Tuesday, 17 November 2009

Anxiety Busters

I had hoped that the end of chemo would coincide with the end of my worries and cares. What with everyone going on about how radiotherapy is such “a walk in the park” and so on I had imagined myself and my slightly pink breast, bathed in rainbows, tiptoeing through the tulips hand-in-hand with Nick, pausing here and there only to pluck a fresh chocolate éclair from the trees.

So I’m a bit surprised to find myself regularly breaking down in tears with Nick having to calm my frenzied bouts of anxiety. Of course money is always a worry for anyone dealing with a serious illness. Those of us who are self-employed don’t even get sick pay. Social Security payments won’t cover the cost of organic groceries, let alone health insurance, home insurance, petrol, parking, new roofs, clothes, phones, broadband, Hermès scarves and a thousand other daily expenses. So, like many people, I’ve borrowed and gone into debt to get through. I am very lucky that my sister Miranda has been able and willing to bail me out.

Another source of anxiety is the prospect of long-term side effects of the various cancer treatments. A quick google will throw up endless opinions that both chemo and radiotherapy cause other illnesses. Many of these are simply scare stories. God only knows who originates them and for what possible reason. But then there are solid concerns too. Last week I read about long-term side effects of radiotherapy on the website of Cancer Research UK. Apparently it can cause fibrosis that leads to hardening and shrinking of the breast. It can also trigger Lymphoedema.

I was quite taken aback. I feel as though I had not been fully aware of these possibilities. I don’t know how commonly it happens. Tomorrow I will be seeing Dr Coulter, my temporary oncologist so I will be able to find out more and report back to you.

But it was enough to start the little hamster of anxiety running on its wheel. Pretty soon my mind has worked its way around to the big looming unknown: Tamoxifen. When it comes to this drug, opinions are polarised. According to Suzy Cleator, Tamoxifen is the most important treatment for Oestrogen Receptor positive breast tumours (the type that I had) after surgery. Many in the medical profession swear that it’s a wonder drug that has changed the outlook for breast cancer sufferers. According to many in the alternative camp it is a destructive and misogynistic treatment that wicked drug companies have sold to credible doctors for their own greedy ends.

The inescapable fact is that Tamoxifen is known to cause blood clots, strokes, cataracts, hot flashes, headaches, fatigue, nausea, vomiting, dryness of the vagina, itching skin, rashes and cancers of the uterus. I still have a lot to find out and a lot of questions to ask. But I sometimes feel that I will inevitably have to make a decision between a disease that may kill me and a drug that may kill me.

The thing that really gets to me sometimes is that a few months ago I was told that Mr Hadjiminas had completely removed the tumour from my breast. The more I learn the greater seem the risks associated with what I had understood to be a ‘belt and braces’ approach.

I’m telling you all of this because you too may be feeling anxious about chemotherapy, radiotherapy or Tamoxifen. You are not alone. I will write more on the matter in the future. But even those who have studied and researched for many years disagree. We simply must do our best to inform ourselves to a point where we feel comfortable with whatever decision we take and then embrace the unknown. In the end, there are no wrong decisions.

Although the situation is disquieting, indulging worry and fret makes no positive contribution. On the contrary, it increases our stress levels. Here is a roundup of all the different techniques I have used for alleviating anxiety.

Breathing. This is obviously a good idea, yet I forget to do it. When anxiety strikes I find myself all tangled up, holding my breath or breathing out when I should be breathing in and then gasping for air. Then I remember to take a minute or two just to calm myself with controlled breathing. Count slowly to four then breathe in for a count of four. Hold your breath for a count of two. Breathe out for a count of four. Hold your breath for a count for two. Breathe in for a count of four...

Singing. No need for talent, just grab a hairbrush and put on an Abba cd. Dance around the living room warbling, wailing and screeching your head off. It creates harmonious resonance in the body and floods the lungs with oxygen. Singing in the car is a fantastic stress buster.

Crying. Don’t hold it in. Go to see a weepy movie and have a good old cry. I always keep a pocket packet of tissues in my handbag these days.

Walking. Don your trainers, or socks-n-crocs if your toes are sore, then hit the streets. Walk slowly and with a rhythmic pace. As you walk try to simply release any thoughts that come into your head. Use this simple mantra: "let go". Think l-e-t as you breathe in. Think g-o as you breathe out.

Yoga Nidra. Put some dolphin music on if that’s what floats your boat. Or Mozart. I listen to a wild soundtrack called ‘Wind and Rain’. Lie on the floor in Savasana. That is on your back with your legs apart, your arms resting palms up at about 45 degrees from your body, your neck extended and your chin tucked in slightly. Savasana literally means ‘corpse pose’. Begin to breathe regularly from your diaphragm. Close your eyes and as you breathe bring your attention to your third eye, the place between your eyebrows. Now say your Sankalpa out loud, three times. Sankalpa is something like a positive affirmation. This is my Sankalpa: “I am happy. I am healthy. I am whole. I am sexy. I am prosperous. I am loving. I am loved. I am FREE.” Next scan your body, checking for any tension or contracted muscles. Start with each finger on your right hand, the palm, the back of your hand, the forearm, the elbow, the upper arm, the shoulder, the chest, the side, the waist, the hip. Repeat on the left side. Next scan each leg from the toes upward, in turn. Scan your spine, neck scalp, ears, face and throat. Relax any areas of tenseness that you feel. Next, imagine your body to be very cold, as if standing in the snow in bare feet, then feel your body to be warm, as if sitting on a sunny terrace. Then feel your body to be very heavy, sinking into the floor. Then light as a feather, hovering above the carpet. Next, imagine yourself walking in a lovely place – somewhere that is special to you. Feel the earth beneath your feet, the breeze on your face. See the sunshine, smell the flowers. Find a comfortable rock beneath a tree with a wonderful view of your world. Now repeat your Sankalpa three times again. Bring yourself back to now by wriggling your fingers and toes and then having a lovely stretch.

Oh, there are lots of strategies but I’m tired now. That should be enough calming measures to keep you and I both sane for today. More later.


Anonymous said...

thank you again for sharing your latest news and views. i wish i had read your inspirational relaxation tips before panicking on the bench today...like you i just want it all to STOP. BIG bruce doesn't offer much amusement nor light relief with all its whirring and zizzling noises; ten sessions in and i'm developing a love/hate relationship with BIG bruce...he's zapping the remnant microscopic cancerous cells Mr Wonderful H couldn't get out but he's also killing my healthy ones. bruce doesn't have a life - we do. i think your concerns about shared decision making are so so valid; on the one hand we are walking with life saving treatments and in the other hand we are wondering when and whether to take a different path - a bit like 'belts and braces approach' versus 'thanks, but no thanks approach'. tamoxifen remains, for me, a rather big horrible threatening monster - worse than bruce. i'd like to try the hokey-pokey, hocus-pocus, journey with it - but all my head cells are saying "SAY NO,DON'T DO IT". the drug was originally used as a fertility enhancer in the sixties. hello? surely we are in 2009? if one in nine ladies will be diagnosed with breast cancer, and presumably a signifcant number will be oestrogen positive, then why is it another drug hasn't come out, which doesn't cause the many side effects, to help other than the one called tamoxifen. where are the statistics on ladies who said no and those who said yes to the drug? i think your hinting comment about money hungry pharmaceutical companys (or is it companies?)is important - i don't want tamoxifen to be my companion for the next five years. is this a campaign drug or is it, in tandem, a money earner? at the end of the day, we all have to make a choice and go with it - it's not an easy choice to make and thank god i don't have to make it for another few weeks. keep going with the radio ga ga, this part of our treatment is essential as part of breast conserving surgery. take care and hope to bump into you at the clinic. lots of love x

Anonymous said...

Hi - I shall certainly try the yogic breathing and meditation. I'm also off to the PEnny Brohn complimentary cancer centre in Bristol next week for a 3 day retreat of holistic therapies and nutrition. I'm sure it will be great. The fees are reasonable - £199 for all treatment and food for wed to sat which is good value when you think how much spas charge even for a day. take care and keep up your great blog
Jo xx