opinion

'I work with cancer patients everyday. But after my own diagnosis, I fell apart.'

"You have garden variety breast cancer," my breast surgeon said.

And I know that’s a good thing. The very last thing you want to be to your cancer team is "interesting".

Turns out I was quite a bit more garden variety than I thought.

Just as vulnerable and just as human as everyone else.

My ‘meltdown’ in the months after hospital-based cancer treatment ended revealed this in startling clarity.

For me, a clinical psychologist specialising in cancer-related distress, I really should have known better. I give advice every day about how to navigate post treatment adjustment. 

"Cancer doesn’t discriminate," I say. 

"Respect the disease, respect the treatment," I say.

My story is an excellent example of what not to do.

Or 'do as I say, not as I do'.

Watch check your breasts, a quick how to. Post continues after video.


Video via Mamamia.

I struggled with accepting the requirement for ‘a new normal’. The reality that post cancer, we can only move forward. To the next version of life. Not back, to that pre-diagnosis version. 

That little voice in my head said, ‘I’ll be different’. 

What a load of crap. 

I counsel the benefits of vulnerability, but I was lousy at living it.

Guilty of going back to work too soon, doing too much, ignoring the wise advice of my medical team and important others. After about eight months post hospital-based treatment, I hit a wall (metaphorically). More like I face-slammed the dirt. 

It was the result of not acknowledging the impact of cancer on me, on my life. Chronic insomnia (2-3 hours of sleep a night) and the creeping side effects of my ongoing cancer treatment wrought a devastating effect on my wellbeing. The hormone-blocking medication caused awful joint pain, hot flushes, high levels of intolerance. My coping mask was still on, but it was getting heavier and starting to droop. 

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I was a high functioning wreck. No one but me knew how much every day was further depleting my diminishing personal resources. I was so far into negative emotional and physical reserves (emotional ketosis), that I was coming apart. 

The tectonic plates of my psyche were stuck. Familiar but now unrealistic expectations of myself versus my new capacity limits.

Seismic pressure was building, a quake was coming.

In a classic wood for the trees scenario, I couldn’t see it.

Three physical events happened in a matter of weeks: a broken rib, an excruciating lockjaw experience, and shingles. It was as if my body was having to hit me hard to bring me to my senses.

The difficult decision was then forced upon me, reactively rather than proactively, to take a block of time away from work, deal with my insomnia, and plan a number of changes that would address the realities of life after cancer.

In truth, cancer sorted me out. It was bigger than me. I wasn’t used to that. I had built a life on setting goals, achieving them, often against the odds. Serious corporate jobs. Mother of four children. PhD. High expectations, big capacity. 

A classic High-wire Life Wrangler... Just like so many women.

On a Monday morning, due at my clinic to start a day of consulting, I found myself sitting in the car in the hospital carpark, unable to move, sort of paralysed. Spent. Brittle. My brain simply saying ‘I. Can’t. Keep. Doing. This.’

After finding a way to gently ask my support staff to cancel my clinic, in a daze I walked up and down a beach with the tears sheeting down my face. I called my oncologist and said, 'I’m taking some time off'. She said, ‘Oh thank god, Charlotte’.

How could this happen? I hear you ask. I ask myself.

Ego?

Arrogance?

Stupidity?

Really slow learning?

Fear?

All of the above. Probably mostly fear.

I was resistant. So resistant to acknowledging and accepting what had actually happened to me. 

Fear (anxiety) rises in relation to the unknown, the uncertain, the unfamiliar. Life post cancer had that in spades. Change presents as a threat. Often, our threat response is to hold on tight to the status quo. When what we may be better working on is making room for change.

I like being functional. Most of us do. We, as women, get lots of positives for coping. ‘You’re amazing’, ‘I don’t know how you do it’. Not too many positives when you’re on the bathroom floor in a puddle of tears and snot.

My psychologist husband says that my clients were still getting the best of me. He alone was on the very sharp receiving end of my turmoil, trying desperately to support me. He says it was like trying to support jelly.

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After a month in a ‘bubble’ at a generous friend’s holiday home, away from pretty much everyone and everything, some serious sleeping medication, daily exercise, and writing, my battery started to recharge. But it was another two months before I was able to gradually re-enter life in a meaningful way. 

During these months, the next version of me started to take shape: Charlotte 2.0. 

It looks like this: 

  • I consult a bit less (about 20 per cent less)

  • I go to bed earlier, about 9pm

  • I sleep in a bigger bed

  • I say ‘no’ or ‘no thank you’ more often

  • I present at more cancer seminars and conferences

  • I take more holidays

  • I drink less alcohol

  • I have my poor shredded fingernails done more often

  • I take prescribed sleeping medication as needed to keep my sleep sorted

  • I plan my physical output and do shorter stretches

  • I exercise more, each day if I can

  • I make time for myself

  • I don’t give a sh*t about a lot of stuff

  • I spend time with people I value

  • I see more of my own therapist

While you're here, listen to Big Kids, a twice-weekly look at parenting as it truly is: confusing, exhausting, inspiring, funny, and full of surprises. Post continues after podcast. 


My struggle, my meltdown, and my recovery, fits into the category of ‘post treatment adjustment’. It begins at the end of hospital-based cancer treatment and lasts at least two years - and sometimes a lot longer. We are often enthusiastic and impatient to reclaim life, and important others are often enthusiastic for that too.

Coming to grips with life after cancer diagnosis and treatment is not an easy thing. We may resist ‘the new normal’, longing for the comfort that comes with the familiarity of our previous ‘normal’ life. We ultimately cope better though, when we allow ourselves to acknowledge and then accept the changes. 

It’s not easy to make wholesale changes to your life. Small changes are more sustainable over time (that’s why crash diets don’t work). 

Self-care takes time though, every day, every week. It doesn’t just happen. Planning and diarising it makes it more likely. Communicating it recalibrates expectations of others and introduces some accountability.

Accepting the new normal is not the same as wanting or choosing the new normal. It is not about resignation. It is about acknowledging and adjusting to the reality that something beyond your control, something bigger than you, has happened. 

I’m not all sorted. Even now more than three years on, I’m still practicing at the next version of me. I continue to struggle with fear of cancer recurrence, body image issues after a bilateral mastectomy, sexuality and intimacy, and some emotional isolation. 

Even with an incredible husband, who gave me space and time and permission to let go, to crumble, and then helped clean up the jelly mess and find the ingredients for the new Charlotte incarnation.

In a lemonade from lemons outcome, my post meltdown writing became the basis of a new 10-episode podcast series with Breast Cancer Network Australia; Upfront About Breast Cancer - What You Don’t Know Until You Do, with Dr Charlotte Tottman. Available here. 

Feature Image: Supplied.

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