Susan Hahn is moving again

Transcription

1 26 M Susan Hahn is moving again into a new home and into a new stage of life after cancer. The Chicago native had moved to Nashville in January She was engaged by that July and quickly began planning a big wedding. She and her fiancé had also just begun plans to tear down and rebuild his house, when three weeks later, BAM, I was diagnosed with breast cancer, Hahn says. It was all so surreal and seemed unreal. B y M e l i s s a M a r i n o P h o t o g r a p h b y i S t o c k p h o t o S P R I N G / S U M M E R 11 m o m e n t u m

2 I N T E G R AT I V E H E A LT H, T H E R A P E U T I C M O V E M E N T H E L P S U RV I V O R S H E A L OVING ON

3 28 he ensuing events progressed quickly. Just ten days after diagnosis, she had a right-side mastectomy and 13 lymph nodes removed. A month after surgery, she and Mark were married. A couple of days after that, they moved into a rental house in anticipation of building their new home. A mere ten days after the wedding, Hahn started chemotherapy. During chemotherapy, she also prepared for reconstructive surgery with a tissue expander. (Chemo) was pretty tough. It was a long time, and I was sick, she says. The barrage of treatments coupled with the rapid succession of other major changes in her life took a toll on her physically and emotionally. Even though the treatments were harsh, they were straightforward. But after the treatments ended, Hahn says she realized recovery was a harder thing to navigate than I thought it would be. All those changes moving, new job, new city, breast cancer, new marriage, building a house it was all pretty stressful, she says. Along with the anxiety of constantly wondering am I really well? A friend (and fellow cancer survivor) had suggested that she look into programs offered by the Vanderbilt Center for Integrative Health (VCIH) a multidisciplinary healing center that combines traditional and complementary therapies with the goal of caring for the whole patient: body, mind and spirit. Hahn brought up the idea to her oncologist, who gave her enthusiastic approval. After her initial consultation with the center s medical director Roy Elam, M.D., Hahn began yoga in hopes of regaining strength and improving her mobility before her reconstructive surgery. Not only was it painful, but when you have some new apparatus in your body, it freaks you out a little bit thinking you re going to rip it, Hahn says. But the gentle yoga practice, she said, really addressed my fears of stretching certain ways. The benefits, however, went beyond addressing her physical pain and mobility. When you start moving your body in a place where you just lost a breast or something, it s emotionally painful as well, she says. And (VCIH) is the place you want to be when you re dealing with whatever your emotional pain is. Hahn has since sampled nearly all of the programs offered by VCIH qigong, nutrition classes, counseling, massage therapy and mindfulness-based stress reduction. I was so fragile in the beginning, but I didn t want to stop moving. I wanted to climb back into my body, and this is the way to do it. BREAKING THE FALL This time of transition after the chaotic torrent of surgeries, chemotherapy and other cancer treatments ends and the life after cancer phase begins is difficult for many cancer survivors. That moment when the treatment stops it can feel like falling off a cliff, describes Rachel Mitchell, yoga instructor at VCIH. In J O H N R U S S E LL Susan Hahn credits integrative health programs like yoga and qigong for helping her climb back in her body after a breast cancer diagnosis.

4 addition to the physical limitations and fatigue that result from cancer treatment, the experience can also affect patients relationships with family members and at work. Psychotherapist and qigong instructor Michelle Foote Pearce, L.P.C., R.N., M.S.N., D.Min., sees many clients at that pivotal time. That s when some of the emotional fallout can hit, she says. And there s actually a lot more healing and recovery that needs to happen at that point. Pearce says people come to the center trying to figure out how to make sense of their experiences and move forward. Often they are very motivated to move forward into a more healthy lifestyle, to take care of themselves and their family in a different way, she notes. So that s a nice time for us to be seeing them and to offer them things to help them move forward in their recovery, whatever that might mean for them. The programs, says Elam, focus on caring for the whole person and on empowering people to take care of their own health. VCIH offers only therapies with demonstrated health benefits e.g., massage therapy, acupuncture, health coaching, nutrition counseling, psychological consultations, and classes in mindfulness/stress reduction, yoga, tai chi and qigong. In clinical practice guidelines published in 2009, the Society for Integrative Oncology, which reviews and evaluates research on various complementary therapies, noted that mind-body practices (which includes yoga, meditation, tai chi, hypnosis and relaxation techniques) can reduce anxiety, depression and mood disturbance, improve coping skills, reduce chronic pain and nausea, and improve overall quality of life for cancer survivors. Elam points out that the programs are meant to complement, not replace, a patient s traditional medical treatments by offering therapies to improve their quality of life. The center does not practice alternative medicine so there are no crystals, no herbal concoctions, no magic spells. The role of integrative medicine in cancer care is not to prolong the patient s life, although it is a wonderful thing if that occurs, says Elam, who is also an internal medicine physician. Our role for cancer patients is to enhance the quality of their life, and especially to deal with the stress and emotional response to their illness. MINDING YOUR HEALTH Some of the questions that may race through a patient s mind after a cancer diagnosis questions like: Did I do something to cause this? Why didn t I see this coming? What will happen next? How long do I have? can keep the attention on the past and future and cause tremendous fear and anxiety. A central strategy in integrative health is to calmly refocus one s attention on the present a concept known as mindfulness. Pearce describes mindfulness as a compassionate way of accepting where we are before we can move someplace else. Mindfulness is central to the approach that we take with all the types of therapies we do here because it is so evidence-based evidence that it is effective in reducing stress, enhancing the J O H N R U S S E LL Roy Elam, M.D., (left) medical director of the Vanderbilt Center for Integrative Health, says integrative health programs can improve quality of life and help cancer patients deal with the stress and emotional response to their illness. Psychotherapist and qigong instructor Michelle Foote Pearce, L.P.C., R.N., M.S.N, D.Min, (right) notes that after treatment ends, there s actually a lot more healing and recovery that needs to happen at that point. immune system, enhancing psychological well-being, says Pearce. Mindfulness is a key component of qigong (pronounced chee-gung ), a Chinese martial art that emphasizes synchronized breathing and physical movement with awareness and moving meditation. Breast cancer survivor Kathy Woods teaches qigong at the Vanderbilt Dayani Center, a medical fitness facility offering a variety of fitness and wellness programs including mind-body practices like qigong, tai chi and yoga. Woods discovered qigong when her husband, VCIH mindfulness instructor Gordon Peerman, D. Min., was developing a mindfulness-based stress reduction (MBSR) class. Yoga had traditionally been the movement practice paired with the sitting meditation in such programs. We enjoyed teaching yoga, but we found that a lot of people who came to take our class found the yoga more challenging than we wanted the experience to be for them. But we found that qigong was such an accessible movement practice everybody could do qigong, says Woods. When diagnosed with breast cancer in 2001, Woods decided to retire from her post as head of the lower (elementary) school at the University School Nashville and focus on getting herself well, which included learning more about mindfulness and qigong. Eventually she began teaching MBSR classes with her husband and offering qigong as a component of the class. Then, in 2006, Woods began teaching a qigong class for breast cancer survivors at Dayani, which has now expanded beyond breast cancer patients and is open to anyone. I ve had students in my class at Dayani who do parts of the practice sitting in a chair, and I think they still get the benefits. The gentle, choreographed movements of qigong are similar J O E H O W E LL m o m e n t u m S P R I N G / S U M M E R 11

5 30 to those of tai chi. But qigong is often easier to learn, Woods says, and therefore, more accessible and appropriate for someone recovering from an illness like cancer. From personal experience and her observations as a qigong instructor, Woods notes that qigong and related therapeutic movement practices can be a particular help to cancer survivors. If you ve had surgery or radiation, these procedures change your body. What are you going to be able to do, and how are you going to feel? This new body is not what you re familiar with. The slow, flowing movements of qigong can help strengthen Breast cancer survivor and qigong instructor Kathy Woods says that qigong has helped her feel more at home and appreciative of this embodied life than I was before I had cancer. the legs and upper back and help with maintaining and enlarging range of motion, she says. Qigong can also provide tools to deal with stress that can be applied outside of class. Each exhale, Woods says, is an opportunity to experience relaxation. Qigong is a way of toning the nervous system. With every activation of the sympathetic nervous system on the in-breath, there s a balancing activation of the parasympathetic system on the out-breath. You get more sensitized to how it feels to be energized and how it feels to be relaxed. During class, Woods asks students to notice how the energizing effects of holding the arms up overhead dissipate as the arms are lowered, and to experience the peace and stillness of that moment. The idea of settling yourself in the stillness as if it were the rest in a line of music if you can really practice that oscillation (between activation and relaxation), it becomes much more accessible. Hahn says the stress-relieving strategies she learned in qigong class at VCIH got her through an anxiety attack during a recent root canal. I closed my eyes and I visualized Michelle (Pearce), and I did some of her qigong and breathing to bring my heart rate down. It really helped, Hahn says. Though the endodontist might have thought I was a little crazy! But beyond the physical benefits, such practices can help a cancer survivor begin to feel at home in this new body that may have been altered by cancer treatments. I found that mindfulness but in particular qigong has made me feel more at home and appreciative of this embodied life than I was before I had cancer, says Woods. I think there s a kind of grace inherent in the practice that reminds you that this life is something to be grateful for every day. MOVING DAY Less than two years past her cancer diagnosis, Hahn is getting back to something resembling life before cancer. She s been able to step up her physical activity, returning to higher intensity yoga classes, working out with a personal trainer at the YMCA, and hiking a 5.8-mile trail at Percy Warner Park once a week. She still makes time every month for massage therapy and counseling and has been able to integrate what she learned from the other programs into her daily life. I m actually doing well, I feel energized enough to work full time and keep my life up and running while I try to work out every day and transition to a new house. Most of all, she s beginning to reclaim her identity, no longer wanting or needing to identify as the cancer girl. I didn t want my life to be all about cancer. I wanted it to be about health and recovery, she says. (VCIH) is not all about cancer, and that s what I like about it. That s why I m still going. You don t want to be constantly reminded that you re the cancer girl; I m just another person looking for better health. As she and her husband now prepare to move into their new home, Hahn recalls proclaiming to her architect as they were designing the house: When this house is built, I will be well. And sure enough, here I am. Even though the house isn t finished yet, Hahn sees the beauty in it just as it is today acceptance that she carries into her perspective of life after cancer. It s a beautiful house. It s in various stages, she says. But we re all in various stages. J O E H O W E LL S P R I N G / S U M M E R 11 m o m e n t u m

6 31 THRIVING AFTER CANCER Breast cancer survivor Adrien MacKenzie isn t satisfied with simply being a cancer survivor. She wants to be a thriver. It s going to be a while before I get over that I just got over chemotherapy look, she acknowledges, but I don t want to always identify as the cancer patient or cancer survivor in the room. MacKenzie, a physical therapy assistant at Vanderbilt s Dayani Center, is on a committee charged with developing a research project called Restore Wellness: Cancer Thrivership Program to determine how best to help cancer survivors thrive. She suggested incorporating the idea of thriving into the project s name. The thing about thrivership for me, it just had a more positive connotation about moving forward with one s life, MacKenzie says. The project, a collaboration between Vanderbilt s Center for Integrative Health, Dayani Center and REACH for Survivorship Program, will offer cancer survivors a series of educational and wellness programs, and determine which ones they find most beneficial. The healing and recovery process for cancer survivors often involves much more than standard medical treatment, says Debra Friedman, M.D., medical director of the REACH for Survivorship Program and director of Pediatric Hematology-Oncology at Vanderbilt. Research like this will guide us as we continue to develop a comprehensive wellness program for cancer survivors, focused on all aspects of their healing mind, body and spirit. Physical activity, getting moving again, is an important part of recovery. One of the biggest predictors of survival in general for cancer patients is the amount of sweaty exercise you get per week. And there s a lot of evidence for that, particularly for breast cancer, says MacKenzie. Participants will attend a structured class on Saturdays, which will include an educational session on topics ranging from mindfulness to nutrition and a guided movement class like qigong, yoga or traditional exercise. Then, during the week, participants can freely choose to attend one of the classes offered at VCIH or Dayani. The goal is to give participants the structure to support their wellness, but also start to participate themselves in deciding what is best for them and what is healthy, says Rachel Mitchell, a yoga instructor at VCIH. Cancer survivors often have some specific needs to address, like nausea and peripheral neuropathies that can result from cancer treatments. And while many cancer survivors experience weakness and fatigue well after treatment has ended, the physical activity components of the program will be gentle enough for most participants. Many of our classes, especially gentle yoga, have been designed for and our instructors have experience with understanding what individual students in front of them are dealing with on a physical level, says Michelle Foote Pearce, L.P.C., R.N., M.S.N., D.Min., a qigong instructor, psychotherapist and nurse at VCIH. I think this study is so exciting because it s designed to help give people some tools to sort of begin to introspectively ask what they need for their own health and wellness moving forward, but with structure so that it doesn t feel like jumping off a cliff, says Mitchell. The mind-body integration factor of this program is going to be important for giving people the opportunity to get some professional instruction on what their limitations should be, so they don t over-limit themselves or expect too much of themselves, says MacKenzie. The combination of muscle-building, cardiovascular, and the more restful, meditative activities (such as qigong and tai chi) will give people J O E H O W E LL Physical therapy assistant Adrien MacKenzie wants to do more than survive breast cancer she aims to thrive. a better sense of their own bodies and help control some of the fear factor that goes along with being a cancer patient, MacKenzie says. She hopes participants will learn it is possible to not only survive, but to thrive after cancer. People who feel like it s been beyond them to stay in shape while being a cancer patient may have a chance to discover that it s possible to do it. Although the definition of in shape may have to change, it really is possible to fight the cancer while you keep your body well. For updates on Vanderbilt s comprehensive cancer wellness program, please visit - by Melissa Marino m o m e n t u m S P R I N G / S U M M E R 11