Conquering Fear After Cancer

I take a deep breath as I stare out across the beautiful blue lake.  The water sparkles in the gentle spring sunshine.  The breeze gently tussles my hair.  The spring scenery is straight out of a postcard but I am nervous.  Today will be my first time scuba diving since being diagnosed with breast cancer a year and five months ago.  Today I am conquering fear after cancer.

Discovering a Passion For Scuba Diving

For more than a decade scuba diving has been a part of my life.  One of my husband’s major passions, I certified soon after meeting him and in many ways, we bonded under water.  It has always been something we shared.  As my own passion grew, I became more specialized.  I progressed from open water diver to advanced diver to nitrox to technical cave diver. 

For years I found zen in the achievements of underwater skill.  My husband and I explored underwater caves with some of the top cave divers in the world.  Many of these divers have become our good friends.  When you dive together you build a great deal of trust.  I trust these divers with my life.  I even expanded my medical practice from pulmonary critical care to include undersea and dive medicine.

Then Came Cancer

But then came breast cancer.  After my diagnosis, I took an immediate diving hiatus.  As a dive physician I was well aware active cancer is an absolute contraindication to diving and as much as it hurt, I had to hang up my fins for my own safety.  Soon, it became a moot point.  After the mastectomy I couldn’t even open a jar of sauce or a cabinet let alone lift a heavy air tank.  For months I was on weight restrictions and it wasn’t until well after my final reconstruction surgery that I could lift my hands over my head.  It was months until I regained full range of motion of my arms.

Divers are exposed to a great deal of physiologic stress.  Underwater they are exposed to cold temperatures, dry air, physical exertion, and through it all they must manage complex gear and perform frequent fine motor movements and tuning of gauges.  As my recovery stretched into months and then a year, I watched other divers sadly from the shore.  I wondered if I would ever be able to safely dive again.  It was a great loss among many other losses.

Self Doubt and Shattered Confidence

I was not only facing physical limitations after cancer.  My confidence and self esteem were shattered.  It seemed overnight the confident, fearless, life-saving, boundary-pushing doctor I used to be disappeared and was replaced by a patient, scared of my own limitations, no longer confident in my skill sets, constantly doubting myself, and always waiting for the next tragedy to strike.

Suddenly I doubted everything.  Could I continue to be a doctor?  Could I continue to do the activities I found fulfilling?  Could I ever get back to some form of normalcy with my newly diagnosed immune compromise?  Would the pandemic ever end?  These doubts plagued me and for many months I found myself avoiding scenarios where I would have to answer these questions.  I stopped traveling (as we all did back in 2020).  I avoided socializing.  I stopped diving.  I struggled to continue beekeeping.  I stopped gardening.  I even stopped having my hair cut.

As the losses piled up, I felt worse and worse.  True, my limitations were very real.  My immune system was weak and the world was limping its way through a pandemic.  COVID would likely be a death sentence for me.  Even a simple cold kept me in bed for 7 to 14 days.  Still, I finally had to admit that my health issues weren’t going anywhere and some of my hesitation was just good old fashioned fear.  I finally acknowledged that if I ever hoped to get my life back, I would have to take some calculated risks.

Conquering Fear After Cancer

I started small with gardening and beekeeping.  I cleaned up the overgrown backyard and restored our rock fountain.  I started putting out bird seed.  Soon the yard was a genuinely nice place to spend time.  Then I started beekeeping.  Opening heavy bee boxes challenged my upper body so instead of the heavier double stacked hives, I opted for single box hives.  I went through my hive inspections slowly and meticulously.  I was mindful of remaining patient with myself and my abilities.  Soon I found little difficulty and was maintaining the hives on a normal schedule.

 I went to visit my brother in the Keys.  It was the first trip I had taken in three years.  Days later I got sick with an upper respiratory infection and was in bed for 14 days.  I spent Christmas alone after having to cancel plans.  This was a big set back to my confidence but once I was better, I tried again.  I increased my yoga core and strength training.  I worked hard on my range of motion. I pushed forward, testing myself with stretches I hadn’t dared try since before the mastectomy.  I was stiff and often uncomfortable, but I realized I was far stronger than I thought.

Next, I cautiously went to an outdoor restaurant with a friend, rekindling a relationship that had fallen by the wayside during my cancer battle.  For days after, I waited to get sick, but I didn’t.  This gave me the confidence to try another step forward.  I joined a river cleanup crew and helped pull trash and debris out of the river.  This greatly tested my upper body strength, but I found I could pull heavy barnacle-laden scooters and bikes out of the river with little assistance.  Heavy, mud-filled tires were still too much but I gave myself a break and realized I wasn’t there.  Maybe someday.  

My success on the river cleanup gave me the courage to start running again.  The day of my first run, I faced pure fear.  Though I had always been a runner, I was wracked with fear after falling while running eight months ago and breaking my hand.  It was a long recovery and I feared falling again, but I kept an eye on my footing, focused on my balance, and pushed forward.  Soon I was running several days a week, slowly but surely building back the confidence in my own abilities I lost with my illness.

Next, I agreed to allow my husband to throw a party in our backyard.  This was a truly tough one.  Though outside, I knew there was no way I could completely mitigate my risk of infection.  We did everything we could to keep me protected.  We installed hospital grade air purifiers in our vents, we kept the windows and doors open to guarantee constant circulation, I set aside a plate of food for myself and completed avoided any communal food or drink, I stayed outside as distanced as possible, and then I said a prayer for my safety.

Sixty people showed up to the party, far more than we expected.  I enjoyed myself and caught up with many friends, but for days after waited to get sick.  But I didn’t.  This gave me the confidence to schedule an appointment the salon for a cut and dye to cover my worsening greys.  The stylist offered me an appointment on a day when there would be very few people in the salon and was completely fine with me wearing an N95 mask.  For days ahead of time I was nervous.  I was truly shocked how scared I was of something as simple as sitting in a salon for two hours.

The stylist was kind and respectful and made me very comfortable.  I walked away with a new style, my old hair color, and new confidence.  Seeing myself in the mirror afterwards I realized how badly my greys made me feel.  After my salon visit I felt much better about myself.  I felt much more attractive.

Getting Back In The Water

Finally, it was time to face getting back in the water.  It was my version of “getting back on the horse”.  Diving was my last skill to reconquer and the most physically challenging.  And so, one beautiful spring morning, my husband and my good friend made the drive with me to a beautiful lake which was also a simple and low stress dive site.

On the days leading up to the dive I was nervous.  My body had changed a great deal.  With 800 ccs of new silicone on my chest, my wetsuit fit differently.  I suspected my implants would change my buoyancy and require me to adjust the amount of weight I carried.  I also suspected it would affect my trim, my body’s position in the water.  I had many doubts.  Would I still have my old skills?  Would I be able to manage the heavy tanks?  Would I be able to handle the underwater stress of managing my gas and gauges?

As my friend and I pulled on our wetsuits she cracked jokes.  Her presence reassured me.  I admitted I was scared to get back in the water.  She was supportive and assured me that we would end the dive immediately if I was uncomfortable.  No pressure.  I was extremely grateful for her reassurance.  After a safety gear check, we put on our tanks and walked to the water.  I found I was able to carry the heavy tank on my back with little difficulty.  This gave me some relief from my nervousness.

Once in the water, my muscle memory kicked in.  It was as if I had never stopped diving.  After discussing our dive plan we were under water gliding through a world of blue.  My stress dissolved away into the beams of light filtering through the water from the world above.  My buoyancy and trim were spot on.  I had to make few adjustments.  I felt relaxed…and then happy, and then overjoyed.  I had conquered all of my major fears after cancer!

As I glided through that quiet, peaceful world of blue, I was so grateful.  I was grateful for the recovery of my body’s strength and mobility.  I was also amazed at how far I had come and how many hurdles I had crossed to make it to that underwater moment in time.  As our dive neared its end, I found myself wanting to stay underwater longer.  It was only then that I realized how much I had missed it.

Afterwards, my friend and I sat in the shade, ate sandwiches, and sipped beer by the waters edge.  For the first time since my breast cancer diagnosis, I felt at peace.  It was an afternoon of achievement.  It is a day I will never forget.