June 5, 2013

How's this for a Hootenanny? Health Roles, Statistical Significance, and The Meaning of It All

First of all, I apologize for the past few post-less days... but they've been a busy few at that. By the time I got home from the hospital on Monday, I had little to no energy to do much of anything but lay on the couch. This was, however, incredibly therapeutic and relaxing, and I encourage my fellow cancer patients to do it often. Tuesday was busier and involved a lot of tidying up, unpacking the hospital bag, and catching up on a dizzying amount of e-mails. Don't get too far behind in your personal and professional lives when you're going through treatment, as it helps to be able to think about something besides cancer. Finally, today I decided to go into the office, and this decision warrants a bit of explanation vis-a-vis the sociology of health.

Roles, Behaviors, and Health
Although I'm a social statistician now, my training is fundamentally as a sociologist, and one tenet of sociological theory involves the importance of "roles." Roles are pretty self-explanatory, but they capture the various social positions we occupy and the behaviors associated with or expected of them. It is tempting when you're going through something like cancer to be singularly focused on the role of "cancer patient." This is understandable, but problematic, because we also know that fulfilling multiple roles and role behaviors is correlated with a more positive self-concept and better health. Put another way, focusing too much on your treatment might actually hinder your physiological recovery... it's true!

Thus the lesson here, and one which seems to be panning out quite perfectly in my own situation, is that we (by "we" I mean all cancer patients AND their support networks) should recognize the time and place to be focused on treatment, and thus also when to forget about it for a while. I'm not suggesting we go all Marco Polo on it and start traveling the globe, but a few simple tips can help you keep balance in your life, and promote the feeling of "wantedness" or importance that leads to greater self-esteem and improved psychophysiology.
  1. Keep at least an hour a day set aside for doing something "hobby-like" that you enjoy. For me this is definitely blogging, but it also includes cooking and baking. 
  2. Whether personal or professional, keep up at least on checking and responding to e-mails. It assures your friends and colleagues that you're doing well, and it feels really good to stay "in the loop."
  3. Spend some time outside, like in your yard or on the deck, but stay close to home. Obviously we need to be careful about going out too much, because of the risk of infection, but when it's nice out, the fresh air and sunshine can be marvelously healing and is a beautiful counterpoint to the dank, stale air of hospitals.
  4. Exercise, a little bit. DON'T go to the gym, but I've found a few rounds of going up and down the stairs slowly is actually very refreshing. It also helps to release endorphins, which stimulate the product of hormones that promote healing.
Statistical Significance and Effective Chemotherapies
Okay so this is definitely a bit heady but involves a funny story. My regimen (DA-EPOCH) involves adjusting upwards the initial dose of the primary drugs by 20% each treatment cycle, to a total final dose equivalent to twice the original dose. Blah, blah, blah, I know. But being the consummate nerd that I am, I actually read the literature on this regimen and follow the course of my treatments very closely. I had noticed this past cycle that my daily infusions were taking longer than 24 hours (upwards of 27 to 28 hours, in fact), which made me wonder whether I was, in fact, getting the precise dose associated with the statistical awesomeness of this regimen. I pointed this out to the nurse, who pointed it out to the pharmacist, who pointed it out to the doctor, who agreed that I had a point (he really doesn't know what to do with me, lol). The problem was that the increased mass of the larger doses of chemo displaced the total volume, which was not being factored in to the infusion rates. The solution was to turn the rates up, to ensure that the drugs were delivered over a strict 24-hour time frame. OKAY: here's the point... BE INVOLVED IN YOUR TREATMENT.. the best way you know how. It gives you a feeling of control, and trust me, healthcare professionals prefer patients who work with them on getting you better.

The Meaning of Things and the Power of the Human Will
This might be a bit metaphysical for some people, but I must confess that despite being a hyperrationalist, I actually follow horoscopes pretty closely. I'll be the first to admit that a good portion of the whole horoscope thing is pretty much hokum. Nevertheless I find them to be thought-provoking, and they help me to stay more deliberate in the words I speak and the actions I take. Sometimes they don't make a whole lot of sense, but I like to find meaning in them by way of what transpires throughout the day. The sum total of this process has led me to believe that whether or not everything really does happen for a reason is irrelevant, because ultimately things can happen for a reason if you give them one. This year has accumulated some pretty intense life experiences for me, to the point where I have come to believe that this year represents a radical turning point in my life. Prior to getting treatment I had almost accepted that I was going to die... I knew something was wrong, but like so many people I was scared to the point of atrophy, and figured that if I didn't find out what was wrong, that maybe it would just go away. But once I started getting treatment, the realization that death was not imminent was followed by a showering of blessings and opportunities in both my personal and professional life. It's strange to say, but there's almost a bit of fear in this new phase of my life, since it feels like everything I knew no longer is, and everything that will be is newly rewritten. But it's also incredibly freeing, because it means that from here on out, I understand that the path my life takes really is the result of the decisions I make in my life, and this has led to a new determination to stay healthy, positive, and balanced.

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