Episode 1 Shownotes - Living Your Best Life After Cancer - Welcome!

Hello, and welcome to Living Your Best Life after Cancer. I’m so glad you are here! This is your first step towards releasing your fear, regaining your joy and reducing your risk. I’m your host, Dr. Deborah Butzbach. I’m so excited to take this journey with you!
I can’t even tell you how excited I am to be starting on this journey. This is episode 1. Things are crazy right now in the world with all that is going on with the Corona Virus, and I considered delaying the launch of this podcast, but I know that fear of cancer is much more pressing than the chance of getting and dying from Corona for many of my patients, so this is happening NOW!
Today, we are going to talk about some of the things I have seen over and over again in my years of taking care of cancer patients, and one of the many easy techniques I have taught patients to help them deal with some of the most challenging emotions they feel.
But first, I’d like to introduce myself, tell you a little bit about me and how this podcast came to be. I’m a radiation oncologist, and I’ve been caring for cancer patients for more than 20 years. I’m also a wife, mother of 4 awesome boys, and much more. I began my journey with life coaching when I decided I really wanted to lose 40 pounds that had crept on after pregnancy and years of stressful work. I joined a coaching group, and lost the weight, but also learned SO MUCH about how to live my best life. I improved my relationship with my husband, kids and most importantly, with myself. I stopped getting angry at work when the day didn’t go the way I thought it should, stopped using food, alcohol, shopping and other things to make me feel better temporarily, and I found the inner peace that I had been craving. That’s when I had my epiphany. My patients need this. They DESERVE this. And so, this podcast began.
I envision this as a stepping off point once your treatment is complete. This is a guide to help you get back into your normal life, and make your life even better than it was before cancer. All are welcome, for sure, but if you are in the middle of treatment right now, that may need to be your primary focus. This could also be helpful for your caregiver or significant other, as many of them struggle with the same fears that the cancer patients do.
First, let me explain to you how most people deal with negative feelings. Most people use one of the following methods to deal with their negative emotions. They either resist, react or avoid. Resisting is like when you are a little kid, and trying to keep your sibling out of your room by holding the door shut. It is so hard, and takes so much energy to keep holding it shut. You hold it shut and they fight to get it open, and when they do, they storm into your room, break your toys, maybe beat you up a bit, and then roar back out until the next time they want to have some sibling fun. If you open the door from the start, they may come in even though you don’t really want them there, but pretty quickly, they get bored and go back to their own room, or settle down and play quietly with you. The same is true with our feelings, we can’t hold the door shut forever, and when the feelings force their way in, they swirl around the room like an open window at the start of a big thunderstorm. But if you don’t hold the door shut, they will just blow through like a spring breeze. The second way we deal with emotions is by reacting to them. We may be short tempered, yell at our spouse or our kids, scream at other drivers on the road, or wail and cry over some minor thing that happens. This is a release, and may make you feel better for a short time, but you are not processing the feelings and allowing them, and they will build back up again. The third, and maybe the most common, is by avoiding our feelings. This is called buffering, and you will hear a lot about this in future podcasts. This can take different forms, but all of them are an attempt to distract ourselves or dull the feelings. Many people overeat. When we fill ourselves up with food, there is less room for the emotions to vibrate in our bodies. I didn’t think I was an emotional eater. I was always pretty even keel, even happy most of the time, but when I started my coaching, I began to realize that I ate at work when things were stressful. When I had bad news to give, I would see what patients had brought for the staff and eat some of it. When the day was long and painful, I would have more dinner, or an extra glass of wine. If there was no food, I might shop online, or play candy crush on my phone between patients. Some people overeat, some overdrink, some shop all the time, binge on Netflix, play time-sucking games on their phone, or even work constantly. All of these are things that push down the feelings, and lessen their vibrations. It doesn’t address them or make them less, so they are still there when you stop whatever you are doing to squash them.
So, I told you I would explain some of the negative feelings I watch patients struggle with. There is so much that is NOT surprising. Fear, grief, loss of body image, anxiety about recurrence, guilt about how this is affecting your spouse, children or parents, are very common and completely normal. We will work on chipping away at these over the upcoming weeks and months. But what makes me the saddest, what I really want to delve into first, is when I see a patient who is cancer free giving up good days to cancer worries. Thoughts of it consume their every waking moment. They can’t enjoy their life because the cancer is always there with them in their minds, even if it is not there in their body. They are losing those days to their cancer, and they cannot get them back. The cancer is beating them, even if it is gone. I want to yell and shake them, and make them see that they are letting the cancer win. My goal is to help you live every day that the cancer doesn’t literally take.
An example of this is a patient turned friend who had completed treatment for a very aggressive breast cancer. She went on her first vacation after her treatment completed. When she got back, I asked her how the vacation was. She admitted that she had noticed that much of the time was spent with thoughts like “this might be the last vacation like this with my kids if my cancer recurs”, “I know everyone is looking at me and thinking I had cancer, since my hair is just growing in”, and “why did this have to happen to me?”. These thoughts took away much of the joy in the vacation, and left her feeling sad and anxious, instead of renewed and refreshed. I heard her story, and was struck that the cancer had ruined her vacation, even though she was currently done treatment and cancer free.
I have studied this for decades and contemplated the best way to help my patients. I have discussed this with other oncologists and the thousands of patients I have personally treated. I have come up with strategies that have been life changing for many. Together, we will learn to allow bad feelings for some part of the day, and then tell our brain that it is done with fear, worrying, obsessing, what-if-ing for the next 24 hours. This is how you do it. Get a timer, your phone, the oven timer, whatever you have. Find time and a place where you can have uninterrupted space. I think early in the day is best, but try and see what works for you. It might be in your car, before you leave for work, or before you walk into the office. It might be in the shower with a locked bathroom door. If you have little children, it might look like setting an alarm for before they get up, or having your spouse take them to the playground for half an hour. This time MUST be just yours, and it must be uninterrupted. This will make you a better parent, spouse, daughter or son, friend, and colleague, so don’t feel like you are being selfish taking this time every day. Put your phone in airplane mode. Set the timer for 30 minutes. Then really allow all the awful feelings. Lean into them. Invite them in. Get up close and personal with them, see what’s there that you are always trying to push down, avoid or deny. Let them wash over you, without a whole lot of outside reaction to them. Some tears may slip out, but uncontrolled wailing is not processing them. Punching the wall is not processing them. The way to start to process them is to describe to yourself how they feel in your body? Are they heavy or light? Where are they located? Do they flutter, or pulse, or sit like a stone in your belly? Are they hot or cold? When you describe them to yourself, it allows you to identify them, name them and gives you some relief from feeling them. I know this sounds really unpleasant, but hear me out. They are just feelings. A vibration in your body. They can’t hurt you. When you let them be there, let them in, they actually get less intense with time. Suppressing or avoiding our feelings is like trying to keep a beach ball under water. You can’t. Eventually, it pops up, and goes higher than if you had left it floating on the surface. So – let them in. It’s only for a little while. Be there with them. When the timer goes off, tell your brain, ok, that’s it for the day. For the rest of the day, I will think about what brings me joy. My family, my job, my pets, what book I am reading or project I’m passionate about. When the thoughts come creeping back, and they will, remind yourself, no, it’s not time for that now. Right now is time for living. There is time set aside again tomorrow for them and they will be there then.
I will tell you how this looks for me right now. Remember, even if you are listening to this 6 months or a year from now, when I am recording this, it is the start of the Corona outbreak. People are at home, schools are closed, and hospitals are beginning to see the impact. I have to admit, as a healthcare professional, I am pretty scared of this Covid pandemic. I take 15 minutes each day to really let myself be present with the fear – not being critical of myself for it, it is normal to be afraid. I let myself feel all the bad feelings. My fear for myself and my surgeon husband, as we are still working full time, my worries for my kids, who are at home doing distance learning without our help, my worries for my parents, my mom with a significant cardiac history, and my dad, a cancer survivor. My fears for my patients, my staff, my friends and extended family. I look at the fear, let it be there, acknowledge it. I admit, I sweat sometimes, and I cry sometimes. Some days, the feeling is fear, in my chest, like a tight band. I describe it to myself, and I name it, and I let it be there without trying to force it away. Sometimes, it is anxiety, and it flutters like a bunch of bats in my throat. It is hot some days, and bone chilling some days. Some days, it is dread and sits in my stomach like a rotten log blocking up a stream. I see it, and say to myself, yes, it is so normal to feel that right now! Things are different and my thoughts about these new circumstances of COURSE would cause anxiety, or fear, or dread. Then I choose to go on with my day. When the fear comes back, I remind myself, not right now, now is the time for remembering to wash my hands, reminding myself not to touch my face and doing the best I can for my patients, because they deserve me to be fully present.
You may be thinking, this is too easy, how can this possibly help? Sitting for a time with my feelings can’t really change anything. What I’ve learned from my life coaching is that first and foremost, we have to FIND what emotions are currently there and let them come to the surface. We have NO chance of changing them if we don’t have any idea what they are. In coaching, we call being aware of our feelings and choosing our thoughts “managing our mind”. Managing our minds allows us to create what we want in our lives. If we are not getting the results we want, the reason is very simple. It is because we are not taking the actions we need to take to get the results we do want. Why is it that we aren’t taking the actions that lead to the results we want? The answer is because of how we FEEL. What is driving those actions is how we feel, or our emotions. And then, the question is “what makes us feel that way?” What makes us feel that way is our thoughts about our circumstances. I’m sure you and I both agree, I can’t change that you had a cancer. It is already part of your past, and no one can change that. But, there is a big difference between the thought from my friend’s vacation of “this might be my last vacation with my kids” to “ this is the first of many vacations with my kids, and someday, grandkids”. At this point, I hear you talking, I hear you saying to me, there is no way to know that I’m going to be ok and travel with my grandkids. You know what? You are right! There IS no way to know if if you will be fine, or if you will be someone who has to battle their cancer a second time. SO, if there is no way for us to know, what thought gives you a better feeling? What thought helps you to live your best life today? The thought of travelling with your children and later your grandchildren. What is the downside of thinking that until life proves things to be different, if it at some point it does? There IS no downside. Worrying does not prevent a recurrence. It does not make you safer. It just makes you miserable. In the words of Ekhart Tolle, “Worry pretends to be necessary, but serves no useful purpose”. This might seem untrue to you, but let’s look at 2 scenarios I see often. One is a person consumed with fear of a recurrence. They often ignore symptoms they are having, may avoid scheduling tests and follow ups, and may not do healthy things like exercising, because they are drinking wine, eating or binging Netflix to distract themselves from the bad feelings. The other person knows they have done everything they can to cure their cancer, and now is working on living their best “Right Now” life. They know that aches, pains, fatigue probably have a treatment related, noncancerous explanation, and talk to their doctors about them in a timely fashion. They schedule their tests on time, because they think the testing will confirm that they are cancer free. They exercise, eat healthy and drink a reasonable amount, because they are not trying to stomp down the fear. Who do you think is more likely to run into problems? As an oncologist, I would say the one not doing anything to help keep their body safe and healthy.
We will talk more about this at a later date, but I think that we can even say that worrying may increase your risk of a bad outcome physiologically. There is evidence that stress suppresses our immune system. We all want our immune systems to be doing their best job, both to help our treatments be the most effective they can be and to avoid all the things we don’t want – a cancer recurrence, to be one of the people who succumbs to a pandemic. So, the bottom line, adding worry does not improve your odds. It does not improve your quality of live. You have the right to choose the thought that makes you feel the best and not the one you think might be the “truth”. I say that, “truth” in quotation marks. Remember, we decided earlier, we have no way of looking into the future and knowing which of these thoughts is true. So, which brings a better feeling for you? This is the one you can choose, and that will bring you a bit of peace.
To switch gears just a bit, I want to talk about the 30 minutes of allowing the feelings, and what you might find. A few days into this, you may find that a type of peace comes over you before the timer goes off. If you can, continue to just be present with whatever comes up. However, some people want to be done when the peace comes over them. I urge you to give it at least 2 minutes more, and I really want you to be in for the full 30 minutes for the first week at least. After the first week, I recommend a MINIMUM of 15 minutes daily. If you sit down, and nothing comes to you, your mind is a blank slate, sometimes journaling is helpful. You can write about what has been the hardest part of your cancer journey, or what made you the saddest. Don’t be afraid of these big feelings. You are a survivor, and these feelings cannot harm you.
So, give it a try this week and let me know what you think. I’m so glad you were able to join me today. You can find more information on my Facebook page, Best Life After Cancer MD. If you have a minute, it would be really awesome if you could write a review. This will help other people who are struggling find my podcast. Again, so nice to speak with all of you today and I will speak with you soon.