Alive and Kicking

I thought we’d killed them!  In fact I had thought they were already dead well before the winter arrived.  We looked for them so many times only to be disappointed when we couldn’t see them.  I presumed the birds or next door’s cat had made them into a feast.  We had stopped feeding them, stopped ensuring the water was clean and had not given them a second thought when the pond froze over. 

Yet, here they are.  Alive and kicking!  More accurately, alive and swimming!  And eating!  Our fabulous fish, still zooming around in our horse trough from the 1800s; Seville (very orange), Beirut (grey white patches with orange head), and two whose names I can’t even remember!  What’s more there’s an extra bod!  It seems the fish got the memo about the Covid lockdown and decided to get busy!  Now, I need to find a new name for our new addition and rack my brain for the other names.  Where on earth were they hiding on all of those occasions we looked for them? 

Blue Sky London Day

Added meaning

I am going to add an interpretation to this event in my mind.  A helpful, healthy interpretation.  We can do that, we humans.  Our minds do it all the time.  We often add a narrative, meaning or attribution to an event that is negative, unhelpful and unhealthy.  When we do, pain and suffering soon follow. 

Alternatively, we can also add helpful, wonderful, healthy, inspiring, enjoyable narratives to events, circumstances, thoughts, feelings and sensations.  These can help us feel and create pleasure, celebration and hope.  I have decided the discovery of Seville, Beirut, Unknowns 1 and 2 and the new boy (maybe it is, maybe it isn’t) are a wonderful symbol of resilience, energy and thriving in a constantly changing environment and when faced with never ending challenges.  My darling fish, you are one of my sources of inspiration for 2021.

I too, am resilient, can find energy, thrive and feel alive no matter what challenges me and changes around me.  This doesn’t mean I will feel ‘up’ every moment of every day.  It doesn’t mean I won’t have the odd tough, emotional, low week.  It does mean that I can cope and I have hope.  Today, is a beautiful sunny blue sky London day, the fish are alive and I have had some great news about my body. 

Undulating caterpillar inching forward to new heights

Long tough road

The horrid month

It has been seven months since I wrote last.  Seven months since I came out from under the horrid month in hospital which almost broke me; the month where I had a stem cell transplant, a blood clot in my arm, a dangerous e-coli infection, went bald and could not be supported by an in-person visit from hubby.  That was the hardest part. 

Seven months since I got home from that experience only to be hit by a c-diff infection.  The time has gone so quickly and seems like a life time ago yet also feels like yesterday, raw, significant, a milestone, an awakening.  Covid, lockdown, fatigue, pain, overwhelm, slowness, feeling good then feeling shattered, taking on too much then letting somethings go. 

The last part of 2020 was a health roller coaster, though mostly without the sharp heights.  Instead it’s been more like an undulating caterpillar of three steps forward, two steps back, experiencing loss and frustration about not being able to do as much, or do things now in the way that I used to be able to do them (and may never be able to again) before embracing acceptance and commitment.  In recent months I have finally focussed on what I can do, in the way I can do things, and consequently felt healthier, happier and positive about moving in the right direction. 

I finally learned that slow can be good.  Really learned it.  Fully experienced it instead of deep down thinking it doesn’t really apply to me, only to others.  I’ve let go of ‘not being good enough’; put a stop to ‘I need to be hard on myself otherwise I won’t perform well, succeed, be respected, be ok, be enough’.  I reminded myself of my catch phrase for last year ‘consistency’ and how the long game even if played slowly, gently, is a good, healthy, empowering game to play. 

Another of life’s games has been restored: work.  I love it.  I love being the clinical psychologist I worked so hard to be.  I love making an authentic positive difference to other people, helping them learn about themselves, find their answers, try out their new skills, manage their mental health and become their own mental health coach.  I love helping people identify what matters most to them, know their values, embody their values daily and use their values to guide their decisions, make and deepen connections, grow and feel whole.  Even writing this paragraph feels inspiring. 

Skin reaction to UTI infection – immune system out of kilter

Yet another infection

Yes it’s been tough and it continues to be tough. My immune system has needed constant boosts of growth injections to help it stand on its own two feet.  Some people with Myeloma recover steadily after their transplant, some are back to work and exercise within three months.  I wasn’t.  I couldn’t.  My body simply couldn’t cope.  It needed more time, more nurturing, more monitoring, more help.  I needed more help and that’s OK. 

Then, once again as I sat safely in the hands of my amazing medical team and began to improve in the early days of January 2021, WHAM, another infection.  Another ‘we need to admit you to hospital’.  Sigh. This was a bummer. 

My mind began racing.  I can’t do this again.  I don’t want to be in hospital, without hubby, during covid, when the risk of coronavirus is high.  I’ll fall apart if I have stay in hospital again…don’t make stupid mistakes, if the oncologist says you should be in hospital, you should go…I don’t want to, it means another PICC line, another chance of a clot, more chances of infection, more chances of low mood and slower recovery.  Please, please, please, let there be another way. Is the Universe giving me another test?  Really?  Don’t I deserve a break?  My mind went to all the old negative unhelpful places. 

Resigned and ready for hospital admission

Back to hospital

Eventually I came up for air, paused, took a breath and calmed my mind down.  I nutted things out with hubby and made a plan.  I negotiated with the medical team that I would medicate and monitor at home, have two weekly check-ups and admit myself if I got worse.  Relieved I didn’t have to go in, I packed my bags just in case, cried and begged my body to get better.  It didn’t.  It got worse.  Fever, weight loss, no appetite, no energy and high temperatures.  Then arrival of a reactive inflammatory skin condition, joint pain, swollen ankles, knees and knuckles.  Lovely. 

Never by halves Janino.  It wasn’t covid, when covid was all the rage and one I wouldn’t wish on anyone.  This hiccup was all caused by a bloody annoying urinary tract infection (UTI) that most of us would send packing to the hills.  Instead with my immunocompromised self, it stuck around, dug in and said ‘hey, you are not getting rid of me that easily’ and what’s more ‘I am going to wreak havoc all over your body’.  I can almost hear the UTI saying, ‘Yeeha, playtime!’

I dressed in clothes to get straight into a hospital bed and reluctantly presented myself for admission at the Haematology Assessment Unit.  Six hours later I was home.  Yeah.  Home.  How cool was that!!  The team had made another plan.  They propped me up with some different medication, organised a dermatology and rheumatology consultation, and knowing how I felt about admission, had reviewed and decided I would recover better and be at less risk, at home.  Here I was back in my safe place again.  Relieved.  Pleased.  Begging my body to improve and begging the bugs to stop bringing my life to a screaming halt over and over again. 

Birthday meal in Lockdown – delicious! Look at those curls!

Walking the talk: I asked for help

The UTI is gone, the skin flare has gone and I’m on a four week steroid cycle for the reactive arthritis that seems to have stemmed from my immune system going into overdrive trying to get rid of the nasties.  I even have a full head of thick hair, albeit an inch all over and bouncy curls I’ve never had before.  I’ll take it.  The arthritis may be challenging, it’s hard to walk because of remaining swelling and pain in my ankles and knees.  It’s virtually impossible to turn anything or pick up anything up with my left wrist but right now I’m feeling good.  It’s been a good two weeks. 

I’ve even re-learned that it is OK to ask for help; help to put my shoes on, cut up food, unscrew the top on a jar, get dressed, stand up, get to appointments, get in and out of a car.  It pushed all my buttons about needing to be independent, not being a burden, and telling myself I just need to get on with it.  I learned to ask for support and for asking and receiving support, to be ok. 

Catching hubby laughing at me for trying to help myself and my being too stubborn to ask him for help did both annoy me and make me laugh; at myself and him.  He knew that gently teasing me was exactly what I needed and often need to help me keep perspective.  I can cope with this residual pain and swelling.  It will pass.  Something else will show up and I’ll deal with that too.  In the meantime, the news from my clinic review today made today an even better day.

Hey body – I hope you know how loved you are

The good news

My immune system is BACK. 

My neutrophils are now up over 5 after struggling to stay over 1.   My body is generating lovely new cells and my platelets are now over 180.  My paraprotein levels are stable coming in between 4 and 6 for the last three months.  Whoop whoop!!

What’s more, I have tolerated my first Covid vaccine (Pfizer) well, with no side effects.  I can now have all of my other childhood vaccinations re-done.  My body is ready.  Thank you, body!  I knew you’d show up.  Well most days I did.  Occasionally I wondered if you were going to say it is too much hard work but here you are, showing up and stepping up.  Thank you! 

I am so so grateful because I love life. I still have a lot to do and more importantly, I still have a lot of person to BE.  I can BE and do that now thanks to you, body.  Once fully jabbed with all the renewed protection, I will be much safer out and about in the community again.  The vaccination timing is looking good for alignment to when UK lockdown eases.  Yippee.

I am now on six weekly monitoring instead of having to go up to hospital for one thing or another at least once per week.  This is thrilling!  This is normal life!!

Latest science about Metabolic Pathways in Multiple Myeloma

Cellular Metabolic Pathways in Multiple Myeloma

 Super scientist

I am becoming super geeky about Myeloma and have begun reading loads of journal articles about the metabolic pathways, processes, genes and enzymes that cause, maintain and promote Myeloma relapse.  I wasn’t ready for this level of biochemical detail before but now I seem to be able to absorb the info and am fascinated by it.  The brain fog has lifted!   In case you fancy a bit of geeky biochem cancer guff – check out this link

I am learning about how to shut down the pathways, fuel and microenvironment that Myeloma likes the best – predominantly glycolysis and glutaminolysis.  This new in-depth knowledge feels empowering, gives me a sense of control, is already helping inform my decisions about further treatment and identify changes and renewed commitments to my preferred lifestyle choices.  A new chapter is opening in my life, health and Myeloma journey.  I am working on creating the best integrated health care plan that I can. 

I am still being realistic.  I haven’t forgotten the stats.  I am still in my 5^th year of a 7-10 year prognosis.  For now, nothing is off the table; the traditional medical route, off-label drugs, supplements (specifically targeted to block pathways), Jane McLelland’s Metro Map and How to Starve Cancer approach, Chris Woollams Canceractive approach, meditation, exercise, oxygen therapy.  I feel full of hope for thriving, for a high quality life, a long life and I feel good. 

I am alive and kicking.

All there is to do now is to be and sit in this feeling, let it cover me like a cloak or envelope me like an exceptionally warm, comfy hoodie, which seems to be all I wear these days! 

P.s. Tookie – while I do love you, keep your paws out of our pond!

Acknowledgements

Images: 

Me and hubby

Unsplash:

Rebecca Campbell – Goldfish; Erik Karitis – Caterpillar; Jon Tyson – Good news; Kristine Wook – Vaccine Teddy Bear; Brandi Ibrao – I hope you know how loved you are; Chewy – black and white cat

© 2021 Janine Hayward www.psychingoutcancer.com.  All rights reserved.

Posted in Blood Clots, C-diff, Covid, E.Coli, Fatigue, Glutaminolysis, Glycolysis, Metabolic Pathways, Pain, Psychology for Cancer, Stem Cell Transplant SCT Tagged with: Blood Cancer, Bone Cancer, Cancer, Crises and Stress, Fatigue, Immune, Immunosuppressed, Mental Health, Metabolic Pathways, Metabolism, Myeloma, Psychology, Stem Cell Transplant, Tumour Microenvironment

56 days slow and bald

56 days since my stem cell transplant (SCT). I’ve now been home for the same amount of time that I was in hospital, 4 weeks.  Hospital seems like a year ago.  Life can be summed up by two words; SLOW and PATIENCE. 

I’ve been slow before (when temporarily injured or after a knee op or three) but this is a new slow. Walking from room to room is slow, sitting down, getting up, slow. Asking muscles to work, their receipt and action of requests, slow. Stairs well, they may as well be Everest! All the yoga flexibility and strength pre transplant has evaporated. Turning on taps, opening containers, putting on shoes are all a huge challenge. Stretching is a mammoth task, let alone trying a forward bend or downward dog.  I’m feeble, weak and extremely fatigued.  Putting feet up after a shower, afternoon naps (usually two hours) and early nights are a daily must.  Sitting down on the closed loo seat mid-way through brushing my teeth is novel yet frequently necessary; standing for two minutes in front of the basin is a tall order.   The pace of my life has almost ground to a halt and my new norm is slow.

Stairs may as well be Everest

C-diff (Clostridium difficile)

I am so happy to be home.  The night I was discharged I was ecstatic to be out. I’d recovered from the worst of e.coli, was on the road to recovery from SCT when WHAM.  Another infection turned up and walloped me in the face.  Well, more precisely it whacked me in the stomach and bowel, attaching me to the loo once again.  At least it was my loo, with nice soft paper, a wide sink in which my hands actually could be washed without splashing the floor and my feet, with predictable hot water, familiar sprays with berry aroma and none of that hospital cleaning fluid smell.  At home, even the loo was heaven.  The nurse apologised for not being able to pronounce the intruding infection’s name. I laughed and reassured her it was fine.  Unfortunately I could pronounce it all too well.  The last word was Italian for difficult!!  We agreed it was aptly named and settled on the more commonly used c-diff! 

Slow slow slow.  Taking it slowly and doing everything to prevent going back into hospital was the name of the game.  I fended off the doctors for a week. I reassured them I’d be fine, reminded them that my temperature spikes were nowhere as bad as two weeks previously and that I could handle the infection at home if they just gave me a nice heavy duty antibiotic.  Being readmitted would have taken the last bit of happy I had left in me and zap me of any remaining optimism about the transplant outcome.  To the doctors’ credit they gave me their dubious looking faces but didn’t push it.  They settled for giving me a three hour drip of fluids and the antibiotics.    I didn’t realise how rough I looked, sitting in my own room in Haematology, having been assigned my own toilet in order to keep me away from everyone else and no doubt keep everyone else safe from me.

Hubby Hero

Home is only safe because hubby is here.  His hidden talents and remarkable loving caring personality have come completely front and centre. I know I’ve said it before and I’m going to say it again, I am so grateful and extremely lucky to be loved in this way.  My heart hurts for those going through SCTs without the support of a caring partner, friend or special loving family member (even when those people prefer space). 

Hubby’s been doing all the cooking, washing and stuff around home with no input from me.  I don’t do his amazing dinners (perfectly cooked fish with burnt butter caper sauce, delicious lamb with salsa verde or Persian aromatic salad) justice as my appetite has not fully returned and my taste buds are just weird.  He gets up in the night (2am, 4-5am) to check I’m ok, to make sure I’m not stuck or being sick, to see if I’m wide awake (often at times the checks took place in hospital) or to see If I have fallen asleep on the sofa.

Our pond with gentle fountain – such a pleasure

He drives me to hospital, often twice in one day.  He frequently waits for hours or goes away and comes back again like an on-call chauffeur so I’m not standing around for longer than I need to. Hubby has made sure the garden is immaculate and created a pond with a water feature because he knows I love the sound of running water.  If chia seeds, baobab and pea protein are super foods then he is a super being (or bean, my new nickname for him)..sought of sung like superman except SUPERBEAN! 

Hospital, new look for waiting

Waiting and self as benchmark

Waiting is the most predominant and draining feature of hospital now. I go twice a week for checks.  It starts with an early morning (7.30am) blood test, a wait for results and then an occasionally short but usually long stint in the Haematology Supportive therapy clinic.  Though from today I only have to go once a week (whoop whoop!).  Other than the general stuff the results the med team are most interested in are my Neutrophils and Platelets and the question asked is, do I have any?  The good news is that while my Neutrophils (immune system) have been roller coastering around between .69 and over 1, teasing me as they get towards 2 before falling back again, my platelets have been doing a fairly steady climb and are now at 123 (well out of the woods of the 30s when I would need to be given a blood transfusion).  The rise in platelets mean my body is generating new cells.  Lets hope they are clear of Myeloma.  Once my Neutrophils get over 2 and start staying there, it means I will have some semblance of a rebooted immune system that might just be capable of having some childhood vaccinations and allowing me to be around more people.

Daily look

The slow, the fatigue, the compromised sense of self, the need to avoid boom and bust, the extreme patience needed with myself about every little thing I try to do and decide not to try to do, is all normal for this point in the transplant recovery process.  I tell myself to remember this and to not worry about what others that are post SCT have been able to achieve, start again or do before I have been able to.  Instead I focus on using myself, yesterday or two hours ago as my benchmark.  Have I been able to do anymore, any faster, any more normally than yesterday or this morning?  Yes, great.  No, great.  It will get better.  I will get stronger.  My platelets and neutrophils are my friends and working on supporting me as soon as they can.  Give them time.

Channeling Audrey

I’m not good at waiting.  Though I’m much better than I was before I was diagnosed.  Hospital and appreciation of the NHS can do that because waiting is part and parcel of hospital life.  I’m still rubbish at it.  Last Thursday I waited 1.5 hours with only a 30 second conversation with a nurse letting me know they are waiting for the doctor. It’s understandable but frustrating as I see other patients’ doctors arrive, see them receive their treatment and leave before me, especially when their appointments were later than mine.  Still I try to remember the overall amazing service I have received over the last 3 plus years. Some days it is hard though and I want to be angry, upset and cry. Unhelpful thoughts drift in; I booked this early appointment so I wouldn’t have to wait so long (again), this is wasting my life, it doesn’t take this long for blood results to come back or can’t you see from your board I’ve been waiting an age – do something! 

Uncovered

In therapy

My clinical psychologist side eventually kicks in and internally speaks to me – the person living with cancer, the Janine living with cancer treatment and its impact. Notice your thoughts and feelings, acknowledge them fully, connect with them (allow yourself to fully experience them, where and how they show up in your body, their nature, their depth, their source) and then once you have given this process time, engage.  Engage with the present world around you (notice three things you can see, hear, smell right now, notice three things with yellow in them). 

It’s ok to be angry, it’s ok to be upset and it’s very ok to cry. It’s also very ok to find your voice and ask the nurses again, what is happening and will the doctor come soon? Breathe, stay in this present moment, remember too who you want to be in the world, with others, with nurses, with doctors. I want to be kind, calm, clever and clear. Good, there is clarity in your values. It’s fine to say, calmly, to say gently to the nurse that you are upset. It’s ok to show tears.  You can still be kind, still recognise the wait is not her fault, that she is doing her best. You can ask her to see if there is anything else that can be done. 

Remember no matter which thoughts come into your mind, acknowledge and connect with them, engage with this moment, right now, moment by moment and then choose to place your attention on thoughts that are helpful, on actions that are supportive. If you are sitting in that hospital chair or waiting anywhere, choose to read, catch up on messages, listen to the radio, write a few notes for this blog, laugh, smile, marvel at your ability to shock yourself as you go past a mirror not recognising the person looking back at you  (I so often forget I am bald and look like others’ common perceptions of a cancer patient). Do this rather than sit, feeding the anger and anxiety by watching nurses and other patients, dwelling, being hooked by, ruminating on the thoughts that are leaving you feeling angry and upset.   

Knobbly head

Hey self clin psych Janino, you are pretty handy at times.  It was no coincidence that I met that side of you/me before being diagnosed and travelling life with cancer was it? Thanks for being there.  Thanks for helping me apply strategies to lift myself from the fog, the negativity, the anger and sadness.  Thanks for helping me notice the little things as well as the big things.  I laughed when I discovered my trackie pants were on around the wrong way today.  I was thrilled when a café gave me my favourite jacket, having kept it for me overnight after I walked away leaving it on a chair outside. Thank you.

Keeping cool

Hubby, our 14 year wedding anniversary comes up this week.  Thank you, from the bottom of my heart to the top, for everything you are, you do and for putting up with my slow.

Acknowledgements

Images: 

Me & Hubby – headshots

Unsplash:

Yogi Purnama – Superman

Michelle Henderson – Mr and Mrs

Macau Photo Agency – Waiting

Erik Nielsen – SLOW

Martin Jernberg – Everest

© 2020 Janine Hayward www.psychingoutcancer.com.  All rights reserved.

Posted in C-diff, Fatigue, Myeloma Treatment, Psychology for Cancer, Stem Cell Transplant SCT Tagged with: Cancer, Fatigue, Myeloma, Psychology, Recovery, Side effects, Stem Cell Transplant

Escape after SCT and E.Coli

Escape! I’m out of hospital.  I burst into tears on leaving. Overwhelmed with a sense of freedom and loss. Loss of four weeks of my life and being in the world.  Last night was my first night at home since June 27^th.  Twenty-six nights in one small poorly ventilated over heated room.  Up until this experience I had never been in hospital for more than a few nights.  Let’s hope I don’t end up back there which is common after a Stem Cell Transplant (SCT).  Most people get an infection of some kind and have to go back in for a while.  Afterall the immune system is still fairly non-existent. Though I think I’ve done my fair share of infection.  E.Coli gripped me for at least two weeks of my four week stay.  Not any old E.Coli either.

E.Coli

Specialist Nurse J came in yesterday.  She asked me, do you know how sick you were?  I said not really; I slept a lot and comparing my bad patch to awful gastro-enteritis which I have had a few times, in some ways it hadn’t seemed so bad.  She set me straight, kindly.

She explained she had looked in on me a number of times but I had been asleep.  This was a good thing because while most people have infection markers of 10 or below and doctors start getting worried and applying antibiotics, getting xrays, pet scans when infection markers are around 100, my infection marker registered over 400.  My temp consistently spiked into 39s.

Nice.  Once again I don’t do anything by halves.  Trust me.  I’m into full body experiences.  Though thankfully I slept through a lot of this one!  Instead of the Dr B predicted two week stay in hospital I was there 26 days and believe me once you feel well, hospital is not the place you want to be or at least definitely not cooped up in one room and one ward without being able to see the world.

Similar to e.coli

Relief

Two windows gave me moments of solace and a wee bit of interim escape.  I could just see people playing basketball and tennis in Ruskin park through the tree canopy.  Though the windows were in the sluice room which while spotless wasn’t a place I wanted to hang around much. Being reminded I may need to use a commode and other goodies at some stage in my hospital visit; if not now then next time wasn’t an image I needed in my mind.  Being in there was handy one day; I grabbed a sick bowl for a moment of queasiness.  Everything I needed right there, in the moment.  Can’t ask for more than that.

The other HUGE thing that provided relief during this ordeal was all the fantastic facebook, insta, video, whatsapp messages I received.  THANK YOU THANK YOU. Also for those I did manage to call for a few moments – thank you for being there, again and again.  You are so so special, all of you.

SCT

The heavy duty chemo and return of my stem cells has appeared to go well and my neutrophils (basis of immune system) are on the rise.  I did get mucositis (raw exposed soreness feeling in throat, mouth and oesophagus) which is common and I didn’t get it badly which I am thrilled about. My platelets are still a little low but heading in the right direction.  Once I have hit the SCT + 100 day marker (October) I am due to have a bone marrow biopsy which is the deep breath moment.  Will my bone marrow show any signs of Myeloma?  Will it show a really low sign e.g. maybe a para protein (pp) of 1, similar or undetectable in my marrow?  After all the cells that went back in were collected when my pp was 1.  Or will it be higher?  Will it come down? Questions, questions, patience needed.  In the meantime I’m enjoying being home!

PICC Lines and Clots

PICC lines are good things and you can be unlucky with them.  I’m a full not by halves person remember so with my first PICC line a clot arrived and ran up my arm above the PICC line towards my clavicle.  If you saw the images on insta, you probably noticed my right arm and hand went an awful purple and swelled to about three times its size.  After a week (I think I was a bit out of it) they took my PICC line out (nasty little buggers – they have a fish hook style on their ends so they grip once in (a good thing, nasty when they have to come out).  At least the line itself comes out fairly quickly, easily, and reasonably pain free.  Another PICC line was put into my left arm and normal intravenous meds resumed.  The sub cutaneous line in my right leg (for the Haldol) was moved to my left arm also which made sleeping on my right side a whole lot easier.

With daily clexane (enoxaparin) injections again, the clot eased after a week and I recognised my hand, thank goodness.  I was worried.  One nurse /doctor (can’t remember now) had said clots can take three months to resolve.  I’m still on the clexane but there are few visible signs of the clot now which is reassuring.  Just bruises and quite a few of them.  Hey, that’s completely manageable so I’m grateful.

A day in the life while in hospital

11pm – finally finish all the intravenous and sub cutaneous meds for the day.  With two exceptions 1) haloperidol and something else in a slow driver which continues to provide  anti-sickness properties through the night, and 2) TPN – essentially food and minerals delivered over 24 and 48 hour periods into my PICC line (because I wasn’t eating enough especially through the e.coli business.  I couldn’t stomach the fortijuice and shakes that were on offer (pun intended!)

2am observations done – blood pressure, oxygenation level and temperature

Between 5am and 6am – more observations and then the intravenous drug regime and oral meds process began.  Some meds couldn’t be dripped in at the same time so I would end up doing one hour of something then a flush of saline (or similar) for 10-15 minutes then 30 minutes of something else and then a flush and then two meds at once for an hour (all while the other two described above kept going in! 

This would continue for the rest of the day; obs and meds pretty much until 11pm and the cycle would start again.  Sleep at night was fleeting.

I showered on good days and confess to going four days without a proper wash!  I can’t even imagine it, yick!  When you are sick you are sick!  I lived in Hubby’s boxer shorts and a singlet.  I didn’t care who saw me pacing the ward (on good days) in these.  Staff have seen worse and the get up was the coolest and most comfortable thing to wear.  Hubby was an angel – delivering freshly laundered clothing, drinks, whims (shortbread) whenever I asked and that meant most days.

Each time I was woken up I’d need to drink, slowly make my way to the loo with Harry; my Med stand with four pump boxes on it to manage each drug and boy could he bleep.  Then back again for the next wriggle up the bed in to a semi comfortable spot and before letting a very patient nurse begin the next hook up!  Harry’s bleep would be every time an infusion was 5 minutes from finishing, then once finished, then whenever one of the pumps got it into its techie bits that there was a downstream occlusion i.e. there wasn’t but I may have moved my hand a fraction so it decided bleeping until it was checked was a cautious thing to do.  In the end I got sick of buzzing for Nurses who had better things to do and would turn the bleeps off myself and restart the infusions when I was sure a pump was being over sensitive.  Anything to stop the bloody beep!

Harry’s mate keeping an eye on me.

Hospital food is beige.  I get they try and have a lot of people to accommodate.  If you have no appetite and are trying to force yourself to eat; the menu is not a pleasant thing.  I did however live on tuna and mayonnaise sandwiches when I was up to it and the kitchen staff were lovely.

Funnies and daft things people say to you

On my second to last day I took Harry to the loo as usual only to realise I wasn’t hooked up to him anymore.  That was one image I could have saved him from!

You’ll be out before you know it (when I’d already been in 3.5 weeks).  Actually I will know it.  I’m willing it.  Now I’m begging for it.

Oh I’m sorry. It will grow back quickly (referring to my hair and shaved head).  Why are you sorry?  I’m not sorry.  I’m cool with it.  I have more things to worry about than my hair!

Do you have kids? No??? It’s not too late.  Oh yes it is!! Its ok my life can be complete without kids.  Just because you have five and want more (pity your wife possibly?) doesn’t mean I need to have them.

By the way my responses stayed in my head and instead I would just smile.

First night at home

I’ve been awake since 4am, walked into the garden and around it about six times, felt the rain on my scalp and face. Read a fabulous big magazine (gift from a neighbour and the publisher).  Check it out here:

https://www.instagram.com/documentjournal/

https://www.documentjournal.com/

I have revelled in cuddles, kisses, touches, smelling and touching hubby.  Holding hands is so special when you haven’t been able to do it for four weeks. 

 Acknowledgements

Images: 

Me & Hubby

Photo by CDC on Unsplash – ecoli style

© 2020 Janine Hayward www.psychingoutcancer.com.  All rights reserved.

Posted in Blood Clots, E.Coli, Myeloma Treatment, Psychology for Cancer, Stem Cell Transplant SCT, Symptoms and Side Effects Tagged with: Blood Clot, Bone Cancer, Cancer, Chemotherapy, e-Coli, Fatigue, Mucositis, Myeloma, Psychology, Treatment, Worry

Silent Dominos

Hello you. Is anybody out there? Sorry I have been so silent for so long; it’s been a heck of a hard eight months. That’s not to say there haven’t been some good times, some great times, times I’ve felt adventurous, happy, even peaceful. There have though, been times when I’ve thought this is just too much. Too much everything. I may have been giving this blog the silent treatment, yet in my head, I have written so many, many, times. 

If any one thing had happened, gone wrong, been challenging; I would have been able to cope. Life doesn’t work that way, though, does it? One thing happens, then another, and while I get my head around those, another and another, like multiple, side by side dominos tracks; they all cascade, one by one and at the same time – bang, bang, bang. 

After about the third bang…my ability to do the helpful, healthy things went out of the window. I fell of the tracks… I struggled to get back on. For a week, I managed it, then I fell off again. I picked myself up, recommitted but only for a day … and then I …gave up.

Sugar, alcohol, copious amounts of coffee, long periods of not eating, then eating crap, withdrawal, duvet days, not wanting to socialise, wanting to be on the couch with TV and the cat…all re-entered my life with a vengeance. I was no longer walking the psychologist and cancer care talk.

Except I couldn’t escape the knowing. I knew what was happening. I watched it happen. I watched everything I’d built up to support me, over the previous year since diagnosis, slip away.  Despite this, somehow, I was still managing to function, to help others, to turn up at the cancer centre and be the psychologist, I knew myself to be.  The cost was high. Exhaustion kicked in. Overwhelm. Then the next domino fell, and the next and another. 

So, I fell off the tracks and self-care plans. I stopped walking my talk. Out went the green smoothies and in came caffeine and Pisco sours. I was in cope, any way I could, mode. 

Turns out I am very, very, human after all. Who knew? 

And the dominos…Well, one you already know about, if you caught my last two blogs,
Isoflavones and Tears on a plane

The others were a shock to me, maybe to you too.

The first set;

1. My hands stopped working.

2. Mum got cancer.

3. An internet troll joined my party.

I’m not silent anymore.

Posted in Cancer in my family, Psychology for Cancer, Symptoms and Side Effects, Uncategorized Tagged with: Cancer, Family, Fatigue, Mother, Psychology, Side effects, Troll

Shapeshifter and Thank you

Boo!

Did I change career over the last month of 2017, become a lead actor in a thriller? This thing keeps creeping up from behind me, above me, beside me, from below, yelling BOO! It sends my cortisol levels sky high, makes my heart pound and brain race.  I’ll be tidying, reading, sitting, walking down the street, thinking about something or standing in a queue, essentially minding my own business, when WHAAAHHH! There it is.

I recognise it straight away. Sometimes, I even feel it sneaking up on me yet it still scares the living daylights out of me. It’s a shape shifter, a dark cloud and an amour piercing arrow. Either way it makes me gasp, scream, crash, sleep, feel defunct. It pulls the ground out from underneath me, leaves me doubting the paths taken and decisions made that previously seemed acutely clear and necessary.  It’s an expert protagonist in this production. It doesn’t take direction.  It’s a master tease, dangling hope and snatching it away, reminding me, it’s in control.  I’m the newbie on set with no Daniel Day Lewis, Dame Maggie Smith or Christian Bale style mentor to guide me.  In the meantime, it picks another corner to hide in and I jump through the roof with the next BOO!

It’s not cancer; it’s fatigue.

Fatigue and Fear

Fatigue, is really getting to me.  I don’t get enough sleep.  I wake every two hours.

I’m also scared.  Though I do know I’m alive!

I’m scared of dying young. I’m scared of missing out.  I’m scared of making a poor decision; making my condition worse or accelerating its progress.  I’m scared of being a burden.  I’m scared of not being enough for my husband, of dragging his life down (all the active plans we had). I’m scared he’ll leave me. I’m scared I’ll ask him to leave me, to go off and find someone else, to have a life with more fun, that doesn’t involve or revolve around a wife living with terminal illness.  I’m scared that I don’t and won’t again resemble my sense of who I am; an active, full of life, adventurous person who stands on mountains, travels everywhere, is strong, independent, sensual.  I’m plain scared.

Fatigue and fear.  I feel them. I get paralysed by them.  I think about them. And, yep you know it by now (if you have read my earlier blogs)..…

That’s OK. It’s OK that fatigue and fear do that.

It’s natural.  I am living with cancer and have had a gazillion sessions of Chemo during 2017, numerous biopsies, scans, endless blood tests, new challenging experiences and learnt a new language of medical intervention.  However, just because I face big challenges or can find myself embroiled in fatigue and fear, doesn’t mean I must let these factors take over this whole blog.

I can do a bit of my own shapeshifting, respond rather than react, slowly little by little unlock the paralysis and pull on a cloak of ‘sitting in all the good things’.  I can start now.  I’m not ignoring fatigue and fear.  I’m not denying their existence.  I am denying them their take over plans.  I am choosing to focus on something else right now.

Today, this blog is going to be about a huge THANK YOU and more Good News!

THANK YOU.

Belated Merry Christmas and / or Happy Holidays and Happy Happy New Year everyone.  Thank you ALL, for reading my blog, for subscribing, for commenting, for sharing it with others who may have an interest in the journey, an interest in what has worked for me so far in managing cancer or an interest in the psychology tips and experience I have incorporated.

Thank you too, for all the wonderful cards, calls, skype time, meals together, moments and best wishes my hubby and I have received over the holidays.  They are so appreciated.  Every single one.

I firmly believe that all your support and encouragement has contributed to my good news. I have felt loved, helped, contained, hopeful and normal at times when things were far from normal.  THANK YOU from the bottom, to the top, of my heart.

THE GOOD NEWS.

My December 2017 results are great.  In addition to those mentioned in the previous blog, titled 48, my recent pet scan, bone marrow biopsy and MRI have overall been extremely positive.  Of the four lesions I was diagnosed with, only ONE near L5 in my lower back took up glucose during the pet scan, indicating active myeloma.  Even this lesion took up significantly LESS glucose than it has done in previous scans.  Yeah Baby!  How good is that?!

I told those tumours they were wasting their time hanging about and I am taking this as evidence that they have been listening and reassessing their landing page!  It is wonderful to read the line in the report that said ‘There are no obvious focal uptake abnormalities in the brain’!!  Let’s hope no un-obvious ones decide to make an uninvited guest appearance.  They’d be about as welcome as a Harvey Weinstein type right now!

There’s more.  The bone marrow biopsy did not show any active Myeloma in my blood or bone and, wait for it…my MRI did not show evidence of any new lesion/tumour.  Yee Ha!

I do have one caveat; I have some mild degenerative disc disease and loss of height and hydration between vertebrae in my spine; my back is looking a bit older than my years.  It is unlikely that I can particularly do anything to repair damage.  I can exercise and ensure by back remains strong, doesn’t antagonise the nerves around L5 and otherwise prevents my degeneration from becoming worse unnecessarily.  I will check with the physio about what else, if anything, may be possible.  It was also wonderful to read ‘the spinal cord returns a normal signal and the brainstem structure is normal’.

Being pragmatic, I am remembering that Myeloma is tricky.  It will come back.  It can also be a bit lazy and not show up at times in these results. It can take a rest or be working out how to manifest itself in a new way in my blood and bone.  HOWEVER, TODAY…

I’m looking on the bright side of life! (How many of you began singing this line? I can’t help myself)

A helpful position to launch from; I start 18 more months of Chemo this week – the maintenance phase on the clinical trial.  Let’s see what this brings.

This is infinitely easier to do with wonderful friends, family, readers, well wishes and my so far ‘beyond amazing’, hubby.  I appreciate all of you.  I really do.

February 2017

December 2017

THANK YOU.

BRING ON 2018.

Acknowledgements

Images; Hands by M & T. Me (February) by Dad. Me (December) by Me.  Thank you image by Tumiso @ Creative Commons (free for commercial use, no attribution required); 

© 2018 Janine Hayward www.psychingoutcancer.com.  All rights reserved.

Posted in Psychology for Cancer, Results Tagged with: Biopsy, Cancer, Fatigue, Good News, MRI, Pet Scan, Results, Thank you

Vampires, Angels and Twiki

Hooked up

My blood spurts everywhere like a regular Fright Night or Halloween movie.  The nurse is trying to put a cannula into each arm, a bloody big cannula, much bigger than my normal (ha ha) Chemo cannula.  The nurse is new to this treatment and seriously nervous. Great. I’m not in the mood today. The mood.  The mood where I am happy to be part of someone else’s learning curve.  I’m just not.  Now she’s made a mistake and there is blood everywhere.  My blood.  My very, very, precious blood.

Another nurse pounces with a clamp and gets everything back under control.  For now. Except, I feel sticky.  My leggings and legs are spattered with blood.  The pillows and bed coverings are no longer pristine white. Stressed, I blurt out, ‘I don’t want to be anyone’s experiment’.  The nervous nurse (NN, my nickname for her) looks horrified. She reassures me that I am nobody’s experiment. Her body language and voice sound like she is trying to convince herself that everything is OK.  I think ‘I can’t afford to lose any more blood; get me someone who has done this A LOT’.  But I don’t say this out loud.  I hope it, instead.  I calm down a bit and give NN, a smile of, ‘it’s ok’. It’s not OK but I figure I need her to be calm.  Everyone makes mistakes. In the grand scheme of Myeloma treatment, this wasn’t a bad one (so long as I don’t end up needing that runaway blood).

I am in the Apheresis unit, finally all wired up (ready for ‘take off’?) to a clever centrifuge machine (very CSI) labelled 3OJO (MOJO with a 3?  A machine with 3 times the MOJO?).  Anyway, this machine specialises in taking blood out of one arm (Vampire-esq), separating out plasma and stem cells and then giving what remains of my blood, back to me, through the other arm (Angel-like). Genius! my niece would say.

I try to relax.  The machine’s sound reminds hubby of ‘‘beedie beedie’ so we nickname it, Twiki, and completely ignore the OJO’s in the end.  Do you remember the TV show called Buck Rodgers? Twiki is a silver robot (cute but with unfortunate haircut) known in the show for saying ‘beedie beedie’ to everything.  Very effective.  I’ll think I’ll use it.

Twiki with a lot of mojo (Stem Cell Collection machine)

All the fancy stuff Twiki monitors

I’m quite intrigued by my blood and its component parts…hanging in a bag next to me is the plasma, a funny yellow colour and next to it, slowly, salmon pink (apparently, that’s a good colour) stem cells appear.  Also on the line in bags are saline (isn’t it always?) and an anti-coagulant.  My lips begin to tingle strangely and I feel a bit faint.  I let the nurses know.  They have warned me this can happen.  My calcium level is ramped up and I’m lowered down a bit in the bed.  A song pops in to my head…Blood, Blood, Glorious Blood…There’s nothing quite like it…My Glorious Blood.

Boredom kicks in for hubby soon after arrival, I’m not very talkative today.  I can’t sleep because to help collection along I am required to pump the stress ball, all day, only taking breaks for a few minutes every 10-15 minutes.  Hubby checks out all the bells, whistles and knobs on Twiki and marginally resists touching them (knobs after all) and is now entertaining himself by dancing on the spot.  I’m trying to work out which music he’s listening to because he occasionally is singing out loud, unintentionally I think, and boy his lyrics are dubious!  The nurses and I catch a look and laugh.  Glad he’s got a day job!  Though I’ve secretly always loved his dance moves.  I still can’t work out which songs he is listening too.  Turns out he’s immersed himself in 70s and 80s and he’s running through Hall and Oates hits (would never have guessed).  We share headphones and have a laugh with the past.  Today is turning into a retro day.

I arrived at 8.30am and it’s now 5pm and I too, am very bored; so ready to be out of here.  I’m waiting for lab results to come back and say they’ve taken enough stem cells. For the last four days, I’ve had G-CSF injections that stimulate the stem cells to move out of my bone marrow and into my blood so Twiki can collect them.  This is preferential to the other option of having them collected directly from the marrow (painful, long, more chance of complications, I suspect).

The injections have some seriously weird side effects; they cause pain from inside my bones (ironically similarly to the way Myeloma does…there are so many ironies with this overall treatment process, seemingly making things worse in order to make things better!).  At random points, shots of pain would pulse from my rib cage or my pelvis, take my breath away and stop me in my tracks.  It would usually be gone within 5-10 minutes and then be back again 10 minutes later or half an hour later or whenever it decided!

Lab results this morning told me the injections had ‘done their thang’ and the detectable level of stem cells in my blood (CD34+ test) was well over the count required to go ahead with Twiki’s collection manoeuvres.  Thank goodness.  The collection target is 7 million stem cells per kilogram of body weight and I hope it can be done in one hit, today.  The results come back and they are good but I still need to rock back up tomorrow (and take another injection).  They have collected 5 million.  A few more are needed.  Hubby and I walk home slowly.  I feel shattered.

I’m baaackk!   The next morning is a funny affair, no more escaping blood and instead a new approach.  Yesterday’s senior nurse seemed to be cautious in approach, going slowly and setting things up so blood clotting was avoided.  Today’s senior nurse explains she prefers to deal with problems when they arise and ‘we’re going to go for it’ and monitor everything carefully.  Funny, I thought coming in two days in a row for the same treatment would ‘be the same’; a standardised process.  I hadn’t factored in the human element and the nurses’ different strategies. Today’s target is 3 million stem cells per kg of body weight so info is plugged into Twiki and I lie back and ?? think of England?  More like think ‘please please collect everything needed quickly’.  It’s an all-day affair again.  My potassium and calcium levels need propping up so I go home with extra meds to add to my ever-growing list.

The call comes through an hour later; they’ve collected another 5 million.  Excellent that’s 10 million stem cells altogether.  They’re sent off for cryopreservation (storage in liquid nitrogen at some crazy temperature, −196°C).  I’m relieved.  Maybe that’s enough for three transplants in the future.  Maybe I’ll live longer thanks to these.  If that’s the case then this last week has been a tiny investment; completely worthwhile.

Turns out from discussions with my clinician later that three transplants are not routinely given at the moment and there is no evidence supporting their benefit.  Instead, the transplant team would usually spilt the 10 million stem cells gathered into two larger lots, for each of the two transplants.  Supposedly there have been some benefits found for higher amounts of stem cells being used per transplant.

Oh well, you never know.  By the time, I need the second one maybe they won’t need as many cells after all and I can eek out another transplant.  Or my transplants will be so successful I won’t need a third one.  Or it will be what it will be, completely in line with current evidence and practice.  I’ll worry about that when it happens.

As part of the clinical trial I am on, I’ve been randomised to another four months of chemo (Carfilzomib, Cyclosphamide and Dexamethazone, half the Dex dose than in the previous four months) rather than an immediate transplant.  I don’t need to worry about the transplant details right now unless something goes a bit wrong and the Myeloma comes back with a vengeance sooner rather than later (after all it is always going to come back).  I crash for two days (the cat loves it) and feel really shattered for the week.

Post collection rest

The good news about my Myeloma is that its presence in my body after the first four months of Chemo has dropped; the IgG kappa paraprotein level is down to 6g/l after being as high as 42g/l.  It’s not quite the 100% response rate I was hoping for but it is damn good.  It is not usual for this rate to rise again for a year.  I’ll have regular tests and jump on it if it decides to buck the trend.

I’m a bit low in mood and I think this is mainly due to low potassium and not knowing what the next phase of treatment is.  Dealing with uncertainty is tough and coping well with it, ebbs and flows.  That’s normal.  I have talked about this in previous blog posts.  I’m also nervous (my turn).  I have a pet-ct scan coming up this week.  Will the radioactive sugar stuff sent into my body find new lesions in my bone marrow, new weak spots or confirm that the treatment has worked brilliantly so far?

Maybe it is a good time to explore my relationship with illness and health.  I can step out of project mode for a moment, round one of treatment has been accomplished.  Now, is as good a time as any to face asking myself, in a more structured way, what it means to have incurable cancer, what it means to be ill.  Which factors, which thoughts, beliefs, feelings and sensations are influencing my health behaviour, my coping…and not coping?

Psychology

One established psychological and behavioural model for explaining how we think about, respond to and manage threats to our health is Leventhal’s common sense model of self-regulation of health and illness¹.  Here are three of the concepts at the heart of the model.

1. our perceptions of our illness directly influence our coping strategies, which in turn influence outcomes.
2. our perceptions and resulting mental representations of illness and health threats have two parallel processes, a cognitive representation (our beliefs about; our identity, causes, consequences, timeline, coherent understanding and control/curability of our illness) and an emotional representation (our fear, distress, anger, worry, depression, guilt or other affective states). We use these mental representations to make sense of threats to our health.
3. we actively engage in problem solving by testing coping strategies (aimed to manage fear from emotions, and danger from cognitions), and checking whether the coping strategies have worked, to help us reach goals (e.g. to overcome cancer, to survive as long as possible, to overcome anger and be the person we wish to present to the world/think ourselves to be despite illness or to be well enough to play with our children every day)

The model is one way of explaining how we go about reducing the tension that arises between holding on and letting go of important values and goals as we come under threat from ill health, disease processes and treatment impact and side effects.  Figure1 below shows this in a bit more detail.

I thought I’d use this model to explore my thinking, beliefs, biases and assumptions about my current health.  If you are managing pain, chronic illness, cancer or caring for someone who is ill, I hope you find it helpful to ask yourself similar questions.  I encourage you to notice the thoughts that pop into your mind without judging them; they may surprise you.  When I work with clients who are living with ill health using this model, they often discover something that they had no idea was influencing their sense of self, or making them feel worse or they discover a rule they had imposed on themselves, based on an unchallenged belief about what it means to be unwell or to be going to hospital or taking medication.

Where to start?

I start by asking myself;

what does ‘health’ and ‘being healthy’ mean to me?

what does being ‘ill’, ‘ill health’, ‘being sick’ mean to me?

Do these concepts mean different things when I think about myself versus when I think about others?

What does it mean to be diagnosed with cancer? With Myeloma?  What does it mean about me that I have been diagnosed with cancer, with Myeloma?  If it was my partner or a stranger with the diagnosis how would the meaning of having cancer/Myeloma be different?

Figure 1. Hagger and Orbell’s (2003) schematic representation of

Leventhal’s (1980) Common Sense Model of Illness (CSM).²

What do I ask next?

I explore a range of questions with myself about the mental representations I have about being unwell and under threat from cancer.   While I work through each question and consider my answers, I also explore how my responses make me feel and what I will do to cope with the event and the feeling.

Stimuli

What am I experiencing?

What are my symptoms? (e.g. pain, fatigue, breathlessness)

What is telling me I’m unwell?  (test results, pain, reduced mobility, hospital appointments)

What do I know about my illness?

Where is my information coming from? (external: medical team, support groups, google, other patients; and internal: physical and mental experiences)

What are my symptoms? (e.g. pain, fatigue, breathlessness)

What is telling me I’m unwell?  (test results, pain, reduced mobility, hospital appointments, calls from medical team)

What do I think about where the information is coming from?

Cause

What do I think has caused my illness?  Do I think any of it is my fault?  Someone else’s fault?  How has my illness come about?  What do I think about the cause/s?

Consequences

What are the consequences for me, of my being diagnosed with cancer? From being unwell?  What will I be able to do and not do?  Will my life change? How will my life change?  How will my relationships change?

What are the consequences for others of my being diagnosed with cancer?  From being unwell?  How will their life change?

Control /Curable

How much control do I have over what is happening to me? Over being sick?  Over getting well?

How much do I think and believe my illness is; curable? able to be overcome? able to be managed well?

What do the consequences of the illness (e.g. likely outcomes, treatments, having to have chemo, a transplant, hospital visits and beyond) mean about who I am? what I am? My capabilities? My sense of being a woman? A daughter? A wife? A lover? An academic? A clinician? An exercise bunny? A coffee lover?  Looking at all the aspects of my sense of self what does being ill, having cancer mean for each of those and who I am?  No change? A change? For better? For worse?

Timeline

How long will I be ill?  Will any changes and consequences be temporary? permanent? If my life changes will I be able to change it back once I am well or coping with the illness? Will it be the same as before?

Emotions

In addition to any coping strategies captured while gathering responses to the questions above…

How do I feel overall, right now, today?

How do I feel about being unwell?  How do I feel about having cancer?  How do I feel about each aspect above; the causes? The consequences? My sense of self? The controllability? Curability? How long I’ll be unwell? How do I feel about each of these?  How do I feel about my thoughts and beliefs about each of these?

Coping strategies

In addition to any coping strategies captured while gathering responses to the questions above…

How will I cope?  What am I trying? What makes me feel better? Feel worse?

What will I do?  What will I avoid doing? Will I ask for help?  From who and where will I ask for help?  What will I practice thinking? Not thinking about?  Where will I put my energy?  What will I focus on? Avoid focussing on?

What emotions will I allow myself to express?  Are there any that I am not happy to express?  Why?

Appraisal of coping so far

What has worked well so far? What helped the coping strategy to work well?  What hasn’t worked well? How did it not work well?  What were the outcomes?

What do I want to change, try next, no longer try?

Working through these questions and using this type of model is challenging to do alone and isn’t something that is likely to be done and dusted in one sitting or even one day.  It may take time to make the enquiry of yourself and find your answers.  Notice the answers that pop into your thoughts, into your head.  The answers may be scary sometimes, difficult to acknowledge or leave you feeling upset and distressed. 

It is important to be kind to yourself during this enquiry.  Its ok to take breaks.  Its ok to feel distressed after noticing the answers.  It’s a good idea to do something nice for yourself after working through these questions.  These are difficult questions for anyone to look at, let alone anyone who is living with ill health or a life-threatening health concern. 

Remember the aims of making the enquiry is to

• understand how we are making sense of our own health, ill health, diagnosis and health journey
• notice the factors influencing both our coping strategies and our appraisals of the outcomes from our chosen methods of coping.
• identify coping strategies that are likely to be most useful (complement our treatment and enhance our behaviour and management of illness, Myeloma) and drop the strategies that don’t work so well

Ultimately, by bringing our mental representations into our consciousness, our awareness, we may be able to pause and challenge some of them, more easily accept others, and create and foster new helpful health representations.

Many patients perceive they can stand extreme toxic Chemo therapy when they also hope and feel that it may result in a cure.³ There is no cure for Myeloma so how do Myeloma patients, how do I, stomach Chemotherapy? Do I stomach it because I hope it buys me time for living and time for a cure to be found, or buys me less pain, less discomfort, more quality of life?  How am I managing fear control and danger control?  What are my representations of illness?  How vulnerable am I?  How motivated am I to take self-protective steps?  How easily accessible is my motivation?  When is it easy, when is it difficult, for me to do the right things, to look after myself, adhere to medical advice, and adhere to the other complimentary advice I have chosen to follow?

Watch this space – I’ll post my answers over the next week or so to give you an idea of what this type of enquiry might look like…and then I’ll talk about what you might do with knowing your answers – how bringing the answers into your consciousness can help us to better manage the challenges that face us, illness based or otherwise.

Right now, I need a break so I only have one answer for you…

Beedie Beedie.

References

¹ Leventhal, H., Meyer, D. and Nerenz, D. (1980). The common sense model of illness danger. In: Rachman, S. (Ed.), Medical psychology, Vol. 2. pp. 7–30. Pergamon, New York.

https://www.academia.edu/259452/The_Common_Sense_Representation_of_Illness_Danger

² Hagger, M. S., & Orbell, S. (2003). A meta-analytic review of the common-sense model of illness representations. Psychology and health, 18(2), 141-184.

https://www.researchgate.net/publication/250571403_A_Meta-Analytic_Review_of_the_Common-Sense_Model_of_Illness_Representations

³ Cameron, L. D., & Leventhal, H. (Eds.). (2003). The self-regulation of health and illness behaviour. psychology press.

https://books.google.co.uk/books?hl=en&lr=&id=P3UoIuANmrIC&oi=fnd&pg=PR8&dq=The+self-regulation+of+health+and+illness+behaviour.+psychology+press.&ots=ARDdFKnVmY&sig=hU9R0fsNauKIs04RB3iezy-yAyA#v=onepage&q&f=false

Posted in Myeloma Treatment, Pain, Psychology for Cancer, Symptoms and Side Effects Tagged with: Apheresis, Cancer, Clinical Trial, Fatigue, Harvest, Myeloma, Para Protein, Psychology, Randomisation, Stem Cell Collection, Therapy, Transplant

Before Diagnosis and Special

I’ve always liked to be special but this is taking it a bit far.  4800 people are diagnosed with Myeloma every year in the UK and now I’m one of them.  I didn’t think I’d be saying that.  Well, actually, I did think I’d end up with cancer at some stage; most people do eventually don’t they?  It is in my family…but then I didn’t think I’d get it until much later.  I certainly didn’t think I’d get a cancer that is more unusual than others (15% of blood cancers, 1% of cancers generally) but, hey, I did say I like to be special.

I’ve chosen a cancer (or its chosen me) where usually a person is male, over 70, of African origin and instead I’m female (hurrah!), under 50, and white.  How is that for ironic?  I tell you… be careful what you put out to the Universe because the Universe delivers…maybe asking to be special wasn’t such a great idea!  Seriously though, this is one interesting cancer and I found myself kicking into scientist project manager mode as I ingested as much information as I could get about this new presence in my life.

Friends have asked: how did I find out?  What had I noticed?

Do people ask this because they’re scared they have an illness they don’t yet know about?  Or are people just curious?  Are they nervous about the seeming uncontrollability and randomness of an illness striking?  We never think it will happen to us, or our good friend or our family member but it does.  Illness happens to good people, bad people, people people, every day.  Some illness may be preventable, you know, the usual stuff about stopping smoking, eating well, exercising.  Frankly, if you don’t do those things you really are making it much harder for your body to keep working well for you.  Otherwise, illness just happens and the why is so often still a mystery.

Maybe my getting myeloma is like a metaphor for those of us who are so driven, organised, high achieving, generally healthy, and happy, who always want more, crave growth and development, yet simply cannot control everything. We cannot eliminate uncertainty and must learn to ‘bounce’, flex and sway in the wind if we are to cope with life’s little and ginormous surprises!  For all you control freaks out there (you know who you are and I love you!), I get it, I do.  I like to plan, organise and manage my way to eliminating as much uncertainty in day-to-day life as possible (we even have apps to help make this happen these days) and then demand and embrace the uncertainty, spontaneity and adventure while on holiday.  When it boils down to it though there is only so much we can control and that is OK. Life is meant to be this way; uncertain (spice of life and all that) and we can learn to cope well.

I knew something was wrong.  I’ve known for years.

BUT…I kept doubting what I knew because all the specialists, GPs and test results over the years had reassured me everything was fine.

Except one, a natural killer (NK) cell test that I’d had during IVF treatment (another story).  Even then no one mentioned that the presence of aggressive NK cells might indicate something nasty was going on, something other than my body being unable to let pregnancy cells implant properly.  When I got this result back in 2009 and it was repeated in 2012 (with increased NK aggression levels) I knew something was wrong with my immune system.

I just didn’t know how serious it was.  I also didn’t know what normal feels like, though I strongly suspected that most people didn’t have the trouble getting out of bed that I did, feel frequently achy, need regular Saturday afternoon lie-downs or constantly feel like their adrenals were maxed out.  I often thought of the wonderful, amazingly energetic women in my life who appeared to have energy to be super-mums, triathletes, Tour de France-type cyclists, mountain climbers, sailors. I’d think: their bodies can’t feel like mine does everyday, can they?  Then I’d look at the stress I always injected into my life; taking on jobs that were often bigger than me with steep learning curves each time, doing a masters and a doctorate, striving to work out a minimum three times per week and think, well, I bring on my low energy by my lifestyle choices.

Recently though, having finished the doctorate and chased it with a long break in New Zealand, I started working from home at my own pace on academic and exciting business projects. I had no reason to feel low energy or low mood or slightly and occasionally breathless. But I did feel these things and I didn’t understand why.  I kept thinking, I’m 47-years-old for goodness sake! I shouldn’t feel like this!  I had mentioned I had some slight breathlessness to Mum who insisted I get it checked out. So, when the offer a free NHS Health check for over 45-year-olds came through the post, I booked the appointment immediately and to see the GP on the same day.

In fact, it had also crossed my mind that my symptoms may be to do with becoming peri-menopausal.  I thought, if so, it would probably be prudent to request a test to get a baseline of all my hormone levels so the GP and I could monitor development and make more informed decisions over the next few years.  Sounds all too sensible when I read it back like this but actually, it was the lady in my local health nutrition shop that had suggested this, after I explained my mood had been a bit up and down, I’d been feeling hotter than usual (heat not sexy unfortunately) and my heart had been racing and loud.   This, coupled with a dip in my energy levels and a marked breathlessness during the previous week’s netball game, made me ignore the locum GP’s stress and deep sighing at my list of discussion points.

I asked her to look at all the niggly, singularly minor ailments I’d had over the years and consider them as a whole, please.  I explained I was sick of putting up with the niggles and it didn’t make sense to me to have them; something more fundamental about my immune system must be underlying it all.  To her credit, she looked at the IBS, hypoglycaemia, skin conditions of vitiligo and keratosis, waxing and waning energy and mood levels, unsuccessful IVF, breathlessness and past glandular fever among other things and ordered a set of tests that had not been ordered before.

I couldn’t be more grateful to her.

I couldn’t be more grateful for my Mum and the lady in the health food shop whose name I must find out.

They have extended my life. 

Acknowledgements:

Statistics: Myeloma UK. www.myeloma.org.uk

Illustrations: Sapphire Weerakone, clinical psychologist, baker extraordinaire, artist and master doodler are among some of her many talents!

Editor: Stephanie Kemp, for reviewing my first post and helping me keep tenses under control!

© 2017 Janine Hayward www.psychingoutcancer.com.  All rights reserved.

Posted in Pre Diagnosis Tagged with: Cancer, Fatigue, Immune, Myeloma, Psychologist, Psychology