Crabby Old Lady on Advertising Drugs to Old People
When You are Well Again

Cancer and an Altered Self-Image

We don't much think about – or, perhaps, it is I who has not done so – who we are. What descriptions we have of ourselves accumulate, I think, over our lifetimes and we hardly notice it happening: doctor, lawyer, Indian chief, mother, father, brother, sister, fat, skinny, young, old, married, single and so on.

For example, since in the United States we mostly identify ourselves with what we are paid money to do, I am a former radio producer, TV producer, internet news managing editor, New Yorker morphed now into a retiree who blogs about what it's like to be old and who, way near the top of the list, thinks of herself as healthy.

No more. Last June, “cancer patient” was added to my list of personal descriptors, something I see in retrospect was an easier change to make than I would have thought.

All it takes is a massive surgery and lengthy recovery period accompanied by pain, pills and doctor visits to self-identify as a sick person Or, at minimum, no longer healthy.

I didn't see it coming, didn't even notice, consciously, that the switch had happened until this week. One way I suspect that happens is the medical checklist.

When you have a serious ongoing disease, you are asked to fill out a lot of forms. They are mostly identical and involve checking yes or no on long, long lists of diseases, conditions and symptoms. I've checked off no in all of them all my life. And then eight months ago, I had to check yes on cancer.

I was not healthy anymore. As I may have related to you in the past, a more light-hearted take on the issue was spoken by my primary care physician: “Ronni,” he said, “except for the cancer, you're very healthy.”

Riiiiight – and other than that, Mrs. Lincoln, how did you enjoy the play. That doctor and I have had several good laughs about his bon mot gone awry.

Who we are in our minds, in our bones, affects how we understand ourselves, present ourselves to the world and informs many of the choices we make. Cancer patient is not what I want to be part of my self-image but it happened.

Then, this week, another change took place. On Monday, I had a CT scan, a more definitive test for cancer cells than the test I told you about a couple of weeks ago. Like that first test, this one came back with the best news any cancer patient can hope for:

“CT looks good,” wrote my medical oncologist in her test results analysis. “There is no sign of the cancer at this time.”

That's two tests two weeks apart with the same great, good news. Only a tiny minority of pancreatic cancer patients get this far so I should be ecstatic.

How come I'm not, then?

Intellectually, I'm over the moon but the the thought lacks the emotional joy I expected, the urge to dance around the house, for example, to Joe Cocker's Cry Me a River at full volume.

Instead, even if I am not shrugging off the news, my mind slipped straight into anticipation of the apprehension I felt this time as I waited for the test results that will be repeated every four months or so when they continue to check for cancer. What is the matter with me?

Here's what I think happened:

That added definition of sickly person crept up on me so quietly I hardly noticed it these past months. Even as I have felt increasingly better physically, the daily pills, the chemo treatments, the blood tests, the transfusions along with the many doctors, nurses and other healthcare providers all became silent markers of my new status which I internalized without any thought, made part of my self-image.

While I wasn't paying attention, I became a different person than I have known for my 76 years, someone identified by a terrible disease, and I suspect I am not alone in this phenomenon.

Major life events, good and bad, are stressors that can alter our self-image. There is even a scale for it called the Holmes-Rahe Life Stress Inventory on which my recent life event, “Major personal injury or illness,” is listed at number six out of 43 items.

Since Monday when I received the good test news and recognized that I wasn't feeling like a kid on Christmas morning, I realized I need another change in self-image – from sickly to healthy again or, perhaps, in the more familiar vernacular of the cancer world, survivor.

It may take awhile to make the switch back, but at least I am doing it consciously this time instead of it sneaking up on me while I wasn't paying attention.

Does this resonate with you? Have major life events changed your sense of yourself? For better or worse?


Comments

I am reminded of movies where the central character goes through a heroic battle against the evil antagonist and then at the climax is lying battered on the ground with victorious music in the background. They're not doing a victory lap around the room because they are too battered, but they did indeed win the day and the background music tells us so. One day soon the hero will pick themself up and pump the air with their fist.

I have had surgery on both my breasts. Ten years between the two times. And I live with the ide tha it might come back, somewhere else.
Once a year, I go for a mammogram feeling fearful, then visit the surgeon and later on my gynecologist.
As I say jokingly, it’s a good thing I don’t have a third breast, but deep down, I know tha I could have cancer of either breast again, not to mention any other part of my body.
But One has to live with this, and I guess it’s better to live with it than to die of it.
It’s so wonderful that you’re cancer free, Ronni.

Brave, beautiful post, Ronni. The Holmes-Rahe Stress Inventory is a marvelous barometer to help gauge our sanity; no, we are not crazy should we feel underwhelmed or overwhelmed by positive news! Great medical results, a hoped-for promotion or upgrade in work, housing, mate, more are all stressors, too! I'm thrilled about your great news! xxoo

From Wikipedia: "In economics and decision theory, loss aversion refers to people's tendency to prefer avoiding losses to acquiring equivalent gains: it's better to not lose $5 than to find $5. ... Some studies have suggested that losses are twice as powerful, psychologically, as gains."

Suggestion: Perhaps you (as would I be were I in your shoes) are averse to loss of good health (or freedom from cancer) beyond all "reasonable" expectation, Ronni. Before your diagnosis, "loss of good health" was such an abstract that it meant little. Maybe it was so inconceivable that you felt no dread. Unfortunately, now you know better.

I am a person who...moved from a house into a "retirement community" because of eye problems which might worsen and of having six concussions which have made short term memory spotty. But I am also a person who...takes darn good photographs and makes nifty videos, who can take folks in worse shape than I am to concerts. A person who has already outlived younger friends. As Mary Oliver asks, What am I going to do with this one precious day?

I wrote about how even lesser events--in this case, shoulder surgery--changed my sense of self--even mentioned you, Ronni.

I've lived with an array of diseases, mostly autoimmune, for almost 40 years - -since I was 28. I typically start my day with a quick scan of parts --body, mind, emotional state. I'm always surprised when I can say: All ok! I can be just as surprised when there's something new cropping up even after all these years.

When you first land in' In the Kingdom of the Sick' (Laurie Edwards great book on this state of being), it's inevitably overwhelming. But what happens when you leave that place? Who do you become now? How do you appreciate the you're waiting for the other shoe to drop? How do you explain, "I'm ok" today when you weren't yesterday or who knows what, tomorrow?

I love your candor, your attitude & most of all, your sense of humor. I have a hunch you'll find your way between the Kingdom and the Sick and the Well.

What a profoundly interesting post, Ronnie. It has sparked some thought to take along on a walk so I can muse upon self. Selfhood as we age. This seems to be more in flux or, perhaps, what our younger selves thought was our " self " really wasn't that at all and we are learning it certainly isn't fixed. You are right, injury, illness, events in life can blast us out of who we thought we were and then we try to reconstruct and get back to that person with sometimes, not much success because a different person gazes back at us from the mirror. I guess for me, finding peace and acceptance in the changes and looking as Mary Oliver does tell us, for the precious moments-thanks to the person who pointed this out a few posts ago. Therein is life. That might be our truest gift and where we can find our newborn sense of self, in that moment.

Ronni,

I had a year of chemo and two surgeries after my diagnosis of advanced ovarian cancer, 23 years ago. It took me a very long time to be relaxed between blood tests monitoring whether or not the cancer had come back. The shrink at Memorial Sloan Kettering told me that was normal, that people had tremendous anxiety when they finished chemo because as they were no longer actively fighting the disease with meds, they felt vulnerable. And of course you are going to be anxious while waiting to see if you have knocked the cancer out for good. At first I had to take an anti-anxiety pill before calling the nurse to get my results. A year after ending treatment I also took a full time newspaper job rather than stay at home and free lance because I wanted to take my mind off cancer. In my case, the longer I went without any cancer recurrence, the less I worried. The oncologist told me at two years we breathe a sigh of relief, at five years I could open the champagne. It has now been 23 years. I drink champagne whenever possible. But when chemo stopped, I was so anxious I felt I would explode. Hang in there and as always, love from New York. -- Joyce

It's that damned "...at this time." ...the realization that at a future time the result *might* be different. May your test results continue to be good for many, many years to come!

Joyce -- how wonderful to see another ovarian cancer survivor. I'm going on 18 years after being diagnosed with advanced ovarian cancer and three years as a breast cancer survivor proudly sporting a flat chest. I was embarrassed at first. How could this happen to someone as healthy and hearty at me? Plus, it was a girly cancer. It takes time to recover emotionally. I think of the Winston Churchill quote -- when you're going through hell, just keep going (or something like that). But when it's seemingly over, you don't quite know what to do. Writing about it helped me a lot, so Ronni, keep writing! No, you aren't the same, but it's who you are now, maybe who you were meant to be, and this is the big reveal.

I applaud your bravery. This post resonates with me, not for me as the patient, but for me as the mom to a young girl fighting for her life. An autoimmune that dropped out of the sky one year ago and hit her and us hard. Learning how to be brave for her and this family has been my lesson. But now, having received a positive glowing final test result, I too am afraid to be ecstatically happy. My husband talks of having faith and I'm never quite sure what to do with that. I think that would make all this easy, but I have to rely on brute strength bravery to weather this storm. Your words spoke to me and I thank you. Sending all good wishes your way. From a former New Yorker who misses "home" all the time. :)

I know what you mean, we all want to "switch back" at times to a former self. That self is in the past, gone. As Karin Bendel wrote above, life is a series of selves. The challenge always is to create a new self we want to live with. Congratulations on your amazing progress and best wishes!

It takes time. after two different cancers and four replacement surgeries, I've come to understand that it takes at least a year to 'let go' and get back to your daily life without illness.
You'll never be the same, but you wouldn't have been anyway because of the normal passage of time with or without Cancer.
Judith

About a year ago, while taking a walk, I began to think of all the personal titles by which I've been identified, excluding anything work related, beginning with "daughter" 74 years ago up to "widow" added seven years ago. Excluding titles such as "second cousin" and "once removed," there are 15 to date. All of which caused me to ponder, who am I? I hope I've been a good example of most, if not all of those various names.

I'm 74. Had breast cancer at 72. So far all the follow-up tests have been clear. I don't think about it much anymore, except occasionally if I have a twinge in the area of the surgery. I think the only change in my self-image or identity is that prior to the cancer, I didn't think of myself as "old." Now I do. The anxiety will probably crank up again just before my next checkup, but otherwise it's just not part of my life anymore. For sure I don't think of myself as a "cancer survivor." I abhore being identified by a disease I once had. Nobody goes around calling themselves a "gall bladder survivor" or an "appendectomy survivor" or even a "transplant survivor." So why should I or anyone identify me as a "cancer survivor." I'm the same person I've always been. Just older.

All of us here are on on the proverbial brink, some more the others - that's our life now. How to live day by day is the puzzle and a much harder one when ill. But my own personal hope is that I no longer have a self-image. Life's a moving maze, changing on a heartbeat, so any hope I may have once had for an 'identity' was erased a long time ago. I now gladly feel more like a collection of parts - memories, dreams, fears, loves, colors and patterns - all far too woven into everything else to feel somehow 'mine' to identify just me. Others of course will identify me as a 'cancer patient' or 'old woman' or god knows what, but I cannot help that and try not to buy into that. Day by day by day... it is all aways changing.

Ronni~ Happy for your great test news! Your posts are always entertaining and you often express my feelings - especially about " aging and becoming invisible". This post caused me to read every comment because I was not able to relate.....yet,but as with all age-related experiences, and illness-related experiences, time will tell. My friend has a daughter who has a daughter (7) who isThea surviving childhood brain cancer and she "lives" from test-test. Maybe your experience is simply that life's highs are not so high and the lows won't be so low.

Thank you and your readers who commented.

So good to read your post. I have been fighting against, denying, and not admitting to the eventual seriousness of COPD. Haven't done my exercises, breathing or otherwise, just sloped around feeling stupid. I was going to say depressed, but stupid is the better word. So this morning, I pulled out all the information sheets the therapists gave me, scanned them into the computer so I wouldn't lose them again, and sat down to read your post while I caught my breath. Synchronicity. Exactly what I needed to read, see hear. Thank you Thank you.

I am so glad to hear your good news, never mind if you have to go back again every four months, it just means you'll have good news again and again!

Odette

Ronni - that is such good news. I think the easiest transition in self-image for you might be cancer survivor -- it is a great image, one of a strong warrior who has defeated that terrible foe. Even if you must have that image reinforced with every future test.

So far I am still very healthy - but over the course of the past few years, have realized I must self-identify as "very healthy but definitely showing signs of wear and tear" -- specifically my degenerating knees, shoulder and hips. Perhaps this is the curse of those who are active. My doc thinks my 10 yrs of frequent and intense ballroom/Latin dancing in NYC contributed in a big way to the arthritis in my knee. I had a torn meniscus "repaired" (i.e. part of the cartilage removed, leaving the joint less stable, hurtling me towards earlier knee replacement) 8 yrs ago. And I began changing how and what I did for activity.

Like you, I have always had a self-image of strong, healthy and active. At only 65, it seems too early to be calling myself old. But some very bad habits of posture have come home to roost in the past 4 months, causing bursitis in both hips which is persistent - and lower back pain. Little by little I am trying everything I can - physical therapy, stretches, specific exercises and modifying my sitting and standing and walking postures (OMG - to change what I've done all my life is hard! but if I don't the pain gets worse).

And so - I finally accept and adapt to the self-image of having an aging body, no longer capable of what I once did.

Congratulations on your wonderful news. Now live every day to the fullest. And don't worry about tomorrow.

I have little to add which, some may say, is a welcome gift from me! I've escaped, SO FAR, the life-threatening illnesses of old age (for how long, who knows?). I haven't escaped some of its physically debilitating effects, nor did I escape the life-altering event of becoming involuntarily--and unexpectedly--retired from my job of 40 years at the end of 2014. Although it's been a bit of a downhill slide from there in some ways, at least I'm still relatively healthy.

Still and all, these are very "small potatoes" compared to what Ronni and many TGB readers have endured and survived. Courageous people, all! Hooray again, Ronni, for your good news--may it continue. . .and continue. . .and continue.

Luckily I have been spared what so many of you have had to endure, but lack of balance has caused me to fall numerous times.

A broken hip was the result of my first fall. After that I felt old for the first time. But I recovered and went on with life.

One a year ago a fall really slowed me down but after I recovered I could still do my own house work, laundry, etc. However, I had to pace myself as when the pain got too bad I would have to rest. Visits to the pain clinic helped me function better, but I still needed to rest between any activity and I could not do more than one major chore a day because I would get so exhausted that I had to rest the remaining part of the day.

A fall last December really curtailed almost all of my activities. As an example, I did two loads of laundry yesterday and was completely wiped out. The last load remained in the dryer because I had used up what little energy I had. It took two more days to fold the clothes and put them away.

That fall was definitely a life changing event and I now think of myself as an ancient. I am a very old woman.

Ronni -- just so happy for you, whatever self-label you take on! And for so many here who "keep on truckin'" in the vernacular of my generation.

As a survivor of two different life-threatening cancers, I like the word "survivor." It indicates you've fought the dreaded disease and experienced all the difficult medical treatments, and highs and lows involved. We survivors understand the journey...the emotional rollercoaster. We are always willing to support the newer cancer victims. We are truly delighted when others come out at the end of the long tunnel as winners. There is no doubt that we are changed in many ways.

I would like to mention my breast cancer surgeon who was director of a breast care center in Boston. She was in her forties; married to a physician. They had wo young children. She was not only a superb physician but beautiful and kind. I cannot begin to tell you how difficult it was to learn that she lost her life to breast cancer after a very long fight. I would have traded my life for her in a second because I was already in my sixties. She had so much more to offer.

I try to make every day in my life count in some small way. Enjoy all the time you have gained by your timely treatment and good fortune. Enjoy your talent for educating your readers while bringing so much humor to the table. I'm looking forward to lots more from the new and improved you. Hugs.

I'm very happy for you and this second piece of recent great news! May there come a time when this all becomes something in the rearview mirror, just one of those things that you "used to have to think about."

The good news is wonderful.

I'm thinking, is this maybe like light PTSD? Where even when the emergency is over you have learned that things can go very wrong and you are in fact forever changed?

Glad to read of the latest medical reports on your health status. What happens to us is just that and not who we are — healthy, recovered, survivor, etc. Language and labels we use to describe ourselves define our self-image, significantly influencing who we are, from my point of view. Choosing positive terms for yourself, wisely considering the facts you know, does not exclude an awareness of life’s uncertainties. The words we use strengthen our outlook, evolving and changing as we do — so, select for yourself whatever fits now.

Ronni, this is the post that spoke to me best today, in all of Webland.

One week from today, after a complete hysterectomy, I will learn whether I have ovarian cancer, or just a pesky cyst on my ovary. I've known the surgery was coming for about three weeks. In those weeks I felt grateful, many times, that our language contains the expressive letters WTF.

I am, as your doctor claimed, in excellent health otherwise. Submitting myself for major surgery seems like willingly jumping in front of a bus. My sister works in an orthopedic practice. They call surgery 'controlled violence '.

So the definition of self is gonna change, I think.

Oh Ronni, that's excellent news!

Sending big hugs to you and Ollie.

Who's a good cat!!

Here's a song dedication:

"I can see clearly now, the rain is gone,
All of my bad feelings have disappeared,
Gone are the dark clouds that had me down,
It's gonna be a bright, bright sunshiny day."

(Johnny Nash)

I've been lucky so far, health wise.

But life can change In a heartbeat, so I try to stay in the moment, keep active.

Mom is in her nineties, no serious health issues, takes no medication.

We figure she has Star Trek genes.


I saw a three wheeler women's bicycle, beautiful, white, shiny for sale at my one of my favorite thrifts yesterday and told my husband in the evening "Do I need it"? I have my
own retirement income so the price is irrelevant to him...but I felt like I would look like an old lady riding it down the street....I walk several X a week, do yoga 2 X, and would like another form of exercise.

I am an old lady ( 78), but my self-image is not one of an old lady, I guess. I haven't been able to ride a 2 wheeler for many years because I have osteoporosis and the last 2 times I rode a bicycle I took a spill and quit.....I can no longer afford to fall.

Glad your tests are positive, Ronni. You need time to digest and adjust to all the big medical events of the past 6 months, would be my guess.

Usually I read all the comments before I write one of my own. But I'm a day late with this, and also it resonated with me so much I want to respond without being influenced by anyone else. No doubt someone above has already said better what I'm about to say.

I think that until something big goes wrong in your life, you don't know how precarious life is. And once that happens, you never quite see the world the same way again. For me, it was a beloved parent's death when I was a teenager. More recently, it was my own serious surgeries. I think the thing is, once something goes wrong, forever after you know that something CAN go wrong. Up until then, we're all blessed with kind of an ignorant sense of invincibility.

Falsely (I think) attributed to the Buddha is a quote that is no less true because of its pop psychology provenance: "The trouble is, you think you have time." None of us know what's going to hit us out of the blue, or when, but once we get winged by something, I think, we are all a little bit more fearful.

The passage of time helps, and with enough time, we regain some of that feeling of invincibility. May you feel stronger and stronger with each passing day. And now I will savor the comments.

"Riiiiight – and other than that, Mrs. Lincoln, how did you enjoy the play. "

MADE MY DAY. STILL CHUCKLING...

Dear Ronni, I haven't had to deal with cancer--but because of Meziere's Disease I've lost all my hearing in my left ear. Then, I nearly went blind because of Glaucoma pressure and so my vision become compromised and that meant no more driving and no more reading a regular book.

Because of those two things--and a serious back surgery last year that left me with six or more months of recuperation--I began to think of myself as old. Not unhealthy, but old. I'll be 82 in April so I am aging. But my spirit and mind and thinking have always been youthful and suddenly I found myself feeling unequal to many of the tasks of life.

Fortunately, that has passed--it's true about the hearing and the eyesight--but I am now engaged in a new venture--self-publishing--that feels so wonderful to me. It's lightened my spirits and made me feel young again. I'm setting out on a new career! That of author. What a gift that has been. Peace.

First of all, I'm so happy to hear of your latest positive results. May they continue to be so!

Second, I have experienced that change of identity--22 years ago when my older son was killed in a motorcycle accident, followed 6 months later by the death of my partner as the result of another motorcycle accident, I felt my identity was so wrapped up with grieving semi-survivor of death, as if I were dragging around a bleeding open wound. This lasted for a good two years before meeting and marrying my current husband. I can happily report that I no longer self-identify (solely) as mother of a dead son and loss of a partner. It's more like one life ended in 1995 and another began. May it be so with you.

One of your top posts ever, precious Ronni ... for the good news, for your reflections that resonate with and stimulate us, for so many of your readers' comments. Thank you.

"Go live your life." Amen to that.
Spring's coming, and so are those razor clams.
Enjoy them Ronnie.
So glad for your good news.
Lynn

I could not be happier for you. . . you are experiencing vulnerability now, but as time goes on and news is positive you will be able to distance yourself from it. It is not logical to think because you got good news, you would automatically return to your old self. You are a new self. Let time go by and be good to yourself. I took care of my totally disabled husband at home for 4 years before he passed away. There were folks who actually thought I would return to my previous self, that did not happen, because I no longer was my previous self. I'm still building a new self or trying to. I understand, you are afraid to let your guard down. Let time help you walk a new path.

In 2009 I was diagnosed with a life threatening illness. With the help of great doctors and nurses and a few surgeries, I survived. But the illness and it's subsequent alterations all but ruined my life.
It depleted my savings, made me move from my apartment, stop driving and isolated me from my friends. That's the bad part.
The good part of all this is that I have become more aware and attentive to my health.
I see a doctor on a regular basis.
I have learned to live a simpler, clutter-free life. And made some terrific new friends.
Out of chaos comes order.

So many of us in The Waiting Room - lets join hands - thanks, that feels good!

I can resonate with this so much. I've had a hip replacement (2010) and before Thanksgiving had a knee replacement that I'm still adjusting to. Both have had the effect of changing how I relate to my physical body, how it feels, and how confident I am. I feel OLD and "not like me" whatever that used to be or mean. And yet, I feel better and wouldn't want to return to the pain and lack of mobility both the damaged hip and knee caused. I do feel better and different at the same time.

I also have a spouse who is a decade older. He's in denial about too many things to list and in poor health. I feel like I'm the one "holding everything together" and like my "alert" sensor never gets to shut off.

Thanks for articulating what I haven't had time to voice for myself.

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