Monday, July 29, 2013

How Cancer Changed Me. And How YOU Can Change Yourself. How To Build Self Confidence, and Be Happy With YOU.

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"So, Nikhil, your liver counts are a bit up, and I've discussed it with Dr Andrews and he and I agree that you should start prednisolone as soon as possible." 

"Are you sure? We can't hold out and let the other medications take effect?"

"Umm," came the voice over the phone, "unfortunately not. It's just creeping up a bit too high and we need to get it under control. So start the steroids today."

"Okay, will do then." I muttered surlily before slamming down the phone. 

Damn... I hate that drug.   
It's a corticosteroid - a drug designed to stop my stem cell donor's immune system from accidentally killing my organs instead of the cancer cells. 

But even though it's helping me greatly in getting better, I still hate it for its side effects. 

The major ones associated with a steroid like prednisolone are much less flattering than the steroids you hear athletes getting busted for on the news. My version of steroids kept me up for way too long - sometimes 40 hours on end. It made me grumpy, all the time. It made my face look like it'd been stung by a whole beehive due to water retention. And it made me get way too fat. 

Yeah, the insomnia and moodiness was horrible. But for me, the most horrible thing about it all was the effect it had on my looks.

I mean it's not like I was god's gift to women before starting the medication, though you could be forgiven for thinking that I thought I was if you saw me posing and winking for the mirror after a shower. But I did manage to get second looks from girls as I walked down the street. And I liked that feeling. 

Losing that alone was enough to make me fall into a pit of self-doubt. But the paranoia I got from the stares that were sometimes thrown my way dug me in even deeper.

In a way, I'd always had issues with my self-esteem. A big cause of that was the remnants of self-consciousness I had in my teenage years. But gaining that extra weight and becoming moon-faced from all the water retention made me doubt myself more than I ever had before. 

The worst thing about that was that I stopped doing what I normally would because of it.

I started going out less. I didn't want to be stared at by others. 
I stopped going for runs, because I hated the idea of being judged by others as I struggled to run the measly fifty or hundred metres I could manage after my treatment. 
I stopped even catching up with friends, because I was scared of what they would think of my appearance. 

I was lucky though. I was able to change myself.

And that's the best thing that's happened to me.

So how did I do that? 
How did I even begin to manage to think that way?  How did I manage to be happy and less self conscious when I started doubting myself after taking the steroids?

The first thing I want to let you know is that it wasn't easy. 

It's not like I began thinking, "Oh yes, I'm going to be happy, no matter how hard my battle with cancer is," and suddenly became a die-hard, living life to the max, #YOLO optimist. 

It's not like I realised that, "Oh my god, I'm just stopping myself from doing what I want to do just because I fear what other people THINK about me," and then became a completely new, extroverted person straight after that. 

The first thing I did - the first thing that you have to do if you want to be more confident - is I took a step back and examined myself with as little emotion as possible. Almost as if you I was someone else peering into my mind and how I lived my life. 

When you do that, you can ask yourself why you act the way you do, and better yet, see  ways of thinking that are different to how you normally would think, and finally, work towards becoming a person who sees the world in a better light. 

But that's only half the battle. 

You've got to start acting on those ideas too. 

You won't become a new, changed person straight away. You'll face obstacles, you'll sometimes revert back to your old self, because it's easier and you've been that way for a while. 

But if you keep at it, if you acknowledge that you may sometimes fall, but get back up again after that, if you know that it'll take some time, you CAN change yourself to become a better, stronger, happier person. 

It just takes effort to get rid of the old you. 
And if you put that effort in, you'll be glad that you did so.

So how did I do it? How did I not only first see a new way of thinking about my weird looks but manage to keep seeing my struggle in that way as I went on?

It turned out that how I beat my cancer
would also help me beat my social anxiety. 

When I'd been told that I had cancer, I cried. A lot. The future just looked so hard, so depressing, so bleak at that stage that that was all I could do, no matter what my family and friends would say. 

But after crying and being depressed for a while, I just became sick of it. I didn't want to do it anymore.

I wanted to change myself. 

I started thinking about my options. I was determined not to be depressed about it anymore, but it was all still fresh in my mind. So I looked at it as if it was happening to someone else. And I began to weigh up my options that way. 

After a while, I realised that I had the disease now. I couldn't go back in time to change it, no matter how much I may have wanted to. So, going forward from here, I had a choice to make.  

I could keep being sad about it all. I could keep feeling cursed, could keep asking, "why me?" I could keep hating myself. 

Or I could think in another, more constructive way.

Because I could see myself now without getting down about my circumstance, I realised that logically, now that I had what I had, the only person I'd be harming by being that sad, negative person was me. 

In fact, I could give myself the best chance of getting better by being positive. I mean, I'd done a bit of science in high school and I knew that you always had to blind people to what they were getting in medical trails sorta thing. Why? Because sometimes, unknowingly, they would think that they were getting a medicine that could help their headaches and begin feeling better just because they thought they were, even if they were getting empty pills. I'd seen that sorta thing happen sometimes in my life as well. I mean, when I was sick, but had a basketball game in a few days, I'd keep battling on, going to school, acting like I wasn't sick and, more often than not, I'd stop coughing and feel better just in time - all because I pushed myself to feel better. On the other hand, sometimes if I had a cold or flu but wanted to make it seem worse than it was to get out of school, I'd actually get a little worse and end up spending a week or two in bed. I realised that by being positive, I could just affect my body that tiny amount and give myself that little extra chance. 
And even if that I was wrong and cancer was something that just couldn't help, logically, there was no reason why I should be unhappy. If I had only a few years left to live, shouldn't I make the most of that time?

It may seem amazing that I could see it that way. In truth though, taking that step back and looking at it without all the emotion made this the ONLY way of looking at it.

But that was only half the struggle. 

Yes, I could now see my cancer in a different more positive light.
Yes I began to think, "Hmm, so maybe being young and having cancer was a blessing, rather than a curse." 

But it's not like I ever doubted myself at all after that. 

The journey between seeing myself another way and acting like a new person took a lot of time and effort. I knew it was going to be hard, and that I'd be scared sometimes, and that I'd be in pain. But I didn't want to go back to that sad kid, crying in bed and resigning himself to death. 

So I started off with the little things. I had people around me to support me - nurses, parents and friends - and every time they gave me a bit of encouragement, I'd take that to heart and I began to grow more and more positive about my chances.

Dad told me about what my brother said immediately after being told I had the cancer and would need a stem cell transplant. Instead of crying, or getting down about it, like Dad, Mum and I had done, he asked immediately, "So how do we do this? He can get the cells from me."

I took so much out of that. My own little brother had realised that I still had a chance, and a good one at that. I mean, the power that had in giving me hope was astounding. 

But then not hours after I'd heard that, I got told that chemotherapy would start in less than 2 days. I got nervous. I was scared. I stayed up for hours past midnight the night before it was supposed to be injected, thinking of all the horrible things that could happen. Of the pain that would be coming my way in the next few weeks. Of the possible infections and even death that may come from my weakened condition. 

But I caught myself just in time and realised that I was going down that slippery slope into sadness again. So I remembered that night when I saw my predicament from another person's perspective and reminded myself that no matter how hard it was going to be, that being happy and positive about it was the best thing I could do for myself. 

That was one of many obstacles along my way. Others included taking my first steps after being in bed for weeks and gradually pushing that to being able to walk around the hospital and eventually getting back my fitness before the next round of chemotherapy would begin - another was getting over the fact that it'd be years before I'd be normal again.

Slowly, but surely, I was changing myself. I was beginning to see things in a positive light, quicker and quicker. 

And now, a few years on, doing just that has changed me so that I see everything in life in a positive way. And I'm a happier person for it.

That was my story beating cancer. 
I've been told it was amazing, but you may be thinking that it was a life threatening condition. You could argue that the dire straights forced me to change myself so much. 

So how does that help you be more confident? 

Sometimes, you'll find yourself just getting along with life, thinking that that's just who you are and that you can't change that.

What you've got to do, every now and then, is to take that step back and examine your life from another person's perspective

And you know the crazy thing? We're already doing that all the time! 
Even if you don't realise it. 
Whenever we wonder what someone thinks about us, be it family, friend or someone whose good books we want to get into, we examine ourselves deeply. We look and we look and often we see our strengths and flaws. When we look at ourselves in a mirror and criticise what we see, we do the exact same thing.

What we don't do often enough though, is try and see how we can see past those flaws, and see how we can improve that person. 

In my case, I stepped back and realised that I was actually limiting myself, and making myself depressed over how I looked. 

I asked myself, WHY? 
In the end, I realised that I was simply scared of what people MAY have been thinking about me.
Every little look in my direction from a stranger would get me wondering, "Wait a second, does that dude think I look weird?"
Every time I'd want to go for a jog, I'd wonder "Wait, what if the local kids point and stare when I start to puff out after jogging for only a minute."  
Every time I'd think of a joke while talking to friends, I'd wonder for a moment, "Wait, is that really funny? Would they even laugh?" before realising that it was already too late to tell it. 

And I realised that the worst thing was that I was killing my own happiness because of that fear of being judged by others.

And I asked myself again, WHY? 

Was it out of fear of what people were thinking of me? Well, first of all, they probably weren't even thinking those things at all! I mean who walks around looking at everyone they saw on the street and criticising them for their looks? Even if they were doing that, why was I letting them, a random person, make me sad? They didn't even know me!
And even if they did, why should I let their thoughts or words affect me? If they were laughing at me behind my back, why should that even matter? I wouldn't even know if they were! Even if they, for some odd reason, did dislike me and wanted me to know that, wouldn't I fulfilling their goals by putting myself down about what they thought about me?

So I decided that I didn't want to limit myself that anymore for what others were thinking about me. I didn't want to be the guy who had to excuse himself from get-togethers and events at uni. I didn't want to be the guy who was too scared to approach a stranger to ask them out, to have a chat, to even ask for directions. I didn't want to be putting on a different persona every time I left the confines of home and family. 

I was going to change myself so I could be happy with who I was. 

Again, it wasn't easy. It didn't happen straight away. But I took it step by step, starting off by simply saying hey to a stranger, to cracking jokes in conversations with friends, more and more, and stopping myself whenever I would walk away from something I wanted for the fear of judgement and changing myself. 

And, over a period of a few months, I managed to become happy with who I was. 

I wasn't bound by people's expectations and only limited by my OWN mind.

That's why cancer was the best thing to happen to me.

If you're reading this, why wait for cancer to be as happy as me?

This sort of thinking doesn't just apply to the things I went through. People doubt themselves, and limit themselves for a whole bunch of reasons other than getting some bad news or being paranoid of what others may be thinking about them. 
--> If you think that you're not smart,  remember that even Einstein never used more than 1% of his brain at a time. You're only stopping yourself from going for your dreams if you make that excuse to yourself. 

--> If you think you're ugly or doubt yourself, then ask yourself why - do exactly what I'd done. And trust me, guys AND girls dig confidence.  

--> If you think you're a weak or dependent person, someone who can't do what I did, the truth is you just need someone to help you get there (feel free to ask me by commenting or messaging me on this blog's FaceBook Page below).

--> If you think it's too hard, then you're only making an excuse to not take that first step and do it. There will always be another way of looking at things, and you can always try.

Too many people just live their lives without being as happy as they should because they think they can't change who they are. 

But, If by reading this, or if you just so badly, want to change yourself into a person you like - Remember, you CAN do it. 

All you've got to do is take that little step back and give it time. <-- My Facebook. If you or a loved one needs help, if you enjoy my blogs, if you want to be as happy as me, or if you're interested in medicine, like this page on facebook or comment here and feel free to message me with any questions =]

Tuesday, July 23, 2013

Humour in Hospital 1 - Mary Johnson.

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Hospitals are boring. 

When you're in there for months at a time, unable to see your friends, go to school or uni or work or even, at times, move for a while, it becomes agonising. 

There are ways to occupy yourself, sure. But you can't FaceBook or YouTube all day, not for a few weeks in a row in any case. You can't read forever. You may not always physically be able to do assignments or answer calls for work. Being stuck in a room or building for a long time is never easy. 
It's what our prison system is based on. 

But there are moments which stand out from the blur of hospital staff, time-pass and treatment. Moments which keep it all interesting. 

And they're almost always funny. 

Humour is really important for a lot of patients. It not only gets them away from boredom, but also cheers them up when life seems rough, especially kids. It can be powerful in doing those things. And the great thing is, it can come from literally anywhere - doctors, nurses, random occurrences in the hospital, or the patient can create it for themselves.

This series will be about some of the funniest, most memorable things that have happened to me while in hospital. 

Here's the first one.

It started off an ordinary night. I was recovering from a dose of chemotherapy. Not many people know this, but most chemos don't hurt or have too many immediate side effects as they're injected into the veins. When it really begins to take effect, the week or so after that, is when it gets hard.
One the common side-effects, one I was experiencing, about 2 weeks after the chemotherapies had been infused was low blood counts. For me that night, platelets were especially low, so I was getting a bag transfused at around 6pm.

My nurse for that shift came and began making sure it was actually me the platelets were for, engaging in idle banter with my mother and I as she did so. They always check with another nurse as well to make sure that there wouldn't be a mix-up. Once she was done, she put the bag up and let it run as usual. 

"Wait a second, you're Mary Johnson right?" she exclaimed as she was about to leave the room. We all laughed as she walked out, attending to another patient. She was one of the funnier nurses in the ward.

I'd had at least a hundred of these transfusions before (I'm not even exaggerating), so it was all pretty much routine for me. But 15 minutes in, my lips began feeling... heavy. It seemed like they were growing bigger, minute by minute. Soon I couldn't even close them. 

I pressed the panic button. Something was up. 

Nurses came rushing in, and soon enough, doctors were surrounding my bed. I was in anaphylactic shock - I'd had a severe reaction to the platelets. My face had swollen to twice it's normal size, I was itchy, everywhere, and my throat was beginning to swell, slowly constricting my air ways. 

I was lucky though. The nurses were fabulous at keeping me calm in such a scary situation, and the doctors were doing their job well too. Within an hour and a few shots of hydrocortisone, anti-histamines and a hit of adrenaline, I pulled out of it fine. 

It wasn't the nurse's fault. I'd had a reaction to the preservatives in the platelets, or the antibodies in them or something else in the bag. It's not like they weren't matched to me. It was only fate which made her joke seem tasteless. She stayed back almost 2 hours past her shift, helping in my recovery and keeping an eye on me after it had all settled down, visibly trembling with worry. 

The next morning, when both dad and mum were in the room with me, she peeped through the door during her shift to check up on me, even though I wasn't her patient at the time. Even though we knew it wasn't her fault, and though she knew that we didn't blame her, she was pale with guilt. 

"Morning, Mary Johnson," said Dad before bursting into maniacal laughter.

The horrified look on her face, the laughter of my parents and the reluctant chuckle she broke into after a few moments will stay with me forever. 

From that moment onwards, I knew that whenever I saw her, or whenever I'd be getting another bag of platelets - even whenever I'd be administering them, I'd think back to that night. 

But I wouldn't be thinking about the excruciating pain of adrenalin as it forced blood too rapidly through the tiny vessels in my head, or the insatiable itching all over my body or the drowning feeling as my airways were constricted by the swelling of its own tissues. 

I'd instead be thinking about the newly dubbed Mary Johnson. I'd remember the shock on her face. I'd remember my father's laughter and my mother's chiding look as he howled on for nearly a minute. I'd remember the looks of glee on the faces of the other nurses as we told them about her new nickname for work. 

And I'm glad that I can see it that way. 

All it took was 1 little joke. <-- If you or a loved one needs help or if you enjoy my blogs or if you're interested in medicine, like this page on facebook =]

Sunday, July 21, 2013

Hope in Medicine.

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I'd often wondered why after being told about being told that I had a deadly disease, everyone seemed to be trying to lift my spirits. Everyone but my doctor. 

In the end, he didn't give me a direct message of hope, ever. Not once did he say something like "Don't worry, you may have a 10 - 20% chance of surviving, but that doesn't mean you're a goner," or "I know it seems hard now, but if you go through this, you may just survive and come out a better person," or "It's okay kid, those other doctors suck compared to me."

And I can see why. As a doctor, you can't sugarcoat bad news to a patient. You just can't. You've got to be honest to them, no matter how bad it may seem. You can't go into every room and cry out "Don't worry mate, you'll be fine. Just give it a few weeks." 

Giving people false hope will, in the overwhelming majority of cases, be more harmful than telling them the honest truth. No matter how bad the news may be. To be given that hope and then have it taken away when you are told that you're terminal, or when you realise that your life is now filled with medications and restrictions when someone told you it'd all be the same is deceitful, and just cruel. 

And the worst thing is, if you do that as a physician, that patient, or his family and friends will never forgive you. And that's not easy to take. In fact, it's devastating. 

Doctors are, in the end, human.

Yet they still have one of the most important roles in helping people in their times of need, often second only to that of the patients themselves. And their opinion, words and messages are more often than not held in the highest regards by those who they're caring for. They're the professional. Of course their opinion matters. 

In my case, I held my doctor's words in the highest regard. He was the one who knew about my condition, the one who was guiding my treatment, the most vital part in my battle with cancer. And, if you've seen my last post, you'd know that I'd managed to see his words in another light to manufacture my own hope.

But not every patient will be able to do that. 

Some will resign themselves to believing that a bad prognosis or survival chance is equivalent to certain death. They may believe their life is cursed by their chronic condition, or that they're inferior and inconsequential because of their learning condition.

Being a doctor isn't only about treating a condition.

You, as a doctor, have a position of power over someone who is at their most vulnerable. You're often the one they trust the most, the one they truly believe, if only because you know more about what's wrong and how to fix it than they are. You therefore have a duty to help them out emotionally and mentally as well as physically. And to do that best, you should help them past their despair and try your best to make them happy beyond that.

You could be the only one who can do that. 

You should remember to be honest. You can't, and shouldn't make up stats or figures or make blithe statements to deceive a patient of their condition. You owe that to them, and yourself. 

And you've got to understand that some people just won't make it.

And that if it comes to that, they have to know.

No-one is immortal.

But how do you hit that balance between giving hope and deceiving someone?

It's not easy. Remember each person is different. And that some will not, or cannot, make themselves accept their disease and move past it. But that shouldn't stop you from trying to pull a patient out of their angst and misery after they've heard bad news. 

You won't happen able to impart hope straight away. They are likely to go through the 5 stages of grief - denial, anger, bargaining, depression and acceptance, even if they haven't been given a death sentence. I know I did in my condition and I've seen it in others with different diseases to me in my life too. You have to try to get them past that before you can start to give them hope, or happiness.
Maybe you could try referring them to a psychiatrist. Maybe you could remind them of the things on their side - perhaps, like in my case, their youth or things like their faith or support network. Maybe you could remind them of their usual optimistic outlook, of their beautiful personality or even of their stubbornness and why that person wouldn't be letting a little disease or condition pull them down. Maybe it's as simple as giving them someone to talk to - someone to understand them. 

Or maybe you won't have to do anything. Maybe you can't. They may, like me, come around themselves or with the help of those close to them. They may be unable or unwilling to put their grief behind them. 

In the end, you've still got to try. 

But your responsibilities as one who may have the biggest impact on how they deal with their disease go even further than just getting them past their misery.

After getting through those 5 stages, I believe there's another stage a person can achieve. But unlike the other five, not everyone will go through it. The best word I could think up to describe it is optimism. But it's not perfect, as it can imply it's only about someone believing they're going to get better.

 As a someone who they trust, you should be trying to move them there too. 

That's where it gets hard though. You mustn't make them think that they're cured, or will be 100%, or that they will have a completely normal life afterwards or that there wouldn't be pain to come in the future. But you have to convey to them that it doesn't mean that they can't be happy, or at least content in their struggle, or in their acceptance of fate. And if they do have a chance, you'll want to give them hope that they're going to get better.

But how do you do this?

First of all, be honest to them.

Remember, you can't and shouldn't kid them. But once they've accepted their diagnosis, try to make them see their new life from a different, more positive perspective. 

Remind them that it's your job to tell them the truth, no matter how hard it may be. But then make them realise that they'd give themselves the best chance of surviving, or leading a normal life or just being happy by being positive about their circumstance. The placebo effect isn't considered in all medical trials for nothing. It may not always save someone from their fate, but it's definitely able to increase their chances. And, logically, if they could give themselves that chance, then they should try. Remind them that even a 10 - 20% chance is still just that - a chance. And they should do everything they can to be in that group of people who survive, both mentally and physically.

Remind them that statistics don't mean anything to an individual. It doesn't consider your personal circumstances. They may have things on their side health-wise that others who made up that statistic or chance didn't like their youth or a more promising prognosis on their particular disease. Even if they don't, they will always have something on their side emotionally. It can be hard to see that. But you can help them understand that there will always be another way of looking at their condition.
Yes, they may have diabetes now and have a chance of developing complications due to it later in life. But when they change their lifestyle, eating habits and start to exercise, they will have a lower chance of developing metabolic syndrome or other diseases. Yes, their broken leg may stop them from work, school or sports in the short term, but it will allow them to really focus on their studies, career, kids or relationships more intensely than they could when they were healthy. Yes, their battle with addiction may be hard, but will turn them into a stronger, more happy individual when they get through it. 

And no matter how hard it may seem, if you help them acknowledge that it will be hard, but reassure themselves of the features that will allow them to get through it, they will not be stopped by obstacles in their journey as they know what to expect and know that it can't stop them. 

Even if they don't want or can't find it in themselves to see their disease in another way, get them to wonder why they should be sad or depressed because of it. They're only harming themselves by doing that. And remind them that they can make the most of life no matter what their condition. Even if they're dying. 

It won't be easy, it may take weeks, months or even years. And it's not like every patient you'll ever have will want to think that way just because you've burst in, cape billowing in the air currents of hospital air conditioning and pronounced that they've got a chance or can be happy with their lot in life. Some people will not have it in them, or may have been through too much to see it in another light. 

But your words will likely have more impact than a lot of others in their life. You have a duty to try. Even if sometimes you may get hurt. Even if you rarely get the time.

And if your support helps only one person live, or be happy despite their problem in your entire career, then you'll be glad you did it. <-- If you or a loved one needs help or if you enjoy my blogs or if you're interested in medicine, like this page on facebook =]