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?

 

From Fog to Focus

Welcome back! Yesterday, I wrote about how chemo fog can affect day-to-day cognitive functioning for those receiving cancer treatments. Now on to the fog you see when you look out a window and can’t see a darn thing except fog. It’s as if the world comes to a halt, only extending as far as your range of vision.

Literary images of fog usually contain some lurking figure in the distance that’s barely discernible, but is there waiting. A lone figure limps across the isolated barren moor in a horror tale. Fog fills uninviting alleys. Fog mysteriously envelops a person and he or she disappears forever.

Most of us are more familiar with this type of fog. You can’t see your mailbox from an inside window looking out. An outstretched arm in front of your face is invisible. Driving in fog is frightening when you can’t see anything in front of you, and you inch along using the white line at the side of the road as a guide. Too much hope is placed on that white painted line.

Planes are grounded. Ships don’t sail. People are cautioned to stay off the road.

Fog limits visibility.

Or does it?

For planes, ships, and cars, the answer is yes. Fog forces us to slow down. People get so busy running from one thing to the next that they scarcely know what their thoughts even are. They live race car lives going at break neck speed around the same track over and over. These cars go nowhere. You can get off the racetrack. Slowing down gives time for thoughts and ideas to change, develop, and strengthen. It may be a subtle shift from not knowing to knowing.

Foggy days have their advantages. I like them. For me personally, fog has reflective benefits. Fog offers introspection and time to think. When fog settles in around the house and changes plans, I just take a step back and wonder what it is I’m being given the opportunity to figure out. Then I proceed to hunker down and figure it out.

Fog leads us to knowing.

In many ways I found myself in foggy territory while I was on leave from teaching. Eventually, it became clear to me that there were more reasons, better reasons, to retire than to return. I have not known what would unfold at oncology appointments or what choices would be best for me. Eventually, I would get information or a feeling that would sway me in a particular direction. There have been relationships I have been unsure about, but when I looked at repetitive patterns, my choices suddenly seemed obvious. It takes time. I need to sit in the fog for that subtle shift to happen.

Last winter brought my part of Wisconsin several foggy days. Plans changed again, and I just planned an indoor day. There was nowhere to hurry, no “have tos” that day, and more of a relaxed pace. When you know you don’t have to go anywhere, there is no worry and anxiety. You are safe in your slippers inside drinking some green tea with pomegranate with you feet propped up. Maybe the world needs more foggy days.

Fog leads to clarity.

Some years I identify a word as a theme for the year. My word for 2019 is FOCUS. At the end of 2018, I was walking in the arboretum imagining thoughts of the year ahead materializing just a few steps ahead of me on the path. Nature really reveals a lot. I heard words of warmth, feeling, and finally focus. I am not sure what big feelings I will have. Maybe it’s a reminder to rely on my intuition and trust my feelings. I am also not sure of what exactly is the significance of the word focus. I waited for more, but nothing came.

It was a cloudy day, but not foggy.

I decided something would happen to let me know where my focus needed to be.

My focus continues to be on my health and happiness. Both are continued works in progress.

It can’t always be sunshine and blue skies. Rain clears away what a person no longer needs. Winds carry new and old away. Winter gives the earth a chance to rest and eventually renew.

And the fog, whereas it first seems like it closes in and confines someone, it redefines. Fog offers a moment in time that is a respite from reality. When it lifts, it has the potential to offer clarity, freedom, and direction. Let it roll in and sit with it for a while. When it’s ready and you’ve had time to sort through confusion, it will roll out, leaving you behind with clarity on what needs to happen.

Sometimes fog just happens and it isn’t safe to be out.

You can’t find clarity wandering around aimlessly on a foggy moor or driving down a road you can’t see. They are lonely and scary places.

Wait until you can see.

The fog will lift.

Today I feel rather foggy on the inside. I don’t have much “ummph.” I think it’s a good day to get super comfy and listen to what messages I may be trying to send myself. Maybe I’ll take a nap and awaken back in a world of sunshine and warmth. Maybe it’s less foggy in my dreams.

Consider responding:

  • How do you find clarity and purpose when you feel foggy?

 

Chemo Brain

Chemo fog is also commonly referred to as chemo brain. It is like weather related fog in that a person just can’t see clearly or get much done. You go through the motions, but life lacks luster. You can’t shake being tired when you wake up. Fatigue of the mind stays with you all day. Other symptoms include difficulty concentrating, trouble remembering conversations or the right word, and taking longer to complete projects or tasks. A serious illness can also bring on extra stress, depression, anxiety, and insomnia. All of these can affect a person’s cognition. Although I never really felt confused or had trouble remembering anything, I just had a general mental fogginess that I couldn’t quite identify. I was slower. You get used to it and just figure it’s part of the collateral damage of treatments.

Then one day, the chemo fog lifted. I remember the morning about six months out from what I thought was my final chemo back in 2012. I woke up and my mind was completely clear. It felt like information traveled faster on neural pathways. It happened again the next morning. By the third morning, I was convinced that I had met one more benchmark that life was returning to my normal.

It hadn’t, but the chemo fog was gone. Even with continual treatments over the past three plus years, I never had that sense of slower processing return. I am grateful that my thinking is as clear as ever.

Many people deal with chemo fog every day. What can a person do to help minimize chemo brain?

Stay well organized.

Make lists and follow routines. Writing important ideas down will ease any pressure to remember so much on your own. Try to keep all your notes in one place so what you’re trying to remember isn’t scattered about in several different places. Use a daily planner, your phone, or an ongoing notebook of lists. A notebook or health journal is also a good place to track chemo brain symptoms since you may discover patterns when it seems better or worse. Medications or specific situations may also affect your memory. Following a routine will help you with day-to-day schedules. Do you always pay bills on a certain weekday? Is pizza night every Tuesday? Do you have a grocery list of staple foods that you always buy? Are there specific days that you use for specific appointments? I always set up acupuncture appointments on Mondays. I spaced an appointment that I made on a Wednesday (even though it was written down) because I just didn’t go there on Wednesdays. I do well with routines, not so much with changes in those routines.

Get plenty of rest and sleep.

It’s said that driving when you’re tired is as dangerous (or more dangerous) as drunk driving. I know people who haven’t had any cancer treatments who are unable to remember much because they simply do not get enough sleep. Lack of sleep slows your brain in processing information. Sleep is important all the time, but it’s especially an important part of healing and recovery during and after cancer treatments. Appointments, errands, and work may go more smoothly if you complete some activities in the morning when you are fresher and have more energy. I wanted to walk the other evening with a friend and was simply too tired to go. I was grateful she cancelled and now I know to schedule those activities earlier in the day.

Don’t do too much.

Focus on one activity at a time. Ask for help from family and friends so you can conserve mental energy for more enjoyable endeavors or your work if you’re working. Multi-tasking doesn’t work well for someone experiencing confusion with an unreliable memory. If you know you need a whole day or two after a treatment to focus on the basics of the basics, that’s fine. There is no need to push yourself.

Play brain games.

I like word games and brain teasers. I did a lot of word puzzles and critical thinking exercises with my students. My mom and I would do jigsaw puzzles together. A few years ago, I bought the memory game Simon more out of nostalgia than any other reason, but it’s a great way to work short-term memory skills. Reading is another way I continue to work my gray matter.

Make healthy choices in terms of eating and exercise.

Veggies are better for brain health than sugar. Moving around is good for both mind and body. It can help decrease fatigue brought on from treatments. This may be a good time to put the word out to friends who have offered to help that a casserole or dinner with fruit and salad would be appreciated.

Stay tuned for a special Monday post where I continue with a few thoughts about the atmospheric fog that limits visibility. It’s a bit shorter, yet, metaphorical and worth pondering.

Consider responding:

  • What has been helpful for you or someone you know who has had chemo brain?

 

 

Categories: Change

 

Tags: fog, clarity, focus, chemo fog,

 

 

 

Exercise and Nutrition

A quote from the 2014 documentary Fed Up concisely sums up how diet and exercise must be thought of as partners in health: “You can’t diet your way out of a sedentary lifestyle. You can’t exercise your way out of a bad diet.”

It seems likely that someone who watches what they eat probably also has an active lifestyle. Eating right and moving around just helps you feel better and fuels your fun. Raw or steamed broccoli is better than a bag of chemical chips. Taking a walk around the pond is better than sitting on my duff watching TV or even, ahem, blogging.

Exercise

I am not athletic. Attempts at running were always short-lived and caused me minor injury in the past. But I love to walk outdoors. Going to the UW-Arboretum or Pheasant Branch Conservancy takes care of my heart, lets me decompress, and promotes creativity. Once I build up a little endurance, I also enjoy biking. Gardening, yard work, mowing the lawn, shoveling snow, and anything functional in the line of caring for my home all count and provide that undeniable feeling of self-satisfaction.

Moving needs to become second nature. My Fitbit has helped me monitor how much I move (or don’t move) on a daily basis. Before that, I wrote down how many miles I walked in a journal. It’s important to find a way to be accountable. A while back I read that making goals wasn’t enough, but a person needed to take goals a step further and make plans. Wanting to walk more is all very nice. Scheduling to walk in the arboretum helps turn the very nice into a reality. Saying I’m going to bike more means nothing if I don’t make sure my bike is ready to go and I make the effort to do it.

Hiking is one of my favorite activities. Hiking gets me out in nature with fresh air, blue sky, and lots of trees. Getting lost in my thoughts and really giving myself time to think away from other distractions always provides me with new insight. There is something amazing that happens in my brain when I pair physical and mental work together. My brain works better and thoughts are clearer. Physically, hiking has a long list of health benefits including improved cardio and muscular fitness, lowering risks of high blood pressure, type 2 diabetes, high cholesterol and triglycerides, and also lowering risks of cancers like colon and breast cancer. It’s a great aerobic workout. Hiking also can provide better sleep quality, reduce depression, and lower your risk of an early death. Being active in general tends to lower the risk of death. Honestly. How not surprising. Psychologically, hiking can provide feelings of relaxation and well-being. Sunshine, fresh air, trees, and feelings of accomplishment all feed into better mental health.

Exercise is important for everyone, but keeping it as part of a daily routine is one of my priorities as someone trying to live well with cancer. There definitely are times I would rather sit through a dental cleaning or a foreign film without subtitles than exercise. When I’m already feeling fatigued as a side effect from treatment, it seems crazy to purposely choose to do something that will make me feel more tired. Strangely though, this is not the case. Exercise combats fatigue. I feel tired after exercising, but it’s a different kind of tired than fatigue. I have more energy after I recover from however I’ve chosen to exercise. The energy sticks around a while. Regular exercise has also been connected to increasing survival rates for women with breast cancer. I want to stay alive, hence I exercise every day.

What about when fatigue isn’t the problem? What if it’s physical pain that’s preventing movement? I experienced this the other weekend with aggravated inflammation and muscle soreness from an injection that caused deep hurt with every step. I fought through most of that day trying to find a way to keep fun plans I had that night to go to a concert. I missed my daily workout because I couldn’t exercise through the pain. I could barely walk. I don’t think exercising when you hurt is a safe idea. Pain is a solid stop sign. The up side to my story is I was prescribed some strong medication to help make my evening of fun possible. I still hurt but there were moments I forgot. The down side is the meds made me puke profusely by the next evening. It took days before I moved well again. I’m not pushing activity and I’m definitely not taking any more of those pills. My body will let me know what I can do.

How much exercise does a person need daily? The current guidelines from the Department of Health and Human Services recommend that healthy adults get at least 150 minutes a week of moderate aerobic exercise (activity that produces a sweat). That’s a mere twenty-two minutes a day when broken down daily. Strength training is suggested at least two times a week. Click here for a short article provided by Mayo Clinic on these recommendations.

Nutrition

After getting through six months of initial chemotherapy in 2012, I needed to make changes in my diet. It’s still hard because of my love affair with sugar. Ideally, I should probably also be a vegetarian, but I love cheeseburgers too much. I try to keep these in check and enjoy them when I eat them. For me, a healthy diet consists of less meat, less processed foods, no alcohol, less sugar, more plant-based proteins, and more fish. More of a plant-based diet in general is a healthy winner. I order a steak about once a year on vacation, but even that is waning because of how I feel after eating it. I eat a lot of fish. My breakfast used to be a fairly tasty blend of five fruits and vegetables in my Nutri-bullet. What I thought was extremely healthy was also providing far too many natural sugars and unknowingly raising my A1C. Now I’ve switched to breakfasts that usually consist of eggs, half an avocado, and one fruit. The avocado cuts the natural sugar from the fruit.

One area in nutrition I’ve been more successful in is eliminating dairy. I miss milk. I love milk. However, it contains casein, a protein that promotes cancer growth in any stage. I know some who have read widely on this and disagree on whether that is true or not. My current feeling is I really don’t have much wiggle room to disagree. It is potentially more beneficial to me to avoid milk than to drink it. There is no dietary reason to consume milk produced by another animal. Calcium can come from plant-based proteins such as quinoa, brown rice, oatmeal, white beans, kale, and collard greens. With all that said, I still will enjoy ice cream now and again, maybe a little more than I should. I like string cheese. I slip every so often and have cereal with milk. It tastes awesome, but it can’t become regular diet. I grew up and live in Wisconsin, also known as The Dairy State. Clearly, there is room for improvement in cutting out more foods made with milk. Did I mention I really love ice cream?

I have also added an Omega low-speed, masticating juicer to extract all the vitamins, enzymes, and minerals in their purest and rawest form to provide the highest juice yield. Kale, spinach, celery, cucumber, and green apples make the most gorgeous green juice I’ve ever seen, and it’s also very refreshing. The color green is both a healing and energizing color. Green juice is a great way to send oxygen and needed nutrition to unhealthy cells. Unhealthy cells don’t like oxygen. Too bad, I’m very fond of oxygen. I get to choose, not the other way around.

Both exercise and nutrition need to work in tandem together to get the best results. I am a firm believer that everyone can do something. One person’s exercise or nutritional needs are different from what someone else needs. For example, most people are supposed to get what vitamins and minerals they need from eating a healthy diet and not need these in supplement form. I take a lot of supplements because treatments make it harder for my body to absorb some things. I also still feel a bit down when I look at people hitting the pavement or trails on their bike who look like they are practically flying. I have to work hard to achieve even a slow speed. It takes time for me to build any true endurance. I do the best I can.

Click here to read the 2015-2020 Dietary Guidelines provided by Mayo Clinic. I don’t agree with all the recommendations, but it does force me to justify my choices. As I mentioned in an earlier post, sometimes I feel like there is so much conflicting information on what healthy nutrition means that it’s hard not to drive myself nuts. I look for overlapping ideas from multiple sources.

I try to make the right choices for me in how I move and what I put into my body. I can’t just do one or the other to be healthy. I can’t compare my needs to anyone else’s either. Everyone has individual preferences, routines, and needs. I do learn a lot from others who share what they know when I ask for their wisdom.

My hope is that we all find a way to eat well and move well.

Consider responding:

  • What are some of your favorite healthy foods?
  • How do you enjoy moving?