Transcription:
Life After Cancer: Managing Your Emotions After Cancer Treatment

Intro: This is BayCare HealthChat. Another podcast from BayCare Health System.

Maggie McKay (Host): Welcome to BayCare HealthChat.

I'm Maggie McKay. And in this episode, we'll be discussing life after cancer and managing your emotions after cancer treatment. With us today is Jessica Kilgore, a Licensed Mental Health Counselor at BayCare Health System. Thank you so much for being here today, Jessica.

Jessica Kilgore, M.Ed., LMHC, CCMHC, NCC, CMHIMP (Guest): Thank you for having me, Maggie.

Host: The range of emotions must be so varied. What are some of the emotions people experience following cancer treatment?

Jessica: So there are lots of emotions and you are correct, it is varied for sure. People can experience something similar to what they were experiencing when they were first diagnosed. For example, there might be fear. There might be trepidation, despair. There might also be feelings of gratefulness, hopefulness, optimism. The emotions can really run a wide range of ups and downs for people. And so some of the most common experiences following treatment are that of both fear and anxiety, as well as gratefulness and hopefulness.

Host: And so how do you advise patients to manage that?

Jessica: So I think the two big things are number one, being aware and being okay that these emotions are there. So, for example, it is very normal and very common for someone to feel scared following treatment. They have been being seen by physicians and other care team providers on sometimes a daily or a weekly basis. And when you don't have that right there, where you have the care provider, it's very normal and like I said, common for patients to feel a little scared, like, hey, I don't have anybody looking after me like I have been for the last several weeks, months, however long it has been. So it is common for patients to say, oh my gosh, how am I going to know if something changes?

How am I going to know if something might need to be addressed going forward. And then again, like I said, it's about that hopefulness of, oh my goodness. I just finished my cancer treatment. This is fantastic. I get to go back into some of my common activities, some things that are very typical for me on a daily basis, and I don't have to see those doctors anymore.

And so that can of feel really good as well. And just hopeful that my goodness, I made it through such a big thing. And so how I advise patients as you were saying to manage these emotions, is one, become aware of them, know that it's okay to feel them and two have a safe space or a safe person that you can talk to those emotions about.

Host: And even though a patient may be grateful, as you were saying, that doesn't mean they can't feel emotions opposite of that. So, do people feel sometimes guilty that they're grateful, but they're still worried?

Jessica: Yes, absolutely. They do. They can feel guilty. Not only still worried because many patients will say I'm finished with cancer treatment. I've done all of the things, I've beat this huge mountain I've done all of these cancer treatments, and yet I still feel like there might be something wrong or the other shoe is going to drop.

And so patients can feel guilty, overwhelmed, even maybe unappreciative of all that they've gone through as well as sometimes people may feel, why did I survive? Why did I get to make it through? And somebody I met along the way or somebody that I know in my family or my friends circle didn't make it.

So they absolutely can be feeling different emotions. I think one of the things that is really important to point out is that somebody doesn't have to be positive and grateful all of the time. That it's absolutely okay and expected for someone to feel sad, angry, scared, frustrated, and even anxious. It doesn't make you a negative person or ungrateful for what you're going through, but rather it makes you human because this is part of the human experience is to have all of these different emotions.

Host: Right, well, clearly the emotions and the idea of cancer don't end, just because treatment ends as we've been saying. So are there tools that people can use to try to put these worries aside or at least manage them somehow so they're not constantly worried?

Jessica: Yes, I would say so I think some of the big items here is, again, awareness. I'm aware of my emotions. I can spend time with those emotions and say, gosh, you're here for me to teach me something or that I need to feel this because being diagnosed with cancer can be likened to a trauma in that the brain doesn't know the difference between emotional and physical danger.

So it responds very similarly and encodes things in that way. And so when the brain experiences such a huge diagnosis, a feeling of being totally out of control and unable to really handle yourself, because you're dependent on other people like your doctors to prescribe your treatment or to make sure that they're getting the appropriate scans.

The brain kind of goes into fight, flight or freeze mode as it would with lots of other dangers. And so being aware and having knowledge that it's okay that I feel an ache or a pain, and that's going to create some anxiety because it's, oh my goodness, when I felt an ache or a pain before, that led to me having a diagnosis and then subsequent treatment, or I have a new scan coming up, you know, a new mammogram or a new CT scan of some sort to check the body for any cancer.

And that people will often feel anxious all over again, because the last time I went through this is when my life changed completely. So, it is very important to just know that that can happen. And then in terms of trying to manage or having some coping skills for those, again, being able to voice those emotions, to be able to tell friends, family, even care providers, I'm really scared about the scan coming up. So, it's important for families to understand and friends that I'm scared of this scan, and I don't know what the results might be, and that can be very intimidating for a patient. And so being able to express that and for friends, family, and care providers, to hear that and to say, it's okay, we're going to be with you through this journey no matter what happens and what the next outcome is.

And still at the same time, having the hopefulness that I went through this treatment, I know that I depend on my care providers and they're leading me in the correct direction. So I have the hope that this is going to be a great scan. So, having those close people and those care providers that we can talk to emotions about as well as somebody like myself, a mental health counselor that can help assist with learning new techniques for each individual person of how they can manage their emotions, whether that's anxiety or frustration or just being able to stay more in those moments of joy and hope.

So a few things patients can do are some breathing techniques. There's something called box breathing. This is actually used in the military to help control heart rate and breath. And it allows for the stress response not to be so high. So box breathing is breathing to a count of four. So you'd go up the one side of the box breathing into a count of four, go across the top of the box, holding for a count of four, breathing out the other side of the box for a count of four, and then holding the bottom side of the box for a count of four. So that's called box breathing, and then you can do that in various counts, but four is the most common.

That's a great breathing technique again, to lower the heart rate, to calm the mind, to be able to just take a nice breath and relax a little bit. Other ways that we can do things, there's something called a grounding technique. That's using 5, 4, 3, 2, 1 - five things that you can see, four things that you can hear, three things you can touch, two things you can smell, and one thing you can taste. And that can be done with your eyes open and in the room, or that can be done imaginatively. So that we're thinking about the five different things that we can see. We can imagine a beautiful beach and thinking about all the things that we can see and on that beach the things that we can touch, the things that we can hear, smell and taste.

And that brings the brain back into the moment and not in that fight, flight or freeze response.

Host: Those are all very useful tips. You mentioned family and friends. What do you say to patients who say they wish their family could understand that they can't go back to being who they were before cancer?

Jessica: This is a really big one and one that I hear from patients all of the time. And I think it's really important to remember that every time we have a conversation, just like now, Maggie, you and I having this conversation, we're changed following this conversation. We've had new experiences with each other. We've learned new things. And so when somebody goes through a big event, they are going to be changed and they are changed both physically and emotionally with something like cancer. So, there could have been surgeries involved in which there's a physical change. There's definitely the emotional change of all of the things someone's been through that, all the information they're taking in, the myriad of emotions that we've talked about, that somebody experiences that we can't just turn that off like a light switch to say, nevermind, I don't need that anymore.

I just want to go back to who I was before I knew all of this. And many patients will tell me, I don't want to be the person that I used to be before I had cancer. Because they'll say things like I have such a new, renewed hope on life. I have a different way of looking at things, a new perspective of what's important. Maybe they say, you know, I don't sweat the small stuff anymore. I used to worry about dirty dishes in the sink. And now I'm like, it's okay that I have some dirty dishes in the sink, you know? So, it really helps patients to be able to embody who they are going forward because there may have been some changes that they really welcome and say, this is fantastic.

I'm all about, you know, traveling, spending time with friends, really getting to live life the way I've always wanted to. And then there's things that happen that I can't forget. And I don't want to forget that I went through such a big moment in my life that I did have these treatments. And not only that, many times patients have a reminder of the fact that they had cancer, maybe their hair is continuing to grow back, or maybe they continue to take a maintenance medication that maybe the outward world cannot see, but that, that patient is dealing with every day. And so to say, I just want you to be who you were beforehand. It's kind of hard for a patient to say, sure, I can be that when I'm still taking the medicine or I'm still noticing changes in my body or my hair is growing in and it's different now. And, and while it could be fun and great to have these new hairstyles while I've got new hair growing in, it can still be very overwhelming because it's just not who I used to be and not what I used to look like.

So, there's constant change that's happening for a patient even after the physical treatment that we all know of, like chemotherapy, radiation ends that just because somebody looks better, like I said, their color is back, their hair's growing back in, they seem to have better energy. That doesn't mean they feel all of those things that they look.

Host: Right. You know, if you've never had cancer or been around anybody with it, this is so much, information that's useful that, you wouldn't even think of until you've gone through it, I guess. How can patients look to the future and chart a path forward using the experience of cancer, as you said, and how it shaped, who they are today? So going forward, how do they how do they chart a path?

Jessica: Yeah. So I think a great thing is remembering to bring all of that new learning with them and to say, gosh, what have I learned? What do I want to keep? What do I want to throw away in terms of maybe I've learned some new things about myself that I absolutely love and adore, and I want to bring that with me and spread that joy and that new love into the world.

And maybe there's some things, like I said, the dirty dishes, it's like, you know what, that's really not important. And I understand that now, so I don't want to bring that with me. And so it's really about finding who you are and where you want to be. Talking with a mental health professional can be excellent for that because you can help yourself with learning how do I express myself to my friends and family in ways that maybe I never did before? How do I want to help set some new boundaries around self-care? A lot of patients have learned a lot about self-care during treatment for cancer, because they have to protect their energy. They have to protect their time.

They have to make sure that they are well. And so allowing those boundaries to continue. So, working with someone to help you, hey, how do I set these boundaries and keep them going? How do I express myself to friends, family, coworkers, as I go forward and what do I want to do? For some patients they want to forget, in terms of like, I just want to move past this. I just don't want to focus on it. Allow them to do that, to find a healthy way to do that. If it's, you know what, I've learned some things, and I know some things about my journey and maybe I would like to make some changes in not only my life, but maybe in other people's lives. Then this is a great time to work with someone to try to figure out like, how can I do that? How can I translate that into maybe even a new career, or a new volunteer activity for myself.

Host: That's a great idea. Thank you so much, Jessica, for your time and sharing your expertise.

Jessica: You're very welcome. I enjoy it. Thank you, Maggie.

Host: Absolutely. That's Jessica Kilgore, a Licensed Mental Health Counselor at BayCare Health System. And that wraps up this episode of BayCare HealthChat. Head on over to our website at BayCare.org for more information, and to get connected with one of our providers. Please remember to subscribe, rate and review this podcast and all the other BayCare podcasts. For more health tips and updates, follow us on your social channels. And if you found this podcast informative, please share on your social media and be sure to check out all the other interesting podcasts in our library.

I’m Maggie McKay. Be well.