Paul's Heart

Goodbye Old Friend, Again

“Hello darkness my old friend. I need to give you up again.”

Coca-cola and I go way back. In fact, nearly forty-five years ago. I delivered the morning newspapers as a teenager, and during the winter it was especially cold, and halfway through my route, I would duck inside a foyer of one of the buildings to get warm. Counter to that effort, there was a soda vending machine just outside the building, and of course, being Winter, that meant the soda would be much colder than the temperature set for the machine, giving the soda a much stronger appeal and taste. My beverage of choice, Coke. And it was good, real good. From there, I was hooked.

In the battle of Cola’s, Pepsi, RC, A-treat, or any other generic, Coke has always been my preference. It was always about the flavor. As an adult, it became more about the boost I would get from the caffeine and sugar. I regularly burned the candle at both ends, and in the late 80’s I would rely on “NoDoze” caffeine capsules to get me through.

In the 21st century however, Coke became a regular part of my diet, easily replacing the recommendation of drinking 8 glasses of water a day. I was easily drinking two to three liters of Coke a day. For the most part, my body was handling all the sugar, or at least it was assumed because it was never checked.

Then in 2008 things changed. Due to late side effects from my treatments for Hodgkin’s Lymphoma, I had to undergo an emergency double bypass, which then led to a major change in my personal care, medical surveillance.

Drinking as much Coke as I was, had a major impact on two blood tests, my A1C would eventually climbe to 9.0 (not good) which is type 2 diabetic level, and my thyroid levels ended up all wonky, which they were bad enough from my radiation treatments. Additionally, with my heart as bad as it is, all factors considered, I really need to quit drinking Coke.

(photo courtesy of ChatGPT)

I have tried multiple times. I see a date ahead, bloodwork. They are going to be looking for my A1C and my thyroid. I have three months to get my numbers corrected, and in theory, if I quit drinking the Coke during that period, they should be happy. Notice, I said “they.”

The problem comes, after my blood test. Two things generally happen following this test, I spend time away with my daughters, which means eating out a lot, or I am facing a stressful period that I need some extra energy. I cannot due energy drinks because of my heart. In both situations, the answer is simple and easy, not just fall off the wagon, I do a backflip triple flare summersault off of the wagon.

The numbers usually come back reflecting the cessation of Coke. I don’t usually lose any weight, something always pushed, in fact, this last time, I actually gained 10 pounds in 4 days. I was definitely not happy about that. I was not about to let that discourage me. I have a goal, three months from now, when I am do for my blood test.

I don’t do drugs, smoke, or drink alcohol, so Coke is really my only vice. And whether my attitude about my health, all of the issues I have from my cancer treatment late effects, it actually makes little or no difference, I am still trying.

I am pretty sure it won’t last, once August rolls around. While Coke is not “literally” addictive in the way nicotine or alcohol is, it can feel addictive, mainly because of its ingredients. Caffeine can cause dependence as a stimulant, craving it. And yes, I get headaches and fatigue hits when I stop. Then, there is the extraordinary amount of sugar in Coke which activates the brain’s reward system with a full blast release of dopamine, making you want more. And then, it is just a matter of habit, at meals, on work breaks, and as in my case, a pick-me-up. I am literally conditioned to associate comfort and energy when I drink Coke, and I end up drinking it again.

For now, I keep trying. But it is so hard right now as once again, I am battling some extreme stress, not sleeping well, and want a Coke.

June National Cancer Survivors Month

June is National Cancer Survivors Month. For me, that makes 37 times I have recognized this celebration, as a survivor of Hodgkin’s Lymphoma. I was diagnosed at the age of 22 in 1988.

June recognizes and honors all cancer survivors, support families, hopefully inspire newly diagnosed patients, and to raise awareness of ongoing challenges and issues facing cancer patients, unbelievable some still since four decades ago. Cancer survivor is broadly defined on purpose, to not leave anyone out, as ANYONE diagnosed with cancer from the moment those words get uttered “you have cancer” through the rest of their life.

There are three phases of survivorship: acute, extended, and long-term. If you have followed me here, you know all about the long-term survivorship already. But the other two phases do not get a lot of attention.

The acute phase of survivorship is the time from diagnosis through active treatment. This includes all the testing, staging (determining how bad the cancer is), and of course the treatments; chemotherapy, radiation therapy, immunotherapy, surgery, etc..

The extended phase, though with treatments having ended, can be just as difficult to navigate through, at least emotionally. It is during this part, that survivors have follow up visits to make sure the cancer is still in remission. It is also important to keep an eye out for any late developing side effects that may, not will, develop. And then the hard part, after not having any control over your life for so long, now is the time you get to do just that, get back to living your life.

Getting back to living our life…sounds easy, doesn’t it? All we want is to get back to normal, some sense of normality. It wasn’t that long ago, we remember what it was like. So why is it hard to get back to normal? And this is where I think healthcare really fails cancer patients, even after forty years.

It is not good enough just to say “OK! You’re in remission! Treatments are done! Go ring the bell and get on with your life!” For the record, there were no bells to ring back in 1990. The truth is, going through cancer is not just traumatic physically, but emotionally as well. And while your life will get back to normal, it is going to be a different normal, a “new” normal. And don’t be surprised as you go through life, that even your “new” normal changes even further. Oncologists need to include this emotional preparation of life after cancer, as part of the treatment plan.

But then there are also those in our personal life. And this is where the “honoring survivors” come into play. What we go through, or have gone through, is one of the most difficult and scariest parts of our lives. If we had a broken leg, you would send us a card. If we had a heart attack, maybe send some flowers. When it comes to cancer, those around us are more likely to disappear, for any number of reasons, but I am willing to guess it has to do with a fear of us dying. But do you know what our biggest fear is? Being alone in one of the most difficult times in our lives. No one to talk to. No one to “do us a favor” like running to the grocery store. No one to just share their day, a much needed distraction from what we are facing. No one offering to just take us for a ride to get us out of the house, away from the only the thought we have. No one to help us even attempt to feel some sort of normalcy. Just, left alone with our thoughts, about cancer.

And finally, our survivors who must never be forgotten, those who have passed before us. In my family, I have lost six members to cancer. Friends and acquaintenances I have lost dozens, well over a hundred, some never even getting to hear the word “remission.” But they were all survivors, having to face something none of us ask to do, cancer.

So, how can you honor someone who has had cancer, or someone you lost to cancer? Participate. There are plenty of events and organizations, such as Relay For Life and Stand Up2 Cancer that you can personally get involved with, and dedicate your participation. You can share stories of those you know as cancer survivors. Of course, if able, donations of gifts, not just money, but plaques, benches, trees, anything that is a physical reminder. And yes, you can donate money to cancer research or patient support organizations. Organize a scholarship or charitable fund. Volunteer.

And perhaps the best way to honor a cancer survivor, never forget them.

I want to finish this post with a great quote that I keep on my desk, that I read every day, my mantra if you will, from the late great sports caster Stuart Scott, a cancer survivor himself: “You beat cancer by how you live, why you live, and in the manner in which you live.”