Tag: living with cancer

silhouette photo of woman against during golden hour

Not Sad

Joanne Dragun, M.D.

As of July I am in a new practice. After 14 years, it is a mixed blessing since I dearly love my patients. I have not left them. They are each in my heart and I pray for them daily. This week, in a new environment, I had the opportunity to meet Sara. She’s been at this “cancer thing” for 5 years. She is worn out, but still courageous.

I introduce myself and say, “How are you?” She raises her head, looks me in the eye and says, “Doc, I am not sad”. It’s a remark that opens the environment for exploration. “Sara, what does that mean to you?” She offers how she explored alternative treatments out West, spent time in “wellness centers”, traveled to yoga/meditation retreats, all in an effort to confront her new life. “You know, I spent a ton of money and energy trying everything. I searched and searched and researched. I hoped I would find peace or comfort or even happiness. But I realized something this year. I just don’t want to be sad anymore”.

I offer that this is worthwhile. She continues, “It is such a relief to just have that simple goal. I don’t have to fight, or be mad or depressed. I don’t have to perseverate on regrets. I just have to choose to not be sad. It is very hard to choose to be happy- it doesn’t just settle on you. So after all this time, I am choosing the simpler concept and it is a huge relief.”

Sara does all the activities we have talked about here: meditation, exercise, eating right, avoiding alcohol, spending time with friends and relatives. But she admits that the undercurrent humming for years has been sadness. Everyone has grief when the life changing event happens. We pine for a return to normalcy, knowing it lies in acceptance not turning back. Sara teaches us that frenetic striving is unnecessary. Calm, peace, acceptance and even love can surface if the weight is lifted. Choosing to be “not sad” is a palpable meaningful start.

The lesson from soft spoken, sweet Sara today helps me as well. My own trepidation for a new adventure has been soothed. I learn that there will continue to be new engagement and ideas to share by “discussing cancer”, which by now you realize is never discussing cancer but living well.

Sara took a chance opening the door to this revelation to a new physician. I asked if I could share her concept which may help someone and she agreed. “Doc, its not earth shattering, life changing or even very philosophically deep. But it works for me and I am so pleased that I found that I can simply choose to be not sad everyday”. It’s a step.

Leftovers

Joanne Dragun, M.D.

No- not the turkey and stuffing, instead the leftover warm and fuzzy or crazy chaos of holiday memories. We all have them, many wonderful, charmed and loving. With any unpleasantries long forgotten so that everyone piles into the car and does it again and again each year. A routine of company, cooking and camaraderie. Last year was just an aberration. we can just jump into the whole celebrate traditions again, right? I suspect that several of you may do just that. However, what a quiet, shut- in year has provoked is a new perspective. While many still love the engagement and make every sacrifice to gather across the miles, there are also those who will choose differently this year. Age, illness, treatments, economics, all sorts of disruptions are forcing decisions. For some, last year was almost a relief- no travel or congregating so there were no choices to make, no need to “take sides”. This year the expectations are back and you put on your game-face and fly, drive, face time and engage. What some patients share is the difficulty of this “hoopla” and the pressure to participate.

“Doc it was so easy last year. Sure I missed them but at least I could eat in peace and not put little Trixie in the kennel”. Frances’ son is insisting that she make her way up to hometown New York and at 82 she is dreading the effort and the cold. Debbie won’t travel to Michigan because the chemo took her hair and she never told her “kids” about her diagnosis, so she made some excuse to stay home and confesses she is going to pretend to not know how to face time when they call her. Phil’s mom is in a home here so he won’t leave her to travel and see he grand kids- pulled in two directions as the sandwich generation is. Nancy’s grown kids are in town but, she is fatigued with therapy so less tolerant. She makes an announcement that ‘ “If they start fighting, out they go!”. Not everyone anticipates loving, joy filled days. For some there is grieving with loss at the table this year. Others are trying to make new traditions. “Doc, I never had to cook a turkey, but need to honor my mother’s tradition.”

For those of us blessed with happy memories: simpler times, a tiny house filled with warmth, the expectation as you introduced you future spouse to the family on the holiday, setting up a high chair for a new addition, helping in the kitchen, or celebrations more quiet: a simple dinner and favorite movie, seeing a friend or helping at the church or shelter, there was always a way to mark the occasion.

If the Norman Rockwell picture perfect moments are illusive this year, then bring out the leftover memories- enjoy reminiscing. No, you cannot recreate, but you can create and make something new. What I know from every interaction is that we have a lifetime of holidays to recall that will warm our hearts. May I also suggest that you engage in a way that is right for you, right now? Perhaps simple, less energetic and emotionally charged activities: visit a drive through light show, walk through a town or open mall in the sun, take pictures of the comical geese or decorations, enjoy the neighbors’ light displays, yes watch the sappy Christmas movies, treat yourself to eggnog, buy a poinsettia and fill it with lights as an easy replacement for a tree. Leftover memories will always be there for you, but your life is changing, so the holidays will as well. Don’t let traditions dictate. You get pushed around a lot with all the “treating cancer business”. Decide how you want to enjoy this season. If you can’t wait to see everyone- do it. I have several patients holding off on therapy until after the holidays so that they can travel. If instead you are like James who does not have the energy to navigate his family’s drama, dig into the work of caring for yourself. It’s a grand reason to stay home. I almost had to write him a prescription “Doc says I can’t travel!” I tell patients to use me as an excuse, I’d rather take the heat for them.

So much has changed for us all this year. If you have the energy and desire to re-engage full force and return to traditions, make that time and do not let any healthcare interfere. If instead, you are ready to keep the memories but lesson the pressure, then take control. Each and every single day is very very precious. Please, I implore you to un-apologetically make these holly-days your own.

Age of Enlightenment

Joanne Dragun, M.D.

Also known as the “Age of Reason” in 18th Century Europe, had its roots in pursuit of happiness and liberty- sound familiar? For this week’s message I am borrowing the phrase to demonstrate how age matters. The practice of Oncology brings us in close proximity to octo and nanogenerians. This week the clinic saw several who, now vaccinated, are ‘enjoying” leaving the safety of home for healthcare. Unfortunately, the risk of cancer increases with age and some folks treated years ago now have new adventures to manage. You would think that having cancer would make this a critical time in their lives. It does not.

In fact, all the scary, threatening, life altering, and fear inducing events have already occurred. At this point they are resilient and philosophical. These patients, strikingly tough in mind, weak in body have many commonalities regardless of their strength, race, creed, sex and economic status. Most take this new diagnosis with a calm, accepting spirit. Their children hold the phone to record or have another sibling on the line. There is a sense of frenzy and fluster. The patient sits quietly, perhaps in a wheelchair, perhaps on oxygen, but usually, composed and resigned. The children or grandchildren wheel them into the exam room with wide eyes and pursed lips. The patient sits in calm peaceful resolve.

Its almost as if they are along for the ride. There are however, almost ubiquitous concerns: how will their family manage the burden of transporting them to and fro, loss of money needed for surviving spouse or challenged relative, will they need to move in with family, the impact on income lost by a care giver. Not thoughts of: will I lose my hair, be sick, or in pain, will I survive? Its almost exclusively about others. This week, the experiences were quite delightful. They each tap into my own philosophical approach to determine how best to serve their needs- health and otherwise. For three of them near or over 90, no treatment was recommended. There was chance it would cause side effects with no impact on longevity. I tell them all to see me in 6 months with another scan or sooner if symptoms develop. One quick witted man slapped me on the back as we left the room together and said, ‘Well Doc, thanks for giving me another 6 months, my kids have me in the grave but instead I’m goin’ fishin'”. We catch each others eyes knowing full well there isn’t a guarantee, but there is allowing his life to unfold as he wishes. Every single relative breathed a sigh of relief that a doc could really see the situation not the disease.

These super seniors are to be admired. They have a calm acceptance, strength and always concern for others. If we listen and respect instead of pushing and pleading, they teach us how unselfishness and generosity of spirit is all that ultimately matters. Enlightened? I surely think so.

100 Times per day

Joanne Dragun, M.D.3 Comments

Gratitude. Express it. Recently you’ve probably read that instead of saying “thank you” it is more meaningful to say “I appreciate you”.

As Einstein said, “A hundred times a day I remind myself that my inner and outer lives depend on the labors of other men, living and dead, and that I must exert myself in order to give in the measure as I have received and am still receiving.” Some have paraphrased this to say, “Einstein said ‘thank you’ a hundred time per day”. Is there a message here and what can we gain from this exercise?

A leading researcher of gratitude, Professor of Psychology and editor in Chief of Positive Psychology Robert Emmons, PhD (UC Davis) defines gratitude as a “felt sense of wonder, thankfulness and appreciation of life”. Basically, gratitude makes us happier and healthier. “Doc, what do I have to be grateful for? I have cancer.” Look at it this way: that change in your life makes it easy to express 100 statements of gratitude. Not just thanking people who support you, give you the therapy, drive you to treatments, make a meal, but even your body: your legs work, your eyes see, your thoughts guide, you have a wheelchair to get around, your vision may be poor but you can hear kind words, your thoughts may be confused but you know your loved one.

I recall an early awareness of this practice of gratitude. In first grade Sister Joseph Raphael lined us up in the hallway for the restroom (there were 98 in my class and no teacher’s aid) She would say, “Thank God for your kidneys”. I had no idea what that meant but there was “kid” in the word so I thought she meant the other kids in line (I was five) .

You express gratitude all the time but becoming more aware and deliberate in the process has benefits. Remember to be grateful for yourself too. Over your lifetime there are so many ways your body has healed or improved. Look in the mirror. Really look at yourself, not the flaws but the strength. Be grateful for your determination; you are fierce and you have the will to live. What you will find is that 100 times isn’t enough! Ultimately you begin to wash your brain of the negative and smile at the positive life affirming messages you can gift yourself every day.

Sister Joseph Raphael may have been overworked and not paid, she may have been praising God not quoting Einstein, but she knew what she was talking about. So now let me say, I am grateful for you.

Birthday Wishes

Joanne Dragun, M.D.

Celebration,balloons,gifts,cake (my favorite) and expressions of love and happy wishes. The month of May happens to be an especially busy time for my family. My husband (today!) mother, sister, Godson and grandson all share the Taurus sign (that is a significant amount of strong wills in one family (oops I meant strength!) Did you have a birthday this year? Of course you did so let me offer my own birthday greeting even if belated.

As spring blossoms and new life in all forms enjoy rebirth, we have an opportunity to savor the delicious day ahead. Having expectation is critical to a good life. Striving for happiness, connections, love, activity, valuable work, contributing to other’s wellness increases our ability to heal.

So here is to our immune systems providing for long and happy lives, not avoiding the pain and trials it may bring, but celebrating our strength and purpose. Gift yourself with a “re-birth day” with a list- not of things you could wish for, but of all the blessings you are grateful for. As you physically write your list envision how each and every pleasure, truth, joy, satisfaction, relative, friend, job and health is providing you with gifts.

Gratitude brings so many blessings into our lives. It can provide courage, vitality, wisdom, fortitude and peace. Enjoy the anticipation of an exciting future today then re-gift yourself with that thought every day. Plan for many re-birthdays!

Happy Birthday to all our loved ones and to you. Happy re-birth to many of you who battle cancer. You have a unique and special place in this world. Your amazing spirits teach us the value of living each moment. Everyday provides us all with marvelous opportunity. Take hold and don’t wait until the next year to celebrate you.

The Comeback

Joanne Dragun, M.D.

Even if you do not follow professional golf, you will be aware of Tiger Wood’s amazing comeback to win his fifth Master’s Tournament this month- his first major win in eleven years. A decade of surgeries, rehab, personal challenges, physical therapy, scandals, loss of sponsors, a truly challenging time when most would give up.

You can anticipate the parallels I see for us all. The victory by one stroke after days of competing, is being called a “miracle comeback”. As exciting as many are for this inspiring champion, even fellow golfers, Tiger’s win has implications for us. After all, patients treated for cancer are ever seeking their own comeback.

In the oncology clinic, Tuesday is a day for following up my patients treated over the past months and years. Everyone is so unique- not just the cancers or the stages, but how each of them has managed, thrived or succumbed to the disease. Some are capable of getting on with life, putting the impact of cancer behind them. Others are dealing with ongoing therapy (immune, chemo or radiation) and hopeful that the next scan gives them a break so they can regain some normalcy. Some have rehabilitated in new and exciting directions with changes in employment, education, having children and grandchildren. What every single one of them needs is hope and encouragement. Rooting for Tiger or not (generally I like an underdog whose life will change with a win and dedication rewarded), you cannot deny the profound message: “anything is possible”. He never lost faith in himself. He didn’t say that he was too old at 43 to push through the pain, he defied every naysayer.

I want you to resist your own fearful, scared voice. Tell yourself that you are a champion. Separate the cure from living- you can! Cancer isn’t who you are. It should not define you. See yourself as whole and hearty. The stronger you think the stronger you will be. Get up. Get out. Envision those muscles flowing with healing blood. Imagine the white light of strength surrounding and protecting you.

Just do it isn’t only a shoe company slogan. Its something you do everyday. You can do it isn’t just a hardware store advertisement. Get it done doesn’t belong solely to another retailer. It is something you can access everyday for yourself. Be a champion, have faith in yourself and your own comeback will be fierce.

Congratulations Tiger and thank you for the inspiration.

Sizing It Up!

Joanne Dragun, M.D.

One cubic centimeter of volume contains one billion cancer cells. Wow! That is a lot! Size matters always with cancer. The larger the tumors, the more readily they spread and damage other organs. As oncologists we are always screening for the small easily treatable disease to keep life as whole as possible.

Why then is bigger so often considered better: material goods like houses, cars, paychecks, property, gemstones even eye lashes?! The big vacations, star studded parties, glamorous lifestyles can all capture our imaginations.

Today I want to remind us all to consider size in a different way. Its rarely the big items (after our basic needs are met) that make us truly happy. The inner feeling of joy and contentment is available to us throughout our day in very small ways. How can we balance the huge diagnosis destroying our peace like cancer? Think of a balance scale. A large stone on one side tips the scale, but as we start to place small, even tiny stones opposite, balance can be regained and even tip the other way. So simple. A smile, hug, a breath without pain, a good night’s sleep, can only begin to balance if we pay attention to and appreciate them. Picture picking up a stone of relief and placing it on the scale.

I had my own awareness when I was driving down the street this Thursday at 6:35 PM. Cars stopped and the drivers were getting out and pointing skyward. Children on bikes jumped off to clap. Landscapers shut down and shaded their eyes to watch. I asked about the fuss. “It’s the Space X Falcon Heavy Rocket launch. Look Look!!” Sure enough I joined the crowd in the street to watch the rocket launched from Kennedy Space Station ( 150 miles South). It was obvious with its triple jet stream against a crystal blue sky. We all were enthralled. I assure you at that moment no one was thinking of their pain or life dramas. This tiny distant force (5 million pounds of thrust- the most powerful in the world) would have no direct bearing on our lives and yet it did. We were transfixed, excited, smiling and cheering. It was a gift, literally out of the blue.

We may not get to see rockets but we can all find that small moment that lightens our hearts and then we can find more and more until the balance of burden shifts. Try it for yourself. If you have heartaches or fear, find ten things today to witness and be thankful for. The next morning as I headed to clinic, I saw two distinct parallel white streaks in the sky curling downward- what could possibly fly like that? Sure enough it was from the recovery of the boosters side by side and synchronized, leaving their mark fourteen hours later, another gift and smile. Sally a patient told me this week, “I love to sit outside and look at the sky, squirrels and birds”. You can change the balance of power in your life everyday. The opportunity is often right in front of us.

Did you find ten joys today? Sharing can help other’s awareness. Joanne