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

That’s the Spirit!

Joanne Dragun, M.D.1 Comment

Fall, football and face painting have arrived! Do you have a favorite college or NFL team? We are “Jag-Adelphia” fans here, but Steeler and Penn State nations are strong in Jacksonville and of course U. Florida. Sunday afternoon I chuckled to see three senior men with ridiculous orange foam Denver helmets at the Broncos- Jags game. Its fun, its spirit, its excitement and it surely is fantasy.

Can you imagine if every conversation you had in a day revolved around cancer? It doesn’t deserve to consume our entire attention. Bright Gator orange and blue fills the waiting room and is the fall fashion here. Football is a common language across socioeconomic strata and regardless the stage of cancer, everyone has a team and are thrilled to represent.

When Ben arrives for treatment, he has switched his First Division Army hat for a Gator one. He never went to college but his two grandsons are enrolled. It is as if he is rooting for the boys to win, be successful, enjoy life. His face lights as he tells about discussing the game with them. It brings a common language to those generations apart.

Binge watching football, NFL and college in a week does have its own risk and too much couch potato time could cause a gain of 5 lbs. But if you think it is all frivolous, enjoy witnessing the buzz of the season. If sports cannot distract you, then give attention to a good book, music, walk in nature, look through old albums, sew, bike, draw, garden, volunteer at a school or nursing home, take an online course or spend time with a friend. Find something that helps you to forget even for a few moments that you or a loved one are being challenged. It will heal your heart from the ache of the diagnosis. It will calm your stomach from the gut-wrenching feeling which will purify your immune system. We cannot live in a constant state of angst. We need relief.

I am giving you permission to live your own fantasy- find something that lifts your spirits and keeps cancer from stealing your joy and time. Protecting your own spirit is what matters. Cheer yourself on to a healthy victory. If it includes a foam helmet or face painting- go for it. No judging!

What spirit lifting activities have you found helpful this week? Feel free to inspire others.

Kindness

Joanne Dragun, M.D.

There are so many ways kindnesses are manifested in the families I am blessed to treat. Relatives and friends pitch in to drive, cook, help with medications, set up appointments and find a myriad of ways to extend support. Right now I have a run on handbags!

Wait. What? Women come for their treatments and their husbands arrive carrying their handbags, some over their arm others dragging on the floor. I noticed this phenomenon more this week because of Mrs. Arnold’s husband. He is a big 6’4″ robust man who arrives daily with his petite wife for her therapy. After her exam she heads to the changing room and he dutifully picks up her tiny purse. He has no concerns for himself and I love it. He smiles at me and shrugs his shoulders.

“Mr. Arnold, I think it is time for you to get a bigger bag, one that suits you. This tiny flowered one can’t hold more than lipstick and a tissue”. He looks down and softly smiles. “Doc, you won’t believe it but now I put my cellphone in here too!” I think: now that is a self assured man! He is laser focused on one thing: helping his wife in every way. Hoping that carrying her bag, assisting her with a sweater, holding her chair will somehow contribute to her healing.

As Mrs. Arnold rounds the corner, he steps up to meet her and transfers the bag into his other hand while he gently holds hers and escorts her to the door. The big gruff man with the tiny handbag is a blessed vision of kindness. I don’t think he will get a bigger bag. I think this one is just right.

Recognize the simple acts of kindnesses that surround you everyday and enjoy the blessings.

Power Packs

Joanne Dragun, M.D.

Cell phones, remote controls, drones, even vacuums all battery powered. People use the phrase “energizer bunny” to describe high energy and endurance, but we are going nowhere without batteries. Some day they will be passe but until then we need to charge.

Could you imagine if we had to have a battery pack for each bodily function? We are living miracles and while we can marvel we can also be disappointed. Bodies are not machines. We are not designed for perfection. Diabetes, heart disease, kidney failure, cancer, joint pain so many ways we wish we could reboot.

You hope the more you are disciplined, work out, eat right, that sickness will stay away. “Doc, I gave up smoking thirty years ago! Can’t believe they found this lung cancer when I had a pacemaker!” Jesse says. He is right it doesn’t seem fair.

Amos says, “Doc this cancer plus dialysis treatment is a full time job!.” At 82 he isn’t frightened or disappointed. He is happy to have today. “Hey, well at least I’m still standin’.” I peer over my glasses and we both chuckle. “Oh yeah, except for my wheelchair!” Now that sense of humor will get him through and recharge him.

Martha drags her oxygen tank down the hallway. She is 100 lbs but the emphysema takes the energy she needs to eat a decent meal. “Doc, I can’t breath and eat at the same time so go ahead and stick the feeding tube in, I’ve still got things to do”.

Everyone talks about embracing the natural but look around. We cannot live without being plugged in and there are many reasons patients accept the burden of medical devices. I am reminded that a life worth living and a future worth anticipating is the real power.

Jesse, Amos and Martha aren’t working hard for themselves. The real power player in our lives is hope for the future. Jesse to see a new granddaughter, Amos to attend his grandson’s police academy graduation, Martha to care for her two little dogs. Your mind and body have the real power- don’t abdicate it to any disease.

Think about what gives you power and when you do, I am certain you will appreciate that it is a life with many joys and expectations. Staying fully charged will provide for your best life.

Great Expectations

Joanne Dragun, M.D.

The patient’s chart is sacred. Personal history of the disease, pathology reports from biopsy, and scans related to a new cancer diagnosis are just words until I give their meaning to the family. I hold the papers in my hands reverently. They contain life and death information. I understand the responsibility I have to the patient and family in front of me. I am just one physician, one small part of a process and diagnosis creating this heart breaking drama.

As I explain all of the details and plan of care, I know they are just words. The space between my voice and their awareness is a broad chasm and the only real substance within that space is one question. “Will I live?” The “chart” becomes heavy. It is filled with all their hopes, real fear, confusion, shock, disappointment and pain. I respect this. Patients hang on every word, facial expression, mannerism, smile of assurance and hand of comfort. Physicians understand this sacred trust.

There is something else: expectation. When Margaret asks, “How can I survive this?” The children wonder, “Will she be in pain?” The husband says, “What can I do, how can I help?” We will work together as a team with the patient’s own strength to carry Margaret and her heavy basket of grief. We are all called on to lighten her burden. Other physicians and our staffs will converge for her benefit. Expertise, wisdom, the newest protocols, as well as comfort measures will be brought to bear. She is not alone.

I ask Margaret, “What is your expectation?” She softly says. “I know I won’t live long but I want to live well”. This is important. She does not want months of therapy. Her disease is stage 4 of an aggressive cancer that will not be cured regardless the treatment.

And so, a plan is hatched that includes non-invasive immune therapy, minimal radiation for pain and palliative care to avoid stealing her time from her family. Margaret may only have a few months, but her wishes and her own expectation – not ours are what matter.

I have great expectations for Margaret- that she will craft her time, have loving people surround her and peace in her heart . She is in control and I expect us to follow her lead.


What expectations do you have for a life well lived? Please share and you will open another’s eyes to possibilities.

Teachable Moments

Joanne Dragun, M.D.

It’s back to school and we are all reminded that every age, every stage and every challenge in life provides opportunity for learning. Isn’t it exciting and rejuvenating to look for ways to improve our life, happiness and wisdom? A lovely relative who thrives on self discipline is always happy to share fitness and wellness ideas. It’s her fault I do yoga (oops I mean encouraged me to explore the peace in practicing). Running, triathlons, biking are as much a part of her 55 year old daily life as her nursing career. Why am I torturing you? Because this woman loves sharing what she has discovered and extending herself to benefit others. The petite powerhouse softly say, “coconut water”. She then offers: “hot yoga… oh and with weights”. If that’s not enough the word “vegan” also escapes.

Frankly having tried vegan for a week I found myself groveling at a fast food drive thru. What I love however is her need to share. She is unselfish in expressing how activities for her own wellness could be a blessing to others.

Since “Doctor” means “teacher”, I hope in some of my stories there are teachable moments. Think about this for yourself. Having lived with cancer or any major life altering problem and run the gauntlet, don’t you have many ideas to also share? Not in a “let me tell you how awful it is” way but what helped, inspired and lifted you? You are a wealth of knowledge. It is as if you went to grad school for cancer survivors! Share your best ideas, how you navigated, and where you found strength.

You will give inspiration to another who needs those words. The best teachable moment sometimes is just realizing that we are not alone. You can calm someone fearful. You can help someone smile who is depressed. You can encourage another who is resistant. You can open the eyes of someone who is rigid. You can let another see that they too can be a survivor and it is not the end of the world. You can be amazing and motivate them to believe.

It only takes a few words to share your power. You will then rejuvenate yourself and be reminded just how strong you really are- no weight lifting required.

Cone of Uncertainty

Joanne Dragun, M.D.

The cone of uncertainty describes more than Dorian. The now deadly hurricane is fierce and captures our imaginations as if everyone is in the Three Little Pigs story. The wolf is at the door in the Southeast; the cone of uncertainty, evacuations, decreased water and gas supplies (oh and chips!?) keep us riveted to the alerts.

People feel a similar impact with a cancer diagnosis. Will I survive, how long, will it devastate my family and me, can I afford the therapy- so many uncertainties personal to each. The “cone” extends from overwhelming you or moving you closer to cure, depending upon the disease and your ability to tolerate. Devastation can occur. It’s all terrifying. If you could evacuate to save yourself, you would. Having no escape but to plow straight through it often requires a rescue plan.

Doctors and patients alike cannot tolerate this uncertainty- we need discipline around the cancer process. We desire outcomes that are positive. We really want to rescue you and fast. So how can we all deal with this drama? Realize that you do not need to know everything now. Make a plan in case you are no longer here to help your family. Even if you don’t need it for years, it will give you calm. Then take a breath and know you are only being asked to cooperate with therapy and otherwise have no control. Give it up. Have faith that your physicians are preparing you and that is the best you can do. Just like the pressure stream swooping in all the way from the Gulf of Alaska pushing Dorian away from the Northeast, you may be rescued by a new drug or therapy just before devastation. I see this with immune and targeted therapy in many diseases.

The storm will be over. You will look back and be amazed at how you survived or you will decide you have had enough. Either way, you will not be uncertain. Your life is unfolding as it should. Acceptance is healing. Stand firm in the eye and above all, never doubt the certainty of your own strength.

Hopeful Stats

Joanne Dragun, M.D.

My good friend Chrissy just completed her therapy of chemo, surgery and radiation. Her squad of several friends including husbands arrived the last day to cheer her on to a renewed life. The excitement and love was evident even for others among them who battled the disease themselves.

It takes months to treat and for Chris and others, the strength for the work is necessary in mind, body and spirit. She remains true to her joyful, hopeful self and inspires my story today.

There is great news for her. She will join 3.6 million breast cancer survivors in the US as well as 17 million cancer survivors.* People are surviving well and in great numbers.

I recall even at a young age people whispering about cancer (“She has the big C”). The thought was that speaking the word would give it power. Well who has the power now? No doubt it takes therapy, fitness both mental and physical, a great support and medical team, but so much of the success resides within.

If I didn’t see first hand amazing cases as a radiation oncologist for over twenty five years it would be hard to hold out hope. Instead what I do experience is miraculous improvements in life, changes in therapies with outstanding results, patients living well with diseases, returning to employment, strengthening with physical therapy, improving nutrition, reconnecting with friends and family: a hope for success at every level.

Whatever the type of cancer or challenge you or a loved one faces, don’t give up. If it has become overwhelming or too much to bear, then believe there can be comfort. Find people who lift you up. If you cannot run a race, have someone take you to sit on the sideline, marvel at other’s fierce resolve and be inspired to be your best.

You are not alone. 65% of survivors are over 65 and almost 70% have survived over five years. (source:NCI) You are a blessed survival statistic. Refuse to identify with the disease. Be hopeful, not that you will conquer this or any other diseases but that you are still destined to live your best life. The statistics today for cancer are in your favor and getting better everyday.

Have faith in yourself and hope will follow.

*NCI division of cancer control and population sciences

Vision

Joanne Dragun, M.D.

Recall the song, “I believe I can fly, I believe I can touch the sky?” A moving inspirational anthem especially in school musicals, singing out life affirming words. I wish I had it piped into the sound system in the treatment room.

When I consult a patient and discuss therapy, I often see the eyes cloud over and a stare replaces engagement. Some patients or families take notes avidly, others really do not want all the information. Not everyone believes they can see it or believes they can do it. The ability to have faith in themselves doesn’t automatically happen when the diagnosis or some life drama appears.

Take Shannon, she gets the children to school, herself to work, stops midday for radiation then reverses her day. There is lots of drama, enough for a reality show in between her footsteps. Does it sound like your life without the lunch “break” ? With the life altering diagnosis that upends their world I am always relieved to see patients who accept and continue moving forward. I want you to know what reality stars these patients are to me. Shannon like others on this path are not intending to inspire others. They all just have a vision.

They want to be healed, a simple plan. They crave normalcy. They want to live an uneventful, uninspiring, quiet, peaceful, boring life. They didn’t sign up for the drama but they work at it everyday. There will be no awards but there will be rewards for their efforts.

Shannon’s simple vision is to be a working mom. She fulfills that everyday. Her goals are not in some distant future. Vision happens with each moment empowering the next.

I admire Shannon and other patients who work for their wellness, taking steps to solidify their own vision into reality. I believe that with vision and belief in themselves, they can all fly.

Life on Hold

Joanne Dragun, M.D.

Many aspects of living actually keep us from truly living. What has tapped you on the shoulder, stopping you in your tracks and caused distraction? Certainly a cancer diagnosis does that. “Wait; you cannot get on with life, you must stop and reconfigure your work, exercise, money and budget, caring for children and others.” No, you cannot put this aside until you are ready. Cancer won’t be ignored.

What a selfish being this cancer thing is. The dynamic is the same for many of life’s events and surprises: a death, sickness, drug addiction, accident, inability to use a limb, hospitalization, divorce, deployment, moving from friends and family. All of life’s stressors. The path you thought you were taking is detoured over very rough terrain and getting lost can happen. Even other joys don’t register when this overwhelming problem appears.

Patients frequently tell about being blindsided: the mother getting ready for her daughter’s wedding diagnosed with breast cancer. The grandmother headed to graduation out of state going to the hospital instead. The son going off to college, now on hold caring for his ailing father. The list is long and daunting. Life as we know and want it to be stops.

As much as I am a fan of pursuing dreams, activity, enjoying life even with cancer, the momentum is not in that direction any longer. May I suggest that this terrible interference can also provide us a moment to stop and take a breath? Yes, it may make you turn around but you can also look around.

How exciting can it be to now make new life-worthy decisions that you may have avoided when your trajectory was “set”? Many of our patients describe going back to school, having or adopting a child, becoming closer with estranged family, getting married, changing the drudgery of one job to something they love. Because this movement also can happen with a re-routed life. There is opportunity to engage in more meaningful ways. At the very minimum is a new-found appreciation for your life.

Do not despair. It may be intimidating when faced with the unknown, but now you can view everything in a different way. Life isn’t on hold, it is happening. It is forcing you to take control and burst out of your sameness. Be assured that you are up for the challenge. Embrace the new experiences, people, environments. You will be amazed at your strength and proud when you recognize new potential. Were you in a steady state that you took for granted?

Be open to letting this change be life affirming. Don’t settle for less out of fear. Open your mind and your body will follow. Above all: get ready for the greatness that is still within you!

Did you discover a new path after adversity? Please share.

You’ve Got This!

Joanne Dragun, M.D.2 Comments

Have you heard that today? If not let me say it directly to you. Whatever the drama: finishing a degree, living with grief, giving a presentation, moving on with your life after major changes, going on deployment, raising a challenged child, staying sober, healing a heartache, or managing a life with cancer. Maybe two or even three of the above apply. A carefree life doesn’t really exist if you are living, experimenting and growing.

You may think, “Doc, you don’t know how it is for me. You can’t understand all I am going through, there is so much pain and tragedy, fear and disappointment, I don’t feel as if I have this at all!”

Aah but you do! Let me offer to you a change in thought: Do not doubt yourself. Whatever you focus on grows; reliving a past drama over and over makes it the main focus of attention in your life. Its important to know where you are headed. You can persevere with positive anticipation if you trust yourself.

Think about when and where you have been strong or even fierce. Did you deliver and raise a child, move to another state, finish a degree, help to run a business or organization, succeed in a sport, hold a dying loved one’s hand, been a good and devoted friend when someone needed you, lived on meager means, overcome addiction, changed careers, or been physically or mentally stronger than you ever thought you could be? Sure you have.

Not to diminish how terrifying and life- altering a cancer diagnosis is, but you’ve met so much adversity in life already. Don’t believe for a minute this is too much for you. I see strength rise in the old, feeble, fearful, tearful, weak and overwhelmed everyday. What I also see is the rebound, relief, steel determination, balance, faith and hope, love and devotion, smiles, new direction, overcoming and miracles.

Believe in yourself. Today and everyday look in the mirror and tell yourself that you’ve got this. Say the words out loud and often, then trust me you can make it so.

Please share your own positive self-talk. Joanne