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Symptoms & Needs

Support for post-treatment symptoms and needs (emotional, physical, functional, financial)

Meditation and Cancer Survivorship

Meditation and Cancer Survivorship

Meditation, if done on a regular basis, has been shown to be able to provide many emotional and physical symptom-relief benefits for cancer survivors. I don’t know about you, but I have tried a few meditation activities and they don’t always make me calmer. When I sit quietly and allow vague fragments of thoughts, feelings, and images to pop up in my mind, sometimes I feel more confused, overwhelmed and stressed. I frustratedly wonder, “Why can’t I seem to relax?!” 

But, let’s back up. What does meditation mean? The dictionary states:

intransitive verb. 1 : to engage in contemplation or reflection (he meditated long and hard before announcing his decision). 2 : to engage in mental exercise (as concentration on one’s breathing or repetition of a mantra) for the purpose of reaching a heightened level of spiritual awareness.

transitive verb. 1 : to focus one’s thoughts on; reflect on or ponder over (he was meditating his past achievements). 2 : to plan or project in the mind: INTEND, PURPOSE (he was meditating revenge).

There are many (sub)types of and ideas about meditation, depending on who you talk with or what you read. To me, meditation describes a state that allows you to pause and reflect on your current situation and life’s journey from a distance to see the bigger picture, feel less overwhelmed, and regain clarity about where you are going. 

One school of thought I like is the, so-called, philosophical meditation:

“A practice whose premise is that a decisive share of the trouble in our minds comes from thoughts and feelings that haven’t been untangled, examined or confronted with sufficient attention. Ordinary life goes by far too fast for us to process events properly in real time – and we suffer, accumulating unthought thoughts and unfelt feelings which make for anxiety, anger, depression, addiction and misaligned goals. 

So we need, according to the theory, regularly to return to the contents of our minds and listen to their garbled signals, picking this or that object of consciousness and submitting it to the beam of reason. Our confused feelings and ideas are not to be pushed aside, for they are – in appallingly muddled and enervating ways – trying to tell us something important about the course of our lives. 

Lying in bed or sitting by a window. We’d ideally have half an hour without interruption, with paper and pen to hand to seize ideas and feelings as they emerge from the mental undergrowth. With the patience of ornithologists, we would be out to catch the mind in its most fleeting, tentative, furtive moments. Key to all this are well-angled questions that we must put to ourselves to extract the full picture. At the heart of a Philosophical Meditation, there are three: – What am I presently anxious about? What am I presently upset about? What am I presently excited about? These are the clues for directing the mind to search its recesses with acuity.

However, if you are facing a life and death situation like cancer, and you feel like your boat has capsized in the middle of the ocean, then your thoughts and feelings may be so intense that meditation alone may not be able to provide relief. In fact, it may make things more intense as all these thoughts and feelings come to the surface. In this situation, it may help if you also go and talk to a professional who can help you untangle and restructure your thoughts and feelings so that you will feel less confused and overwhelmed by them. 

Thank you for visiting me. Below I’ve included a few things to educate and entertain you. Remember, I share ‘extra treats’ if you follow me on Facebook, Instagram, Twitter, or Pinterest! Plus, you can get notified of a new posting by subscribing to our newsletter!

Live and Feel:

  • Meet our newest family member – Melky!

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Pulled in Different Directions

Pulled in Different Directions

We all know that time is precious, but my patients tell me — and I experienced myself — that the concept of time changes after a cancer diagnosis. You suddenly wonder how much time you may have left for everything you want to accomplish. Oh boy, there is so much to be and do! Make your legacy. Spend time with loved ones. Maintain your body as healthily as you can. Some of these goals and tasks, whether simple or complex, are in direct conflict with each other which can cause decision fatigue and frustration. How do you decide what’s more important? How do you compare the choices when they are different like apples and oranges?

Do you eat that cookie or a carrot?

Do you go to the gym or sleep a little more?

Do you spend time with loved ones or alone?

Do you stay in your current secure job or do you venture into a job that is more meaningful to you?

Do you work on your career or preserve your free time?

Do you build towards a legacy or make memories with loved ones? Can you find something that would target both?

Do you simplify your life by downsizing your house or keep everything as it is until the end and have others help at that point? 

Do you spend money on a trip to visit your loved ones or a trip to a new destination so you can broaden your horizons and become newly inspired?

Do you have a(nother) child, find a new partner, friend, or pet or spend more time with the loved ones currently in your life? 

There is no magic answer, no way to know that the choice, decision, or path you arrive at will work for you. In fact, the “right” answer may continue to change over time. 

Some choices might be more challenging than others. Desire and fear can coexist; human minds are fascinatingly complex. Your thoughts and feelings can be opposed, perhaps resulting in feeling ambivalent, conflicted or shut down. You might be able to repress one of the opposing thoughts or feelings temporarily, but sooner or later the conflict may come to haunt you again. Conflicts between quantity vs. quality of life and hope vs. reality might become more intense when the stakes are higher, such as for cancer survivors.

It’s possible to work your way through decision-making on your own by reflecting on it in your diary or during a nature walk, but sometimes you may need to talk with loved ones or even a professional. We all have blind spots and others can help us understand why we are conflicted and facilitate a resolution. 

Here are a few pointers to help you with your next fork in the road:

  • Make decisions or plans when you are well rested and well fed.
  • If you have the luxury, sleep a few nights over your decisions to ensure you’ve made a choice you’ll continue to feel good about.
  • Discuss the decision with your loved ones and the persons who will be affected by the decisions you’re about to make. This, along with possibly talking to a professional who can help you gain insight into the motivation behind your thinking, will hopefully provide clarity.
  • Sometimes it can be helpful to break a decision down into smaller steps and decisions.

Nature has a way of working things out on its own. A constellation of circumstances like humidity, temperature, and wind create a unique snowflake that can travel for miles carried by the wind, being pulled in seemingly random directions, until it reaches its destination and falls into place with many other snowflakes creating a beautiful white blanket that provides shelter from the harsh weather for animals and protects plants and roots until the warmer weather causes each snowflake to turn into water again, continuing the circle of life.

Thank you for visiting me. Below I’ve included a few things to educate and entertain you. Remember, I share ‘extra treats’ if you follow me on Facebook, Instagram, Twitter, or Pinterest! Plus, you can get notified of a new posting by subscribing to our newsletter!

Learn and Think:

Live and Feel:

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Magic Wand

Magic Wand

Once upon a time, I wished there were a magic wand that would:

Take all the pressures, stress, and worries away and allow me to be in peace. 

Fix it all.

Make me feel invincible again. 

Remove the dark cloud hanging over me, push away the fear of recurrence that was always in the back of my mind. 

Prevent me from needing to see so many health care providers and do so many tests.

Make the simple things easy again, such as using my body to get around in life. 

Allow me to be comfortable with my own body.

Enable me to keep up with work, family, friends. 

Prevent me from asking, ”How do you know?” when people tell me that all will be fine and “Do I have a choice?” when people tell me to hang in there. 

Make my medical bills disappear. 

Remind me to go through life walking like a tortoise, with occasional little sprints like a hare. 

Reduce my use of the words “I should” and make me less hard on myself. 

Teach me to accept not having made the healing progress I was told to expect, rather than fighting it. 

Help me grieve for my old me and find the new me.

Make me feel I belong and am accepted for who I am as a person, rather than for what I do professionally or what I cannot do emotionally and physically. 

Even though there is no magic wand, I believe humans have magic powers. Over time, sometimes with the help from loved ones or professionals, we can find our “happily ever after”. It may not be in ways we imagined, but it may be more happiness than we would have found without having gone through cancer. It often takes hardship to be humble and appreciate the good. 

Thank you for visiting me. Below I’ve included a few things to educate and entertain you. Remember, I share ‘extra treats’ if you follow me on Facebook, Instagram, Twitter, or Pinterest! Plus, you can get notified of a new posting by subscribing to our newsletter!

Learn and Think:

  • Colon cancer screening guidelines have been updated to reflect the new advised starting age of 45. Katie Couric has televised one of her prior colonoscopies and provides logistical and practical guidance on this site. 
  • Middle-class Americans getting crushed by rising health insurance costs is a sad reality. If you find yourself in financial difficulties, there is no easy solution, but please let your healthcare providers know so they can connect you with local resources for support. At the national level, the American Cancer Society provides some very practical and concrete solutions. 

Live and Feel:

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Scary Cancer

Scary Cancer

I remember when I found out that I had cancer, I was about 15 minutes from seeing a patient in my outpatient clinic.  To my surprise, even though I am a professional and I had been dealing with these near scares for over 15 years, my world stopped right away.  I was paralyzed for a few minutes, trying to understand what had just happened. Then I got a bit scared and started crying. After a few minutes of those intense emotions, I called my husband who had trouble making out my words since I could only utter, “I have cancer”. Then I called the nurse who supports my clinic who came to console me, gave me tissues, and took me to start seeing patients. Just as instantly as my emotions appeared, they dissipated and I switched into my professional mode – cool, calm, collected, and focused on my patients. 

Working allowed me to ‘forget’ about it for a bit, but when I came home I went straight into my pajamas and covered myself under my blankets and just lay there. I didn’t want to speak with anyone, I just wanted to be alone. I was still paralyzed, some of my patients call it “shut down”. The next morning when I woke up, my fighter instinct had kicked in. I was ready to tackle this health issue like it was a checkbox on my to-do list, which it was, although its impact on every aspect of my (and my loved ones’) life was major and lasting. 

When you’re first diagnosed, it seems like you go into automatic pilot mode, keeping your eye on the ball and reprioritizing your work and life to make time and preserve energy for performing tests, seeing doctors, and undergoing treatments. You may not understand or tolerate these treatments well, but you accept them because you trust your providers and you want to throw anything you can at your illness so it goes away and you can resume living your life happily ever after, as if the scary cancer never happened.

But it did happen. And it will change you. You cannot go back, you cannot unsee or unknow it. It forces you “to find the new you‘….

Everyone reacts differently. Some may get sad, while others get angry, quiet, or shut-down.  Some react a little, some a lot. Some react instantly, while others are delayed. Some reactions may last, while some are short-lived or intermittent. Even not having a reaction is a reaction.

I often wonder, “Why is a cancer diagnosis so scary and overwhelming?” Other non-cancer diagnoses/diseases, such as heart attack or stroke, may have similar associated life expectancies, but they don’t usually trigger the same intense emotions. So what is so special about cancer? I have been trying to figure this one out, and I’m not sure I have the answer, but it may have something to do with the notion that cancer behaves unpredictably. Also, cancer and its treatment can wreak havoc on one’s body and mind. Patients may feel especially fearful if they have experienced horror stories from movies or family members who went through cancer in the days when our supportive therapies were not as well-developed as they are now.  

When  an experience (or the threat of an experience), such as physical/sexual abuse or  serving in a war, becomes too overwhelming for your body, mind, and spirit to handle, and/or you do not have adequate emotional support, it can become a traumatizing experience. Cancer can be a traumatizing experience, too. The word itself can trigger scary associations, resulting in it being referred to as the “C-Word”. 

The tricky part of having been through a traumatizing experience is that it may have primed you to (over)react easily to other triggers, retraumatizing you. This can manifest itself by keeping you always on the alert for when such a trigger may come around again or having anxiety, nightmares, flashbacks, or trouble concentrating, If you think this may apply to you, please know that there is help for you. Allow yourself to speak about this with your loved ones or healthcare providers. You are not alone. There is no need to feel embarrassed or ashamed. Everyone has their breaking point. Like Mr. Rogers said, “Anything human is mentionable, and anything mentionable is manageable”! 

Learn and Think:

A book and documentary describe the phenomenal progress that has been made in the cancer field. Cancer: The Emperor of All Maladies.

Live and Feel:

A Beautiful Day in the Neighborhood, the movie about Mr. Rogers — is out.

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Cancer Fight – Supplements, Time

Cancer Fight – Supplements, Time

Dear Fellow Traveler,

It seems like I’m always seeing and hearing people describe cancer patients as being in a fight with cancer. The word “fight” makes sense in many ways, but at the same time it makes me cringe a little because the word can mean many different things depending on one’s cancer status and where a survivor is in their healing journey. 

Dealing with cancer might be the major fight of and for our lives using a heavy arsenal of artillery like chemotherapy, radiation, and surgery. However, using the word “fight” suggests that cancer and we are equal partners and that we have a fair chance to win. With our current medical knowledge, we do not always have that chance. Thinking of cancer as a fight may make cancer patients feel like they have failed their loved ones (who are often unrelenting cheerleaders!) and themselves when cancer starts to “win”. This may give a person in the final stages of their life a heavy burden to carry – shame, embarrassment, and guilt — as if they could and should have tried harder to fight it. It is important to remember that the fight with cancer is not fair. The knowledge and therapies available to us in the 21st century do not yet guarantee that we can outsmart cancer. And yes, lifestyle may play a role too – but we have to note that there are so many other, often unknown, factors in our body, the black box, that affect cancer outcomes. 

Cancer is our enemy, since it can literally attack and break our bodies down resulting in suffering and death. The emotional rollercoaster it sets us on may result in anger, sadness, and frustration. But over time, perhaps with help from others (including professionals) we may be able to see the silver lining of a cancer diagnosis. It confronts us with the fragility of life and teaches us empathy, humility, and the value of time and love (which can, at times, seem rather abstract). In the end, we all try to make sense of our lives, the good and the bad, by telling our life stories in a way that makes sense to us, comforts us and allows us to be at peace. 

Cancer therapies can result in battle scars. Emotional scars, in the most extreme form, can be similar to the PTSD (post traumatic stress disorder) that soldiers have when they return from war. Physical scars — from surgery, radiation, procedures, port placements, etc. — serve as a constant reminder of your illness when you look in the mirror or when other people ask about them. That may be more than you or your loved ones can handle. Healing may require a little bit of work to allow you to accept that cancer is a part of your life story and new identity, but nothing more than that. Even though cancer can be all-consuming, you are defined by more than your disease. Recognizing this may allow you to remain graceful, resilient and adaptive when others comment on your scars. You may openly explain to them that you are not ready to delve into that topic yet or are not ready to deal with their emotions. Alternatively, you may have a ready-to-go, light reply that strikes a balance between humor and respect (“Oh! Those are my battle scars!”) that allows you to kindly dismiss and change the topic. Most people will get the hint. 

When a person deals with cancer, depending on where they are in their healing journey, describing them as fighting cancer can be a seemingly innocent, yet charged label, that may give them the feeling of being a loser or a failure.  Remember, the fight isn’t always fair. I believe every person is brave and deserves a Medal of Honor! 

Thank you for visiting me. Below I’ve included a few things to educate and entertain you. Remember, I share ‘extra treats’ if you follow me on Facebook, Instagram, Twitter, or Pinterest! Plus, you can get notified of a new posting by subscribing to our newsletter!

Learn and Think:

Live and Feel:

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The Gifts and Challenges of Caregiving

The Gifts and Challenges of Caregiving

Dear Fellow Travelers,

When my husband got sicker, there was no denying that aside from work, he would be unable to contribute at home. There was no question, no need to talk it through. I had to step up and take responsibility — managing my job, a baby, my husband’s needs, and a household on my own with limited resources. This dynamic lasted for years. He was not aware of how much I tried to handle. When I started to deal with my health issues, I felt, as a strong and independent woman, that I could not and should not ask for help.  My health issues were minor in comparison to his. Over time, he started to heal more while my health issues lingered and resulted in difficulty getting around. This required me to clearly communicate what I needed help with, and it required my husband to hear me and meet my needs.

As you can imagine, this sounds easier than it was. Men and women are from different planets and have different ways of feeling, thinking, and communicating. On top of that, the dynamics in our household were constantly changing in response to a growing child and both of our jobs and health issues. My husband and I alternated between being a caregiver vs. needing a caregiver – sometimes even at the same time. These dynamic power shifts did not always go smoothly, causing friction and extra stress. At some points, we would talk patiently and transparently and find a compromise that would work for us all. At other times, we would say things that would hurt each other and would end up feeling regretful. We always aimed for the former, but to our frustration, we often ended up with the latter. 

Caregivers can be anyone who feels responsible, has the resources and time, and loves you –  spouse, parent, child, or friend. Caregiving may feel like a duty or obligation at times — if no one else is available to take on the responsibility,  if you feel it’s your turn (when caring for your parents), or if you’re stepping up because you’ve promised loyalty through thick and thin to your spouse. Some people seem to be more naturally skilled in anticipating another person’s needs and wants than others. Similarly, some of us are better at expressing our needs and wants. These two qualities are related – the more a person feels genuinely cared for, the more they are willing to ask for help. But even if caregiving does not come as naturally to a person, this skill can be fostered over time with love and patience  (Still, sometimes external support may be needed from professionals.)

Both the caregiver and care-recipient have their limits. Pushing beyond those may lead to exhaustion and conflict, in particular when stressed due to constant change or mismatched dynamics, for example:

  • Grief. Both parties may be in different stages of acceptance.
  • Autonomy. There is no manual. Every duo needs to make their own decisions about when to ask for help and when to give help without becoming too overbearing. Both of you may change your perspectives on loss of independence over time.
  • Self-centeredness. When we don’t feel well, we often need to focus on ourselves to get through the day. If the normal balance between giving and receiving is out of sync for a prolonged period of time, it can lead to guilt for the recipient and exhaustion/resentment for the giver.
  • Finances. When illness results in more money going out than in, this can cause major stress on every facet of one’s life. The caregiver may feel strained between finding ways to earn more money (which may require hiring help for home) versus doing it all alone.
  • Affection. When preoccupied with health issues, expressions of affection are not to be undervalued since they help to keep the bond strong and resilient. The ways in which you express your love for one another may need to be changed, because the illness may have changed your physical, functional, or emotional abilities. At times, it may also help for both parties to mingle with other person(s). Sometimes, even the kindness of strangers can be surprisingly helpful. (Beware, however, some strangers may not appreciate your vulnerable state because they cannot relate). 
  • Logistics. At times caregiving by a loved one may become too challenging for financial, physical, or emotional reasons. In these cases, it may help to talk with your providers to explore relevant sources of support, including but not limited to respite care, which allows the caregiver a chance to recharge. 

For the most part, every duo is unique. Both members of the duo need to make decisions and compromises that they feel respected by and at peace with to maintain the relationship. Please keep in mind that it usually is more like a marathon than a sprint. You are only human; give yourself permission to refuel. You cannot help another if you have nothing to give. Ideally, caregiving can be a win-win for both the caregiver and care-recipient. It’s good to feel that you have support and will be carried when needed. Similarly, being of help to someone provides meaning to our lives! 

Thank you for visiting me. Below I’ve included a few things to educate and entertain you. Remember, I share ‘extra treats’ if you follow me on Facebook, Instagram, Twitter, or Pinterest! Plus, you can get notified of a new posting by subscribing to our newsletter!

Learn and Think:

Live and Feel:

As cancer survivors know, that dread disease [cancer] is a challenge, and it helps to know that people are rooting for you”. She vowed to stay on the job “as long as I’m healthy and mentally agile.

Quote from Justice Ruth Bader Ginsburg. 

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(In)fertility after Cancer

(In)fertility after Cancer

Hello, Fellow Travelers!

When I was younger, I dreamed of having a large family, with lots of children – likely because I grew up in a small nuclear family, or because I am strongly maternal. (Some people call me Mother Duck.) Regardless, the scenario I had dreamed about needed to be rewritten. When our first child was three months old, my husband was told he needed to be placed on the organ transplant list for autoimmune disease-related organ damage. My husband’s and my health issues made having more children impossible. 

I have heard too many tragic stories. Patients who were diagnosed at a young age and time or resources or medical knowledge did not allow for sperm/egg harvesting. A couple who didn’t meet until later in life and only had a limited fertility window remaining when cancer hit. A mother diagnosed with cancer while pregnant.

When fertility is maintained throughout cancer therapies, many cancer survivors become concerned with how pregnancy will affect their health and if their genes or previously-received cancer therapies could affect their offspring. Pregnancy will be fine for the majority of cancer survivors and their offspring, but you should discuss your desire to become pregnant in advance to allow evaluation and optimal support throughout the journey from conception through postpartum phase. Despite the many medical advancements for saving one’s fertility when diagnosed with cancer, success cannot be guaranteed. Cancer can either prevent the ability to have and carry your own biological child or put a couple through the incredibly difficult choice of choosing between the life of the child or the mother.

Sadly, cancer may force us to change our dreams and life stories as we grieve what will never be, such as having our own children or grandchildren. I hear so many people say that people who are not suited to having kids continue to get them, and those who have the potential to provide loving homes cannot have them. Then there are mixed feelings when someone close to us gets pregnant. We often suffer in silence, trying to be happy for them while feeling that immense pain inside that it will never happen for us. It can feel so unfair. 

Denial, repression, avoidance, and anger are a subset of the feelings and thoughts you may experience in reaction to this hurt. You cannot control or fix this. It truly happened to you. Some people may attribute it to bad luck, faith, or fate. Some people may even wonder if they are being punished. Your mind may become your worst enemy in response to the absence of a thing so essential to life for many – reproduction. You may feel helpless. Ashamed. Embarrassed.

Friends, colleagues or family members may repetitively ask you seemingly innocent, yet painful, questions – “When will it be your turn? When will you get pregnant?” For some of your loved ones, like your parents, your inability to produce children may alter their hopes and dreams, too. I can still remember our child, when he was younger, asking repeatedly when he would get a sibling like his friends had. I tried to deflect and when he was older explain. I don’t know if he was in denial or not mature enough to grasp it yet. For me, that was the most painful part of it all – seeing my child’s longing and sadness about not having a sibling.

There are a growing number of alternative options to try to have a child which might be challenging and costly. Your cancer center may have resources available that can guide you and support you (grant support, fertility experts, behavioral health etc).

But at the end of the day, I hope you will feel defined by more than your (in)ability to reproduce an heir. Your maternal/paternal instincts may be rerouted towards healthier coping styles that may facilitate your sense of purpose or meaning, such as:

  • Transformation. Not needing to spend time and energy on raising your biological kids, you may be able to channel your love into socially acceptable alternatives, e.g. adopting a child or pet, babysitting, volunteering to work with kids.
  • Altruism. Helping others (not at the expense of self-care) may distract you from your own pain.
  • Humor. This is a tricky one. You will have to find your own comfort level of dignity and respect. For example, if you’re not ready to discuss your infertility, you may find your own funny reply to deflect the question, “When will you become pregnant?”
  • Suppress your pain by consciously deciding not to devote energy to related thoughts and feelings. Suppression is different from denial and repression, which are defense mechanisms that keep your pain and grief in your unconscious. You might say, “What’s the harm in that?” Denial and repression make it so that you cannot control negative emotions and they can wreak havoc by popping up at random times and causing discomfort for seemingly unknown reasons (e.g. anxiety, nightmares, panic attacks, depression). Suppression allows you to be aware of your grief and pain, while trying to reduce it. Some methods to try are:
    • Stop method. Tell yourself to STOP going down that rabbit hole.
    • Set a limit. Allow yourself a certain amount of time per day, e.g. 15 minutes, t allow yourself to ruminate about your infertility, but when the alarm goes off,  stop and don’t allow yourself to do this again until the next day. If thoughts and feelings should arise throughout the remainder of the day, you can write them down for the next day’s session.

Only you know if at any point along the journey you hit a wall and need to talk with someone professionally who can help you rewrite your story and legacy. Please be kind to you!

Thank you for visiting me. Below I’ve included a few things to educate and entertain you. Remember, I share ‘extra treats’ if you follow me on Facebook, Instagram, Twitter, or Pinterest! Plus, you can get notified of a new posting by subscribing to our newsletter!

Live and Feel:

“Families are like pieces of art. You can make them from almost anything, any kind of material. And sometimes they look like you, and sometimes they don’t. Sometimes they come from your DNA and sometimes they don’t. And the only ingredient you need to make a family is love. Unconditional love. 

Mitch Albom on CBS News.

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I Just Need to Lose Weight! – Updated Cancer Exercise Guidelines, and more.

I Just Need to Lose Weight! – Updated Cancer Exercise Guidelines, and more.

Dear Fellow Traveler,

As we are heading into the holiday season, many of my patients are dreading the temptation of being surrounded by lots of food (cookies!) and the resulting weight gain.  When concerned about health outcomes, weight is an easy culprit – blame it on the weight!  Recently while discussing new health issues, one of my patients told me — surprisingly calmly considering this has been a priority for this patient for years already —  “I just need to lose weight”. I sensed the defeat and helplessness.

Weight is a topic that is central in many people’s lives. It can be viewed statically (as the number on our scale, our perception of our weight) or dynamically (losing weight or gaining weight too fast and/or unintentionally). Weight is associated with many negative feelings, such as defeat, helplessness, shame, guilt, frustration, embarrassment, judgment, sadness, and stress. These feelings can contribute to unhealthy eating patterns and the vicious cycle of emotional/stress eating, or even yo-yo dieting. Almost every patient asks me about their weight. What can they do to get it and keep it down? What should their weight goal and speed of weight loss be? Which weight loss methods are the best?

The misconception often goes that if one is more disciplined, one will have better weight control. But weight control cannot be simply reduced to only two factors, food intake and energy expenditure. There are many unknowns about which factors control and stabilize one’s weight. This makes it hard to determine the best interventions for losing weight. Many different homeostasis models have been proposed by the scientific community, such as the set-point theory. Beyond that, in regard to  improving cancer outcomes, we do not yet fully understand which factors matter most – e.g. weight in normal range, weight loss, physical fitness, redistribution of fat deposits.

There is not a magic solution. There are many resources out there to guide weight loss, most of which manipulate what/when you eat and how active you are, but most have not been studied or compared with robust scientific methods. Everyone has to find the approach that fits with their belief system, personality, and lifestyle. Here are a few general pointers that you may find helpful:

  • Any change is hard. Start low and go slow. This will allow you to solidly integrate a new habit it in your life.
  • Multiple small interventions may be more sustainable and wholesome than a one-prong approach. E.g. Swap out your current breakfast for oatmeal or call your friend while walking around the block.
  • Rather than pursuing diets that omit certain food groups or ask you to fast for a prolonged period of time, it may help to pursue a diet as nature intended: a wholesome, plant-enriched diet of moderation and variety, while minimizing processed foods.
  • Please allow yourself a treat every now and then since eating also allows you to socialize and enjoy life.

If ever the cancer should recur, then I hope you will not blame yourself, since there are more factors associated with cancer outcomes than lifestyle. You can only do your best with the resources and the physical/emotional abilities available to you, and you likely will fall off the wagon once or even several times along the journey. The point is that you keep trying in ways that fit where you are in life!

Thank you for visiting me. Below I’ve included a few things to educate and entertain you. Remember, I share ‘extra treats’ if you follow me on Facebook, Instagram, Twitter, or Pinterest! Plus, you can get notified of a new posting by subscribing to our newsletter!

Learn and Think:

  • A near decade-old guideline update has been released, issued jointly by the American College of Sports Medicine, the American Cancer Society and 15 other international organizations, with new advice about physical activity for cancer survivors. More precise and practical details are still needed from future studies, however. As always – any exercise is better than nothing!

Live and Feel:

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Finding the New You After a Cancer Diagnosis – Cleveland Clinic Healthy Now Survey, Reading Suggestions, Tom Hanks, Virtual Travel ideas, Cancer Whisperer!

Finding the New You After a Cancer Diagnosis – Cleveland Clinic Healthy Now Survey, Reading Suggestions, Tom Hanks, Virtual Travel ideas, Cancer Whisperer!

Dear Fellow Traveler!

There is growing evidence for the notion that cancer therapies may age our bodies prematurely, as nicely outlined in this article by a geriatric oncology pioneer who sadly died at a too-young age due to a car accident. This week, while doing some self-reflection and talking with other cancer survivors, I wondered if cancer can also stress/strain/accelerate one’s emotional development. When I researched, I found out that might indeed explain a lot about the identity crisis cancer survivors often find themselves in at some point along their journey. Let me try to explain.

Per the psychosocial developmental stages of life, as described by Erikson, deeply reflecting upon one’s life usually does not take place until one hits age 60+. But many cancer survivors find themselves torpedoed forwards into this reflective life stage as they wonder what they have accomplished and what their legacies will be if they should die prematurely. (This is a very normal reaction as long as it does not overtake you, in which case, please talk with your loved ones and health care providers). Per Erikson, humans continue to mature from birth through the end of their lives, striving for their own unique balance in overcoming particular life-stage specific conflicts:

  • Stage 1:
    • Period: Infancy
    • Conflict: Trust vs. Mistrust
    • Goal: Sense of security, safety, reliability
  • Stage 2:
    • Period: Early childhood
    • Conflict: Autonomy vs. Shame and Doubt
    • Goal: Independence, autonomy
  • Stage 3:
    • Period: Preschool
    • Conflict: Initiative vs. Guilt
    • Goal: Purpose
  • Stage 4:
    • Period: School Age
    • Conflict: Industry vs. Inferiority
    • Goal: Competence
  • Stage 5:
    • Period: Adolescence
    • Conflict: Identity vs. Role Confusion
    • Goal: Personal identity
  • Stage 6:
    • Period: Young Adulthood
    • Conflict: Intimacy vs. Isolation
    • Goal: Development of strong and lasting relationships
  • Stage 7:
    • Period: Middle Adulthood
    • Conflict: Generativity vs. Stagnation
    • Goal: Accomplishments like raising a family, succeeding at work, and volunteering in the community
  • Stage 8:
    • Period: Maturity
    • Conflict: Ego Integrity vs. Despair
    • Goal: Wisdom and satisfaction

These stages are arbitrary (in terms of the age they start/end) and fluid. When challenged by an external stressor like cancer, previously-acquired coping skills may not suffice anymore. The experiences you have had in your life will determine how overwhelming (or even traumatizing) a cancer diagnosis may become — and if it will be an opportunity for emotional growth or a trigger for emotional stress or despair. You may need to go back and forth between stages to refine or rework your coping skills. 

After this long introduction the big question is, how can you find the “new you” or relief for your “identity crisis”? A lot has been written about this. But in the end, everyone has to make their own peace with their own unique life story, which may take time. A key aspect of working towards finding the new you is the refinement of priorities and coping styles. This sometimes may include processing past hurt with help from a talk therapist. But here are a few general pointers that you may find helpful:

  • Are you doing something because you think you need it (e.g. to fit in with societal expectations) or because you want it? Be true to yourself – dare to be authentic!
  • To prevent loneliness, surround yourself with people who accept you for who you are and are not afraid to join you on your cancer journey. If friends like this are hard to find nearby, you may find comfort in online friendships. 
  • Set a meaningful, fulfilling creative or altruistic goal and stick to it. Quality matters more than quantity – in particular when you have functional impairments – “if you cannot run, walk”!
  • It’s never too late to start a new venture! See this man who after retirement felt “he was waiting for his obituary” – and started his own business at an older age to “get his blood flowing”!
  • Allow yourself to be spontaneous, laugh, and make memories.
  • Recognize that your actions impact others through the ripple effect (legacy!). Work to make that impact authentic, respectful, and memorable.
  • Become comfortable with change. It’s the only constant in life.
  • It’s easy to be self-critical. When reflecting on your life, recognize that you did the best you could with the knowledge, wisdom, and resources you had. 

Remember, we are all works in progress!!!

Thank you for visiting me. Below I’ve included a few things to educate and entertain you. Remember, I share ‘extra treats’ if you follow me on Facebook, Instagram, Twitter, or Pinterest! Plus, you can get notified of a new posting by subscribing to our newsletter!

Learn and Think:

Live and Feel:

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You Cannot Always Win – Cancer Survivorship Apps, The Biggest Little Farm

You Cannot Always Win – Cancer Survivorship Apps, The Biggest Little Farm

Dear Fellow Traveler,

Sometimes my life feels a bit complicated, like a chess game in which I’m always trying to anticipate and strategize. I guess everyone’s life is like this, but dealing with a chronic health issue adds another layer of complexity. If your health causes you to have less energy at the beginning of your day, if that energy is drained faster because your body is less fit and if you have extra tasks to take care of your health (e.g. doctor’s appointments, medical tests, paperwork for e.g. leave/disability/accommodations), life can become overwhelming. At times it may even feel like you’ve been checkmated!

Most of us try everything we can to control our quantity of life to the degree that quality of life may suffer. For instance, many things we do because we think they’re healthy may turn out to have downsides (e.g. vitamin intake may be associated with lesser survival,  calcium pill intake may be associated with heart disease and Zantac may contain a carcinogen). Please note that all of these observations do not imply cause/effect, but reflect associations requiring further investigation. 

It can sometimes feel like you can’t win. You take two steps forward and one back, or one step forward and two back. It may help to remember that life is a marathon, not a sprint. When you find yourself spinning your wheels without clear purpose, stop and breath. Be kind to yourself. Rest, sleep, watch a movie, anything to allow your brain and body to rest and gain a new perspective. We’re not the only ones who have a hard time making sense of life. Even though we live in the 21st century, the medical community still has a lot to learn about our bodies, this ‘black box’ in which many systems are closely balanced and interrelated.

The internal tension you may feel forcing you to ‘fight for your survival’ after you have faced a traumatizing diagnosis like cancer is (in most cases) a normal and healthy response. You may need to find ways to distract from your own thoughts and feelings and navigate your internal energy outwards into more productive channels. I have listed a few examples to get you inspired! Please note that I intentionally did not list exercise, sleep, and diet, since they can become more a source of stress than relief in cancer survivors. Also, I did not list much about relaxation techniques (e.g. yoga, meditation), because when you have so much inner energy boiled up, it may be quite difficult to relax. First try blowing off some steam by actively doing any of the following:

  • Invest time each week in creating a calendar that visually outlines your schedule. This may allow you to recognize conflicts and/or reorganize days that may prove to be rather hectic. Break tasks down into smaller steps and rank them by priority — in terms of what you need as well as what you want! Perhaps ask a loved one to help you plan your calendar so you can identify opportunities for them to support you or join you in social activities that you can both look forward to and enjoy. (Feel free – or better yet – I challenge you to make plans to spend a few hours together doing nothing!) 
  • Absorb nature (even if you only sit) and allow all your senses to be stimulated. It can be a calming and humbling experience! 
  • Distract yourself by getting a new hobby. (What were your favorite activities to lose yourself in when you were younger?) 
  • Express your thoughts and feelings to yourself (e.g. by writing them down or typing them into your phone) or to others. Sometimes it may feel safer to express your worries to people you don’t love (such as a healthcare provider) since you may not want to hurt your loved ones with your worst thoughts/feelings. 

Control is an illusion. Please allow yourself to accept the things that you cannot change, since fighting them only makes your life harder. Life is not only about the destination, but also about the journey. Please be kind to you along the way by acknowledging that no matter how hard you try, you cannot always win! 

Thank you for visiting me. Below I’ve included a few things to educate and entertain you. Remember, I share ‘extra treats’ if you follow me on Facebook, Instagram, Twitter, or Pinterest! Plus, you can get notified of a new posting by subscribing to our newsletter!

Learn and Think:

  • A review of publicly available apps for cancer survivors.

Live and Feel:

  • A fascinating movie (The Biggest Little Farm) tells the true story of a young couple who left Los Angeles to successfully start a farm for a barking rescue dog whom they had promised would never change families again. Enjoy going back to nature while you watch this!

Please help by nudging us if you encounter technical problems.

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