception may need to be revised, since evidence has shown multivitamins can indeed harm and may actually help a tumor thrive rather than improve your overall health. As such, until we understand better, it may be wiser, to boost your vitamins in a more natural way, such as a balanced diet that healthfully includes a variety of vegetables and fruits. As always, trust your provider, especially if they specifically recommend and prescribe you to take certain supplements (e.g. when you are at risk for decreased absorption, or have been found to have low levels of vitamins B12 and D).

Another nutritional consideration may be whether or not to ‘go organic’. Organic foods are thought to contain more ‘of the good’ and less ‘of the bad’. But organic products can be less readily accessible and are often significantly costlier. You may want to prioritize your grocery list by investing in the organically produced dirty 12, and be less concerned about the clean 15.

My personal take on this is that there are many diets out there, and it is simply not possible to have a complete and accurate comparison of the benefits and flaws between them. Some diets can be expensive and may be restrictive by omitting certain food products or food groups. Until we understand more, it may be best to adopt a lifestyle that is ‘all things in moderation’. Don’t forget variety is the ‘spice of life’ and at the end of the day, we can only hope to have done our best. Our health outcomes are determined by many factors, and our diet is only one.

Allow yourself to enjoy – Bon Appetite!

Toxins Actually….Toxins Are All Around….!

Toxins Actually….Toxins Are All Around….!

Throughout every generation of human existence there have been dangers that threaten our longevity. Science has made many discoveries that make us better at preventing and even eradicating some threats such as disease, (i.e. influenza and smallpox) and in anticipating or managing natural disasters such as those caused by severe weather. The unfortunate trade-off is that we have created new dangers that can pose as much, or even greater, harm to our earth and body. The line between the natural and man-made disasters often becomes blurry.

In this twenty-first century, we have become aware that our environment can pose a danger to our health and, depending on our level of exposure and susceptibility, can have significant implication for an individual’s health and wellness. Cancer survivors, who may be wondering why they developed cancer to begin with, may be very concerned about what their body meets; what they inhale, eat, drink, or even apply to their skin. Consequently, everyday life takes on new challenges and everyday habits, such as a trip to the grocery store, can become a stress-filled and lengthy experience. In an ever-changing environment there is a new reason to explore and educate ourselves constantly to minimize the risk of exposure and find ways to work around them. Even then, there is no assurance that we have done ‘enough.’

Since it is not socially acceptable, nor desirable to live in a balloon, we need to have some confidence in the work that government and medical organizations like the CDC and the Human Exposome Project have set in action. Bringing together investigators and professionals to measure and understand the impact of complex environmental influences and human health, we must have some measure of trust that best practices are implemented and care for our world is a priority. 

Hopefully, as time progresses, the impact of our environment on the health of future generations will lessen, making a place instead to reduce the impact and effects of the next ‘disaster’. Until then, all we can do is use common sense. At the end of the day there is only so much we can do to protect our body without jeopardizing the quality of our lives. The psychological impact of this vast awareness of the dangers around us may haunt you at times in your cancer survivorship journey. If you notice that it starts to interfere with your ability to function and live your life, then please let your provider know, so they can provide support to help you through this time of stress. A little well directed guidance can help you quicker and faster than you may be able to accomplish on your own. Remember the mind can become another one of our biggest enemies; don’t let it run away with worst case scenarios. Be brave, be strong, be wise!

The Freedom to Move….!

The Freedom to Move….!

Not all of us are meant to be ballet dancers, but being fit as well as having stamina, strength, and range of joint motion contribute to one’s ability to dance through life. Cancer treatments may have affected you physically and emotionally. Pain, malaise, fatigue, low blood counts, difficulty breathing, etc., resulting in the loss of muscle mass and stiffness and painful body movements keep this vicious cycle of deconditioning going. You may not ever be able to regain your pre-cancer diagnosis level of fitness, strength, and flexibility, but it can often be improved upon.

Be sure to first discuss with your doctor if more diagnostic testing may need to be performed and which one of these following options might be a best choice for you given your health, availability of resources, and/or insurance coverage. Upon reconditioning, the eventual goal is to try to participate in a safe and consistent exercise program.

You can work with professionals to rehabilitate your strength, ability, and balance. This can be through e.g. physical therapist, occupational therapist, cancer-certified exercise trainer, or an exercise physiologist. 

It can feel frustrating when you have pain, stiffness, and a limited range of motion, especially when no clear biological explanation or helpful remedy can be found. It’s persistence can lead to dysfunction, disability, and emotional distress. One option to consider is a technique called Myofascial Release. The evidence has shown this techniques to be safe, gentle and effective.  The essence of the technique involves the professional application of gentle pressure or a pulling motion  (“telescoping”) that will allow the careful release of tight myofascia. 

Most likely you are familiar with the plastic wrap that is commonly used in the kitchen and that can get wrinkled up before you are able to cover the intended target resulting in needing to get a new piece of plastic wrap and starting the process all over again! Your body has a similar “wrap”, called myofascia, that covers your organs, bones, tendons, and muscles. It can become tight due to stress,  physical and emotional trauma, medical procedures, or injuries. These may result in stiffness, a limited range of motion, and pain in areas that may not make anatomical sense. Since this fascia is connected through your whole body like a web, you may not feel the symptoms in an expected location (for example, if you pull on the bottom of your shirt, you might feel that in your shoulders). Your nerves and blood vessels run through this web, which can produce unique symptoms, when the ‘web’ tightens.

To find relief, you can 1) try various self-help myofascial release methods that can stand on their own and/or 2) consider working with a professional. Having someone to partner with in developing a plan, such as a dedicated professional can alleviate not only your pain but also the stress. Locating a professional can be challenging depending on your location. There are a variety of providers that can offer myofascial release such as physical therapist and chiropractors. As with any field, please be sure to seek out someone who has undergone and continues in their specialized training and certifications, such as those providers trained in the John Barnes Method of Myofascial Release.

Enjoy moving through life, with grace, one dance at a time!

When It Simply Becomes Too Much…

When It Simply Becomes Too Much…

We all know that someday, we will all face death. A cancer diagnosis makes this realization personal, and often comes at a time that we would not have necessarily thought of our own mortality. As you reach the post-treatment phase, you may find that your priorities in life have changed and this may lead you to consider making changes in your life. You may be worried about your environment and what you put on or in your body as you continue to wonder why or how you developed the cancer. The people around you may not understand or even be open to talk with you about these changes. After so much focus on the treatment of your body and the cancer, you owe it to yourself to tend to your emotional needs and long-term goals. 

Emotional distress is real and can negatively affect your quality and quantity of life. But worrying about being stressed can have negative health effects on its own. 

Don’t be afraid to seek the help you need to heal from this journey. Most likely your cancer diagnosis started abruptly and forcefully pulled you away from life as you knew it.  The journey continues and now leaves you to pick up the pieces from this experience. It can continue to be overwhelming and even traumatizingat times.

Consider reaching out to the many professional services that are available to you within your community. One or a combination of interventions may sometimes be recommended (e.g. exercise, talk therapy and/or medications). Professional therapists are ready to help you process and make sense of your thoughts; to help you find new meaning and purpose, and to help you build new hopes and dreams.

Which Vitamin Source?

Which Vitamin Source?

Dietary Supplements and Mortality Rate in Older Women The Iowa Women’s Health Study (JAMA 2011)

Do Cruciferous Vegetables Really Fight Cancer? (NYT 2018)

Bottom line – until we know more and understand better, it may be preferable to get your vitamins from a large variety of dietary sources rather than pills (unless specifically recommended/prescribed by your health care provider).