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. ❤

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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.

How to Change Your Mind

There was another shooting this week.

This one was in the USA so it got lots of news coverage here. It could have been anywhere. All over the planet there are similar examples of violence and hatred. It feels like a vicious circle; a shooting happens and the response is anger and hatred, and the anger and hatred build and bounce until someone else snaps and the whole cycle starts again.

What to do.

If you’re a caring, compassionate person events like this one can leave you feeling hopeless. What’s to become of our species?

It’s an acute form of the same kind of distress we experience when we’re confronted with selfish, greedy people that don’t care about the planet or the other animals we share it with, or selfish, greedy people that don’t care about other people.

What to do?

I see friends responding with anger towards these types of events. There are cynical posts on Facebook, heart-felt expletives, conversations through teeth ground down by years of frustration.

And then an afternoon spent looking for something entirely different leads me to the work of Tania Singer. I was concerned about the way world events can be deeply distressing to highly empathic people. As an ex-police officer with a history of PTSD I now avoid the news. It’s just too upsetting. There’s so much research about how easy it is for us to ‘catch’ the emotional distress of others. So when I caught sight of this article in an issue of New Scientist I was drawn to it:

How Sharing Other People’s Feelings Can Make You Sick : New Scientist 2016

You’ll need to pay to read the whole article but if you’re the kind of person that’s deeply affected by distressing events I recommend it. Does this resonate with you:

Overdosing on the misfortunes of others is not just a problem for those in high-exposure professions such as nursing. All of us are vulnerable to catching the pain of others, making us angrier, unhappier, and possibly even sicker.

What was really interesting to me about this article was that the research done by Singer and her colleagues provides some great strategies for combating this distress. Teaching people how to meditate on loving kindness, and how to become better at observing their emotional responses to different situations can have a protective and healing impact.

Impressively, these processes can actually change your brain. Singer demonstrates using MRI’s how their program altered the neural activity in their research participants. She and her team have also demonstrated that these changes do more than just improve individual wellbeing; they also change the way we treat each other.

In tests that examine economic modelling and how people behave, Singer’s team established that meditation and other cognitive awareness practices shifted people’s behaviour from selfish to generous, from individualistic to cooperative.

If you’d like to learn more then here’s the link:
Tania Singer: How to Train Your Mind and Your Heart

This work relevant to anyone interested in social change and the evolution of our species beyond our current state. Compassion and extending loving kindness can change our brains and lead us to behave in more compassionate ways.

All those from religious traditions that believe meditation can change humanity are, in fact, correct.

The flip side of this is that a world filled with hate, cynicism and negativity has the potential to hard wire us for competition, greed and cynicism. When we give in to anger we’re doing to opposite of meditating on loving kindness and our brains (and lives) will suffer as a result.

I was on a course recently with a wonderful group of people that genuinely care about humanity and the planet. Even given this strong, positive bias I was surprised by the level of anger and negativity in some people. ‘The one percent’ came in for a lot of hatred, as did individuals seen as belonging to it. There was even some conflict within the group as some people decided who they did and didn’t connect with. Even here, there were the seeds of weeds that become violence.

Is it really as simple as loving everyone? Even the greedy and the violent, even the destructive and the selfish? And is that even possible?

There are reasons to practice meditation in any case. Evidence suggests it can protect your brain from the effects of ageing, provide you with a calmer, happier life and help you to overcome depression and anxiety. There are lots of free meditations available on the internet if you’d like to give it a try, or just do this:

  1. Find a comfortable, quiet place to sit. Hold your body in a neutral position – not too relaxed or too stiff. You want to be comfortable but you want to avoid falling asleep.
  2. You don’t have to close your eyes but many people find it helpful.
  3. Listen. What can you hear. Spend a few moments paying attention to the world around you.
  4. Now focus on your body and how it feels. Feel where it’s in contact with the chair. Feel your clothing against your skin.
  5. Shift your focus to your breathing. Notice that it’s cooler breathing in and warmer breathing out.
  6. Your mind will drift. This is normal. Be relaxed about it. Imagine that your mind is the sky and the thoughts that try to pull you away are like birds that fly across the sky. You can notice the bird and let it fly past. Bring your attention gently back to the sky.
  7. Now cultivate a feeling of loving kindness. Think of someone you love (If you struggle to think of a person then try a loved pet) and feel the emotion build up inside you. Imagine this feeling is like the sun, shining in the sky.
  8. Extend a feeling of loving kindness out into the world. Start with yourself. Bathe yourself in loving kindness. Then extend it to your close friends and family. Wish the very best for them; their health, their happiness and that they should also achieve peaceful and compassionate minds.
  9. Now extend loving kindness beyond the people that you know to the people that you don’t know. Remember this feeling is sunshine and it doesn’t discriminate; just like the sun it shines on everyone. If you struggle to shine loving kindness on some people, imagine them as small children or babies. Cultivate loving kindness towards all humanity.
  10. Now extend loving kindness to all life on earth. To trees and animals and microscopic life. To fungus and whales and chickens and lizards. Everything that lives can experience your loving sunshine.
  11. As you do this, your thoughts will continue to drift. This is normal. Just gently bring them back. You might like to imagine that your loving kindness is a river flowing out into the world and your distracting thoughts are like leaves on top of that water. Just let them float by.

You only need to set aside five or ten minutes a day to do this. After a while it becomes like cleaning your teeth. It’s just part of your routine. There are other ‘mindfulness’ practices like yoga and tai chi that will also help you to develop your meditation skill, but remember that it’s specifically a meditation on loving kindness and the practice of extending compassion to others that will have measurable benefits for you.

From personal experience, this practice has been extremely beneficial in helping me to live with post traumatic stress disorder. Part of my policing career involved child protection work, so you can imagine the challenges I face when it comes to extending loving kindness to all human beings.

But I do. Even to the offenders I’ve arrested. They were once children too.

Perhaps my greatest challenge has been to move beyond the anger and hatred that I used to feel for these people. They are not monsters, and treating them as monsters is only feeding the creature. I sometimes laugh at the realisation that The Beatles knew the answer and I’ve been hearing it all my life; Love really IS all you need.

I’m not saying it’s easy to avoid being pulled back into old patterns. When a shooting happens or I hear that the Great Barrier Reef is dying or I read that a politician has acted in a greedy, selfish way it’s simpler to just get angry and to launch into a rant. And then I remember that hate makes me part of the problem.

I sometimes wonder why adults that would not allow their children to bully other children with name-calling are perfectly okay with doing exactly the same thing to other adults via social media. Does calling Donald Trump a dickhead really make a difference? Or does it feed into the dynamic that allows him to exist at all.

One of the most common despairs of anyone passionate about the planet and the people on it is this: How do we change the minds of the destructive and selfish? It turns out that the answer was in our question the whole time: by changing their minds. Perhaps we need to focus on finding ways to engage these people in compassionate meditation. The research suggests it could shift their behaviour.

In the mean time, we can be the change we want in the world and work on refraining from the kind of behaviour that will make our brains like their brains. Could it be that simple? Maybe the next time you’re tempted to share an insulting thought or denigrate a public figure, pause and give thought to what you’re cultivating.

What’s most interesting to me about all of this new research is the extent to which it validates some very old philosophy. Buddhists have been teaching compassionate meditation for generations. The minds of Buddhist monks look very different under MRI analysis. They have changed their minds.

When events like mass shootings happen I am now able to avoid the anger and depression, not least of all because I recognise that these emotions feed the creature. Change is possible. We have the means for our own evolution. Spread the word.

Funeral for a Friend

Anyone who was at our wedding remembers a very special moment when my husband and four of his childhood friends posed for a group photo. In their forties, they were still great mates. One of them, Nick, had flown in from New Zealand to surprise the others. He died suddenly doing what he loved a few years back.

This week we received the sad news that another of the five, Philip, had also passed. Philip was diagnosed with thyroid cancer in his late teens and told he wouldn’t live to see his 21st birthday. Tomorrow we’ll attend his funeral. He was 59.

Philip and his wife, Kathy, are a testament to the power of faith. Both deeply religious, they built a successful dental business and raised two beautiful children to be competent and compassionate adults. A good portion of Philip’s life was spent undergoing difficult and painful medical treatments. They prayed. They went to church. They believed that God would help him through.

I do not belive in God but in recent years I have come to believe in belief. Science keeps proving that state of mind can have a positive impact on longevity, quality of life and recovery from serious illness. For many people, religion helps them to find and maintain that positive state of mind.

I had a great conversation with an elderly friend recently. She’s been religious her whole life, and she’s also a great thinker and academic. The two seemed incongruous to me so I asked her about the paradox; how does such an intelligent person place so much faith in an imaginary being?
This is what she said.

“The biggest mistake that atheists make is assuming that people of faith are simple minded or delusional. Logically, I accept that there is no mythical being with a long beard that watches my every move and grants wishes to people that pray to him. I’m not a fool. God, for me, is a word that represents love and hope and all those intangible things that connect us to every living thing. My belief is a choice. I choose to believe because my life is better with these beliefs and I am a better person because of them. Every week I spend time with other people, thinking about how well my behaviour matches my values and being grateful for everything I have. Churches are full of people that don’t literally believe in God.”

It seems for some people that faith is not just about belief. It’s also about suspending disbelief.

I didn’t know Philip well enough to ever ask him if he literally believed in God. It doesn’t matter. On the few occasions that I met him and Kathy I was impressed by the depth of their faith and the significant impact it had made to the quality of their lives. They were better humans because of it.

There have been times in my life when I’ve been cynical about all religions, convinced that they were responsible for war and persecution. I now believe that this argument confuses cause and effect. Some humans will use religion as an excuse to behave badly and to incite others to do the same. But in the absence of religion, wouldn’t the same people simply find another excuse? Would a world full of atheists be a kinder and less violent world? I sincerely don’t think so.

I’m a skeptic. Most people confuse that word with ‘cynic’. A skeptic is someone that believes something based on evidence. I also think it includes being open to the possibility that something might be true where there is insufficient evidence to prove it either way. This is very different to the flawed argument I often see in relation to things unproven; that what is unproven is false, ineffective or useless. Something unproven may be all these things but it may also not be all these things. We just won’t know until there’s evidence.

Having seen the movie, The Connection; Mind Your Body, with expert after expert citing research into what’s known as ‘the mind-body connection’ I no longer doubt the significance of belief. The evidence is there. Our state of mind influences everything. It can switch dangerous parts of our DNA off and it can help us to defy the predictions of doctors.

That’s why I think we should support anyone’s decision to participate in religion.

I do have concerns about some of the dogma in most major religions but I also notice that many of them are evolving. There are now female clergy in previously all male positions. There are people of faith prepared to openly acknowledge that the texts upon which their religions are based are archaic and should be the starting point for discussion rather than than a rule book.

I don’t think it’s okay the threaten children with burning forever if they don’t comply and I do think young people should be taught to behave ethically for its own sake, and not because they fear the consequences.

And yet, when I spend time with adult friends whose faith is significant to them I am struck by a common theme. Regardless of which faith they belong to (and I have friends in most of them) their faith is a source of inspiration, comfort, guidance and community.

Tomorrow my husband will help to carry the coffin of one of his dearest friends. It will be deeply sad for him. Philip’s friends and family will take great comfort in the idea that he is now in a better place and finally free from all the pain and suffering that plagued his life. There will be a service. They will thank God for the long and happy life that Philip shared with his wonderful wife and children.

Credit where credit is due. Regardless of the beliefs of anyone else in the church, there can be no doubt that Philip’s faith, and the faith of his family, have kept him alive for many, many years beyond expectations. It will also be apparent that faith will provide those that loved him with deep consolation during their grief. It seems to me that these benefits make faith a very powerful force in our lives.

Farewell, Philip and thank you for being such a true friend to my husband. You will be greatly missed. Thank you for teaching me, through your undeniable example, about the power of faith.

I am not likely to join any organised religion. All of them have elements that I find difficult to reconcile with my own values. That doesn’t stop me from recognising that faith is powerful force. I believe in belief.

I will keep working on living a life of kindness, gratitude and being the best person I can be. I will keep being inspired by the natural world and the breathtaking spirituality I feel in a rainforest. I like A. C. Grayling’s observation that you don’t need to believe in a god to have a spiritual life.

I know that having this spiritual aspect to my life helps me to be well and helps me to continue to evolve, to test my behaviour against my values, to make mistakes and learn from them. I suspect this is what is supposed to be at the core of all religions.

Perhaps the final word goes to another religious friend who told me this when I asked her about her faith:

“God is another word for love. When you hear god just replace it with love. That’s how you can understand my religion.”

I’ll be doing that tomorrow during Philip’s funeral service. I’ll replace the word ‘god’ with ‘love’ because, when it comes right down to it (and at funerals, it really does come right down to it), love really is what it’s all about.

I will also spend time reflecting upon the power of faith and the benefits of religion. There can be no doubt that it’s a source of comfort, inspiration and love for many, many people.

Play

I usually start the new year with a very clear idea of what my theme is going to be. I wrote about this back at the beginning of January. Usually it comes to me as an obvious choice; last year it was ‘health’. A bit of a no-brainer really.

This year I was throwing around ideas about learning, creativity, listening, paying more attention to the people I love…….and while all of these seemed like good ideas, nothing really jumped out at me. When this sort of situation emerges, as it does from time to time, I think it’s best to trust the process and wait. Yes, it can feel a bit drifty for a while but then, as surely as the sun appears to rise, I move towards the place I need to be and it’s suddenly there on the horizon.

This week a woman I admire but do not know well sent me this video. She’s an amazing artist and was advertising workshops for the coming year. She attached this half hour piece by John Cleese on creativity:

Creativity; making the time and space for it.

If you have the time to watch it I highly recommend it. If not, here’s the short summary. Creativity happens when we make space for it and when we recognise that it’s a particular mode. We have our day to day mode of operating in the real world but to be creative we need to shift into a mode where we are free to explore the new and the unusual. Cleese suggests that it’s worth timetabling this, actually setting aside a half hour or an hour just to see what emerges.

Importantly he recommends play as the great generator of creativity. The solemn and the serious are the enemies of creativity. Play frees us of our usual constraining thought patterns and allows the new and unusual to emerge.

It’s also just fun.

This was the word I’d been looking for: Play.

I’m going to spend more time this year being playful. I’m going to approach everyday things with a sense of play. I’m going to laugh more and play with the people I love for the joy of it, without expectation or purpose, just for the fun of it.

Already I’m noticing the difference this single word can make to my day. I was heading out to have lunch with a friend on Monday and before I left the house I reminded myself: Play. My friend is always wonderful company but I suspect I was better company for being so light hearted.

I’m inclined to be serious, judgemental, argumentative and stern. It’s almost certainly a hangover from my policing career. I’m likely to be the wet blanket that worries about personal injury or gives you unsolicited advice about leaching chemicals in plastics or oxalic acid in kale. It’s not a lot of fun. It doesn’t make me fun to be around.

This year will be about shifting that default setting. I’ve had a couple of years of some very stern and serious stuff. I need a break and so does everyone close to me. Actually, I need a permanent shift towards playfulness.

I sometimes wonder if the great joy experienced by new grandparents is partly to do with the fact that babies give you permission to play again. We can make silly noises, pull funny faces and roll about on the floor. Why should we need babies to give ourselves permission to do that?

I’ve always balked at those memes that advocate never growing up. To my mind, being a grown up is just about taking responsibility for the consequences of your actions. It doesn’t mean you can’t be joyful or silly or playful. I sometimes wonder if what the authors of these memes are really saying is that we all need a bit more play in our lives. We shouldn’t see it as childish or immature (or perhaps we shouldn’t see ‘childish’ as insulting!). We should consider it one of the great joys of life.

When I watch dolphins leaping for the sheer joy of it, or dogs playing tag with each other, or cats wrestling but not hurting each other it occurs to me that play is natural, normal and probably essential.

John Cleese suggests that humour and play are the space that make creativity possible. We don’t latch on to the first solution we think of. We don’t rely upon the best known way. Play throws up unusual combinations and possibilities. It relieves us of the everyday pressures of life and makes space for something new.

I think it’s great advice when approaching any kind of creative pursuit. I like to paint and I know my painting improves when I just let it happen and don’t think about it too much. Start getting too analytical and it all falls apart. I’m going to try intentional playfulness with anything creative to see what happens.

I also think that play is worthwhile for its own sake. We should set aside some time to be joyful just to be joyful. If we solve world hunger or invent a better mousetrap in the process then that’s an wonderful product of our play, but I don’t think it should be our goal. Play for the fun of it. Approach ordinary activities with a sense of play. Set aside time to play with people you care about.

That’s what I’ll be doing this year.

 

Chemo Brain And How To Treat It

My brain is back.

It’s like the sun coming out after a week of rain. Except it’s been raining for over two years. The return of my full cognitive function hasn’t been as sudden as a change in the weather, but the impact on my mood has been as dramatic.

It’s like discovering I’ve been living in just one room and that my home has three storeys. It’s like discovering I’ve been driving around in first gear and my car has five gears. With hindsight, I realise how badly my cognitive functioning was effected by treatment, although living through it I probably wasn’t cognisant of how impaired I really was (and this might be one of the few benefits of chemo brain).

I know this condition has a huge impact on the quality of life of so many survivors, so I thought I’d share my best advice for recovery.

First of all, understand that as far as researchers have been able to determine, it’s not exclusively caused by chemotherapy. While we all call it ‘chemo brain’ or ‘chemo fog’ the correct description is ‘mild cognitive impairment following cancer treatment’.

The causes haven’t been clearly identified but it’s a real condition, and it can be picked up with imaging technology. In one study, breast cancer survivors not only required a larger area of their brain to respond to a question, they used more energy to do so. In another, the resting metabolic rate of the brain was slower.

So the first bit of good news is you’re not imagining things. That inability to remember your phone number, the name on the tip of your tongue or the misspoken phrase are all manifestations of ‘chemo brain’. So is a general feeling of fogginess, mental sluggishness and difficulty learning anything new.

Coping with it usually involves implementing the kind of strategies they give people with early dementia; keep lists; use a calendar and a notebook; have one spot where you always put the things you lose regularly. All of this helps but what we really want is an effective way to hasten our recovery.

The really good news is that recovery is not only possible, most people find it relatively easy to achieve.

Apart from physical damage caused by treatment, chemo brain might also be caused by a range of other factors. The main suspect is anxiety, which can cause cognitive impairment all on its own. Hands up anyone that managed to get through cancer without feeling anxious. Depression is also a common after effect of treatment and yes, it’s also characterised by brain fog. If you suspect you’ve got ongoing issues with either anxiety or depression it’s important to discuss this with your doctor.

Vitamin D deficiency could also play a part because most of us had to avoid the sunshine for several months due to either chemotherapy or radiation. If you didn’t take your vitamin D supplements and treatment just got you out of the habit of sitting in the sun then an improvement could be as close as eating breakfast outside every day. Special note here to avoid supplements with calcium in them because they’ve been shown to be a health risk and to favour sun over supplements when you can because the type of vitamin D your body manufactures in response to sunlight is more beneficial.

If you’re experiencing serious mental impairment it’s also worth asking your doctor to give you a simple cognitive test to rule out dementia or any other illness that might be impacting your cognitive function. Don’t just assume it’s a result of treatment.

Having discussed chemo brain with a number of survivors there’s now been several that have overcome their problems by dealing with anxiety, depression or vitamin D deficiency so consider those first. Once you’ve ruled out other causes there’s still plenty you can do to reclaim your brain.

Here’s my top six recommendations for treating chemo brain. Many of these are things we should all be doing to improve our health and boost our immune system so adding them into your daily routine should bring a whole lot of benefits.

Please treat this list as a menu rather than a prescription. Choose what appeals to you and try it for a few months before you rule it out. And please share any other ideas you have about this condition.

  1. Fasting (aka The Fast Diet or 5:2 calorie restricted eating)
    What it is: an eating strategy where you limit your calories to 500 on two days each week.
    Why it might help: Fasting triggers autophagy, the body’s natural mechanism for cleaning up dead and damaged cells. Even people that haven’t been through cancer treatment regularly report improved mental clarity when they adopt this way of eating.
    My experience: My cognitive function had been improving over time since I finished treatment but my biggest step forward coincided with switching to this way of eating. Of course it’s possible that this shift was coincidental so I’d be very interested to hear from anyone else that tries 5:2 or some other fasting regime and notices a brain boost. There are lots of good reasons for cancer survivors to consider fasting in any case.
  2. Yoga (Seriously, what isn’t yoga good for?)
    What it is: an ancient practice that links physical exercise with breathing and mindfulness
    Why it might help: Research shows that yoga has a profound effect on our physiology, including our cognitive function and our ability to deal with anxiety. Some of the benefits are undoubtedly associated with the increase of oxygen to the brain but yoga has such significant benefits over other forms of exercise that it’s clear they’re only scratching the surface of what’s going on inside us when we practice it.
    My experience: I’ve written before about the profound impact yoga has had on my ability to deal with treatment and my recovery. The benefits have ranged from helping me to deal with anxiety and pain to preventing nausea. Yoga helped me to restore my energy when treatment drained it and played a big part in my recovery from surgery thanks to my physical strength and flexibility.
    If you don’t find yoga appealing then exercise will also help you to recover your brain. I just don’t think it will achieve this as quickly or as well as yoga.
  3. Mindfulness
    What it is: a practice of focusing on the present moment and doing one thing at a time. Some people use meditation to learn mindfulness and others learn it by just focusing on whatever they are doing right now.
    I use both. Mindfulness for me includes listening to recorded meditations on my iPod and paying close attention to whatever I’m doing during the day. Even the washing up can be a meditation.
    Why it might help: Mindfulness trains your brain to still the ‘monkey mind’ that jumps from one thing to another. It also helps to reduce anxiety which might be a major contributor to cognitive impairment.
    My experience: Mindfulness has helped me to stay calm and to be present. My mind functions better when it’s calm.
  4. What you put in your mouth
    What it is: Attention to good nutrition, good hydration and avoiding those things you know aren’t good for you.
    Why it might help: Food and water are fuel for our bodies and the functioning of our bodies is directly linked to the quality of that fuel. We know that children show huge cognitive improvement when their diet is improved and that it also has an impact on mood and behaviour. Recent research into the addition of fresh vegetables into the diets of older people also demonstrated improved cognitive function. We are what we eat.Water is also critical to healthy brains. I noticed in hospital that my low blood pressure was immediately remedied by drinking a glass of water and our brains rely upon a good blood supply to function.

    Avoiding those things we know are unhealthy, including alcohol, highly processed food and high sugar food will also have an impact on our brains. People with allergies and food sensitivities will know that a small change in diet can mean a big improvement in health.

    My experience: My diet was pretty good before I was diagnosed. It’s even better now. I’ve significantly reduced all of those things I know are unhealthy while still allowing for the occasional treat. We predominantly eat organic food and I cook from scratch. I’ve cut right back on gluten after I noticed (thanks to The Fast Diet) that it made me tired and bloated. I still need to work on drinking enough water every day but I’ve improved on that score too. It comes as no surprise to me that the better I eat, the better I feel.

  5. Iodine Supplements
    Regular followers will know that I’d rather get my nutrition from food than supplements but based on my own research and an examination of my diet I determined that there was a possibility that I was iodine deficient. I don’t eat a lot of fish and while dairy used to be a good source of iodine, changes in farming practices mean it’s no longer used. The clearing of the fog has coincided with the introduction of iodine into my diet so it’s worth considering. Please let me know if you have similar results. As always, I strongly recommend you discuss any supplementation with your medical team, particularly if you’re in active treatment.
  6. Sleep
    Sleep is the great healer. When I was in treatment it was common for me to sleep in excess of ten hours a day. As my health has improved my need for sleep has declined but I still regularly get eight hours. Sleep is such an important part of recovery that I’m dedicating all of my next blog post to it.

Here are some other things you might like to try:

  1. Learning a language or a musical instrument
    If you’ve read any of the recent research into neural plasticity you’ll already know about this one. It’s long been thought that the only time when the brain was ‘plastic’ and able to create new neural pathways was during early childhood. Now it’s clear that we can keep building new connections in our brain for the whole of our lives. The quickest and most effective way to do this is to learn something new. Languages and music are particularly good, but learning anything new will help. A number of people have told me they’re finding ‘luminosity’ (a web site that charges you a monthly fee to play ‘brain training’ games) very helpful. You could also try puzzle books or free online puzzle sites.
  2. Get creative
    Creative pursuits are good for your brain and your mood. Pick something you really enjoy and dedicate a bit more time to it. It might be gardening or scrapbooking or making furniture out of scrap wood. It really doesn’t matter what you choose as long as it gets you making lots of happy choices. There’s a huge surge in the popularity of colouring in books for adults at the moment. I wish these had been around when I had chemo. They’re very relaxing and great fun, combining creativity with mindfulness.
  3. Take a holiday
    A break from your usual routine can be good for your brain. It doesn’t need to be expensive or involve air travel. It might just be a weekend visiting a good friend. The aim here is to find something restful and calming. If the thought of packing a bag and going anywhere makes you anxious then stay home.
  4. Have a cuddle
    Not that anyone needs an excuse, but cuddles are good for your brain. They increase oxytocin levels and this helps you to feel calmer and happier. You can cuddle a person or a pet. You can cuddle a partner a friend or a child.
  5. Have a massage
    It’s a combination of cuddling, mindfulness and increasing oxygenation. It’s the triple whammy of treatments when it comes to helping you restore cognitive function. You can also credit it with reducing anxiety, giving you a break from your routine and helping you to feel good about your body. There are now massage therapists that specialise in treating people going through or recovering from cancer treatment, so look up ‘oncology massage’ and treat this as a necessary part of your recovery (rather than an occasional treat).

Finally, don’t give up. There’s no upper limit to how well we can be. Recovery from chemo brain is certainly possible and most of the things that help us to achieve it are things we should probably be doing anyway.

One Year Post Mastectomy

Fanfare please!

It’s been one year since my bilateral mastectomy.

It seems like an appropriate time to post an update on my recovery and to reflect on what’s helped, what’s hindered and what needs to happen during the next year.

There will be photos, so if you’re squeamish about scars then best skip this one.

The short version; I feel great. Lately I’ve actually been feeling well, really well, for the first time since my surgery. I’m amazed by the body’s ability to heal and surprised at how long it’s taking.

If you’d asked me just after surgery how long I thought my recovery would take I would have guessed three months or so. Even one whole year later there’s still a little way to go before my body is done.

This is important.

There have been times during the last year when I’ve thought, ‘Is this as good as it gets?’ It seems to me that healing will happen for a while and then there will be a plateau where nothing much changes. I’ve come to think of these plateaus as the body taking a rest from the hard work of healing.

The whole experience has been an opportunity for me to take a hard look at my life and my habits. I suspect there are people whose recovery is passive. They wait and hope, trusting that whatever medical treatment they received will do all the work for them.

It’s been my long experience that recovery from anything needs to be active. We can support or hinder our recovery with some very simple choices, like what we put in our bodies, how much sleep we get and how much stress we’re prepared to tolerate.

I’ve been actively participating in my recovery.

I’ve cared for my skin, particularly the site of my surgery, by using a body oil after my shower. I’ve also taken care of lymphatic drainage from my left side by using gentle massage throughout the day. This area has had a lot of damage following three surgeries and radiation. While I haven’t had any signs of lymphodema, I see regular lymph drainage as an important preventative measure. I’ll be doing this for the rest of my life.

I’ve lost weight using The Fast Diet. My doctor recommended this because there are statistics showing that excess weight can contribute to breast cancer risk. Fasting also triggers autophagy, the body’s natural mechanism for cleaning up dead and damaged cells. Anyone whose experienced triple negative breast cancer knows that we don’t have any of the new ‘wonder drugs’ available to us. Fasting seems like the best thing I can do to prevent recurrence. I’ll be doing this for the rest of my life.

Yoga has probably made the single greatest contribution to my recovery. I do at least one class a week (two when my husband joins me) and I practice at home every day. When I wake up in the morning I get dressed in my yoga gear. I have coffee and check my messages and daily schedule and then it’s straight into yoga before breakfast. I’m able to do things with my body that I couldn’t do before I was diagnosed. Of course the point of yoga is not to twist your body into increasingly difficult poses. Yoga is about integrating the mind, the body, the spirit and the breath. Yoga has helped me to love my post-cancer body and to feel strong and flexible, mentally and physically. I’ll be doing this for the rest of my life.

Massage has also been a big part of my recovery. I found a local massage therapist with specialist oncology training. As well as regularly helping me to move back into my own body she’s gently massaged my surgery site and this has greatly assisted in settling all of the nerve pain and helping me to regain sensation in that part of my body. It’s also deeply relaxing.

I was eating fairly well before diagnosis and treatment has been an opportunity to review what goes on my plate. We’re shifting towards more and more vegetarian meals. I rarely eat gluten any more and I feel better for it. I’m naturally eating less food thanks to The Fast Diet and the impact on my appetite. We’ve adopted the SLOW principles as much as possible; Seasonal, Local, Organic, Wholefoods.

I’m eating much less sugar and finding that I can’t eat anything really sweet anymore. I suspect this is because fasting has killed off the gut bacteria that trick my brain into wanting more sugar. The recent discoveries in relation to the gut biome continue to fascinate me. I’m sure we’re only just beginning to understand how important this work is for our future health. It’s certainly a strong motivator to avoid processed foods with all their additives and preservatives that prevent bacterial growth.

Thanks to a couple of visits with a psychologist with ACT (Acceptance Commitment Therapy) training and Russ Harris’s books on the subject, I’m now very clear about what’s important to me, what I value and what I want my life to stand for. To celebrate my one year anniversary I’ve enrolled in a permaculture course. There are those that would argue I don’t need this training because I’ve been practicing permaculture all of my adult life.

My friend Cecilia challenged me to ‘become a world famous permaculture teacher’ which is what motivated me to finally enrol. She’s clever. I don’t really need to become famous (nor do I want to) but I really do want to teach the skills I’ve been practicing for so many years. Permaculture is simply the best way to be human and the map for the survival of our species.

One of my favourite quotes has always been ‘Be the change you want in the world’. When I was a teenager I looked at a photograph of the planet from space showing all of the lights of civilisation and spontaneously thought ‘human cancer’. I was distressed by the damage we were doing to the planet and a sense of helplessness. For me, permaculture holds the key to healing humanity’s cancerous impact on the planet. It’s probably going to keep me well too.

So here’s my latest photos.

As you can see, I’ve come a long way since surgery.

P1070559 P1070558 P1070557 P1070556

 

 

My chest has gone from being almost completely numb to almost completely recovering sensation. I still have numbness along the scar lines and there’s an area of nerve damage above my original surgery scar (that’s the little arc high on my left side). Nerve damage feels like electricity under the skin. It’s continued to improve with massage and I’m hopeful that it will eventually disappear.

My chest still feels a little tight, as if I’ve got a large sticking plaster on it, but this has improved and I believe it will also vanish in time. For most of last year I felt like I was wearing an undersized bra (how ironic) and the tightness extended all the way across my back. That’s resolved now and I only have my chest to deal with. Yoga and massage both help with this.

I still need to remember to keep my shoulders back and to hold my body up. My doctor tells me it’s common for mastectomy patients to develop a stooped back and rounded shoulders. I suspect this is a combination of relieving that sensation of tightness and, perhaps, embarrassment at having no breasts. I regularly roll my shoulders up and back, particularly when I’m at the computer.

My neck has taken a while to adjust to the absence of two F cup breasts. Removing close to two kilos of weight left my neck and shoulders in a state of shock and once again, yoga and massage have helped. A friend showed me this neat trick; point your index finger at the sky; now bring your finger so it touches your chin and the tip of your nose; push back until you feel your neck is back in alignment. You can also push your head back firmly into a pillow when you’re in bed, or the head rest when you’re in a car. This simple exercise has had more impact on my neck pain than anything else.

As for the other side effects from treatment, I’ve also seen big improvement. I rarely experience any peripheral neuropathy in my feet. I still wake with sore hands but they warm up quickly. I need to be careful with any activity where I hold my hand in the same position for any length of time, such as drawing or sewing. My hands tends to cramp up and become painful. I haven’t given up on my body’s ability to regrow nerves. While one doctor told me I’d probably be stuck with whatever I had at twelve months post chemo, another said it can take six years for nerves to regrow. I’ve already had improvement since my twelve month mark so I’m going with option B.

I have a mild hum in my ears. This is probably also chemo related nerve damage but it could just be age. My Mum has age related hearing loss. It’s important to remember that not everything going on with our bodies is related to treatment. I don’t have that awful metallic taste in my mouth any more and I think this is also a form of peripheral neuropathy. Food tastes wonderful again, particularly straight after fasting.

I wonder to what extent the fasting has promoted healing. The science indicates that it should make a difference. In early days, I certainly noticed more rapid healing following a fast. I’ve observed that if I have any kind of skin blemish it’s usually completely healed after fast day.

As you can see from the photos, the radiation damage to my skin has greatly improved. As well as the circulatory benefits of massage, I think the regular application of rose hip oil has made a huge difference.

As you’ve probably already guessed, my mental state is great. People recovering from mastectomy are, not surprisingly, at high risk of depression. I’m very grateful that the care I’ve received and the work that I’ve done have helped me to avoid that particular complication. In many ways, depression is a worse disease than cancer and certainly at least as deadly. I think avoiding depression has involved a combination of things but particularly the information about ACT, practicing ACT and the benefits of yoga.

The most significant contribution to my state of mind has been the love and support I’ve received from so many people. Special mention must go to my beautiful husband who has continued to love and cherish me through all of this. I’m still beautiful to him. It’s an enormous advantage to have someone like that in my life and I grieve for those women that go through this on their own, or whose partners leave them during treatment.

I no longer experience ‘chemo brain’. I feel as mentally alert as I ever did. I’m also calmer, happier and less stressed than at any other time in my life.

I’m now taking stock and asking ‘What else can I do to continue with my recovery and to improve my health?’ I’ll also be doing this for the rest of my life. I believe that there is no upper limit to how well I can be. To put it another way, no matter how well recovered our bodies seems to be, there is always more we can do to improve our health.

Thanks to everyone that’s been following the blog and the accompanying Facebook page. Special thanks to those that have taken the time to let me know that something they’ve read has helped them with their own recovery. You’re the reason I keep writing.

Go well. Live well. My best wishes for your continuing recovery.