Archives for posts with tag: mindfulness

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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I attended the March for Science on April 22nd. I was also a member of the national Facebook group for the march. The page has a lot of members, from diverse backgrounds. There were mostly very interesting and supportive posts in this group. Some members had beliefs very different from my own, for example, the member who claimed “emotions aren’t real.”

We tend to separate our brains from the rest of our body and our emotions from the rest of our being. Perhaps, emotions are tied to concepts such as spirituality, which are seen to float around and exist apart from us. From a mental health/science perspective, however, the brain is very much a part of the body and emotions are very much a part of the brain and central nervous system.

Stress isn’t an emotion but it is tied to strong emotional states and certain life situations. Stress can be acute or chronic. Stress can be motivating. Stress can harm our bodies when it is excessive.

Last Thursday afternoon, while finishing up with my last patients of the day, I felt sudden achy pain along my upper back, accompanied by nausea. I was able to finish and then felt the same achy feeling under my arms, and in my chest. Although not the smartest thing to do, I drove myself home. When I walked through the door, my husband looked up, gave his beautiful smile, and said, “Hi Sweetie! How was your day?”.  I replied, “I am not well. Call 9-11.”

The fire department arrived less than 5 minutes later, closely followed by paramedics, the latter of which had a portable EKG machine. I was impressed by the professionalism and kindness of the first responders. They didn’t seem incredibly concerned about the readings but recommended that I go to the hospital E.R. rather than wait to follow-up with my primary care physician in the upcoming days. I agreed.

The achy pains had lessened some with the extra oxygen I had been getting since the firemen hooked me up to an oxygen tank at the house. It was rush hour in Seattle. The ambulance driver expertly dodged through traffic. Fortunately, an outstanding aspect of my city is that drivers are very quick to get out of the way of emergency vehicles.

I was admitted to the E.R. I changed into a gown and my blood was drawn for the first of what would be eleven needle jabs over less than a 48 hour period. They were testing my troponin levels and they were able to do the test bedside, instead of having to send it to the lab. Troponin is an enzyme released by the heart when it is damaged. When my nurse returned to the room, he saw the test results. (The test had been started by a phlebotomist.) He said, surprised, “This is elevated. Is this YOUR test?” He confirmed that it was.

Although no one said this outright until I was discharged, from this point until the following morning, the assumption was that I’d had a heart attack. By 6:30 pm, my pains were totally gone. I had an EKG that night followed by subsequent blood draws, one at midnight, one at 2:00 am, and another at 5:00 am. I was surrounded by kind and skilled medical staff. The night nurse, Lorenzo, was particularly good. He was kind, personable, and knowledgeable. (By the way, one thing I love about my hospital, Swedish Medical Center, is that I’ve always had wonderful night nurses. I’ve heard horror stories about other hospitals.) Lorenzo was also excellent at  communication with me as well as with the other services. Continuity of care is a huge challenge in hospitals and he was excellent in his efforts.

At 5:30 am,  I started having back and chest pain again. It was incredibly small but Lorenzo had told me to report any pain, however minor. It was also in the same location as previously. I was given nitro glycerin and when that did not totally eliminate it, I was given morphine. The pains gradually lessened and were gone by 7:30 am.

Due to the recurrence of the pain and my blood test results (the troponin levels had increased over night as well as another enzyme used as a marker for heart attack), I underwent cardiac catheterization. I was taken to the Cath Lab and the procedure was carried out by a cardiologist and a team of four others. A catheter (small tube) was inserted through an artery in my wrist and threaded up to my heart. Contrast dye was also pumped into my body through the catheter, allowing imaging of my heart and circulatory system. I was sedated, but alert, during the procedure. (By the way, it was not nearly as awful as it sounds.) About midway through, the cardiologist asked, “Has something really stressful happened to your recently?” I told him that something had happened. You see, although he could see that my heart was not compressing normally, there was no evidence of a heart attack or heart disease. As two members of the cath team wheeled me back to my room, they were visibly happy for me.

The cardiologist made a preliminary diagnosis of stress cardiomyopathy, also known as, Takosubo cardiomyopathy or more poetically,”broken heart syndrome”.  This diagnosis was corroborated by the results of an echocardiogram. Excessive cortisol, a stress hormone, can affect the heart muscle, preventing it from being able to contract fully. This results in symptoms similar to a heart attack. Unlike a heart attack or heart disease, the heart damage cause by stress cardiomyopathy typically heals in 1-4 weeks.

I was put on three new medications, two of which can have a blood pressure reducing side effect. My regular blood pressure is about 110/70. It got really low after the medications so I stayed another night at the hospital.

I was discharged yesterday afternoon. My treatment was top-notch but being in a hospital is neither restful nor fun. John had been by my side the whole time, spending nights at the hospital. We were so glad to leave!

It is now time to implement a new self-care program. These are difficult times in my country. I think they are causing chronic stress for many. I know it has for me and I’ve been left with a smaller reservoir with which to deal with new stresses that come into my life. I have left a message with the psychologist I saw during my breast cancer treatment. There are some things I really need to process as well as a need to return to a more consistent mindfulness practice.

Having a caring heart is mostly a wonderful thing but it can also be a burden. Life brings unwelcome surprises like chest pain and welcome ones like looking into a woman’s heart and not finding heart disease and blockage.

On the day of the March for Science, I wore a sign demonstrating my ongoing commitment to the importance of fostering caring hearts. Without them, there is no love, no laughter, no curiosity, no passion, and no motivation. We would also not work to protect ourselves from possible harm. Without emotions, there is no humanity.

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My daughter and husband are out tonight. I decided to watch something on television that might only appeal to me. I used to occasionally watch, The Gilmore Girls, a mother/daughter drama-comedy with very fast-paced dialogue. They brought the show back after many years for another season. I decided to watch the first episode.

The Gilmore Girls is a smartly written show with appealing lead actors. In other words, it is not a bad show. That’s not the point of this post. The opening scene of the show took place outside, in the town square. The first thing I noticed is that everyone in this town is white. The mother and daughter characters were drinking coffee from paper cups that were obviously empty. I realize that this is a common use of props in television and film. Without fail, I notice that the coffee cup is empty. I can tell by the way they handle it! There’s no weight in the cup! Why can’t they just fill it with water or something?

The all white town, then the empty cup. Next, they pass the sign for the town, “Stars Hollow”. Really? That’s hollow, too? It’s not a bad show but really, the first 10 minutes were too symbolic for me.

Life is full. If I take a drink of life, the weigh of the cup registers in my hand. It has flavors, colors, aromas, and sounds galore.

The fullness of life is a big part of what makes life so amazing.

A hollow cup is easy to understand. It is easy to master. There are no surprises.

But what, precisely is the point?

Yes, I am a bit agitated today but as always,

Peace, friends.

I attended a sitting meditation two weeks ago. The instructor read a poem at the beginning. There was a phrase in the poem that has stuck with me, “bearing reality.” Mindfulness is about bearing reality, bearing the way things are right at this moment. Daily, there are difficult realities, especially at this time. I keep reminding myself that today’s reality is not necessarily tomorrow’s reality.

But this is when it gets even more difficult. The joy of today can give way to heartache tomorrow. The fears of today can give rise to positive action. This is the bearing of possibility, the what could’s. As a psychologist and as someone who practices mindfulness, I know that living in the future is tricky business. It is important to visit future possibilities in order to plan. However, the future, though a good place to visit, is no where to live.

The challenge, in our country, in our world right now is to bear it all. We must bear reality and possibility in balance. As with “baring it all”, “bearing it all” leaves us vulnerable. Right now I am considering my options for formal activism. I have done individual acts but I have not become a member of a group effort. I have been hanging out on the edges observing possible groups. There are a lot of them, by the way. Some of you may belong to one or more of what must be one of hundreds of resistance groups across the country. Since many of these groups cropped up after the election, there is an understandable amount of disorganization and flux. I am a practical person. I don’t want a “feel good” group. I want to be part of a “do good” group. I want to be effective. There’s a gamble no matter what I choose.

Today, I am bearing reality. I am weighing my options. I am bearing possibility. These are scary and exciting times, these times of bearing it all.

Part of my mindfulness practice is to live my life with intention. I have a strong intention right now to be more of a social activist because 1) this is no time in the U.S. to feel helpless and 2) I might be able to offer something positive, however small, to the world. Also, following up on my last post, I have made a point of being more conspicuous. I have been a pretty outspoken person since about 5th grade when I first remember my teacher commenting (not negatively) about my feminism.

I find myself now, however, not just being outspoken about my beliefs but also being outspoken about my behavior and linking it explicitly to my political activism. Honestly, the U.S. presidential election initially left me feeling betrayed by a substantial proportion of my fellow citizens.  When I left my house the morning after the election, I made a concerted effort to count every act of kindness that was directed toward me. It helped me feel safer.

I have continued to do this but I have also tried hard to do positive works. And since I am putting this within the context of social activism, I have let people on social media know about what I am doing and why. I include charitable contributions, phone calls to congress, and small acts of kindness that I do with intention of creating loving social connection. Announcing my actions is my version of carrying a sign in a protest march. What if I decided to protest in the park, by myself, without a sign and without saying anything? How would anyone know what I was trying to do.  I am labeling my action. Others might feel inspired to do similar things. I know that I have felt inspired by others. I also know that when I announce my intentions in public, I am more likely to follow through.

Objective labeling is a big part of observing and being mindful. I have learned the practice of labeling my mental behaviors during meditation. When my thoughts are judgmental, I can label it by saying, “That’s my judgmental mind making judgements”. I have been taught that this is a way to stop the brain puzzles that keep me out of the moment and I have found it to be an effective technique. To be aware of myself makes it easier for me to act with intention and to respond to life instead of simply reacting to it. Sometimes I have to make a sign to myself to understand myself better.

I think of this as a practice of using signs, some turned out to the world and others directed inwardly. Both are extremely useful to me.

What’s your sign?

Peace to you, friends

Between 2012 and 2014, I had 9 surgeries; three of them were to remove cancer and the other six were to patch up the damage. Not all of my surgeries were major, but nonetheless, I spent a lot of time in a hospital gown, with my ass hanging out. I am outgoing in many ways and have been for the most of my life. However, I also spent the first 46 years of my life being fairly modest when it came to revealing my body. For example, I did not wear a swimsuit for years, because I was very self-conscious. Medical visits were another thing. I didn’t mind that so much. But when it comes to surgery, it’s different. My body was on display to a parade of people whom I did not know. Even worse, you know how I am a child psychologist and see patients and their parents for a living? Some parents work at hospitals. My hospital. To see people I knew from the community, in my role as an expert and a leader, with my ass hanging out, could have been mortifying.

Guess what? It was not mortifying. It was merely embarrassing and not gravely so. This is because, I used my mindfulness practices to stay in the present and to try to keep those thoughts that make a stressful circumstance into a mortifying one, at bay. For example, instead of focusing on how embarrassed I was and what must a person from the community think of me, I focused on her kind treatment of me. Further, the more times I was “exposed” both literally and figuratively, the less difficult it became. It was less and less embarrassing.

I feel grateful for the way I was able to cope with this. It may have been quite different earlier in my life. One of the things this coping taught me is an appreciation for my body and far less embarrassment about it. Any embarrassment I have now about wearing a swimsuit in public is really manageable. It doesn’t keep me from enjoying myself. I don’t worry about my appearance when I encounter people in the community on the days I am not in the office. I am comfortable going around town with no make-up and wearing work-out clothes. If it is raining, you will see me in a rain hat with ear flaps. It’s not cute. It’s functional. It keeps me doing the things I love to do, like taking long walks during every season of the year, which also benefit my physical and mental health. Those things are more important than being cute. I am free to be who I am, even the facets that are not cute, without embarrassment.

I have also noticed a significant decrease in my embarrassment, more generally. I used to get so embarrassed when people sang “Happy Birthday” to me. I felt very self-conscious even though on some level, I enjoyed it. Last Thursday was my 51st birthday. It was also Thanksgiving. Seventeen of my loved ones sang, “Happy Birthday” to me. For the first time in my life, the only feelings I had were purely positive. I felt happy and joyful. I thoroughly enjoyed it, smiling the whole time and being able to make eye contact with my well wishers. What a marvelous power to be able to absorb and appreciate love from my friends and family!

I have been thinking a lot lately about the power of acting in spite of embarrassment or fear. We are in times when this power is of utmost importance. Our country and culture are divided. Oppression and hatred were a problem before and now are more so. I was reading an excellent article, Eight Ways to Stand Up to Hate, published by the University of California-Berkeley’s Greater Good Action. One of the recommended strategies is “practice being conspicuous”. For example, walk around the neighborhood in a funny hat. The goal is to learn to tolerate the discomfort of being conspicuous so when we are in the presence of a stranger in need of help due to hateful acts by others, it will be easier to act and not freeze, the latter of which is a natural response for many.

These are times when it is natural for many of us to try to be careful about everything. To worry. To look for problems in everything. To accept only the perfect solution when none exists. “I don’t want to support x cause because it does not solve every problem.” We need lots of efforts and strategies to make this world a better place. Some of our efforts will only help the tiniest bits. Others will fail.

To fail by not trying is not a way I choose to be.

As always, peace to you friends.

As you can imagine, I am still reeling from the U.S. election results.  Like many have written in other blogs, my reaction was much like being told my positive breast cancer biopsy results in May 2012. A major difference is that in the case of my cancer treatment, I felt very well taken care of by competent healthcare providers. I also had relatively clear choices to make.

No, I am not saying that the election was worse than cancer. I actually don’t know.  I don’t know what will happen to my country and the world. I don’t know what my health will be like in the future. We just don’t know the future.

A lot of people has commented that the election “woke people up”. I would say that it woke some people up the way hearing a bomb blast would. Others have their eyes open, their sleeves rolled up, and are following a clear purpose and direction.

I am in neither of those groups. I am, however, trying to follow a process in mindfulness, to be awake but at ease. This means observing pain, emotions, and even thoughts in as much of a grounded way as possible.  I have had moments of being mindful and at ease since the election. That is not most moments. But I continue to practice my meditation to cultivate compassion, to be aware in the moment, and to be as active and constructive as I can be.

It is tremendously difficult but even in those moments of balance, the results have been tremendous. Those moments provide me with hope.

May I be awake. May I be free from suffering. May I be at ease.

My you be awake. May you be free from suffering. May you be at ease.

Peace.

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Last week at the U.S. Presidential debate, I saw a women interrupted 51 times in 90 minutes by one man. I hate being interrupted. Actually, some interruptions are fun, the kind that you exchange with a friend with whom you share a great deal of empathy and can finish eachother’s sentences. Those interruptions show the strength of connection and intensify it. The interruptions I hate are the ones that change the subject, argue, and contradict. Repeated interruptions are like a salvo of little assaults that compromise one’s ability to share thoughts and feelings.  Interruptions are jarring and for me, they take me away from myself, at least where I was and where I wanted to go.

For many breast cancer patients in the U.S., October, “Breast Cancer Awareness Month” is an unwelcome interruption. Many people are active in advocacy for breast cancer research as well as for increasing access to quality healthcare. These are critically important concerns. Then the pink tsunami comes in and interrupts with new messages, one of using a disease as a marketing tactic and wrapping it in “awareness” a construct, which is vague and inoffensive. For those of us who do think about the word, awareness, thinking, is not enough. Awareness solves nothing once everyone is made aware and nothing else happens.

Breast cancer itself, was a major life interruption. I was 46, going about my middle-aged life assuming that my only health issues were that I was overweight and not exercising enough. Bam! Cancer! There were two years of starts and stops. Cancer treatment brings many interruptions.

Those of you who are regular readers of this blog know that I strive for integrity in my life, the sense that the parts of my life contribute to my whole self, in a way that makes sense. This contributes to a sense of balance. There is a teaching in mindfulness that the past, present, and future are all part of one’s being.

I continue to accept cancer as part of my past, my present, and my future. Even if I never have a recurrence, the knowledge of the possibility is still there.  Cancer is part of me but not all of me.

Watching the debate reminded me that the best way to handle an interruption is to keep going instead of just stopping and let the interruption take over.

Life interrupts, keep moving. You may need to make course corrections but you are still going forward.

Today is International Peace Day. I think a lot about peace and I try hard to cultivate it within myself as well as to be a peaceful participant in the world around me. The degree of success varies but it is rare that a day goes by without my being mindful of my intent.

I have not written as frequently as in the past, in part, because my mind is fragmented. My emotions are fragmented. The world is not making sense. There are many things going on but they are all getting wrapped up literally and metaphorically in our U.S. Presidential election. It is white male heterosexual privilege against everyone else. We have a major presidential candidate with no experience who is viable just because he is white, heterosexual, powerful, and more importantly, an explicit spewer of hate and selfishness. When he cheats, he is savvy. His exploitation of people and resources makes sense because he is the right sex, orientation, and color to dominate others.

Meanwhile, we have a very competent woman running for president with decades of experience who manages to get things done despite the fact that she’s been held to a level of scrutiny that arguably no other candidate has ever faced. Her crime? She’s made mistakes. Women are not allowed to make mistakes. They are allowed to be perfect mothers or to serve men.

Meanwhile, African American people, some children, are being murdered by police. No, this is not new. What is relatively new is that the incidents are now filmed and even when they can be viewed, many white people still come up with reasons why the person, often unarmed, sometimes with their hands-up, deserved to die.

Meanwhile, an African American football player decides to stop standing for the National Anthem at football games. There is strong backlash against this kind of “disrespect” to our country as well as to our military. This is a peaceful protest by a man who belongs to a race that has been owned, systematically oppressed, and clearly shown on video, hunted. It is 2016. This is still happening. We have a major presidential candidate who is whipping up hatred for every “otherized” person. People, what are YOUR PRIORITIES? Respecting the flag or not killing people?

Meanwhile, nearly half of the homeless youth in the U.S. are LGBT. LGBT youth, more generally, are subject to a high incidence of sexual and physical assault, drug/alcohol use, and suicidality. This is all because we believe that not being straight or cisgender somehow threatens our safety.

Meanwhile, immigrants, potential immigrants, or anyone who resembles an immigrant from a non-European country, are being treated like terrorists, despite research evidence pointing to the opposite. Immigrants, by and large, are hard-working people. Their children, on average, engage in significantly less crime and drug use than U.S. born white youth.

Meanwhile, I was at home yesterday when my husband received a text from a friend, who referred to him as “a girl” as a joke. My tolerance for this kind of sexism is low. I told him that it was a misogynist joke. He disagreed and his feelings were hurt. Both men are good and decent men but I was taken aback that my husband defended the joke and acted like I was overreacting. My reaction may have been stronger than usual but that is only because it is exhausting and unhealthy to be in a constant stage of outrage over the insidious and outright violent oppression in our country and world.

I know that I can best advocate for peace, when I have more myself. That does not mean not being angry, afraid, or in grief for some very hateful forces in our world. But it does mean balancing them with the good that exists around me.

In about an hour I am going to the Frye Museum in Seattle where there is a sitting meditation every Wednesday. That will help as will meeting my friend, Nancy, there.

I wish you all peace in your hearts.

 

On May 25, 2012 I walked into the Swedish Cancer Institute for the very first time.  I had learned of my breast cancer diagnosis the day before and I was there along with my husband and my friend, Nancy, for a consultation with the physician who would perform my first three breast surgeries, two lumpectomies followed by a right-side mastectomy.

I remember a few things from that morning. One of the strongest memories I have is a feeling of surprise when the physician’s assistance asked me to step on the scale for my weight. To me the word, “consultation” meant “talking” and that’s what I had expected. To relieve the tension, I joked, “I have to get weighed? That’s worse than having cancer!”

Granted, I was joking but as you know jokes come from some where. Who among us have not felt defined by a number, our age, our weight, our grades, or our annual income? Most of us have at one point or another, defined ourselves this way.  And the definitions can come with a great deal of negative judgment.

As a researcher and clinician, I also know that numbers can serve as useful data. There are two properties of measures that are important in yielding meaningful data. One property is the validity of the measurement tool. A valid measure actually measures what it is intended to. When I stand in front of the ruler on the wall of the doctor’s office, the ruler actually measures my height. However, not all measures are valid at all. For example, when I walk out the door in the winter time it sometimes “smells like snow”, meaning that I am detecting something in the air that to me is the odor of snow.  This predictive measure, as it turns out is not very accurate. It is not a valid measure of snow potential. I don’t even know what I am perceiving that makes it “smell like snow”.

The scale can be a useful measure. But is it a valid measure of value as a person? No, a scale, a good one anyway, is a valid measure of weight. It is not a valid measure of general health because general health is not defined by just body weight. It can be a factor in health but it is not all-encompassing.

Just like people say, “age is just a number” it can be tempting to deal with the judgment that comes with weight and just conclude that “weight is just a number”. This implies that it has no meaning or usefulness.

My weight has been creeping up steadily over the past year. I am almost to the weight that I was before I lost my last 40 pounds, nearly 4 years ago. Based on the way my clothes fit, I can tell that I am not as large as I was at that time, I assume because I am more muscular than I was then. But I am noticing that I am able to wear less and less of my wardrobe. I’ve gotten noticeably larger.

I did a great deal of work on my body image when I was going through cancer treatment. I learned to appreciate what my body does for me. I have a positive body image. I feel strong. But I also know that having had estrogen and progesterone responsive breast cancer that it is important that I maintain a healthy amount of body fat. Right now, it is clear that I have too much.

I’ve known this for awhile. Behavior change, developing new habits, and re-developing old good habits is really difficult. Every once in awhile I get to a point at which it seems harder to continue doing what I am doing than motivating myself to change. Last week, I asked my husband to start going to Weight Watchers meetings with me. I had been doing their online program  on and off for the last 10 years. Since I have not been following the program for awhile, I thought going back to meetings might be helpful. My husband has been having a lot of back problems and I thought that his losing weight might be a positive for him, as well.

He agreed. We went to our first meeting the next day, which was last Sunday. Three days down, many to go.

Measures can help guide me to follow my intentions and commitments in life. They don’t define my worth.

 

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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