Tag: physical

It’s Time To Get Back to the Smoothie

I finally went on a vacation after almost two years. It was amazing. In the weeks preceding it, I became acutely aware of just how much I NEEDED it: emotionally and physically. I felt like every cell in my body was about to burst with the drive to get the hell out of town an away from everything: my environment, my routine, my town, everything. In between the vacation cravings came the vacation fears. What if something terrible happened to one of us? What if we didn’t get to go at all? What if we didn’t survive it? Let’s be honest for a moment. Each and every time we tried to have time off in the last two years, something awful happened. A pandemic started. Someone had a heart attack or, my favorite, someone got cancer. You see what I mean? The vacation fears almost took over the vacation cravings to the point that we felt jinxed just to utter the word vacation. We started saying pause or any other euphemism to avoid saying the word vacation. It’s ridiculous I know, but it’s what happened.

So, the big day finally arrived. We were all packed and ready to go, BEFORE 2 am the night before. This in and of itself is a miracle…lol We celebrated each mile stone with vigor. Hurray we made it to the airport. Hooray we made it through security. Hurray we made it on the plane. And then, the celebrations stopped because flights were delayed…and cancelled. But, we even made the best of that and just kept switching gears as fast as they changed.

Finally, we made it to our destination: sunny Key West Florida. I had never been. It was gorgeous and hot and sweaty. I was in love. I thought for sure that it would be smooth sailing from there. It was, sort of. I realized quickly that we both had forgotten how to really take a vacation. We were kind of anxious at first, waiting for the other shoe to drop and wondering how we would handle it so far from home. I think we each took our own day to fall apart a little and lift each other back up again. It sounds like a waste of time, but it wasn’t. We needed that time to absorb that it would be ok and that we would be ok and that we were allowed to just have fun and relax. We did get the hang of it eventually.

It ended up being a marvelous vacation, plane snafus at the end not withstanding. We did relax. We did have fun. We ate stuff. We did stuff. We saw old friends. We tried new things. But, after a week, it was time to get back to the real world. I realized the routine I had been so vigorously campaigning against before we left was not actually a bad thing. There is safety and comfort in the routine. For chrissakes, for the past two years life has been anything BUT routine until lately. If I am being honest, things were finally getting normal enough to even be able to notice a routine. I told myself that the routine was dragging me down, but it wasn’t really true. The routine just let’s me know that I am okay and that things are ok. That’s a good thing.

According to Diane Lang, 40 % of our lives involve routines. Routines give us a sense of structure. They give us a sense of accomplishment. They let us know that we are doing ok. They give us a pattern to follow. They are even important for our mental health. They allow us a sense of what we can control. I think this has been especially important during the pandemic. I know that for me, being able to establish a routine has been essential in my continued healthy survivorship after cancer. The bottom line is, routine are not so bad. On that note, now that I am home, I think it is time to get back to the smoothie. I missed it while I was on vacation.

Dr. Katz

It’s Not Over Just Because Chemo is Over

Wow! There are so many things they don’t tell you about being a cancer patient! When I say “they” I am referring to a proverbial all-inclusive group of people that includes everyone that is in charge of your care and even other patients who are unable or unwilling to share their experiences. I am learning a lot as I go and I am convinced more than ever that it is my mission to pass on what I know or have experienced to all of you. I am still determined to be the flashlight that helps guide patients through both their cancer experience and what comes after.

So, here is what I have realized. It is not really over until it’s over. What the heck do I mean? Let me explain. Most of us logically assume that when the last drop of chemo has coursed it’s way through our blood stream and the most recent scan confirmed that we are cancer free, at the moment, that we are, in fact, done! Yay! Hooray! Whooo! It is time to party, right? That’s what I thought. I really truly thought, or at least hoped, that the moment I got that final good news that this warm and fuzzy feeling of overall cleansing and good health was going to wash over me, my energy and health would be renewed and I would be ready for anything that came my way! Nothing could have been further from the truth. Now I am not blaming anybody. Nobody told me that that was going to happen. I am solely responsible for my own rose-colored glasses personal patient vision. However, nobody counselled me to the contrary either. I was just kind of left to figure it out after my perfunctory but heart felt congratulation speech from my health care team.

Here is what really happened. I got my good news. I was elated at the moment and kind of skipped out to my car( and then got short of breath from skipping..lol). Then I got into my car and, ironically, We are the Champions by Queen came blasting on the radio. I then proceeded to sob hysterically for about 20 min before driving home. I want to believe that the tears were all happy, but now I am not so sure. My mind started racing with all kinds of different thoughts ranging from yeah, I’m free to omg what do I do now and who is going to look out for me? My head was completely spinning. I had to take a minute before my head was clear enough to drive home. I started to realize that this was not really over. I had the next five years of my life mapped out with repeat scans and follow ups. Was it going to really be over then? What if I got some weird symptoms or twinge in the wrong place? Should I ignore it or should I worry because something else might be wrong?

I spent some quality time trying to talk myself down from the ceiling and rationalize the fact that I would need to give myself some time to be able to process information from my body normally again. That lasted all of a few minutes before I was on the phone to my therapist, making sure that I had regular appointments scheduled for the next several months. I was not going to be able to do this alone and I wasn’t allowed to restart my anti depressant for another month or so.

Ok, so now I had my therapy appointments in place. I rebooted my calm app on my phone. I reached out to my friends and fellow patients. I felt like I was doing everything right, or at least what I could do at the moment. Everything was going to be ok right? Nope! Then, the later complications of chemo started rolling in. My liver and kidneys took some hits and had to recover and my thyroid died completely. All the symptoms I was having that I was trying to assume were psychosomatic were actually real! Some of the stuff could have actually killed me! Thank goodness that we have modern medicine and options for all of them, but still scary nonetheless. There was no room for relaxing! There WAS still stuff to worry about! I knew it! My doctor said that some of these complications and side effects could be a factor for years afterward. Fantastic! I understood going in that there was going to be a risk trade off in exchange for curing my cancer, but on some level, I don’t think I fully understood just how significant the risks would be. I don’t think any patient does.

Here is where I think we need to do better for patients. We need to do better than handing someone a stack of papers several inches thick to read over and sign. We need more than just one chemo teaching session. We need to counsel patients that complications are real and that we need to have a reasonable level of vigilance after treatment is over. We need to recognize that PTSD is real and affects people that have experienced any kind of trauma, whether it is casualties of war or cancer. There needs to be a plan in place for those kind of things BEFORE they happen. We need to shape patient’s expectations for their treatment and for themselves BEFORE things happen. We need to give the a glimpse into what can happen and what they can expect and let them know that we have tools to address all of it. I have to believe that being proactive could potentially save a lot of suffering, both physical and mental, for patients. It has to be better than being behind the eight ball and struggling to deal with all of these issues when they are already full blown and both your mental and physical energy is already depleted.

Here is the bottom line. I am proposing a new plan. First, start with detailed one on one counselling before treatment starts for as many sessions as necessary with the key goal of shaping expectations and making preparations. Second, assign each patient a mentor who has actually gone through the process that can be a touch stone throughout treatment and beyond and who can offer encouragement, and more importantly, guidance and reassurance as things happen. Third, anticipate the possibility of PTSD, complications, and side effects after and during treatment and try to prepare the patient as best as possible. Set them up with therapy from the beginning. Start them on medications if possible during treatment. Be vigilant for side effects and try to catch them early. This all sounds like common sense but I am willing to bet that it is NOT common practice. I truly feel that implementing these few extra steps would have a tremendous positive return on patient recovery and outcomes that would far outweigh any additional healthcare costs incurred. I guess it boils down to what the true goal is : patient survival in terms of numbers versus patient survival in terms of whole health, mental and physical. Last time I checked, we are all more than just a number.

Dr. Katz