Five Years Plus











{December 13, 2013}   Time Fast

How often do you check the time?

I believe it is respectful of others to be on time for appointments, yet I struggle to do so. In fact, it’s an ongoing issue for me that I never feel like I have enough time. In particular, I often feel challenged to fit in my yoga and meditation practices in the day. I’m not an early riser and have never managed to sustain the recommended first thing in the morning practice.

In November, Chuck and I had the honor to attend a wedding of some dear friends at Copa de Arbol, an isolated rainforest and beach resort in Costa Rica. The only way in or out was by boat or on foot. Once we arrived I turned my phone off and settled in to relax and enjoy. The tiny clock beside our bed helped me pace each day, but otherwise there were no clocks evident around the place. Even though the situation was ideal for simply being, I noticed that I still stressed about the time – after all, I didn’t want to be late to the wedding!CopaDeArbol

On our last day while visiting our friends’ cabana, I noticed they had unplugged their clock. Duh! Since Thanksgiving followed our vacation, I decided it was a good time to experiment with unplugging from time. I began my “time fast” by removing the two visible clocks at home. Over the weekend time fasting was novel, easy and fun. I made a point of spending more time on my yoga mat and relaxing. I felt free. I wanted more.

Each Monday I teach yoga at 10 am, so I need to know the time. I set my alarm for two hours prior and simply work on what I know needs to be done to get ready. I feel more focused in my preparations and easily arrive on time. It took me over a week to realize that the car clock had to go. After all, once I get in the car I am not really in control over how much time it takes to reach my destination. So now there’s a strip of tape over the car clock.

My time fast is now two weeks old. I no longer glance up to where the kitchen clock used to be. I notice I am less worried about how long things take. I have learned not to look at the time when I pick up my phone. I go to bed when I am tired. On the three days I teach tennis in the afternoon I set my alarm at a designated time before I need to leave so I will not feel rushed getting ready. If the time fast becomes stressful I can consciously choose to look at my watch rather than doing it reflexively. I’m beginning to see that ultimately neither time nor the time fast is particularly serious.

I can also see that I used to be obsessed with time, often feeling overwhelmed. The time fast has helped me to notice when this is happening so that I can consciously develop better mental habits. For example, last weekend while we waited for friends to join us at brunch, I was able to enjoy the company of my husband rather than obsessing about the time and checking the door for our friends with each new arrival.

Finally I am beginning to understand that there is always more to do than time available, and that’s ok. If I don’t make time on my yoga mat a priority, it will never fit in. I know that sounds like simple common sense and I’m not sure how it is for you. For me, it feels different now. I’m starting to give myself the time to practice despite everything there is to do and manage. My time fast has been just the thing to allow me to let go enough to be present in my practice rather than worrying about what I have to do next.

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{October 29, 2013}   3 Weeks Post

Three weeks out from surgery I am pleased to report that I am doing great. I decided to recount some of the highlights from this time in hopes that it might be interesting to read or helpful to someone else going through this or other major surgery.

Week 1 – Coming Back to my Body

It helped that we knew ahead of time that the first few days after surgery would be challenging. Chuck cleared his schedule to take care of me full time and we had many of our meals prepared by friends and delivered to us at home.

I didn’t sleep much the night in the hospital, I expect because of the trauma and all the drugs. When I got home I slept like a baby for four days straight: waking every two hours at night and then sleeping intermittently all day. I could only lie on my back with pillows under my head and knees. It was too painful to roll to either side, so I would wake up pretty sore. I started gentle stretching to work on range of motion almost immediately. I used some ideas from a video about recovery from breast cancer and also included some spinal movements to relax my aching back.

Mastectomy followed by reconstruction is painful, I’m sure even more so for women who have a double. My core is strong from a consistent Pilates practice over the last five months and this really helped my mobility; even so I needed Chuck to help lift me from lying to sitting for the first couple of days. I had two solid days on painkillers, then went off them cold turkey in an effort to combat constipation. I don’t know why medical doctors don’t address this more and perhaps prescribe a stool softener from the get-go. Too late a friend mentioned to add Magnesium to relax things.

Week 2 – A Reason to Get Up

This may sounds crazy, but we had out of town visitors stay with us at the beginning of the second week. They are very special friends that we really wanted to see and they had given us the option to change their plans at the last minute if need be. As it turns out, this visit gave me the motivation to get out of bed.

The day before they arrived I had what seemed like a lot of activity: watering the plants, rechecking the guest rooms and arranging flowers. Their visit marked my return into life,  that is being awake and up for most of the day, going for short walks outdoors, helping to prepare a meal and drinking a little red wine.

Nine days after surgery our friends departed and I had post-op appointments with both the surgeon and the plastics surgeon. One of my two surgical drains was removed. Day 10 was a day of rest. By the week-end I decided we must get the apples picked. This involved both reaching and ladder climbing, a sure sign that my body was healing. As the week progressed the pain let up considerably and I could begin to roll and lie for short periods on my right side. I upped my yoga practice and stretching, began to bear a little weight with my arms and did some gentle core exercises.

Week 3 – Gaining Strength

This week I focused on gaining stamina. We have a 3-mile forest-meadow walk out our back door which I have been hiking most days. I also began to prepare meals again. By the end of the week I was able to work four hours in the kitchen making applesauce from the apples we had picked the week before. Yum.

On day 16 I finally had my second surgical drain removed. This is an annoying but important contraption, like a tiny soaker hose on the inside of the tissue, and a rubber hose that protruded from my side. This feeds into a larger rubber ball that provides a gentle suction and holds blood or lymph fluid that drains from the surgical site. Early on Chuck sewed me a makeshift bra from ace bandages which featured a pocket to hold and support the dangling ball. He regularly emptied each drain and recorded the quantity it held. The drainage had to reach a minimum of 25cc in 24 hours before being removed. Now I could shower freely and lay for short periods on my left side.

Being able to lay on my left side was my criteria for returning to my Pilates class. This was a challenge for sure but a landmark all the same. That evening Chuck and I had an impromtu dance party in our living room. I also started to go to physical therapy this week for an added support in getting stronger. I am now able to stretch without fear of injuring myself and have nearly regained full range of motion, though there is still quite a lot of stretching pain at the end range of movements of my left arm.

Support

Chuck has been a foundation of consistent, loving support throughout these weeks. There is a certain beauty and intimacy in being so dependent on another and both of us have enjoyed this sweetness.

The support of friends and family is also fundamental to healing. From preparing food and organizing its delivery, to lending me books to read, making visits and calls, sending cards, flowers, inspiration texts and emails, I feel incredibly loved and supported. One couple even let me plan a dinner menu which they prepared and brought, shared with us and then cleaned up.

While my surgeons are both great doctors, in a post-op period without any complications, they are not much involved. I have supplemented my healing with weekly bodywork from my talented and versatile massage therapist. Two days after surgery she did mainly energy work. By the third week I was able to briefly lie on my stomach for some gentle back massage. I also added a lymphatic bodywork session in the second week when I realized my arm was swelling slightly. Not the least to mention that we asked our cleaner to come weekly in the pre and post surgery periods.

This post-op period has certainly been smoother than eight years ago. We knew more what to expect and we prepared well. I have been able to rest and sleep well throughout. Even so, we have had to be adaptable as there have been surprises, like having to have a drain in for over two weeks, Overall I think I went into it stronger physically, mentally and emotionally, in part because I took enough time between the diagnosis and surgery.



{October 3, 2013}   A week away…

It is now less than week away from my surgery date: Tuesday, October 8, 1pm. Certainly it took quite a few appointments, tests and some organization to get to this point. Now it’s taking quite some preparation to get both my home ready and leave behind appropriate plans for the classes I will miss when I’m recovering. I’m balancing this with teaching my current classes and most important, I keep reminding myself, staying healthy. And did I forget to mention – enjoying this absolutely gorgeous weather?!

The surgery planned is a mastectomy followed by the first step of reconstruction – insertion of a tissue expander. I’ll also have a sentinel node dissection, which means a small number of the lymph nodes most likely to carry cancer cells will be taken out for testing. All going well I’ll be in our local Crouse Hospital for just one night.

I had fully intended to keeping a regular account of this second time around the breast cancer journey. I didn’t anticipate the sinking feeling that would hijack my inner world after I returned from the tournament and visit in Vancouver. As that lifted it was back to work and the busy-ness of fall – that is, the fall of perhaps 2000 pears from our trees.

Now I’m feeling remarkably calm. I admit it’s hard to remember so clearly what is ahead and just how painful it was last time. But I also feel confident in my doctors and my ability to heal and move on. I’m practicing keeping the soul searching that easily accompanies this kind of diagnosis to a minimum. I’m aiming to simply live today as best as I can.

Thanks for taking an interest by reading my story. I’ll ask Chuck to update you after the surgery.



{August 10, 2013}   Cancer is not an Emergency

It seems natural that a cancer diagnosis leads to panic. I was not immune to this feeling in the days following my recent diagnosis. I wanted to control the tests I had, the timing of my surgery and have it almost all wrapped up by mid-September, ready to get on with my life.

Meeting with my surgeon last Monday was like a breath a fresh air. “Good to see you”, she said. It was in fact nice to see her, even though I didn’t really want to be sitting in her office again. She deals with breast cancer every day and exudes a matter-of-fact calmness while still maintaining an excitement about the advances in her field. Together we worked out what to do.

Every person and each individual cancer is different. The initial pathology report suggests that mine is not immediately dangerous. I am planning surgery and am waiting to hear when this can be scheduled. In the meantime every appointment takes its toll on my mental health. I feel pretty good most of the time, however, in the early morning hours anxiety hits. Usually discussing my worries with Chuck helps relax me so I can get back to sleep.

Overall I’ve shifted from panic to patience, accepting that each step takes time and trusting that the process will unfold exactly as it should. At times I have glimpses of optimism that we can figure this thing out and I can come through healthier and better than ever.



{May 15, 2010}   Soytistics

I was born in the era where women were encouraged by their doctors to use formula and forget breastfeeding. My mother, with three toddlers underfoot, found bottle-feeding with a milk-based formula convenient and it had the added bonus that my dad could more easily help. As the youngest the program was well-established in our household, but when it was my turn, I developed an allergy to the cow’s milk formula. Soy-based formula was the solution. Eventually the milk allergy resolved itself, but by that time, my love affair with soy had begun.

I learned to cook tofu as a sophomore in college. I would wrap the soft block  in cloth and press out the excess liquid with heavy textbooks before chopping it into cubes and sitting it in a soy sauce marinade. Later, gently sautéed, the warm salty exterior provided a sumptuous contrast to the silky inner. Next I discovered tempe, a fermented soy cake that has a chewy texture. Marinated and sautéed or added to spaghetti sauce it was delicious.

Around age 28 I went through a difficult time and discovered warm soy milk as the ultimate comfort food. It probably reminded me of the soy formula I had been fed by my parents many years before. I even made soy Bailey’s Irish cream, though didn’t hesitate to add that crucial can of sweetened condensed milk to the mix. After moving to America I developed a morning ritual of drinking Earl Grey tea with soy milk and and was thrilled to learn I could order creamy soy milk in my latte. I thought I was doing a good thing for both my body and the planet by regularly eating these soy foods.

I ignored it when a cook at a workshop I was attending in 2001 mentioned that soy milk might not be so good for me. There was no way that I was going to replace my thick creamy soy milk with rice milk, which seemed thin and watery by comparison. I was much happier to receive the inputs from the mainstream press that soy was a health food and its consumption could even help to prevent breast cancer. When I finally learned that eating large amounts of soy based foods can actually create havoc in the body I still didn’t want to believe it. How did I get it so wrong for so long regarding soy?

The answer to that has a lot of parts. A good place to start is the issue of bias. For example, when I was listening to all the good things about soy and filtering out suspicions about this food, I was exhibiting a human trait called confirmation bias. It is human nature to pay more attention to things that agree with opinions we already hold. It sets us up to ignore things that disagree with our positions until the contradictory input is overwhelming.

There was also a bias in the research I was reading in the 1990’s. For example, the conclusion that eating soy might prevent breast cancer was based on a correlation between the Japanese population and a lower incidence of breast cancer. However,  correlation does not equal causality. There are other factors at play like the amounts of fat and alcohol consumed. What’s more, the Japanese eat only small quantities of tofu and little or no soymilk, and most of the soy products in that diet are fermented, such as tempeh, miso and soy sauce. Fermented soy is chemically, enzymatically and metabolically distinct from non-fermented soy products. One important difference is that unfermented soy contains a large quantity of phytic acid, which can block the body’s absorption of essential minerals like calcium, magnesium, iron and zinc. Fermentation reduces this concentration and has other desirable effects.

Soy contains compounds called phytoestrogens which are plant produced substances that can bond to the estrogen receptors in human cells. The hypothesis that soy prevents breast cancer was based on the theory that the phytoestrogens offered protection by preventing human estrogen that encourages cell growth from occupying the receptors. Data from clinical studies doesn’t clearly support this theory and in fact, raises serious concerns that phytoestrogens from soy might accelerate the growth and or proliferation of cancerous tumors in some women. Debate continues and there are differing views on this issue.  Notably the American Cancer Society is no longer recommending consumption of soy.

Research also suggests that excessive soy consumption may disrupt normal thyroid function and some of the compounds in soy are toxic to the thyroid tissue.  There is a good deal of scientific evidence today that soy-based baby formula, although recommended by Dr. Benjamin Spock and others in the 1990’s, can be damaging to newborns.

With everything that is at stake, why hasn’t there been an outcry in the media to correct the misconceptions about soy? While not exactly an outcry, the mainstream media has reported the two sides to the soy question. Perhaps media consumers like simple points that can be turned into sound bites while nuanced discussions and fine distinctions make for poor headlines. It’s also possible that another bias is at work, since the multi-billion dollar soy agribusiness is served better while confusion on this point persists. The industry has been very successful promoting soy products as healthy through multi-million dollar advertising campaigns and intense lobbying of the FDA.

Soy protein is prevalent in many foods, both “health” and mainstream, and in animal feed, in part because of the fact that soy protein is a cheap industrial by-product of the production of soy oil. The hidden cost of making soy mass produced, cheap and plentiful is that over 90% of the soy sold in the United States is genetically modified. Genetically modified organisms (GMOs) are touted to increase yields and resistance to pests, and provide better tolerance to environmental variations, all of which reduce costs. Monsanto introduced Round-up Ready Soybeans in 1996, which are genetically modified to tolerate the broad-spectrum herbicide Round-up (the number one seller in the world since 1980). Round-up kills just about everything in the soil it is applied to except the plants genetically modified to resist it. There are numerous scientific studies showing this herbicide’s toxicity, disruption of endocrine function and links to gene damage in humans.

So what is a health conscious soy lover like me to do? Decide for yourself. You can follow the links in this article to read research and opinions on soy and make up your own mind about whether, what kinds and how much soy is healthy for you. Here are some suggestions:

  1. Consider using soy products in moderation or eliminate them from the diet entirely. For example, serve a soy based appetizer like miso soup instead of serving tofu as a main dish.
  2. Use fermented soy products from a certified organic or other high-quality non-GMO source.
  3. Read labels to cut down on the unintended consumption of soy.
  4. Substitute soymilk with rice milk, almond milk or coconut water, all of which are available in the health food store. I make my own almond milk by soaking ½ cup almonds for 4 to 6 hours, sliding the skins off and blending at high speed with 3 cups of water. Strain through a muslin bag if desired. If straining, the almonds do not need to be peeled.
  5. Vote with your wallet. If we educate ourselves and buy accordingly, business will be forced to respond.


{March 6, 2010}   Baby Steps

This week’s blog is inspired by a question from Jim (Between Two Worlds, February 21, 2010). “Where does one start on an alternative path when faced with a recently diagnosed cancer?” A life-threatening diagnosis can feel completely overwhelming and after receiving one it takes a tremendous amount of strength and support to follow an alternative path. Whether you want to follow an alternative course or not, there are some crucial first steps to take:

  1. Put together a team of health care professionals to support your health-care choices.
  2. Set your priorities – what weight do you put on getting the cancer out and seeing to it that it won’t return, the quality of the life you are living and the amount of time you have left to live? Strangely, these three things do not always go together with each of the treatment options you may be presented. It’s not easy to decide what to do in those cases, but doing some soul-searching ahead of time is paramount if you are to have any control of your destiny in cancer treatment.
  3. Begin working with a qualified nutritionist who is familiar with cancer therapy. Diet and supplements are fundamental to healing, whether you are following conventional cancer interventions (e.g. surgery, radiation, chemotherapy) and/or alternatives. For information about how to get started immediately I have found David Getoff’s website to be a good resource.

In the weeks following my breast cancer diagnosis, I gathered a diverse team – co-captained by my husband and me – of conventional and alternative health care practioners. My team consisted of my GP, breast surgeon, gynecologist, psychotherapist, nutritionist, homeopath, chiropractor, massage therapist, manual lymphatic therapist and colon hydrotherapist. Later on I added an oncologist, radiologist and plastic surgeon. I also rallied friends and family who showered me with love and support in many different forms, such as giving advice, accompanying me to appointments when my husband was not available and helping around the house and with meals. I also received many touching cards, sometimes from completely unexpected people. This healing team and support system got me through the worst and I am forever grateful.

As I grappled with the psychological distress of my initial diagnosis, my husband did research, starting with the question: “Is it harmful to take our time to make informed and considered treatment decisions, or do we need to do what the first surgeon urged and ‘get the cancer out as soon as possible’?” It was in the course of this research that we found out about conventional medicine’s concept of the Standard of Care, which means the course of treatment that experts agree is appropriate, accepted, and widely used. Medical health care providers are obligated to insist on the standard of care and generally will not be well-informed about or supportive of alternatives, including (unbelievably) proper nutrition.

The medical standard of care is a well-developed and researched course of treatment designed to remove cancerous tissues from the body and prevent its recurrence. This is the top priority of medical cancer treatment. Early on we discovered that quality of life is secondary in the medical treatment of cancer and that there is little regard for individual differences that may affect outcomes.

I would never tell anyone what their priorities should be as this is such a personal decision. It is also quite possible that they may shift under the harsh glare of a cancer diagnosis. My top priorities were and are quality of life, followed closely by the length of time I have left to live. Getting the cancer out and keeping it from recurring is important for me, but only to the extent that it serves my top priorities. Because this is fundamentally philosophically different from the medical standard of care, I had to be very careful to understand the effects of each recommended treatment option. This takes time. Time to research the evidence for and outcomes of conventional therapies, time to discover and research alternatives and time to weigh the trade-offs. So the answer to the first question, was that it was potentially more harmful to me, in terms of my priorities, to move really quickly to “get the cancer out”, without first understanding the consequences of the treatment.

Eventually we came up with a set of principles of our own which simplified this process. The first principle, we got from the Hippocratic Oath, “First, do no harm.” For me this means that if a treatment itself is harmful, it must have a clear long-term benefit in terms of my quality and/or length of life that out-weighs the harm. The second principle is to use scientific evidence, wherever possible, to weigh these long-term benefits. The third principle I applied is to clean up my life in terms of a eating a healthy diet, exercising, limiting my intake of and exposure to toxins and ultimately re-examining every aspect of the way I live. The fourth principle is to conserve my energy for healing by putting some pursuits on hold. The final principle is that if a treatment causes no harm whatsoever and I want to try it, then it is fine, even if there isn’t conclusive scientific evidence for its effect on cancer.

Six year old pear tree

My husband’s favorite Chinese proverb is, “The best time to plant a tree is 20 years ago. The second best time is now.” By far the best time to improve our health is when we are already healthy. We have no pressure, can take our time and choose the place we want to begin. This seems obvious, but we don’t always have the motivation to make changes when what we are doing is what we know and seems to be working OK.

The beauty of taking steps to live healthier before a crisis comes is that it doesn’t really matter where we start. Any time we make a positive change it will affect other areas of life. For example, if I am chronically overeating, eating less gives me more energy and thereby makes it more likely I will walk in the woods rather than slump in front of the TV. Making changes can be a powerful gift to yourself and can actually be fun. Perhaps you have wanted to begin a yoga class, try a new sport or hobby, or express yourself in a food journal.  These baby steps can lead to a healthier life in which you never have to deal with cancer treatment decisions. But even if you do face them, the healthier you are when you start, the better you’ll be able to deal with the challenge.



et cetera