Floating

Adventure is not my middle name. Not even close. I still do my share of new things. Plenty. Floating is one of those new things. I decided to try something new and purchased a series of floats at Float Madison. My adventure began as I left an icy, dreary, and drizzly January day behind for a womblike world of peaceful comfort, safe and soft.

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Float Madison offers floating experiences in either a small room or a pod.                                             Image credit: Float Madison

Floating has many merits. Professional athletes use it as part of training programs to let their bodies rest and recover. The Epsom salts used during floatation therapy give your body magnesium which supports muscle recovery and relaxation. Pressure is taken off your spine and joints which will help reduce inflammation. Creative thinkers and artists enjoy floating and feel it can help them reach their highest potential and expression. No one learns or performs well when in a stressed state. I can’t help but draw upon lessons learned from past students from my life as a teacher. Children can’t learn well who come to school tired, hungry, worried about friends, or afraid of looking stupid or embarrassed about something. We are all alike that way. Being relaxed opens up possibilities whoever you are and whatever you’ve chosen to do.

Being relaxed opens up more possibilities for me as a metastatic breast cancer patient. Space is created for emotional healing. I believe other toxic medication may work better if I’m not stressed out about treatments, tests, and the other challenges living with this disease throws at me.

The biggest draw for me is the time to just BE. It truly is the gift of nothing. You can’t get up and do that thing you forgot to finish (or start) earlier. You can’t quickly go online and then discover you’ve lost an hour you’ll never get back. No one will interrupt you. There is no one right way to float, so whatever happens is meant to be and is absolutely perfect. Perfect moments in my life are few and far between. I’d be happy with nearly perfect.

Just BE.

Here is a list of verbs used to describe a floating experience:

  • Unwind
  • Connect
  • Heal
  • Explore
  • Grow

Reread them. All are positive. All are affirming. There is no room for fear, doubt, or negativity.

I did far too much thinking during the float. Giving my body over to floating was much easier than I thought. I knew immediately I was not going to be the only person ever to sink. I was comfortable and safe. I focused on the sensation of the water gently meeting skin still exposed above water. It lapped unobtrusively and was barely detectable. A feeling of oneness with the water prevailed. With my arms resting above my head, my fingers pushed off from the top edge of the tank. I thought I was cognizant of when my body stopped moving, however, all motion was slow and delayed. A few seconds after I thought I stopped moving, my toes would bump into the bottom edge of the tank. Back and forth I went for some time at this because I was fascinated and like repetition. I also did a lot of experimentation with twisting and stretching, each time proving it was impossible to sink. Not being encumbered by any floor while doing all this was magical.

A deep bluish hue was the mood lighting in the tank. Pinpricks in the ceiling created a star effect. Calming music lulled my soul. A preset timer would eventually fade the music. Knobs inside the tank were my responsibility to push to turn off the bottom and ceiling lights. Then I would be immersed in the stillness of no sound and no light.

Pitch blackness.

I can be claustrophobic in the right settings (MRI tubes). It’s why I signed up for the ocean room rather than a floating pod. I wanted a little more room.

Woman of adventure that I am, I turned out all the lights.

Total darkness.

I was okay, more than okay. I knew where I was. My spatial awareness is quite strong and I could still feel where the buttons were for the tub and ceiling lights, as well as the dry washcloth if I needed to wipe salt away from my face. I splashed with my fingertips that made sounds of lonely drops echoing like they were dripping from a long distance. It was water music.

Floating is called the gift of nothing. I understood the concept of nothing while I floated. The point is to let go of all the inner chatter, not think, and have a meditative experience. Meditation would be a goal for another float.

I may have mentioned in an earlier post that living with metastatic breast cancer is stressful. The floating environment is not stressful. I entertained thoughts of how floating could be used to remove some of the stress I experience with the ongoing stressors in my life.

Could science, in all its exacting facts and structured design, turn the MRI scanner filled with all its anxiety and pounding sounds into a floating experience? No deafening noises. No breath holds. Freedom to make small movements. It would still provide precise and accurate results. Try as I might to imagine the current medical technology as a comforting cocoon, it is ineffective in many ways. Chances are if the floating tank was ever associated with a scan as part of cancer testing it would inherently turn into something stressful. Still, a girl can dream. Scheduling a float session after a stressful scan is a more realistic way to deal with the stress of scans and not associate it with scanxiety.

Floating can still be effective in reducing some of the emotional issues cancer creates like stress, anxiety, sadness, as well physical issues because it can relax muscles and ease tensions on joints. Less stress opens up the possibility of more healing.

Any moments I can get away and relax are important to me.

Many write posts of life after treatment ends. I’m always in a state of ongoing. The best I have are in between times. It is hard to find times of sustained peace, balance, and happiness.

I have become better at living in the NOW.

Now is all I have. Now is all any of us have.

Meditation has been only so-so effective for me. I do well when I meditate on a walk, through prayer, through writing. Sitting quietly works for me. Focusing on my breath often doesn’t. The next time I float I may try doing more of a guided imagery practice. Imagining and envisioning scenarios and outcomes have been successful. Visualization is a proven way to plan steps to reach a goal.

Floating was the first of several adventures I have planned. Stay tuned as more unfold. Maybe adventure could be my middle name. Just maybe.

Consider responding:

  • What is a gift of nothing you give yourself?

 

Cancer Research Lab Tour

I had the opportunity last week to tour the Burkard Lab for Breast Cancer Research at the UW Carbone Cancer Center. Dr. Mark Burkard is one of the oncologists there. In addition to seeing patients with breast cancer, his research interest is in targeted therapies, especially those directed at protein kinases. He also heads up the Outlier Study in addition to work in clinical trials. It’s his lab that I toured.

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Burkard Lab for Breast Cancer Research, UW Carbone

My working knowledge of cancer started when my mother was first diagnosed with primary breast cancer. I learned a lot more years later when hers became metastatic and with my initial diagnosis of metastatic breast cancer in 2012. A period of time exists between then and now where lots of information has blurred. Science never was my strongest subject. I’ll do my best to summarize what I understood from the evening’s tour. Beware of technical difficulties.

The lab tour was guided by graduate students and research team members through several stations in the lab much like learning stations would be set up in a classroom. The structure lent itself well to guiding a group of people through areas in smaller groups to provide a more personal experience. Snapshot descriptions of each station follow.

Cell Division Station

The first station was led by graduate student Roshan Xavier Norman. He explained how erroneous cell division can cause lagging chromosomes that form a micronucleus. This micronucleus doesn’t have all the material it’s supposed to have. It can lead to cancer if a cell doesn’t have the same nucleus material as the others. His work involves staining proteins in cells and looking at them through expansion microscopy. This enables him to see molecular structures at high resolution and see the difference between normal cells and abnormal cancer cells. He talked at length about chromosome segregation, spindle abnormalities, and differences in cells from mitosis that were damaged because of lagging chromosomes during DNA replication. It became very technical for me to understand, but the gist I took away was he was being successful in pinpointing these errors in cell division and there are applications to research.

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Expansion micCell Division in Various Stages

Outliers Study Station

Rob Lera, PhD, is a research associate and has been with the Burkard Research Group since 2009. He talked about the Extreme Long Term Survivor Study. The goal of this study is to identify patterns that attribute to long term survival in metastatic breast cancer patients. This study is also known as the Outliers Study because despite the odds, there are metastatic breast cancer patients living well beyond the expected two to three years median survival rate when diagnosed. There are two survivors still going strong by surviving greater than forty years, one of whom was on the tour that night! I felt like I needed to go and rub up against her for luck. Fifty of the longest survivors since their original primary diagnosis have been surviving from 22-42 years.

Data on participants in this study are gathered through extensive paper/online questionnaires, phone interviews, saliva kits, and extracting tissue samples. Most participants are HR+ Her2 – but there is representation from all MBC subtypes. Then it is all analyzed for patterns.

Preliminary results can be found HERE.

It appears the only conclusion drawn so far is there is no apparent correlation between exercise and time living with cancer or metastatic breast cancer. Cancer is so individualized. My personal opinion is that the 720 participants in the study surely must have done things outside the medical box and thrown some of the medical advice out the window to still be around today. I need to think outliers didn’t get where they are from playing by all the rules. It sure would suck if there were no correlations at all and extreme long term survival amounts to pure luck.

I was discussing some of the possible factors determining survival with one of my friends on the tour who has a nursing background and we unscientifically agreed that if an individual thought something made a difference, then it made a difference. I happen to believe the daily exercise I do now makes a difference in my health. I exercise daily and get my 150 minutes each week, usually more. Feeling like I’m doing something positive in terms of my health matters to me. Belief is a powerful medicine. It is one of many attributes and patterns that can’t be measured through this study.

I filled out a preliminary survey for the Outliers Study and felt I provided lots of information on why I feel I’ve survived so far. I am one of the little lines on one of their charts. I haven’t survived long enough to be interesting enough for further study. Someday I will be.

Patient Derived Organoids

Rachel Sundstrom is a research specialist with a degree that’s focused on biochemistry, cellular and molecular biology. Her work involves analyzing patient derived organoids (PDOs). PDOs are cancer cells from patients with breast cancer tumors that are grown in a 3D model. They mimic the biological characteristics of the primary tumors. I think this is what she meant when she talked about organoid morphology and how she is working with different Taxol concentrations that cause cell death, trying to find the just right level for that to happen.

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I had the opportunity to look through the microscope at a sample PDO.

All this work is worthwhile. I spoke to another friend the day before this tour and she told me about experiments where cancer cells were taken from a patient’s body, grown in separate petri dishes, and then various chemotherapies and targeted therapies were tested out to see which treatments the cancer responded to best. I asked if this type of work was being done at Carbone. No, it isn’t. Well, I responded that’s the direction I felt research needed to take. She said some work similar to what I had asked about is being done at the colon cancer lab on campus headed by Dr. Dustin Deming. I have met Dr. Deming and heard him speak about his work with colon cancer treatments. He told me there are some crossovers that may be applicable to breast cancer. Anyway, I made it clear I wanted that kind of work to happen at this lab. Why wasn’t it being done?

It’s expensive.

My response: Yes, research is expensive. People die. That has a cost, too.

I hope my comments were heard and get discussed further elsewhere in the context of future projects being planned. I know a handful of people on the tour that evening had metastatic breast cancer. We were there because of our health and want to live. We support research being done. We want to be outliers. I was not there just to learn and pat them on the back. I want to drive change.

It seemed like the perfect opportunity to communicate, “Is this being done? I would like this to happen here. When will it happen?”

I felt a little like it was the elephant in the room.

I wondered if I was the only one seeing it.

Immune Response Station

Yang Hu presented his graduate work on the effects of Taxol on activating an immune response to cancer cells. T cells are a type of white blood cell that are important to the immune system. They are important because they can adapt and tailor a response to specific pathogens. These cells are often likened to soldiers that target and destroy bad cells. The challenge is to get these T cells near enough to the cancer cells in order to kill them off. His work is showing that paclitaxel/Taxol can stimulate T cell immune responses for some people. His sample size is small, however, there may be a small pattern emerging where triple negative breast cancer (TNBC) patients have responded more to this type of treatment than other breast cancer subtypes.

I would like to know what goes into the process of determining which projects get accepted and researched. The lab was interesting to see. In my mind I pictured it as being very spacious and sterile, filled with high tech equipment, cold, and lots of white. People would walk around wearing lab coats, goggles, and gloves. That’s how TV and movies depict research labs. It wasn’t at all like those images. Every nook and cranny was used. It was crowded with color. I was reminded of how I used space in my old classroom.

I am grateful that these researchers are using their time and talents to dedicate their lives to breast cancer research. Teaching hospitals often have tours of research facilities as it’s one way to promote their work and thank donors who’ve helped make that work possible. My suggestion is it’s well worth your time to find one to tour, learn about what’s being researched, and ask the questions that matter to you. Do some research!

Top Character Strengths

“Our ability to handle life’s challenges is a measure of our strength of character.” ~ Les Brown

Life is challenging. Some folks seem to have more challenges than others, but we all have challenges. A lot has been thrown at me thus far that I’d rather not have dealt with at all. I’d like to think I have continued to grow for the better through challenging times. Chalk it up to an inherent teacher trait that I always need to learn something from situations, regardless of whether the situations are good or bad. I’ve become more hopeful, determined, and resilient over the past several years. I am grateful for these gifts and the opportunities I have had to use these strengths. These are amazing traits, but I am not sure I would have chosen them as main character strengths before my cancer diagnosis.

I would have put kindness, positivity, and a good sense of humor at the top of my list.

Being kind is what I try to show the world and what I expect from others. Our world needs more kindness. I can find a positive perspective in just about anything. Even if something sucks for me, I recognize it as truth and allow myself to be there for a while. My sense of humor has brought a smile to my face when I’ve needed it.

Not everyone gets my jokes.

How we see ourselves, how others see us, and how we truly are may all be the same or different. It’s natural to see ourselves how we want to be seen. Circumstances factor into how we are seen by others. I believe we are a mix of so many traits that are fluid and dependent on what is needed. My virtuous side may shine in the public eye, but I may need to channel my stealth if I were to plan the next great diamond heist. Luckily, I have more of an attraction to pearls. My theme here today is on character strengths rather than weaknesses, so I’m determined to stay on topic and not focus on unflattering qualities. I have those like we all do.

I stumbled across research on character strengths while doing some reading about happiness. A company that researches character strengths referred people to their website for anyone interested in identifying their top character strengths. The idea is to know your strengths so you can use them effectively. It takes about fifteen minutes to rate yourself on how much you fit various descriptions. Directions include responding to how you feel you are and not how you want to be, although I’m sure there is personal bias involved. How could there not be?

According to their research, they assert that people who use their strengths are 18 times more likely to be flourishing and happier than those who don’t know or use their strengths. Flourishing! I wanted to find out what they deemed my strengths and see if I agreed since I want to flourish as much as possible.

According to results, my top three character strengths are perspective, spirituality, and humor.

Perspective

The ability to see the bigger picture and what is best for a situation was my top strength. I can see the big picture but am also detailed oriented. Some describe this as seeing the forest and the trees. I think being able to think mindfully about situations has helped me consider the advantages and disadvantages of a situation. Having made my share of mistakes and learning from them also has developed a sense of knowing that comes with looking at different viewpoints. Having different ways of looking at the world helps make sense of it.

Seeing alternate points of view is important. I can apply this to my own life in a way where I listen carefully and weigh all possible sides. It’s harder to do when there are heavy health decisions to be made. The best options moving forward may involve hard parts but still be in my best interests. How will treatment options and side effects affect my quality of life? What are the chances of success? Am I a good match for a proposed treatment? Why is it being suggested for me? I make a lot of pro and con lists. I weigh some factors more than others. I look at the facts I have. I consider my feelings. I ask the people I trust for input and their valued perspective.

Careful listening is needed to understand and value perspectives different from yours. Doing research so I can make informed decisions is important to me. Asking questions fits here too. I won’t discount intuition because even after all the research has been gathered and all the questions have been asked, there is a feeling about what the right choice is for me.

Spirituality

Spirituality was my second highest strength. It reflects a sense of meaning and purpose in the universe. It’s a search for the sacred whether that’s secular or nonsecular.

I was surprised this strength ranked so highly. I used to identify very strongly with spiritual ideology and concepts around faith. It’s been shaken. I don’t believe having cancer has shaken it as much as the rigidity of the religion that I’m a member. I question more and I believe questioning is good. I am not going to narrow the sphere of spirituality to religion. Spirit to me has become a much larger force and a person’s chosen religion or choice not to be religious doesn’t determine a person’s faith, spirit, or worth. There is no one way for everyone to be spiritual. We each find our own way.

How can I use spirituality as a strength living with cancer? I know I am more than this body where I currently reside. My views on the afterlife have evolved. I have pondered a great deal about the meaning of life that influence my choices and give me peace. There is some sort of transcendence at work that allows me to connect to something greater. I have a peace journal. I meditate. I pray. I engage in discussions about faith with close friends. I feel a connection to the universe when I’m in nature.

I can still talk to my parents and feel their presence. I talk to God daily. I let myself be quiet and I listen to the stillness.

Humor

I’ve always found situations amusing. Sometimes not at the time, but I could laugh at them later. It seems I can make other people laugh even if it’s not my intention. I will choose a comedy over a drama. Children and their natural shenanigans are gold mines for humor. Stephen Colbert and his writers craft a masterpiece nightly with his monologue that has made the past couple of years more bearable. I have become a fan of good political satire. I love being around people who can make me laugh. It’s a quality I look for in strong relationships.

How can I further use my sense of humor as I live with cancer? It’s very useful in dealing with stressful situations. Cancer is stressful. Seeing the lighter side in a situation reduces stress. A person living with metastatic breast cancer faces a lot of adversity ranging from medical obstacles, social relationships, and navigating through it all off road because it is a wilderness. A good sense of humor has the potential for transforming something negative into something positive because of a shift in perspective. My former oncologist and I had such a good chuckle over a theory a radiologist gave about why I had severe muscle cramping to the point of hospitalization. His theory was I wasn’t moving around enough in the MRI tube. It is just absurd! There isn’t ROOM to move around in there and you need to stay motionless for the imaging to be accurate. The radiologist knows a person can’t move around in there. I shared the story with my oncologist and he said, “What are you supposed to do – jog around in there?” The stupidity behind this utterly false theory is astounding, but the image of jogging in an MRI tube cracks me up every time. Being in good humor doesn’t necessarily mean you are laughing all the time. It’s more of an outlook you carry with you.

How a person handles life’s challenges certainly is an indicator of their character. I will strive to handle mine with a perspective that affords me meaning, a sense of humor, kindness, positivity, and a dash of grace if I can get it.

 

Consider responding:

What do you feel are your top character strengths?

How do you apply your strengths so you flourish and make the most of them?

Click here (viacharacter.org) if you have an interest in completing the survey for yourself to learn about your top character strengths. It’s free to take and get results. I am not affiliated with them in any manner.

End of a Decade

 

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Image credit: pixabay.com

December not only ends another year but it will finish a decade.

2020 is days away.

What has made history since 2010?

A lot. The world is a big place and I will leave out many events. My perspective is primarily through the lens of someone living in the United States. There have been cataclysmic forces of nature that ended lives. Gun violence has become common and largely ignored. I’ve included advancements in technology that have changed our lives for better or worse. Many events happened that aren’t mentioned here. The following is a mere sampling.

The decade got off to a horrific start. Haiti was devastated by a magnitude 7.0 earthquake on January 12, 2010. It left more than 316,000 dead or missing, over 300,000 injured, and over 1.3 million homeless.

The first iPad came out in April of 2010.

On April 29, 2011, over 22 million viewers watched Prince William marry Kate Middleton.

Many viral challenges came and went in the past decade. The Ice Bucket Challenge raised over $115 million for ALS awareness and research during the summer of 2014.

The world argued over whether a dress was black and blue or white and gold in 2015.

Apple also released racially diverse emojis in 2015.

The Supreme Court ruled that gay marriage was legal on June 26, 2015.

The largest single-day demonstration in U.S. history took place on January 20, 2017, to support gender equality, civil rights, and other issues that affect women. It was called the Women’s March and drew over 5 million people in over 600 marches across the world. Reportedly, around 500,000 people were in attendance at the Washington March.

On September 20, 2017, Hurricane Maria struck Puerto Rico. The Category 5 hurricane caused a major humanitarian crisis to Puerto Rico’s 3.4 million residents.

A total solar eclipse was visible across the U.S. in August of 2017. Another one won’t be visible until 2024.

The most diverse class of lawmakers in history was sworn into Congress in January of 2019.

Astronomers captured the first image of a black hole on April 10, 2019.

Donald J. Trump became the 3rd U.S. president to be impeached on December 18, 2019.

What has the last decade been like for me personally?

I sold my condo and moved into a beautiful home in 2010.

I planned to become an adoptive parent. Cancer had other plans.

I was diagnosed with metastatic breast cancer in the spring of 2012.

My mother died from MBC in April of 2013.

I taught for the first six years of the decade which I found blissful, purposeful, and frustrating. I went on medical leave from my job in the fall of 2016 and officially retired from a teaching career in June of 2018.

I started this blog on August 25, 2018.

Cancer sucks and it has consumed far too much of the decade and taken far too much of me. But I’m still here.

It’s easy to say fuck cancer and that the last decade sucked. I do say it. Things often undeniably suck in a very fuckful fuckable fuckety way.

A Triple F if you will.

It’s harder to embrace all the goodness and joy that abounds when you are living with a deadly disease. Amazingly, I have felt profound joy and happiness when I have been filled with feelings of love and something divine out in nature. I have basked in the warmth of time spent with dear friends. I have been inspired by encouragement and support from my family, friends, and strangers. I have been filled with prolonged moments of peace.

This decade has been harder for me than I ever could have known. I will move forward into 2020 with the intention to continue living in love, hope, and light.

What advances have there been for treating cancer over the last ten years?

I became overwhelmed trying to sort through information. Many drugs that have been approved for one kind of cancer have also been effective in treating a different kind. There are different approval dates based on different indications. Some drugs work well in conjunction with one another but didn’t start out that way. Some drugs have different FDA approval dates based on changes in dosing. Fulvestrant is one of these – it’s been around a long time but receiving a high dose (fulvestrant HD) when first receiving this drug makes an old drug better. This change has been approved within the past couple of years. New combinations are being tested in trials every day. I can’t do justice to all the approved breast cancer drugs in one post. I encourage those interested in learning more to visit the National Cancer Institute and Food and Drug Administration to conduct your own searches.

As I nosed around on FDA.gov, it looked like there have been over 20 approved drugs for treating cancers in 2019 alone. I don’t know how many of these are applicable to specific breast cancer or metastatic breast cancer settings. It was part of my feeling overwhelmed.

Back to the last decade and the development of drugs to treat breast cancer.

I begin with these caveats:

  • Information provided is true to the best of my knowledge.
  • The first known FDA approval date is given unless otherwise noted.
  • Drug names are listed first followed by brand names.
  • Keep in mind, this is not a complete list.

Just for fun, here are a few drugs from the 90s that are still widely used today:

  • anastrolzole/Arimidex  1995
  • letrozole/Femara  1997
  • trastuzumab/Herceptin  1998
  • capecitabine/Xeloda  1998
  • exemestane/Aromasin  1999

Early 2000s:

  • fulvestrant/Faslodex  2002
  • lapatinib/Tykerb  2007
  • everolimus/Afinitor  2009 (2012 for MBC)

And finally, here is a snapshot of what the last decade has seen in FDA approved drugs for treating breast cancer:

  • eribulin/Halaven November 2010
  • capecitabine/Xeloda September 2013
  • gemcitabine/Gemzar (2004) with carboplatin  2015
  • palbociclib/IBRANCE  2015
  • neratinib July  2017
  • abemaciclib/Verzenio  September  2017
  • trastuzumab and pertuzumab December  2017
  • alpelisib/PIQRAY  May 24, 2019
  • trastuzumab deruxtecan / Enhertu is the newest drug available to treat metastatic breast cancer with FDA approval as of December 20, 2019. Read about this latest advancement here.

Tucatinib also is showing a lot of promise for those with metastatic breast cancer. From what I’ve read or heard, this is still in trial status. If my science friend Pauline is reading this and would like to drop some science on us, please comment below and share in language we understand and can take to our oncologists.

I started my cancer life on a regimen of doxorubicin /Adriamycin (approved in 1974) Cytoxan (approved in 1959) followed by paclitaxel /Taxol (approved in 1994).

No new drugs were approved between 1974 and 1994. How is that true?

As I look at the lists of drugs above it seems abundantly clear I would not still be here without the advancements of the last decade. So many targeted therapies have emerged and many more are in the future. Research is responsible for these advancements. I have been on many of the drugs listed above. I need more options that will specifically target mutated cancer cells in my body. I believe in research happening at UW Carbone.

My medical background is that of a patient. Gone are the days when I say I don’t have a medical background because I have had quite an education. I don’t have a degree, but I have a background. Unfortunately, the past decade has schooled me through first-hand experience. I bring that knowledge to the table and to each office visit. I plan to keep bringing it.

And I will find a way to bring it wherever I find myself in 2020.

Happy New Year.