Chef Moffatt, Play & Beckta Fine Dining

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Chef Geoffrey Morden, Fairmont Chateau Laurier

Chef Duane Keats, Luxe Bistro

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Chef Kenton Leier, Westin Hotel

  

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Getting back to normal

Completing treatment is a positive milestone on our journey.  We want, and expect, life to return to normal after the disruption.  Few of us resume life as it was before.  The person who went into treatment is usually not the same person who comes out of it.  Some, like Lance Armstrong, emerge from cancer to accomplish spectacular feats.  Other celebrities find a new life balance or lifestyle and inspire many survivors.  These celebrities are good role models for hope and for what we can accomplish after cancer.  But---they are the exception.

Our health status after treatment defines our “new normal”.   Reduced physical functioning, from treatment or disease, might limit our activities.  We might have reduced cognitive capacity.  Some women report memory and cognition impairments, known as “chemo fog”, up to a couple of years after treatment.  Some of us may experience a lingering fatigue and loss of energy.

These changes can make us feel awkward, embarrassed, or even inadequate.  It takes awhile to realize that you may never get back to where you were.  Every loss creates an opportunity.  Though we have lost something with the illness, we have gained something with the experience.  Athletes with career-ending injuries often remain in their sport by coaching or managing. 

Our journey can change our perspective.  Many of us look for meaning in our cancer experience.   We might:  re-assess our priorities; try something new that we’ve always wanted to do; live a more balanced and healthy life; spend more time with family; write a book; travel the world; wind-up a career; give back and volunteer; and even do the same as before, but differently.  Cancer celebrities’ high-powered achievements result from their own search for meaning.  Unlike most of us, they are supported by publicists, personal trainers, sponsors and other resources. 

Don’t feel pressured to get back to life as it was.  Take time to accept that things have changed and then re-invent yourself.  The “New You” is the product of your new normal and your new perspective.  Have faith that you will succeed in putting the pieces of your life back together.  However, if your recovery is taking too long, or is affecting those around you, consider getting help.

Once we embrace our “New You”, we can get on with living and embrace our loved ones and our survivorship.  

Survivorship 101: Transitioning from active treatment to post-treatment

Finishing treatment is the beginning of our survivorship journey.  Our destination is the return to a normal routine and life.  Before we get there, we must make the transition from active treatment to post-treatment. 

While we’re in treatment, we have the comfort of routine and oversight.  We know our treatment plan, test schedule, appointment dates, and next steps.  We meet with our oncologist on a regular basis.  Sometimes, we develop relationships with members of our treatment team. 

When our oncologist discharges us, it’s bittersweet.  We’re happy that we can resume our normal routine.  But it’s also scary because we won’t see our doctor for three months.  Because no one is watching over us, we may develop fears of recurrence and abandonment.  We’re usually on our own to get answers to our questions about how to stay healthy and cancer-free. 

The good news is that we can help ourselves and get help from others to fill this post-treatment gap.  You’ve recently focused on the short-term goal of completing treatment.  Now focus on the long-term goal of a future of health and well-being. 

Make and follow a plan to help you transition from patient to survivor.  Your personal action plan might include these activities: 

·      A celebration of your “graduation” from treatment.  Don’t forget about family, friends and others who helped you on your journey! 

·      An “exit interview” with your oncologist.  Address the issues that might arise before your next appointment in three months:  signs and symptoms of concern and whom to call; recovery time; restrictions on activity, exercise, work and routine; updates to insurers and employers; immune system matters; managing health risks after your treatment; and addressing physical quality of life issues.     

·      Check-in with your family physician.  Request a “20-minute” appointment with your family physician to give an update on your cancer treatment and current status.   Agree on a plan to monitor your post-treatment health risks.

·      Understand your cancer, its treatment and its risks.  Inform yourself about how your cancer and its treatment could affect you during your life. 

·      Assemble your health file.  Preparing the file can give you sense of closure to the treatment phase of your journey.  Include: your updated medical history; copies of your test results; a list of physicians consulted and why; information about your treatment and medications during treatment; a list of your current medications; and your doctors’ recommendations for monitoring.  Take it to your health appointments.

·      See your dentist.  Oral health is an important part of overall health.  If your oncologist gives the ok, get that dental check-up you’ve postponed because of treatment.  Update your dentist on your cancer, its treatment, medications and your current health status. 

·      Find and use community and internet resources.  Speak to survivors and/or professionals who can help you with your transition to post-care (e.g., cancer transition programs, support groups, peer counselors, psychosocial oncology programs, supportive care programs).

·      Regain your physical quality of life.  Get referrals to resolve treatment side effects that affect your physical quality of life, e.g., lymphadema, joint pain from steroids, vision or speech problems, etc.).  Contact the psychosocial oncology program at your cancer centre.  Staff in these programs include speech-language pathologists, physiotherapists, occupational therapists, clinical dieticians, and exercise specialists. 

·      Develop an exercise and movement plan.  Work with your doctors to develop a physical activity program that is right for you.  Then just do it---regularly.

·      Learn how to prevent cancer.  A focus on lifetime health and wellness requires a preventative approach.  Learn how to reduce your risk in daily life.

·      Take stock of emotions.  Use this time to assess whether there is any distress in your or your loved ones’ emotional, psychological, and social well-being.   Your cancer journey affects you, others and your relationships.

·      Get help for distress.  Get individual, couple or family counseling for emotional, psychological and social areas of distress.  Social workers, counselors, psychologists, psychiatrists, and spiritual care advisors are members of your lifetime health care team.

·      Prepare for reintegration.  Use this time to get ready to return to the workforce or social circles.  Put the pieces of your life back together.  Don’t be surprised if your priorities, needs, goals and capacities are different now.

 If you’re busy with your action plan, the three-month wait until your next appointment won’t seem so difficult.  You can take control of your survivorship!

Tuning out and focusing on surviving

We need our energy and strength to deal with cancer.   Negative thoughts can drain our energy.  I have heard many unsettling comments during my journey from family, friends and workplace colleagues.   Learning to deal with comments will help you preserve your precious energy.

Expect odd comments.  The friend who said, “You look great.  Are you sure you’re sick?” was probably trying to cheer me.  I didn’t have the energy to reply that the steroids in my chemo gave me those nice rosy cheeks. 

Some of our loved ones habitually make awkward comments.  I still am fond of my neighbor who asked me, “Are your work colleagues jealous because you’re taking an extended vacation?” I don’t want to travel with her if she thinks medical leave for cancer treatment is a vacation! 

In spite of the survival statistics and the progress in treatments, many people still associate cancer with death.  When I heard I had lymphoma, it was my first thought.  Thinking it is one thing.  But hearing it from our loved ones is another thing.  I was quite rattled when a doctor-friend said to me, “If I ever got cancer, I’d pack everything up because it’s a death sentence.”  I was speechless when a relative remarked about her inheritance, “Someday this will all be mine.” These insensitive comments can hurt.  Don’t dwell on them.  Give the benefit of the doubt.  Your cancer moves your loved ones out of their comfort zone.  Perhaps they are uncomfortable with your situation and don’t know what to say.  Perhaps the speakers’ comments are awkward vocalizations of their own mortality. Besides, we’ve all said bonehead things when afraid or nervous.  Our family and friends love us in spite of the things we may say or do---so why shouldn’t we love them? 

If you’re working, expect to hear some harsh words.  I was devastated when my boss said to me, “We’d like you to go on disability leave”.  Our work can give us self-esteem, an identity and a social network.  Many of us want to keep working if we can---it’s one less loss due to the illness.  The boss may compel you to take medical leave because your illness can affect workplace productivity and the bottom line.  Sometimes we can negotiate special arrangements such as working from home or shorter work hours.  The boss must balance compassion with the bottom line. 

Most importantly, don’t hold your family, friends and colleagues hostage to their comments.  The illness disrupts our lives and our relationships.  If nothing else works, remember the adage, “Don’t nurse a grudge”.  Instead, focus your energy on healing and surviving.