Face Fear

What I’ve learned about fear over and over again is that the anxious anticipation of something is always worse than the event itself. There have been conversations I have dreaded and events I was sure would result in my getting the short end of the stick. The events happened and life went on.

One of these events was returning to chemotherapy back in the summer of 2016. I wanted to avoid this option like I want to avoid a bad cold, negative people, and raw seafood. It was my second experience with chemo – an unwanted sequel to that of years earlier. Eribulin was the name of the chemotherapy drug to be used. It is a cell cycle specific drug that attacks something called the microtube structures within cells. These microtube structures help a cell divide and reproduce. Stopping the microtube structures from functioning results in cell death. Goodbye cancer cells. Normal cells grow back.

I was terrified of effects like I had had when I had chemo back in 2012. I threw up so much after the first infusion back then that I needed to go to the hospital for fluids. I contracted fungal pneumonia and the shingles a couple of months later that landed me in the hospital. I gained a lot of weight due to steroids to battle nausea. I was lethargic and my mind was in a fog for months after the treatments ended. I knew what going through chemo was like and it was something I really didn’t want to repeat.

But it was my best option.

The day came to receive the first dose of eribulin on July 26, 2016. No throwing up, no nausea, no lethargy, no weight gain. I lost my hair again and was without it for over three years because of this drug and the drugs that followed. That reality and my feelings associated with it were difficult to navigate again. Otherwise, I felt unbelievably good. I had energy and could focus on activities that I enjoyed.

The weirdest thing happened once I faced my fears of having chemotherapy again and started treatment. Without the fear, profound moments of immense peace, joy, and intention took hold of me. The depression I had struggled with lifted when I went off the oral chemo pills I had been taking. I wasn’t teaching at his point in time, but I didn’t feel depressed. In fact, eribulin was a new lease on life. Every day off work was a day closer to coming back. I didn’t realize at the time it was the end of my career. My feet didn’t hurt with every step. I could walk again. I could hike.

Fear is almost always worse than the event itself. The fear I held about doing more traditional treatment again was worse than the reality. The eribulin wasn’t difficult to receive or tolerate. It was pushed through a syringe over two to five minutes. I didn’t feel a debilitating loss of energy and almost no nausea. For the first couple of months, I found I actually had lots of energy and felt wonderfully healthy (aside from needing chemotherapy in the first place). Low white blood counts were an issue, but that was a common problem encountered with many cancer treatments.

There are new fears. It’s a repetitive cycle every time I start a new treatment. What side effects will I experience? Will this treatment work? Lots of “what ifs.”

I have a lot of fears of treatments not working.

Fears of not having options.

Fears of my team not caring enough.

Fears of getting worse and losing my independence.

Fears of lots of things that make me cry and those thoughts make me feel unsafe and very alone.

And then there are the fears that my lovely hairstyle will always look like I’ve electrocuted myself. It has calmed somewhat over time. That one makes me smile and brings me back to where things are okay. My curls remind me I have no control and the straight and narrow never was my path. I’m unruly like the clouds in the sky. My hair feels comforting.

I face fear every day as someone living with metastatic breast cancer. The fear of having MBC has become so commonplace that I know it’s there, but I try not to think about it and I give it the least amount of space possible if I have to think about it at all. I face it down and get on with my day. I face fear like I face the mirror in the morning. Some days it takes more work.

Every so often I sit with it. We talk. Mostly I feel. Then I’m done. Until it resurfaces.

Fear has been on my mind more than usual lately. There are more unknowns. My biggest fears revolve around cruel consequences if my treatment is affected because of COVID-19. These unknowns could severely impact my other unknowns. I’ve hunkered down as much as I can and it still might not be enough. I began this post writing that the anticipation of an event is worse than the event itself. This virus may be the one scenario where that isn’t true. I don’t know. It will continue to play out over time where one domino affects another, even if the dominoes at first seem unrelated. Facing fear does not mean to act willfully stupid. It doesn’t mean you roll the dice and take your chances. Facing fear means being informed and having a plan. Right now that plan involves choosing the most protective option in all my decisions. I will continue to face the fear in my life by making smart, well thought out decisions. I will be grateful in my belief I am staying safe. I must believe hope is more pwerful than fear. And it is.

What Coronavirus Means to Me

I never thought I’d see a pandemic happen. It’s 2020. We live in a world where medicine, technology, and people working together are supposed to prevent something like this from happening, certainly from spreading.

But here we are.

I also thought I wouldn’t write about this topic. But it is everywhere I go – or don’t go to reflect life more realistically.

News changes rapidly. I wrote this post on a Friday to post on Sunday at its usual time. I hate to wonder what might change in the interim.

I have a much higher chance of dying from coronavirus than a healthy individual should I get it – a 79% chance to be exact – because of cancer. I would be one of the ones not given a ventilator if I needed one and there is a shortage because of others who would have a stronger chance of surviving. A ventilator shortage is something I don’t want to think about for anyone.

I am one of many. I know people who have respiratory issues, diabetes, heart conditions, and others with cancer. I have friends who are worried about their children with health conditions. I know this affects more than just me.

It affects ALL of us.

I should be freaking out. I am fearful, yes, but fear is present in my life anyway. I minimize that fear where and when I can. I’ve been doing it for a long time. I am surprised that I am as calm as I am.

My treatment took place as planned last week. The hospital had an excellent plan in place that I could see at every level of my visit ranging from the parking structure to my treatment. I hope my health continues to be as high of a priority in the future as it is now for the doctors and staff who care for me. I do have worries how my life living with cancer might be affected. I am concerned there may be delays or unplanned breaks in my treatment and changes in my protocol out of what is deemed by an institution as best for me. That may be an entire post on its own.

Living with metastatic breast cancer has made me better prepared for this than I thought it would. I am high risk.  As the virus continues to unfold, this is what I’ve discovered about myself.

I am good at social distancing.

Isolating myself isn’t really new for me. I have stayed home from activities before because I might catch a cold or the flu. I have canceled plans with friends to be safe. I haven’t hugged people, high fived, or shaken hands. Visitors have used separate hand towels. I moved off the sidewalk to the street when I encountered others on a walk the other day. I offered a friendly wave but no explanation to these strangers. It’s better for me to be safe than sorry and I will keep my distance. Literally.

I am prepared if I get sick suddenly.

Or as prepared as I can be. I may be more prepared than the average person, but I am not sure that’s true in these crazy times. I already had several days of non-perishable and easy to prepare foods stocked if I were to catch something from someone or if I were not feeling well due to cancer. I shopped early on and stocked up on cold medicines, cough drops, lots of choices for multi-symptom relief for diarrhea and stomach discomfort. I always have more toilet paper than one person probably needs. I know my current side effects. I know my needs.

The news changed about a month ago to when – not if – the U.S. would be hit with coronavirus. I made more plans for what I needed and have plenty of food to last me and other supplies. It took several trips to find hand sanitizer, but I eventually found some. I completed my first online grocery list and will do curbside pickup later this week. I still think there are advantages to choosing my own groceries, but I’ll see how online ordering goes and will decide later what to do another time. I likely will make an early morning trip here and there for milk and eggs, but I have powdered milk and a frozen quiche if the situation worsens and I can’t. Some panic oozed into a couple purchases. I guess I am okay with a degree of panic in unknown situations that change day to day. I have a solid plan for the time being and I am a good planner. On to point number three . . .

I plan my life around side effects.

Based on past treatments, I knew when I could schedule something fun or do necessary errands on days when I wasn’t hit with side effects. Fatigue and nausea could be predicted. Low white blood counts could be predicted. Insomnia and days of hot flashes and the chills all could be predicted.

My plans now revolve around oncology appointments and treatments. Keeping those are a top priority. I will move mountains to stick to my treatment schedule. Every other event or activity I’ve planned has been canceled. Not my treatments.

I am good at occupying time on my own. My home activities include:

  • Reading
  • Writing
  • Making cards
  • Exercising
  • Meditating
  • Writing thank you notes
  • Talking on the phone
  • Playing piano
  • Finger painting (have the paints but haven’t done yet)
  • Touch up painting on walls and trim (always low on my list)
  • Decluttering and Organizing (sadly also rather low on my list)
  • Watching TV and movies
  • Puzzles
  • Walking outside by myself if weather permits
  • Hanging out in my sauna
  • Practicing Reiki
  • I even have a microphone and a very small sound system where I can change the voice effect (harmonizing, choir, echo, robot) when I feel like singing at home where no one will hear me.

I have control over what I do and where I go.

I have had lots of practice at this. I have gone days, even a week here and there without seeing people or having face to face conversations due to my health or the health of others. I have made decisions to cancel plans that I haven’t wanted to cancel but it’s been in my best interest to do so. All my practice has made me good at it. I know how to stay as safe as possible during a crisis like this. It sucks but is the right move for me.

It’s the right move for all of us.

Temporary changes will have long term benefits.

It only takes one to infect many.

Stay home.

Don’t travel.

Go for a drive or walk outdoors on your own.

Don’t be a carrier or feel you’ll be okay if you get it because you’re healthy. The elderly and those with preexisting health conditions are not expendable. We matter. We are loved.

You matter.

For the love of God . . . cough and sneeze into your elbow.

Wash your hands or hand sanitize after blowing your nose.

We need to work together by staying apart.

What does coronavirus mean to you?

Taking Risks and Ospreys

Two years ago, I saw an osprey on a warm summer day. It landed squarely on a small tree right in front of a window in my family room. There couldn’t have been more than six feet between us. It should not have been there at all because these birds like water areas filled with fish. A small pond is located a stone’s throw from my home, but I have never seen anyone fish there. Yet, there on a very obvious branch perched an osprey for me to see it. It got my attention. Right away, I knew it wasn’t a red-tailed hawk or a peregrine falcon. I had no clue what it was, but it edged closer to my window for me to observe for around twenty beautiful seconds. We stared at one another. Moments later it spread its wings and flew away. I grabbed my bird book and took to the internet to find out what I saw and what the sighting meant.

osprey-pixabay4059786_640
Image credit: pixabay.com

I learned ospreys submerge their entire head underwater when preying on fish. They symbolize that you can be very much out of your comfort zone (or usual environment) . . . and survive. These birds teach us to take risks, not be frightened to take risks, even if opportunities seem out of reach. Although all birds are messengers, ospreys bring awareness that an important message is on its way.

They remind us:

YOU are ready.

YOU are skilled.

YOU are fearless.

The rest is up to us.

Like the osprey, I have been very much out of my comfort zone and survived.

I have survived many things. I have survived chickenpox, many flu viruses, and other illnesses. I have survived bullying. I have survived airports and air travel. I have survived chemo and a myriad of other treatments and side effects. I have survived tornado warnings and personal emotional storms. I have survived the pain and grief that follows the passing of loved ones. I have survived many challenging students in the classroom, and they have also survived me. Surviving cancer is just one thing I’m living with and doing my best to survive. I am so many things, as we all are. Being a survivor is just one part of me. I’ve changed, but I call myself a survivor because I am still here.

Taking risks is part of living a fulfilling life. Some look at risks as adventures. Some thrive on danger. Some choices in life don’t seem to be choices, but rather the only choice you could make at any given time. I felt like this when choosing my first round of chemotherapy. I felt it again each time I needed to move on to another treatment regiment. It seemed I didn’t have much choice because the alternative was an outcome that wouldn’t work well for me. I feel like the past seven years have been an exercise in risk. Each treatment is a risk.

I’m risking my life in order to stay alive.

It’s hard. I get tired. And yet, I know I’m worth the risks I take. I want to be healthy and happy.

There is something missing. I’m so focused on staying well that I don’t have much time for anything else. The risks of sky diving or strolling by my lonesome through prime lion habitat don’t appeal to me. Developing a gambling addiction also isn’t the kind of risk I want.

On the one hand, I’m torn between not wanting to do anything, go anywhere, or see anyone who may put my health at risk. Parents who choose not to vaccinate their children for flu or preventable diseases could have life-threatening consequences for me. I must be over cautious. I can’t afford to take much risk in regards to my health. I am always going to base health decisions on scenarios with the lowest risk aligned with the greatest outcomes. Nothing is a sure thing. It all carries risk.

We all take risks in hopes of gaining a desired result.

But there’s the other hand. I don’t want to pass up chances to go out and have fun! I don’t want to put self-imposed limits on myself because I am unsure what I’m capable of achieving. I want to live with passion and purpose, to continue to learn and to lead, to change and to grow for the better.

There is some element of calculated risk in every choice we make. Some have bigger impacts than others. There are people who interpret risk as an opportunity, and others who see it as an assured failure. These are not the same people.

Taking risks has benefits. The most obvious, of course, is being rewarded with your goal. People who take risks are said to be more adaptable and they try more new things. They do not see failure as failure. Failure is an opportunity. They learn from these opportunities and bounce back more quickly compared to those who view unsuccessful risks as failures.

Risk-taking involves moving past fear in pursuit of what you want.

Fear prevents you from taking chances. Fear keeps you stuck. Life continues to happen if you choose to stay stuck – that’s still a choice. Taking a risk involves ignoring possible judgments from others. It may mean standing on your own, pushing past self-imposed boundaries, and doing something outside of your comfort zone. I don’t think it’s so much of a “no pain, no gain” philosophy. It’s more of an “if you always go with the flow, you never grow” mentality.

How might someone incorporate a little more risk into his or her life?

Pick a few from the list or come up with your own:

  • Explore a new town.
  • Ask for what you need.
  • Sign up for a ropes course.
  • Give someone new a chance.
  • Take a class to develop an interest.
  • Order something different at your usual restaurant.
  • Write or talk about emotions you find hard to process.
  • Ask more questions at your next medical appointment.
  • Respectfully disagree if you are misrepresented on an issue.
  • Share an honest opinion in a place where your view may not popular.
  • Make an appointment with a therapist if you know you need extra support.
  • Risk being rejected, turned down, the possibility of failure, or hearing NO.
  • There’s always sky diving if that’s really something you need to do.

Sometimes the biggest risk we take is not taking one.

Back to the osprey.

My head is submerged most of the time as I keep exposing my body to ongoing treatment. I’m definitely out of my comfort zone. The outcome has surprised me. It is one more thing I have come to accept. The big risk with treatment is it may stop working. That risk is worth it to stay healthy. I’ve learned I can take these risks even when they frighten me down to my bones.

The opportunities I have to be healthy are not out of reach.

It is why I keep my head submerged.

A Moment in Amsterdam: Fear Alley and Stress

Alleys are narrow. I envision them as dark, lonely places, filled with scary things and unpleasant smells. Forgotten garbage litters the ground. Feral cats and large rats compete for scraps. Alleys potentially are filled with scary people who I’d like to avoid meeting. I wouldn’t be excited about the cats or rats either. They are not safe spaces. No one hangs out in an alley because it’s relaxing.

Back in my youth, I was much more adventurous. I found myself exploring Amsterdam for a few days on my own. I loved it there. The colors of flowers from the numerous flower markets were intense. I took canal rides to tour the city. I lost myself in a VanGogh museum. I relaxed in a beer garden and wrote postcards. The Anne Frank House where Anne hid from the Nazis for two years was transformative. The tourist in me took in everything possible. I may have mentioned in an earlier post that I make an excellent tourist. I even let a stranger buy me a drink and joined his family for dinner one night.

Amsterdam is also known for its nefarious red-light district. I figured it was fine to see during the day. My plan was to turn around if I felt it wasn’t safe. It was an easy walk to that area. I felt plenty safe but was very much out of my element. Gradually, I became aware I was one of the only women in the area not “working.” Women didn’t seem to be outdoors at all. I could not imagine what the area was like in the dark of night. It was time to turn around, however, I did not relish backtracking through what I had seen.

I spied an alley to my left. At the end of the alley rose a tall church steeple. Surely, I would be in a better environment if I took this shortcut. I couldn’t see anyone lurking about there. It was a short distance. It couldn’t be too bad. Weighing my options, I decided to do it. Was it a good idea? Yes and no. I had to use my hands to shield my eyes from windows on both sides that featured more things I didn’t want to see. I walked with a determined pace that was almost a run. I emerged from the dark alley back into the open sunshine and was thrilled to discover the church steeple I had seen was now a building that sold Christmas decorations. Perfect. I found a different route back to my room.

Where am I going with this?

Sometimes walking down a narrow, dark alley may be the only way to find the light again.

From time to time, something scary has to be experienced in order to get to a better place. The scary thing can be unplanned, unavoidable, and unravel life. Fear can stop us from pursuing or reaching our goals. Fear can stop any meaningful movement forward. Fear can keep us unwell.

I have had a lot of practice with fear as someone living with cancer. There has been information to process and digest. Decisions have been made. Many appointments, tests, and results have been faced that I would rather not have had to deal with at all. The process has repeated over and over with revised information, more decisions, and so many more appointments. Life has been filled with uncertainty in the same way as not knowing what may be lurking and waiting in an alley. It seems I’m always adjusting and adapting. I face all these hurdles because not facing them is more fearful than facing them. The distance has been much longer than what I walked in the alley in Amsterdam.

Functioning well in what I call Fear Alley for the long run is too hard. Bodies in a constant state of stress do not recover. Cortisol is known as the stress hormone. Living in a state of chronic stress where cortisol levels are always elevated affects health negatively. Living in fear is like being in survival mode all the time. It’s high stress. Your body, your mind, your soul can’t recover when in a constant state of fear. Those things are sacrificed so the fear can survive.

Chronic stress is the metaphorical mugger lurking in Fear Alley. Stress can contribute to health conditions such as obesity, ulcers, depression, anxiety, heart disease, high blood pressure, and hair loss. A negative relationship exists between stress and the immune system, affecting the way certain cells find and attack cancer cells. Our natural killer cells don’t work as well in a stressed environment. The immune system works better when unstressed. Stress is very handy to have around in fight or flight situations, but surviving in a heightened state of prolonged fight or flight for months and years is going to cause more problems in the long run that will cause a vicious cycle of ongoing stress. Those living with cancer have better outcomes when stress levels are lower. To remain in some type of warrior state where I feel like I am in a constant battle keeps me in a state of stress. I won’t do it. I can’t. It makes my heart hurt. My body physically shakes. Muscles in my gut tighten as if anticipating a punch. The fear and worry spike my anxiety levels.

What if we believed in hope instead?

What if fear and stress were left behind in the alley and images of the alley just faded away forever? You would be left standing in the sun, absorbing warmth, light, and hope into every cell of your being. Your body would have an opportunity to relax and thrive. You’d sleep more soundly and feel assured that things were going to work out. Thoughts and ideas would connect easily in your mind. You’d feel something in your soul that just felt right. This sounds really good to me! For me, less stress means I’m much calmer and more relaxed. My heart doesn’t race. I don’t shake. My stomach is happier. So am I.

Absorbing warmth and hope into every cell means leaving stress behind. How does this happen? Meditate. A few breaths make a difference. Start with inhaling fully for three or four counts and then slowly exhale for the same number. Repeat this four or five times. It’s a mini-break and gives your body an opportunity to reset. Go for a ten-minute walk if there’s time. You’ll combine deep breathing and get a few minutes of exercise. Other ways you can lower stress are to spend a few minutes writing in your gratitude journal, think of something to make you laugh, or make a quick phone call to a friend. Use affirmations to set the positive, hopeful, no stress mindset that you seek.

Hope isn’t found at the end of a dark alley. It’s found in all the little moments where a thought makes you smile, you spend time doing something that brings you joy, or you take that ten-minute walk. All those moments add up. Hope is found in the heart. Ultimately, this means hope could even be found as you walk through what is fearful. Somehow. Maybe it’s just a small molecule of hope, but it grows as you inch toward the end of the alley. Hope is always within.

Don’t let fear crush hope.

Hope makes living with cancer so much easier than trying to live with it from a place of fear. It’s like permanently living in the Amsterdam flower market or having the Van Gogh museum completely to yourself. Every part of your life feels better with hope. There may be alleys to walk through that are unavoidable. I wouldn’t recommend strolling down any just for the experience. Hope is obtainable without an alley walk. I’d like to think hope is also unavoidable.

We all need to hold on to hope and not let go.

We all deserve the sunny parts of Amsterdam.

All the time.

 

Consider responding:

  • When can fear be the only path to lead you to something better?
  • How can you approach fearful places differently and come from a place of hope?