Pain in the Butt, Part 2

After trying everything that’s worked in the past to clear up the pain in my low back, with no real success, I decided to take a more aggressive approach.  I lined up a month’s worth of daily treatments, a different modality for each day:  cranial sacral work, physical therapy, Pilates, acupuncture, gua sha and massage.  Nothing was helping very much, but I had high hopes.  Both the cranial sacral practitioner (who is a physical therapist) and my physical therapist (Betsy Ogden, who is also my Pilates teacher), said my pelvis and sacrum were way out whack (auto accidents, pregnancies, large uterine fibroid–take your pick of etiologies).

The last day of week three was massage with Kevin.  As usual, the first part of the massage was wonderful.  But when I tried to turn over into the prone position, I felt a shooting pain from my hip down my leg and simply couldn’t manage the turn.  So I got dressed (with difficulty), went home, cancelled the rest of the appointments, and booked an appointment with a primary care physician.  I thought I had sciatica, but I wanted an MRI to get, so to speak, to the bottom of the problem.

I had never met this doctor before (my usual one moved away a month ago).  I picked Patrick Francis from the list because, in addition to being an internist, he also practices preventative care and “narrative medicine.”  I liked him!  He, too, thought I had periformis syndrome, which produces sciatic pain, but agreed that an MRI was called for due to my cancer history.

By lucky chance, the sciatic pain vanished almost as soon as I finished up with the MRI.  Like the bruise Katy gave me two years ago, it served as a metaphorical wake up call to a more serious problem.  The MRI revealed, among other things, that I had “innumerable lesions” in my vertebrae, sacrum and marrow consistent with metastasis.

Oops.

Such an ugly word, “metastasis.”  Sounded aloud, the word hisses like a snake, and the mouth forms a sneer.  The Sorting Hat just put me in Slytherin, and I wanted to be in Gryffindor House!

The time had come to get my complementary medicine team involved.  Dr. Francis ordered a chest x-ray and blood panels, and he gave me referrals to a radiation oncologist (Anna Fariss) and to the oncologist I had interviewed two years ago (Letha Mills).  In addition to the chest x-ray (lungs are still clear!), I’ve had a CT simulation scan as preliminary to radiation therapy, a PET scan (which showed that my liver is also clear of cancer), and tattoos to mark the spots for radiation (just freckles, alas–no dragons or hearts).  I’m on day 3 of 10 days of radiation therapy.  After, Letha will put me on hormonal therapy to drive estrogen out of my body.  Kari, my surgeon, called to express her concern and to answer any questions I might have.  When I asked her when I should schedule a mastectomy, she told me that the horses were already out of the barn and my breast tumors were the least of my problems now.

Not a single soul has uttered an “I told you so” or even hinted that I got myself into this fix by choosing classical Chinese medical treatment.  One nurse (clearly a Bosox fan) wondered why I’d waited until “the bottom of the ninth” to see the oncologist again, but the line was delivered with a twinkle in her eye, and I didn’t feel judged at all.

I’ve been in bit of a whirlwind these past two weeks.  I have compound fractures in several vertebrae and it looks like I’m in peril of breaking a hip or two, so I’m pretty happy with the full court press (sticking to sports metaphors, but I have degrees from Duke and UNC-Chapel Hill, so I prefer to talk hoops).  Also, it is alarming how quickly the pain increased (even before the MRI), so I’m looking forward for the radiation therapy’s fire magic, which is supposed to ease the discomfort.  Letha assures me I’ll be able to resume all my normal activities (gardening, kayaking, traveling) in the future.

I plan to get back to classical Chinese medicine treatment with Brendan as soon as possible.  Biomedicine has been a godsend to me, but I still believe Chinese medicine will drive the cancer away for good, and maybe I won’t ever need a mastectomy.  Metastasis can be part of the healing crisis.  It would be crazy to forego biomedical treatment in light of the damage to my bones, but my body’s so darn close to kicking out the fire toxins (which radiation will add to, no doubt), that I want to continue on this path once the metastasis is stabilized.

Although it turns out that Slytherin isn’t so bad, I miss my Gryffindor friends.

 

 

 

 

 

 

 

 

 

Pain in the Butt

I think it’s fair to say that having breast cancer–actually, any cancer–actually, any chronic disease–is a pain in the ass.  In my case, it seems also to be the literal truth.

Since a dramatic auto accident in my late 20’s, I’ve totaled three additional cars (two of these accidents were Not My Fault).  No one got hurt in these crashes but me, and luckily mine were only soft tissue injuries–no broken bones, concussions, damaged organs, or blood loss.   Also, during the 24 years I lived in Boston, I was rear-ended at least eight times–once when I was sitting in a parked car!  I’ve become an expert in dealing with wrenched muscles and sinews.   It’s a lifetime challenge to keep the body’s structure reasonably in place and functional once those muscle and bone attachments get jerked around (they are not overly resilient).  If I don’t regularly stretch, strengthen the supporting muscles and get frequent therapeutic massages, even years after my last injury, the scaffolding gets stiff and rickety very quickly.

I am a huge fan of therapeutic massage.  I’ve been getting massages from Kevin for at least 12 years now.  It took years before Kevin could liberate my whip-lashed neck, and I’m very grateful to him for that.

Over the decades (wow! decades!) I’ve experimented with many exercise regimens to keep me going.  I’ve dropped out of most of them either because of scheduling conflicts, expense, or just plain boredom.  About two and a half years ago (pre-Breast Cancer Conciousness) I discovered that Pilates is the one exercise routine I look forward to.  It helps that my Pilates instructor, Betsy Ogden, is also a physical therapist, so she modifies my routine to accommodate whatever ache or pain I show up with.  I even have my own Pilates reformer at home so I can keep the training going between appointments.  I love Pilates!

Six weeks ago, though, Betsy sent me home at the beginning of our session.  I had an unfamiliar type of pain, located precisely on my sacrum, that felt hot and stabbing.  The surrounding tissue was swollen, too.  Clearly, there was some inflammation going on.  When I first noticed this new pain–in the middle of the night, of course–my first thought was “Yikes! Has the cancer metastasized to my bones?”  I dismissed that line of thinking because I didn’t want it to be true.  I was sure Betsy would show me a maneuver on the Pilates reformer to alleviate the discomfort.  It was a bit unnerving to learn she couldn’t help.

I saw Brendan the next day for my weekly acupuncture treatment.  He reminded me that our bodies store latent heat in several places, including in the holes in our bones (referred to as “foramina” in Western anatomy, “liao” in Chinese medicine).  We all have foramina, especially in our skulls, scapulae, and pelvis.  These foramina allow for nerves and blood vessels to pass through them.  The sacrum bone has 8 holes/liaos.  These liaos are so important in Chinese medicine that each one is a separate acupuncture point on the Bladder Meridian.  There’s a pulse quality on the chi position of the right wrist that indicates metastasis.  Brendan and I check it often, and that quality has yet to manifest.  We concluded that the sacrum pain was part of the healing process, the last release of latent heat before I could defecate or urinate the fire toxins out.

Common Latent Heat

Here’s the simple explanation of the Chinese concept of common “latent heat.”  When an external pathogen (akin to bacterial, fungal or viral infections) enters a body with weak Kidney Qi (usually from overwork or an intemperate lifestyle–which sums up how most of us conduct our lives!), or when an especially virulent pathogenic factor attacks and overwhelms an otherwise healthy defense system, the body’s energy pathways try to protect the vital organs by shunting the pathogens into storage areas until the body’s wei qi (defensive qi) becomes strong enough to eject it (usually by opening the pores and sweating it out).

Unresolved (not sweated, vomited or urinated or defecated out) pathogenic factors, usually introduced into the body by Wind, can cause a myriad of chronic diseases.  These p.f.’s get stored in large joints–elbows, shoulders, knees, hips.  Other storage areas are the foramina and the teeth.  Lingering smoldering heat eventually becomes full Heat and wreaks havoc in our bodies in the forms of arthritis, autoimmune diseases, AIDS, cancer, and other diseases.

Kiiko Matsumoto, one of my classical Chinese Medicine teachers (Japanese style), tells her students that, no matter what a patient comes in for, if he/she has a history of sinusitis, treat that first–pathogens lurking in the sinus cavities eventually consume fluids in the body and lead to joint pain and other inflammatory conditions.  Sinusitis, even between flare-ups, sabotages the body’s ability to heal.

Chinese medicine does not recognize the “common cold”.  Instead, it describes a progression of symptoms that follow the penetration of pathogenic factors, from the initial superficial level (scratchy throat, stiff neck, slight chills) to the deepest level (fever, body aches, juicy cough with thick green phlegm, gastrointestinal distress).  The first formulas taught in Chinese herbal medicine classes deal with treating these “Wind-Cold” and “Wind-Heat” conditions:  we learn how to identify which stage the patient is at as the pathogen travels deeper into the interior, whether the wind-cold pathogen has begun to transform into wind-heat, and whether the wind-heat is still exterior, interior, or somewhere in between.  Each stage, and each constellation of symptoms, requires a different formula and maybe some modifications.  Frankly, when I was studying all this, I thought it was a waste of time–who would take time off from work to make an appointment, pay out of pocket for the office visit, and then take these herbs (which do not work quickly) when the local drug store offers fast acting and cheap symptom relief?  We don’t huddle under blankets and sweat it out anymore.

So, probably for most of my life, with each head cold or flu bout, my body’s been sweeping these pathogenic factors under the rug, then into the closet, and then finally into my bony crevasses.

To be clear, I doubt latent heat itself directly causes cancer, but it’s probably a strong co-factor.  In truth, few cancers have a clear origin.  Latent heat does create an ideal terrain for tumor growth, though, and perhaps adds complications to treatment.

Since my diagnosis last March 2012, Brendan and I have been clearing heat out of my meridians with herbs, acupuncture, and diet.  It’s only been recently that this heat has been reduced to a small amount of residual heat in my Large Intestine meridian, the final area of concentration before clearing takes place.  Along the way I’ve enjoyed the benefit of reduced joint pain, and even an old scar from a Caesarian section, which has been tender and painful off and on since the original incision, finally calmed down.

Latent Heat Due to Cancer

Cancer, by definition in Chinese medicine, is heat–specifically, fire toxins.  Sometimes the body is able to contain the toxins by surrounding them with fat or fluids (yin, therefore cooling, substances) or by packing the toxins into bony crevasses and liaos.  Bones and teeth are also yin substances.  One of the two principle treatment strategies for cancer in classical Chinese medicine is to deliberately induce latency when the person is too weak to clear out the toxins.  It’s a stopgap strategy that buys time for the patient to build up strength and the immune system or at to least get his/her affairs in order.  Our body does this, too, by containing the fire toxins within yin substances.

Therefore, my sacrum pain clearly relates to the bones releasing the latent heat.  The question becomes, is this part of the healing process (releasing the garden variety latent heat) or is it metastasis.  It turns out that in my case, both are probably true.

To be continued…

 

Letting Go

After my woodland retreat in early May 2012, the plan was to change my life in all ways that mattered.  It’s always good to have a plan.

Plans and intentions are fragile boats on a changing sea, though.  In spite of my determination to keep an upbeat attitude toward this cancer and my treatment choices, the fact remains that the diagnosis daunts.  Even now, I can almost never forget that I have cancer.  Most of the time this consciousness remains a muted presence at the edge of my awareness, rarely interfering with what I do or think.  But sometimes I sink a bit.

I tried to keep up my Chinese medical practice, but it wasn’t fair to my patients.  Chinese medicine is an energy medicine.  During acupuncture sessions, the practitioner needs to be fully present with the patient to be sensitive to subtle changes in the patient’s energy.  To be honest, I know I’ve given acupuncture treatments from time to time while my mind and energy wandered off, but I always strove to cultivate a consistent “presence” in the treatment room.

In the months following the cancer diagnosis, I needed time to focus on my health and to regain emotional equilibrium.  Therefore, in late May I told my patients I was taking a leave of absence for the summer.  My daughter’s upcoming August wedding provided a great “cover” for this leave, since sharing personal problems with patients violates their boundaries and is unethical.  For the few who didn’t buy that excuse I admitted there was an illness in the family–as well as the wedding–that needed my attention.  (For the record, Diana and her fiance did all the work for the wedding.  My job was to show up in a nice dress and shoes.  All went well.)

At the end of August, I decided to close my practice permanently because it was unclear when or if I could ever be wholly or consistently present for my patients again.

When I returned to practice in September I announced I would retire in mid-November to current patients and closed the practice to new patients.  Most people would finish their course of treatments before R-Day, and those with chronic conditions would have time to find other suitable Chinese medicine clinics.  Turning 64 and my growing family (another grandchild on the way!) provided plausible reasons for this decision.

For many years I’ve shared my office with a muscular therapy practitioner and friend, Kevin, who agreed to take over the lease.

Earlier in the year, an acupuncturist new to the area asked to use my treatment room on evenings and weekends.  After I retired, she took over the space.  I didn’t sell my practice to Marni or give her my patient charts (unless the patient asked), but it was a relief to know my patients would have at least the continuity of the location if they wanted it.

Now, almost a year later, I can report that the decision to retire was the right one.  I did, and still sometimes still do, though, miss this work that I loved for decades.

Kevin’s keeping the office has allowed me the luxury of just walking away.  I don’t have to deal with disposing of the office furnishings, just yet, and Kevin doesn’t mind all the herbs still on the pharmacy shelves (they smell wonderful).  I’ve given all my powered herb concentrates to Brendan.  Eventually I’ll either pass along the healing roots, berries, leaves, shells, cicada husks, barks, flowers, etc. to someone who’s trained to use them, or I’ll compost them for my meditation garden.  I’m keeping the prepared herbs (tea pills and tinctures) because they remain viable for a long time, and might prove useful to me, family and friends in the future.

This beautifully laid out office became, to me, and possibly to Kevin (I’ve never asked), a sacred space for healing.  I frequently see Kevin for massage, and it’s taken a while to enter the office as “just” a client without a wistful pang.  But heck, my art collection is still on the walls that I patched and painted when I set the office up years ago, and Kevin keeps “my” potted plants in excellent health.  As I deeply inhale the earthy fragrance of the pharmacy that wafts into the waiting room, my mind and body relax to the green beings’ message that “healing is here.”

This has been a soft exit for me.  I can still imagine that, when the tumors dissolve, I can take up my career again without even having to set up a new office (providing Marni would be willing to share the treatment room).  The possibility of return made the transition less wrenching last year, and each passing month finds me more peaceful about letting go.

“Letting go,” actually, is a major theme in cancer treatment, especially in breast and prostate cancers that occur in late middle and old age.  It’s a “Dai Mai” thing.

When we were tiny blastocysts, our energetic matrix was comprised of the Eight Extra Vessels (8EVs), which roughly form an octahedron-shaped energy scaffolding within the body.  The 8EVs pretty much governed our development for our first few years, then receded deeper into our bodies when the Primary Meridians and other secondary vessels reached maturation and took over.

What’s germane to this post is the 8EVs’ influence that continues after that.  Each of the eight “mai” (“vessel” or “meridian”) controls an aspect of our life’s “curriculum” from birth to death, in a specific chronological order, following our life cycles of 7/8 years (7 for women, 8 for men).  The last stage, the final 8EV cycle, is that of the Dai Mai.

The Dai Mai is the only EV that runs horizontally across the body.  Sometimes called the “Belt/Girdle Channel,” it roughly circles the waist area.  Its job is to absorb any unresolved issues from our post-natal environment, to be a holding receptacle for all the wrongs, traumas, betrayals, and other deeply held emotions that we couldn’t deal with when they occurred.  By the time our 8th life cycle comes around, most of us have accumulated quite a lot of stuff there.  “Middle age spread” is a visual analog of these emotional accretions.

Physical symptoms of Dai Mai pathology include bloating, low back pain, a sensation of sitting in cold water, stiffness in the hips, watery ears, cataracts, glaucoma, tremors, spasms…

Emotional symptoms usually include obsessive thinking, dwelling in the past, holding on to bad habits or ineffective coping strategies, resisting change…

When we cling to whatever doesn’t serve us anymore–old griefs, old grudges, old fears, old beliefs, old failures, even old triumphs–these useless artifacts collected during our lives can congeal into physical lumps and tumors.  Uterine fibroids, prostate and breast cancers, and omental fat (from accrued unresolved stress) are all Dai Mai issues.

The Dai Mai represents the final cycle of life.  This is the time to release all that stored detritus (through diet, exercise, body work, meditation, therapy, journaling, or whatever does the trick for you).  If you jettison the junk and take down all the barriers that block your will, you’ll unfetter your energy, heal your body and create a more satisfying life. Freeing yourself from the past encourages forward movement.  Dai Mai treatment is the closest thing we have to a “reset” protocol, with the added bonus that “reset” doesn’t mean “erase.”  We get to keep our life’s experiences–all of them–but without the emotional weight that drags us down and makes us sluggish and, turns us, frankly, into boring old geezers.

“Letting go” is the plan.  Dai Mai issues, though, by their very nature and duration in our lives, can be quite stubborn!  Letting go, and I mean really letting go of past stuff, takes time, effort, and patience, but, most of all, courage.  It means examining all those painful traumas, regrets, cringe-worthy deeds, and sins of omissions, and then stripping them of their power by forgiving ourselves and others.  I’ve mentioned earlier the acupoint Zulinqi/Gall Bladder 41/”Receptacle of Tears that Should Be Overflowing.”  This point, so important for treating breast cancer, turns out also to be the Dai Mai’s “master point” (even though it’s on the foot!).  Not surprisingly, in Chinese medicine, the Gall Bladder’s energetic system is the one that gives us courage to make decisions, to act, and to make changes.

Letting go of my medical practice was the logical first step in this process, because I now have time to wade through the swampland of my considerable Dai Mai accumulations.  The last time Brendan needled Zulinqi on me, a few weeks ago, I spent the rest of the day sobbing.  It took me a long time to get to that point (pun may be intended), but letting go of those stored up tears is a great second step.  First you cry, then you decide to act and make changes.