Post-traumatic Stress Disorder

A couple of weeks ago I had my second PET CT scan since adopting a ‘surveillance’ approach to my stage 4 cancer in January this year. I am now playing the long waiting game and am not due to see my consultant for another two weeks.

I have so many reservations about this, but I know deep down (or at least I think I do!) that if there were any hot spots coming up on my PET CT scan I would be called in earlier to see my oncologist. I’m now an outpatient, so currently not seeing my oncologist and his team nearly half as much as I have done in previous years. It feels strange to have let go of the stability of having the hospital on speed dial and trust that the people who have been keeping me alive for the past decade are still doing the right thing.

I almost feel abandoned now that my appointments are few and far between. It feels like trying to ride a bike without stabilisers for the first time without any instructions. The anxiety and fear around this will never leave me, but hope in time it’s easier to cope with. It’s become apparent to me that I am suffering from some PTSD, aka post-traumatic stress disorder since I found out I had stage 4 cancer.

I haven’t officially been diagnosed, but I think that most of people who have a cancer diagnosis must suffer from PTSD at some point; life changing events such as surgery and chemotherapy are bound to have an effect. Some of the side effects induced by particular treatments might lessen in time and become less severe, but even the diagnosis itself can be earth-shattering and seems like the perfect place for PTSD fester. I know I have suffered with this for a while, even prior to my Immunotherapy finishing. Thanks cancer for giving me something else to deal with!

I am still in disbelief that I am not on treatment right now. I’ve had trouble coming to terms with this, even though I hoped and prayed for it for years it doesn’t feel like I expected it to. It would seem that cancer is the gift that keeps on giving!

I’ve been open on honest on this blog about my struggles with anxiety and depression over the years, and have only come to recognise this fully more recently. I kept kidding myself that I should be grateful my cancer is treatable despite being stage 4. Living with cancer, palliative or not is one long nightmare!

Over the years I’ve noticed the increasing number of PTSD triggers I have that I can’t seem to control. I’m never going to forget I have melanoma; but some sights, smells and sounds remind me of the multiple hospital trips and specific events such as major operations. My mind is constantly taking me back to moments that will be etched on my memory forever more. Certain triggers cause me to suffer vivid flashbacks that are often deeply distressing and sad. Not a day goes by that I don’t think about my diagnosis and the impact it has on my life.

There are so many misconceptions when it comes to PTSD. People reading this might suggest that I should move on and try to get over what has happened. But I’ve suffering from anxiety and depression around my illness for so long and having PTSD isn’t a choice. I can’t ‘just get over it’ when it impacts my life so much.

Back in 2010 when I got told I had brain and lung tumours I suffered emotionally in private, I wasn’t ‘out’ on social media like I am today. I deleted Facebook for almost a year and didn’t use any other social media platforms back then. Over time I’ve tried to stop feeling guilty about the way I feel as I know have been through a lot, it’s pointless and detrimental to me to pretend I haven’t and that its not been a struggle.

Talking about my situation helps immensity, but in the past I have often kept things quite from family and friends because in some ways only other people who have had cancer can fully understand. I don’t want to make others sad or reminded that they could be next, so for a long time I suffered in silence and put on a front.

Sadly a life with cancer doesn’t end when treatment ends. I can’t wait to gt my scan results out of the way and hopefully my PTSD symptoms will die down for a while and I’ll have some space to breathe.

World Mental Health Day

World Mental Health day took place this week, and I saw lots of long posts on social media about the importance of looking after all aspects of our health. The day aims to draws attention to the importance of mental health and increase education on the subject which people often shy away from. Having stage 4 melanoma has hugely impacted both my mental and physical wellbeing. Knowing that I am dying, that something inside my body is killing me, and I’m constantly having to fight it off is often too much to process. 

Receiving a diagnosis of a serious illness such as cancer can have a huge impact on a persons mental health, and I have felt this over the past few years, particularly since receiving different chemotherapy and immunotherapy treatments. Thanks to my terminal diagnosis It is normal for me to experience huge levels anxiety, worry and fear on a daily basis. I touched on this previously back in April in a blog post called Maintaining Mental Heath, which focussed on the importance of exercise, It’s amazing how much a little exercise can help mental wellbeing. I sometimes take part in the occasional Parkrun, my time has actually gotten worst since I first went, but I do feel better for taking part. I tend to walk / jog the route, but its better than not doing it at all. I’m focussing my breathing rather than all the other negative thoughts that cloud my mind every day.

Having cancer is so draining, and the frequency of doctors appointments and hospital visits often adds to my anxiety and worry. Over the past seven days I’ve been to the GP twice and the hospital once, and I’m due to go in for immunotherapy tomorrow. Sometimes it just feels like too much! I’d love to escape somewhere for a few weeks with no hospitals around.

I’ve read a lot about Post-traumatic stress disorder and the effect it can have on cancer patients. People experience flashbacks and panic attacks as a reaction to exposure to very stressful and traumatising events they’ve experienced in the past. I’ve truly never really appreciated being mentally well, and the impact being unhealthy can have on a persons life until mine completely changed. I’ve always been a stressed person; school and studying at University were huge challenges for me, constantly worrying about deadlines etc, but that’s nothing compared to the way I feel nowadays. I once tried to see a psychologist when I was first diagnosed with stage 4 melanoma, but back then I felt worse for it. It was another trip to the hospital I just didn’t need! All my friends were embarking on new careers whilst I wasn’t well enough to get out of bed in the mornings, let alone go to work, and talking about it felt like a constant reminder of what I had lost. Years later I tried to seek counselling, and was fortunate enough to be referred by my GP to a local service in London. The idea with the sessions meant I had to commit to seeing someone for at least twelve weeks, however as I was about to mention this to my work I found myself back in hospital undergoing life saving surgery.  I never managed to make it to my first appointment, and since then I haven’t attempted to try again.

I know that I will always continue to experience these negative feelings and sadness because I am still having treatment. I am about to undergo my 23rd cycle of Pembrolizumab. There is still no end in sight, my treatment will continue, and I know I have to try to accept this. There is no being ‘out the other side’ of cancer.

Being in the know is very helpful when it comes to my diagnosis, I like to have as much information as possible so I feel like some things are within my control. I had a PET CT scan late last week and will get the results in three weeks time. I hope it will be ok, but I don’t think I can ever be that confident it will be. Ultimately it won’t be ok, and the longer I am well, the closer I am to becoming unwell again. Yes, it being mentally draining is an understatement! I live my life in cycles of twelve weeks, so I am really hoping I can continue on Pembrolizumab and refocus after I received the results. I really want to enjoy Christmas and New Year.

As I get older I find mental health problems seem more common than I once thought, but perhaps that’s part of being an adult and being more aware. Sometimes it’s ok not to be ok, I know I have both good and bad days, and have to accept that. Tomorrow is a new day as they say! I’m sure there are some people reading who have or will be effected by mental health during their lifetime, either themselves or by knowing family or friends who have struggled. Luckily I have a strong network of people around me to talk to, as well as using this blog as an outlet for my feelings.