Tuesday, April 9, 2013

Good News and Lessons Learned

I had my post-treatment follow up appointment with my endocrinologist this past week and she confirmed that there was no distant metastasis and I am finished with surgery and treatment for now. On some level I had been expecting this good news, but what I didn’t expect was the instant elation and the feeling of a weight being lifted from my shoulders. Once a year I will have a thyroid cancer screening, and it is something that I will always have to think about on some level. There is a 25% chance of recurrence in the next 10-20 years, and I have been on the wrong side of the odds often enough in the last year to take that statistic seriously. However, I am ready to move on and get back to living a rich and full life.

In my last blog entry I wrote about an inspirational composer named David Maslanka. It was over 20 years ago when I last had the pleasure of working with him, but I remember his lessons so clearly. I took a leap and wrote to him, sharing my story, my blog, and his influence (and asking him about a commission, but that is a story for another time…) He wrote back, honoring me with more wise words: “One of the functions of illness is to make us stop and truly pay attention to needed changes. Sometimes illness is the only thing that can get our attention.” These words resonate with me in a powerful way.

Allow me a tangential moment: Some say thyroid cancer is a “good cancer” to get, and others say cancer is cancer. Roger Ebert died last week from papillary thyroid cancer –the most common of the four kinds of thyroid cancer and often referred to as the “best” kind. I can see both perspectives. On one hand, I am so very grateful that I wasn’t diagnosed with a more deadly kind of cancer and it is absolutely amazing that there is a treatment that targets and destroys only thyroid tissue. I know that it could be so much worse. On the other hand, there is danger in minimizing something that is a serious condition. I minimized it myself, which almost prevented me from being open to the lessons that illness can bring.

After I was diagnosed, a conversation with my friends Don and Teri was a turning point for me. I began to take my condition more seriously. Don, who is a colon cancer survivor, talked about some of his reflections that came about as a result of his journey along this path of diagnosis, treatment, and recovery. Two words in particular stood out: “More joy.”

LESSON #1:  More Joy

How simple, yet profound. While I am grateful for having a career that I love, I will be the first to admit that my life/work balance is not always very good. Will I get to the end of my life and regret not working more hours? Wish I had spent less time with friends and family? That sounds ridiculous, but in reality that was the life I was living. I am so fortunate that joy is something I experience in my day to day work, but if I learn this lesson well, it will also be a more regular part of my personal life as well. Summer – bring it!

LESSON #2: Slow Down

When I had my first surgery I planned it in the perfect space between two gigs, neither of which I wanted to give up, and over Thanksgiving break, so I didn’t miss too many days of teaching. When I was faced with the reality of a second surgery and treatment, I met with my supervisor and explained the situation and timeline. He very humanely told me to take the six weeks off to take care of myself and heal. I am not exaggerating when I tell you that a wave a panic crested within me. The first words out of my mouth: “I can’t take six weeks off!” He looked at me patiently and said, “You need to take the time off.” After some back and forth negotiation, we settled on two weeks off, followed by four weeks of a reduced schedule. (I simply couldn’t abandon my students giving recitals this semester.) In retrospect, although it isn’t something I would have done without encouragement, taking the time to slow down and concentrate on taking care of myself was essential. On my better days I was able to prepare healthy food, go to yoga or acupuncture, and take walks. On my bad days, I was able to get the rest I needed and not worry about what I was missing. Making the time and space to slow down and take care of myself is a lesson I need to continue to working on. This time off was a gift, and I used it wisely. The challenge will be continuing with self-care as I return to work full time.

Lesson #3: Ask for Help

This has been the hardest lesson for me. I like to take care of people. I hate asking for help. When my friend Karen was healing from surgery, she made up “The Karen Game.” Every time she asked for help she got points. Every time someone helped her, they got points. Everyone won the Karen game! I started playing “The Tracy Game,” and I was “in it to win it” as my sister Kerri would say. When I asked my friend Morgan to set up a meal train for me at www.mealtrain.com we both got points. Everyone who brought a meal got points, and I got points for asking. When Jenny drove me to my scan, we both got points. My mom, and my in-laws got serious points for coming to Colorado to take care of me, and I got points for admitting I needed their help. What a fun and positive way to realize this simple idea: When someone has an illness, people want to help. People can’t make the illness go away, but by participating in the healing process with a meal, a gift, or a visit; they are doing something, which feels good. When I simply reversed the situation and realized I would want to help, I realized that asking for help is a way to allow others to participate in a meaningful way.

I have been overwhelmed and humbled by the enormous outpouring of support I have received. It has lifted me up and surrounded me in love. It has shone light into a dark time in my life, and made my journey far easier than if I had traveled alone.

Lesson #4: I am loved. 

Thank you from the bottom of my heart.  

Tuesday, April 2, 2013


No winter lasts forever; no spring skips its turn. ~Hal Borland

My friend Kate sent me this quote on the day of my full body scan, which was also the day of the vernal equinox. She said it was no coincidence that the scan was to occur on this transitional day.

The day began with an early morning drive over the pass to the hospital where I had gotten the RAI one week earlier. My friend Jenny drove me since I was in no condition to be behind the wheel. When we arrived, the nuclear medicine technician led us both back to the testing room. He asked me if I am claustrophobic. I said, “I don’t think so.” Well, I didn’t think so until I opened my eyes to find the machine just millimeters from my nose. Suddenly a feeling of panic developed within me. Fortunately, my rational brain quickly took over and decided that panicking was not going to help the situation. Instantly a few techniques I have practiced kicked into autopilot: breathing, audiation, and visualization.

I attend a weekly restorative yoga class where I have been in the practice of holding one gentle pose for 10-15 minutes while focusing on my breathing. This form of meditation was the first technique I used to stay calm and focused. In reality, the scan is not a difficult process, but knowing I needed to stay still in this machine for 40 minutes did take some mental creativity to manage.

Once my breathing was slow and regular, the first thing that popped into my mind was the song “Somewhere Over the Rainbow.”  At the time, that was my happy place. Why, I wondered? When I thought about it, the message for me was that reality is not always as scary as what we fear in our heads. When I was a child, The Wizard of Oz was my favorite movie…except for the tornado. I was so afraid of the tornado that I refused to visit my aunt who lived in Kansas. Reality: Tornados are dangerous, BUT the chance of being caught in one (and transported to Oz to meet a wicked witch) is highly unlikely (especially growing up in Massachusetts). Reality: Cancer can be deadly, BUT I am fortunate to have a good prognosis and to have caught it early. I am doing everything within my control to take care of myself. This is a temporary condition and I know I will get through it.

The rest of the scan was a surreal retrospective/flash forward as a 70's/80’s rock radio station played a soundtrack to my visualization of the upcoming year. Aerosmith sang to me while I visualized a visit to Las Vegas in April to see my husband perform with his percussion quartet, and to catch a few rays sitting by the pool. Elton John was my muse while I imagined a fabulous sister weekend in Denver with Kerri. Guns and Roses sang to me while I imagined a road trip in June, with my husband (and a new puppy?) to visit family and celebrate our niece’s high school graduation. Billy Joel serenaded me while I imagined a fun and epic road trip with my mom traveling from Florida to Colorado.  Finally, David Bowie sang to me while I visualized our trip to South Australia in January for teaching and performing. In my mind, this also includes lazy days at the beach, exploring Australia’s wine country, and a cage dive with great white sharks!

Although it is important to live in the present moment, there is also value in looking forward. Having something to look forward to in a time of darkness sheds light and energy on your day. Having dreams and making plans can be a positive way to remember, “this too shall pass.” Life is a series of transitions. I recall with great clarity a lecture given by the composer David Maslanka during my undergraduate years at the University of Massachusetts. He drew a shape on the blackboard that looked like this:

 He then described life as a series of these passageways:

Our whole life we transition from one wide, expansive space to another, but in order to get to the next wide, open space, we must pass through these narrow, uncomfortable spaces that challenge us. Similar to passing through a birth canal, it is a passageway to another phase in our lives. I have always remembered these wise words at challenging times in my life and the visual image is a beacon of hope. There is comfort in the certainty that the challenge or discomfort is a temporary condition and that beyond it lies the next open and expansive space.

The scan came to an end and it was time to go home. The med tech let me take a picture of my scan with my phone, and told me off the record it looked normal to him, in other words – no metastasis! You can see my thyroid bed shining like the North Star, some radiation in my salivary glands just above it, and then the path of radiation through my digestive system. 

My follow up with the endocrinologist will be April 4th and at that time I will get the official results and find out what the next steps will be. There is some concern that there is too much residual thyroid tissue left and it could mean a third surgery, but my hope is that this narrow passageway is about to give way to a new wide, open, expansive space.

I have been on the thyroid replacement hormones now for two weeks now and I dare say I am starting to feel like myself again.  My husband was home last week for his spring break and we had a wonderful time together, catching up with friends and soaking in hot springs. The weather has shifted toward spring, which means long walks along the Rio Grande and summer is around the corner.   

No winter lasts forever; no spring skips its turn.