A Day in the Life of a Radiotherapy Patient

1231372_427466207358465_989752009_n

For those about to undergo radiation treatment or those just interested in what’s involved, here’s a typical day in one of the thirty days when I’m zapped for my own good.

I wake up late. Radiotherapy makes you tired. I’ve also had some uncharacteristic difficulty getting to sleep and I sometimes wake with a jolt during the night, sure that I’ve just dreamt something shocking enough to wake me but unable to recall it. I don’t know if this is related to treatment.

I usually dress in my gym gear straight from bed because this makes it more likely that I’ll do my daily yoga. Lately it feels like I can hardly lift my arms but I know that I need yoga the most when I least feel like doing it. Even five minutes makes a difference. I have coffee first, then do as much yoga as I can handle and then have breakfast.

My treatment is usually scheduled for the middle of the day. I thought this would help me to avoid school traffic and also provide me with the opportunity to combine treatment with lunch. Lovely lunches with girlfriends have helped to make treatment more pleasant.

I usually use the time between yoga and treatment to catch up on a few chores, check my messages or pick some produce from the garden. After this I shower. I have the water at my usual temperature while I wash and then I turn the hot down and run the cooler water over the area being treated for a few minutes. This really seems to help and my skin always looks a lot less pink afterwards. To make sure I have enough time under the cool water I sing ‘Happy Birthday to You’ twice.

When I get out of the shower I don’t dry off. I have some hemp oil in a pump pack with some essential oils in it to improve the smell. I used this all the way through chemotherapy and it’s still keeping my skin healthy. It goes on in a thin layer all over my wet skin from the neck down and then pat myself dry. I pay special attention to my left breast, the centre of my chest and the area under my arm. It’s easy to find because the radiation makes it pink and it’s also causing some seborrheic keratosis (little brown lumpy things on my skin). I’m careful to avoid anything that might interfere with the radiation treatment including sun block, anything with minerals in it or zinc cream. The advice from the nurses at the treatment clinic is to only use natural products and to avoid anything with chemicals. Too easy. They sell a range from a company called ‘Moogoo’ but it’s not compulsory.

After my shower I dress in something that will make it easy for me to strip to the waist. I also wear shoes that are easy to slip off. I like to get a bit dressed up for treatment. It’s part of feeling positive and confident. No, my self esteem is not linked to my wardrobe but the ‘Look Good, Feel Better’ program helped me to understand how much better you feel if you know you look nice. I’m a convert.

The drive to the treatment clinic is about 20 minutes from home and there’s plenty of parking. As I come past the reception area I scan my card with a bar code. I don’t like having a bar code. It makes me feel like a product. Yes, it helps the clinic run more efficiently and it ensures I rarely wait more than a five or ten minutes, but I still don’t like it. I keep thinking of alternatives, like a really cool key ring or a bracelet. I have a seat in the large waiting room. There’s a coffee machine, biscuits, magazines and even some communal knitting. There are stands with lots of Cancer Council information and free turbans made by local crafts people. I’m not usually here long.

The sliding door opens and they call my name. I needed to remind them during the first week that I am not a ‘Mrs’ and I prefer to be called by my first name. It might seem like a small thing but anything I can do to make this process more pleasant is worthwhile. I walk down a short hall to one of two change rooms. They both have good curtains to ensure privacy and a sign asking people not to enter if the curtain is closed. My gown is stored between treatments in a pigeon hole on the wall. There’s a piece of tape with my name on it. I strip from the waist up and put on the gown, opening at the back. I put anything I take off in a basket and then sit on a chair in the hallway with the basket on my lap while I wait to be called in to the treatment room. People I don’t know walk past me. Some of them smile. Some of them do that disconnected busy stare that people use to avoid contact. Once again I wish the waiting area was more private.

The clinic has about ten different technicians. Over the course of treatment I’ve met most of them and I make a point of remembering their names. It’s another way to make things more personal. One of them calls me into the treatment room. It’s huge, and so is the machine, but not claustrophobic. I head straight to their iPod set up and plug in my own music. It’s my relaxing selection from chemotherapy. I don’t like their 80’s hits and they’re very happy for me to bring my own. Just one more way to personalise the experience.

There’s a foam support on the treatment table that goes under my knees and a moulded support for my body. They made this at my planning session. It’s like a small bean bag with the air sucked out of it. I lay back into it and take my arms out of the gown so my breasts are exposed. I put my arms above my head and hold on to the top of the body mould. My job from here on in is to imagine I am a bag of wet sand.

Two technicians find the four tiny tattoos on my body and mark them up with marker pen so they’re easier to see. They use a laser line and the markers on the table to line me up. This usually only takes a minute or two. Sometimes they need to push the body mould over slightly, or to use a cloth under me to roll me just a tiny bit. My left upper arm usually needs to be rotated so it’s not in the way. Sometimes they adjust the whole table and there’s a loud clunk with each adjustment. I need to resist the temptation to help them. Helping isn’t helping. Be the bag of sand.

The technicians sometimes exchange a bit of small talk but mostly they have a conversation predominated by numbers. Twelve. Twelve. Six point five nine. I’ve got eight……..

Once they’re happy with my position someone always say “Here we go,” and sometimes “Stay still now” or perhaps “We’ll see you in a couple of minutes.” There’s a closed circuit camera above the machine and a two way microphone so they can see me and talk to me if they need to. They don’t usually need to. They know I prefer to have the lights down so someone usually adjusts them on the way out. I appreciate this kind of consideration. I also like it when someone thinks to cover my right breast. I know it seems redundant when I’ve been so exposed but it’s a sign of respect and understanding. Nobody likes to be this exposed and anything that reduces the discomfort is welcome.

The machine rotates around me. I can see a large, grey rectangle above my head. There’s a sticker on it warning people not to sit on it. In my current position I find this concept mildly amusing. I imagine technicians throwing wild parties and riding the machine. They use it to take an image and there’s a low hum. Then there’s a pause while they look at the scan.  I wait. I breathe. I imagine wet sand and try to relax my body.  Sometimes they adjust the table remotely. Clunk. Clunk.

The machine rotates again and a large metal circle with a glass window moves over my head and down below my left shoulder. On the roof I can see a curved shadow silhouetted by the light from the machine. It’s dissected by the red laser line. I don’t know if it’s a shadow of my breast or my arm and I can’t move to find out. Why do I have the same thought at every treatment? The machine gives off a metallic hum for a couple of seconds, followed by a shuffling as the aperture is adjusted and then there are two shorter bursts.  The machine rotates again and now the giant eye is above me and hovering over my right shoulder. It’s pointed back towards my left breast and the sequence is repeated. One longer hum, shuffling and two shorter hums. The whole thing only takes a few minutes.

About half a minute later and I can hear the door to the treatment room open. I’m told I can put my arms down and I take the opportunity to put the gown back on and cover myself up. One of the technicians adjusts the table so I can climb off it. I unplug my iPod, pick up my basket and head back to the change room. I use my own wet wipes to remove the marker pen from my body and once again wonder why they don’t do this, or at least provide the means to do it. The first couple of treatments I had marker pen stains inside my bra. I get dressed and head home.

There hasn’t been any effort to explain the treatment plan to me. The treating doctor explained the rationale for radiation treatment at my first consultation and since then someone has put together the actual treatment schedule. I know from the sheet they give me with all my times and dates on it that I’m having ‘syn breast six flds’ but I haven’t asked for details. It’s unlike me. I’m usually the information glutton.

When I get home I take my top off and soak the treated area will cool, salted water. This idea came from a book I read and not from the clinic but the nurses there have okayed it. I put a teaspoon of salt into a couple of cups of cold water and use a washer to soak my breast and underarm. I do this for about ten minutes and my skin looks and feels cooler afterwards. I follow this up with some cream. I’ve been using an aloe vera based body lotion by Swisse which smells and feels lovely.

If it’s possible, I try to spend the next few hours without a top on. A lot of the problems associated with radiation are caused by clothing rubbing against the site. No clothing means no rubbing. Simple. My husband is particularly fond of this part of the treatment and is also happy to help me apply cream. He stands behind me and makes sure I’m well covered. We laugh and kiss. Suddenly radiation treatment is not so bad after all.

This has been my week day routine for the last several weeks. I get weekends off. I usually try to give the area a special treatment on weekends, like a good, thick coating of paw paw ointment. It all helps. I rest. I sleep. I am getting very good at taking it easy. Radiation works by killing off the cells in my breast. The healthy ones regenerate and any stray cancerous ones get zapped.

Every so often I have a treatment review with one of the nurses. They check on my progress and how my skin is holding up. They’re both lovely, compassionate women. I’ve had one appointment with the doctor during my second week of treatment. I only have one more visit with him when treatment is finished. Once a week a get a bill for services and they process the medicare claim at the same time. Treatment won’t cost me more than $2,500. If I had gone to the public hospital I could have had it for free but I elected to use this private clinic. They take an image before every treatment to make sure they’re on target and the public system only does this once at the start of treatment and once half way through. With my heart so close to my tumour site I thought this was an important difference. I’ve also spoken to two women that used the public system and both complained of long delays and nasty skin burns.

I’ve still got seven treatments to go but so far no skin burns. I am so relieved. Fingers crossed for not having to deal with that although I’m told they can still occur in the weeks following treatment. My doctor was of the view that I might not have any burns so there’s something in the way treatment is planned that obviously has an impact upon this.

Seven treatment days to go. Some of this will involve a ‘boost’ to the tumour bed and they’ve already mapped me for this. They’ve got a piece of transparent film that they put over my breast while they copied their markings and they’ll use that to position me for this part of the treatment.

There are risks associated with this treatment, including a very small risk of a more aggressive cancer, but given the aggressive nature of my original cancer and the overwhelming data showing radiation can reduce my risk of recurrence, I’ve decided to have it. Like so many aspects of cancer treatment this is a very personal and individual decision. Some people prefer to avoid the risk of side effects by taking their chances. It can be a hard call.

Apparently some people get emotional on the last day of treatment. I’m guessing that’s the relief of having it all over and done with. I’m going to organise lunch with a girlfriend. There may be a few tears but I don’t think so. I’m starting to shift my thinking beyond treatment.

This will be the end. From June last year until April this year my full time job has been recovering from cancer. Now I’m planning life after illness. I’m very much looking forward to that. I’ll also be counting down to my three year anniversary. Triple negative breast cancer has a higher rate of recurrence than other breast cancers, but if I can make it to three years without that happening the odds of it coming back at all drop significantly. I’m very much looking forward to that, too.

 

Advertisements

But I Don’t Need a Psychologist!

996646_581569135243949_408399903_n

Status report:
I’m just over half way through radiotherapy. I’ve got 14 daily sessions to go. So far my skin has become a bit pink by the end of the week but there’s no burning, blistering or peeling. I am greatly relieved.

I’ve managed to overcome the impersonal nature of the treatment by learning the names of the various technicians and engaging them in brief conversation each day. We share tiny bits of information. Be become more human to each other.

I’m also unplugging their iPod full of hits from the 80’s and plugging in my own music. It’s the same meditative selection that I used through chemotherapy. It’s a way of making the treatment room temporarily mine.

I’ve become very good at keeping very still. It makes treatment go faster. I’ve even memorised the marks on the table where the foam leg rest should be and I move it there each time. It means that when I lay back into the body mould they’ve made for me I need very little adjustment. Adjustment involves people with cold hands manually moving you to line up with laser generated markers so minimising this is a good idea. I know to keep still, to pretend I am a bag of wet sand, and to let other people move me into position. Helping isn’t helping.

Meanwhile my body continues the long recovery process. My hair now looks like a deliberate choice rather than a medical aftermath. It’s much thicker too. My eyelashes are fully restored and my new eyebrows are so well shaped that I don’t need to pluck them any more. On the flip side there’s the return of the chin hair. My pubic hair is just ridiculous and I may shave it and use it to make a wide brimmed felted hat! My fingernails are just days away from growing out the chemo damage and the line in my biggest toenails that marks my treatment is slowly moving upwards.

The chemotherapy induced menopause is a bonus from my perspective. I was well past my child-bearing years when cancer struck. The hot flushes and night sweats have become less frequent and less severe. They’re a welcome alternative to menstruating. The predicted mood swings haven’t happened. If I cry it’s with good reason and I don’t cry often. I don’t churn negative emotions into negative behaviour. I use my words.

I’m still in considerable pain. I don’t think this is related to the radiation treatment. The peripheral neuropathy caused by chemotherapy has left me with painful hands and feet. It’s much worse in the morning when I can’t form a fist with either hand. Sometimes the pain wakes me at night. I’ve also got pain in my elbows which seems to be related. My right elbow is particularly bad and I’m using my left hand for anything weight bearing. My lower back is sore and I think this is related to the difficulties I have with my feet. I try to make a conscious effort to stand straight and walk well but I find myself hobbling like a caricature of an old lady. My trusty Birkenstocks make the back pain worse. Way back at the beginning of all this when they scanned me for other cancer I was told I had arthritis. At the time I laughed it off, given the significance of the cancer diagnosis. Now I wondering if any of this pain is arthritic.

In spite of all this my mood continues to be great. I’m almost at the end of treatment and looking forward to declaring myself well. I know I’ve still got six months or more of recovering from side effects but I’d much rather recover from side effects than be killed by cancer. Daily I prove that it is possible to be happy in spite of chronic pain, in fact, it’s possibly the best way to cope with it. I now know that happiness is not a random mood that descends upon me from nowhere only to vanish of it’s own accord.

The biggest lesson from the whole of my treatment is that I really can choose to be happy, and using a few simple strategies I can achieve happiness most of the time. I had learned about all of this prior to my cancer diagnosis but some part of me didn’t believe it. I dismissed it as just so much new age psycho-babble. I believe there are times when I may have actually said “Try telling someone with a cancer diagnosis to choose happiness and see how far that gets you.” Turns out I can choose to be happy. Even with cancer. Even with pain.

Recently my happiness took one giant step forward. In spite of my reservations about some of the content in Jacqueline Helyer’s relationship workshops, I am pleased to report that it did serve as the catalyst for improving my relationship with Graham. We are much more intimate. I have fallen in love again.

So why did this week see me spending an hour and a half with a psychologist?

Well firstly, it was free. The Radiation Oncology Institute where I’m having treatment has a psychologist on staff for all patients. Gratis. This is worth knowing if you’re due to start radiation treatment, or any other form of cancer treatment. Private facilities in particular are increasingly offering free or cheap psychological support for patients. Some public hospitals are also introducing in house psychologists. Where they’re not available on site, it’s often possible to get a referral to a psychologist and your GP can refer you if your specialist can’t. It’s my opinion that everyone can benefit from spending some time with a psychologist. Here’s why:

We all have different filters that we use around friends and family. We are careful about how much information we share and what emotions we choose to express. Yes, you’ll sometimes meet someone dealing with cancer that behaves like a spoilt three year old and demands that everything be about them, but most people continue to be considerate of those around them. You don’t need a filter with a psychologist. They’re a professional, impartial listener trained to help you get back in touch with how you’re really feeling, without pressure from anyone else.

Prior to spending time with Kerrie, the resident psychologist, I was fairly sure that I was travelling along pretty well. A visit with Kerrie confirmed this. This doesn’t mean it was a waste of time. It was possible that I’d walk into her office and fall in a heap, finally able to let my guard down. Checking in with someone professional can be hugely beneficial either way.

I’ve heard people say that a psychologist is a waste of time because they won’t tell you anything that you don’t already know. My response is that sometimes it’s really helpful to be reminded of what you know. Sometimes we forget. A good psychologist will also reassure you that what you’re feeling is normal, expected, human and appropriate. Sometimes, when we are feeling overwhelmed, this is reason enough to see one.

Psychologists spend a lot of time just feeding what you say back to you. “What I’m hearing is………….” “So if I could just summarise, it seems you’re saying………….” “You seem to be having some emotion around X. Would you like to tell me more about that?” It can initially feel very contrived but this technique is great for helping people think out loud. It also respects our ability to come up with our own answers if we’re given the time and the safety to do it. I like it very much for that.

Friends tend to give us well meaning advice. Sometimes this is a bit like you telling me you’re having trouble seeing and me handing you my spectacles. I’m sure they’ll help you. They certainly help me! Psychologists don’t ‘solve’ our problems for us the way friends do. They provide us with a confidential, safe environment that supports our growth, but at our own pace and in our own time.

Of course, not everyone has the ability to unravel their own problems and knit them into a new way of being, or to do it consistently. Psychologists can offer us tools to help us change. Whether it’s something as simple as taking a couple of deep breaths to calm down or something as complex as a diary to record and rewrite destructive internal dialogue, psychologists know some great, proven strategies for helping us to improve the quality of our lives. They don’t have prescription medications to ‘cure’ us because the work they deal with can involve time and commitment. Change is always fuelled by effort and growth is often preceded by pain. A good psychologist helps us to understand that, no matter where we are, we walked there with our own two feet and we’ll need to walk out of there the same way. Nobody is going to carry us.

Perhaps that’s the reason that so many people avoid seeing a psychologist; it’s likely that they’ll call us on our denial. It’s possible they’ll see through our self delusion. It’s likely they’ll hold a mirror to our obfuscation.  That’s precisely why we should see them. They can help us to break out of unproductive or unhappy patterns. They can shift us closer to happiness. It’s true that we may get there on our own but I think a psychologist can provide a short cut, or at least a road map.

What they won’t do is make you lay down on a couch and talk about you childhood, or your past trauma, or something acutely humiliating……..unless that’s what you need to talk about. This Hollywood stereotype of ‘therapists’ is possibly also responsible for frightening some people off.

It’s worth knowing that a psychologist is not the same thing as a life coach. ‘Life Coach’ is a relatively new term and there are no specific qualifications required. I could have cards printed tomorrow calling myself a ‘Life Coach’ (or a counsellor for that matter) but I could not call myself a clinical psychologist without a degree, supervised practical experience and professional registration.

If you’re wondering how they’re different to psychiatrists, the practical difference is that a psychologist can’t prescribe medication. The therapeutic methods are very similar. Psychiatrists have all trained initially as doctors and then chosen to specialise in psychiatry. A psychologist does a degree in psychology followed by practical training in counselling. They’re both good, although in my experience some psychiatrists seem far too enthusiastic about medication. While I have no doubt that antidepressants and other therapeutic drugs have saved the lives of some people with mental illness I also think that it’s sometimes a case of ‘If you like using a hammer then everything looks like a nail’.

As a result of an hour and a half with Kerrie I know that I’m travelling well. I am mostly, genuinely happy. I am appropriately emotional about the possibility of an early death, particularly if I contemplate my unborn grandchildren and the possibility of never knowing them, let alone sitting down to celebrate their 21st birthdays. I can easily get teary over the thought of my husband on his own, my daughter coping with babies without her Mum to help her, my Mum burying her daughter. This is just life. All of us have reason to be sad about the things that we will miss when we die. Cancer just puts these things in sharp focus.

And my early death is far from certain. It’s possible. That’s all.

In the mean time I’m going to be as happy as I can be for most of the time and appropriately sad when I need to be. Life is wonderful. Precious. Joyful.

I’ve made another appointment to see Kerrie when I finish radiation therapy. The end of treatment can be a difficult time for a lot of people and it’s possible I might need some help. Even if I don’t, I know that having the opportunity to check on my mental health is as important as any of the regular checks I make on my physical health.

I probably don’t need a psychologist. I’m going to see one anyway.

Staying Alive

1381455_10151806814238172_997787025_n

I used to be a smoker. Not an occasional, just at parties kind of smoker but a serious, pack-a-day addict. I enjoyed the way it made me feel. I also enjoyed the way it gave me a legitimate break from work and the opportunity to meet people from all over the organisation I worked for. There was a kind of ‘smokers network’ that knew more about what was happening in the organisation than anyone else.

I stopped close to a decade ago. In my own time. When I was ready. Up until then I sang various versions of the dedicated smoker song:

“I need it to relax. It helps me to calm down.”

“Everyone needs a vice and this is mine.”

“I could give up if I wanted to but I don’t want to.”

“I could get in a car today and die in a car accident. Everything has risks attached to it.”

“Oh statistics! You can use them to prove anything.”

“I’m going to die of something. It may as well be cancer.”

Addiction has fascinated me for a long time. You see a lot of the consequences of addiction when you’re a police officer; young people almost dead from heroin that wake up angry when they’re given the antidote, diabetics with a food addiction that die young as a consequence of chronic obesity, gamblers that steal from the people that love them in order to support their habit. It seems to me that a propensity for addiction is part  of being human.

It’s also similar to the kind of thinking you see behind a lot of criminal activity. People know the dangers and the risks but do something anyway.

Interesting that when you ask people to define addiction they often use the word ‘compulsion’, or some other description that defines the behaviour as being beyond control. I’m never sure about this. I suspect we like to think of our addictions as beyond our control because it gives us an excuse not to deal with them. For me, a big part of giving up smoking involved recognising an obvious truth; I cannot smoke unless I put a cigarette in my mouth and light it. I may feel a very strong urge to do so but ultimately I must make a decision. To smoke or not to smoke.

Eventually I confronted the horrible truth. Smoking was bad for me. It carried with it a serious risk of developing any of a number of cancers as well as a bucket of other illnesses. If I really did need it to relax then I probably needed to take a long, hard look at why my life was so stressful and what I was going to do, other than smoking, to deal with that stress.

It was true that I might die in a car accident but there was a flaw with this analogy. A car provides all kinds of real benefits. At the time it allowed me to travel to work and earn a living as well as giving me the convenience to shop, travel and enjoy the company of my friends. The risks of an accident were minimal and when weighed against the benefits of car travel I was prepared to accept those risks. The same was not true of cigarettes.

The statistics argument didn’t take long to destroy. It’s true that statistics can be misleading. If you only have a one in a million chance of getting lung cancer and smoking doubles your risk then that’s still only two chances in a million. Had the odds been that long I might have kept smoking. Of course the evidence against smoking is far more damning for so many types of cancer. It’s considered a group one carcinogen. That means it’s been proven to significantly increase your risk of cancers. No question. And as to choosing a way to die, I think just about anything would be better than dying from cancer.

When I stopped smoking I also made a number of other changes. I improved my diet, increased the amount of exercise I was getting and learnt meditation to relax my mind. I read several books on the psychology of happiness and practiced some of the methods they recommended. Life was good. I was fit and healthy and taking better care of myself than most people. Then I got cancer.

I read this recently in a book written to help women with early breast cancer: “..the general medical opinion is that there is no known cause of breast cancer. It’s not one of the ‘lifestyle cancers’ like those that result from smoking of sun exposure…” (One Piece of Advice, Yvonne Hughes)

Wait a minute. What? Not a lifestyle cancer?

I’m pretty sure that there’s no cancer on earth that isn’t influenced, to some extent, by lifestyle. When I asked my oncologist why there was so much breast cancer around these days she didn’t hesitate. “Alcohol. Certainly here, around the north shore. The Central Coast also has issues with obesity, but mostly it’s alcohol related.”

Wait a minute. Alcohol increases the risk of cancer? Since when? That can’t be right. Surely there would be warnings on the bottles just like there are warnings on cigarette packets.

I spent several hours researching alcohol and cancer. It turns out that alcohol IS a group one carcinogen, just like cigarettes. If you google ‘alcohol and cancer’ and ‘alcohol and breast cancer’ you’ll find all of the evidence you need. Here’s a few choice samples:

“The International Agency for Research on Cancer (Centre International de Recherche sur le Cancer) of the World Health Organization has classified alcohol as a Group 1 carcinogen. Its evaluation states, “There is sufficient evidence for the carcinogenicity of alcoholic beverages in humans. …Alcoholic beverages are carcinogenic to humans (Group 1).”[14]

There’s no ‘may be’ here. This stuff is toxic. Alcohol causes cancer. Then there’s this:

“A woman drinking an average of two units of alcohol per day has 8% higher of developing breast cancer than a woman who drinks an average of one unit of alcohol per day. A study of more than 1,280,000 middle-aged British women concluded that for every additional drink regularly consumed per day, the incidence of breast cancer increases by 1.1%. Approximately 6% (between 3.2% and 8.8%) of breast cancers reported in the UK each year could be prevented if drinking was reduced to a very low level (i.e. less than 1 unit/week).

Among women, breast cancer comprises 60% of alcohol-attributable cancers.

Okay, two units of alcohol a day is about what most people call one home-poured glass of wine. Some genius in the wine industry managed to get a standard drink classified as 100mls. I don’t know anyone that pours themselves a 100ml serve of wine. 8% might not seem like much of an increase unless you figure in the general risks of getting breast cancer. That’s currently around one chance in ten. Ouch.

If you didn’t like that you’re going to hate this:

“A study of 17,647 nurses found that high drinking levels more than doubled risk of breast cancer with 2% increase risk for each additional drink per week consumed. Binge drinking of 4–5 drinks increases the risk by 55%.

Wait…..binge drinking is four to five drinks? That’s not even a whole bottle of wine. (A bottle is generally seven and a half standard drinks by the way. Most people think it’s about four.)

But haven’t they proven that red wine is actually good for you? Well, sadly no. In fact the research that’s used to promote red wine involved one compound extracted from the skin of red grapes that was tested in vitro. They didn’t even use wine. Just something from a grape skin. And in vitro proves nothing. It just provides a good starting point for other research. And even if this research pans out it will prove the benefits of red grapes, not red wine. Eat all the grapes you want.

The short version; there is no safe level of alcohol consumption. If you doubt me, do your own research.

Let’s get back to addiction. I think the definition that works for me, when getting my head around addiction, is this one:

Addiction is the continued repetition of a behavior despite adverse consequences. Classic hallmarks of addiction include impaired control over substances or behavior, preoccupation with substance or behavior, continued use despite consequences, and denial.  Habits and patterns associated with addiction are typically characterized by immediate gratification (short-term reward), coupled with delayed deleterious effects (long-term costs).

So here’s my problem. Given what I know about alcohol I feel I cannot continue to drink. It’s a group one carcinogen.

Even if I hadn’t already had cancer, this information should be enough to make we want to stop drinking. It was enough to make me stop smoking.

The popular advice is that it’s fine to have a couple of drinks a few times a week but here’s my acid test; if instead of breast cancer I’d had lung cancer would you be okay with me having a couple of cigarettes a few times a week? Or would you consider that to be stupid, self destructive behaviour?

What’s fascinating is the resistance I get when I talk about alcohol and cancer. Guess what people say:

“I need it to relax. It helps me to calm down.”

“Everyone needs a vice and this is mine.”

“I could give up if I wanted to but I don’t want to.”

“I could get in a car today and die in a car accident. Everything has risks attached to it.”

“Oh statistics! You can use them to prove anything.”

“I’m going to die of something. It may as well be cancer.”

In some cases, the people making these statements are the doctors and health professionals that are treating me. They all have their own excuses for why they still drink. It reminds me of the data around health professionals and smoking back when they first tried to ban it in public hospitals.

What interesting animals we are. Knowledge on its own will not change our behaviour, even when that knowledge warns us that something is very dangerous. We have an extraordinary capacity for denial, for redefining our own circumstances as ‘special’ or exceptional or just pretending not to know better. If knowledge were sufficient to change behaviour then nobody would smoke.

And nobody would drink alcohol.

But I’m guessing that if you are already a drinker then nothing I can write here will make you stop. It’s okay. I’m not on a campaign. I’m really just fascinated by how this relates to my recovery and my survival chances.

I gave up drinking a week ago. Unlike smoking, this wasn’t very difficult. I’ve previously given up alcohol when I was pregnant and breast feeding for 18 months. I also gave it up for three years when I was in a relationship with an alcoholic (although his therapist warned me that this was codependent behaviour). I’ve always enjoyed drinking and used to have a reputation for being able to drink fellow police officers under the table. Not my finest achievement.

Having concluded my research on alcohol I showed my husband a page of information that summarised the cancer risks. It’s not just a risk for breast cancer but for several different cancers, including cancers of the mouth, liver, stomach, colon, rectum and lung. It’s not just large quantities of alcohol that increase your risk, but low to moderate amounts. The only reason various cancer organisations have issued drinking guidelines is because they accept that most people will continue to drink, but read their actual position statements and it’s pretty clear that there is no safe level of consumption. When Graham had finished reading the summary I asked him this:

“Do you think I should give up drinking.”

His answer was “Having read this, I don’t think anyone should drink. You should stop. I should stop.”

I didn’t ask Graham to stop drinking. (I understand codependence now)

Still, he’s decided to only drink very occasionally. He’ll probably still have the odd glass with friends over a meal. Or he might just stop. Certainly he hasn’t had anything to drink for the last week.

For me, a big part of the decision was influenced by how I will feel if the cancer comes back. If I haven’t done everything I can reasonably do to prevent recurrence then how will I feel? Surely there will be a part of me wondering if avoiding alcohol could have prevented another bout. It’s not a situation I want to be in.

My first thought when I read about the dangers of alcohol was, “I could stop drinking any time.” My second thought was, “What’s wrong with right now?” It’s possible my drinking has already cause permanent damage to my body. That’s not a reason to compound the problem. Even a couple of drinks a week can increase my cancer risk and I don’t NEED to drink.

I also find it hard to dance around the addiction issue; if I continue with a behaviour that I know to have adverse consequences then, by definition, I am an addict. That’s just the cold, hard truth of it.

Now observe your own reaction to that statement for a minute.

Or just pour yourself a nice glass of red and ignore me. 

May as well have a cigarette while you’re at it.

Falling in Love Again

1148753_221528658033361_508058645_n

I’ve only written one post about sex and cancer. Here it is for those that missed it the first time around:

https://positive3neg.wordpress.com/2014/01/07/i-suppose-a-ro…f-the-question/

Trigger warning for anyone that doesn’t like reading about her mother having sex, or anyone else that would rather not know about my intimate life. You can skip this post.

Back when I wrote my first post about sex I was bald in an all over kind of way. I was puffy from steroids and gaining weight. I felt about as sexy as a pair of sensible shoes.

Since then I’ve recovered from surgery, grown a nice pixie hair style and a perfect pair of eyebrows. I’ve even had to shave my legs for the first time in nine months. My daughter tells me not to worry about the weight I gained during chemotherapy (“Your body is fighting cancer, Mum. That’s enough for now.”), so I’m not going to give it more than a passing nod as I keep up with my daily yoga, eating well and feeling good.

I’ve still got some peripheral neuropathy in my arms and legs but it’s tolerable. I know it will improve over the next year or so. Nerve endings take a long time to grow back. I’ve started radiation and although it’s not at all pleasant, it’s already one week in and only five to go. This too shall pass.

Going through a period of time when I didn’t feel much like sex, and where my husband, thanks to the warnings that my body was highly toxic, didn’t feel much like joining me, has made me realise how much I enjoy sex. Not just any sex, but that deeply emotional connection you can only achieve by having sex with someone you love and someone that loves you in return.

Cancer makes you think about your priorities. If your time is limited, what are the things that really matter? If you only have a few years left (and with triple negative cancer you really need to consider this) then how do you want to spend them?

Some people find conversations around this subject depressing but I enjoy them. We are all going to die and it seems to me that being reminded of that is a good thing. It’s a wonderful way to strip back the inconsequential. If you let it.

When you’ve had a cancer diagnosis you also need to plan for the possibility of a long, slow slide into debilitating illness, because if cancer is going to kill you it will usually involve that very unpleasant slope. You need to think about which activities will require the most physical wellness. I’ll probably be reading books until the last time I close my eyes but stand up paddle boarding has a limited window. This is true for everyone, even if you never get cancer. As we age, most of us will experience a reduction in our physical ability. It’s worth planning for.

One of the best things about having cancer has been the ease with which my husband and I can have a conversation about how precious our time is, and how it’s important to identify what really matters to us. The last time we spoke about this, my husband asked me what one thing I would put at the top of my list. I said, “I’d like to fall in love again.”

He looked like I’d punched him.

I realised what had happened and said, “Oh Darling, I don’t mean with someone else. I mean with you!”

Really, of all the things I’ve done in my life, falling in love has to be a contender for my number one spot. Giving birth is up there too, but at 52 I don’t think I’ll be doing that again. But falling in love is possible, achievable, and easy for those of us already in relationships with people we love. What a wonderful thing it is to have that kind of connection with another human being. How joyful.

One of the benefits of falling in love is the excellent sex that comes with it. What’s at the top of my ‘bucket list’? Well, I want to fall in love again, and I want to have falling-in-love sex again.

The trouble is that Graham and I were struggling before I got cancer. He’d been sick for a couple of years and his recovery was long and slow. We never stopped being kind to each other or affectionate, but somehow, even when we’d reached the point where sex was once again an option, we just let sex slide. I think this happens to a lot of couples, and happens far too easily. I found myself reluctant to initiate sex in case it wasn’t wanted.

Graham credits his English heritage with his reluctance to talk openly about sex. Of course, I belong to the school of thought that if you can’t have a conversation about sex it’s very easy for assumptions and misunderstandings to undermine you. We had reached a kind of sexual stale mate.

My cancer diagnosis didn’t help things at all. Apart from looking and feeling shocking, I was told that chemotherapy meant we couldn’t have sex without my husband wearing a condom to avoid toxicity. Yes. A toxic vagina. Now that’s about as unsexy as it gets.

I think it’s a credit to the strength of our relationship that while neither of us has been happy about the absence of sex it hasn’t been a major issue.  I think we both recognise that one of the physical limitations as we age is likely to be sexual performance. But we don’t need to lose the intimacy.

We decided some months ago that we would end each day by spending some time in bed just holding each other. Sometimes we talk and sometimes we don’t but for both of us this has become a gentle and comforting way to reconnect. Recently I’ve been feeling like it would be nice to go further, but it’s not easy.

There’s now new concerns about the physical impact that my treatment has had on my body. Will sex still be okay? Or even possible? Does peripheral neuropathy affect the nerve endings anywhere else in my body? Do all lubricants smell like hand sanitizer? These are the details I fret over.

The bigger issue has been how to get across the gulf. How do we move from affectionate friends to passionate lovers?

I considered a sex therapist, but we didn’t really need therapy. We just needed some kind of a jump start.

I love a good short course or a workshop so I went in search of one. I know some people feel awkward about this sort of thing but I’m of the view that there’s not much you can experience in life that’s completely unique. Most of what we live through is well travelled by others, and some of them have been generous enough to share what knowledge they acquired on that journey. Books can be another great way to access this knowledge but I wanted something we could do together.

After surgery, I was given physiotherapy exercises to help me regain full movement in my left arm and to prevent complications. Sometimes we need emotional physiotherapy.

I decided against the Relationships Australia courses:

“Each state and territory has compiled its own set of relationship skills courses and seminars that are responsive to the needs of the community.
 People participate in relationship courses and seminars to gain insights, knowledge, skills and understanding to enhance their relationships.  They also attend to get support and to explore similar relationship experiences with others and to hear from others about what works for them in their relationship.”
Hmmm. Sounds about as sexy as a trip to the motor registry. Also, our relationship is great. It’s just the sex that needs a boost. Not surprisingly there’s a lot of courses out there including courses in tantric love and something intriguingly called ‘the 100 candle surprise retreat’. Perhaps not.
I also avoided the course that promised to help me identify which shamanistic animal type represented my sexuality. I have bad luck with anything that assigns animal archetypes. I always want to be a lion or a tiger but I’m a capricorn born in the Chinese year of the Ox. You see how that works.
After a bit of google I found Jacqueline Hellyer’s short workshops. Here’s the link:

http://www.jacquelinehellyer.com/tantra_workshops

The course descriptions looked interesting. There’s a little bit of tantra in there but it’s clearly not going to be about three hours of coitus without movement while you experience the divine connection (as one other course promised). Jacqueline also appears to be well qualified and her courses come with this disclaimer:

“All workshops are practical, liberating and inspiring, completely classy and sleaze-free. There’s no need to share personal details, and there’s no nudity or actual sex – that’s the homework!”

Okay. Good. Because although I love sex and I’m more than happy to talk about it, I have no desire at all to engage in group sex, or sex in the presence of other people, or to watch other people have sex. I really just want to have sex with my husband.

I sent Graham the link, asking him to take a look and see what he thought (remember, he’s not comfortable having conversations about sex). A couple of days later he appeared at the door of my study and said, “I think we should do that course.” This is part of why I love him. He might be shy about the conversation but that doesn’t mean he’s clueless about the problem and he’s always happy to sign up for anything from cooking classes to salsa dancing if it gives us a shared experience.

We took Jacqueline’s recommendation and signed up for all three workshops. Graham headed off to the men only ‘Black Belt in the Bedroom’ as I reflected on how lucky I am to be married to someone that’s prepared to participate in this sort of thing. A lot of men would scoff at it. The description of the four hour evening looked intriguing and actually a lot more interesting to me that the women’s workshop.

He arrived home with a grin on his face and told me that he didn’t want to discuss the details until I’d been to my ‘Luscious Women’ workshop the following evening, although he did tell me he thought the evening was ‘very worthwhile’ and that they’d had beer and pizza for dinner. I joked the the women’s workshop would probably be quiche and salad.

The women’s workshop included some participants with some serious problems and most of the evening was spend ‘going around the room’ so that participants could ‘share their story’. I was wishing there was a female version of ‘Black Belt in the Bedroom’.

I think it’s fair to assume that any course you do will contain some things that are relevant to you, some that aren’t and sometimes, some that you actually object to. This course was no different. I found Jacqueline’s repeated characterisation of men as ‘simple’ annoying. Deriding men might be a great way to bond with the single women in the room, or those in unhappy relationships. I find my husband to be at least as complex as I am and the same to be true of most men I know.

I also found her division of humanity along fairly traditional gender lines to be irritating. The whole ‘women are soft on the outside and strong on the inside while men are strong on the outside but secretly soft on the inside’ is just rubbish to anyone with a feminist sensibility and a passing knowledge of human psychology. She uses the ancient Chinese symbol of ‘Yin and Yang’ as a model for her paradigm, apparently missing the irony; this symbol of the balance between male and female is meant to be something that each of us strive for as individuals. All the same, at least one woman considered this model to be profoundly useful. She had ‘a false yang that was hiding her true yin and thereby preventing her inner yang to be fully realised.’

I sat through most of this without comment, other than to offer that some of us had genuine ‘outer yang’ even though we were women and to object to her use of the phrase ‘ball breaking’ to describe strong, competent women. A feminist she is not.

That’s not to say I didn’t get something good out of the ‘Luscious Women Workshop’. I liked her suggestion that we redefine ‘sex’ to include all forms of intimacy. I have been guilty in the past of only counting genital intercourse as ‘real sex’ and for no other reason than social conditioning. Even the legal definition of intercourse is broader than that. Defining all forms of intimacy as legitimate expressions of our sexuality is a great idea, particularly as we get older. It allowed me to move from “I’ve only had sex once in the last year.” to “My husband and I have lots of very gentle, satisfying sexual contact on a regular basis.” This was no small thing for me.

I also liked Jacqeuline’s analogy for male and female sexuality (gender stereotypes aside). She describes male sexuality as being like fire, igniting quickly and burning itself out, and female sexuality as being like water, a lot slower to heat up but able to hold heat for much longer. Her advice to all of us seeking to be luscious was to see to our own simmering. It’s unreasonable to expect a man to take you from frozen to boiling at every sexual encounter. I really liked this analogy and admit that I had fallen into a pattern of waiting for my husband to ‘warm me up’. I’ll be doing that myself in future.

To be fair, there was a lot of information in the folder for the Luscious Women Workshop that we didn’t get around to and most of it looks a lot more interesting than the seven goddess model. I’m sorry we never got around to the ‘flute breathing’ or the ‘visualisations to raise sexual energy’. Jacqueline conceded that they’ve only recently reduced the course to four hours so perhaps they’ll get better at delivering more content in less time. 

Dinner was salad and quiche.

Once I’d finished the workshop Graham and I had a great conversation in the car on the way home about what we’d both gotten out of the respective individual evenings. Graham observed that he really saw now that it wasn’t possible to have a good sexual relationship without talking about it (and for this alone I would recommend the workshop) and that he didn’t think he’d learnt anything new but that he’d been reminded of some things that he shouldn’t have forgotten. Physiotherapy.

I told him that I didn’t think much of Jacqueline’s seven sex goddesses. Nor did I get much from visualising each of them in turn and thinking about what colour or smell came to mind. I don’t understand how my ‘warrior’ is really a negotiator and the whole model feels contrived, as if she’s trying to come up with the basis for a blockbuster of ‘Mars and Venus’ proportions. I also apologised for not simmering my own water and shared my joy at the notion of redefining sex to include a lot more than just intercourse.

Which brings us to the couples workshop.

This was a much better use of my time and money than the women’s workshop. Once again, a lot of this was not new to us. We liked the way Jacqueline used pieces of music to time the different exercises. “Sit facing one another and make eye contact. Keep maintaining eye contact until the end of the piece of music. If you find this too intense then just close your eyes briefly.”

The exercises in the first part of the evening included melting hugs and breathing in unison. We were prompted to ‘open up’ to the love we felt for one another. Yes, some of this did feel awkward and forced but some of it felt like rekindling something important to both of us.

We also did playback conversations. For those unfamiliar with this tried and tested therapy technique, one person starts a sentence with “I really appreciate it when you………” or “I really love it when you………….” and the other responds with “What I’m hearing is that you really appreciate it when I………………..” If the second person gets the playback right then the first person just says something like ‘that’s right’. If they don’t get it right then the first person gently corrects them. We both enjoyed this. It’s a very structured form of communication but it does give you the opportunity to  tell your partner about some of the things you really love about them.

Although we were cautioned to stick to the script for playback conversations, one couple managed to shift into conflict. You need to stick to the script if you want to get any benefit from this type of exercise.

After dinner (salad and quiche again – is that significant?) the exercises included feeding each other dessert with one person blindfolded and asking each other to touch us in ways we enjoyed. Yes, it was a clothes on workshop and Graham and I spent most of the time giggling and massaging each other’s feet. Some couples got pretty worked up but the game was over before anyone got messy.

The evening ended with an invitation to a couples retreat in the Blue Mountains or Bali. Or perhaps we’d like to come along to the ‘Tantric Lounge’ held weekly in Sydney. Probably not but we might have a look at some of the other ‘couples retreats’ on offer to see if we can find something that appeals to us.

By the time we drove back to the Central Coast we were both too tired to do anything other than fall into bed and pass out, but the material we covered in the workshops has continued to be a great source of interesting (and sometimes hilarious) conversations.

Did I fall in love with my husband again?

Yes. Yes I did.

Did I get crashingly good sex as a consequence?

What do you think.

Radiation and Post Traumatic Stress

 

1381455_10151806814238172_997787025_n

Given how willingly I marched into chemotherapy asking for my fabulous cancer-killing drugs, everyone has been a bit surprised by my attitude to radiation, including me. Yes, it’s much less invasive than chemotherapy and the side effects are reportedly easier to deal with, so why have I been so cool about it.

I’ve considered the possibility that after nine months of treatment it’s just that my enthusiasm is flagging. I want to be well. I don’t want to go back into the treatment tunnel where life revolves around appointments and managing side effects. It’s partly about that. But there’s more to it.

Certainly there’s a lot of shock reporting of radiation and the longer term side effects, including claims that it causes cancer. I’ve had to deal with a couple of people insisting that it’s too dangerous to be worth considering. As you will have seen from my previous blog on this issue, I don’t accept their assessment. In short, there are risks associated with radiation but when I balance them against the benefits, particularly for a highly aggressive cancer like mine, then those risks are acceptable to me. If I get a secondary cancer it will be because I’m alive to get it. Not having radiation might prevent me from becoming one of those statistics but death might be the means for doing so.

Radiation is, in my opinion, a dehumanising process, or it is when it’s carried out using the methods and processes of the clinic I’ve chosen to attend. I understand why giving me my own barcode to scan saves time but it does make me feel like a product. Unlike chemotherapy there’s no social aspect to radiotherapy, unless you can start up a temporary friendship with the patient that’s scheduled before or after you.

Treatment involves changing into a gown and putting your things in a basket, carrying the basket to the treatment room, climbing onto a table and into a body mould designed to hold me still and then imagining I’m a bag of wet sand. My breast are exposed and my hands are crossed above my head. What follows is a conversation between technicians that most consists of numbers, marking my skin with a texta, and moving me until I’m aligned with their laser marker lines.

Once they’ve lined everything up the treatment only takes a couple of minutes and, once again, my role is to be as still and as relaxed as it’s possible to be. Breathe normally. Don’t move because this treatment is targeted and my heart is directly under my tumour site.

The staff so far have been different people each day. I suppose by the end of six weeks I’ll feel a bit more comfortable with some of them but there’s no room for chit chat. When the treatment is over I pick up my basket and take it back to the change room, smiling at the next patient sitting in the hallway waiting for their turn on the machine. I wipe off the texta marks (it seems the staff don’t do this) and get changed, leaving my gown in a pigeon hole in the tiny change room so that I can use it again.

Okay, so it’s not at all pleasant, but even that doesn’t account for my strong aversion to being there at all. I’ve spent the last few weeks wondering what was going on. The clue came during my first appointment with the registered nurse that does my ‘treatment review’.  As she was listing the now familiar side effects I noticed my reaction to the words ‘skin burns’.

During my 20 years of policing I developed post traumatic stress disorder. It’s so common in policing that many of us just accept it as a natural consequence of the job. In a culture where seeking help made you ‘weak’ I pushed through it until I developed fibromyalgia, almost certainly as a consequence of the post traumatic stress. What you notice when you have this condition is that even relatively small stressful events can ‘set you off’. You get a rush of adrenalin and cortisol. Your heart rate elevates and sometimes you break out in a sweat. Your mind gets sucked down a wormhole and deposited inside the memory of a previously traumatic event. With time you learn to recognise these symptoms. With practice, and in my case, yoga, meditation, cognitive behavioural therapy and learning the cello, you become better at calming yourself down.

The minute the nurse said ‘skin burns’ I recognised a post traumatic reaction. Here was my clue.

I will spare you the details of why the phrase ‘skin burns’ causes such a strong reaction. It’s sufficient for you to know that policing sometimes involves being around people that have been badly burned. If you’re lucky, they’re already dead.

So problem soved? Sadly, it’s not that easy. The thing that most people don’t understand about an irrational fear is that knowing the source of it, and knowing it’s irrational, will not cure the fear. Consider my first husband’s vertigo. Get him somewhere with any sort of height and he experienced an almost debilitating fear. When we took our daughter, then a toddler, up a high building to enjoy the view he stood next to the lifts while she ran to the windows. He’s an intelligent, capable man and he understands that he’s not going to fall, but that doesn’t stop the fear. Somehow my daughter, in spite of her early enthusiasm, also experiences vertigo as an adult. It annoys me when she’s trying to conquer her fear and some well meaning stranger laughs at her or tells her not to be stupid. The fear is real even if, in the circumstances, it’s unwarranted.

So it is with me and radiation. I know that I am not going to incur massive burns and that my burns, if I get them at all, will be temporary. My fear is not about the facts. It’s as much about living with the smell of burning skin and the memories that will trigger.

My first husband provides a clue. When he wanted to become a police negotiator he was required to climb the harbour bridge as part of his training. This was long before the famous bridge climb was in existence so the only protection was a wire with a carabiner attached to it. In spite of his almost crippling fear, he wanted very much to be a negotiator. He made the climb. I don’t know if he ‘cured’ his vertigo but he certainly improved it. Recently he posted a photo from China. He was standing at the lip of a huge cliff over a river. He’s come a long way.

The local reptile park runs a program for helping people overcome their fear of spiders and snakes. As I understand it, they gradually introduce you to situations where you come right up to the edge of your fear and then retreat. In time you can hold the object of your fear without a reaction. If you think about it, a lot of common fears make sense. Being afraid of spiders, heights, deep water, snakes and things that are dirty isn’t ‘irrational’ if you’re in an environment where those things might kill you. It’s what my Mum calls ‘lizard brain stuff’. It’s a remnant of the time before logic and reason.

All this is useful to me. Clearly I need to remind myself of the benefits of radiation therapy and why I’ve chosen to have it. I need to recognise my fear and understand the source of it, and then decide to push through it. I can use logic and reason to help deal with my primitive fear, but I think there’s a bit more to it than that.

I have a problem with prawns. I ate a bad one a long time ago and had explosive food poisoning as a consequence. I can enjoy really, really fresh prawns but most of the time I give them a miss. I know there’s only a slight risk of food poisoning but my body has acquired a natural revulsion to them. My husband has the same reaction to egg custard for the same reason.

If you think about it, this aversion is protective. My body’s ability to remember something dangerous and to warn me against it makes sense. It’s got evolutionary benefits. If an animal can’t differentiate between what’s good to eat and what’s potentially poisonous then the odds of survival are shortened.

It got me thinking. What if my post traumatic stress disorder operates the same way? What if the whole point of my ‘fight or flight’ reaction to seemingly innocuous situations is my body’s way of trying to protect me from further trauma. This makes sense to me. Suddenly, a condition that has been a source of anxiety and frustration becomes a force for good.

I’ve decided that one of the ways I can help to deal with my reaction to radiation therapy is to meditate on safety. This is simple. I sit comfortably, close my eyes, breathe slowly and repeat the phrase (either to myself or out loud) ‘I am safe.’ I’ve also started using it while I’m pretending to be a bag of wet sand on the radiotherapy table. I am safe. I am safe. I am safe.

For me, this is proving to be a useful way of retraining my subconscious. It involves acknowledging that my body is trying to protect me, and being grateful for that reaction. There’s a sense of ‘honouring’ the post traumatic stress, of recognising the benefits of a system designed to help me avoid further distress and trauma. I’m finding that this simple meditation is having a profound effect on my mood and my anxiety levels. I’m hopeful that over the next few weeks it will help to put my fibromyalgia symptoms (mostly chronic, wide spread muscle pain) back in their box. I’m recognising that even the fibromyalgia is a protective mechanism. My body creates a condition that requires me to retreat, rest and recover. I will pay attention to that.

I’ve got a copy of Jon Gabriel’s guided visualisation on safety and I’m going to start plugging in to that on a regular basis. Jon is a ‘diet guru’ with some pretty whacky ideas, including the notion that your weight might be a consequence of ‘past life trauma’ (seriously?) but this particular mediation is a lovely one. He speculates that excess weight can be a protective mechanism and that people may ‘hold on’ to that weight because they don’t feel safe. This visualisation is designed to address that. I think it can help me to overcome my post traumatic stress reaction. (If I drop some of the weight I gained during chemotherapy then that would be an added bonus!)

It seems to me that regardless of whether or not you’ve got post traumatic stress or cancer you’re going to have to deal with fear. Sometimes that fear will be sensible and protective, like the fear you feel in an empty city car park at 3.00am. Sometimes the fear will have an obvious but irrational source, but the fear will still be real. Sometimes some people just feel fearful and the source is unknown. In all of these circumstances the process is the same; figure out what’s causing the fear (and know that it may be something programmed into you through circumstance or genetics), consider changing  the circumstances if you can (get out of the car park), or work on using your reason and logic to overcome the fear.

Finally, acknowledge that the subconscious is rarely convinced by logic or reason. ‘Knowing’ something doesn’t automatically lead to a change in behaviour. I ‘knew’ for a very long time that smoking was bad for me but it didn’t stop me smoking for a period of time well past the acquisition of that knowledge. So what is it that reaches the subconscious?

For me it’s a simple, positive statement that addresses the causes of my reaction rather than the symptoms.

I am safe.

(PS: For long-term changes in the way things work try learning a musical instrument or a language. Both have been shown to ‘rewire’ the neural pathways and if you have post traumatic stress that’s  a good thing.  If you doubt this methodology then spend some time researching ‘neurological plasticity’ or read ‘the brain that changes itself’. I’ll never be a great cellist but learning an instrument had a huge impact on my post traumatic stress symptoms. For short term changes and day to day management of fear try a simple meditation.)