I watch as the tropical fish peacefully glide by. The bright yellows, oranges, and purples of the tropical fish contrast beautifully against the deep blue of the water. For a moment I am in my own world separate from the dozens of children darting around me this Sunday afternoon in the reef exhibit at my local Aquarium. Lost in thought, I admire the skill it requires to maintain a large and healthy salt water aquarium like this one. Then it occurs to me that my post cancer body is very much like the saltwater aquarium I stand in front of.
Saltwater Aquariums
As I snapped back from my daydream, I laughed at the thought but the concept stuck with me. As days passed, I thought about saltwater aquariums a great deal. Much precision and skill is required to keep them healthy and functioning. The salinity must be perfect. The water pH must remain balanced. The temperature must remain within range.
To keep these parameters in range you must have a strict, regular maintenance regimen. The regimen must be maintained at all cost. Even minor deviations in salinity, pH, or temperature can lead to catastrophic die offs or the tank’s Armageddon-like end of days.
Though I have always loved aquariums and have had many freshwater aquariums over the years, I have never braved the unforgiving climate of the saltwater environment. I just never felt up to the daily water quality testing, frequent water changes, algae scrubbing, mixing of perfectly balance salt water, and the myriad of other daily and weekly requirements of such high maintenance tanks. Though the saltwater fish and corals are unrivaled in their beauty, I simply wasn’t up for the challenge.
A Body With No Limits
Before my diagnosis of breast cancer at the age of 39, I was a superhuman of sorts. My body had no limits. When I was a child, I worked manual labor on the family farm from sunup to sundown. As a teen I could run miles upon miles without difficulty. For fun I went scuba diving in deep underwater caves performing extreme underwater physical exertion in cold temperatures.
In my twenties and thirties, I worked thirty hour critical care shifts in the hospital regularly. I worked for weeks on end with minimal sleep. I went twelve to sixteen hours at a time without eating, drinking, or going to the bathroom on an almost daily basis. For almost 15 years I worked 80 hour weeks in critical care units under intense stress sometimes as many as 14 days or nights in a row. I have worked days, nights, weekends, and holidays. This long term punishment was standard, it was business as usual. And my body tolerated it without complaint, a never ending well of physical tolerance.
My Changing Body
And then I got breast cancer. Just weeks after my diagnosis I had a bilateral mastectomy and spent the following four months going through an extremely painful expansion and reconstruction process. During the mastectomy they removed both breasts, cut through all the nerves in my chest, and placed rock hard expanders under my pectoral muscle.
For weeks I was unable to open a jar of sauce, lift a dinner plate, cook, or drive. My daily pain was excruciating. It took months to be able to life my arms over my head or lay flat and half a year before I could lay on my side.
After reconstruction surgery and the true recovery process began. Every movement of my upper body was work. After five months of regular expansion procedures, intense stretching of my chest muscles, and ever so slow nerve regeneration, my body was a mess.
I struggled with balance and fell several times, once leading to a broken hand. I struggled with fatigue. I had very noticeable limits. When I reached my physical limit, I was done. There was no more pushing though. My body demanded to be heard.
At work I found myself needing to sit frequently. I started to see noticeable backslides in my physical recovery when I pushed my physical tolerance in any activity but work in particular. The fatigue became overwhelming and forced me to take breaks, a need that was completely foreign to me. My body craved food and fluids on a regular schedule. It was shocking to see how much my body had changed. It forced me to reevaluate the way I lived my life, my job, my activities…everything.
Why My Post Cancer Body Is Like A Saltwater Aquarium
After my final surgery, I quickly realized my new reconstructed post cancer body would no longer tolerate the pre cancer punishment I dealt it so freely. Much as a saltwater aquarium requires very specific parameters to remain healthy and functioning, so did my new body. In the same way that a deviation from needed daily and weekly maintenance could lead to a die-off in a saltwater aquarium, I found out the hard way that any deviation from necessary post cancer self care would lead to a physical crash, burn, and backslide.
Much as a saltwater aquarium has specific requirements for salinity, pH, and temperature, I found I had very specific post cancer requirements for nutrition, hydration, and rest. These needs were not up to me. They stopped me in my tracks.
All the sudden my body would simply not tolerate my grueling, exhausting work schedule. I could no longer tolerate dehydration, skipping meals, or sleeping less than eight hours a night. If I did these things, I ended up sick in bed for days and had to work that much harder to regain my strength and energy afterwards.
One of the hardest parts of my recovery was accepting that my post cancer body was different and if I wanted to stay healthy and maintain a decent quality of life, I would have to work with my body not against it. My life would have to change.
Making Peace With My New Body
These changes did not come easily. My body’s new needs were frustrating and limiting. At times the changes in my body made me feel hopeless, angry, and sometimes sad. It was exhausting constantly hitting the wall of my own physical limitations. Having to force myself to change my habits for the sake of survival seemed so very unfair. Though I wanted to jump back into my old life, it simply wasn’t possible. It took many months to accept that my life had changed for good and I would have to learn to live within my new needs and limitations.
I eased back into physical activity. I walked and stretched. I took it slow and easy and when I overdid it, and started running before I was ready, I fell, broke my hand, and took a four month backslide. This was probably my hardest lesson on living within my new set of needs. Throughout my entire recovery, every single time I overdid it, got dehydrated, didn’t eat enough, didn’t rest enough, or over exerted, I regretted it. My body was loud and clear regarding its needs and if I didn’t listen, I ended up with illnesses, severe fatigue, or broken bones.
I finally started listening to my body and giving it what it needed. I made extra efforts to stay hydrated and eat a properly balanced diet. At work, I made a point to drink nutritional shakes on the days I couldn’t eat lunch. I forced myself to slow down, sit more, and take breaks. If I was unable to meet my nutrition and hydration needs during work, I made sure to hydrate and supplement calories as soon as I got home.
During periods of exertion, I added more protein to my diet. This was an emotional challenge given my decades long preference for a plant-based diet. Still, I gave my body what it needed even if that meant adding animal proteins such as fish or chicken into my diet during periods of stress.
I even made an effort to cut down work stress. I began taking ten hour bedside shifts instead of twelve or sixteen hour shifts. I started a second job where I remotely monitored intensive care units instead of working entirely at the bedside. Now on the shifts I work remotely, I am able to eat full meals, stay hydrated, and use the bathroom any time I need it. This is a big change and though it is hard for me to let go of the high powered bedside critical care work, I have at least cut back.
Finding Balance
Slowly but surely as I started listening to my body’s needs, I started making physical progress. Over time my walking turned to running and my stretching turned to yoga. In time I was able to go back to my preferred plant based diet. My tolerance for strenuous activity has increased and for the most part I feel pretty much back to my pre cancer level of fitness. I am again able to work the twelve to sixteen hour bedside shifts, but I choose not to. Overall, after a year and eight months of ever so slow physical progress and listening to my body, I feel pretty good.
Feeling healthy is the most important thing to me in this post cancer life and though I could probably restart that grueling pre cancer lifestyle and physically tolerate it, I have no desire to. Instead, I prefer to focus more on the self care that got me where I am today. I continue to be mindful of my body’s needs. I continue to hydrate daily, eat a balanced diet, and exercise regularly. I minimize alcohol. I make a point to sleep at least eight hours a night. If I’m tired, I rest.
As long as I continue doing these things, life is pretty good. Still, I know if I stop or allow just one of these parameters to get out of balance, I will crash and all that I have worked for will quickly fall apart. Just as it takes much time and energy to maintain a saltwater aquarium, taking care of myself requires a great deal of effort. Just as it takes much time and skill to learn how to maintain an aquarium within its needed parameters to prevent a catastrophic die off, it has taken me months to become an expert on my own body’s needs and learn to provide them every single day without fail.
Still, the effort is worth it. Healthy saltwater tanks are beautiful. To watch a healthy ecosystem thrive is extremely rewarding. My new body is also tone and beautiful. Being healthy and feeling good is beyond rewarding. It’s the best thing that has happened to me since the diagnosis all those months ago. So who knows, now that I’ve made great progress towards mastering post cancer self care, maybe there is a saltwater tank in my future. If I can survive cancer I can do anything, I’m definitely up for the challenge.
Thank you for writing this post!