A Spring In My Step

Over the past ten days I’ve started to notice a major change since the end of my cancer treatment. After approximately six months of being free from Immunotherapy, I’ve finally started to feel less fatigued, or at least I think I have!

I recently had a couple of weeks off work, which allowed for some much needed down time; it culminated in a trip to the Isle of Wight to see one of my friends get married. It was a fantastic weekend, full of sunshine and dancing and on the evening itself I didn’t get to bed until the early hours! I couldn’t tell you the last time that happened, and I’m not sure I could’ve done that a few months ago! The day after the wedding I felt exhausted, but in a different way to after hospital treatment. I felt really tired, but it certainly felt different to the extremely fatigued, glazed over sop-you-in-your-tracks feeling that I have been so used to. It was a great realisation that perhaps the long term effects of receiving cancer treatment might be fading slightly, therefore allowing me more room to breathe. Once I’d caught up on sleep, I felt really happy I’d danced the night away.

Despite feeling as though I have more of a spring in my step, I still feel broken by everything I have been through, and I know that feeling will never go away (or at least not easily). Over the past two years I’ve seen three different counsellors, had CBT and now take regular antidepressant medication and I am not sure my mental health will ever truly recover.

No matter how hard I try, I still have days where I am completely exhausted by the whole process of just living my life. It’s hard to navigate in this new world I’ve suddenly found myself in, I’m still baffled that I haven’t been to go to the GP in the past month. It’s literally blown my mind! This must be what other people feel like?!

I still live in constant fear of disease reoccurrence and I have frequent dreams about my demise, include finding out I have another brain tumour, or being in constant abdominal pain due to another bowel tumour. Sometimes I wake up and It takes me a moment to two to realise it wasn’t real after all. I don’t want cancer to define me, but it has been such a huge part of me that I am finding it hard to separate my life with cancer and my new regime without treatment. This is what I have dreamt and hoped for, but it’s much more difficult than I ever imagined it would be. I hope that in time I can start picking up the pieces of my shattered existence and start taking small steps forward again.

I haven’t written on much on my blog recently as I’ve been trying navigate in the new world I’ve recently found myself in, and hoped a blogging break  would help me to feel less like cancer is still ruling over my life. I do think it has helped, but I also find writing is a little like therapy, and helps in a similar way to my counselling sessions. 

I have a busy month ahead as I am due to celebrate another birthday in a couple of weeks. All birthdays are milestones for me, and I am very happy to be turning the glorious age of 32. My situation has changed beyond comprehension in my 31st year. Having been diagnosed with stage 4 melanoma with metastasis in my brain and my left lung at 23, it was a shock I made it to my 25th birthday, let alone my 30th a couple of years ago. I also never thought in a million years I’d seen the younger members in my family grow up, but two are about to enter into the adult world, and we had a new addition join our family at the end of last year, which has been life changing. These are life events I never thought I would be alive to see, and when I think about it, this makes me the happiest. I know I need to keep reminding myself of how far I’ve come and try to use this to my advantage.

I hope my energy levels continue to increase and get more plentiful as time goes on. I’ve already got the date for my next PET CT scan in July, so I am hoping and praying i continue to reap the rewards Pembrolizumab has offered me so far. 

Cognitive Behavioural Therapy

I recently came to the end of a counselling programme which focussed the talking therapy Cognitive Behavioural Therapy (CBT) to help me manage my depression and anxiety. I wrote about starting this journey in an earlier blog post, The Rough And The Smooth a few months ago.

I was initially referred for this treatment at the end of 2017 and I have been attending regular CBT sessions since April in order to help me manage my emotions and thoughts around my cancer diagnosis. It’s not easy to rewire your brain to think in a completely different way, but it’s helped me a lot, and I’m hoping I’ll be able to continue using the techniques I’ve learnt so that I don’t fall back into a negative thought cycle.

Over the past few sessions I’ve practiced various different techniques used in CBT,  one I’ve found particularly useful so far is Thought Challenging. This technique allows a person to look at a situation from alternative angles. By doing this I’ve started to consider things from a more objective point of view, rather than just assuming that my negative thoughts are the complete facts, so not necessarily about just thinking positively in a negative situation, which is often a particular challenge!

A simple example of this may start with a friend cancelling dinner because they’re busy at work. My irrational brain tells me that I am not important enough and worry they think I am boring or I’m constantly talking about my cancer diagnosis or my own issues, therefore I am not a good enough friend to them and they don’t want to see me. So many thoughts run through my mind about the reasons why they cancelled. Keeping a Thought Challenging diary has allowed me to weigh up the for an against and come up with an alternative thought. Now I can be more rational and recognising we’re all busy people, particularly when work comes into play. In the grand scheme of life its simple to reschedule for another time. It’s key for me to remember I am important and that I am lucky to have a lot of people around me who are always there to listen no matter what, even though some live thousands of miles away!

Through this process I’ve learnt that I tend to think in a very black and white way, (know as All-or-nothing thinking) which has had a significant negative impact on my self-esteem, happiness and relationships over the past few years. I’ve tried to overcome this by keeping a list of my negative thoughts and writing down different ones. I have to remind myself that this thought is extreme and in turn come up with one that is more balanced. Another example would be me calling someone and them not picking up the phone; I’ll start to panic that something really bad has happened to them, even though they’re probably just busy at that time. Similarly, if someone says they need to go to the doctors my mind will automatically worry they might have a serious health problem and I constantly fear awful things will happen to my loved ones

During my life with cancer I’ve been taking everything one step (or one PET CT scan) at a time. I’m often surprised I’ve not had a breakdown over the last eight years. Sometimes I get emotional and feel like I’m in full on mid-life crisis mode (I am now in my 30s after all) so CBT has been a great way to try and combat that! I’ve yet to try and revisit my youth, or buy a sports car,  so perhaps I’ve not had a my own crisis moment just yet! I always feel like cancer means ‘I can’t’ do things and there are so many other things ‘I should’ be doing. Thinking in this was is unrealistic and therefore I put too much pressure on myself.

Staying alive is on the top of my priority list, and despite all the challenges that have come my way I’ve succeeded so far. Although difficult at first, CBT has been a lifeline as it has helped me find was of copying with all the negativity my illness throws at me. I am now waiting for a referral for another type of counselling that I hope will help me move forward further. In my last CBT session I wrote down my future goals for the short, medium and long term and I’ll need to keep looking back at it to make sure I’m following my own advice. My first goal over the next six week is to try and maintain a more positive outlook, my recent promising PET CT scan results have been a huge factor, so here goes…

The Rough And The Smooth

I used to find it so clichè when people described having cancer as being on a rollercoaster, but at the moment, it feels like one of the best ways to easily articulate daily life living with stage 4 melanoma.

In my previous post I mentioned that amazing news that my last PET CT scan results were stable. Despite this, I have felt very up and down over the past three weeks. Sometimes I find living with the side effects of cancer treatment can be harder that having the treatment itself.

Sadly the results don’t mean all my side effects from taking Pembrolizumab disappear over night, it’s probably quite the opposite as somehow I feel more aware of my body than ever before. Living with cancer has so many ups and downs, it’s mentally challenging and know from experience that the good news can change to bad very quickly.

Last week I dreamt I had five brain tumours, not one, but five! Negative thoughts like this will always haunt me, and dark clouds will follow me around wherever I go. I worry so much, particularly about getting a brain tumour. I had one removed when I was initially diagnosed with stage 4 cancer in 2010 so for me this isn’t an irrational thought.

Over the past few weeks I have been attending regular CBT sessions in order to help me manage my anxiety surrounding my diagnosis and the depression that comes with it. It is hard to accept that having been labelled as terminally ill it essentially means I am dying. It might not be today, or tomorrow, or in a month or perhaps even a year, but one day cancer will get the better of me. For all those people who suggest I could get hit by bus tomorrow and die instantly so I shouldn’t worry; trust me it is not that same thing. At the moment I’m taking each day as it comes, taking the rough with the smooth so to speak. When I’m in a negative spiral it can often take a little longer to ride out, even though I try to be a positive as possible.

According to the NHS website, Cognitive behavioural therapy (CBT) is a type of talking therapy that can help you manage your problems by changing the way you think and behave.

It’s most commonly used to treat depression and anxiety, and is based on the idea that negative thoughts and feelings can trap a person in a vicious cycle. The therapy aims to help people deal with problems that feel overwhelming in a more positive way, by breaking them down into smaller parts. Essentially learning how to change negative patterns and become more positive, looking for practical ways to improve a persons state of mind.

Through my experience so far I think CBT has been beneficial, however as I write this I am mid hospital appointment, having just broken down in tears. A hospital is the last place I’d ever want to be, but I don’t have a choice about coming to have treatment. Sometimes it’s all too much, even if the appointments are running to time. It’s not one particular thing that makes me emotional, it’s the whole treatment process. A classic example of a day which had been pretty unstable; I feel like I’ve experienced so many emotions in one afternoon. Hopefully tomorrow will be a better day and the CBT will continue to help me move forward living with cancer.

This July marks two years on current wonder drug Pembrolizumab and 7.5 years of living with stage 4 melanoma. Any tips on helping manage emotions would be much appreciated.