Brain Fog and a String of Pearls

For anyone out there currently struggling:

Me, too. Brain fog is a bitch. Mornings are better than afternoons.

Healthline defines brain fog in a kinder way, “a symptom that can be caused by stress, sleep changes, medications, and other factors.” This totally applies. “It can cause confusion, memory issues, and lack of focus.” Check. Check. And check.

Then due to symptoms and medicinal side effects, I swing between anger and sadness. I’m tired of tearing up at school. I’m terrified of unleashing on a student or co-worker or even worse a friend. Lucky for me, the screaming and computer screen punching only happen at home. Something has got to give.

***

After lunch on school days, I find myself staring at my attendance screen not knowing what button to push. Students swarm me to say things of dire importance that I may or may not remember—one hands me a late essay (now to delete the zero from my gradebook until I can grade the work), one asks what she missed when she was absent (which is all online), one needs help with his paper, schedules an appointment, and later no-shows. Twenty-five chat like the teenagers they are in the background. The bell is ringing. Five more walk in late. I try to write things down. I try to decipher my notes. I try to remember to take attendance. I try to teach the Tragedy of Macbeth. Meanwhile, since lunch, here are three e-mails from parents and five e-mails from students and seven e-mails from counselors requesting updated paperwork for students with accommodations. Where are my accommodations? Can’t I get some *%#@-ing accommodations? Then I stare at the stack of 190 research papers. I exaggerate. I’ve graded 33, and 30 essays are late, so it’s a stack of 127, plus the one just turned in 128. How will I find the energy to contact those parents, not to mention the energy to grade the rest? For now, I’m a warm body in the classroom who can still teach Macbeth and throw the rest of my balls in the air.

I’ve been told a person with cancer should stick to a routine. Routine these days means taking a shower and going to school with wet hair unless I feel like lifting the hair dryer above my head. Most mornings I’m sweating my make-up off before I leave the house or I’m nauseous or both. I can tell when my blood pressure is elevated. I’ve spoken to my doctor about all of this and said I need help making it to the ends of my days and to the end of the school year. My medical team has suggested a psychiatrist. They threw around the terms—depression and anxiety—and compiled a list of doctors. I haven’t made an appointment. I’m not opposed. Just tired. If someone would make the appointment, I would show up.

Meanwhile, I’m seeking healthy ways to cope and finding.

Back in February after finishing my radiation, I watched a documentary on Netflix called STUTZ. If you’re struggling with your head space, I say, “You must-see.” Oscar-nominated actor Jonah Hill spotlights his own psychiatrist Dr. Phil Stutz and his approach to self-care. Together they share tools that take a normally unpleasant experience and make an opportunity. Dr. Stutz gives his patients notecards with visuals that “turn big ideas into simple images.” During my second viewing, I took notes:

Dr. Stutz and Jonah Hill discuss the concept of Life Force and how a person can always work on that. It’s the part of yourself “capable of guiding you when you’re lost.”

“If you think of it as a pyramid, there’s three levels of the life force. The bottom level is your relationship with your physical body…The most classic thing is [people are] not exercising. Diet is another one and sleeping.”
Dr. Phil Stutz

“Your relationships are like handholds to let yourself get pulled back into life. The key of it is you have to take the initiative…You could invite somebody out to lunch that you don’t find interesting, it doesn’t matter, it will affect you anyway, in a positive way. That person represents the whole human race, symbolically.”
Dr. Phil Stutz

“The highest tier is your relationship with yourself…get yourself in a relationship with your unconscious because nobody knows what’s in their unconscious unless they activate it. And one trick about this is writing. It’s really a magical thing. You enhance the relationship with yourself by writing. The writing is like a mirror. It reflects what’s going on in your unconscious, and things will come out that you didn’t know you knew.”
Dr. Phil Stutz

Dr. Stutz says if you work on these three things, “Everything else will fall in place.” Quite frankly, my relationships—self, others, body—have suffered in the last six months or so. I don’t feel like going out after work or talking on the phone. I don’t have much brain power for texting or writing. I don’t care to eat or exercise. I know these things have strengthened my Life Force in the past. I know…

Regardless, I talk or text with my daughter almost every day, and she means everything to me. In my passing death fantasies, I focus on my reason for living. Don’t get me wrong. I don’t have a plan for ending my life (I’ve discussed this in detail with my medical team), but I’m struggling. So—last Friday after school on Minute One of Spring Break, I hopped in my packed car and drove to Oklahoma City. I broke out of my cocoon to spread my wings for a mother-daughter weekend with Lauren and a perfect storm of culinary experiences and shopping, binging TV and deep talks.

On Sunday, we dined on Thai with my two cousins. One had COVID in November, which caused her to wake up dizzy in December. She drove for the third time since her illness just to meet us and hasn’t worked in almost four months. My other cousin said, “Savage women…” our moms are sisters born of Catherine Savage, “have always had a way of sacrificing themselves for others. Be kind to yourself, Crystal. Don’t work if you don’t have to.”

Dr. Stutz says that when adversity comes, we face a judgmental part of ourselves called Part X. I’m happy to have a clinical explanation of this. Part X is an antisocial part of ourselves that wants to hold us back from changing or growing. Part X almost told me to stay home and not attempt a seven-hour, one-way road trip. I’m happy I didn’t listen to that inner voice.

“Part X is the voice of impossibility. Whatever it is you think you need to do, it’s gonna tell you that’s impossible. ‘Give up.’ It creates this primal fear in human beings.”
Dr. Phil Stutz

When my cousin said, “Don’t work,” I remembered Dr. Stutz’s 3 Aspects of Reality:

Pain
Uncertainty
And Constant Work

Clearly, there are more aspects of reality including good things, but these are probably the ones that cause his clients to make appointments. I thought he was talking about coming to an acceptance of pain, uncertainty, and constant work, but he says we have to learn how to LOVE the process of dealing with them.

“What will make you happy is the process. You have to learn how to love the process of dealing with those three things. That’s where the tools come in. Because the highest creative expression for a human being is to be able to create something new right in the face of adversity, and the worse the adversity, the greater the opportunity.”
Dr. Phil Stutz

So while I’m learning to love cancer, symptoms, side effects, uncertainty, and constant work along the way, allow me to share one more memorable visual tool. The String of Pearls. Dr. Stutz says this is “probably the most important thing, motivationally, you could teach yourself.”

Picture this: Line. Circle. Line. Circle. Line. Circle.

Each circle is an action. Each action has the same value. The String of Pearls is about taking action. No one can put a pearl on your strand except you. Last Friday, my pearl included a seven-hour drive to see Lauren and my Grand-Pup. On Saturday, my pearl was a shower, lunch with Lauren’s friend, and arts-district shopping. On Sunday, my pearl included cousin-time, Panang Curry, and the strength of my roots. On Monday, my pearl was making the trip home and brunching with a friend along the way. On Tuesday, I wrote for the first time in a while. On Wednesday, I posted. Creation in the face of adversity. Opportunities around the corner.

Today comments are closed. I must grade.

Lessons from the Sweats

On Sunday night, I went to bed with the night sweats. On Monday morning, I woke up with them. Since the beginning of the new semester, I had missed nine days of school. To clarify, this teacher doesn’t like missing school, especially nine days in one month, but cancer. I had finished my radiation Friday and planned to return to school Monday. I don’t like breaking plans. I missed the kids. I didn’t have sub notes. I couldn’t stay home another day. I was going to school. Sweaty or not, I pulled my hair into a ponytail. Only later would I notice my horrifically crooked eyeliner. I looked like shit. I would wear a mask.

Back in 2021, I had cap and gown portraits made at Houston Baptist. The photo package included a mask with the lower half of my face. I bought it, and it’s so creepy. My smile is oversized. See? An understated message. I would fake it till I make it.

My students are working on research papers, a good plan considering my absences. Monday would be a workday. I would be available for consultation at my desk where I would sit and play catch up.

Before classes started, I searched YouTube for Snoop Dogg and clicked Dr. Dre’s “The Next Episode.” How appropriate. With the tunes on my overhead speaker, I wrote the kids a note and displayed it on my overhead projector. “I probably should have stayed home,” I said, “but I needed a sense of normalcy.” What is normal? I thought yet again. I signed the note, “with love.”

Between the gangsta hip-hop on my speaker and the ridiculous mask on my face, my students may have been more concerned than ever before. So much for faking it. My note said I needed a silent study hall. Never mind my music. Of course, they wanted to know how I was doing.

I’m not good with “How are you?” Especially with people who really care. The kids really cared. When I’m not okay, a super-sensitive version of myself sometimes appears. When my mouth opens, sometimes so do my tear ducts. I think I cried in every class that day, just trying to say I’m okay.

I CLEARLY was not okay. I possibly hit an all-time low. F-bombs exploded overhead, like a battle cry as I worked from my desk and tried to concentrate on grades and missing assignments, failures and emails, lesson plans and life. The kids seemed to get me, and through the sweats I made progress toward some goals. In the end everything was okay.

Back at home, renewed energy conquered my sweats. I decluttered a corner of my world, put away misplaced things, and patted myself on the back. Action lead to action. And Tuesday was better, and with each day came strength. Cancer has definitely been teaching me a thing or two. Here’s a favorite:

I can do hard things.

The One about Radiation

Before my first round of radiation therapy, I lay on a treatment table for a computerized tomography (CT) scan and simulation to help my doctor and team plan my treatment. They made me a custom foam mold, shaping it to my torso, with my left arm extended above head. With a purple Sharpie, someone drew a cross on the left side of my left breast, another cross on my chest, one on the outside of my right arm, another on the inside of my left arm. Then came vertical lines, one on the upper abdomen right of center and two more flanking my torso toward the back of my ribcage. Then came the hypoallergenic tape over the markings, which would help preserve the lines to quickly align my body during the upcoming treatments. I left the simulation with a gift of the purple Sharpie, for touch ups if needed. Radiation would begin eight days later.

Radiation therapy targets tissues where cancer cells remain with high-energy rays. While normal cells repair themselves between treatments, the cancer cells die. During appointments, I check in, go straight to the dressing room, and change into two gowns, the first opens to the back, the other to the front. My other clothes go into a disposable plastic bag. In the waiting room, I give a weak masked smile to three other ladies and listen. They’ve all had chemo and lost their hair, one had lost her job and health insurance, and I don’t quite fit in this conversation. Part of me feels guilty for an easier cancer. Then, like clockwork, Caroline appears and says, “Mrs. Byers?”

I stand and follow.

“What do you want to listen to today?”

“90’s rap,” I say.

She shoots me a look of surprise. “Did you say rap or rock?” I had requested indie music on Days One and Two. This was Day Three.

Still masked up, I say, “Rap.” Our eyes meet and twinkle.

She asks me my name and birthday and double checks my wristband. She waves a wand around my body checking for prohibited devices and lets me snap a few photos before we head to the treatment room.

I remove my outer gown, spectacles, and mask, lay them on a side table, and scoot onto the treatment table, my body cradled in foam. Caroline hands me earplugs—the machine acoustics are noisy—then headphones. She aligns lasers to my markings. Once positioned, I slide into the tubular machine, try to relax, breathe easy, not move a muscle. I can’t feel the treatment. It’s like having an x-ray, except the dose of radiation is higher and given over a longer period. From the other side of the wall, the team monitors via closed-circuit television, and I can call them from the tube and talk if needed. When I start to feel claustrophobic, I talk to God instead. When the sounds of the machine ramp up to an electro-magnetically induced triplicate of Dee Dee Doos layered with a Wee Woo, I can no longer hear Snoop Dogg through my headphones, but I know my thirty minutes or so in the tube is drawing to an end.

My radiation oncologist told me I may feel more tired than usual but that I won’t be radioactive. I laughed at the joke, but when she said it more than once, I realized she wasn’t joking. I suppose some people have that fear. Becoming radioactive never crossed my mind.

My fatigue has been fierce, and I puked my guts out one night. Just one. Nausea isn’t listed as a side effect, and I never get sick, well, except for the cancer, but back at home, I’m physically ill. I’m not hungry. I have no desire to move. I miss my mother. But nothing lasts forever.

Yesterday, I finished the fifth of five treatments. Five of five while others get a month, plus surgery, plus chemotherapy. Let’s say a prayer for them. I’ll be okay.

For Everything There Is a Season

Tuesday was the day. The much-anticipated day.

For the past few months, I’ve followed doctors’ orders. On a medical trial for the purpose of eliminating the need for breast cancer surgery, I’ve taken the endocrine therapy intended to shrink my small malignant tumor, and I’ve waited. On Tuesday, a slew of tests and appointments awaited: an ultrasound, a CT scan, an MRI, blood withdrawals, a COVID examination, and a visit with the radiation oncologist.

Sure enough, the real-time sonographic imaging measured a 20% decrease in the volume of my irregular hypoechoic mass with indistinct margins. The medicine that I’ve hated for blocking my hormones has finally done me a favor. It shrunk my tiny tumor, which means no surgery for me. Why can’t I say that with a little extra enthusiasm? This is such great news. Oh wait, my hormones. Going, going, gone. I wonder if I will ever feel like myself again.

For now, I stay the course with the medicine. I tell myself no feeling is final…words have power…God has my back. On Wednesday, I start my radiation, five rounds, every other day. The end. Over and done. And then I wait. Again. I let it all happen and just keep going.

3 For everything there is a season, and a time for every purpose under heaven: ²a time to be born, and a time to die; a time to plant, and a time to pluck up that which is planted; ³a time to kill, and a time to heal; a time to break down, and a time to build up; ⁴a time to weep, and a time to laugh; a time to mourn, and a time to dance; ⁵a time to cast away stones, and a time to gather stones together; a time to embrace, and a time to refrain from embracing; ⁶a time to seek, and a time to lose; a time to keep, and a time to cast away; ⁷a time to rend, and a time to sew; a time to keep silence, and a time to speak; ⁸a time to love, and a time to hate; a time for war, and a time for peace.
Ecclesiastes 3: 1-8

When God Speaks

It’s not like I hear a booming voice in the sky saying, “Crystal? Hello!” But God has a way of showing up. Like, over and over.

Once when I was fifteen or sixteen, I happened to have a severe earache while at church, my little non-denominational church in my little Oklahoma hometown. Pastor Charlie stopped mid-sermon and said, “God has laid it on my heart that there is someone here in pain. Someone with an earache. I’m going to stop and pray.” And so he prayed from the pulpit and returned to his message while I sat in the congregation awestruck. Believe me or not, my pain subsided 100%.

Then when I was twenty-one, I packed my bags with my mother’s help and loaded Drew into his car seat. I drove out of Colorado and left my young husband and the Rocky Mountains in my rearview mirror. I prayed along the way. “God, I don’t know what to do. Please. Send me a sign,” I said. It wasn’t long before Kody drove to Oklahoma to see me and Drew. Time apart had served us well. We had a happy family reunion for three. A month later when I missed my period, I took the positive pregnancy test as my sign. Thirty-one years later on a Friday night, we sit on adjacent couches. Our toes connect on the ottoman, and we smile at each other while the Astros play on TV.

God and I have been tight through the years—and sometimes not. Sort of like me and Kody. My mother once told me, “There’s a fine line between love and hate.” I’m stubborn when it comes to conforming. I tend to hold grudges when life doesn’t go my way. At times, I stick to the mantra—I can choose hope (through God) or despair, and who would choose despair? Then suddenly, I find myself despairing.

This past week, one of my students asked if she could use my room on Thursday at lunch for a meeting. Their regular meeting spot, or maybe their sponsor, wasn’t available this week. “No problem,” I said. I’m not sure I even asked what kind of meeting.

When Thursday lunch arrived, I grabbed my sad little sandwich from the refrigerator in the teacher’s lounge and returned to my classroom where a small group of some of my favorite students sat in a circle of desks. One of them read Philippians 4:6-7. “Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus.”

I sat at my desk on the opposite side of the room. I might have had some tears in my eyes. This scripture was one of my mother’s favorites. I wonder how many letters she wrote me that included this verse. Was my mother speaking? Or God? I believe they’re in cahoots.

The students took turns discussing the meaning of the words.

One said, “Whatever you’re going through, His peace is greater than your anxiety.”

Another one said, “I just know that we’re all struggling with grades and college applications, and God’s going to get us through it.” There was a pause. “We’re not going to do this on our own. God’s going to get us through it.”

And with these words, I felt convicted. How often do I try to rely on my own devices? That’s a rhetorical question.

Confession time. I struggle with alcohol. I like wine. I like bourbon, vodka, and tequila. I like the relaxation that comes from a drink or two and the comedy that ensues after three or four. According to my oncologist, daily drinking is alcohol abuse. She had the nerve to write that in my charts. Alcohol abuse. The American Cancer Society says, “It’s best not to drink alcohol” and recommends that women “who choose to drink should limit their intake to 1 drink a day.” One?! I swear, I’ve Googled this more than once hoping I’ll find a different answer. Anyway, I’m trying to make healthier choices. From the end of August to the end of September, I did great. I was practically alcohol free, but I was pretty bitter about it, and I mean, downright angry. Notice all the I’s. I. I. I. I. I. I…twelve. Then came October, and I fell off the proverbial wagon. I can’t do this on my own. The mouths of babes confirm it.

So—Thursday after school, I drove home and slipped into some leggings and a long t-shirt and my tennis shoes and went for a walk instead of pouring myself a drink. It was a gorgeous fall evening, and my steps fell to the beat of my music. YouTube picked a song for me. I swear, I think it was God again.

The Hormone Hijacking

I can’t help thinking about the history of breast cancer. How 100 years ago I probably wouldn’t have been screened. How 50 years ago surgery would’ve been inevitable. I’m not exactly sure when the outlook changed.

When I spoke to my general practitioner about my biopsy results, she thought she was breaking the news to me. Little did she know that Solis, the mammography center, had called the day before. They gave me the name of a surgeon. They said I would be having surgery within a month. I told her also about the doctor who performed the ultrasound pre-biopsy. The one who twisted his mouth when he said, “I’m sorry. We caught this early. It’s tiny.” I had been processing this almost official news of the C-word for nearly a week. I had hoped for the best, was prepared for the worst, and would be unsurprised by anything in between.

My general practitioner said that I needed to see an oncologist first. She said she knew a good one. “But you’re driving this bus,” she said. “Where do you want to go?”

I hadn’t thought that far ahead. Still, “I want to go to MD Anderson,” spilled from my lips. I can’t drive to work without seeing an MD Anderson billboard or hearing an ad on the radio. I know many-a-person who has traveled to Houston for treatment. U.S. News & World Report ranks MD Anderson as the #1 cancer hospital in the U.S. It’s seven miles from my house. ~~Duh.~~

Within days I was there. A day of more testing. Another day of meeting my team: my oncologist, my surgeon, my radiation oncologist, and my nurse practitioner.

I was told that statistically breast cancer returns at the same rate whether a person has a lumpectomy or a bilateral mastectomy. Both surgeries were options, but I had a third option. A medical trial. No immediate surgery. With such a tiny hormone-positive tumor (that means my hormones feed this cancer), I will block my hormones with a pill, once-a-day for three months. Then, I’ll have another ultrasound to check the size of my little friend. If there is no growth, I will have a round of radiation (we’re looking at January now) and stay the course with the hormone blocker. If the tumor happens to grow, I’m no longer in the trial. I would have the surgery of choice and radiation. This medical trial has fought and won for others, so I expect the same for me.

I’m a week and a day into blocked hormones, and how do I feel?

Like someone hijacked my hormones. ~~Duh.~~

Early detection and treatment is still considered the best line of defense against breast cancer. Current technology lets researchers learn at a faster pace than they did decades ago.

As technology evolves, more treatments — and, perhaps, methods of prevention — will be uncovered.
Healthline, “History of Breast Cancer”