Adventures with Acupuncture and Alcohol

Some time around November my peripheral neuropathy returned with a vengeance. For the uninitiated, this condition is a common side effect of chemotherapy. The variety of chemotherapy they gave me is designed to knocking out all the cells that reproduce quickly. That includes the cells that form hair, fingernails, the lining on your mouth and the surface of your tongue. This is why we go bald and develop ‘metal mouth’, where everything tastes strange. Unfortunately many people also get a kind of dieback in the nerve endings at the extremities of the body.

For me, peripheral neuropathy turned up just before my last chemotherapy session. My final dose was reduced but I still wound up with uncomfortable pain in my hands and feet. It gets worse than this. Some people are crippled by peripheral neuropathy and others find doing even simple tasks with their hands acutely painful.

Nerve pain is unlike any other kind of pain. It can be difficult to describe. Most commonly it’s compared to ‘pins and needles’, or that aching numbness you get if your circulation to your hands is compromised; if you ever tried sitting on your hand as a kid you’ll remember the exquisite numbness as the blood supply returned. Sometimes my hands feel like I’ve just removed them from iced water, and other times they feel hot and itchy. It all went away when they gave me gabapentin following the bilateral mastectomy. It’s a great drug for nerve pain but in my case it also affected my brain in unexpected and unpleasant ways. Gabapentin is also used to treat epilepsy so this was hardly surprising. In my case, I started coldly and calmly contemplating suicide. I wasn’t depressed or unhappy. Taking my own life just started to seem like a logical option. It was a scary time.

Denied the drugs that usually help with the condition I’ve tried various supplements, including fish oil, evening primrose oil, ginkgo and vitamin D. I also practiced daily yoga and stayed away from inflammatory foods, including gluten.  At some point my hands and feet returned to normal. The pain was gone. I should have kept a journal. Perhaps I’d know what to do now that the pain has suddenly, inexplicably returned.

The trouble with nerves is that they grow very slowly. My radiation oncologist told me that things wouldn’t be done for about eight years. This means that establishing a causal link between anything I did or took is problematic. Since November I’ve been trying to diagnose what caused the relapse with no luck. I’ve figured out that avoiding sudden changes in temperature helps, so maybe summer’s air conditioning was a trigger. Who knows. Of course I hit the internet trying to find clues. Acupuncture kept turning up as a possible treatment.

I’ve had acupuncture only once before. When I had fibromyalgia I saw a local doctor who put needles into my pressure points. These are acutely painful spots on your body that occur in a pattern that is typical of this condition. Having needles stuck in them was enough to bring me to tears. I had two sessions before deciding that even if it was helping I would rather have the constant dull ache of fibromyalgia than the intense torture of acupuncture.

Then I had a series of people randomly mention a local acupuncture practitioner, not knowing I was considering treatment. My friend, Maryanne, would say the universe was speaking to me. In any case, I decided to make an appointment.

Tim, the acupuncturist, is a warm, friendly person and easy to like. He asked me a series of questions about my history and symptoms before taking my pulse. Somehow, this pulse taking allowed him to diagnose that my energy levels were low and that I needed to express grief. The skeptic in me observed that these would be fair assumptions to make about anyone that was coming out the other side of a bilateral mastectomy and treatment for cancer. He explained that according to Chinese medical tradition, energy is stored in the kidneys and mine are running on empty. This means there is not enough energy to reach my hands and feet. He also detects ‘lung blockage’ which is how he has diagnosed grief.

I have family members that would roll their eyes and scoff, but if there is one thing I have learnt throughout my treatment it is this: We have no idea what we don’t know. I had the kind of prognosis that left doctors convinced I would no longer be alive, and yet here I am. I have no doubt that my massage therapist has played a large part in my survival and she ‘talks to spirit’ and allows my body to tell her what it needs. Who am I to argue?

So I climb onto the table and let a stranger stick pins in me.

The first few are surprisingly painless. No really. Completely painless. I can feel a sensation that is similar to someone resting the head of a pin against my skin, but no more than that. The next few are more noticeable but still not painful. Tim asks how they feel. The only word I can find is ‘weird’. Tim tells me that’s the word most people use. It’s a very odd sensation. I get a sudden pressure in my head which Tim relieves with a bit of massage. Once there are a few pins in my feet and legs and a few more in my hands, Tim leaves me for ten minutes or so to allow the acupuncture to do whatever it does. I am very conscious of holding myself still because the idea of bending or breaking a needle is horrifying. I breathe and practice a bit of light meditation. It helps.

Tim returns, removes the pins and processes my health fund rebate as I pay. Very handy. I make an appointment to see him the following week.

In the week that follows I’m conscious of the risk of observation bias. It’s possible that any shift in the peripheral neuropathy will be attributed to the acupuncture but with a sample size of one and no control, how can I be sure. My hands don’t feel as tingly, but they still ache. I find I have more energy and acknowledge that this could be coincidental. I watch a movie that a friend recommends called ‘I miss you already’, which is all about a woman dying of triple negative breast cancer (okay, maybe the universe IS talking to me) and I have a really good cry. I realise that when you go through treatment it’s enough to just get through each day. I am also aware that my policing background taught me the unhealthy habit of parking my emotions rather than dealing with them in real time. The movie helps me to grieve. I feel much better the following day and every day since.

My second visit is much the same as my first. Tim takes my pulse again and seems disappointed that my kidney tanks remain empty. I tell him that thanks to my improved energy I managed to spend a whole day out in the garden, hauling and placing mulch. He politely tells me about patients he has treated with chronic fatigue that undermine their own treatment by rushing to do all the things they haven’t been able to manage. I get the message. Rest, rest and more rest until I see him next time.

There are more pins on the second visit, including two at my neck that are painful. Tim apologises and explains that instead of refilling my kidneys, all my energy is rushing to my head and this is why I have experienced pressure during both treatments. I notice that the pressure in my head has subsided since the pins went into my neck. Perhaps it’s like that old joke about stomping on someone’s toe so they don’t notice their headache.

Following the second session I have a massive sugar craving and I feel extremely weary. I eat chocolate and go to bed. I’ve booked another session. I’ll let you know how it goes.

I’m not sure how much of this treatment is about the needles and how much of it is about the talking. I’ve been encouraged to grieve and rest and both of those are helping. I’m also paying close attention to my symptoms to see if I can identify any contributing factors. Alcohol is the only clear villain. I knew that.

I’ve written before about my ongoing relationship with alcohol. It reminds me of low level domestic violence. I enjoy the first drink, and the second. If it was possible to just have those two drinks once or twice a week then I would be complying with the new standards for anyone that has had breast cancer. The trouble is that alcohol lowers impulse control so any time I have the first two I usually find myself continuing to drink throughout the evening.

The honest recommendation is that we not drink at all, because alcohol is a known carcinogen, and if we do drink to limit it to half a bottle of wine a week (or the equivalent). This is a compromise. My oncologist tells me there was a lot of debate about just issuing a statement against all alcohol but they are realistic and believe that setting some kind of limit means we’ll all think more carefully about our drinking. This is a bit like telling a smoker to cut down.

I am very familiar with this dance. I tell myself that I will limit my drinking to X amount or to X days or X circumstances only to break my own commitment, feel remorse and recommit. I used to do exactly the same thing with cigarettes. The time is coming when I will give up alcohol (even typing that was hard and I wanted to type ‘consider giving up alcohol’ but caught myself in my own delusion). Just like cigarettes, I anticipate a few false starts before I move towards a healthier, happier life, free from post-drinking remorse. Just to be clear here, I’m not talking about binge drinking or hangovers or behaving badly. My drinking behaviour is what the vast majority of my friends would consider normal. That in itself is a worry. We used to smoke at our desks at work too, and while we were driving around in police cars. Times and standards change.

The trick for me with cigarettes was that I became sick of giving up. I used to joke that eventually I gave up giving up and that might be just the trick for alcohol. Stop. Enjoy the alignment of my behaviour with my values. Celebrate that unlike cigarettes, giving up alcohol will actually help me to stay a healthy weight. Find friends and activities that aren’t associated with alcohol and, at least for a time, avoid friends and activities that are. Except my husband drinks wine! I wonder if it’s reasonable to ask him not to drink at home for a while, just until I find my feet. Is that any different to asking him not to bring chocolate home when I’m trying to lose weight? I guess it never hurts to ask.

Oh wait. He turns 60 next month! How could anyone celebrate a birthday without alcohol? And that right there is the problem. It’s so much a part of our culture that deciding not to do it is seen as just a bit odd. I’ll just tell everyone I’m the designated driver. That should work.

I notice that even as I write my brain throws up objections. My daughter gets married this year. Won’t I want to toast the bride and groom? How about afternoon wine on the verandah with my husband? Do a really want to give up what has become a ritual that connects us after a busy day?

I have a cousin who gave up drinking some years ago. She tells me that it’s a grieving process. Perhaps that’s another layer to all of the various layers of my grief. My inner three year old wants to throw a tantrum and insist that I ‘deserve’ alcohol.

Maybe I need to give her a big hug and explain that I deserve good health much more.

 

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The stuff we put on our bodies

Yesterday my daughter sent me a link to an article. Researches have established a causal connection between dark hair dyes, chemical hair relaxers and breast cancer. Here’s the link:

Breast cancer and hair products

I started finding grey hairs when I was in my early 20’s and started dyeing my hair shortly after that. Because I was naturally dark brown, I chose to dye it to something close to my natural colour (apart from a scary auburn period during the 80’s, but hey, it was the 80’s!). That’s more than 30 years of what my husband referred to as ‘soaking your head in toxic chemicals’ about every six weeks.

It was at Graham’s suggestion that I stopped colouring it. I also shaved it off to raise money for blood cancers, because this seemed like a great way to break the dying addiction and support a charity. Two years later I lost it all again thanks to chemotherapy.

I’m now naturally grey. To my surprise and delight I get more compliments about my hair than I have at any time in my life. It’s got this great thing going on that looks like I’ve paid a fortune for highlights. I haven’t. It just grew back like this. Meanwhile I see lots of girls in their twenty-somethings colouring their hair grey!

It has always seemed odd to me that we have strict laws about food and very few about cosmetics. We know that the skin is great at absorbing chemicals. That’s why nicotine patches work. It’s why you can now get transdermal patches for all kinds of medical conditions. They allow you to absorb chemicals over a long period of time rather than getting it all at once from an injection or a pill.

So why is don’t we have the same kind of regulations around cosmetics? We are essentially consuming everything we put on our bodies. It turns out that a large number of cosmetic products contain known carcinogens and that even those that don’t contain chemicals with unknown risks to our health. Yuck.

And it’s not just cosmetics we need to be concerned about. It’s everything that comes into contact with our bodies. Take triclosan. You’ll see it listed as an antibacterial ingredient in hand sanitiser, toothpaste, dish washing detergent and liquid soap. Pretty much anything claiming to be ‘antibacterial’ either includes triclosan or has been treated with it, including furniture coverings, bedding and underwear. Triclosan is a hormone disruptor. Here’s an extract from the Wikipedia article about it.

Because of potential health concerns spanning from antimicrobial resistance to endocrine disruption, triclosan has been designated as a “contaminant of emerging concern (CEC)”, meaning it is under investigation for public health risk. “Emerging contaminants” can be broadly defined as any synthetic or naturally occurring chemical or any microorganism that is not commonly monitored in the environment but has the potential to enter the environment and cause known or suspected adverse ecological and(or) human health effects.[34] Triclosan is thought to accumulate in wastewater and return to drinking water, thus propagating a buildup that could cause increasing effects with ongoing use.[35]

In an article from May 2015 on the current status of triclosan, Gurpreet Singh Dhillon and colleagues cite various studies that report “emerging health concerns related to the use of TCS such as microbial resistance, dermal irritations, endocrine disruption, higher incidence of allergies, altered thyroid hormone metabolism and tumors development due to TCS and its by-products”.[36]

 

Interestingly, it’s still considered safe ‘in small amounts’ but how much is too much? If you’re working in a hospital and sanitising your hands several times a day, wouldn’t you be absorbing a huge amount of triclosan? And here’s the kicker; it doesn’t work as well as soap and water when it comes to cleaning your hands.

Of course this is just one example of one chemical. The list of potentially toxic substances that wind up in our homes is a long one. You can spend a disturbing time googling and reading for more information. This chart is a pretty comprehensive one, but it only has household products, not cosmetics or all personal care products:

Toxic products in the home

If you’d like to really spoil your day then here’s a couple of articles about those:

The 20 most harmful ingredients in beauty products

15 toxic beauty products that most women use anyway

So what to do? Well, educating ourselves is the first step. Know that ‘organic’ is nonsense then it comes to beauty products or household cleaners. It might just mean they’ve included a few organic ingredients with the chemicals. It might mean they’re using the scientific definition of ‘organic’ (hint; everything is organic!) rather than the commercial use which is supposed to indicate that food has been grown or manufactured using only a limited range of approved chemicals (another hint; there is no such thing as ‘chemical free’ because everything is made of chemicals.)

It’s a good idea to read labels and choose products that avoid the known nasties. True, the thing you buy could contain something that gets proven to cause disease next week (or next year, or whenever) but at least you’ll have limited your exposure to things that are known to be bad for you. This might mean having slightly less shiny hair, but you’re worth it.

Know that most liquid things that come in plastic bottles will also be contaminated by the plastic bottle. If you want to go hard core you might consider decanting shampoo and conditioner into glass or ceramic dispensers (most people won’t) and give up liquid soaps and body wash products completely in favour of a bar of soap.

Go natural. Okay, it’s not practical for a lot of women because there’s still this weird expectation that we all look a certain way, a requirement that strangely does not apply to men. If you have to wear makeup, or you love to wear makeup, you might want to avoid cheaper brands, opt for a less ‘made up’ look so that you wear less, and choose things with fewer ingredients and none of the nasties. A simple rule of thumb is to buy things labelled ‘fragrance free’ or ‘sensitive skin’ because they will have less dangerous chemicals than the perfumed varieties.

And finally, have a long hard think about your hair and what you would like to do with it. Now that there’s a clear link between dark hair dye, chemical straighteners and cancer, do you really want to keep putting that stuff on your head. If the answer is ‘yes’ then perhaps consider hunting for safer products and going lighter. Or perhaps it’s time to get a really flattering cut from a great hairdresser using all the money you’re going to save on hair products. There’s an obvious pun here about dying for dyeing but I’m not going there.

If you are a man reading this then please start telling the women in your life how great they look when they haven’t put makeup on their faces. Love them as they are and support their decisions about kicking the dyeing. I read a comment from a woman recently who said her husband tells her to colour her hair so she doesn’t look old. Seriously.

I’m pragmatic about all of this. A ‘chemical free’ home is almost impossible to achieve. If you don’t have tank water then there’s chlorine in your water and it evaporates into your home every time you shower. But you can reduce the toxic load by making smart choices about what you choose to use.

As a final tip, avoid redecorating disease. Lounges, cushions and soft furnishings like mattresses are typically treated with flame retardants that are, you guessed it, highly toxic. Get something with washable covers or just keep the things you already have until they fall apart. You’re probably rolling your eyes at all this. I don’t blame you.

That’s enough about chemicals. I’m off to the garden to put my feet into some healthy dirt. Apparently, there’s something in the soil biome that helps us to avoid depression. It turns out that lots of bacteria are beneficial to human life and that trying to kill them all off with disinfectants, herbicides, fungicides, antibiotics and solvents was a really stupid idea. Imagine.

Book Reviews!

There’s something mildly terrifying about writing a book.

In the writing phase I was consumed with craft and content. I wanted it to be simple, but not too simple. Useful and not overwhelming. Helpful and not exhausting.

After completing the first draft I put it aside for several weeks, came back to it and was shocked by how much repetition and useless waffle it contained. I edited fiercely.

A couple of people read through the draft for me, including one very generous friend whose a professional writer. The feedback was good. It was time to publish. No reason not to just jump right in and do it. And yet it felt terrifying! It suddenly occurred to me that I was putting myself out there, open to whatever criticism people decided to hurl at me. I metaphorically chewed my nails as I waited for the book reviews to arrive.

First came the friends. How I love my friends! A couple of them found the time to post their comments on the Amazon site. Here’s what they said:

A very valuable resource for everyone, not only those that have had cancer. There is so much knowledge and information within this book for tools with working through freeing yourself from fear. I believe sometimes when we get caught in fear, there is fog, we don’t seem to acknowledge our own values and get lost in the mist. There is so much within this book that draws on many techniques for working through this and with a lovely sense of humour, it shows Meg McGowan has had the life experience to walk the talk. Thank you Meg McGowan.

And this:

If I could pay $5 to avert one hour of meaningless fear, would I spend it? “Of course!” I thought, and bought this book.
It turned out to be full of practical ideas that I can use straight away on myself and the fearful ones around me…thats everyone alive.
Holding hands with the fear-monster is a sweet image, and does it work?
Well, I tested it.
After reading the book I did a suitable amount of scary-monster hand-holding, then went though a list of scary phone calls, scary conversations, procrastinated tasks.
I’m unharmed, and the quality of my future is now better. You don’t need a life-threatening illness for this book to protect and nourish you.
As a bonus, dandelions will forever look more beautiful, after reading this book.

When I checked today I found two reviews from people I don’t know. How exciting! Here’s what they’ve said:

If a cancer diagnosis feels like too much to bear, you’ll find solid comfort here. The exercises are quick and easy to perform. Yet they are profound and will produce lasting results. McGowan’s book is filled with wisdom that can only have come from one intimately familiar with the traumatizing effects of cancer diagnosis and treatment. I strongly urge you to buy this book. You’ll be glad you did and will, like me, refer to it for years to come. This book is a rare find, and the author deserves praise.

And this:

This book ticks all the boxes for handling the fear of recurrence that is part of all cancer patients’ lives after diagnosis.
It is written clearly and cuts through all the fog that surrounds us when we feel overwhelmed.
As a breast cancer survivor, I think Free from Fear should be on everyone’s Important Items list.
It is an exceptional read from someone who has been there, and understands.

Over on the Breast Cancer Network Australia site I’m also getting some really great feedback. Time to exhale.

You see, the thing is, even if I now get negative responses, or even if I never sell another copy of the book, it’s all been worth it.

Maybe I should write another one 😀

Here’s the Australian link (Kindle only)
Free From Fear on Amazon.au

Here’s the US site where you can also get the paperback.
Free From Fear on Amazon

There’s a promotion coming up on the 19th of June when the Kindle version will be available for free for three days. I’m celebrating four years since that visit to Breastscreen found three triple negative tumours, so it seemed like a good way to celebrate.

Thanks so much to everyone for all of your support. I couldn’t have done it without you. ❤

Falling in Love Again

Cancer makes you question everything.

You realise your days are numbered. You realise your days have always been numbered and you’ve been ignoring that universal and obvious fact for most of your life. Oh sure, at some level you’ve known you were ultimately going to die, but it always seemed like an event that was so far away it didn’t register as important.

Then cancer.

Then the possibility that death might be closer than you think.

Suddenly, your life so far gets thrown into sharp focus. What have you done with it? What can you mark up as achievements? What dreams did you realise and what got lost along the way?

Perhaps the most important question of all finally occurs to you: Is this how you want to spend the rest of your life?

Some people are transformed by cancer. They walk away from boring jobs, leave abusive or uncaring partners or abandon a life they inherited rather than created. Some finally find the courage to take big risks. That might involve jumping out of a plane or finally having an honest conversation.

There’s not much about cancer you’d call wonderful, and yet…

It is wonderful to have the opportunity to take an honest inventory of your life so far, to acknowledge the achievements and the joys, to mark the disappointments and the failures. It’s very reassuring to be in a place where we understand that our lives have been very much like every other person’s life. The colours and the flavours of our experiences are different but the ebb and flow of joy and sorrow is common to all of us.

It’s an opportunity for deep conversations about what has been and what will be and how it will all be evaluated. My husband asked me, ‘Is there anything on your bucket list?’

I’m one of those people that’s found ways to do the things that were important to me as I went along. I don’t have a burning need to hang glide (did it), or parachute (not doing it). I can look back over the last 50 years and be proud of some of my achievements and embarrassed by some of my behaviour, just like everyone else. So this was the answer to my husband’s question.

“I’d like to fall in love again.”

It was a punch to the heart. He looked away. He sighed. He curled his lips in and waited, with that look he gets when he’s about to say something difficult. Then he said this.

“I can understand that. I ………..”

He hates it when I cut him off mid sentence but I really had to.

“Oh Sweetheart! I didn’t mean with someone else! I meant I’d really like to fall in love with YOU again!”

We’ve been together a long time. Like most couples, we’d settled into a routine where our patterns were well known and predictable. We were comfortable. We were both content. But faced with the sudden possibility that I might not be around much longer I’d taken to contemplating what really mattered to me. What really matters to me is connection, intimacy and love.

Stuff is just stuff. You buy it. You enjoy it for a while. Then you have to maintain it. You give it away. You buy more stuff. It will never make you happy.

Achievement is a little more rewarding but ultimately no less fleeting. Who will remember what I did during my working life? Or the art or the writing or anything else I produced? Most of us will not have any impact beyond our circle of friends, and perhaps some of the people they know.

But love? Ah, what is there that compares to it. It’s no surprise that research into human contentment keeps turning up intimacy and connection to others as the main precursors to a good life. There’s also our personal experience. Think back to the times in your life that brought you the greatest joy and they’re probably about love.

So how to fall in love again? With the same person?

I started with a New York Times article that’s become so well known it turns up in television shows (most recently Big Bang Theory). It reported on a piece of research where strangers asked each other a series of questions and many of them fell in love. Here’s the link:

The 36 questions that make you fall in love

We spent a few evenings working through these questions. It was fun. We had some great conversations and were surprised to find that we still had so much unknown territory to explore. I think part of the reason we fall in love is that the early stages of a relationship, when we are getting to know each other, are so fascinating. We are not just fascinated by our new friend, we recognise that they find us fascinating in return. Is there anything more attractive?

I started thinking that perhaps the reason the 36 questions worked so well was less to do with the content of the questions, and more to do with the process. When you’ve been married for a while you stop being fascinated with each other. You also stop having that experience of your partner finding you fascinating. Questions that give you the opportunity to get back there could be about almost anything.

I spent some time researching similar ideas. It turns out that there are a lot of lists that people have put together. Some of them are about building greater intimacy, having better sex, building commitment, having interesting conversations or just getting through a party where you don’t know anyone. Working on the basis that the process of setting aside time to ask each other questions and to listen to the answers was more important than the actual questions, I bought a few packs of blank playing cards and copied out anything even remotely interesting.

The challenge here was not to edit too savagely. As you’ll see from the 36 questions, something surprisingly inane might lead to a really great discussion. When it comes to your partner, you don’t know what you don’t know and you shouldn’t make assumptions.

I put the cards into a little decorative box that I picked up at the discount store. It’s now part of our lives for one of us to suggest that we ‘do cards’. About once a week we’ll sit in the family room and take turns drawing a card and answering the question on it. Sometimes we’ll both answer the same question and sometimes we’ll just stick to our own card. Sometimes we’ll get through several cards and sometimes a single card will prompt and entire conversation.

The cards help us to ask each other questions that would be difficult without a third party. Drawing a card that starts, “Do you think……….” allows for an open discussion, where asking the same question directly can get caught up in assumptions, hidden subtext and anxiety. There are definitely questions in this stack that would unnerve me if my husband had asked them directly (Where is he coming from with that? What’s the point of that question? Is he trying to tell me something?) but the card makes it neutral. And either of us is allowed to decline to answer. We just put the card on the bottom of the pack and draw another one.

It’s a fun game. The result is that we’re now connecting the way we did when we were first dating. My husband continues to surprise me with his wisdom, insight, humour and kindness. The cards provide me with the joy of his undivided attention, and an opportunity to talk deeply about things that really matter to us, rather than the functional conversations we have everyday.

At one point, Graham suggested marketing the cards. Proving that most great ideas have already occurred to someone else, I found a sight called The School of Life. Guess what they sell. Yep, cards with questions on them.

The Game of Life Shop

We’re not through my home made cards yet, and we could probably work through the pack a few times and have several different conversations, but when we’ve exhausted them I’ll be buying some of these.

As a consequence of spending time together, talking about a huge range of things and sharing our feelings and opinions, we’ve found that we feel closer than ever. This has carried over into other parts of our lives. We’re enjoying each other’s company and looking for events to share together. I’m remembering what it is that made me want to marry this man.

It’s also helping me to understand that, post surgery and without breasts, my body matters less to my husband than my mind and my heart. We will both get old. I’m hoping we both get really old! Our bodies will continue to be less attractive to anyone else. This has nothing to do with our deep connection to each other. We still love to touch and hold each other. We will never stop discovering things about each other. To the rest of the world we are just ordinary people, but to each other we are fascinating.

Have I fallen in love again?

What do you think.

 

 

 

 

A Day of Rest

I might be about to officially enter the ranks of ‘old person’. I’m going to write about something we used to do when I was young that doesn’t happen anymore. ‘In my day…..’

Please don’t misunderstand me. I’m generally not sentimental about the past. I think our species has come a long way in the last fifty or so years. We are, on the whole, less violent, more tolerant and more interested in family and community than we are in power or the accumulation of personal possessions.

But I miss Sundays.

When I was a kid the shops were closed on Sunday. Saturday was the day you went shopping. If you were fortunate enough to live in a country town you also spent a lot of time saying hello to other people, stopping for a polite chat with those that weren’t close friends, but were part of your community. A lot of people also relegated time on Saturdays to cleaning the house or mowing the lawn.

Sundays were for resting.

For those that were members of a church or other religious congregation, Sundays were a day of gathering and worship. For everyone else there were the secular traditions; a Sunday roast with immediate or extended family, a walk or a nap after lunch, a quiet corner with a good book and an early night so we were all well rested for the week to come.

I wonder to what extent the chronic stress, anxiety and depression that now plagues us can be traced to the introduction of Sunday trading. You can now shop seven days a week. Thanks to online shopping, you can now shop 24 hours a day.

Marketing has always played with human psychology. It’s designed to make us want what we didn’t know we wanted. Its primary weapons are greed and anxiety. It seeks to convince us that more stuff will make us happier, more attractive, more successful. Even though we know in our hearts that this is untrue, we buy anyway.

This week three things bubbled to the surface of my world. The first was a piece about two studies into human behaviour that have been running for around 70 years. They’ve been tracking participants since they were kids at college in the USA. They can now tell us what it is that leads to people declaring their lives successful and happy. It’s connection to other people. Imagine! Not wealth or power or fame. It’s all about the quality of your relationships with others.

The next bubble was an article about resilience. Researchers are recommending that all the techniques for dealing with trauma and stress are of little benefit to us if we don’t take time to rest and recharge. It’s the quality of our time out that makes the difference.

How interesting that both pieces of research seem to be stating the glaringly obvious.

The final bubble in this week’s mix was a tiny purple flower that appeared on Facebook. It allowed us to express our gratitude. In addition to indicating that we liked or loved something, or were amused, amazed or angered by it, we could show our gratitude. A few days after it was introduced it was gone. There’s a petition to bring it back. I loved it. So did a lot of other people.

The research into expressing gratitude shows us that doing it regularly is good for us. It helps us to be happier with what we have. It pushes back against the marketing onslaught and allows us to look around our existing environment and appreciate that, for most of us, we already have enough. Gratitude also reminds us that the things that matter most to us are our relationships with other people, the opportunities we have to connect with nature and fun we have when we take time out from work.

I wonder if there’s a group of highly paid psychologists somewhere, recommending the Facebook owners avoid anything that encourages people to express gratitude. It can’t be good for business. If we are focusing on what we have and the importance of relationships and experiences over things, we are surely much less likely to want to spend money on things we didn’t need in the first place. We might even decide to spend less time on Facebook.

For my part, I’m signing the petition to bring back the grateful flower, I’m continuing to limit Facebook to no more than an hour in the morning and I’m spending time each Sunday recording seven things I’m grateful for.

I’m also reinstating a commitment to Sunday as a day of rest. That might mean lunch on the verandah with good friends or just going for a relaxing walk with my husband. There will definitely be more reading and the occasional trip to the movies. I also want to spend more time sitting in the garden and just enjoying it, rather than planting, weeding and mulching. It’s not that I don’t enjoy the gardening. It’s that I want to stop and appreciate the outcome.

I hope this week you’ll find some time to rest and recover. Maybe it’s time to reflect on your achievements or the quality of your close relationships. Maybe it’s escaping into a book or a movie. Whatever you decide to do, know that you’re doing your mind, your body and your spirit a favour. Rest is undervalued. I think it’s time we turned that around.

Do we get what we expect?

I’m in the void between writing and publishing; that place where you send your baby book out to a few trusted people for what you hope are some minor corrections and constructive feedback.

And then you wait.

Early indications are that it’s readable and useful. I’m still on track to publish either late April or early March. I still don’t have a name I like. I started with ‘What if the Cancer Comes Back?’ but figured most people wouldn’t want to buy it. I moved on to ‘Worried Sick by Cancer’. Same problem. I really want a title that’s focused on what the book will help you to achieve, rather than the problem it’s trying to address.

Having said that, popular wisdom is that it needs the word ‘cancer’ in the title. Something to do with algorithms and search engines and online potential. I really like ‘Fear + Less’.
It’s a book about fearing less. But is this too obscure? And it doesn’t contain the word ‘cancer’. All thoughts and suggestions are welcome.

In the meantime, I’m contemplating the extent to which we get what we expect. I had coffee with a friend that hasn’t been to yoga for a few months. She hurt her foot and ended up in one of those ski boot looking things that they use instead of a cast. She was telling me that when it came off, her whole leg was wasted and that she’s still regaining strength.

Then she said this: “It will never be the same. I’m always going to walk with a limp.”

Hold on a minute. You’ve only had the boot off for a couple of weeks and you’ve already decided that you’ve got a permanent disability. When I asked her why she thought this she replied that her doctor had delivered this miserable diagnosis and that it reflected her own fears, so she saw no reason to reject it.

I reminded her that post-mastectomy I was told I’d be likely to experience some permanent restriction to my range of movement. It was likely that taking two F cup breasts from my body, and the subsequent scars running under my arms, would mean that my arms just wouldn’t be able to do what I was used to them doing. A combination of scar tissue and nerve damage would see to that.

When I put my hands above my head I still need to slightly adjust my left hand to bring it to the same height as my right. That’s it. Oh, I sometimes have some tightness to the left side if I twist. I can also put my hands into a reasonable ‘reverse prayer’ (put your hands into prayer position and now see if you can do the same thing behind your back), and a couple of weeks ago I held something called ‘crow pose’ for a good five seconds.

Crow pose involves crouching forward with your hands on the ground, putting your knees on the backs of your upper arms and then lifting your feet. Google for impressive pictures. Essentially, I can support my entire body weight on my upper arms.

I’m a 55 year old woman whose had a bilateral mastectomy.

I’m also close to four years since my diagnosis and a few months further away from three since my surgery. Recovery did not happen quickly. I still have some issues with my hands and my feet thanks to the nerve damage from chemotherapy and I also get annoying pain across various parts of my chest on a regular basis. It turns out that this is common post-mastectomy. I don’t accept that either condition is permanent.

I think of all the various aches and pains I’ve had during treatment, and all the way back throughout my life. What an amazing capacity our bodies have to heal. I also recognise that some recovery takes much longer. I think we have a mindset that a few weeks is a reasonable healing time because that’s about how long it takes for a cut to heal.

Here’s the thing. Skin heals quickly. It has to. It’s the outside, protective coating for our bodies. Other things heal more slowly.

I was told by my oncologist that whatever nerve damage I had at the end of twelve months was probably my ground zero. Things weren’t going to get any better. Then the radiation oncologist told me that nerves can take up to eight years to regrow. Eight years! So let’s wait until then before writing off my healing capability. Certainly things have improved slowly but if I’d accepted the first diagnosis I’d be focusing on the pain and discomfort and not bothering with physiotherapy to improve my condition.

I’ve recently read about some interesting research into chronic pain. People that experience it have a different kind of brain. Researchers can put 100 people through an MRI and detect which ones experience chronic pain by looking at the architecture of their brain. Here’s what’s really interesting; they can also predict which people will develop chronic pain using the same techniques.

It turns out that to some extent, pain really is all in our minds! At least, it’s more likely in those of us with a particular kind of mind.

This is huge. About one in five people report either chronic or sever pain. It’s the reason pharmaceutical companies invest so much money in pain relief. It also explains why so many of these medications affect brain chemistry.

This might sound like your propensity to experience chronic pain is just some kind of genetic lottery, but it’s more complex than that. A whole range of things directly impact the way our brain functions. It’s no surprise that chronic stress can cause exactly the kind of changes that result in chronic pain. People with higher levels of anxiety or depression are also at risk. Some recreational drugs, including alcohol, are also linked to the same kinds of changes in the brain that result in chronic pain.

So what about the brains of people that are less prone? Of course those with a calm disposition, and good techniques for coping with anxiety and stress do well. (Don’t ever let anyone try to tell you that there’s a human being on the planet that never experiences anxiety, stress, grief or anger.)

The robust mind might also belong to someone that used to be prone to chronic pain. These people have usually altered the way they live their lives to reduce stress and anxiety. They probably practice meditation regularly and may also use yoga, tai chi, qigong or some other form of calming exercise routine. Track these people over time and their MRI’s will show physical changes to their brains. They don’t cope with a pain-prone brain by soothing it, they actually change the architecture of their brains to something less likely to experience chronic pain.

Of course, what this means is that even my ‘permanent chronic pain’ diagnosis is now up for argument. It’s just possible that with yoga and meditation I can overcome pain. It’s certainly highly likely that I can reduce it.

I noticed a few months back when a visitor complained of a headache that our medicine chest was full of pain relief medication. I had stocked up on it, having been told I’d probably be taking it for the rest of my life. I couldn’t be sure about the last time I took anything but it was certainly months ago. I didn’t decide not to take the pills, or to endure serious pain. My pain just hadn’t been strong enough for me to want a pill.

There are still times when I consider medication, and still very rare times when I take something, but that’s a long way from six tablets a day. I think my progress is due, to a very large extent, to my daily yoga and meditation.

I also think that part of it is due to my expectation that we can always improve our health. There’s no upper limit to how well we can be. Ultimately, a doctor’s diagnosis is just an educated guess, an opinion based on what they thing other patients in similar circumstances have experienced.

Personally, I’d like to see doctors trained to talk about possibilities rather than absolutes. This isn’t about putting a shine on a bad situation. It’s about being accurate. I’d like to hear them use language like this:

Based on what we know about your condition there’s a possibility that you may have permanent pain or physical restriction and there’s also a possibility that you may not. The body has an amazing capacity for healing and it can sometimes take years before it’s finished the job of recovery. There’s a lot you can do to improve your health and there’s no upper limit to how well you can be.

I suppose we’re still years away from meditation being recommended, in spite of the overwhelming research that proves it’s more beneficial and more effective than any pharmaceutical your doctor can prescribe. Ideally, I’d like to see practices that included a psychologist to teach people the techniques they need to live a fulfilling life. I’m sure that would have more impact on public health than all the pills in the world.

Regardless of where you are with your own recovery, please know that nobody has the right to steal your hope. Doctors that make proclamations about your limits are sharing their opinions, and while they are very well informed opinions they are not a sentence. When it comes to recovery it’s best to keep an open mind. We may be capable of more than we think. Certainly we will never get more than we expect.

The Best Anti Cancer Diet

I get more questions about diet than anything else. People want to know if they should give up sugar, go paleo, fast, quit saturated fat or just eat whatever they want on the basis that it can’t make a whole lot of difference.

In a world where it’s now possible to make a living out of giving other people dietary advice it’s difficult to sort fact from fiction. Most of the ‘evidence’ is anecdotal; this person quit sugar and has never felt better; that person ‘went paleo’ and beat their allergies. There’s no question that some of these people have achieved what seems to be better health by changing the way they eat, but have they reduced their risk of cancer? And how will we know what the longer term impact of these diets is likely to be without experimenting on ourselves?

Well meaning people have sent me links to articles from Dr Mercola and David Avocado Wolf, along with contributions to a whole range of ‘natural health’ sites. My first reaction is always to google the author and to add the word ‘fraud’ to the search. What I find is not encouraging. Of course the conspiracy theorists then counter claim that these authors are being undermined by big pharma or food manufacturers with a vested interest. These claims are not without foundation. A recent, reputable article provided evidence that the sugar industry intentionally marketed saturated fat as the dietary bad guy in order to distract us from damaging findings about sugar:

How the sugar industry shifted blame to fat

There’s also reasonable and serious concern about the ethics involved in research. Much of it is sponsored by organisations with a vested interest in the outcome and you’ve got to wade through the academic language to read it, or rely upon someone else’s often inaccurate interpretation. What to do?

The best dietary advice I ever had came from my friend, Cat, who said, ‘You need to find out what works best for your body.’

It may well be that excluding certain types of foods has a big impact on your health. Someone close to me recently tried the FODMAP protocol with the support of a dietician and discovered a fructose intolerance. Yes, that means she can’t eat apples! Just about every healthy diet I’ve ever seen includes apples but for her they’re a disaster.

I’ve recently found a nutrition site that appears to be well researched and presents health information via clear, plain english videos:

Nutrition Facts

But even this site has nothing about intermittent fasting, which I believe is helping me to avoid recurrence and manage my weight. There’s also a problem with sites like this: It’s easy to become so overwhelmed with all of the advice that you just throw your hands in the air and break out the tim tams.

For those interested in my personal opinion on how best to avoid cancer I’m going to give you a summary. I offer it with the following disclaimers:

  1. While I have done everything I can to verify my choices using research I allow that future research might disprove anything I’ve read so far. I also allow that I have no way to verify the authenticity of any research. At some point you just have to decide to trust it. Also, I’m not a doctor.
  2. What works for me may not work for you. The two best measures of a diet are how well you feel on a day to day basis (this is fairly easy to determine) and how well you are over time (much more difficult).
  3. Diet is a major part of staying well but it is not the only factor. Please also consider your stress levels, your environmental exposure to things that may have a negative impact on your health, the quality of your sleep, the amount and type of exercise you get and the quality of the relationships you have with other people. These matter too.

Eating to reduce the risk of cancer

So here’s my current best advice for reducing the future risk of cancer and staying well. I hope it helps you to make some positive changes.

  1. Eat more plants than anything else
    A plant based diet consistently demonstrates a range of benefits to human health. Leafy greens are the only prebiotic proven to improve gut health and most of the food candidates for ensuring human health at a cellular level belong to this food group. Legumes show up as a major dietary component in every culture on earth that demonstrates unusual longevity. Fruits and vegetables are particularly important for forming healthy (non cancerous) cells, and for triggering the death of damaged (potentially cancerous) cells. Nuts and mushrooms are both returning impressive research results and most of us don’t eat enough of them. (Yes, I know fungi aren’t really plants but let’s put them in here anyway).
  2. Be wary of supplements
    It may be that your dietary intake of a particular micro nutrient is inadequate. In most cases that’s easy to fix. Add a food containing it to your diet. There seems to be a very relaxed attitude to supplements with most people considering them to be safe, but many can be toxic if you take too much of them and many can interact with medications in dangerous ways. You also need to be careful if you’re approaching surgery because a lot of popular supplements (e.g. fish oil) can cause excess bleeding. It’s almost impossible to get too much of a micro nutrient from food so if you think you’re lacking anything, try googling ‘natural sources of …….’ and improving your diet. Always discuss supplements with your doctor and when you’re asked ‘are you on any medication?’ make sure you disclose any regular supplements. We should be treating these pills with the same caution we apply to pharmaceuticals. Your doctor may prescribe a supplement as part of your recovery (particularly vitamin D) and you should make sure these are taken according to the dosage instructions. More is not better.
  3. Reduce animal protein
    I remain convinced that eating some animal protein each week is good for me, particularly for maintaining healthy levels of iron, B12 and essential amino acids. I’m also sure that I don’t need more that three or four serves a week. I’m also convinced that the profile of organically raised, grass fed meat is different and more nutritious than factory farmed and grain fed meat. There is research to support this view.
  4. Eat less food
    Most of us still eat too much. Just eating less can have a positive impact on our health and survival. I suspect it’s actually healthy for us to be hungry some of the time but with the modern availability of food, most of us can reach for something the second we feel any hunger. A meal should leave you feeling pleasantly satisfied, not stuffed like a pillow. If you’ve been conditioned to eat everything on your plate then it’s time to recover from the notion that overeating is somehow virtuous.
  5. Reduce or eliminate alcohol
    Sorry to say that the evidence for alcohol as a category one carcinogen is overwhelming. If you decide to drink then there is some evidence that resveratrol in red wine may help to reduce its carcinogenic impact, but you’d be better off eating red grapes or including some red wine vinegar in your diet and avoiding the wine.
  6. Pay attention to your body
    You may want to try some kind of protocol to determine if you have any food intolerances or you might prefer to just observe how you react to different foods. Either way it’s important to notice how you feel, and how your body reacts, after different types of food. Your bowels are a good indication of gut health and if you’re not seeing at least one well formed bowel movement every day your body is trying to tell you something. Same goes for bad breath, sallow skin, hives and rashes, acne and other physical symptoms. That’s not to say that all of these things are always caused by diet, but they may be. It’s also important to recognise that we are complex organisms and there are many different things affecting our body, including hormone levels, underlying health, regular medication and even the weather. I’ve met many people eating highly restrictive diets because they are certain they’ve had a reaction to something, once, a long time ago. A lot of self-diagnosed food intolerances aren’t real.
  7. Fast regularly
    The evidence for fasting having significant health benefits is, I think, compelling. It can lower human growth hormone (typically high in those at risk of cancer) and trigger cell autophagy (the body’s natural process for cleaning up damaged cells). I have two fast days each week where I eat only 500 calories as an evening meal. Apart from the milk in my morning coffee that’s all I have all day. I’ve also achieved a healthy weight using this method. Don’t fast without talking to your doctor first. It’s unsuitable for some people, particularly those on regular medication.
  8. Drink more water
    It’s critical to the optimal function of your body and you can raise low blood pressure within minutes just by drinking water. This is an excellent demonstration of how important it is to stay well hydrated. I often see sites that say we are inclined to confuse thirst with hunger, but I think this misses the point. Our bodies aren’t mistaken. There’s really no difference between hunger and thirst because a lot of our moisture comes from our food. Our ancient ancestors didn’t carry drink bottles and probably got a lot of their moisture from food. This is another reason to eat fresh fruit and vegetables (they have a high water content) and to have a big drink of water before you eat a meal.
  9. Prepare most of your meals from scratch using whole foods
    Takeaway and eating out are both fine from time to time (and may well fall under stress reduction if you just can’t manage cooking), but if they’re a regular part of your week it’s likely you’re eating far too much sugar, saturated fat and salt. There’s also a much higher risk of overeating because we tend to eat the serving rather than paying attention to our appetites. My preference is to use organic ingredients at home whenever I can and to prepare them fairly simply. I also avoid most processed foods. The additives in processed foods appear to have a negative impact on the human gut. Processed foods are also typically higher in sugar and saturated fat than home cooked meals.
  10. Don’t Panic!
    I sometimes wonder how much damage we do to ourselves with food anxiety. On the one hand, it’s great to feel like we’re making a difference to our health by eating well. On the other hand, we can quickly descend into guilt and worry after a weekend pizza or a few hours on a nutrition website. I think food, and sharing food with friends and family, should be one of the great joys of our life.

By paying attention to how I feel and how my body reacts to certain foods I’ve significantly reduced sugar and gluten in my diet and I eat well most of the time. I also enjoy eating out, eating takeaway, eating soft cheese and eating chocolate. Sometimes. Much less often than I used to. I’m still making improvements to my diet on a regular basis and doing some online research from time to time to see if there’s anything else I might add or subtract that will make a difference, but I’m not obsessive.

I hope this short summary is useful. My final advice is to take a long view when it comes to fashionable diets. They have always been around. They will always be around. Very few of them have stood the test of time and I see no reason to expect that will change. Use one of them if it helps you to eat well but don’t feel pressured. The truth is that we still don’t know nearly enough about how the human body interacts with what we eat, but we do know that eating well can make a big difference to our health, so let’s just focus on that.