Overcoming the Shock and Fog of Cancer

A cancer diagnosis causes shock.  And you can feel like your in a fog.  But you can quickly overcome these feelings by being deliberate and proactive. 

Learning that you have cancer is a shock to the system.  It affects you mentally, emotionally, physically and spiritually.  There is a feeling that I describe as being in a fog.  Others have told me of having a similar feeling in the days immediately following their diagnosis.  Here’s the learning: no matter how together you may think you are, no matter how positive of an attitude you can muster, you will experience some amount of shock.  The same is true for loved ones and people who care about you.  Cancer knocks you off your center as you adjust to the new reality.

There is a funny thing that happens.  You definitely feel different than you did before the diagnosis.  How the difference manifests itself varies person to person.  For me, there was a sense of things slowing down.  At times I felt like I was observing rather than participating.  I recall a professor at Wharton talking about “sitting on your own shoulder” as a metaphor for how to be better aware of yourself and others during meetings and, especially, difficult interactions.   The metaphor captures how I often felt during those early days, which for me coincided with my travel Antarctica.

As I described in an earlier post, continuing with the planned trip was a very good thing for me.  The trip provided a great combination of quiet time and busy times full of beautiful scenery, adventure and learning.  I took time to think, reflect and write in my journal, especially during the three days at sea crossing the Drake Passage.   My daughter was not feeling particularly well during our passage.  (Did you know that the Drake Passage has some of the most turbulent seas in the world?  More on that in a later post.)  I was so sorry for her being seasick.  My sea legs and strong constitution did not fail me, and I quite enjoyed the passage.   And I used the time to clear the fog.

A particularly interesting part of my adjustment occurred during mealtimes.  While this was not a typical cruise in most respects, it did provide the opportunity to meet new people and making new acquaintances at breakfast, lunch and dinner.  Of course, with only about 125 guests on this adventure cruise, we had a chance to meet almost everyone on the boat.

Whenever I met new folks, I had this silly, awkward thought.  Should I tell them I have cancer?  Imagine if I said:  “Hi, I’m Lee Dittmar and I have cancer.”  Of course I never said any such thing.  But there is absolutely no denying that you have this new, distinct, but invisible part of who you are. It is a chapter of your life that you are just beginning. It is now part of your story, but it is still so new and your not sure who to share it with or when to share it. I reminded myself that behind every face is a story, and that each and every person on the cruise had experiences and challenges.   I set my intention on being interested rather than being interesting.  I would be deliberate in learning about my fellow travelers, and focusing much less on myself.

During what you can think of as the “shock and fog phase”, your mind will continuously filter your experiences through the still new information about having cancer.  I learned not to fight this and accepted it as part of the process.  It was impossible to not think about the fact that I had just been diagnosed with cancer.  It was too new. But I did fight off the nagging “what if” questions.  I accepted that I had cancer, but I did not accept the inevitability of negative outcome.

I made sure to exercise every day.  I had already made it a habit to exercise several times every week.  And I knew that being fit would help me deal with the side effects of whatever cancer treatments lie ahead for me.  There was a small fitness center on the boat and I was a regular there.  (Most days I was there alone.  A couple of days I overlapped with a couple of very fit guys.  One was a pilot for Southwest Airlines and the other was a pilot for Lufthansa.)  The elliptical faced a wall of glass that allowed me to look out on the vastness of the Southern Ocean, with only an occasional sea bird breaking into the picture.  (Seeing Albatrosses with huge wingspans was an awesome part of crossing the Drake Passage.)

There was a beautiful library on the boat.  It was decorated with hardwood paneling, filled with books with a decidedly adventure and documentary bias, and furnished with comfy chairs.  I made it a point to go there each day (usually first thing in the morning) to meditate, write in my journal and set my personal goals and expectations for the day.  This practice gave me a dedicated time to face any worries, fears and wacky thoughts, to remind myself of all I had to be thankful for, and to set myself up to enjoy the present.  I recommend some combination of mediation and journaling to help get the most out of every day.  I especially encourage making this a habit for anyone dealing with a cancer diagnosis.

In order to overcome the shock and fog of the cancer diagnosis, I was deliberate in focusing my mind on questions, thoughts, ideas and affirmations that were beneficial.  For example, in my “5 Minute Journal, I answered these two questions each morning:  What am I thankful for?  What would make today great?  And then I wrote down affirmations, either from inspirational writings or from my own thoughts.  Later, at the end of the day, I would answer two questions: What great things happened today?  What would made it better?  (I keep my 5 Minute Journals in the “Evernote” app. This allows me to write and read my entries on any of my devices.  There are hardcopy versions of the 5 Minute Journal that you can buy online.)

TTFN.  I leave you here with my 5 Minute Journal entries from 2/18/2017:

What am I grateful for today?  
 
That Krista is feeling better (seasickness)

For my positive attitude and initial response to the cancer news.

For my overall fitness and head-start in physical health as I look forward to starting treatment.

Debra’s efforts to research doctors and plan for my treatment.

Debra, Krista, Connor, Cameron

What would make today great?

Krista able to function and enjoy

Sighting some sea mammals

Maintain inner peace

Exercise

Reading

Affirmations

The universe is conspiring to accomplish my complete healing and recovery.

The changes that are in process are for the greater good.

The power of intention is a major force in the universe, and I use intention as a lever to achieve my goals and objectives.

Every day can be a masterpiece.

I live everyday to the fullest, and look for the good in every experience.

Internalizing the Diagnosis

It was Valentines Day. I had just told my wife that that I had throat cancer. And I was leaving for two weeks for an adventure trip to Antarctica with our daughter. I told myself: “I’ll deal with the cancer when I get back.”   I was very much at peace with continuing with the trip as planned. I did wonder whether I was delaying the start treatment and whether that would make a difference. I chose not to dwell on that question, and took comfort in the doctor’s advice to continue with the trip as planned. But I was very worried about my wife. I feared that the learning of diagnosis would have a devastating effect on her.  And it did.

During the morning of that first day, I was happy to have something all-consuming upon which to focus. We had to complete final preparations, as we would soon be on our way to JFK airport. It was exciting. Krista and I would be setting foot on our seventh continent.   We had both been all over world, but this was a different kind of trip.

I don’t really remember the drive to JFK, but I do recall a feeling like being in a fog. Quiet times led to a thousand questions passing through my mind. Of course, there were no answers for the questions; at least not yet. Answers would only come over time.

The biggest worry initially was “is the cancer widespread? Has it metastasized?” I did not speak of this worry. Instead, I told myself that I was going to need to let this play out. There was no benefit in worrying or continuing to ask “what-if” questions.   I realized that this cancer journey was going to take mental discipline and emotional control. I resolved to prepare myself. I was determined to develop routines and habits that would help me deal with whatever was thrown my way.

I was very fortunate in that cancer struck me at time when I had developed habits and routines that would serve me well. A notably positive thing about the timing is that I was quite healthy and fit at the time of the diagnosis. I had lost 25 pounds over the past 18 months. I was exercising regularly and focusing on my diet. At the time, I was well into eating the Ketogenic diet, which was working quite well for me. Coincidentally, the low carbohydrate high-fat Ketogenic diet is one that research has shown to be beneficial in the battle against cancer.

Five months before the diagnosis, I had taken up the practice of meditating. After a slow start, I had been practicing daily meditation for several months. The other routine I had established was daily journaling. I was doing two types of journaling: 1) a daily “5 minute” journal (which I did in Evernote);  2) a longer hand-written journal, which I did tried to daily but settled for 4-5 times per week.  These routines would help me internalize the diagnosis, process my thoughts and emotions, and decide how I would think and act during the battle.

Tim Ferriss (author, podcaster, and evangelist of leading life hacks) speaks of his journaling as “taming his monkey brain.” In other words, clearing the clutter and getting focused. It certainly worked well for me, especially as I prepared to battle cancer. The following is directly from my handwritten journal, grammatical errors and all, written on February 15, 2017 at 8:50 AM, on Aero Argentina flight 1857 from Buenos Aires to Ushuaia. This is how I internalized the diagnosis.

So, the day came to get the test results. And guess what? A new game in town. We are now in the “C” game. Not what I wanted, but honestly, I was not surprised. It has been less than 24 hours since I got the report from Dr, Gallagher. Awkward timing. But what timing would be god for this. My first thought was “How would Deb deal with this?” I was thinking about how I would tell her before the doctor was done explaining.

Gotta play the hand your dealt. And this is one I’ve got to play very well. No room for screwing around. Must become an expert. This is now part of who I am. Part of my reality.

Key Principles:

1) Positive attitude

2) No whining – no blaming – no looking for cause

3) One step at a time (live in the moment)

4) Team effort (cannot do it myself)

5) Health & fitness first priority

6) Must get good rest everyday

7) Complementary protocols

8) Document the journey

9) Knowledge is power (follow the data)

10) We win – no matter what

Live your life. The disease is only one factor. It does not own me.

How do I reconcile my goal to ski at 100 with the near term challenge of surviving the next 5 years? Of course, this is just part of the journey. This is a necessary chapter in the book. My experience conquering cancer will prepare for the rest of the journey. And it will help me to value and enjoy every day. I also think it will help me and Deb. It will bring us closer together. It will make the other stuff far less important, some of it totally unimportant.

I must be sure affairs are in order. The financial plan will likely change. Unlikely to be able to get life insurance at reasonable price. So other strategies come into consideration.

So enough about “C”. Krista and I are on our way to an adventure of a life time. In just a few hours, we will be in Ushuaia. In 30 hours, we will be boarding the Silver Explorer on our way to Antarctica. Hard to believe! But if you can dream it, we can make it happen.

Until I started to work on this blog post, I had not re-read that journal entry since the trip to Antarctica. I now know that my thoughts that day, set forth sloppily in my journal (my handwriting is so bad, I need to print so I can read my own notes), laid the foundation for how I would think and act in my battle with cancer. The principles I listed actually guided me on my cancer journey, and allowed me to really enjoy the journey to Antarctica.

The Day of Diagnosis

The opportunity for a meltdown occurs when you first hear the diagnosis. Cancer is like that.  The moment you get that diagnosis is etched in your memory.  It’s similar to how people know exactly where they were and what they were doing on 9/11.  The news can be disorienting, and over the first few days your emotions can swing wildly.  When I reflect back on my own experience, I now know that how you internalize the diagnosis is very important for yourself and for the people who care about you. Take it slowly. It is important to go with the flow during that time.  Don’t alter your near term plans. It’s not a time to make big decisions or big changes.   Here’s how it happened for me.

For a couple of months (my wife would say for even longer), I had been experiencing periodic hoarseness; no other symptoms, just hoarseness.  I remember researching the causes of hoarseness, and way down this list was the “C” word.  I took note, but I was not particularly concerned. By early January, the hoarseness had gone from episodic to persistent.  So, I was off to see my primary care physician, who then referred me to an ear, nose & throat specialist

When the ENT doctor examined me, his camera quickly revealed the likely cause of the problem.  I had a polyp on my vocal chord.  The doctor explained that he would surgically remove the polyp, and he said that more than likely this would resolve the problem.  He explained that the polyp would be tested to determine whether it was benign or malignant.  The surgery was scheduled, and I hoped for and expected a successful outcome.

The surgery (known as a Laryngoscopy) was conducted on February 1, 2017.  All seemed to go well.  I had expected my voice to return to normal after a week of rest and healing.  But this was not to be the case.  Something was still not right. My voice was not recovering.

My post-surgical follow-up visit was delayed by a snowstorm.  Because of my schedule and the limitations of the doctor’s office hours, my appointment was ultimately pushed out to Valentine’s Day.  Coincidentally, this was the same day that I was scheduled to depart for Antarctica. It was special trip with and for my daughter, Krista, arranged over a year ago to celebrate her receiving her MBA from the University of Texas.

Mine was the first appointment of the day. I arrived early, as in less than an hour, I would be on my way to JFK airport to fly to Argentina. After parking my car, I sat for a few minutes and reflected on the likely outcome of my meeting with the doctor. What would I learn in just a few short minutes? Should I expect to learn that the polyp was malignant? While I hoped for good news, my instincts told me that I should prepare for the worst.   I remember asking myself “what’s your prediction?” As I opened the car door, my mind told me to get ready for the ‘C” word. While a part of me still hoped I would not receive a cancer diagnosis, the fact is that, at that moment, the mental and emotional battle had begun. I had already started thinking about how I would deal with it.

Before I knew it, I was in the examination room and, much to my surprise, the doctor showed up promptly. It had been almost two weeks since the surgery to remove the polyp. The doctor had received the biopsy results well over a week ago. We talked about how the winter storm had played havoc with our schedules. He told me that he was going to call me earlier, but when he saw I was on his schedule he decided to wait. He could hear that my voice was weak and raspy. He wasted no time in explaining that my voice had not recovered because of the cancer. The biopsy had shown the polyp to be malignant. Boom!  There it was.  The dreaded diagnosis.  Time seemed to stand still. Even though I thought I had prepared myself, the truth is that I felt like I was in shock.  My rationale self started to ask questions. How far along was the cancer? Was it treatable? What would treatment entail? What were the next steps?  But I am not sure I was fully hearing the doctor’s answers.

The doctor was calm, and I tried to be as well. He spoke positively about the prognosis. I thought he said something like “it seems we caught it early” evidenced by the fact that my only symptom was the hoarseness. He also said something about the biopsy results suggesting that the cancer could have had its origins with a virus.  But he did not say whether that was a good or bad thing.  Then he explained that the typical treatment would entail 6-8 weeks of radiation and, potentially, chemotherapy.  It was too soon to say with any certainty.  Special testing would be necessary to determine exactly how wide spread the cancer was. The biopsy of the removed polyp only confirmed that there was cancer in my throat. But how far had it spread? Getting a pet scan would be the next first step.

I had told the doctor previously about my planned trip to Antarctica. Now, in light of the diagnosis, I asked him if I should still go. He did not hesitate or hedge in answering. “Absolutely” was his advice. He said it could take at least a week or more for a pet scan to be arranged. He also said that it would take some time to research oncologists and get an initial appointment scheduled. “Of course, go to Antarctica” he said.  “I would.”

Before I left his office, I had an appointment scheduled to get a pet scan. It would happen the day after I returned from Antarctica.

It seemed like hours since I had arrived at the doctor’s office, though it was probably only about 15 minutes. And ever since the doctor had told me that the biopsy revealed the cancer, all I could think about was “how would I break the news to my wife?” The ride home from the doctor’s office took about 20 minutes. The entire way I thought about what I would say and how I would I to say it. I hated that I had to put my wife through this. Ugh. Would it make sense to wait until I returned from Antarctica? It took only a second to dismiss that idea.   The only thing that made sense was to share exactly what I had learned, without embellishment, interpretation or extrapolation. The news was not positive, and there was no sugarcoating the fact that the biopsy revealed the presence of cancer in my throat. But that was all we knew at this point.

When I got home, my wife, Debra, was working in the office on the top floor of our home. My daughter was finishing packing for our trip. The car service would be picking us up in about am hour. I asked Krista to come up to the office because I wanted to share the results of my doctor’s appointment with her and Mom at the same time. And that is what I did. My recollection is that I was calm and matter-of-factly in giving the report. Before the question could be asked, I related the doctor’s strong encouragement for me to continue with the trip to Antarctica as planned.

There is no doubt that Debra was very worried. She told me that she had expected the news to be bad. “I knew it” she said. She did not argue that we should cancel or reschedule the trip. But she expressed her concern about any delay in starting treatment.   I tried to reassure her, based on the doctor’s information, that it would take significant time to get the start of treatment whether or not I went on the trip. I knew she was not fully accepting of this explanation at the time. But nonetheless, she was outwardly supportive of the decision to continue with our longstanding plans.   As I will explain further in a subsequent blog post, this was a great decision me, initially a very difficult one for my wife, and one that bore out the doctor’s predictions about how long it would take before any treatment would begin.

My lesson from the day of diagnosis is that it is important to continue living.   This does not mean to ignore good medical advice or common sense. The diagnosis of cancer must be taken seriously, of course. But if the context of the diagnosis is otherwise good health, continue to live each day to the fullest. In my case, I did not feel sick and I was not experiencing any pain or functional limitations. Remember, my only symptom was hoarseness. My doctor had been very clear that there was no treatment benefit to be had from changing my plans.

Now I know that having plans to travel to Antarctica at the time of a cancer diagnosis is not a particularly common situation. But the lesson is applicable even if your plans at the time involved more routine activities. Don’t stop beING you are or doing what you do. Yes, it is easy to start thinking the worst. It is easy to begin asking yourself “what if” questions. But for yourself as well as for your family and close friends, don’t panic and don’t stop living. Be pragmatic. Give yourself time to internalize the diagnosis, which is a process. I’ll discuss my process and what worked for me in the next blog.

A New Years Eve Reflection

I wrote this note early in the morning on December 31, 2017.  As you read this blog, think of this as beginning with the end in mind.  Here I am happily on the other side of my battle with cancer, reflecting on the journey and thanking people who joined the battle.  Enjoy.

I hope you are in a safe, comfortable and welcoming place as we prepare to say goodbye to 2017 and welcome in 2018. However you prefer to spend this time, I wish you peace of mind, a spirit of gratitude, and inspirational goals for your future.
You might think that I am more than ready to put 2017 astern. In many respects, you would be right. It was a year that I would not want to repeat. The cancer, medical appointments, treatments, tests, pain, hospital time, loss of physical energy and strength, inability to eat, seemingly endless medications are happily behind me. But in spite of the very challenging and difficult times, there was so much good during this very different journey.

Because of my ordeal, I experienced love, caring and support like I had never known. I was humbled and I learned to be a “receiver”. I experienced the power of prayer in a very personal, intimate way.

My family grew closer and stronger. We were challenged, for sure, and had times of worry, fear and uncertainty. But we were forcefully reminded of the things that truly mattered. I could not have fought this battle without the love and support of my dear wife and life partner, Debra, and my three precious children, Krista, Connor and Cameron. I love you more than I can ever express.

I got to know some of my friends better than I ever had. I was touched and inspired by their depth of caring, and by how deeply they were affected by my diagnosis and my journey. Most of all, it was truly wonderful to see, hear and read their true joy felt and expressed when the test results showed that the battle had been won.

The support on Caring Bridge was so very special and so very important to me. Wow. Did you know that I was reluctant to jump into this sharing through journaling? Part of me did not want to bring focus on my disease. I did not want to be defined by the cancer. But I realized that this was not a battle I could fight alone. I came to know that it was necessary and appropriate to share this journey, because it was not just mine alone. It was a journey for all who chose to take it with me. It was a battle that required an army of spiritual warriors.

I cannot describe how much I enjoyed your many notes in response to my journals. You often surprised me, always in a positive way. Some of you responded often, others occasionally, and many did not write responses in Caring Bridge. In the latter group, many sent separate text or email messages. Some even tried calling. And many sent physical cards. (Some call that last bit the “revenge of the analog”).

How can I fully describe the positive energy, confidence and inspiration your individual support provided to me? How can I even attempt to explain the incredible power of your collective support? Alas, words will never do it justice. But perhaps knowing that today I feel physically, emotionally, mentally and spiritually stronger than ever will begin to give you a sense of the impact you have had and continue to have in my life.

And so, I hope you see why 2017 was and always will be a special year for me. It would be easy to let the negative stuff define it, but today I choose to hold on to the many blessings I received during the year. I believe I am in a better position to be a help and blessing to others. In regard to people who are battling cancer, I have real empathy from my personal experience. I have learned a lot about myself and a lot about other people.

Because of everything that happened in 2017, I am looking forward to 2018 with a freshness and openness like I have not experienced before. My goal this year is to be a consistently positive source of inspiration and energy for my family, friends, colleagues, and – here’s the stretch goal – everyone with whom I have the opportunity to interact with. I appreciate your encouragement.

Happy New Year to you! I pray that you will have a year that creates many positive memories. Challenge and believe in yourself. Live life to the fullest. Be a blessing to others. And remember, you are someone’s role model, even though you may not know who is watching or when they are watching.

Thank you for being along with me on A Very Different Journey.

Welcome! Are You Ready for A Very Different Journey?

I have been inspired and encouraged to share my journey, along with the insights and lessons I learned along the way. And so here we go, into the world of the blogosphere.

I have been a student of self-help, motivational and inspirational teaching and coaching for many years.  It started about a year after I graduated from college and was working as an engineer building a nuclear power plant in Florida.  I had moved away from home confident, independent and self reliant.  Things were going well at work and I very much loved living, working and playing in Florida.  Unexpectedly and surprisingly, I found myself in a deep funk for no apparent reason.  So what did I do? I went to the bookstore and searched for books that would not only help me understand what I was experiencing, but also provide steps I could take to get out of the funk.  I was successful and soon overcame the funk.  (Much later, I would learn that I was experiencing symptoms of mild depression.)

That was the mid-1970s.  Since that time, I have read many books, attended workshops, worked through guided programs and listen gurus and coaches on tape, CDs and podcasts.  I took to heart Stephen Covey’s lesson about “sharpening the saw.”  To this day, I continue to seek to learn from the experience, techniques and practices of others.  If you drive in the car with me, you might find yourself listening to a podcast from Tony Robbins, Tim Ferriss or Scott Smith.

After many adventures and challenges, I realize that I have been the beneficiary of people who were willing to share what they had experienced and learned along the way. I have always been willing to try to help others by sharing my own personal experience and lessons learned.  But, until now, that has mostly been on a one-to-one basis.  With much prodding and encouragement, I begin the process of sharing through writing and with a broader audience.  This blog is a first step.

We will begin with recent events and, specifically, the part of my personal journey that motivated me to start this blog. When we visit our doctor, what’s one word that we most fear hearing.  For many of us, that one word is “cancer”.  How would you react if your doctor told you that recent test results showed you had cancer?  How about if this happened to a family member or a close friend.  I know that for many of you this is not a theoretical exercise; so many people’s lives have been disrupted by cancer.  On Valentine’s Day 2017, my doctor spoke the dreaded word.  He said that my test results revealed I had CANCER.  That was 10 months ago, but I remember the moment like it was yesterday.  It was surreal.

I don’t really want to relive the experience or dwell on my cancer journey.  I would much rather focus on the present moment.  But I know that for others, the cancer journey is your present moment.  And so I feel an obligation to share how I got through the treatment, to provide experience-based suggestions on specific strategies and techniques that worked well for me.  I also want to provide insights for friends and family trying to be supportive and helpful to cancer patients in their lives.

Expect the next few editions of A Very Different Journey to focus primarily on the physical, mental, emotional and spiritual aspects of fighting cancer.  TTFN.