It’s Just a Little Tougher to Bounce Back Nowadays

Wow. I have to say that having cancer has brought about more change than I realized. I think I tried to partition the whole experience in my mind as a discrete entity with a finite beginning and end. It somehow made it easier to trudge through with a positive attitude when visualizing an actual light at the end of the tunnel.

After the end of chemo, I am slowly realizing that, while that visual was helpful, it was not necessarily realistic. My journey did not abruptly end when chemo did. As I have discussed before, there have been many after effects and pitfalls since and I am learning about new ones every day. Each one I try to embrace, while fighting the little chip on my shoulder that I have to deal with it in the first place.

Most recently, I got my first actual illness outside of chemo in the first two and a half years. Yes. It’s true. Now that I think about it, one little-publicized actual positive side effect of the pandemic has been that we all have had less of the regular sick season viruses, etc because we have been wearing our masks, not doing as much, washing our hands, trying to avoid sick people, and not touching our faces as often. Granted, some of these precautions (like hand washing) should not have been new additions to our routine. Nonetheless, they have all contributed to less routine sickness. Anyway, my point is, that I haven’t really been sick in over two years. So, when I got this crappy gi virus, it really through me for a loop. Number one, believe it or not, I wasn’t really used to being sick. ( I get it. That sounds ridiculous considering I just went through cancer and chemo.) Number two, I was that much more stressed out about the repercussions of missing work because the economic strain has been significant from all the previous missed work. Number 3, it hit me a lot harder than I remembered from previous illnesses. Number 3 is what got me the most. I am just not bouncing back as fast I think I should be. There are a lot of reasons why that could be true. One could be my loss of perspective on being sick outside of chemo. Another could be that chemo has left lasting side effects that keep my body from fighting off sickness as well. My kidneys are not working as well so I get dehydrated more easily. My thyroid is still dead so I get fatigued and my metabolism is altered. The list goes on. You get it though right? There are plenty of reasons for me to have trouble bouncing back from regular illness. So, I shouldn’t worry, obsess, and beat myself up about it. But, alas, I do. I get distracted and instead of doing things to help myself get better, I waste time feeling guilty about who I am letting down this time, as if I haven’t left enough people down with all the cancer stuff. It’s kind of a vicious cycle.

So, here’s the thing. What do I do about it? The fact of the matter is I am the only one that can do something about it. NO one is making me feel this way but me. The guilt is all mine. I have to make the decision to accept this one more thing about surviving cancer. There will be changes that last long after the cancer is gone. They are not my fault. They are not my punishment for things done wrong. They just are. I can chose to move forward…or I can chose to be held back by things that I cannot control. I say forward it is. Otherwise, my recent win was all for nothing.

Dr. Katz

Hiya PTSD! How you doin?

Truer words have never been spoken. I love this quote because it acknowledges the things you potentially can’t change, while redirecting you toward the things that you can.

Let’s talk about trauma. What the heck is trauma anyway? Trauma is defined as an emotional response to a terrible event. Immediately after the event, shock and denial are the most typical responses. Longer term response are more unpredictable and include mood lability, flashbacks, strained relationships and even physical symptoms like gi distress, headache, nausea and aches and pains. This sounds pretty straightforward but is actually much more subjective than you might think.

What is a terrible event? I am sure that we all have some standard ideas like natural disasters, rape, or war, but I am willing to bet that there are hundreds more, depending on the individual and the situation. It is not as black and white as it seems. Something that was pretty terrible for you may see like no big deal for someone else. To a large extent, it is a matter of perception. It is no one’s right to judge another on their response to trauma because it is impossible to truly be “in their shoes.”

So, what is post traumatic stress disorder? This is a mental health condition that is triggered by a terrifying event that is either experienced or witnessed. Symptoms include everything from nightmares, severe anxiety, flashbacks and uncontrollable ruminating thoughts about the event. It is normal to have temporary responses to trauma, but in individuals with ptsd, these responses don’t improve, often last for months or years and even disrupt daily functioning.

Well, I might as well tell you that I am having some ptsd after finishing chemo. Cancer, despite my positive attitude, still had it’s way with me mentally somewhat. It was, in fact, traumatic on multiple levels. Just like I have discussed before, I knew this was one of the risks after completing cancer treatment, not because anyone told me, but because it seemed logical. I mean, look at what my mind and my body have gone through. Chemo and the cancer itself blessed me with aches, pains, nausea, fevers, severe fatigue, neuropathy, etc and then when it was all over, my liver and kidneys took a hit and took awhile to recover….and then my thyroid died and it almost sent me into a coma….all when I was supposed to be done with all that! Mind you, I went through all of that while being off prozac so there was no mental health/anti anxiety buffer available so it was full on unrestrained feels and fear all day long. I got through it. I mean I am getting through it, but it has left some scars. Every twinge or pinch sends my brain racing with death defying possibilities if I allow it. Because, twinges or pinches meant something was terribly wrong before right? So why wouldn’t it mean that now? Oh yes, that’s right. I just had scans that were clear not even a month ago. I am ok. I saw it on film myself. Still, those rational thoughts aren’t the first ones that come to my mind when those symptoms come up.

Last night I was having a basic fibromyalgia flare, brought on by stress, like I have had a million times before, even before cancer. This time, you would have thought that I was dying. I started panicking. I decided that I wasn’t going to the party I was planning on attending. I put myself to bed and started ruminating on all the terrible possibilities until my amazing daughter pointed out that the symptoms were the same as always and she gently reminded me about the stressful day we had. Listening to her broke though my fear bubble just enough that I was able to get myself together and actually go to the party with my husband. We had a great time by the way. Thank goodness for her understanding and her voice of reason when I was being somewhat irrational. But, that’s what post traumatic stress is. It’s irrational. You sometimes cannot see your way out of it without some help.

As the quote above states, the kind of trauma that causes ptsd causes change that you don’t choose. I didn’t chose to get cancer and have organs shut down and be sick for months and months. That was a trauma and that is still affecting me. But, I can choose to continue to heal and get help for my symptoms rather than settling into them and just accepting them as if this is how the rest of my life is going to go regardless of my say so. I do have a choice! I am getting therapy. I am learning ( or trying to learn) new coping mechanisms. I am listening to my family. I am realizing that I do not have to turn in my Wonder Woman status just because I am dealing with this. I am embracing the fact that this is a battle that I do not have to fight all by myself and that is ok.

Speaking of not battling alone, I wanted to leave you with a screening guideline for PTSD from HelpGuide

Do you think you could have PTSD? Here are some screening questions. If you answer yes to three or more of these, you may also have PTSD and should seek help and therapy from a qualified mental health professional.

  1. Have you witnessed or experienced a traumatic, life-threatening event?
  2. Did this experience make you feel intensely afraid, horrified or helpless?
  3. Do you have trouble getting the event out of your mind?
  4. Do you startle more easily and feel more irritable or angry than you did before the event?
  5. Do you go out of your way to avoid activities, people, or thoughts that remind you of the event?
  6. Do you have more trouble falling asleep or concentrating than you did before the event?
  7. Have your symptoms lasted for more than a month?
  8. Is your distress making it hard for you to work or function normally?

If you answered yes to three or more of these questions, you can get help. Cognitive Behavioral Therapy can be very helpful. When you look for a therapist, make sure to look for someone that specializes in trauma and PTSD. There are also a multitude of PTSD support groups in Michigan, which is where I live. Here is some contact information.

  1. PTSD Support Group- meets in Allen Park, Mi. Hosted by Juanita Hinton 734-530-4371
  2. Trauma Recovery Empowerment Group- meets in Warren, Mi. Hosted my Tracy Denice McCall 313-635-0188
  3. Women, Trauma, and Addiction- meets in Novi, Mi. Hosted by Dr. Trisha Stock 248-721-4534
  4. ACT for Anxiety and Trauma-meets in Ann Arbor, Mi Hosted by Dr. Amy Paggeot 734-345-1356

These are just a few resources. My point is, if you think you are suffering from PTSD, don’t go through it alone. There is help out there. You may not have chosen the trauma that was inflicted on you, but you can chose not to be it’s perpetual prisoner.

Dr. Katz

Chemo is done and the party still hasn’t started

My last day of chemo was June 9th, 2021. It was a day I looked forward to for a long time. I thought for sure that it would be the beginning of everything being all right again. I thought I would feel different. I thought the sun would immediately shine brighter and the birds would sing louder and all would be right with the world. I even thought that somehow the last chemo session would be easier, just by knowing that it was the last one for awhile.

To tell you the truth, I could not have been more wrong. For one, the last chemo was no less intense and grueling than all the others. In fact, it was worse than the others because the cumulative side effects somehow intensified and lasted longer. I didn’t feel better immediately either. Surprise surprise. I was still tired all the time. I still had fatigue. I was still swollen. My gi tract still didn’t work and I bloated like a nine month pregnant woman every time I ate to the point that I could hardly breathe. I couldn’t push a grocery cart by myself without getting so winded that I had to stop and rest. I had ptsd every time I had the slightest twinge, wondering if this time the symptoms meant something like they did last time. The sympathetic head tilt looks didn’t instantly stop after chemo was done because I was still bald, which was a visual hallmark of continued illness. I had multiple organs try to fail, some still are trying, from chemo side effects, which brought on many more complications. On top of all that, I was struggling, and still am, to rescue my business from everything that had happened during the pandemic and when I was actively sick. It was all crushingly disappointing.

I think the biggest problem is that I wasn’t mentally prepared for any of this. I just wasn’t expecting it. My logical self should have assumed that it was impossible for everything to right itself immediately. However, my chemo patient self was ready for any cheerful fantasy to be true instead. I had a lot of help with this misconception. At my last chemo appointment and doctor’s visit, everyone acted like a huge celebratory gong was to be rung and that it would be all smooth sailing from there. Congratulations flowed all around, uplifting my mood. I can remember stumbling to my car and suddenly breaking down into tears of joy as We Are The Champions came on the radio. I understand the focus of that final visit was to rejoice, but I think it would have been helpful to have a small dose of realism injected in at the same time. I am not talking about not celebrating. I am just talking about balancing the good end of treatment news with some tips about potential complications, what to expect, and how to realistically move forward. I think it would have saved me a lot of frustration and disappointment. I understand so much better now from experience and I have definitely had success in making my way post chemo and I am very grateful for how I am doing now, but I feel like the journey could have been a little less scary with some prior warning.

Dr. Katz