HANDLING IT

I'm not sure where I first heard the expression that "God only gives you what you can handle."  I quote it all the time.  I quote it mostly to convince people that they can get through whatever curveballs life has thrown their way.  But I also quote it because I have seen so many situations where people are spared something that I don't think they could manage, or they are given just enough that they are close to breaking but won't.

My mother can handle this.  I know she can.  And so, this is further evidence in support of the quote.  For example, everyone who knows my parents would say that it is far better for my mother to have this diagnosis than my father.  She is far better at taking each day as it comes, and rolling with the punches.

I wonder, though, if sometimes she feels like she has to live up to her reputation for being able to do that, even when she can't.  If she is being the strong one because that's what we all know her to be, and that's what she expects of herself.  I suspect that sometimes she wonders if she actually can handle it, although that isn't something she would ever let us see.

I wish the quote were different.  I don't want the people in my life to just handle it.  Handling it suggests holding on for dear life with eyes clenched until it is over and you can take a deep breath.  I want better than that for the people I love.  Is that a crazy idea?  Is it inappropriate to wish for joy through adversity?  Can we do better?

At times like this, it is normal to seek explanation in a higher power.  Like this is all being handed to us as part of a master plan that was thoughtfully calculated by someone who knows our strengths and weaknesses and has a grand master plan for our destiny.  It brings to mind another cliche that everything happens for a reason.  Don't use that on someone facing serious adversity unless they are a strong believer.  That one makes a lot of people angry. It kind of depends on what you think of as a reason, I guess.

Whatever the reason and whatever the journey, I want my mom to be able to be her true self through it all.  I want her to let go and cry, clench up and scream, release and breath, let loose and laugh. I want her to reach the point that many people don't find until they are much, much older than she.  I want her to just be- not necessarily with detachment, but with a kind of wisdom that let's her feel it all and still think it is okay.  And of course, I also wish that for myself.

YOGA FOR CANCER

I am at a yoga therapy and research conference this week. I have forged relationships with amazing yoga therapists who specialize in working with cancer patients. I know the masters who train the yoga therapists that work exclusively with cancer.  These are therapists who work in the oncology ward at Memorial Sloan Kettering, and who conduct the research funded by the National Cancer Institute. I have seen the data on the incredible effects of yogic tools during every stage of the process.  These tools include deep breathing practices, progressive relaxation, meditation, restorative poses. But there is something more to the process of yoga. There is something about taking that time to care for and honor your body, even when it is struggling, even when it is full of pain, even when it is letting you down. There is something about sending the energy of your breath to the places in your body that are being depleted by treatment. There is something about doing a twist to massage your liver, which is working double time to filter the toxins of chemotherapy.  But there are also guiding principles in yoga. Coming to terms with ahimsa (non-harming) and what it means in the context of a cancer battle.  Honoring satya (truthfulness) about what is really happening in your life, your body, your mind, your heart, your family. And perhaps most challenging is aparigraha  (non-grasping), letting go of what is no longer possible, or is not possible right now… admitting where you are, what you can do, and when it is time to back off from expectations placed on you by self and others. I want to bring all of this to my mother, but I don’t know how. I want to hold her hand and let the yogic teachings move through me like in a science fiction movie. Or I want her to discover it somehow, completely on her own, as though she never knew that this work has been my life for many years.  But that desire means that I am not practicing yoga myself. My work is to let my yoga be a part of my own healing, my own coping, my own growth as someone touched indirectly by cancer.  So perhaps I actually need Yoga for Cancer for me.

HEALTHY PERSPECTIVES

I have always disliked the idea of “battling” cancer, instead of a more positive image that the body is working through a healing process.  But in clinical trials, visual imagery of battle is actually effective in tumor shrinkage. I don’t think we can universally say that anything the immune system does is protective.  In my work with RA patients, their immune system has decided to attack the connective joint tissue and ultimately their major organs.  Their chance of a full life is dependent on long-term use of immune-suppressing medications.  I agree that genetics are merely a switch, and our lifestyle/environment/behavior flips that switch.  It might be stress, it might be pollutants.  Unfortunately, many times we do not have control over the inciting incident.  I can’t tell my RA patients to undo the lyme disease infection that turned on their disease. 

The patients who have the greatest success in living a full life are the ones who ultimately see their disease as a gift.  Those patients talk about working WITH their RA, instead of fighting against it. This is an outrage of an idea for some, but I have a few patients who recognize the way RA changed their perspective, their priorities, and their self-care.  If someone with cancer can reach a point where he/she is thankful for the disease, I would be on that person living far longer than predicted.  But that is something that must be discovered, it cannot be taught.  And frankly, I would hope I’d be that kind of patient, but I don’t know if I would be.

The importance of faith in the process cannot be underestimated.  Whatever the treatment plan is, the patient and his/her support system have to be fully in support of it.  You have to make a choice, and then be “all in.”  It is not helpful to second guess the treatment once it is underway, because the treatment’s success is somewhat impacted by the attitude of the patient and his/her team.  You should not tell a woman who had a c-section that it could have been avoided for the benefit of her child. You can only tell her what a beautiful baby she has, and what a gift that life is.  You cannot tell someone who underwent a double mastectomy that genetics are only a fraction of cancer risk.  You can only tell her that you support what she felt she had to do for her peace of mind and her family.  

There are a million things that a person with cancer can be told about how to increase her chances of full remission.  She has to filter all of that and choose, because it isn’t possible to do it all.  I imagine that it would be overwhelming to be the recipient of everyone else’s great ideas, no matter how great they actually are, and especially when many of them conflict.  I am finding that my role in my mother’s recovery is not at all similar to how I would coach a client or a student in her situation.  She does not want my relaxation tapes and my protein shakes.  She wants my love, and the healing power of her grandchildren.  There are endless sources of information and ideas, but only her dearest family can give her unending support, unconditional encouragement, and truly healing love.

SHARING LITTLE MOMENTS

I send my mother photos of the kids by text message.  Whenever my daughter puts on one of her crazy mismatch outfits, or my son gets into a precarious situation.  I do it because I know she feels like she is missing these precious years by being a few hours away.  They are growing so fast and changing every day.  These pictures are my way of helping her to be there, so it doesn’t pass her by.  They are also a way for me to reach out to her without saying anything.  

Since these are her only grandchildren, and grandchildren are an obvious source of joy, I feel it is my obligation to give her doses of that medicine on a regular basis.  We Skype too, and she watches them run around the playroom being goofy.  I can see that she is tired, but for a little while anyway, she doesn’t have to say a thing.  

My mother is owed a lot of milestones.  I have an 87 year old grandmother who is falling often.  It seems sometimes like she is living for the next milestone (this one getting braces off, that one having a 5^th birthday) but she knows that she has been blessed to live a full life and see so much already.  My mom deserves that.  She deserves to see them lose teeth and start school, ride a bike and give a speech, have a crush and learn to drive, win an award and win a game.  I want to make sure that she doesn’t miss out on any of the little milestones.  I don’t want to give my son a first haircut without making it an event.  I don’t want to see my daughter sing in a show without inviting mom to come.

Her father died when she was young. I know that my mother will always see that as unfair for him and for her.  And even though my mother raised me to adulthood, I still feel entitled to another 30 years.  If she misses any of that, I will always think that we both deserved more.  But I know we are given this life with no guarantees, and we should be grateful for every milestone we are able to experience.  It is my goal to optimize the joy my mother feels from each little marker in the fast-moving lives of my little ones. 

WHY I'M WRITING

My mother was diagnosed with cancer over a year ago. She has always been a small powerhouse of a woman. She is strong and feisty, and she doesn’t let anyone stand in her way or tell her what she can’t do. She wants to carry her bags by herself, drink with the guys, and be the cool mom who can roll with the punches of any risque conversation.  My memories of her during my childhood were that of a whirlwind. She was always late. Always rushing to or from the car, always a bit overwhelmed by all of the things she had committed to do, because she didn’t want to disappoint anyone (including herself) by being less than invincible.

My mother is not invincible. She is tired and she sometimes wheezes as she tries to breathe normally after too much exertion.  Exertion used to be a hard workout in the home gym or a day or moving heavy furniture, but now it is sometimes walking the length of the parking lot.  She has good weeks and bad weeks, depending on the duration since her last chemo treatment.  

The thing is, we really all expected she’d be past this by now.  I mean, she is one of the fiercest, healthiest people I know.  When I was growing up, everyone in the house would infect each other will illness and she would keep on, making us all soup and tea.  If anyone was going to breeze through this diagnosis, it was her.

So, we all bucked up for a long and difficult year as she went through chemo, then surgery, then radiation.  And a year later, we were at the starting point again.  Would it “take” the next time around? 

Honestly, I had this small thought that maybe the process would even be a blessing for her.  Maybe after a challenging year of treatment, she would slow down a bit… change her priorities.  Maybe she would get less frazzled by a deadline or dinner guests.  Maybe she would be more willing to say no, or have less to prove.  In my line of work, I have seen many people with chronic disease who have gone through such transformations- some even coming to a point where they are thankful for their diagnosis. Those are rare, but they are the ones who thrive.  They are the ones who see what they have gained from the journey and the point that they never could have reached any other way.

During the first year of her treatment, I often felt helpless.  I live further away than most of the family.  I can’t stop by to empty the dishwasher or bring her a funny movie.  Our phone calls were strained by my wanting to address the illness, but ignore it at the same time.  I wanted to pretend she didn’t feel sick, make her smile or forget.  But I also wanted her to know that I was thinking about it- that I cared every moment of every day about how she was doing and feeling. It turns out that I was also always calling her during her weakest and most fatigued time of day.

So, when we started in to a second year of treatment, I sat down for a heart-to-heart.  And since then, our phone calls are still strained.  I still call at the wrong time of day. I still don’t know what to ask or what to tell.  And I still can’t stop by for tea.

I am not sure what happens when we die, but I have experienced enough that I believe our energy can continue to be a presence in the lives of those we love.  Maybe it is our choice to hang around on this plane without a body. Maybe we are on another plane with a one-way glass allowing us to see in without being seen.  And I believe that if that is a choice, my mom will choose it.  She will be right there with me, telling me which paint colors to choose, and what she thinks of my daughter’s outfit.  But I don’t want to wait until she is gone to speak to the air and hope she hears me.

Maybe she will be in her body for another 30 years.  Maybe she will see both of my children grow up.  Perhaps she will attend their college graduations and weddings and the birth of their first children.  But perhaps the fight between the cancer and the treatment will be over far too soon.  And I don’t want to feel like there were things I should have said when I could still hold her hand, still see her face.

I don’t think I have the guts to sit down with her and tell her everything I want to say.  I don’t think I could formulate it well, and I think it would be too awkward, too fatalistic, and too brief.  I have seen many books and blogs written from parents with cancer to their young kids.  They seem to be a kind of proxy parenting from the page- all of the advice they will need to hear in their heads for the rest of their growing years.  But I haven’t seen the other side of the conversation.  There are things that we kids want to say to our parents also. I haven’t lived long enough to know everything I will want to say to my mother for decades to come.  But I do know the many things I want to say now, before I am speaking to the air and hoping she hears me.