Is The Book Flying Off The Virtual Shelves?

As of today the book has been downloaded 160 times. There has been no real marketing. It’s just me, posting on Face Book and LinkedIn. I don’t know if 160 downloads in two weeks is a good number or a pathetically low number 😂, but it definitely has not gone viral. That said, about a dozen people have contacted me and said some great things about how the humble handbook is helping them. That confirms to me that the book has value to some people. I’m pretty happy about that because that's the whole point of it in the first place. Anyone have ideas for pushing this book out to a wider audience?    

Cancer and PTSD

Most people do not normally associate PTSD with cancer, but it’s now known that cancer patients and even their caregivers are subject to it.

In 2018 when I was a patient at Brigham & Women’s in Boston I got a taste of it. After a long and complicated surgery I spent nine days in the ICU. I was conscious and functional but restricted in movement by all of the stuff attached to me. It’s never dark, and people came in at all hours to draw blood, take x-rays, check vitals, etc. About one week into it I started to hallucinate. I was seeing things that I knew were not there, which was really disturbing. I was finally transferred to a step-down unit and spent almost two weeks there. The drudgery and routine were mind numbing. By the time I was discharged I was mentally and emotionally exhausted. It was great to be home again, although I wasn’t out of the woods yet.

 

When I finally got home I slept in a downstairs bedroom by myself. I was too weak to go upstairs to the normal bedroom. I started having ferocious nightmares every night. They were so bad I didn’t want to go back to sleep. I turned on the light, listened to music, read for a while; anything to keep me occupied until daylight. Then I’d get up and have a coffee before laying down on the couch and sleeping for a couple of hours in broad daylight. Somehow it seemed safer. I still remember one recurring dream. I had some kind of metal plate bolted to my chest with a rope or chain dangling from it. A big dog would come and grab the chain, pulling hard on it like it was trying to rip it out of my body. I screamed; it was excruciating and I thought I’d die if the plate was ripped out. Then I woke up in a sweat. The nightmares went on for a couple of months and then finally faded. Since then I’ve had a new level of empathy for people who suffer from PTSD but can’t manage to shake it.   

Stealthy Overlaps That Can Work Against You

I'm happy to report that my shoulder is healing well. It's been a little more than a month since the surgery. I started PT and I'm super lucky to have a great physical therapist. I still have a couple of months to go before I return to my normal activities, so this first solid sign of progress is reassuring.

You might be wondering why I'm posting this, because it isn't cancer related. But in fact it is because it's an overlapping problem. In my previous post I wrote about the importance of staying physically active. If your physical abilities are reduced for any reason, it narrows your opportunities for movement. For example, if you break an ankle you won't be doing much for a few months. You can still exercise your upper body or swim, but you won't be doing squats or running or even walking. Now let's say you already have chronic bursitis or tendonitis in your elbow or shoulder. You just got boxed in. Maybe you'll find something to do, but during that time you'll de-condition and lose muscle mass. When your ankle heals you'll have dig yourself out of that hole. 

In the real world there is more complexity than my simple example. You can break it down a bit with a quick risk/benefit analysis. Should I jump out of an airplane and risk breaking a bone? Maybe, because I haven't it done it before and it sounds exciting. Should I ride my mountain bike over a skinny see-saw? Nah, I've done it a few times and crashed once.

Always Be Moving

It took me a long time to write "Practical Steps For Dealing With Cancer" and when I finished it I knew it was too long. I whittled it down to the size of a handbook. I did this for two reasons. The first is that I wanted it to be short, focused, and easy to read. The second is that I wanted it to be universal so that the book applies to the widest possible audience. To achieve that I had to leave out some things that are important, and one of the most important things is staying physically active. 

Whatever your circumstances are, do what you can to keep moving. Get as much exercise as you can. Run, ride a bike, walk, workout, do yoga, get out of your chair/couch/bed regularly. If you have always exercised and have been de-conditioned by health problems, try to build back up, and accept it if you can't return to the same standard. Just re-set your standard or find something to replace that activity. There is overwhelming evidence that movement and exercise have a positive impact on your health. 

It's not always easy to stay motivated for exercise. If you're good at visualization, think/see your idealized self. It feels good and can lift your spirits and get you psyched. It's something that professional athletes do. As for me, I've always been obsessed with data, e.g., for cycling and workouts. It helps me create focus for the next ride or next workout. I recently started wearing an Apple Watch and I have to admit, the damn thing helps keep me moving. I set it to remind me to get up and move every hour. I set personal goals for activity and it reminds when I'm slacking and how much more I have to do. It's like I'm competing with myself. You get the idea. A "wearable" can be a good tool for at least some of us. That said, I'm a "watch guy" and I prefer to be wearing an actual mechanical watch. No problem; one on each wrist. But no matter what, always be moving.

It Never Ends, Does It?

I have two recent updates. First, at the end of January I had an arthroscopic procedure done on my left shoulder. It's been periodically inflamed and painful since 2016. Physical therapy and cortisone injections helped manage the problem but have become ineffective. So anyway, the surgeon cleaned up the joint and snipped one of the bicep tendons. Three weeks later it's, wait for it...  still inflamed and painful. I understand that recovery is at least three months. At the moment I can barely use my left arm at all. I'll provide some updates on this from time to time.

Second, as you may know, I've been treated for prostate cancer in 2010 and again in 2022. The indicator for effectiveness of the treatment is PSA level. I week ago I saw the radiation oncologist to discuss my slightly increased PSA level since the 2022 procedure. There is some cause for concern, but post-treatment PSA levels can bounce around for a while. Next test in 3 months. I'm following my own advice and putting this in a "box" until I need to think about it again.