fbpx

Articles with #cancersurvivormd

Pity vs. Compassion – Wild Horses, Journaling

Pity vs. Compassion – Wild Horses, Journaling

dog-2785077

 

Dear neighbor!

How are you today? This week I shared a meal with another cancer survivor. We ended up talking about how we try to carefully gauge when, how, and what we share to avoid becoming a conversation stopper or the object of pity. But not sharing our pain can lead to feelings of ‘self pity’ and isolation. On the other hand, the sharing of our stories can also make us feel worse or even compelled to comfort the other person, in particular when sharing our pain triggers negative judgment (such as ridicule, inferiority, failure, or pity).

The bad press received by pity concerns both what pity lacks, namely, actual assistance, and what it implies, namely, a feeling of superiority and satisfaction with our own position. Source.

And this brings us to compassion. Pity and compassion are two reactions (to seeing someone suffer) that overlap and are on opposite ends of a spectrum that also includes sympathy and empathy. I like the following graphic, which visualizes the relationship between these 4 terms:

inforgraphic
Designed by Robert Shelton.  Source

 

These different terms correlate with different perspectives on life that one may have been born with and/or acquired over time.

Someone who has compassion senses a cancer survivor’s suffering and has an active desire (and ability !) to:

  • Allow one “to just be” (which may take a survivor already quite a bit of energy/effort!),
  • (Often silently) provide company (while respecting boundaries),
  • Universalize the situation (because life is not fair for many),
  • Create temporary distractions from problems (with e.g. silly activities),
  • Allow one to feel less of a nuisance,
  • Take on the challenging task of knowing when and how to help, since a cancer survivor may not always need instant help or a solution. And may even (stubbornly!) prefer to first try to sort things out on their own (perhaps needing you as a listener or a sounding board),
  • Jump in if you see HELP signals, e.g. trouble taking care of oneself, dysfunction in their family or society, posing a danger to self/other,
  • Be comfortable with the unsatisfied desire to help. In particular, if the survivor is not (just yet) open to accepting help (you can bring water, but cannot force one to drink), or if there is no clear solution at this point in time.

Compassion is one of the main drivers of altruism, which in its turn can facilitate well-being. Altruism can be a noble (or even self-motivated) initiative to alleviate suffering, but helping others can also be a defense mechanism in which one distracts themselves from their own thoughts/feelings. The helper needs to also care for him/herself to minimize risk for caregiver burnout.

Compassion for me translates into a few key words and noble goals that we all should aim for: honesty, unconditional love, genuine care, and passionate generosity. But please remember that you are only human – it’s the reaction to and recovery from our unavoidable mistakes and failures that count and allow us to grow!

Won’t you be my neighbor…?

Please…find below a few things for education and entertainment!

Learn and Think:

Its cucumber time, or also a slow-medical news-season. Give your brain a rest!

 

Live and Feel:

  • Enjoy this video of one of the few remaining herds of wild horses – the Chincoteague ponies and Assateague’s wold horses!
  • Visible Ink offers Memorial Sloan Kettering Cancer patients to express themselves in writing with the individual support of an experienced writing mentor. Their initiative has been described in the NYT. Journaling may be one way in which one can write their thoughts and feelings away to facilitate healing!

 

Please help by nudging us if you encounter technical problems.

“The Other Shoe” Phenomenon, Glass Half Full/Empty – Implant associated Lymphoma, Mr. Rogers

“The Other Shoe” Phenomenon, Glass Half Full/Empty – Implant associated Lymphoma, Mr. Rogers

aqua-3445987

Dear neighbor!

The summer is passing quickly. Many of you are likely already starting to prepare for the next 6 months – health, school, work, family, house, car, travel, and the Holiday season….etc!

Life can feel like a never-ending whirlwind at times – pulling you in many different directions, leaving you to organize and streamline the chaos.

Having been told that you have cancer, one of life’s “worst case scenarios”, you may have, unconsciously, lost trust in your body or life, and started to be more ‘on guard’, ready for “the other shoe to drop” or deal with whatever or whenever the next ‘worst case scenario’ may be. You may also know this as the Fight-or-Flight response. But this response can go into overdrive at times, affecting all aspects of your life, even the routine ones. Perhaps you used to be a glass-half-full person, but now you may have become more of a glass-half-empty person.

I hope this writing will allow you to try to Stop-and-Think-First before you act, when you feel your body tensing up for a ‘fight’….(unless, of course, there truly is a life-or-death emergency, like a lion chasing you!).

Pause to get yourself e.g. a delicious meal, a good night’s rest, a meaningful conversation with a loved one, whatever it takes to regain a more neutral and realistic perspective….and then rethink your decision-making again….you may discover that your glass is neither half-full, nor half-empty…..it may actually be refillable, maybe even to the top….!

Life is not always fair….some people may have more suffering on their path than others….but some may also choose to keep their suffering more private….please don’t give up hope….and find “neighbors” who can help you carry your backpack!

Won’t you be my neighbor…please? Please…find below a few things for education and entertainment!

Learn and Think:

Certain breast implants have been in the news this week due to a FDA recall:

Based on the currently available information, our analysis demonstrates that the risk of breast implant associated lymphoma (BIA-ALCL) with Allergan BIOCELL textured implants is approximately 6 times the risk of BIA-ALCL with textured implants from other manufacturers marketing in the U.S.

At this time, the FDA does not recommend removal of these or other types of breast implants in patients who have no symptoms due to the low risk of developing BIA-ALCL. The FDA will continue to evaluate any new information and may, as a result, take action regarding other breast implants, if warranted. Source

If any questions or concerns, it may be best to contact your plastic surgeon.

Live and Feel:

Lately, I have become fascinated with Mr Rogers’ legacy, probably encouraged by the upcoming release of the Its a Beautiful Day movie in which Tom Hanks portrays Mr. Rogers. Mr. Rogers courageously displayed his own vulnerability/sensitivity and preached “love” to encourage “being”, acceptance, respect, confidence, and health. His award-winning messages and poetry are simple, yet deep, and just as helpful as they were 50 years ago, independent of your age! His thought-to-be-last video message to his grown-up fans gently encourages “the expression of feelings in ways that will bring healing”.

Fred Rogers once said:

“Part of the problem with the word ‘disabilities’ is that it immediately suggests an inability to see or hear or walk or do other things that many of us take for granted. But what of people who can’t feel? Or talk about their feelings? Or manage their feelings in constructive ways? What of people who aren’t able to form close and strong relationships? And people who cannot find fulfillment in their lives, or those who have lost hope, who live in disappointment and bitterness and find in life no joy, no love? These, it seems to me, are the real disabilities.” Source

 

Please help by nudging us if you encounter technical problems.

Being (a) Patient – Colonoscopy, Happiness, Lion King

Being (a) Patient – Colonoscopy, Happiness, Lion King

img_4488

Dear Travel Buddy!

Great to see you have stopped by to check in – always appreciate the company! This weekend, my family (thank you!) assembled a few pieces of furniture….which inspired me to write about ‘patience’….! 

When my patients express concern that their medical care is moving (too) slowly or their recovery is taking longer than expected or desired, I often ask them if they know why a patient is called ‘a patient’. Usually this results in an inquisitive, speechless gaze. The word patient is derived from Latin:

Adjective: Able to accept or tolerate delays, problems, or suffering without becoming annoyed or anxious.

 

Noun: Person receiving or registered to receive medical treatment.

Citation

 The precise meaning of the medical definition of patient continues to be inconsistent, likely as the medical field and society continue to evolve. As such, a renowned medical journal had even devoted an article in 1999 (!) to the discussion of the pros and cons of finding a new word for patient. The article’s conclusion was that the massive undertaking of changing the word ‘patient’ to something else (requiring it’s own research, implementation, and distribution efforts) is likely not worth the diversion of time, effort, and resources away from providing and innovating patient care.

A similar discussion is ongoing about the ‘cancer survivor’ label. For some, the term cancer survivor may allow recognition and unity. For others, it may result in discomfort, because they don’t feel that their journey was heroic enough or because the label may allow division among survivors or represents survivors’ guilt or even a Post-Traumatic Stress Disorder trigger. 

The reason for your impatience may change over time:

  • Initially, when you are newly diagnosed (and undergo testing, await treatment plan decisions and insurance authorizations), being impatient may be a reflection of a fear of the unknown, lack of control, or feeling overwhelmed. Starting cancer therapy is usually the best remedy to provide some relief. But in the interim, it may help to know that only a few cancer types and situations represent a true medical urgency/emergency. Even though anyone would like to have their cancer treated as soon as humanly possible, for the majority of cancer diagnoses, it is more important to be strategic. The quality performance of a number of strategically selected and rapidly evolving imaging, laboratory, and pathological tests will facilitate informed decision-making and the creation of a personalized cancer treatment plan that aims to optimize benefit and minimize harm. Furthermore, it also may help to know that there are many official organizations that hold cancer centers accountable for administering cancer treatments in a timely manner (e.g. the Commission on Cancer in the USA).  
  • Next, as you transition from the active treatment phase into the post-treatment phase, impatience may become more reflective of a frustration with the slow or incomplete recovery process, a need to gain more control over your life (and survival), or a desire to catch up on life that was abruptly put on hold for the cancer treatments. With respect to a frustration with delayed/incomplete recovery/healing, I would like to refer to a previous post on acceptance. The instinctive urge to catch up on lost time could be interpreted literally, since some cancer treatments can be really intense and prolonged. But it can also be interpreted figuratively: the cancer experience may have increased one’s awareness of their own mortality and ignited an urge to get certain things done ‘before time runs out’. It may help to know that your priorities will often change after a cancer diagnosis, allowing you to live closer to the essence of your life, catch up with (and perhaps even surpass) your pre-cancer trajectory! 

Please try to be more patient with yourself…..this is not a sprint, but a marathon! And I sincerely hope you will feel comfortable enough to ask your health care providers for help, if you feel ‘your mind is becoming your worst enemy’ and leads to dysfunction. There is no need for shame or embarrassment in this current time and age. You are only human – everyone has a breaking point!   

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

Learn and Think:

  • Health maintenance alert! The American Cancer Society recommends that most people – those at average risk – start regular colon cancer screening at 45. People with an increased risk may need to start screening before age 45. Please discuss this with your health care providers! 

Live and Feel:

  • This non-profit organization, Action for Happiness, is devoted to making the world a happier place by providing various insightful tools and resources that promote the 10 essential keys to happier and more resilient living (for free or low cost).  
  • The original Lion King movie from 1994 is one of my favorites. Its music and story themes (circle of life, the good prevails) resonate with me. [The Lion King 1 1/2 movie is hilarious, which tells the Lion King story from the perspective of Timon and Pumbaa]. This weekend the Lion King movie’s remake premiered – I didn’t get to see it yet – did you?! I love the Circle of Life song – click here for the video, see below for the lyrics! 

“Circle of Life”, partial lyrics

From the day we arrive on the planet
There's more to see than can ever be seen
More to do than can ever be done
There's far too much to take in here
More to find than can ever be found
But the sun rolling high
Keeps great and small on the endless round

It's the Circle of Life
And it moves us all
Through despair and hope
Through faith and love
Till we find our place
On the path unwinding
In the Circle
The Circle of Life

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

 

 

Acceptance – Nutrients, Perfectionism, Photo Ark

Acceptance – Nutrients, Perfectionism, Photo Ark

 

mallard-3466950

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

silhouette-683751

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:

It’s the little things – Finances, Marijuana, and Symptom Reporting

It’s the little things – Finances, Marijuana, and Symptom Reporting

children-441895

Dear reader! How have you been?

I have been home alone this weekend. My boys are at an out-of-town baseball tournament. And even though I love them dearly, I am sure many of you can relate if I would share with you that it can also be really nice to be home alone. And being able to take the time to enjoy routine activities as well as to explore, e.g. by trying out a new grocery store, and then coincidentally discovering a new ice-cream place…..shaking things up a bit…..being fascinated by the little things…..stimulating the senses. Over the last few weeks my existence had shrunken down to the work and home environment – and so it felt really good to be able to be ‘out and about’ for a bit….expand my world….allowing the simple things to bring distraction and joy, just like in childhood!

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

Learn and Think:

  • Cancer care is rather expensive and not always (fully) covered by insurance, resulting in 25% (1 out of 4!!!) of cancer survivors facing financial hardship. Therefore, it is encouraging to see that there is a government-led, bipartisan initiative, Cancer Survivors Caucus, that tries to improve care for cancer survivors!
  • You should feel comfortable to discuss any of your symptoms, no matter how seemingly small or innocent, with your health care provider to allow them to figure out why it is happening and if anything can be done to provide you with (partial or total) relief. And there is now evidence to support that those who self-report symptoms may live longer!
  • Medical marijuana is a trendy modality that you may have heard of or read about and wondered whether it is something you should try? Dispensaries are popping up everywhere. It often needs to be paid for out of pocket. It is not yet FDA approved – evidence is limited. Here are a few good articles (from the CURE Magazine and NIH) to allow you to decide for yourself. And as always, please discuss with your own providers first before pursuing a medical marijuana license.

Live and Feel:

  • Article: Saturday Night Life alum Vanessa Bayer reflects on her cancer journey that started in her teenage years.
  • Movie: I saw this movie recently (Cast Away). It reminded me of how random life can be at times. And how our inner strength can surprise us at times when it instinctively rises to brave life’s challenges. And lastly, how everyone needs someone…..even if it’s only Mr. Wilson!
  • Video clip: This bird was spending quite some time interacting with my car mirror. For me it symbolizes that “sometimes when we cannot go where we’d like to go, we may discover that we already are where we are supposed to be!”.

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.”

Happy Weekend!

Happy Weekend!

Hello you!? What are you doing this weekend with the summer ahead of you?

I am trying out a new blog format in which I will share a few topics that may allow you to learn and feel! Let me know what you think!

Till the next time!

 

Learn and Think:

Does Cancer Battle Bring Personal Growth? Yes and No, Survivors Say “It’s normal for people to find meaning in their cancer experience while still acknowledging it as a terrible ordeal”.

How to Talk to Your Kids About Your Cancer Diagnosis. This short read with helpful advice from experts and a mom who’s been there twice may be helpful. There is no right or wrong way, as long as everyone feels loved and supported.

The cost of cancer: 25% of survivors face financial hardship report finds – CNN. Health care providers should ask patients in a respectful and nonjudgmental manner about their ability to afford their treatments – and if difficulties, then refer patients to local resources (e.g. navigators/social workers) or regional/national resources to receive advice and sometimes even grant support. Similarly, cancer survivors should not be embarrassed to tell their providers that they struggle financially. Awareness of the magnitude of patients’ financial hardship may urge policymakers to change legalization and health care coverage.

Live and Feel:

Happy video about a Dog Becomes a Sun Flower.

Beautiful video featuring a rare albino mantras ray.

 

National Cancer Survivors Day 2019!

National Cancer Survivors Day 2019!

Dear reader,

You may have missed it….but today was the annual National Cancer Survivors Day….

This day may have different meanings for different people….which is understandable, because all of our stories are different.

But, eventually, what may unite us all is our universal goal of trying to prioritize the creation of new memories and meaningful connections, every minute of every hour of every day, despite our responsibilities (related to e.g. work, home, health).

Love!

Cancer and Brain Fog

Cancer and Brain Fog

What:

It is common and frustrating for cancer survivors to experience a condition generally referred to as “brain fog.” Some people may notice difficulties with concentration, memory, and/or thinking. They may have a hard time reading a book; repeating the same paragraph over and over, or they may find themselves needing to jot down notes that will help trigger their memory. Thinking may be slower and less efficient leading to difficulties, especially when trying to multitask.

When:

While brain fog can manifest itself both during and after treatment, you may be surprised to learn that it can even start before actual cancer treatment begins. You may have heard the term “chemo-brain” but this reference is not quite accurate in its description since the clinical entity is often the result of a combination of many factors.

Why:

Researchers have found that this condition can be caused by many different factors: the tumor itself (through the secretion of circulating agents), lingering side effects of  sedation (from procedures), changes in medications, new levels of physical activity, changes in nutrition, sleep patterns, vitamin levels, hormonal changes, cancer treatments and the emotional roller coaster that all of these new stimuli bring about. People who may have been on the verge of developing sleep apnea, may find that weight gain leads to the development of full-blown sleep apnea, which results in less oxygen to the brain overnight, and then less brain function during the next day.

Work-up:

Dementia screening tests usually do not pick up any abnormalities, because this type of brain dysfunction tends to be more subtle. The most essential part of a work-up includes talking with a provider who will work with you to try to find out when the brain fog started, which symptoms you experience and if they change over time, and what else may be going on in your life that may be a contributing factor.  Sometimes your provider may order labs, brain imaging, or even neuropsychology testing. The more dysfunction one experiences from this, the more diagnostic and therapeutic tools providers will need to explore. On very rare occasions the condition may become so bothersome that a person may need to consider special accommodations such as seeking a disability status.

Therapy:

In general, there is no one remedy that is able to correct the condition quickly and completely. Relief is often the result of a multi-prong approach which tackles the most significant problems that were identified through a variety of options. Talking with your provider is the best first step. They will be able to discern what course, e.g. correcting laboratory abnormalities, referencing sleep apnea issues, and addressing resources for emotional support is the best path for your individual situation. Surprisingly, exercise has been the one consistent and most potent intervention found to be a major factor in cancer survivors to help many symptoms, including brain function. While we do not yet understand the connection fully, current studies are underway to explore these findings (better perfusion of brain or toxin removing organs?). A smaller subset of individuals may benefit from provider prescribed stimulants and/or brain training exercises

Prognosis:

As far as current evidence tells us, “brain fog” does not represent a precursor of dementia. With the proper attention and intervention, the brain can, and and in most cases will, continue to improve. This process can take time and patience, but is an achievable result!

Resources:

Relevant links from major cancer organizations: