On the Evening of a Bad Day

I know that no one ever promised life would be fair. 

I know there is no reason that this shouldn’t have happened to me and no reason why it did.
I know that sometimes things just happen and we don’t know why.

I also know that I’m fine in myself, which is how I say that I am basically, fundamentally at peace and that a stream of quiet joy and serenity flows underneath all the hard stuff and that once I calm down I’ll be able to tap into it again.

I know all those things.

But right now? Right now I’m sad that I’m in pain and that I have advanced cancer and that my life has become so limited. (*)

I’m glad that I have friends around the world and that I can reach out to them and have contact within minutes, less. But I wish there was someone here who would put their arms around me and hold me and pray with me and stroke my hair and help me through the hard parts.

Sometimes people write very complimentary things to me in the comments of posts. That is part of the reason that I think it’s important to write about these times, too. Yes, I practice mindfulness—but not all the time. Yes, I know how to change my attitude—but sometimes I don’t have the strength to do it.

I get down, I get angry, I get lonely, I get frustrated. These feelings come and they are awful. But I also know that “feelings are not the boss of me”, as I like to say. I know that in a few hours or the next day I’ll be back to baseline.

So right now I’m going to make some hot chocolate and take a sleeping pill and set another pain pill out ready in case I need it during the night. I’m going to spend some time with my friends on Facebook—and these are real people, real friends—and then I’ll go to bed for the night.

This sonnet by Keats fits my feeling at this time. Sleep, comfort, loneliness, death.

To Sleep

O soft embalmer of the still midnight,
      Shutting, with careful fingers and benign,
Our gloom-pleas’d eyes, embower’d from the light,
      Enshaded in forgetfulness divine:
O soothest Sleep! if so it please thee, close
      In midst of this thine hymn my willing eyes,
Or wait the “Amen,” ere thy poppy throws
      Around my bed its lulling charities.
Then save me, or the passed day will shine
Upon my pillow, breeding many woes,—
      Save me from curious Conscience, that still lords
Its strength for darkness, burrowing like a mole;
      Turn the key deftly in the oiled wards,
And seal the hushed Casket of my Soul.

(*) Up to this point, the text is copied from my Facebook status.

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Cancer cannot take this away

Image credit: pixelsaway / 123RF Stock Photo Used with permission.

Image credit: pixelsaway / 123RF Stock Photo
Used with permission.

Yesterday I was in enough pain to take the stronger medication for it. I was also sad and upset about several unrelated bits of bad news that I’ve received recently. I was feeling alone and needy and, truth be told, more than a little sorry for myself. I spent most of the day in bed, feeling drugged and loopy and groggy and dozing off and on, feeling needy and weepy when I was awake. It was not a good day.

Today I woke up and I’m in enough pain to take the stronger medication for it. I am still sad and upset by the bad news. I am still alone and I still need help with simple tasks. But I am not feeling needy, I am up at the computer writing this post, and I am having a friendly chat with my home help, L, who is here working her magic.

So what is the difference between yesterday and today? Yes, my home help L the wonder-worker is here, but the truth is that hours before her arrival I was up and showered and dressed in clean clothes and sitting at the computer doing my sorely neglected email. What changed?

The pain didn’t change. The fatigue didn’t change. The cancer didn’t go away. The sleep issues were not resolved. Why am I up and smiling today? I think it’s the A-word: attitude. Before I went to sleep last night I made a decision to change my attitude.

It’s as simple as it sounds and as difficult as it sounds. I wrote a short update in a Facebook cancer support group to which I belong, and I was complaining about everything from bone tumor pain to mosquito bites. I knew that I would get lots of “poor you!” and hugs and supportive comments and a joke or two in response. But by the end of the my update I found myself writing:

The best thing on earth is that tomorrow is a new day! And also I was able to get up and make some food and drink. And my home help is coming tomorrow. So I should just get off the pity pot and make a gratitude list. 

Damn. I hate it when I talk myself out of my moods! 

I somehow allowed myself to change the focus, to look in a different direction, to change my attitude. Sometimes that’s all it takes.

When I was an undergraduate (a long, long time ago in a galaxy far, far away) I was profoundly impressed by Victor Frankl’s Man’s Search for Meaning. This is one of the books that changed my life. In particular, this: “Everything can be taken from a man but one thing: the last of the human freedoms—to choose one’s attitude in any given set of circumstances, to choose one’s own way.” 

That blew me away forty-some odd years ago and it still does. No matter what cancer takes away from me. No matter what bad news I receive, no matter what problems I face, I have the freedom to choose how I relate to it. This doesn’t mean mindlessly smiling through a crap storm (remember – not recognizing reality is insane), but it means that I can choose to collapse under it, to fight it, to accept it, to try to change the circumstances, to move out from under it. I can choose to identify myself with the crap storm or to remember that it is separate from me, it is not me. As a religious woman, I can choose to put my faith in the hands of the Creator, remembering that in my religious tradition God helps those who help themselves.

Whatever I choose–even if I choose through inaction–it is my choice. That is the power that is left to me, “the last of the human freedoms”, and when I choose to exercise it I reclaim some of my personhood. My personhood, the choice of my attitude: cancer cannot take that away from me.

Don’t forget: Anyone who is affected by metastatic breast cancer is invited to submit a post for me to publish during October. If you are interested, please contact me at the email in the sidebar or tell me in the comments. We want to hear your voice!

Cancer, anxiety and mindfulness

It’s no secret that a cancer diagnosis makes people depressed and anxious. It is less known that some medicines used in the treatment of breast cancer can cause anxiety, particularly hormonal treatments.(1)

It is even less well known that, in contrast to the depression, which tends to decrease over time, the anxiety tends to persist and may even become worse.(2) This study was cited and discussed in the New York Times “Well” blog post “Anxiety Lingers Long After Cancer” by Jan Hoffman.

I recently wrote about the things I do to (attain and) maintain mental health, and in an earlier post I wrote about my choice to live intentionally, to live an examined life:

This business of living intentionally isn’t New Age or mystical or Buddhist or maladaptively introspective.  It only requires pausing in your day, or even in your week or month, to be aware of your interior and exterior worlds. What am I doing? Is it what I want to be doing? Is there a change I’d like to see? Can I bring it about? What path am I on; is it likely to bring me to where I want to go?

I started this practice when I was about fifteen years old. I was a member of a dramatics group and the director used to have us sit quietly at the beginning of each lesson or rehearsal to do a “here and now” exercise. It’s very simple. You start by sitting still in a comfortable position and saying, “Here and now, I am aware of…” and naming what you see, hear, smell, feel. You do this quietly, in pace with your breathing. As you physically relax, you can close your eyes and your awareness gradually switches to the interior world.

By interior world I mean thoughts, feelings, wishes, desires, discomfort, contentment, hopes, satisfaction, anger, delight… a kind of mindfulness. It was a great exercise for me at that difficult age, and it remains so when I am in a tizzy or need to get back in touch with myself.

I was very interested to see that my intuition about using mindfulness to cope with stress and anxiety was borne out in a small Danish study that was published this past April in the European Journal of Cancer.(3) The investigators provided a “structured, eight-week group mindfulness-based stress reduction program (MBSR)” and found that even a year later it had “clinically meaningful, statistically significant effects on depression and anxiety after 12 months’ follow-up, and medium-to-large effect sizes”.

The women participating in the study had been diagnosed with breast cancer at Stage I, II or III and had undergone surgery. I wonder if the results would be different with participants who have Stage IV cancer (advanced or metastatic breast cancer). As usual, however, we mets-ers were not included. (A topic for another post.)

In any case, the statistical results are far less important to me than my lived experience: mindfulness exercises and meditation and living an examined life help me to cope better with stress and anxiety, and that is all the proof I need. Studies like this one, however, might lead cancer centers to provide MBSR or similar approaches to patients in their survivorship programs, and I think that would be a very good thing.

Notes:

(1)See, for example, this page at BreastCancer.org.

(2)See, for example, a UK study published in Lancet Oncology online in June of this year. The abstract can be accessed free of charge at PubMed. (Click)

(3)The abstract can be read free on line at the journal’s website. (Click)