Episode 48 Shownotes - Wisdom from the First Year of Best Life After Cancer
Well, hey, folks! This is a big week! It is the anniversary of my first podcast a year ago. So exciting! I can’t believe I have done 48 episodes – at the start, I couldn’t imagine doing the first four, and now I am done 12 times that! I know many of you feel like we are old friends at this point, but for the people who are new, I want to tell you how this all came to be. As most of you know, I am a radiation oncologist, and I have been in practice for more than 20 years. About 5 years ago, I was struggling in my life. After having years of fertility treatments, and then ultimately, 4 kids, I was slowly gaining weight. I thought this was from not exercising and really loving food. I was fighting with my kids, and always irritated with my spouse. I was feeling burnt out at work. I blamed most of this on being too busy and feeling sluggish from my weight. I knew I needed a change, but wasn’t sure what. I thought if I could just fix my weight, everything would be better. I joined a life coaching group focused on weight loss for physicians only. I did lose weight – about 40 pounds, but more importantly, I realized that so much of my struggle was the thoughts I had about my life and my job. I had constantly pushed down the grief and stress from dealing with seriously ill patients with cancer until I no longer even realized it was there. I ate to feel better in the moment, to bolster me on days when I needed to give bad news. To reward myself at the end of a hard day. To put on a happy face coming home to 4 kids under 5. But then I was taught that we have the ability to choose our thoughts, and that our thoughts drive our emotions. What my coach taught me is that even if a thought is true, if the thought makes you feel terrible, there are other options. I also learned that suppressing feelings guarantees that they will resurface, bigger than they were initially. Once I realized this, I knew that so many of my patients would benefit from learning this as well – so I spent a year getting a life coaching degree in addition to my MD. I made a goal of touching the lives of 10,000 cancer patients in 5 years. One of my best friends is Esther, a breast cancer survivor, and we have talked a lot about how I can make this happen and also be accessible to as many patients as possible. We came up with many ways for people to get the help they need. The answer was high quality free resources covering what the majority of the people need. The first thing I started was this podcast, which is truly free, untouched by advertising. I started a Facebook page where I teach weekly about what patients need to be on the lookout for and how to maximize wellness in my Monday Office Hours posts. In the free private group, patients are encouraged to share struggles and wins. I created and designed my website Best Life After Cancer – and I want to tell you – I did the website entirely on my own. It was a true labor of love! On the website is a section with freebies, where you can find a free 12 month guide to improving your odds and overall health, a free printable with questions for your team if you are just starting treatment, and a free 3 part video series overviewing how to reduce your risk, release your fear and regain your joy. I plan to try to add things every month or so. My goal is to have ALL of my teaching available for free, with only people who want individualized help needing to join one of the coaching groups. To this end, in November, I kicked off my first weight loss after cancer treatment group, and took a number of awesome women through this program who wanted to lose weight as quickly, easily and efficiently as possible. I am happy to say that all of those who showed up, followed the suggestions and did the work lost at least 15 pounds in their 3 months with me, but across the board, they felt like the program was so much more than just weight loss. The program allows me to coach a group of motivated women improve their health and outlook – what could be more rewarding and enjoyable than that?
When I look back, I can’t believe how much I have accomplished in just a year. This year has been one of such growth personally – I have learned new tech, and learned to manage my mind about the challenges of a new venture. I have leaned into the discomfort of having this seem slow to grow, because I know that this will eventually help so many people, and I just have to help them find me. All of this while working, dealing with a pandemic and taking care of my 4 awesome boys! No surprise I am tired some days! So that is who I am, and how I got here. I am also a wife, daughter, sister, ballroom dancer, closet sci-fi nerd, amateur photographer and lover of travel and adventure. We all are so much more than we seem on the surface, right?
As I said, the first thing I created this year, and what we are celebrating today, is the podcast. In the past year on the podcast, I have had the opportunity to interview a number of inspiring doctors, and we learned about the future of personalized medicine and cancer vaccines with the former chair of the board of the ACS, Dr. Baskies, about living an intentional life from Dr. Faryal from Palliative medicine, and about sex after cancer from Dr. Caspersen. We heard inspiring stories that bring hope and comfort from Justin, a survivor of childhood leukemia following transplant, Chris, with his journey with an aggressive sarcoma of his thigh, Esther with inflammatory breast cancer, who by the way, is celebrating 5 years from diagnosis this month, Shana and her battle with triple negative breast cancer, Katie who lost her mother to lung cancer, then developed Her 2 positive breast cancer, Joann’s nearly decade long challenge with metastatic cancer, my father’s story of cancer and alzheimers, and Olivia’s breast cancer journey that spurred the creation of the Humor Beats Cancer nonprofit organization. We have talked about how to maximize survival, how to deal with weight gain, and more.
I thought I would spend today recapping some of the most important things that I have covered in our first year together, because a lot of people have not gotten back to the earlier episodes yet, and I really want to be sure that everyone has that foundation moving forward. I would also like to invite you to tell me what you would like to hear about. On apple itunes, you can write a review and request topics for me to cover this year – I would be thrilled to know how this podcast can help you even more. So for starters – a super brief survivorship review, because I think this is what I most want you to know to maximize your odds of survival. There are many things you can do to get better odds, but in my mind, likely the very most important is EXERCISE. Exercise has been shown to decrease recurrence as well as improve overall survival in many different types of cancers and across the stages as well. Meaning – this is not limited to Stg I breast cancer – this is also true in Stg IV colorectal cancer! The goal is 150 minutes of mild to moderate exercise per week. It doesn’t have to be an expensive gym membership – walking is perfect! It just needs to raise your heart rate and keep it up. If you take nothing else from all I teach, this should be it. The second thing only you have control over is alcohol. Alcohol increases the risk of developing cancers and in many, is also shown to increase the risk of recurrence. Most conservatively, it appears that people who drink 1-2 drinks per week have very little or no increased risk over the nondrinkers. Up to 5 drinks per week seems to only mildly increase your risk of getting your first breast cancer and of recurrence, so for the people who currently drink daily, I tell them that clearly should be their goal – 5 or less per week, if they are unwilling to decrease to 1-2 drinks per week. Getting to and staying at an optimal weight is important, not just for cancer risk, but also for heart disease, diabetes, and more. Finally, I personally believe that all of us should get the Covid vaccine. We are up to 3.1 million deaths in the world from Covid as of May 2021. Compare this to the normal 250-500,000 deaths per year from the regular flu – a 10x greater death rate. The rate of anaphylaxis from the vaccine is 2 to 5 people per million doses, and to date, no deaths have been attributed to anaphylaxis. I did a whole podcast on the vaccines a few months back. People may be worried about the vaccine, but the statistics show that 95% of doctors have taken it when it was available to them. We aren’t just recommending it, we are lining up to get it. Finally, keeping up to date with your preventative testing is important – gyn and prostate exams, colonoscopy, skin checks and more are covered in my 12 month freebie.
Where I really think I am able to help people after cancer is dealing with the emotional aftermath of a cancer diagnosis. Fear, grief, emptiness, sadness, loss are all very common feelings during and after treatment. Some patients even experience a type of PTSD after treatment (there was a full podcast on PTSD previously). For so many, figuring out how to move on is incredibly challenging. People know they feel awful, but don’t know what to do to feel better. How do we deal with these emotions? First we have to understand how the human brain works. The bottom line is this: humans brains function based on something called the motivational triad. This means that we have evolved to seek pleasure, avoid pain, and minimize effort. Dealing with the aftermath of cancer is not easy, so our instinct is to make that pain go away. Typically, humans do this in one of three ways. It may be by resisting the feelings, meaning pushing them down or pushing them away. Resisting emotions is like holding a beach ball under the water – but imagine if every time you pushed it down, someone pumped a little more air in it. Eventually it would pop up somewhere – maybe not where you think it will, though. This leads to the second way we avoid our feelings – by reacting to them. Our diverted emotions are like the beach ball popping up in unexpected places – they lead to us yelling at our kids, crying hysterically at something stupid, or flying into a fit of rage on the highway. These outbursts are like a pressure valve – they take the pressure off for a time, but don’t work through the emotions, so they are guaranteed to build back up and start the whole process over again. The final, and most common, way we try to make pain go away is by avoiding our emotions. We often suppress them with things that make us feel better temporarily – eating, drinking, shopping, video games, endless scrolling on Instagram or Facebook, or binging on Netflix. The problem with this is twofold – one, when we stop whatever we are doing to feel better, the negative emotions resurface, and two, there are negative consequences from the buffering. If we are eating, we are still sad but now fat and sad. If we are drinking, we are still fearful, but now hung over and fearful. If we are shopping, we are still grieving but now in debt and grieving. The bottom line – not dealing with our emotions creates more net negative in our lives.
How do we start to deal with this? First and foremost we have to understand that there is a difference between our thoughts and our circumstances. Circumstances are provable in court – something everyone would agree on. Thoughts are sentences in our heads about the circumstances. For example – circumstance: a doctor says these exact words, “you have breast cancer”. Thoughts (which I remind you are optional!) could be wow, great – we caught this early, and will get it taken care of or OMG I’m going to die. Each of those thoughts creates very different feelings and experiences in our lives. Most people believe it is the circumstance causing our feelings, not the thought we think about the circumstance. As soon as we realize so much of our grief is caused by our thoughts, immediately we want to first, beat ourselves up and second, immediately change the thought. Two things should be noted here. This is not cause to beat yourself up. This looking for the negative is NORMAL. Our human brains also evolved to look for danger and bring it to our attention. In the past, it was constant alertness for a big cat in a tree, a poisonous snake in the grass or signs of a wolf pack nearby and was very useful for human survival. In modern day, our brain is pointing out challenges with colleagues, medical dignoses and social issues, most of which are not something we can avoid or easily change. It isn’t just like not stepping on the snake or walking under a different tree. The problem is often more complex, with no quick, easy fix. It feels rotten thinking about it, so we push it down, or eat to feel better. But our primitive brains think we need to be aware and paying attention! So the more we avoid or ignore, the more our brain is screaming at us: hey, this bad thing might happen and I think you aren’t paying attention! We need to acknowledge what our brain is pointing out, and work through the emotions that initial thought brought, before we can work to create a new thought.
Processing emotions is allowing them to be there in our bodies until they naturally dissipate. This happens much more quickly if we get OUT of our heads and INTO our bodies. Note the sensations in your body, describe them (where they are, how they feel, weight, color, texture, smell, anything else). Then imagine wrapping them in a loving embrace like an overwrought child, and helping them to take breaths, slow, calm, deep. You will know the emotion is processed when it begins to loosen its grip and lighten up.
Once you have processed the emotion, you can work to find a new BELIEVABLE thought. That is the key. It must be truly believable. That is why “yep, I have cancer, but I’m going to be 100% fine” doesn’t work for so many people. Not believable. One I suggest starting with is “to the best of my knowledge, I am cancer free today”. Significantly better than, OMG I’m going to die, but still believable. The goal is to work towards thoughts that feel calm, accepting and drive positive action like eating well, exercising and getting good rest. This is one of the places that a life coach is SO useful – in helping to show you what you think are facts that are actually thoughts, and help you create new, believable thoughts that drive positive action. Many times, you have to ladder your way from the original thought to your desired thought, one slightly better thought at a time, practicing them until they are second nature, then moving to the next step.
This is a process – it takes work. It is not one and done. You don’t find a better thought and immediately have it “stick”. You have to work on redirecting your mind when it naturally goes to your old thought. I think of it like the path of a stream. The water wants to go in the original path. It keeps trying to go back to the original stream bed. But slowly, we can create a new channel, and as it deepens, more and more water will go that way. Same with thought processes in our brain. The pathways we have used for 20 years are easy for our brain to shoot thoughts down. New paths take energy. They have to be used more, with the old path used less, and slowly the thoughts will change. It is so interesting – what we think often, we get better at thinking. So, if you keep thinking a negative thought, it will get more and more engrained in your brain.
For many people, seeing our thoughts as thoughts, and not circumstances is a HUGE challenge. Often, we need someone outside of our brains to help us see that it is a thought, although writing things down helps us to see that as well. For anyone looking for help in this, I will be hosting a free webinar about weight loss after cancer, and you can sign up on my website for this at www.bestlifeaftercancer.com. In June, I am launching my next Post-Cancer Weight Loss group. I’d love to see you there!
Well, folks, that is the first year in a nutshell. I am so grateful and happy you are here with me on this journey. Please take a moment to rate, review and subscribe to the podcast on Apple Itunes and let me know what you would like to hear about in this upcoming year!
