Articles with #cancersurvivorphysician

(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.

Please help by nudging us if you encounter technical problems.

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:

Please help by nudging us if you encounter technical problems.

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:

Please help by nudging us if you encounter technical problems.

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.

Crooked Body – Menopausal Symptoms, Olivia Newton-John, and the Atlantic Festival

Crooked Body – Menopausal Symptoms, Olivia Newton-John, and the Atlantic Festival

Dear Fellow Traveler,

How has your week been? My highlight of the week is that I did something that I had promised myself I would never do. I gave in to a minimal and natural amount of highlighting to camouflage my more than average amount of gray hairs…and to my surprise, it boosted my feeling about myself more than I had anticipated! I even purchased a few hair accessories which helped me to feel human and feminine. 

Sometimes our health struggles can make us feel less attractive or desirable.  In fact, sometimes I feel crooked! Crooked, because I feel that my body must be broken since it developed cancer to begin with and then was further damaged by therapies. It may seem that cancer is the gift that keeps on giving in terms of nature and frequency — even though it may be hard to tell whether your medical issues developed due to your genes, environmental exposure, cancer treatments, etc. You may feel like your list of medical issues is never ending and continues to grow with late- and long-term effects. You’re probably tired of constantly going for testing and seeing doctors. (If you’re like me, your health care team has grown drastically.) Do you find yourself wondering when this will slow down, stop, or just normalize?

Some of you may be more like Tigger, trying to be proactive and on top of your health, while others may prefer to be more like Eeyore, forced to react when things hit him in the face. (Ignorance is bliss.) Both perspectives and anything in between are what make all of us different, unique, and human. As with everything in life though, it’s best to pursue moderation and avoid being on the extreme end of the spectrum which may lead to paralysis from anxiety or procrastination.

You’re only human. We all find our own illusionary balance in managing our medical issues. What works today, this week, or this month, may not work forever.  The trick is to keep an eye on the big picture by remembering that you don’t live to go to the doctor, you go to the doctor to live! Your health may control many aspects of your life and at times may try (and succeed) in making your mind become your own worst enemy. Illness can bring you to a dark place of anger, sadness, and frustration. In that case I hope you will be open to getting professional help (yes, adding another provider) to help you grow through the rough spot to arrive at a better space where there is room for little joys, new memories, and the pursuit of meaningful activities, regardless of how small your world has become due to your health and the amount and severity of medical issues you are juggling. It’s the little things that matter and can bring a gorgeous smile on your loved one’s faces that will brighten your mind and warm your heart!

This balance will allow you to be more resilient when life throws yet another inevitable curveball! And remember that the opposite holds true. The darkness and rain allow you to be more appreciative and grateful of the sunny periods in your life. The good and bad go hand-in-hand, keeping us in line and life in perspective.

You may feel guilty that you are complaining while you should be grateful for being alive, but the cancer journey can be complicated and overwhelming. It may help if you make it simpler by breaking it down into smaller steps, asking your health care team members to prioritize your appointments and testing, and asking loved ones to help you schedule your appointments, as well as drive and accompany you so you can have some distraction while there. Perhaps you can combine a doctor’s visit with doing something that touches your soul or makes you smile, no matter how small! 

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! 

Learn and Think:

This week, since we are about to head into Breast Cancer Awareness Month, I would like to recommend a few resources that might help the women amongst us. (Sorry, men. However, parts of these books may be helpful to you who have women in your lives.) 

Live and Feel:

Please help by nudging us if you encounter technical problems.

Keeping It Real on Social Media – How Many Steps a Day?, Healthy Food Trends, and How to Avoid Drama

Keeping It Real on Social Media – How Many Steps a Day?, Healthy Food Trends, and How to Avoid Drama

Dear Fellow Traveler! 

I have not posted anything in the last few weeks. I was busy with work and hosting a visitor.  Then I had to have a colonoscopy, an experience I expect is well-known to many of you. (Thankfully, it didn’t find anything concerning!) Taking a break from social media was refreshing. That made me think…

Reading posts about someone’s seemingly perfect life (that we may not ever be able to achieve) can lead to feelings of isolation, anxiety, and inadequacy. Posts detailing someone’s complaints about the world can make us feel down too, in particular if we feel that they may target us, either directly or indirectly. Social media sites have begun changing their rules to create a more respectful platform that will hopefully foster more meaningful connections. This is a great beginning, but I think more subtle changes are needed.

Before posting on social media, ask yourself what your purpose is. If your goal is to elevate yourself by showing off your accomplishments, to ridicule someone, or to express your complaints or frustrations, perhaps you should think twice. If your intention is to help others by posting content that is inspiring and authentic (whether focusing on the ups or downs that are inherent to life), then your post is more likely to have a positive impact. Social media can be restorative. Even if you cannot interact with others in person due to your health circumstances, you can still help them and create a legacy online via the ripple effect of shares, clicks, and likes! This might make you feel as if you are exposing your vulnerable side, so you may want to start slowly. Follow your comfort level.

If reading social media causes you more grief than joy, you might consider turning off your accounts. If that seems too extreme, you should feel free to change who and what you follow to dynamically match your evolved taste and life priorities. This will allow you to maintain the feelings of belonging and meaningful connection that social media was intended to create. If you are homebound due to health concerns, social media can be a great way to stay present, engaged and in touch while you travel the virtual world!.

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! 

Learn and Think:

  • How Many Steps Should You Take a Day? I believe the short answer is: “It depends”. This article describes 1) the fascinating history of the arbitrarily chosen target of 10,000 steps per day as well as 2) the notion that one’s daily physical activity goal cannot and should not be reduced to a target step-count since the target depends on your personal fitness level. Plus, physical activity includes so much more than only steps. However, anything is more than nothing! 
  • Eat This, Not That had an entertaining clip on a recent Today show episode about the Tastiest and Trendiest New Healthy Foods! I was particularly interested in their featured broccoli crust pizza, oats and keto-ice cream product! Yummy in my tummy!

Live and Feel:

Please help by nudging us if you encounter technical problems.

Animals and Illness – Hormone Replacement Therapy, Mastectomy Reflection

Animals and Illness – Hormone Replacement Therapy, Mastectomy Reflection

Dear fellow traveler! Hope this week has treated you well.

Over the last few months, our household has been having an ongoing discussion about the pros and cons of having a pet. Also, we’re wondering what kind of animal would be best for our lifestyles. Since pets come in all kinds of shapes and breeds, we began to consider size, activity level, and maintenance. We live in an apartment and are all busy busy, including my boys. They are often on the road for their baseball activities, so the pet and I will probably become best buddies! Having grown up on a farm, I know that having an animal around would rekindle some happy memories for me. Eventually, after lots of thinking and talking, we decided to start off with a cat, a calm breed who loves cuddling but can also be alone. The Dutch word for milk is melk and we’re fans of this MLB baseball player. Hence, the cat’s name will be Melky. Our pet-to-be is now a few weeks old and will come to us in December. We are all so excited! 

Pets can play a significant role in the lives of human beings (and hopefully vice versa)! Animals may improve the quality, and even quantity, of life! Dog ownership has recently been associated with better (heart) health (likely due to dog walks)! Furthermore, pets may distract and soothe us, allow us to release and process our feelings, and remind us of the fragility of nature and life. They can function as role models in terms of resilience, gracefulness, and self-care. Pets often love to receive and give affection in an unconditional and nonverbal manner.

More than that…..pets play a meaningful role in society:

  • Service animals are trained to support their disabled owners.
  • Emotional support animals provide therapeutic benefits to those with emotional difficulties.
  • Therapy dogs do not have the legal access rights that the above mentioned animals do, but they provide great comfort to people suffering in medical facilities and nursing homes. In fact, training your dog as a therapy dog is a fulfilling way to give back to your community.

Whether you decide to get your own pet or spend more time with someone else’s, please check with your healthcare provider about which kind may be best for you. You and your loved ones may have sensitivities or allergies. In addition, your previous or current cancer therapies may increase your risk of acquiring an illness from your pet.

Continue to be kind to yourself and others! Thank you for visiting me. Below I’ve included a few things to educate and entertain you. Follow me on social media for ‘extra treats’ (@CancerSurvivorMD on Facebook, Instagram, Pinterest, and Twitter)!  

Learn and Think:

For those of you who are going through the change of life prematurely, perhaps as a result of cancer therapies, please find here the results of a recent major study that provides updated guidance on hormone replacement therapy. Being educated on this topic can help you talk with your healthcare provider.

Live and Feel:

A survivor’s reflection on her mastectomy.

Please help by nudging us if you encounter technical problems.

Describing Symptoms Accurately – Link between Vacation & Disease, Taylor Swift, Shore Birds

Describing Symptoms Accurately – Link between Vacation & Disease, Taylor Swift, Shore Birds

parrot-1070624

Dear fellow traveler! 

As a physician I am expected to know all about symptoms. However, I have found myself having difficulty describing my own symptoms this week. And even though I have very supportive healthcare providers, this made me feel a bit inadequate. Why I would feel this way? I have been thinking it over for a bit, and even explored a little online, but did not find too much written about this topic. My husband told me that I ended up asking my provider several times “does this make sense to you”? (which I discovered is one of the recommended tips when describing symptoms to doctors) and now I am wondering, dear reader, do I still make sense to you? I have given this topic a place within my heart and head and hope that my writing may comfort you. 

We see the world and we sense our bodies in our own unique ways, colored by our genes (nature) and our past (nurture). It is not always easy to translate our feelings into words. There is even a formal name for it: alexithymia. Some of us may experience this difficulty expressing ourselves more often and more deeply than others. Many factors contribute to this challenge, such as: 

  • education
  • brain function
  • pain thresholds
  • vocabulary (I never know how to answer a question about the character of my pain – dull, burning, sharp?) 
  • self-awareness (which may be affected by traumatic experiences)

I think there may be an extra layer of complexity to this. What if your body has been damaged or altered by your disease or treatments? I can imagine that altered anatomy, myofascial planes, blood supply, lymph drainage, and nerve routes, may change the ‘normal’ (if there ever is any) or expected presentation of a symptom. These physical transformations may further challenge the often already difficult communication about symptoms between the provider and the patient, making illness harder to diagnose and treat.

It can be daunting for a patient to know when a chronic symptom has worsened to the point of needing to seek help. If you wait too long, your illness may become more severe. Also, you may find that you’re unable to explain when and how the symptoms started changing (over the course of days/weeks/months?) or how exactly this presentation is different from before. If you seek help too early, you may worry that you’ll earn the reputation of “the boy who cries wolf“. 

Physical and emotional symptoms can coexist, interact, and synergize with each other. You may be upset about the effect a symptom may have on your life, as well as be wondering why it is happening (Is it a sign of the cancer recurrence?) and will it ever go away? But then, stressing over it will not help your body either.

Symptoms may not always have associated objective findings on diagnostic testing. And even if they do, how do we know for sure they are related and not a coincidental finding? The description of invisible symptoms is not unique to cancer, as described by this Multiple Sclerosis blogger. 

Take home points:

  • Find yourself a provider who actively listens and treats you with respect.
  • Ensure that life-threatening problems will not be not missed, while your emotional toll is not being ignored. 
  • Be accepting of your new reality. Accept that your body may be irreparably damaged and your situation may be chronic.
  • If a therapeutic intervention is being proposed, carefully balance the pros/cons (high potential to help coupled with a low risk to do harm). 
  • Be aware that there are a lot of expensive and time-consuming scams out there that prey on people who are rather desperate for relief. To me this is cruel beyond words. 
  • Learn to balance uncertainty (as to etiology/prognosis) with the hope that there might be options out there to take the edge off and make your symptom(s) a bit more bearable. 

I hope this blog entry will allow you to 1) feel that you are not alone in this experience and 2) be empowered to go out there and find yourself a personalized treatment plan! Continue to be kind to yourself and others!

Thank you for visiting me. Below I’ve included a few things to educate and entertain you. And I share ‘extra treats’ via social media!  

Learn and Think:

Even though the cause/effect relationship is not confirmed yet, a recent publication has revealed a (not very surprising?!) association between more frequent vacationing and a reduced metabolic syndrome risk. Metabolic syndrome is associated with the risk for heart disease and likely many other diseases, including some cancers. Try to utilize all your available vacation time! 

Metabolic syndrome is a collection of risk factors for cardiovascular disease. If you have more of them you are at higher risk of cardiovascular disease. This is important because we are actually seeing a reduction in the risk for cardiovascular disease the more vacationing a person does. Because metabolic symptoms are modifiable, it means they can change or be eliminated. Bottom line: A person can reduce their metabolic symptoms – and therefore their risk of cardiovascular disease – simply by going on vacation. We are still learning what it is about vacations that make them beneficial for heart health, but at this point, what we do know that it is important for people to use the vacation time that is available to them. “One of the important takeaways is that vacation time is available to nearly 80 percent of full-time employees, but fewer than half utilize all the time available to them. Our research suggests that if people use more of this benefit, one that’s already available to them, it would translate into a tangible health benefit.

Source

Live and Feel:

“It’s taught me that there are real problems and then there’s everything else. My mom’s cancer is a real problem. I used to be so anxious about daily ups and downs. I give all of my worry, stress, and prayers to real problems now. It’s really interesting because I don’t think I have written a song quite like that before. And it’s just sort of, like, it’s just a tough one. It’s just not something that we deal with until we have to, until we see it, until we experience it, until someone close to us is going through something like that. And so, writing about it was really emotional. And I’m just gonna stop talking about it now.

Source CBS News and Source Today

Please help by nudging us if you encounter technical problems.

Missing in Action

Missing in Action

dog-1530644

 

Dear Neighbor!

A few loyal readers had checked in on me this week, because they noticed that my weekly posting did not take place last weekend! This experience was heart warming and led me to write this brief entry. I am sorry for my radio silence. As many of you are very much aware, our bodies do not always cooperate. I am on the mend, prioritizing my employment and healing. As a result, there was no time/energy for ‘extra’ things such as social activities and writing a blog entry….but I hope to release a new post in a few days – stay tuned!

In the mean time,  you may enjoy watching this conversation between two male tv personalities who shed tears when they speak about grief (this message is not politically motivated). Please let me know if you cannot view the link.

Be kind to yourself!

Please join us – click here to sign up for our newsletter! 

 

 

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.”