Sara's playbook for dealing with cancer

My care team has commended my playbook for managing symptoms and dealing with cancer treatment. 

I can't compare my cancer experience to others', because everyone's cancer is different. But, I can say that I'm coming out of this feeling like a better version of myself, and I didn't experience the intensity of symptoms that most people experience. 

I'm a firm believer in doing what I can to manage what's thrown at me and take control where I can. 

Here's my playbook for dealing with cancer in case it's helpful. 

Note: If you think it might help to share with someone who has a recent diagnosis, I recommend first asking them if they're open to a perspective on managing life during treatment, sharing only if they say yes. 

1. I treated food as fuel. I learned which ingredients reduce inflammation and which ingredients help the body recover, and I chose foods with them instead of comfort foods as often as possible. These ingredients can be found across cookbooks dedicated to managing many diseases and are research-backed.
   
   Our bodies are amazingly resilient, but they need energy. Just at the time when it seems everyone is encouraging you to eat anything you want (to "treat" yourself, to just get any calories in your body) is the exact moment it needs to healthiest, highest quality food.
   
   Every proactive choice helps you make more better choices! I'm doing things today that, even in my most motivated times in my life to be healthy, I never would have done.
   
   It will take discipline to make good choices, but the payoff is worth it.
   
   My favorite cookbook for learning: "Beat Cancer Kitchen"  
   
   
2. I used supplements—the ones my care team approved—strategically. The general guidance is to avoid supplements. But some are still OK. I worked with my oncologist, pharmacist, and dietician to take the ones that help with symptoms management without counteracting with treatment.
   
   
3. I exercised throughout treatment, modifying as necessary. There is a mountain of research showing that exercise helps with symptom management. The guiding principle I used comes from a story of an Olympian going through cancer, told in the book, "Moving through cancer": Even on your worst day, exercise for 10 minutes. Otherwise aim for 30 min of medium heart rate activity a day, and strength train a couple days a week.  
   
   That book was critical and easy to reference to get an exercise routine organized to ensure I would maintain strength throughout treatment. The information matches what I learned from my exercise oncologist.
   
   My top recommendations: Ask your oncologist for a referral to your hospital's exercise oncologist (usually they're a PT too). Also, "Moving through cancer" really is easy to use as a reference. 
   
   
4. I took cannabis tablets and a tincture every day (and still do). They helped me with managing pain (instead of Advil or Tylenol), neuropathy, nausea, and myriad other changes to my body. This does not mean smoking weed and getting high. (Smoking is much less effective, and you don't need the amount of THC, which is the part that makes CBD activated, that people normally take to get high.) I worked with a medical care team to guide me to the right products for my needs and set up a (research-backed!) care plan. 
   
   My tip: Work with medical doctors and nurses rather than only rely on dispensary advisors. I used Acute on Chronic, which will be rebranding to a plant-based medicine practice. I also got my medical marijuana card for my state, which in Illinois can get you a discount that usually covers taxes, which are stupidly high (pun intended). 
   
   
5. I went for acupuncture every 1-2 weeks during treatment. Acupuncture is another technique to manage all types of symptoms.
   
   
6. I had a good therapist and talked with her every 1-3 weeks. 
   
   
7. I leaned into my feelings when they came up rather than avoid them. 
   
   
8. I took 6 months off of work to give myself space to prioritize taking care of myself. If you have the option (a privilege) to take time off of work, do it. You are fighting cancer. Work is not more important. Your career is not more important. To be clear, you are in an emergency situation, even if you have a great prognosis.
   
   I thought of it as being paid to take care of myself. Trust me, your day will fill up before you know it, between doctor's appointments (and travel to/from), exercising, research, healthy food prep, walking the dog, time for fun and lightness, and time to rest and reflect daily.
   
   If you have to work, treat it as that: work. Show up, do your minimum, and go home to take care of yourself.
   
   
9. I accepted support—and from more than 1 or 2 people. Let friends, neighbors, coworkers, and family help you. Ask for more help than you might need; ask for help for things you don't think you need help with. But don't put it all on one person either. Each person in your circle—especially those who you are close with—will be processing their own feelings about this illness and how it's affecting a person they care about. They need space and time to process too. Allow support to come from many. 
   
   
10. I played the cancer card! I found this to be more of a mentality for empowerment and permission to say what I want and need, rather than what "playing a card" symbolizes: a manipulative tactic. That's what I needed, at least.
    
    
11. I researched just enough to understand my query and make a decision. I did not read message boards except in very specific topics I couldn't find in formal resources, and even then, I limited the amount of comments I took in. 
    
    
12. I strategically used my energy. I tuned into how much energy I was using and how I felt across moments with a goal of conserving energy for when it mattered and avoiding energy-draining people and things.
    
    For example, in the first month of my diagnosis—the most stressful time, I found—I could tell that my heart would race when I tried to put on a TV show of my usual favorite genre. It didn't feel good! And not feeling good was the last thing I needed. So when I needed to zone out, I found shows that matched what I was seeking to feel (uplifting, empowering, lighter, etc.). If what I needed to feel was sadness, I made sure to lean into that within reason. 
    
    Sometimes I needed to limit who I engaged with, and I gave myself permission to be choosy about the frequency and "who" I involved in my life. Most importantly, this meant limiting those around me to folks who could support my approach to tackling this: being proactive, staying positive, and living life to the fullest within reason of my capabilities at the time.
    
    If you're reading this and you're thinking, "Oh, you disappeared from my life during treatment, what does that mean about what you think about me?!" please don't think that way! While it's true that I paused relationships with folks who weren't likeminded, I also paused relationships and engagement with like-minded folks simply to conserve my energy because I trusted they understood I was taking care of myself and wouldn't hold it against me if I disappeared for a few months. I'm so grateful to have *so many important people in my life* that I had to limit myself. 
    
    
13. I found ways to celebrate milestones—and asked people to celebrate with me. One example: My friend Erin encouraged people to ring a bell wherever they were on the day I finished chemotherapy to correspond with when I rang the bell that day in the cancer center. I got lots of videos of friends, coworkers, and family playing instruments, dancing, cheering, etc., which felt amazing. I told people I was doing this, which felt awkward initially until they all thanked me for telling them. I also said it was OK for Erin to encourage people to do it too. 
    
    
14. I took steps to set the tone with how I wanted to be supported. People will want to share advice and referrals. They'll ask how they can help. Sometimes, they might come up with ideas that don't work for you. Sometimes, they might say or ask the wrong thing at the worst time. I became hypersensitive and didn't always have the space or readiness to respond.
    
    In addition to reminding myself that there's no perfect way to communicate or talk about cancer, and that they're doing their best, I accepted that I needed to help manage people's actions and feelings if I wanted support, which I knew would be good for me. So I:
    
    - Wrote a cancer manifesto to declare my approach to tackling this. It helped me organize my own feelings. Sharing it helped people understanding my thinking.
    - Created a space—a spreadsheet, actually—for people to share advice, offer to help with something that felt good to them, and contribute to my wellness needs (a juicer, a personal trainer, a massage).
    - Put the above messages on a website so I had a place to direct people who asked to help. I committed to keeping it updated weekly, and to keep it simple and easy to manage, I created a section at the top called, "How I'm doing / How I'm feeling". That section was short and straightforward. It had the date and a few lines that answered that question. If I wanted to write more, I linked off to a blog post that went into more detail.
    
    I did this so folks didn't feel like they had to read a diary about cancer just to check on how I am. 
    
    
15. I redirected conversations when they weren't helpful. This looks different for everyone. For me, I put up a boundary around hearing other people's cancer experiences, or if someone pitied me.
    
    How this played out: If people started to share stories about a person in their life who went through treatment, and it went on more than a minute, and it triggered my anxiety, I'd interrupt and say, "Oh my gosh, I appreciate your telling me about them, but everyone's cancer is different. I can tell they meant a lot to you, and it sounds like a [difficult, powerful, etc.] experience. Thank you for sharing."
    
    Or: "I need to interrupt you, because I actually don't feel that way—everyone's cancer is different. I know you care, though." 
    
    
16. To limit my risk of catching any virus, I got real choosy about when I exposed myself to groups of people (busy restaurants or events). I wore a mask when in crowds and on public transportation. 
    
    
17. I let people "treat" me. My local coffee shop baristas comped my cappuccino every so often. My friend offered to pay for a plane ticket to visit her in Florida after radiation ended. I could list more examples! I could pay for these things. But I accepted these gifts and the warmth in my heart that they gave me. I basked in the feeling of support. I shared my gratitude with a smile and thank you. 
    
    
18. I channeled gratitude, of course! Is it with your doggy neighbor you see everyday? The nurses in the infusion center? The hospital front desk person who stamps your parking ticket every visit? The acquaintance who dropped off no fewer than 15 home cooked dishes during the last 2 months of chemo? The coffee shop friends who chit chat with you? I took a few moments every day to mentally make a list of what and who I was grateful for. I also tried to show my gratitude to these folks too. (My care team got "boob" cupcakes!)  
    
    
19. When I didn't want to answer, "How are you feeling?" I didn't. Sometimes I waited several days (maybe even longer) to get back to people. Or, I'd thank them for checking in and direct them to my site. If you're tired of talking about it, it's OK to say so: "Thank you for asking. I'm going through the motions. I'd love to talk about anything else though!" People will understand and offer grace. 
    
    
20. I talked to God and my relatives that have gone before me. 
    
    Amen.

***

I experienced the difference in the intensity of my symptoms when I started or stopped any of the tactics above. It was an amazing experiment, honestly, and validated the power of taking time for wellness.

I know that cancer won't be the last diagnosis in my life. But I do know that going into treatment with a solid wellness foundation meant I was in better shape to endure side effects; I also know that the healthier steps I took, the easier time I had. 

I now feel confident that I did all that I could to set myself up for success: following my treatment plan and maintaining the best quality of life under the circumstances.