Wednesday, August 29, 2012

The All Clear

Yesterday I got the all clear. That's two years cancer free.

I knew I was fine. However, I am not naive enough to think that this thing cannot return in a heartbeat. As mentioned in previous posts, I feel better and more positive now than I ever did before.
What was unusual about yesterday was that I can honestly say that I felt absolutely no anxiety whatsoever when going into the hospital for the results. At the risk of sounding like the IceMan (or an equivalent unfeeling entity), I was totally calm. The doctor actually said to me that he had seen a half dozen patients before me that morning already, all of whom were in various states of anxiety or nervousness, even those who had been free of cancer for 7 or 8 years....and I was the most relaxed person he'd seen all week. I remember the way I sat - almost perched into a relaxed but attentive position. I think this reflect my new ability to take things as they come, try to focus on the now. Of course I had thought about a negative outcome, but had rationalised it and broken it down, seeing clearly what that would look like and how I would cope. This, it seems, is the value of my experience. What will be will be. I must say this was a strange position to be in but left me feeling confident and strong, rather than cold.

I drove home at a very slow pace, thinking about what had just happened, playing it over in my mind and out loud. This felt like a lonely conversation. But of course everybody's experience is different, everybody's fears are different and everybody's vision of their future is different. So in many ways, this was a unique experience.

Then I went back to work. Within an hour I was back doing the mundane, ordinary tasks of the day. And later I made dinner and read stories to my children before going to bed.
But that's o.k. Aren't they the things I got better for? They are the things I choose to do...because I can.

Sunday, August 26, 2012

My Running

I have been running on and off for 20 years. Nothing impressive mind you. The most I ever ran consistently was about 20 miles a week a few years ago - and boy, did I get skinny. I have always struggled with the same issue I have with everything else - i.e. I end up pushing myself too hard, running too often and then I crash from tiredness. Most of the time I ran about twice a week, about 2 miles each time, which really is just for basic fitness. I usually squeezed this in on the treadmill at lunchtime at work if I could. However, when I achieve consistency, that's when things really start to go right. I'm in the middle of one of these periods right now. I started about 10 weeks ago, going outside and running three times a week - twice I'd do 2 miles and once I'd do 3 miles - nothing spectacular but steady. There is a "threshold" you reach after doing consistent exercise for a while - the running becomes easier. It is a wonderful feeling to be able to run and not struggle for breath. This week I stretched to an extra run, 4 in a week, and so far I feel fine. It's not about distance or speed for me - because I only run a few miles and I'm slow - it simply about consistency and feeling good.
The reason I mention this in the context of this blog is that I can honestly say that I have been feeling different in the last 10 weeks. I feel consistently positive, consistently calm and more 'present' than I have ever been. I can only put this down to the running as this is the only thing that has changed in the last while. I'll admit that the children being off school for the Summer has also helped as there has been less stress but I don't think that's the main thing. I have been really focused on looking after myself in the last while and running (as well as diet) is an integral part of it for me. A recent book I read (Running with the mind of Meditation), really helped me understand the value of running to your overall wellbeing - physical and mental.

I think maybe I'm over-focusing on my health but....it is what it is.....it is a period of reflection for me and I believe it will be a template for  how I live in the future. My wife takes the piss out of me about being such a health nut but, let's face it, it's hardly surprising given my history here. I know there are no guarantees with health - I'm just reducing risk.

Wednesday, August 22, 2012

"You're looking so well"

One of the things I have faced in the last two years since my recovery is people who have not seen me since I was sick meeting me and saying "You're looking so well".
Now, initially I took this as a complement, bald and thin as I was, and said 'thank you'. However, two years on when it is said to me I sometimes forget I was sick and that they are saying this thing with my illness in mind. I'm regularly stuck for something to say so I often just say, 'thanks, you look great too'. I mean, hey, this is often not relevant (or true :)) or appropriate but I don't know what else to say.

Sometimes these people, who all mean the best by the way, do actually bring up the illness and ask how how it impacted me, how I am feeling now and if I have any symptoms since. After two years this feels like a crazy question but, as I say, it is well meant. I'm polite and am general and generally skirt around the issue before changing the subject. What else can I do? I mean, the truth may not work so well. I could mention extreme constipation, puking, losing my hair, low blood count to the point of not being able to walk, sharing a ward with other cancer patients staring (their) death in the face every day, a million needles, steroids leading to horrendous nightmares and chemotherapy 24 hours a day for 7 days six times over.....all of this is not after dinner conversation....at least most of the time. Just writing that has made me smile as I compare my life now (i.e. free of all that stuff) to then.

And speaking of horrendous dreams......at the end of each 7 days chemo I would have 10 days off before the next round. The hardest thing during this period was dealing with the 'come down' from the steroids. The doctors had said that this was not common, but by God did I have nightmares for two nights after I stopped. The worst I remember was me as a petrol pump attendant in Las Vegas (Given I live in Ireland the reason for this is not clear) - a car pulled up with two Pandas in the front and two rhinos in the back with Chewbacca from Star Wars and they proceeded to chase me with axes and iron bars. Funny in hindsight, but at the time I woke up in a cold sweat.
Hey, maybe that's the story I tell these people who tell me how great I look. It's got to work better than the truth.


Sunday, August 19, 2012

Post Cancer - Regular Scans

Tomorrow I have my annual CT scan. It is two years since I was given the all clear. I think it is fantastic that I am privileged enough to be in a country with a health system where not only was I cured, but I can undertake these scans to provide assurance. There is a train of thought, even among some oncologists, that these regular scans are unnecessary and that they are clogging up the system. I appreciate that point of view but, as you'd expect in my position, I disagree with it.

Statistically, I am more likely to have a recurrence of cancer than other people who have never had it. This weighs on my mind. I was lucky in that I was given a statistical probability when I got sick that 80% of people had full recovery and it never came back. I thought they were good odds back then and gave me huge hope. I still think about this and take succour, particularly as I know the odds for other types of cancer are not nearly so good.

While I feel absolutely fine now, the fact that I was sick is always front of mind. My dedication to looking after my health now is at the very front. As a result, while it is a pain in the ass having to go to hospital, it really is a small price to pay for the reassurance. I am not nervous or anxious. I am way past that at this point, after the experience I have had. In fact, I cannot remember the last time I was anxious about anything.  What will be will be.  This brings to mind the phrase "What doesn't kill you makes you stronger". This has been absolutely true in my case. I would not go as far as to say cancer was the best thing that ever happened to me (because, let's face it, that would be ridiculous) but it certainly has given me a more rounded perspective on life.

Thursday, August 16, 2012

Dreams

One of the things I have started to get interested in since I was sick is the idea that your body tries to provide you with messages and signals. This can be as simple as things like being particularly tired -  Before I got sick I used to simply ignore this feeling and keep working until, inevitably, a week later I would crash. Now I listen and actually rest (at least most of the time). It can also mean that dreams are providing you with messages. Now, I'm not talking about the ones where a camel with wings and a buck tooth are chasing you down the main shopping street of town. I'm talking about the ones which are personal to your situation. I started to notice this when I was recovering from cancer. Now it happens quite regularly and more often when I am in good shape (eating well, running, not drinking and doing some meditation). I have this simple theory that the first thing that comes into my head, literally the initial interpretation, about what the dream is trying to tell you is probably correct.

So I had one of these dreams two nights ago. I was sitting around a large table with my family and extended family and we were all singing Elbow's "One day like this" (the significance of which to me was explained in a previous post). Now my family as as not particularly musical, although it has its stars, but sitting around singing songs is not something that happens any Monday afternoon.
However, given that I was about to visit the town where my extended family is about to meet up as part of a local festival this was quite telling for me. I had been thinking about how important it was to connect with friends and family when the opportunity arises and this dream was, to me, indicating that I need to grab this opportunity. Simple? Yes. But when I am actually in this situation (i.e. with friends and family) or about to be, this dream then serves to help me stay in the present and enjoy every moment.
Now this is all fine. However, the same night I had a pre-ceeding dream that I walked out of a door which was on the side of a cliff. I had the choice to try to clamber down (which would lead to certain death) or go back in through the door. This was just a huge metaphor for the cancer journey I had gone through and so I don't think that the fact that the "Elbow" dream that followed it was coincidence. A clear message to myself that I had chosen to live (with the no small help of chemotherapy of course :) ) and I should grab it with both hands........all things I have started to focus on since I started blogging on this subject.

So the conclusion for me is that I am very in touch with what is going on in my mind or that I have completely lost my mind.



Tuesday, August 14, 2012

Stress and Cancer


I've been catching up on my Horizon episodes this week as I'm on holidays. As usual, it is insightful in the extreme and often seems relevant to what is going on in my life.

The episode I watched last night was "The Truth about Fat". It is mostly about what causes people to overeat and what can be done for obese people to change their eating habits. All very interesting. However, what I found of most interest was a study by Prof. Tim Spector from King's College, London  on identical twins. They are genetically identical in every way but the twins he is researching have a marked difference in their weight as adults.  The presenter, Surgeon Gabriel Weston, said that "Stress can create parallel but different destinies. Spector stated that "When they were put under stress they reacted differently" (i.e. the one with more stress put on more weight due to the relevant gene 'switching on' and that "It is not set in stone - you can reverse whatever signal has taken place to switch a gene on."
Now, I have blogged before about my firm belief that I caused my own cancer as a result of the environment I put myself in (i.e. stress). But that is all it was, a belief, a feeling I was right. What this program has hinted is that there is more direct scientific research to suggest that genes can be switched on and off as a result of environment. This may not be news to some people but it was to me. I have a science background and had always assumed that genetic predisposition is exactly that, set in stone at the moment of conception. My oncologist said that what happened to me was a 'genetic blip', not caused by environmental factors which causes some cancers (e.g. smoking, drinking excessively etc.).  While this makes sense, I have recently believed that this 'blip' had a trigger. Stress, I believe now, was that trigger, despite some of the things which I have read that suggests this is unlikely.

So the upshot of this for me is very positive. It is even more reassuring that reducing stress in my life, obviously along with eating healthily and taking exercise, will definitely reduce the likelihood of cancer in the future.  It has also driven the need for more personal research in this area to understand what kind of stresses may have a genetic impact. Any pointers would be much appreciated.

Monday, August 13, 2012

The Wonder of Bicycles

My Grandfather was a keen cyclist. When he got older he was seen around town several times a day with his bicycle with a portable radio on the handlebars and another portable radio on the back carrier, and inevitably they were on two different radio stations.
For a long time I never really understood why you'd bother getting out on the bike. However, as part of my recover two years ago I bought one - nothing fancy, just a touring bike with a basket and carrier. I cycled for a half hour per day for ages, treading the same paths I had tried to walk when I was going through chemo. The difference when I got stronger though was that I put a child's seat on the back and took my (then) two year old on it all the time. Then, as now, I found it therapeutic. I do a 3 or 4 mile journey on back roads which is quiet - horses, sheep the whole rural thing. The quiet. I never noticed the quiet before I got my bike. But then I realise now I never needed the quiet before I got sick (or thought I didn't). It is a similar to the quiet I get when I run but different in that it is more gentle.

Of course the (now) four year old is in a different place so I don't always get the quiet. I now get "Hungry! Hungry! Hungry!" or "We always stop for sweets Dad", while at the same time getting my shirt lifted and getting a slap on the back. Of course I usually do stop, simply because it guarantees a quiet journey. But again, I see this as another huge positive that came out of my being sick. I have spent so much time with him on this bike in the last two years since I was sick, time I never would have had otherwise, and time I did not get with my older two children (as I was always too busy working or studying). Strange how something so positive can come from something so negative.

This evening we brought our 8 year old out on her bike. She's the one with attitude. She said things like "Can you please stop talking Dad because I want to sing to myself and you're distracting me" and "I've asked it before and I'll ask it again, how could you have married this lunatic (i.e. my wife)?". Think I'll be struggling to regain the quiet for a while yet.

Elbow - One Day like this

Last night I watched Elbow on the Olympics closing ceremony singing "One Day Like This". I cried.



When I was recovering two years ago, when I had been told that after four of the six chemo sessions that the scan showed the cancer was gone, I used to listen to this song every day. I remember going through the last two chemo sessions and listening to this song as it was a symbol of the light for me at the end of the tunnel. "Throw those curtains wide" was like a message for me - live every day to the full. It helped me get through those last two sessions with a positive outlook.
I cried last night not just because it reminded me of this time but because in the last 6 weeks or so I have, as suggested in previous posts, had a rekindling of this positive view, literally seeing things in a way I have not done for two years. It was like a reminder to stay on this path.
Incidentally, I have been listening to Elbow's last album recently (Build a Rocket Boys) and the more I listen, the more I think it is inspirational too. Lyrics that are so gentle. If you have not had the pleasure, trust me, it's worth it.

Saturday, August 11, 2012

Stress

A few years ago I saw a great documentary on BBC2 by Stephen Fry on depression. It was largely about his own difficulties with depression and how it impacted his personal and professional life.
As usual with Fry, it is has total honesty that endears one to him (I read his autobiography last year and was astounded by this). Anyway, he also interviewed other people who had depression, the most notable of which for me was Richard Dreyfuss.
He described how he has regular serious depression - the kind where he took lithium on a regular basis. He said that the most productive time in his life was in the late 70s and early 80s when he had very few bouts of depression - and then his career took a nosedive as he relapsed and working became so very difficult. What was most interesting to me though was how Dreyfuss described stress (which came from the depression in his case, but his comment was general). 


He said that when you are stressed you literally cannot function like you normally do. It is exactly that lack of stress which allows you to function, be productive and have normal healthy relationships. Now this may sound like common sense but we all find it difficult to cope with normal life when we are stressed due to children, work and other commitments (like taking too much on).
This is something I have become even more conscious of since I have been sick. I am not saying I am never stressed (well, I'm rarely as stresses as I used to be) but I regularly notice the lack of stress now - I recognise it when I am "fully present", which happens more often than it ever did. This has helped me make some decisions recently about helping to remove sources of stress (and potential sources). I stop when I am tired now and don't try to do everything or be all things to all people. I think I'll always have to work on this though as it does not come naturally to me. But as you might expect, I am a strong believer in a link between stress and cancer so this is my motivating factor.

Friday, August 10, 2012

Eat, Fast and Live longer

I watched a fantastic program this week on BBC2 - Horizon - Eat, Fast and Live Longer. Michael Moseley went to the US to have a look at some of the cutting edge research on food and how limiting calories can have a big impact on many health factors such as cholesterol, body-fat levels and ultimately some of the most common cancers. It highlighted a number of different types of "diet" (and by that I mean a way of eating rather than a crash diet). Examples were
- A long term (i.e >10 years) low calorie diet. The guy who had been on this diet, who was over 50, was tested for some of the main health factors and had a considerably lower risk of cancer (and other diseases) than Moseley who was of similar age.
- A diet where you must fast completely for four days per month. Moseley did this and even after one round of this some of the health factors showed a big decrease. Research had shown that the decrease was cumulative over time in other patients.
- A 5 plus 2 diet - where you eat totally normally for five days per week and have a low calorie (600 calories or less than a third of the normal amount) for the other two days. Again, Moseley did this diet for a few months and his risk factors had decreased by 50%.

Where there was a reduction in health based on these diets there has been a huge decrease in the amount of pharmaceutical drugs people have to take to manage their health. This doesn't surprise me at all.

I mention this because I've always had a huge interest in diet and health and it seemed to be even more evidence that how we eat has such a big influence on whether we get some types of cancers or not. I think I probably could do the '5 plus 2' diet as I have serious will power. However, I also think that reduction of calories or a consistently reasonable amount of calories particularly as we get older, goes a long way to keeping us healthy.
I also think, like everything, it is a choice. I see these things more in black and white now than I dud before I was sick. If you want to be healthy and reduce your risk of illness, then look after yourself. If not, then don't. You need to make a choice and stick to it. Of course there are no guarantees but by taking responsibility for your health you reduce your risk. I urge everybody to make the right choice - while at the same time being completely open to freedom of choice - or "freedom to shoot yourself in the foot" as I like to say. I have made the choice but still want to avoid some of the extremes that Moseley demonstrated - back to balance.  However, it has made me think even more about ensuring I don't eat ever too much. I think this is a small price to pay.

Tuesday, August 7, 2012

Lance Armstong

When I was sick two years ago a friend of mine bought me a book by Lance Armstrong, the (many time) Tour de France winner who had cancer in the late nineties. It covered how he got sick, what happened and how he got back to health. Even though I must say I was not crazy about him as a person (I thought he was quite arrogant), I was hugely encouraged by this book at the time and would recommend it for anyone who has cancer now or indeed has gone through it and come out the other side.
He was hit by the same issue I had during chemo, a serious decrease in white blood cells which meant he found it difficult to move about (and cycle even a short distance which he found very difficult). I was also inspired by the title, 'My journey back to life' because that is exactly what I felt I was going through, literally trying to get back to a life which I considered to be on hold.
I bring this up because today my wife bought me a running top which is from his brand with Nike, some of the money from which goes to his foundation. She said that felt it would help keep me encouraged when running considering where I had come from two years ago. I think it just might.

And of course I bought a bike when I was at the end of the chemo. But instead of a bike to race on, I got a touring bike to out my two year old on and cycle around town. A much better idea and I have got great use out of it. Only problem now is that he'll only get on the bike with me if I promise to buy him sweets on the journey -it's no longer the pleasure of the spin for him. Can't have everything I suppose.

Monday, August 6, 2012

Two years ago......

At the moment I'm saying "two years ago I..." a lot. Yesterday, I said 'Two years ago I had to stay with my parents for 2 days as one of my children was sick and so the doctors advised me to get out of the house in case I picked up the illness and I'd be in trouble. I went to my parents' house and could hardly walk to the end of the street. Today I went for a three mile run in my parents' home town and then went for a few pints with my Dad". I'm finding that doing this comparison is healthy for me and helping me appreciate the individual moments of a day.  It is helping me remember just how much I used to push to always be doing something productive. It seems crazy. Now I can simply 'be' and enjoy it.

I'm reading a book called 'Running with the mind of Meditation' at the moment, a gift from my brother. It is fantastic. It is basically about the balance that a life with both running and meditation can provide you. An easy read. There's a good Youtube clip which illustrates what the author is about and it's not too heavy. Hey, these things are aspirations and are not easy to reach but I am feeling that it is a good aspiration for me to have. I'm not taking it too seriously but I think the central message about the link between mind and body is what is so poignant for me given that I believe that this disconnection was what caused me to be sick in the first place. I see it as a therapy to ensure this does not happen again.

I met a guy last year who spoke like this as he told me that he, some years ago, had cancer twice. He "didn't learn the lessons the first time" he said. This was such a powerful message to me and one I have never forgotten.

Saturday, August 4, 2012

Children

Two years ago when I had Cancer my children were 9, 6 and 2. I would imagine this paints a difficult picture. And it was, but as I've said previously, my wife handled it so well and things were as normal as was possible. The only things I think they noticed was that I was not at work and helped to get them ready for school in the morning and the fact that I was bald. A neighbour's child, a friend of my then 6 year old daughter, used to come in every day and nonchalantly say "hello baldy", which I loved. Being bald never bothered me in the slightest, an advantage of being a man I expect. It was when the eyebrows went that I looked really strange which took a little longer. Then I really did look sick.

Anyway, my 9 year old boy was at the age where all he cared about were his friends and his nintendo (which is even worse now), the 2 year old was too young to know any difference. But the then 6 year old girl was a revelation. She was acutely aware of what was going on, always watching me out of the corner of her eye..."are you alright there Dad?", "can I get you anything Dad?". At 6 this was astonishing but I suppose I shouldn't really be surprised as girls (and women) in general are better at that than us.  One of my favourite memories of that time was when she fell off her bicycle (bare with me). She came in howling with two cut knees, two cut elbows, a gash on her chin and all the blood that  minor cuts can pump out. In the middle of this she started yelling "I don't want to die, I don't want to die". I love this. In the middle of my cancer nightmare, between chemo sessions and coming off steroids, she was saying this. This is one I'll be bringing up when I'm making a speech at her wedding to ensure her husband (or wife :)) to be knows what their getting into.

People asked us, "did you tell the children what was going on?". And we did. We were very open with them. We first suspected things were not going in when the 6 year old came home from school one day and said she had told her teacher that her Dad was sick. When asked what was wrong with him she said "Alcoholic". Me thinks something got lost in translation.

Then, about 2 months after everything was finished we were at dinner one evening and we asked the 9 year old and 6 year old to remember the Summer and asked what had been wrong with Daddy. Totally blank faces resulted. We started laughing and pushed saying, 'you do remember Dad was sick?'. They did. A few minutes later the 9 year old said "Malaria". The only reason this came into his hear he later told me was that he thought I had the same sickness as Cheryl Cole, who did indeed have Malaria that Summer.

So my conclusion is that my sickness has no impact on my children. Well that's something anyway.

Thursday, August 2, 2012

Hospital - what a place!

To back up a comment from the previous post about hospital being a terrible place (despite the wonderful people)......
One weekend between chemo sessions I was rushed in due to a rising temperature, potential danger...the whole palaver. I ended up isolated for 24 hours followed by spending 2 days and nights in a Heart ward as there were no other beds in the hospital. It was both a sad and a funny experience at the same time. There were 8 guys in a room, at least 3 of whom had no idea where they were due to age or drugs or both.  Anyway on the second night I got chatting to this old man and we exchanged war stories about surgery and illness. He then said something that will stay with me forever - "I am 88, more than twice your age, and I want to get out of here just as much as you do." I love that. The simple drive for normality has no age boundary. The abhorrence of sickness has no age boundary. He made me smile when we agreed that to go for a pint was the normal thing we both wanted the most......I already knew that alcohol has no age boundary.

Learning

So what have I learned about myself after all this?
Firstly I learned that I'm a "bit" wired at times. I remember being in the hospital and being quizzed about my lifestyle from a nutritionist and she just laughed at me....not because of all the healthy things I was doing on top of all the work, but the fact that I had been hiding the fact that I was doing a Masters degree from my wife (see previous post).  She had heard of guys going on benders or playing too much golf and pretending to be at work, but omitting  masters degree from a wife's list of 'need to know' was new to her. With hindsight, this speaks volumes really - the fact I didn't tell her indicates I knew she would think I was taking on too much and try to prevent me. Of course this simple logic was not front of mind at the time....and this 'wired' factor has decreased on the last two years.

Secondly, it reconfirmed what I knew already - that I am very focused and driven and can put my mind to anything.    Of course the chemotherapy did the job on the 'thing' but I like to think my determination played at least a part. It certainly did in relation to enduring the chemo.

Thirdly, I have an amazing family - my wife and parents and siblings were my rocks. My wife is a seriously strong person - Samsonlike in her determination to ensure the kids' lives were maintained as normal.

Lastly, I learned that it is important to remember it. It puts everything in perspective. I always say that the worst day at work is a million times better than the best day in hospital. I know it is hard to keep this front of mind when work and normal life is difficult, but it really helps to consider it on those days.

Wednesday, August 1, 2012

How did I end up in that situation?

Many people may think that asking that question is crazy after two years. Why did I get cancer? I was healthy and fit. I was only 38. I didn't smoke and I drank in moderation. I ate very healthily. All in all, I felt I had the 'balance' I mentioned in previous posts. Well, with hindsight I know that I had the farthest thing from balance. At the time I was sick I had a family, with 3 children under 9, a full time job which was quite demanding. I also had taken on two assistant lecturing positions at the open university, increasing from the single one I had six months earlier. Oh, and I was also finishing a Masters degree. So, what I now know is that I thought I could do everything. I'm smart (well, smart enough) and capable....."why couldn't I do all of this?" was my attitude. I actually remember thinking this.
So in summary I fully believe that I made myself sick. This may be a controversial view to some. My doctors called my non-hodgkins lymphoma a 'genetic blip', literally an accident of genetics. And that's fine. But I believe that this blip was triggered by my situation. I think this because of what I have learned since. I have read alot about eastern medicine and meditation and they indicated the strong links between mind and body.  I believe I pushed myself so far and so hard for so long that something had to give. And it did.
So this now explains my search for balance. Sometimes the old me rears its head.  I recently got it into my head that I wanted to do a doctorate and got all the information on what I needed and thought through the logistics over a period of weeks. Then one day I realised that this was the old me. I had this feeling that this idea did not feel right all along. I meditated on this last night and made a clear (and amazingly quick) decision that I will not persue this crazy idea at this point in my life. The clear lesson I have learned is "JUST BECAUSE I CAN DO SOMETHING DOES NOT MEAN THAT I SHOULD'.  For years I always felt capable and I fully believe that I can do anything I put my mind to, a feeling I have even stronger now I've been through cancer. However, wisdom is about knowing when not to do something and finding the balance in your life. This is a hugely positive step and decision for me and I will take this learning into other parts of my life.