Leonard Cohen on Marriage

I’m reading the book, “I’m Your Man”—it’s the new biography of poet/songwriter Leonard Cohen. I’ve loved his writing forever, and his music of course, and I am coming to love his contradictions: a ladies man who is a monk, a fabulous performer who hates to perform and a homely man who is supremely attractive.

He said this about marriage:

Marriage is the hardest spiritual practice in the world. Anybody can sit on Mount Baldy for hours on end, weeks, months. But it’s nothing compared to marriage. If you’re really there, really present, for marriage it’s self-reflection 24/7. Who can take that?

The Cancer Triangle

Now we are in-between. It is its own strange time. We are making holiday plans, shopping for birthdays, talking about gifts and trips and life—as if cancer is over. But is it over ? Or only away on a trip of its own? They say that people who have cancer are never really over it. Once you know this can happen to you it’s always there hovering in the background. That's true for caregivers too. It’s there in the back of the closet--that shirt, and the back of the fridge--no more lasagna--and in the medicine cabinet. Will we ever toss the anti-naseua meds? It is there in the relationship too. Always a third party. A strange relation who never quite leaves.  Will we ever have a relationship that is just us? Or will there always be a triangle: me and him and cancer?

In Cancer Care, Cost Matters

An important article on the OP-ED page of today's New York Times regarding the cost of cancer drugs and how those costs are passed on to consumers. Bach, Saltz and Wittes from Sloan-Kettering Cancer Center authored this piece (link below) describing the decision of Sloan-Kettering to NOT offer a new drug --Zaltrap--for colorectal cancer.

Very interesting and maybe surprising to hear this from the preeminent cancer center in the world where you'd expect them to try everything no matter the cost. But these docs have decided that more expensive is not necessarily better. They also explain how monthly outlays for cancer fighting drugs have risen from $4,500 per month ten years ago to drug regimens that now cost $35,000 per month. Yes, per month.

This is a short piece and worth reading. Even if you have great health insurance or Medicare no one can afford this.

Here's the link:
http://www.nytimes.com/2012/10/15/opinion/a-hospital-says-no-to-an-11000-a-month-cancer-drug.html?smid=pl-share

Live Strong and Wrong

Lance Armstrong has hurt the sport of cycling, and he has hurt the world of professional sports, he has hurt his teammates and fans as well, but there is another group of people that Lance Armstrong has hurt badly: Cancer patients and cancer survivors and all the residents of CancerLand.

Now we know that he misused lots and lots of drugs and hormones and additives and he used suspect medical practices to improve his performance. The testimony is making clear that he also bullied teammates and staff members into participating.

But what about all those yellow bracelets? What about the unbearable hubris of his “I got cancer but I can still win the Tour de France”. What about Live Strong and Lie; Live Strong and Wrong? Live Strong and capitalize on years of testosterone abuse possibly leading to testicular cancer and then capitalizing on that cancer?  What feels the worst is suggesting to other cancer patients that they too can power on and climb cancer’s hills and wear the yellow jersey, but oops forget to mention I abuse my body—and others --mercilessly.

I know this is tricky territory. We’re not supposed to blame the victim in CancerLand. But now we know that all those yellow bracelets bought him so many free passes and so many looks the other way.

I remember feeling sad when Lance and Sheryl Crow broke up. But now I wonder, “What did Sheryl Crow know?” I’m glad she’s out.

And I just gotta say, here at The Amy Winehouse House, we never liked him.

It's a Life

I work for a nonprofit as an advocate for people living in poverty. I write about military mental illness and trauma. I interview vets with PTSD and I write about cancer and caregivers. I also play golf, dance, swim, adore Pilates and yoga, and I love the Pittsburgh Pirates, Steelers and Penguins. And I dance, write fiction, teach writing, and when I get a chance I love to be at a podium to speak about any and all of that stuff.

Even I have to admit that's a lot.

And because I am so grateful that I get to have this life and all of that --that I also complain about --"I'm so busy and so tired and so stressed"--I try to have an active and growing spiritual life. There are days like this one when it's so clear to me that with out the ground of faith under me I would have none of this--my health, my good marriage, John's good humor and support, all the curiosity and fierce energy that I get to bring to my work.

Years ago I came so close to dying.  I saw the light and was almost gone. But I didn't and it never quite made sense. Now it does and I have work to do.

This is part of it.

Sexy Funny Smart Breast Cancer

Yes, October is Breast Cancer Awareness month so let the pinking begin! For the most part the pink insanity infuriates me. Girly? Babyish? Infantilizing?  Yes, all that. But I was tickled pink when a cancer colleague sent me a link to a great cancer org that combines sexy, funny and in-your-face advocacy for breast cancer.  The perfect combo for for Love in the Time of Cancer.

Take a look at the website at  www. Save2ndBase.com

http://save2ndbase.com/store/womens.html and note the tee shirt that has a drawing of two baseballs at oh, about breast height, with the slogan, “Save Second Base.”  Brittany who sent me the link said, “Some find this a bit “in-your-face, but we find breast cancer a lot more “in-your-face” – especially the havoc it wrecks on patients and their families.”

Save 2nd Base began as a cancer charity walk team for Kelly Rooney. Rooney, a mom of five who died of breast cancer at age 43, designed the T-shirt.

Proceeds from the sale of these items benefit the Kelly Rooney Foundation (www.kellyrooney.org). The Foundation inspires support, research on breast cancer in young women.

Check it out and get one of these great shirts. You can’t imagine the double takes you’ll get at baseball games. It’s kind of a boob IQ test.

Caregivers May Be Hidden Patients

In today’s Live Smart section of the Albany Times Union there is an article about health risks for cancer caregivers. We’ve been documenting the health risks for female caregivers for some time (MetLife has done a lot of that research) but today’s article discusses the impact of male caregiver stress for men who care for a partner with breast cancer. It’s true, as you’d expect, that there is a health decline for men when their partner is going through diagnosis and treatment but what the new research shows is that there is an ongoing health impact and serious decline for those male caregivers even after the partner’s treatment.

This longitudinal research comes from Ohio State’s Department of Psychology and Psychiatry. The studies document that the male caregivers of a partner with breast cancer experience significantly more stress, abdominal pain, digestive disorders, headache and migraine, coughing, respiratory ills and nausea. And that these, plus guilt and depression, last for years.

The study’s recommendation is to physicians and clinicians reminding them to inquire about the health of caregivers who are accompanying patients.

But really, have you ever heard a caregiver say anything other than, “I’m fine” if they are asked how their health is during a cancer crisis? Even in private or with close friends most caregivers will reply, “I’m not the one with cancer.” But we have intuited, and now we know, that for both women and men who are caregivers their serious health problems can begin while they are in caregiver mode.

This risk is compounded by the practical reality that caregivers do not want to make one more doctor visit during the intensive caregiving months—so their own health risk can be even greater as essential symptoms are ignored.

So what to do? Caregivers pay attention. Friends of caregivers, pay attention and encourage. And patients: even in the midst of your own care be mindful that your caregiver may be at risk and encourage them to get a physical and routine tests. Also give the caregiver private time with the physician so they can talk guilt-free about how they are really feeling.