Mental Health August 2018

First of all I had prepared the initial part of this blog for my next blog 21st August but I decided it was too deep to be only touched on – So I am keeping this one separate

A little recap. I was diagnosed in Feb 2014 with Stage 4B Hodgkins Lymphoma- I underwent 6 months of Chemotherapy ABVD which was followed by 4 weeks of radiotherapy on the second week of Dec 2014 I was given 6 weeks to live. I managed to recover and gain full remission by Feb 2016, only to relapse in March 2017 and rescued for Stage 4 Non Hodgkins Lymphoma (stage 4 was liver, lungs, throat, right eye & bone marrow) I commenced ICE chemotherapy in April 2017 and had a Stem Cell harvest in June 2017 I was told I had less than a 5% chance of surviving to June However In July 2017 I had further chemo called BEAM for six days followed by a full Stem Cell Transplant immediately follow this I was placed in palliative care and told I had less than a week to live. I walked out of the hospital 21 days after been admitted- in March 2018 I was formally told I was cancer clear and in remission. My Mum passed away in April 2018 at the young age of 86 which was heartbreaking as I was very close to her and considered her not just my Mum but my greatest friend. I ended up clearing the family home and will finally turning the key for the last time in the front door this week after living and been part of that home for 56 years and that will be a very upsetting day.

Mental Health

This is an area that I have covered more than once. I have been both complemented and criticized for my approach. So before I start this let me just point out that unless you have undergone chemotherapy and radiotherapy plus having a prognosis of been terminally ill you have absolutely no right to criticize any cancer patient for their views. Cancer is a battle not only from a physical point but from a mental point. The views I adopt throughout my blog are my views they are unique, I write these blogs in an attempt to help others and to show how a strong mental & physical approach has help me to survive through three terminal prognosis.

Fear

Fear is described as an unpleasant emotion caused by the threat of danger, pain, or harm. In psychology Fear is a powerful and primitive human emotion. It alerts us to the presence of danger and was critical in keeping our ancestors alive. Fear can actually be divided into two stages, biochemical and emotional. The biochemical response is universal, while the emotional response is highly individualized.

Fear is something that every cancer victim experiences from the moment the oncologist says the words “you have cancer”. In biological terms it is when your body is attacked by chemotherapy drugs and from an emotional point it is described as individual. For me it was mental preparation, the “It won’t kill me” attitude, a fight worth fighting.

With the past four and a half years behind me fighting Lymphoma I have to say that the build up mentally to test & meeting the oncologist is actually harder than chemotherapy for me. You never know what to expect. Pains in areas that you may have had operations on suddenly ring alarm bells, now this is a subject that lead me to tell one reader to very directly fuck off. Cancer patients who have had surgery can experience pain in the area particularly from surgical biopsies for years following that surgery, 9 times out of 10 it is from severed nerves. Do not try and tell the person it’s psychology because it’s not. I am personally a highly motivated & driven individual and the pains from surgery are very real. The nervous system is quiet incredible and stress/fear can trigger pain. The relief when the oncologist tells you that “your still clear” is like winning the lotto (not that I know what winning the lotto is like but one can dream)

Fear is danger, pain, or harm. The danger of the side effects of Chemotherapy are well documented, even the danger of Cancer itself are clear. Pain can be from something as slight as an injection all the way to recovering from an operation. Pain thresholds play a big role here and the ability to combat pain is very much down to the individual. I was first diagnosed with Kidney Stones in 1992 (a hard mass formed in the kidneys, typically consisting of insoluble calcium compounds; a renal calculus) I produce about 20 plus stones a month which I now pass with ease. I remember in 1992 the pain was unbearable but my body adjusted and the pain now is more like a pinch in the side. The brain can distort pain, a new pain in any area registers in the brain as “unknown” and magnifies its pressure until the brain is satisfied that it knows what the pain represents, with a second occurrence of pain in the same area it automatically registers in the brain and the level of pain is reduced. After nearly 26 years of Kidney Stones my brain hardly even registers the presence. My oncologist even now will turn around and say after a scan, “and by the way you have stones in both kidneys”. The presence of these stones over the years has increased my pain threshold which has really helped in my recovery. There is no known cure for kidney stones and we have chased multiple avenues trying to pinpoint a cause without success.

Stress

I mentioned stress above. In psychology, stress is a feeling of strain and pressure. … Humans experience stress, or perceive things as threatening, when they do not believe that their resources for coping with obstacles are enough for what the circumstances demand.

in reality stress & fear go hand in hand. One can lead to the other. Close your eyes and try to imagine what a prognosis like cancer means to you, now double what you imagine and your getting close. But stress itself can produce physical medical issues. These range from simple headaches to serious cardiovascular issues. The pure fact that having any form of cancer is classed as one of the major stressor a human can face, a terminal cancer victim will without doubt enter into the highest levels of stress know, it is why sedatives and calming medicine like Diazepam, first marketed as Valium, is a medicine of the Benzodiazepines family that typically produces a calming effect, these medications are commonly used with Cancer patients

But fear and stress are also defined as emotional. Hence the mention of psychology. We all have our own unique way of dealing with this but the best advice I can offer is to share these emotions openly. A key to mental health is the ability for others to listen and not to form opinions but just listen & be there.

Throughout my blog pages I have touched on mental health because I believe I am alive today not only because of the incredible medical teams but because of my ability to self motivate and keep fear and stress at bay. Walking can really help here and having the ability to block out negative thoughts during your walk becomes quiet easy particularly if you live in an area that has country walks like I do, nature is a very calming beauty. I now average 70,000 steps a week and if I feel any form of stress coming on I get out for a walk. Meditation is also an excellent means of keeping stress at bay but meditation takes time to adjust to and solitude.

Google The top five most stressful life events :

Depression and Anxiety

Depression, in psychology a mood or emotional state that is marked by feelings of low self-worth or guilt and a reduced ability to enjoy life. A person who is depressed usually experiences several of the following symptoms: feelings of sadness, hopelessness, or pessimism; lowered self-esteem and heightened self-depreciation; a decrease or loss of ability to take pleasure in ordinary activities; reduced energy and vitality; slowness of thought or action; loss of appetite and disturbed sleep

It goes without saying that a patient diagnosed with cancer can quiet easily become depressed.  Luckily for me it was one of the areas I did not suffer from. But most of these items are connected like fear can lead to stress that can lead to depression and so on. Sometimes its quiet difficult to pinpoint exactly which symptom a victim is experiencing but it is vital that the medical team diagnose this correctly so that the main cause is properly approached.

I will be looking at depression a little later in this blog relating to post cancer recovery also called living with cancer.

Self Harm and Suicide 

This is a substantial area and one that more and more Oncology teams are facing day in day out. Fear, Stress, Depression and Anxiety can all come under this heading and are all major contributors to suicide. Those who know me will immediately count me out of this section but they would be wrong. Self Harm – no but Assisted Suicide -yes.

When I diagnosed the second time and told that I had less than a 5% chance of surviving 3 months I looked into the possibility of Assisted Suicide in Switzerland and Holland. I actually went quiet deep with this. Been a very strong and motivated person I decided initially against the idea and made the decision to commit to tackling ICE chemotherapy directly.

PTSD

Post-Traumatic Stress Disorder (PTSD) is a trauma and stress related disorder that may develop after exposure to an event or ordeal in which death, severe physical harm or violence occurred or was threatened. It is now considered to include the diagnoses of Cancer. PTSD is the only mental issue that the psychiatrist considered necessary to treat me for ( Psychiatrists are trained medical doctors, they can prescribe medications, and they spend much of their time with patients on medication management as a course of treatment. Psychologists focus extensively on psychotherapy and treating emotional and mental suffering in patients with behavioral intervention). I am a trained psychologist and hold three higher diplomas in psychology, which is why I have constantly refereed back to mental health throughout my blog . The psychiatrist based her diagnoses last May (midway through ICE Chemo) on life changing events both prior to and during extensive exposure to high levels of chemotherapy, she also took into consideration the effects of betrayal from a particular former business associate that had occurred in March 2017 just weeks prior to commencement of Chemo. The statement “Its nothing personal its just business” took months to get over and my conclusion was “everything in business is personal, it is what defines the ethics of the business”. PTSD takes time to get a handle on and to this day I still believe that I have continued symptoms. 

Grief and Bereavement

Grief is the psychological-emotional experience following a loss of any kind (relationship, status, job, house, game, income, etc), whereas Bereavement is a specific type of grief related to someone dying.

I have intentionally added bereavement here and will cover that section first. During chemotherapy a patient will interact with other cancer patients. Even though this is encouraged by the teams this practice has one serious con. Not all victims survive. So I believe a far greater amount of research needs to be conducted on this. For two victims who are both diagnosed with similar cancer and undergo identical therapy the results can and generally are different. If the two victims get to know each other and one dies the other will suffer mentally and the effects of this loss can be devastating to the recovery process. And yes I did experience this during therapy but I had not got that close to the victims. I also experienced this when I was recovering from the Stem Cell Transplant. A personal friend and the founder of a cancer care center was diagnosed with a serious level of bladder cancer which spread rapidly and she passed away in Nov 2017, her passing had a serious impact on me that took weeks to control. I need to correct something here, during chemotherapy patients tend to discuss openly what effects the chemo is having on them and apart from negativity the medical teams encourage this. However during Stem Cell Transplants this does not happen for more than a psychology reason. The SCT chemotherapy destroys the persons immune system and the slightest cold could kill the patient, so you are quarantined and basically you don’t meet other patients. With bereavement I lost my Mum this April, she had been diagnosed with vascular dementia in 2016 and fought her way through it, vascular dementia attacks the ability to communicate and mobility. She had to be placed in a specialised home as she required 24/7 care. Days after I was placed in remission in March I was told that my Mum was on a down hill spiral, she had developed pneumonia, which she beat twice only to get bilateral pneumonia in early April which ended her life on the 9th of April. The effects of this loss was substantial on me. Overall I do not believe that as humans we never fully recover from any bereavement, it takes not only some of your heart but some of your soul.

Grief – Lets look at that definition again Grief is the psychological-emotional experience following a loss of any kind. A loss can be anything, the loss of friends, relationships, family, status and of course financial. No matter where you live the financial burden created by cancer is substantial, My first therapy was financially manageable as I was permitted to continue running my business so my income was not affected, however my second therapy was completely different – I was instructed to stop working, my so called business partner and a person I considered to be a friend for 22 years took the opportunity to backstab me, I stated above that this persons last face to face words to me were “Its nothing personal Its just business” but like everything else with this individual he will not recall saying that which falls into the ego mania persona. I will be covering financial aspects in the below section “Living with Cancer”.

Loss of friends – so many emails about this and so many victims pointing out that this section had serious mental health issues. I couldn’t believe how many friends turned their back on me, it was substantial. Some used excuses like “I can’t handle the thoughts of this” others “I’m in denial ” all of them pure crap. Your real friends never leave you ever. They are there for you and will fight for you. I truly believe that friends and relationships fall hand in hand here. I was lucky that my relationship suffered little if any from over 4 1/2 years of battling cancer. It depends on how solid the foundation is. 

Family I will not get into at this point. A saying my late Mum hated was “you can choose your friends but you can’t choose your family your born with them”

Status. In my case I ran and owned a transport company, I worked about 70 hours a week and employed 30 people. I was very much hands on and closer to operations than necessary. My status was a company Director. The day I commence ICE that status went.

Conclusion

I could really write a book just based on this topic and totally enjoy doing so but I am not a writer and basically could not afford financially to place that much time aside. I have had an interest in psychology since an early age but only recently commenced studies & achieving qualifications. The deeper understanding of psychology has helped me to overcome obstacles in my way and better understand ego’s and so called world standards.   There is no real conclusion to this and I will continue to write as much as I can about mental health. This has become the longest blog I have ever undertaken to write. It is my view and my story of how I handled mental health.

 

Living with Cancer

I’m going to keep this part of the blog under mental health and that is Living with cancer because it is not only a medical issue but a psychology issue. For some this is easier than others. Not wishing to generalise here but younger people under 30 have a better chance of living with cancer. Why do I say this? Basically younger people are more aware of cancer, it’s not the evil word know as “The big C” like it was for those growing up in the 70’s and 80’s. I was born in 1962 so I have a built in fear of the word Cancer, I remember in 1994 when my dad was diagnosed with colon cancer everyone I know went “how longs he got to live” my father was diagnosed in August 94 and died at 66 in Nov 94. He was told he had cancer and didn’t fight, he simply gave up. Luckily that attitude is changing, medical science has leaped forward and we are all aware that mentally and physically we can survive cancer.But let me talk about myself for a little while on the subject of Living with cancer.

With the leap forward in medical science more and more victims are surviving. But what happens after the medical team complete chemotherapy, radiotherapy, Transplants, surgery and other treatments. For the teams their job is done and the patient will get to see their oncologist 3 or 4 times a year. But the patient is generally left to pick up the pieces. I am aware that greater research into this is currently been approached worldwide. It is difficult to describe what it feels like on your last day in treatment, it just stops. Yes there are follow ups and yes there are continued test but the intensity during therapy is gone. Your given dates or a letter is sent to you telling you when your next test or meeting will be and you basically get on with it.

Living with cancer for me has been really strange. Prior to first been diagnosed I was running a very successful business, advising other businesses, training people and supporting other businesses. My mobile never stopped, to the point that I had to place my phone on silent to sleep, with the exception of Saturday’s and Sunday’s when I covered the financial part of the business. Anita once said she would love a holiday where I didn’t get calls. My e-mails were about 300 plus a day and likewise Anita pointed out that she really wanted to go on holidays without the laptop just once. I even used to log into my company servers on holidays to produce wages and weekly invoices. But that’s just the work side. On average I was offered either senior jobs, positions on boards and on two occasions the opportunity to merge business. BUT that was all before I was diagnosed – from a few weeks after been diagnosed all the offers stopped, it was very noticeable. Bridges were burnt by people who simply underestimated me. So here I am, diagnosed at 51 (Diagnosed in Feb 2014 birthday in June so my 52nd birthday was spent in chemo) remission at 53 and relapsed to Non Hodgkins Lymphoma at 54 (again diagnosed in late March 2016 and completed chemo and stem harvest before my 55th birthday in June 2017) Back in remission at 55 and still in remission at 56.

An interesting post from LinkedIn and really a list of what I have overcome in the past year. I’m still working on Number 3 but getting ahead of it, outside influences have delayed this one but those individuals are liars and liars are always proven to be what they are.

I have spent most of the last year on academic  achievements as I was not permitted to return to work. My studies were in business, leadership, motivation and psychology. My resume is really something else.  The academic studies really helped from a mental health point of view as the studies helped to distract me.

But how difficult is it to achieve employment at 56 ? Not just 56 but twice a cancer victim in remission ? And a bunch of idiots still trying to stop me getting work. I have sat with some great companies and continue to meet more. But the illusive job has yet to materialize. Not because of the lack of trying I can assure you. Over 200 applications between Ireland and England. Now on the other side of this and there is always another side, I have been quiet fussy about who I apply to. I never want to work with a company that lack ethics nor do I want to work with business who believe customer service equates to the amount of money or gifts they need to give their customer to over look service failure and other companies competitive tenders (and yes this is why a bunch of idiots are trying to stop me getting work). So getting a senior management position in an a company with excellent ethos and policies in place to prevent bribery is the challenge. Recruitment advisors have asked me to remove the part on my resume that refers to my past 16 months battle with cancer and I have refused. My view is that the type of motivation and commitment to beating cancer twice outweighs all academic and employment qualifications. Awareness is the bottom line here and I need to work with people who are aware, supportive and honorable.

I keep returning to the point that this is really all about me. Living with cancer or surviving cancer is a substantial challenge. For me the loss of my business meant that the only entitlement to social welfare under Irish law was in the form of a Disability Pension issued on the bases that I have a Stage 4 Cancer. This welfare equates to less than a 20% of my original wage, that is an 80% loss of weekly wages. Yes cancer is expensive. We have cut back on everything and we have plans to reduce costs even further. But the hope is to get back into a business environment. My oncologist will sign me back in without hesitation. I created a GoFundMe account that has managed to raise €6,584 out of the €22,000 needed. So far Cancer has cost me a little over €15,000 plus income loss for 16 months. The well is running dry. Really a serious part of the Mental Health issue.

Financial burdens like these bring on serious issues relating to re-entering social life. Would we like to go for a good meal, yes we would love to but basically we can’t afford to. Would we like to visit Anita’s family in the UK, yes we would love to but basically we can’t afford to. Would we like a holiday and/or visit close true friends in Lanzarote yes we would love to but basically we can’t afford to. Would we like to travel around Ireland to meet our true friends here in Limerick, Belfast and Dublin yes we would love to but basically we can’t afford to. I’m in Dublin nearly every week but that is to clear the family home for sale and that ended this week. Its one of the areas that we see as a cost saving now that I will not be traveling up every week.

So living with cancer can actually be a bigger issue that having cancer. The fight changes and the person must adapt to those changes. I have battled Cancer twice and won both wars, I have been told three times that my prognoses is terminal yet here I am writing a blog about mental health. The human brain is incredible,

“If you can imagine it, you can create it. If you can dream it, you can become it.”

And a second quote

Before you speak, listen.
Before you write, think.
Before you spend, earn.
Before you invest, investigate.
Before you criticize, wait.
Before you pray, forgive.
Before you quit, try.
Before you retire, save.
Before you die, give.

William Arthur Ward 1921 to 1994 inspirational

To finalise all of this I have covered both mental and physical health in this blog. I have shared my own experience with you and hopefully you will walk away with a greater understanding of what a cancer patient faces. Surviving and beating Stage 4 Lymphoma Cancer twice has made me an exception to the norm. I represent the extreme end of the cancer scale, the place where life or death are so close you could never imagine. I have with my blogs very openly showing my pain, my anxiety , my ability to absorb substantial levels of chemotherapy (I have been called a Chemo Monster by my Oncologist), my struggle, my recovery and a positive motivated attitude. I have been asked to give motivation speeches but that would most definitely need serious finances that I do not have. always remember I have to say that I totally enjoyed writing this particular page, it allows me the opportunity to share how I have dealt with Mental Health and awareness its a long detailed blog. So the word count on all my blogs to date amount to less than 9,000 words. This blog has added over 4,400 words to this alone and I will close this blog with a promise to return to both the mental health issues and living with cancer soon but I will leave you with this