Exercise your options...

Special guest blogger: David Haas.

You can find more about David at http://about.me/haasblaag

The common link between physical fitness and cancer prevention has been proven time and again, though lack of a regular exercise program is acknowledged as only one potential risk factor. Still, it is one of the risk factors that individuals have control over, so the emphasis is justified. Cancer experts have found through a number of studies, both clinical trials and epidemiology, that fitness is just as important during treatment.

Exercise during breast cancer treatment, for instance, has been shown in over 30 studies to reduce the common symptom of fatigue, improve quality of life scores for patients and reduce the risk of recurrence. Unfortunately, it has likewise been shown that a diagnosis of breast cancer typically results in lower levels of physical activity.

Similar findings have surfaced for other common forms of cancer, including hormone-based and colorectal cancers. Exercise is an important adjunct to treatment, capable of reducing the problems caused by cancer and treatments. Loss of self-image can cause emotional disorders, and chemotherapy often results in a mix of symptoms, like nausea, insomnia and poor bowel function. Exercise provides relief from these problems in otherwise healthy people, and modern medical research found that it works just the same for cancer patients.

Risks of Exercise During Treatment:

The primary reason exercise is not being adopted faster by cancer clinics, despite recommendations by the leading research organizations, is patient safety. Doctors worry that patients can be injured or may reduce their body's tolerance to treatment. While it is true that certain forms of exercise are inadvisable in certain conditions, such as high-intensity aerobics during mesothelioma treatment; all patients are capable of and will benefit from the use of a regular exercise program.

What that program looks like depends on medical evaluation and the patient’s own preferences. Most breast cancer patients will be able to engage in moderate-intensity workouts like walking, while those with bone cancer may be steered toward a no-impact exercise, such as water aerobics. For those facing a terminal prognosis, exercise can still provide benefits by reducing symptoms. The more the risk of exercise increases, the more imperative it is to seek the services of a fitness expert trained in cancer care.

Role of Personal Trainers:

A growing number of clinics and insurance plans are providing physical therapists for patients after surgeries, because specialized exercises have shown valuable in speeding up recovery time. Personal trainers can do much more though, especially when working as part of the clinical team. They can give suggestions on the most appropriate forms of exercise, as well as share knowledge of local resources. They are also skilled in helping patients stick to the program. Check with clinics to find one that provides fitness experts.

As always. We have the bullet in our hand - JM

2012. My turn...

Come on. You DID NOT want to squirm and see Dick Clark suffering through another countdown did you?

I didn’t think so.

2012. Twelve years into a new century. Sometimes I laugh at the thought. As a child, I envisioned hover cars, transporters, Klingons, and new worlds. I suppose there is a lot to be disappointed about with the lack of advancement in regards to humankind. Wars are still waged. Global warming still, well, warms. Dogs sleeping with cats. It’s utter chaos.

I used 2011 as a year of introspection. Being a recovering introvert, I am pretty good at tearing my insides up and rebuilding them. Every person is a story and an interesting one at that. My story is no more or less interesting than the person across the street or on the other side of the world. There is drama, heartache, heroics, tears, laughter, comedy and all of the elements that make up something called Life. It is my limited experience that tells me, the difference between human stories is that one of the many elements of that person’s life may be inflated more so than the next person. Someone who has grown up in war torn Bosnia knows the tragedy and heartache of human folly more than the average Hollywood starlet. And that starlet may have personal trauma that no one within 10 clicks can understand. Someone wins a lottery, and someone dies hungry. Someone is born to live a century and someone is born only to die moments later. It is humans being and it can be maddening.

To that end, I have been evaluating all the relationships that I’ve forged in life. This is not an easy task. We meet many people hour to hour. Some are fleeting glimpses of passersby rushing off to their lives, never to intersect with our existence ever again. Others are temporarily permanent. That’s not a misprint. Permanence in our time means little. Those who are held longest in our lives are deemed ‘permanent’ but, in reality, they are just a protracted existence.

Still relationships, good, bad, dramatic, indifferent, take energy. So does blinking an eye. It takes energy, albeit very little. Blink one hundred times as fast as you can? More energy.

It’s well documented the medical miracles I’ve encountered. Perhaps this is the driving force behind my introspection. I am by no means cocky. On the health scale, there is someone out there, probably a doctor or two, who is holding their breath. I don’t speak from bravado. I speak all too much from feelings.

I feel 2012 is my turn and I want to take as many people as I can with me on this journey. That would mean some couldn’t make this trip. The energy is no longer there. The tank is empty but it's my tank, my turn, my guts, and my aspirations. This all is about ‘self’ and with that comes the instant association of ‘selfish’. I don’t believe this is true. I consider this a choice. The betterment of oneself. The pursuit of fulfillment. It’s a path that most ignore. Some recognize this earlier in life. Some never acknowledge it. To say “this is who I am” is being human.

Maybe it is a survivor’s instinct to kick forward with full force. After all, we’ve been told we only have so many bullets left – why not use them? What are we waiting for? We’ve been caught by the storm unprepared and we’ve been told it could happen again. I am no longer waiting for the hurricane to rage again.

It is time. Time for all of us to charge and time for all of us to change. We may be unsure as to when, or where or even how to proceed, but if you look hard enough, you will see your wall. You can see what it is that holds you back from being who you truly need to be. It may take more subtly than brute force, more planning than sheer will. I’ve never been a patient man but I have been a patient. I don’t want to wait for that again. If change is to happen, then I want it to happen, even a fractional amount, because of what I am dictating at this moment.

This is 2012. Twelve years into a new century. And now it’s my turn.

New Voicemail

The weather outside is frightful. Actually, for this time of year it is downright disgusting. As the holiday spirit continues to elude me, I await ‘the call’. It has been 6 months since the last clean scan. I am due. Happy Holidays. Felix’s Nativesdad and all that.

Public perception usually is dictated by television. Medical shows more often than not do a hatchet job, no pun intended, on the true happenings between patient and doctor. There is no haunting musical overtone alluding to a possible future. Doctors aren’t all good looking either. No offense to the fine staffs that I have had the privilege to be cut by. There is no priest standing by. There is no brilliant yet unorthodox in their approach medical scientist that will swoop in with a last minute idea that NO ONE IN THE WORLD thought of.

It’s more basic than that. There is a deadly silence. You always remember the lack of sound. All you hear is the singular voice speaking to you.

And there is no bracing yourself for it. It’s the good, the bad, and the ugly, in one distasteful swallow. In many ways, it is a standoff, only you are guaranteed never to draw first.

If subtly had a gravitational force, one may turn into a black hole. I attempted to draw first.

Process is king in the medical world. You don’t get a ticket to the show until your agent health coverage approves anything you do. So you wait.

I’ve never grown rich on my own patience. I called to see if/when I would get my next scan. Call it a To Do of life.

I always ask for Cindy. She is the best representative of any office. She’s pleasant. Informed, probably more so then she can ever let on. She has seen many walk through the door, some for the last time. She carries on with the same attitude and smile. She has a job to do. She knows me by name of course. I can tell when she picks up the phone that this is not the best of times for small talk.

“I’ll get back to you. There is a backlog.” She’s being polite but I know when to hang up.

Now you wait. You draw but can’t fire. Okay. Patience.

As with most things in life, the true triumph and tragedy comes from the fact that no matter what happens in your personal space, the world continues to rotate. It’s nothing personal. Just a reality.

I am at work - a place where it is easy to forget the joys and sadness of the real world. Your call, good or bad.

The task at hand was one of my favorites – lunch. Per usual, I didn’t realize my personal cell was flopping along my desk. Very few contact me this way. The small font is glowing NEW VOICEMAIL.

It is Cindy.

“Joe, looking at your chart you are now going to a yearly scan. Next one is in June.”

There is a pause that ensues like when answering machines ruled the landscape. They knew you were home and waited for you to pick up as you launched yourself over Scooby slippers to grab the reciever.

I can hear a smile. I know that’s not possible but I can.

“Have yourself a great Christmas, Joe.”

It is a long moment before I press 9 to save the message. It was subtle. No fanfare. No angels singing. No champagne to be poured. It just is.

I am still on a leash and probably will be for the rest of my life. For now, the leash has been let out a little.

And I’m okay with that.

Sweet Dreams

It’s called PTSM – Post Traumatic Stress Management. Not that I ever read up on it. This is a fancy term used nowadays by many to help those who have had a trauma in their lives that, well, basically they can’t get over.

It’s the domino effect. The ripple that never ends. I’ll tell you, it’s one helluva pebble in the water.

Sweet dreams are made of this

Who am I to disagree?

I was about 8 years of age. I remember my bedroom being cool, so I am thinking it was autumn or spring but I am not really clear on that memory.

The reel of that night keeps playing over and over. I am used to the sensations now after decades of deciphering, brooding, and burying.

I can clearly say I haven’t slept like a normal person since I was a teen, possibly longer.

I was floating. Everything around me was white. All I could hear was a booming voice that shattered my skull and shook me to the core. It was my dad’s voice.

I had to save something. What it was, I can’t remember. I probably never knew in the first place.

The voice boomed. I screamed to shout above the thunder. Nothing works. All I know is that I have to save ‘it’.

I remember waking up screaming. The dream had faded to the edges of my bed but the waves of terror never really left.

I was surrounded by my family. I had been screaming for a half hour or more. My mother talked me down and I can still feel the thrumming of my heart back then to this day. Some have called it night terrors.

The next day, I arrived back from school and promptly went to my room. A wave of haunting familiarity flowed over my skull. I swooned a bit, heavy with emotion, all of it tugging at my brain like so many rats eating something dead on the side of the road.

It was surreal in every sense of the word. Black art. It wasn’t the last time that my night would be plagued by such sleep patterns but it was one of the most memorable.

I have long ago faced these demons and such dread hasn’t infiltrated my sleep for some time. But demons never fully retreat – they recede. Always on the edges, always watching, and always waiting for your moment of weakness.

I don’t sleep. That has been well documented. I am forever in search of a formula and my patterns have gotten better.

I understand the demons and I find some solace in that. You know the tracks so you know the animal.

As a young boy in a hospital, like most patients, I was awakened constantly for testing. 1 am. 3 am. Stabbed for blood. “How are you, hun?”

Some of them want to abuse you

Some of them want to be abused

I still can’t sleep on my back for some innate fear of being stabbed. Silly but an 8 year old mind has difficulties wrapping around nights filled with a cacophony of machines beeping, whining, and patients moaning for a nurse to come help them.

Brutal? By today’s standards possibly. It’s mine to deal with. No one else’s.

It was years of staying up all night. No college partying. Just staring at a TV test pattern.

Too many nights turned into dawn. So tired I trembled from exhaustion.

I remember feeling comforted by one prevailing thought – I lived through the night.

It’s been decades of working on sleep hygiene. Ambien. Melatonin.

http://www.webmd.com/sleep-disorders/tc/melatonin-overview

Nothing really is a silver bullet cure. Like any sculptor, I have to keep chiseling at the stone. Hammer and hammer until the flecks pile up. I know there isn’t an end to it. This is what I have to do to get by.

Mornings can still be very rough. I try to be anti-caffeine but the body and mind are forced by real life to charge up. I carry a glimpse of what a war veteran may go through. Just a peek anyway. I keep breathing. I keep moving. When there is some sleep, the difference is quite discernable.

The dominos have fallen long ago. The ripple effect continues. There is progress, albeit microscopic at times.

There are days of sweet dreams. Not many, but I savor them.

I’m gonna know what’s inside…

Put on a clinic...

Same walk. This time I was late.

For the first time I noticed that the sign above the clinic stated Edwin Forman.

I had learned that he had retired. He was my primary doctor back in 1974. Like what the late Steve Jobs did for computing, Dr. Edwin Forman forged the hospital's burgeoning clinical research to the forefront of medicine.

It was fitting that his name was above the door.

I am a bit of a museum piece. No, not chronologically. I get a nod as I walk in. He's here.

It's a tad unsettling. In a microcosm of surreality, I am the Elvis of the clinic even for a few minutes.

After the ceremonial information exchange, I go back to the waiting room that had sent me into consternation during the last visit almost a year ago.

This time was different. Instead of being surrounding by balding, bloated children who clung to IV poles while battles between Spiderman and Iron Man raged on, I was alone.

I picked a chair in the corner of the room facing the door. The lights were dimmed giving the room a morose glow.

When you are diagnosed, you feel like the loneliest person in the world. You are handcuffed to a roller coaster and you have to ride. Once you are done with the corkscrew, the nosebleed heights, and plummeting depths, you are asked to get off the ride - alone again.

And now I sit in a 20 x 20 room, a Wii glowing in the corner, and blocks scattered across the tables. Alone.

Looming out of the shadows, a tall eighteen year old male says "Good morning". He's totally bald with a dramamine patch under his right ear. He's lean with a basketballer's body. The IV pole was at his side of course.

I nodded in his direction, ashamed that I had hair.

He drifted back into the other offices.

The nurse practitioner flew in like the opening song from a grand musical. She's over-happy. I am always amazed by this. It's a gift that seems out of place in the clinic. It shouldn't be. I am just not in the right frame of mind.

She isn't alone this time. Her bright smile has eclipsed the young social worker that fell out of a spy novel. Her character replete with chart in hand was already jotting down notes before I said a word.

As the few hours pass, I am poked, prodded and jabbed like a basic prison film.

It's sobering. I feel guilty and it hasn't been an easy road, dammit. I just want them to leave me alone now. I can't of course. This is how it is. You are now in unknown territory. Alone.

"How do you feel? Are you losing weight?"

Hell, I am trying to drop 4 more pounds but thanks for asking.

The nurse leaves me and the counselor, a student intern, alone. She has a few dozen questions for me. She gets a kick out of the fact that I am Italian. She spent a semester in Italy.

Sad. I spent four years commuting, no less, to Smithfield, RI.

"How were your grades?"

"I was diagnosed with ADD. I flushed the Ritalin after two weeks."

"Interesting." (Jotting on paper) "Do you sleep?"

"Not since I was 14..."

More jotting...

She means well. In fact, I think she will actually do well. Part of survival is that the disease can be the ultimate mind-fuck. People like her will help those coming up from the ranks.

Anyway, they take my blood. My phlebotomist is a middle child but her father's favorite. No lie. We talk about such things.

I am sent on my way with a hand picked Wolverine band-aid. They will send me another post card with my next appointment. Joe, Boy Wonder, will be back. I have no answers for their curious questions other than this is what I do. It is who I am. Sure, I can speak to someone who may be staring a similar situation. There is no formula. It's basic dike survival. Shore up the dam before the next wave hits. Pretty simple really. Grab anything, throw it against the wall and hope it holds.

It will hold. For now. I have a few more decades left in me.

After all, I am putting on a clinic...

Survivor Blog Questionnaire

To all Survivors...

I am seeking to catalogue via a series of queries on your life changing event. It will be a set of questions that will be posted to this blog. Outside of your first name, or preferred nickname, all personal information will be withheld. The point of the blog will be to document your life experience, aspirations, functions, dysfunctions, questions you may have, and help you may have to offer.

We are all related. Your words will help someone.

Thank you....

If you would like to participate in this event, please email me at the following:

joe.mazzenga@yahoo.com

Please put in the subject line: Survivor

Be well. Be strong. Be you.

JM

I can't stress enough...

Stress.

I call it the silent punisher. In the very least, it can be the ultimate agitation. The itch you can't scratch. The bill you can't pay. The grass you need to cut...again. And why doesn't the driver with the Massachusetts plate know that their blinker has been on for three miles?

Our ancestors knew stress. Neanderthals (some will state they are not part of the gene pool of modern human kind - sue me) had the stress of survival. Eat or be eaten. A broken bone sealed your fate. Hence, it was a miracle they lived to forty years of age.

Today? We live longer. Science and chemistry have seen to that. Instead of battling herds of wooly mammoth, we battle personal deadlines, inflation, money worries, wars amongst ourselves, social pressure, and diseases that may or may not be manufactured by the very environment we live in.

Same thing? Maybe. Where our ancestors had to fight for survival, more of their physical, instinctual and mental abilities were tested on the whole, daily.

Today, we are surviving on a different level. We match wits with styrofoam boxes instead of killing for our food. We sit all day in the name of being 'productive'. We don't walk miles to forage, rather, we jump on rolling treadmills to sweat for thirty minutes a day.

Still, there is stress. Like The Force, it surrounds us. Sometimes it obeys our commands. Mostly? Kills us slowly it will.

Like high blood pressure, it is silent. It can be seductive as well. Like a good cup of coffee, we grow addicted to heart pounding action. We feel we have purpose because "we're getting it done". To that end, we put deadlines on ourselves.

Is it worth it? Science tells us in many ways that stress is a great way to kill ourselves off.

Think of it if you take a car and max it out between each red light, eventually it will break. It's a fact not an opinion. The slower the pace of the car, chances are the more longevity.

As stated before, whenever I get cornered by stress (in certain areas of life it is inevitable), I repeat five things I am thankful for. Any five. It can be from the extreme to the extremely simple. Just do it. Repeat it. State it twenty times a day if you have to. And always remember to breathe.

It is all very mystic of me isn't it? Not really. It is clarity of thought and a restatement of what is important in life.

I can't stress it enough...