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I am grateful for my cancer meds everyday. I am grateful that I live in a place where they are accessible to me. I am grateful that my family hasn’t been bankrupted to keep me alive. I am grateful for the pain relief they are able to give me. I am grateful even if I still can’t live a normal life, doing the things I once did.  But cancer medication also comes with challenges. I take over 40 pills per day and each one has its own benefits and its own side effects. The one that I have struggled with most is the change to my mental health. While I wish I could wake up and enjoy each day to its fullest, I now can wake up with a heaviness and sadness to a level I had never experienced before.  I wanted to show an unfiltered look into a good and bad day. So I challenged myself to keep a diary, both when I am experiencing depression and another day when I am feeling hopeful. This is the result.

From the dark place.

A dark cloud descends over me for one week in a five-week cycle brought on by my cancer meds, causing a hormone imbalance and increased pain if I do not do self care by pacing my daily activity.  Although I am on antidepressants it still always happens. Sometimes it lasts longer and it has lasted as long as a month. It feels hopeless.

I wrote this over the course of three days to track my inner thoughts. It was very hard to do, as I felt sad and frustrated when writing it and too self consumed. I kept asking why would anyone want to read this? Who wants to read a sad boring journal entry? I hope someone might benefit from reading it.

I hoped I would benefit from writing it. 

I hope I can look back on the entries the next time this darkness comes and it will help me through it. I can see both the bad and the good laid out in front of me. 

To be honest, I did put a lot of time and energy into making this coherent. The reality is that the more pain and the more pills I need to take, to foggier my thoughts seem to become. I did not talk about my physical pain, but instead stuck to my mental pain. The physical pain is always with me and pain meds help take a pain index (where ten is full intense pain) from seven to three. I fluctuate from three to seven throughout the day, depending on activity. For optimal results, I need to take pain pills before the pain starts, which is hard to navigate, so I usually have 30 minutes of higher intensity pain before the pills take effect. Mornings are the worst and many times Al (my husband) sets his alarm to give me a pain pill, as he knows my last one at night will wear off by 7:30am. 

Dear me,

It is back. The weight of it all is back. My mind is racing yet it has no place to go. It feels so heavy, dark and destructive. The same thoughts are finding their way into my mind again.

I feel ugly on the inside and on the outside. 

This journey feels relentless and as though it will never end.

Right now, I feel anxious and as if there is a large peach-sized pit in my stomach that will never go away.

I feel hopeless. Sometimes worse than hopeless. I sometimes feel nothing. 

Not happy, not sad, just an empty void of nothingness.

The tears keep coming and I want to hide away and sleep away my feelings. 

But when I wake up from a nap, I know they will eventually come. Sleep just delays them.

Food is stuffed down as I seek comfort. It pushes down on the pit in my stomach. I pile on with cookies, cakes, anything to make it go away. But it just adds to the feeling of ugliness and unworthiness.

I want to shower and get dressed, but I feel too tired to do anything. 

I want to disappear.

The sunshine is horrible. I do not want the suggestion of going for a walk. I want rain and thunderstorms, so I can feel no judgement in having a lazy day. The sunlight feels like an enemy.

Nothing good is on TV. There are no good movies to watch. There are no books worth reading.

It is all crappy… I keep looking for something to get lost in, to help distract from the reality of how shit my life is and what a fraud I am.

I need some pain pills. I need three but better to take two, as I am afraid I will become a junkie. Maybe I already am one. 

I wonder when people go from casual pill popping to “junkie”. 

Yeah, I will just take two. 

Plus, I read other cancer pain patients take less than me.

I cannot text people or post anything. The energy it would take is too much. 

I need to preserve it. I need to hold onto it in case I decide to use energy to pretend I am fine, just tired and in pain. 

Do not mention depression, as then they will all suggest ideas of how to make it better. They will look at me with disdain. They will want me to go for a walk, but I know I am too weak to even go outside. 

I fake it but it takes so much energy.I am so tired now. 

I want to sleep but I cannot. I will take some Ativan to sleep but what if it does not work and keeps me awake but I’m still so sad? (I want to say fucking sad but swearing and anger take energy.)

I am in pain. 

Nothing works. 

This life of pain sucks. 

Why do I feel so much back pain? 

I need to stay in bed forever.

I can take a sleeping pill and sleep away the day, but we have only so many and I will run short. But we can get more, right? 

Al will ask too many questions. Do I have gravol around? Gravol does not work. It is like taking baby aspirin to fix a migraine.

Just sit here and think about is it really worth it? 

Yes, it is. I want to live. I do not want to be without my family. What happens if Zach’s plane crashes? I cry with fear of that. Or a drunk driver hits his car on the way back from the airport. What happens when my parents pass? I cry, realizing my parents and Al are close in age and I just keep crying.

This stupid pain… I take my third pill. I am so weak.

I need to respond to customers and package up our orders. But why bother? I have become a retail clerk and not even a good one. All I have is memories of when I was smarter and better at business. 

I live in the past. My current life sucks. I suck. I need to respond to work emails. If they knew how lazy I am they would lose any respect for me as an owner. Thank god for Zach. He is the smart one. 

I try to think of something happy. I think of my dogs, cuddle them, hug them, and they do feel good. I am a bad puppy mom. I do not walk them. 

I hear Al doing my medications in the bathroom. He knows I am missing a sleeping pill. I will tell him what I did. I am a shit wife. I offer nothing in return. He does everything and I do nothing. He will leave me by having a heart attack. He works so hard. When he is gone I will be alone. Zach will need to quit school to step in for Al. That is selfish. I am a bad selfish mother. Zach will figure that out one day. I do not deserve him or Al. I am a bad stepmom. I should do more. I am a big fraud. I hate when people say I am brave or an inspiration. I am weak and needy.

I am in pain. My stomach flares up. I show my family so that they see a physical side to the illness. They know my pain is real. But maybe I am weak and have low tolerance. I know people with cancer in their bones and they hike. I am a shit cancer patient.

Ana, my caregiver and overall helper with the house, is making my bed while I sit here lazy and entitled. How do other people in my situation deal with it? They are stronger and better at having cancer. Ana takes care of me all day and what do I do to deserve that? She is a saint whose husband had a heart attack in his late forties and she worked three jobs before she came to me full time. She is so strong. One day she will leave me and then what? She knows how selfish I am with my shopping and she knows me so well. She knows I am a fake. She sees my weakness.

My Circle of Strength group chat, I need to do a video or text them. I need to be a better friend. Tomorrow I will do a video and give all my girlfriends an update. If by tomorrow I do not do one I will soon lose my friends. I really need to become a less self-centred friend, but my video update will be too boring. I have nothing to say. I am a shit friend.

Zach packaged the orders. I just needed to write the customer card and add their special gift in. I used to love doing that job but why bother? Customers do not care about a personal touch. They just want their order to be correct. Zach prepares the orders, as I have messed up a few. I am even shitty at making sure they get the right items they ordered. Zach has lost his trust in my ability. That is why he does them and I only do the fluffy, not important stuff.

I have so many things to do. I need to make a list for tomorrow: 

Brainstorm new sales ideas 

Package up 25 kits for charity 

Go for a walk 

Do physio

Practice mindfulness 

Eat better 

Make my bed 

Have shower 

Schedule a work call 

Do an update video for friends 

Package new orders 

Organize my office 

Text back everyone 

Write my friend whose father passed away 

Write a blog post 

Be a better wife, mother, and sister, especially to my sister Kim who is in chemo. I am a shitty sister to her. 

Maybe I will prolong the timeline by two days. 

If I do not get this done my life is meaningless and I am worthless. 

Eventually, I am able to turn a corner.

Dear me,

Today is a better day. 

I got up and got dressed. It took a lot of motivation to do that, but I knew I needed to and was able to find the energy to do it. I need to change things up. It is time to get out of my negative headspace. Why was yesterday so negative and today so different? 

Are my hormones coming more into balance? I stopped drinking milk after realizing I have an intolerance and I don’t know if that is helping my mood as well. 

What else have I done differently? 

I slept in till 10, my preferred time to get up. I went to sleep last night watching the movie Cake with Jennifer Aniston, who plays a chronic pain patient and I related so much to her character. 

I took half a Ritalin this morning, which is a drug prescribed to many teens who have Attention Deficit Hyperactivity Disorder (ADHD). This drug helps give focus and clarity. For cancer patients it can help give a boost of energy.  Many people told me the best part of Ritalin is the high when you first take it. I never experienced that. I meditate when I take it to hopefully improve chances, but no luck so far.

Some days after I take the pill I will sleep even more. That leaves both my husband and I stumped as to why it has the opposite effect at least 50% of the time. The best day for me to take Ritalin is if in the days preceding it I have rested a lot and taken it easy. If I take one after I have eaten I will be nauseated. 

I lay on the ground outside and it feels so good to connect to our Mother Earth. I lay with the sun beating on me and think of how lucky I am for our house and the land it sits on.

The dogs are out and Hope, our dachshund, is cuddling beside me while Coco, our rescue, sneaks up to give me a sloppy wet kiss. The incessant barking and rough playing of our other dogs for some reason does not bother me. Have I learned to tune out or accept that it is their way of communicating. 

My caregiver is Portuguese and sometimes I hear her talking with her daughter. It sounds like they are fighting, but Ana says that is just how they talk to each other. Maybe it is the same way with our dogs. I think about that analogy often. If a dog doesn’t bark much maybe it’s culture is more British or Wasp where communication is more passive aggressive and bottled up emotions. It sounds silly as I write it. 

I think I am getting back on track and the dark days are behind me. Let’s see it can last longer this time. I know it feels like it will never end and it all seems so hopeless sometimes. But it does end, and I will wake up feeling a little better each day. 

I need to remember those thoughts are lying to me. My depression and anxiety are covering the real me. I am still in there. I need to push those thoughts out. 

Take deep breaths and push the negative thoughts out one by one, for every negative thought breath in and out three times. 

My depression and anxiety do not own me. They are tricksters playing games with my emotions. I visualize a better place and repeat until my mind knows it off by heart. Then say it until your throat is sore, and then until I fall into a nap.

Today we feel strong.  I see us in our garden taking out the weeds and spraying refreshing water on the vegetables and herbs we will be eating.  We are walking through the magic garden where we stop and talk with Faith the dragon (a sculpture). At night she comes and spreads fairy dust over the garden.

Come into our beautiful home we worked so hard to have. We deserve our life because we are good people. 

Jump in our shower, shave our legs, do a face mask, condition our hair. We look great. We are beautiful. 

Let’s put something stylish and comfy on. Let’s do something kind for others. Think of three things and then we will do them. 

Let’s put some healthy yummy food into our belly. We feel so good after eating well. Our body feels taken care of. 

I have not thought about pain as I have put that aside. I feel free. I feel joy.

Good nap? Say this again and now do it. I remember that I control my thoughts and mind. They only enter in because I let them. I am strong enough to walk away. I can do it. Do you know why? Because I have done it countless times before. 

-Karla xo

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Karla believes in revealing the truth and getting the real story out there. For the past two years, her Stand Up Speak Up Podcast has told the stories of those who had been neglected or forgotten by mainstream society. While recording these episodes, Karla was fighting her own battle.  Listen to Karla’s Story >

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