Category: Life after cancer, cancer support, cancer therapy, finding purpose

Comfort and Joy

Joanne Dragun, M.D.2 Comments

There is a new trend in holiday gifts. No, not the 72″ plasma TV. Shelves are packed with cozy comfort. Embrace the trend and hopefully find that gifting yourself and others some of these “doctor recommended” items will enrich your holiday, while soothing some “doctor-induced” side effects to treatment.

Oh so hot! Women with breast cancer and men on hormonal therapy suffer with hot flashes even long after menopause. Cooling sheets, pillows and towels are now available, a small fan to place by the bed and even peppermint bath and lotion can cool them down.

Have the tingles? peripheral neuropathy in hands and feet after chemo may be helped with tens units now available (often used for pain- but stimulation works) , foot massagers and hydro baths help too.

Work it out! Following a few weeks of physical therapy, keep the activity going so exercise bands, squeeze balls and rollers are useful.

Pampering is welcome! Certificates for massages, reflexology, scalp stimulation,makeup application and salon services can boost a mood.

Snooze alarm. Physicians are limited in our ability to prescribe pain and sleep aids. I recommend trying CBD oil and creams, chamomile tea, eye masks, meditation apps or CDs and a new favorite: weighted blankets.

On the scent. Scented oil diffusers or essential oils for topical use are calming. Lavender infused wraps and stuffed animals are always appreciated.

Change the mind and the mood. When my mother was not active, my sister gifted her with a beautiful scarf to lay over the blanket and add cheer to the room. Another sister advises continued learning and mind stimulation and with a subscription to “The Great Courses”.

Reminisce. Gifting memories with booklets or albums.

Can’t open a jar? Arthritic issues abound so copper infused compression gloves, knee braces, hot wax hand therapy and hemp infused creams may help.

Applause. Tickets to a show or game shake the doldrums and remind them life goes on.

Comfort food. Any homemade dish or cookies please.

Feel free to add your ideas here to inspire others. We are all about the wellness, but the true gifts of comfort and joy are not my “favorite things”. It is your presence in their lives. That gift is priceless and always the most appreciated.

ps: suggestion: print, highlight favorites and leave for Santa to discover!

Note: If you click the website link URL below, you get to see the adorable picture with each post – love this one!

About Face

Joanne Dragun, M.D.

“Doc I am thinking about getting a face lift.” Jane was treated for cancer four years ago and is in for a check up and doing well. “The cancer took a toll on me. I don’t even recognize myself. I saw a plastic surgeon and she recommended a partial face and neck lift, brow lift, blepharoplasty, fat injections and cheek enhancement”. Wow. Of course I ask the obvious question, “Jane are you going into witness protection?”

While Jane’s plan seems rather extreme, recently I am seeing patients choose less invasive procedures even trending toward a more natural look. Just last week the NIH reported an increase in breast cancer with permanent hair dyes and straighteners. Expect to see more grey heads. Its important to always consider the risk/benefit ratio. General anesthesia for radical procedures, while very safe, can have side effects. As we age, we will require some healthcare, but we should protect our brains from insult whenever possible. After a certain point (say 70) we should more carefully consider any elective procedures.

POCD (postoperative cognitive decline) following general anesthesia is a real phenomenon especially in people with heart and lung disease, stroke, Parkinson’s and Alzheimer’s. At 73 Jane already has “senior moments” and may want to reconsider her aggressive plan.

All procedures have some risk. Personally, I tried Botox to erase a frown line that can send a message of concern to patients even when I have good news. Unfortunately my eyebrow dropped (a rare complication). My internist said, “Joanne we should test you for myasthenia gravis with that eye droop”. A pulmonologist friend told me to get a chest x-ray looking for a Pancoast lung tumor that causes ptosis (droopy eye), A neurologist said “I know you are healthy but could you have had a stroke?” It took six long months to revert to normal and the frown was still there.

“Jane, I will support your decision but be sure you are well informed. Perhaps you could start with less invasive procedures and injectables that do not require anesthesia, it may be just enough to refresh you.”

My best advice is to guard your overall wellness, even while you may seek physical or cosmetic improvements. The spirited, clear, happy mind behind your beautiful eyes is what matters most. Wonderful youth enhancers readily available with no down time or recovery include a quick smile, joyful demeanor, sparkle in the eyes even with laugh lines and rosy cheeks from exercise. People will not notice your wrinkles if you listen and give them attention. Let your glow from within project a youthful mind and vitality. Trust me, you look Marvelous!

Rudolph

Joanne Dragun, M.D.3 Comments

We all have favorite Christmas carols and hymns, but even if you love the holidays, we can have fatigue for “BuBuBuBlue Christmas” quickly. I was reminded of my least favorite this morning. I stopped in the dark morning run to admire a full bright starry sky and big dipper. Thank goodness I did. A second later two large dear dashed across the path directly in front startling me, then a possum scurried in the opposite direction. My peace was disrupted but at least my heart rate was up.

Radio stations and malls start at Halloween and people feel pressured to decorate, shop and make travel plans two months ahead. This extended season causes many modifications in healthcare as well. People hold off on elective procedures, and often therapy is interrupted for travel. Patients pull out calendars filled with doctors visits interspersed with activities. Many cancel their plans to travel with a new diagnosis. “Doc, I wish I didn’t have the biopsy last month. I could have enjoyed Christmas more. Now I can’t stand hearing “I’ll be home for Christmas”.

Its a trade off- not just modifying the cancer journey but moving from hearth and home to live a warmer life in Florida. We all miss our relatives this time of year and face- time replaces the hugs. For those who can travel they will brave the cold, ice and snow to be close. What I experience with patients is how emotional the season can be. Many realize that time is marked by these holidays. Mary asks, “Doc, do you think I will be here next Christmas?” You know by now how important hope is. “Mary, I can say with absolute certainty that you will be here next Christmas, even if you are the Christmas angel”. She smiles sweetly.

Of course as always I have a recommendation. Cancer really doesn’t grow overnight. Some forms take years. You can postpone breast and prostate biopsies, scans, Mohs surgery, or starting radiation. Holidays are full enough- why invite more drama? Take control. Enjoy friends and family when you can. Too often I see patients dug into the therapy as if its the only thing important in life- it isn’t. There are empty seats at all of our tables this holiday. We won’t recall our loved one’s therapy. We will joyfully remember a time they celebrated with us. Make some memories for yourself and others. As a cancer physician I am giving you permission to celebrate and forget everything related to any illness. Do not forgo interactions because you don’t feel up to it- others will give you the energy you lack.

If you are already well into treatment and cannot get away, deliberately play the carols on the car radio and sing out loud- you know every word. Let them wash over you and smile at the memories. Indulge in corny holiday movies, make some cookies, brew Christmas coffee or sip some eggnog. You can still participate in the warmth and cheer. I love to do my shopping on line but then head to the mall to see the decorations and watch the anticipation the little ones have as they wait their turn for Santa.

Just remember when you hear the holiday music to smile and enjoy, unless of course it’s “Grandma got run over by a reindeer“. It was a close call!

Healing words

Joanne Dragun, M.D.

“Doc, I want your opinion. The medical oncologist told me I had a 50-50 chance of beating this. What do you think? ” I am often faced with these conversations but wondered how to help fearful Gertrude who has metastatic disease and is still doing well with aggressive treatment.

“Do you have a coin in your purse?” She pulls out a quarter. “So Gertrude, the other Doc essentially described your survival as a flip of the coin. Why not try it, OK?” First she is dismayed but timidly hands me the quarter. “Here we go, heads you are a survivor and tails you live a good life. Call it!” I says these words so fast and flip quickly before she processes that I didn’t say live or die. It hits the floor and we both look down. “Tails it is! you live a good life!”

Did I negate Gertrude’s concern and misguide her? She is 80 years old, the disease will take its toll and some side effect from it will shorten her life- how long? I don’t know. She keeps tolerating therapy and does well. She already is a survivor so “heads” is right. She can still live a good life so “tails” is as well. Docs shouldn’t be in the business of scaring people to death.

“Gertrude, everyday we each have a zero or 100% risk or hope for survival. No body lives 50% and so as long as you do well, you are living your best life.” Worry and fear will only ruin what time she has left. Careful to not ignore end of life discussions, I often send patients to hospice who are finishing the fight. What I object to is the vagueness of percentages that have no meaning but to insight fear. And so, our little game today gave Gertrude a lift and I am reminded how words can heal. Speech “therapy” comes in all forms. Physicians may hold the tools for wellness but we do not hold the key for life and so for my practice, I refuse to steal what isn’t mine to give or take away.

It is important to think, read and speak healing words over our drama. My best advice is to give yourself 100% chance everyday.

Goal Oriented

Joanne Dragun, M.D.

What goals have your set for yourself? Is one to beat cancer? Probably in there somewhere, but usually our goals are more tangible: get to work, exercise 30 minutes per day, eat healthy. Very simple objectives. If you are on chemo right now, the goal may be to do all of these without being sick.

Every goal starts with an intention then action. Will you choose to set one today? Finish a project or start one? Mix up your routine, sign up for a course, go to a social? What all of these have in common regardless the objective is movement from inertia. “Hey, Doc I have cancer over here-leave me alone!” Remind yourself that you are not living for the cancer, you are living for you.

How about if we make a deal? There are 48 half hours in a day. If you haven’t exercised, then start for 30 minutes. That still leaves you 47 half hours to do other things! When we think about time in this way, it opens so many opportunities. It’s not some enormous commitment. Its 2% of your day.

Out of 1440 minutes in a 24 hour period, 30 is almost nothing, but the impact on you can be everything. Find something enjoyable or challenging. That’s it. Do this for you. When it becomes a part of your routine, find something else for another 30 minutes. It may be as simple as a walk in nature or visiting or calling a friend.

There are many opportunities to enhance your life that cancer has no control over. Take your power back thirty minutes at a time. Watch yourself gain strength. Allow intention to find destination. If you can remember to smile while you do it, even better!

Reminder: Monday is Veteran’s Day. We do not take you for granted. Thank you for your service.

“This is my fight song

Joanne Dragun, M.D.6 Comments

Take back my life song” (Rachel Platten,2015) . What a moving uplifting and powerfully energetic anthem when over 100 women hit the stage to sing out “I might only have one match, but I can make an explosion“. Yes they can and did in front of over 800 people in Cherry Hill N.J. last weekend. Everyone on stage was a survivor of cancer- most breast and ovarian for the million dollar fund raiser for Pink Roses Teal Magnolias brunch to benefit MD Anderson, Cooper Hospital Foundation.

My family and friends were present to witness this phenomenal event as our son, Anthony the Chair of Radiation Oncology was honored with the a “Hero’s Award”. Yes we are the parents bursting with pride. The day was magical on many levels.

Participants in the audience became joyful and overwhelmed. The survival stories were heartfelt and fearless, delivered by these inspiring women, expressing the drama of their own personal journeys, and the atmosphere was absolutely electric. There were tears and cheers and memorials as well.

The 10th anniversary celebration was lead by the former Mayor with her own ovarian cancer diagnosis who shared her mother’s journey as well. Her teal boots a physical sign that she will stomp out cancer with passion and funk. Of course our hearts burst as they honored our son- for his work at the hospital and also his research on the national protocols designed for the treatment of breast cancer. He has even cared for my own friends in this our former home town.

While everyone cheered the heroes, they also found encouragement, wisdom, love, compassion and a bond with the hundreds affected. They are NOT victims- not a one. They are champions and proud of their own work toward wellness. When they joined on stage, the energy was infectious. As they sang out: “Cause I’ve still got a lot of fight left in me” I doubt there was a dry eye.

Congratulations Pink and Teal committee- the monies raised stay at the hospital to help cancer patients – always the best way to donate to a cause. The devoted committee members now have oxytocin to spare and their strength built a wall of protection. Thank you for an amazing experience. Anthony said he is blessed to work with outstanding physicians and staff, while caring for wonderful patients and brave survivors. God Bless you all for your inspiration and Congratulations Anthony!

BOO!

Joanne Dragun, M.D.

As you push past the erupting Christmas decorations to shop for a Styrofoam pumpkin, are you enjoying the cooler temps and fall foliage? It is always my favorite time of year, kicking through the multi-colored leaves, enjoying the vibrant mums and the children’s excitement.

What was your favorite costume? Somewhere in an attic is there a cape, wonder woman bracelets or cowboy hat? Long before costumes for purchase, it was fun to cobble together with elaborate creativity an outfit to change your identity. I loved anything with makeup but actually won a contest at age 5 for the “crying bride”. There is a picture of me wailing on the ground in a beautiful veil and dress my talented seamstress mother made, but I was so shy and terrified that I sat down and wouldn’t move. Hmmm, I didn’t understand the irony.

Recognizing the character costumes today is a challenge, but what hasn’t changed are the the precious smiles on the trick or treaters’ faces. I fuss and exclaim how great they look and watch even the shy ones beam. Its a time we get to be face to face with many youngsters and if we allow, the masquerade can be a treat for us too.

For just one day, enjoy the frivolity. Carve and light a pumpkin. Maybe dress up yourself- I know your little dog already has an outfit. If there isn’t trick or treat where you live, consider volunteering at a school that has a party- always needed. You can really get out of your own head and drama when an entire town or neighborhood is being frivolous. Giggle, you owe yourself an opportunity for fantasy. Play a little- answer the door in a sheet, get a mask, take part. Whatever else the scariness is in your life right now, please do not let another holiday go by without joining in 100%. Remember a time when you too believed you could be anything- you still can. The cape is waiting.

No Time for Losers

Joanne Dragun, M.D.

‘Cause we are the champions… of the world! (Queen ’77). Stanley Cup, Super Bowl, NBA Finals, March Madness, World Cup, US Open, now World Series… Everyone loves championships! If your favorite person or team is involved, even better. People enjoy the distraction sports provides.

Mr. Martin discussed his time in D.C. when the team was the Washington Senators and moved to Arlington Texas in 1972. Without a team for 33 years, Washington finds themselves this week in the World series (with Huston Astros) for the first time since 1933! “Doc, worse than having a losing team was having no team at all. We were abandoned. I loved taking my kids to the game on family day. To see a team in my lifetime make it to the series is a gift from God!” His eyes sparkle, he puffs out his chest and 700 miles away in Jacksonville, he is rooting for a home team winner.

Mr. Martin didn’t expect to see this day because he has stage four lung cancer and has lived well for three years. Immunotherapy, found to be effective for his type, is keeping it under control and he is thrilled. Mr. Martin believes he was meant to live for these games. He ties his own wellness to their success.

There is only one issue that matters in this story: Mr. Martin has found an event that captures his imagination. This fills him with joy, lifts his spirits, boosts the immune system fighting his lung cancer. It doesn’t take an IV, hours in the chemo chair, beams of radiation, recovery from side effects or cost of healthcare. It is a shot in his arm of pure goodness and life that doctors do not prescribe.

I understand that not everyone will feel this engaged with the Series, but Mr. Martin demonstrates how easy it is to find a happy engagement in life and is available to us all. It may be a grandchild’s graduation, a son’s wedding, a spouse’s good news, the birth of a new baby, so many events in our own life that help us to celebrate with the champions.

Life didn’t throw you a curve ball so that you can strike out. Difficulties happen that give us opportunities to overcome and bring elation into the heart. There really is no time for losers, we can cheer the champions or become one ourselves. Each one of us must have awareness for the brave and proud unfolding of our lives and raise a toast to our spirits.

School Days

Joanne Dragun, M.D.

When Mrs. Hale arrives for a visit I know there will be energy and joy to spare. I ask after her mother and she tells how she moved in with her because, “Doc, 97 year old people just fall over too much so I have to keep propping her up!” 80 year old Mrs. Hale is the youngster and full of vitality. “Sorry I’m late, with school and everything”. I commiserate that it is difficult to navigate Jacksonville with the traffic and buses.

“Oh no, Doc, I am late because I have a job as a crossing guard! I go to my post at 7:30 AM and again at 2:30 PM and I just love it. The kids are great, I am watching them grow up and they keep me young!” This is really awesome. “I feel as if I am playing. I laugh, tell them how smart they look and get lots of hugs”.

Mrs. Hale found a way to have recess late in life. “You know I didn’t make it past middle school. We lived on a farm so I had to work and never got an education. It makes me feel real good to see these little ones so happy to go to class and to tell my mom everyday that I have to leave for school!”

She will likely live a long life, as her mother is doing, especially if she stays active. Mrs. Hale has a quick laugh, is young at heart and has stories to share. She reminds us that age is a state of mind. What a blessing for the children to see her smiling supportive face each morning. She is impacting their lives with her encouragement. This octogenarian found a way to boost her own immune system without chemo or doctors. She is smarter than most and schooling us all!

Discovery

Joanne Dragun, M.D.2 Comments

Whether it’s Columbus, Erickson or Indigenous Day, its a time to say “Yay for new adventures!” What Columbus has to do with not getting mail or the bank closing is a mystery but what matters is the concept of discovery.

Lets take a moment to personalize this idea of discovery. If I asked you to describe yourself in 3 words, could you do it quickly? You will surely not say cancer victim. You may include survivor, but I hazard to guess that you do not even elude to an illness. When did you discover yourself? Was it when you were tested by a life altering threat? Did you find that you are strong? When you went to school and were able to help a classmate who struggles. Did you admit you are smart? You may have worked out, lost weight and become more physical and self assured. Do you see confident? Have you taught, spoken, advised developed a plan and see yourself a leader?

At what time in your life did you enter into discovery of your own uniqueness and strength? Have you ever taken the time to consider how truly amazing you are? In 1492 Christopher Columbus did not discover a new world, he set out with profound bravery to expand the old world and in doing so demonstrated that exploration changes lives.

All the sacrifices, pain and suffering endured led to adventure and honor still recognized over 500 years later. Don’t think for a minute that your own trials and efforts will evaporate. Your strength, discovery and exploration of your legacy will last for generations to come. You will have constructed a life to be revered. Fortitude will be ingrained in your children’s children and they will have wisdom, laughter and love because you sacrificed, learned and grew. This is not to say they will never suffer, but there will be a strength they didn’t know they possessed. You are the blessed result of your own ancestors and their profound life discoveries.

The Nina, the Pinta and the Santa Maria may have been vessels of ambition, but your own personal discovery of faithfulness, hope and love are destined to last forever. Take a moment now to think of three words that describe you and in doing so discover your own new world.