Archives for posts with tag: healing

I have been working half-time this week, following what turned out to be two small heart attacks. As I wrote previously, the current working diagnosis is Spontaneous Coronary Artery Dissection (SCAD). It is infrequently diagnosed and mostly seen in women in their 40’s to 50’s, physically fit, and with few or no heart attack risk factors. The cause is unknown. It is possible for dissections to heal so I am taking a number of medications to improve my heart functioning as well as to prevent the formation of blood clots. I have follow-up tests and lots to learn about heart functioning.

This was a shock, to understate things. Just two months ago, my husband and I were in Southeast Asia. We were walking through ruins in extremely hot conditions, just as we’d done when we were in our 20’s, on our honeymoon in Egypt during the summer. During the vacation, I was really pleased by the health of my body and what I was capable of doing. I thought of trips that John and I could take in the future.

Yesterday, I had a mammogram. It was normal. My 5 year “no evidence of disease” anniversary is in two weeks. This is big news that has been upstaged by my heart. In the past, I have compared cancer to a natural disaster. It can happen to anyone, no matter how virtuous. I am re-thinking that metaphor, at least in my experience. My breast cancer was more like a failed safety inspection. The treatment was to prevent a disaster. One of the harder aspects of breast cancer treatment is that it made me feel sick when I hadn’t felt sick.  The heart attack was like a natural disaster, a small earthquake followed by an aftershock. They caused damage to my heart. The medications I am taking now actually seem to be making me feel better.

Today, I have no work responsibilities or health care appointments. I am taking care of myself. I am listening to my body. Yesterday, it told me that taking a walk with a friend was a good idea and it was. Today, my body told me to sleep in. It has also told me to spend a lot of time resting on the couch. Finally, it has told me to take pause and check in with my thoughts and feelings.

One thought that passed my mind was, “I’m still healing from the cancer and now I have heart problems.” I felt the urge to cry “foul!” (And it would have been fine if I had.) My next realization is that I have always been healing from multiple wounds.

We are all healing from multiple wounds.

Be kind to yourselves, friends.

Don’t turn away. Keep your gaze on the bandaged place. That’s where the light enters you.
-Jalaluddin Rumi

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As many of you know, breast surgery often results in a lost of sensation. I had a right side mastectomy. I would make sense that in removing all of that tissue that nerves would also be removed. Now my grasp of physiology is better than the average person, but by no means expert. What I can tell you, though is for nearly two years, I have had no sensation at all in the area where my right breast used to be.

This means feeling no pressure, no heat or cold, and although it is delicate to say, no sexual response. Actually, if I want to be really clear, there is no response at all. No affectionate response. No, ”ow, you just accidentally elbowed me in the boob” response. My husband could hold a hot coal to this breast and I would not feel it. No one warned me of this side effect but I had read about it myself. So prior to my second lumpectomy when my husband asked about whether a bilateral mastectomy was indicated, I responded by spelling out the implications for our love life. I had already completed a literature review on my risk of contra-lateral breast cancer, learned about the Gail Index and so forth. I knew that my estimated risk of cancer in my left breast was at a level low enough that I found personally acceptable.

In the last few months, I’ve noticed something. The numbness in my tissues has subsided to some point. I am starting to regain sensation, at least around the edges of my mastectomy site. But what I am feeling is the occasional itch. Sometimes it is deep down and unreachable. Most times it is on the surface of my skin. I am allergic to wheat and when I do eat it I get a flare of eczema within two days and it takes about two months to clear. If I cook all of my own food, this does not happen. But over vacation last August, I ate out, had a salad, and there must have been some wheat in the dressing because I am still waiting for my skin to clear. At one point, I could see that I had an eczema flare over my breasts. We also had family photos taken at the time. It looked like I had acne. Oh well. In any event, I could feel the itch of the eczema. However, when I scratched it, I felt no relief. As my internist told me when I described it to her, “That’s just not fair!” My rash, however, got worse.

In addition to itch, I have also had the return in a sensation that can only be called, “uncomfortable”. It is the mildest of pain, though still noticeable. And it is, again, felt around the edges of my mastectomy, which was performed in August of 2012. It would not be until March of 2013 that the major part of my breast reconstruction would be completed. I am no surgeon but in my own logic, it seems likely that more digging around and transplanting that occurs, the longer tissues take to heal or as my plastic surgeon describes it, “settle”.

I have numb parts. They are starting to awaken. To what extent they will awaken is unknown. But what I do know is that the awakening is uncomfortable and at times, a bit painful. This has called to mind the numbness that can happen to each of us emotionally and cognitively. I consider myself to be above average in self-awareness. However, I have neglected parts of myself, the parts that are numb. And numb parts get that way through damage, through loss of trust, emotional baggage, past trauma. Our mind protects us from many scary and lonely thoughts and feelings. The problem is, however, that it can do too good of a job.

Sometimes the parts of us that are most important, most in need of attention, are the parts that we just don’t think about or feel. The parts that are tired, afraid, and numb.

As you know, I have been digging deep and trying to feel what I need to feel and process it all through. It is a painful but productive process. In keeping with my mindfulness practices, I have tried to keep with my thoughts and feelings throughout. This has guided my decisions. At times, I move forward, full steam ahead. At other times, I take breaks. At these times, I catch my breath, assimilate new learning, and observe a new way of looking at my life.

There are parts of me that are coming alive. At this point, there is discomfort but I believe that in time there will be continued healing and awakening.

My daughter saw it for the first time. She saw my TRAM scar. She had been very careful to avoid seeing any of my surgery scars especially a year ago, after she saw my very small and tidy scar that runs the circumference of my belly button that was a result of TRAM reconstruction. Seeing that little nothing of a scar was upsetting to her. She is not squeamish. It upset her because as she explained at the time, “They did it to MY mom.”

I was trying on blouses. I had to wear one in the charity fashion show with jeans. My daughter also happened to be trying on clothes and since I have a full length mirror, she was coming in and out of my room.

She happened to walk in when my TRAM scar, which sits about 3 inches below my waist, was exposed. She said, “Mom, your scar! That must hurt!”

The scar is wide; it arcs from one hip to another. I have been told by physicians that it is an incredibly neat scar for a TRAM; my surgeon is extremely skilled. It has faded over a year’s time. But it is still red and the vertical suture marks are quite visible.

I explained, “It doesn’t hurt any more. But yes, it was a big surgery and it hurt a lot at the time. That’s why it was hard to get around and why was home for seven weeks.”

She listened relatively attentively and then went on with what she was doing. This was the longest conversation we have ever had about one of my surgeries. She didn’t run from the room. She didn’t say, “Mom! I don’t want to talk about it!”

When I first had my TRAM surgery, I could not stand upright and I was instructed not to do so for some time to avoid damaging any of the internal or external stitches. I couldn’t laugh for awhile. I could feel my strain of my tissue against the edges of my sutures, which were basically holding me together. It burned like Hell. The same thing happened if I sneezed or coughed.

Currently, I have no evidence of disease. The searing and burning fear of cancer have faded for now along with the physical discomforts and pain. There were times, early on, when my daughter was so anxious about my cancer that she paced like a caged animal.

My daughter is a teen and her life is complicated. Most teens have a lot of emotional tumult in their lives. It is the norm and it is part of the re-organization that takes place that allows them to grow and become independent. I know my daughter’s emotional plate is full without having to worry about her mother. And I hate that. I hate that she has to deal with her mother having had a life threatening illness and that she has to deal with the possibility of recurrence. It’s a loss of innocence; I don’t know if she really appreciates that.

I’ve never been an emotionally perfect mother. I work to be as healthy as I can be. And I can’t expect myself to be a physically perfect mom, either.

The love I have for her, though not perfect, is infinite. I am so happy to be a mother and I am beyond blessed to be the mother of my remarkable girl.

I am not a naturally calm person. Like many successful nerds, I am naturally anxious. I like to know what to expect and if what is expected is not to my liking, I like to know how to change it. I like it when people are happy and they like me. I would like to know that my wonderful and unique daughter could never be harmed and will be a happy adult with meaningful relationships and work. I would really like it if none of the people I love got sick or died. I would also like it if my house were clean 24/7. Finally, I would like it if my daughter were to stop singing a Justin Bieber song at the top of her voice, while I am trying to write this post. I don’t care if she’s changed the words to “this is such a stupid song.” It’s REALLY loud. And it’s a Justin Bieber song and not only are his songs bad but it looks like his life may be going toward a very sad Lindsey Lohan direction. I’m a mom and a lover of kids and I don’t want a sad life for Justin Bieber, whether I like his songs or not.

But I have digressed, once again. None of us have control over our lives. We have influence and that is it. It is the same for our children’s lives. We have influence but not control. It is the same for breast cancer. I have influence to reduce the risk of recurrence or the occurrence of another potentially deadly disease, but not total control. As individuals, our relationship with the universe is one in which we matter but are not masters.

Prior to my forties, my current life circumstances would have likely put me around the bend. There would be a lot more crying and beating of my breast. I would yell at my husband, a lot, because that is what I do when I am feeling totally out of control. Or I would just stay in bed all day, every day, thinking dark and scary thoughts.

Not to say I don’t have my moments, but I am still a happy person and pretty even-keeled. To what do I attribute this calm? Well, there are  a lot of things including my wonderful friends, family, healthcare providers, and blog buddies, but today I want to talk about mindfulness.

Mindfulness meditation is the real deal. It has been used in eastern philosophical and religious traditions for a long long time and in mainstream, evidence-based psychology, and behavioral medicine for 20-30 years (yeah, I should look it up, but I am lazy). I am far from an expert in mindfulness but even my very beginner-level 10 minutes of deep breathing every morning and evening coupled with a mindset of trying to stay in the moment and observe and accept what comes my way, have gone an enormous way in helping me keep balance in my life.

And this is not a fringe practice, mind you, the big University of Washington, which is turbo-research oriented and one of the top institutions in the country (multiple disciplines including psychology and medicine), loves mindfulness. Mindfulness meditation is helpful for a myriad of difficulties from suicidality, to day-to-day stress management, to pain management, to the prevention of the recurrence of breast cancer.

I started practicing mindfulness consistently after my mastectomy. The first thing I noticed is that meditation was relaxing and unlike some other forms of meditation I have done, I wasn’t struggling to make my mind “blank”. In mindfulness, it’s not a “no-no” to drift off in thought. It’s just something that happens. The second thing I noticed was that my brain got a chance to rest. That doesn’t happen frequently for me.  I have a very busy brain, which was put into turbo drive by my cancer diagnosis. The “voices in my head” gradually became less chatty and frenetic. The third thing I noticed is that I became much less irritable and much better equipped to handle big stressors without freaking out.

If you are interested in trying it out, if only to help pass the time while you are seated in a doctor’s waiting room, I recommend any of the following resources:

Mindfulness Meditations for Teens (Yeah, I know it says “teens” but it’s my favorite and very applicable to the world of adults) by Bodhipaksa. I also see that in addition to CD form, it is now available as an mp3 download.

Mindfulness-Based Cancer Recovery: A Step-by-Step MBSR Approach to Help You Cope with Treatment and Reclaim Your Life (This is particularly good if you like a program that is laid out for you week by week. There are a number of mindfulness techniques explained, including breathing, meditation, and yoga.

Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. (This is a good place to start if you would like a background on mindfulness meditation. The author, Dr. Kabat-Zinn has been teaching mindfulness meditation skills for decades and also produces CD’s. and mp3 downloads.)

George Lakoff

George Lakoff has retired as Distinguished Professor of Cognitive Science and Linguistics at the University of California at Berkeley. He is now Director of the Center for the Neural Mind & Society (cnms.berkeley.edu).

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