Fear

What do you fear? And what do you do with that fear?

We all have fears, big and small. I'm afraid of spiders; they creep me out. I'm afraid of fish - you know, a big fish swimming up underneath me when I'm swimming. I'm afraid of running into the bear when I'm running or hiking.

I'm afraid of not accomplishing what I set out to do. I'm afraid of not finishing the race, or bailing on a climb. 

I'm afraid of pain. And I am always afraid of my cancer coming back. Or a new cancer.

Of course, some of these fears are more based in reality than others. Really, how likely is it that a fish will swim up and bite me? (Although this fear got a new breath of life when friends, doing their first Ironman in Cozumel last weekend, told me of getting stung by jellyfish and one swimmer being attacked by a barracuda.) 

And my fears do not have equal consequences. If I don't finish a race, who cares?

But some fears have more merit. I had a high number of positive lymph nodes, so I know that I'll always be at a higher risk of cancer coming back - no matter how many years it's been. And since my cancer was such an anomaly (young, healthy, not in my family, virtually no risk factors), I sometimes fear that there's some flaw in my body that would make it easier for some other cancer to grow as well.

Two days ago I returned home to a message from my doctor's office to call - never a good message to hear. I recently had been for my annual exam - totally routine - except that once you've had cancer, nothing really seems routine again - even after 10 years. It was too late to call that day, so I got an evening full of all my darkest fears....cancer, pain, cancer, cancer, pain, oh god I'll have to tell my parents I have cancer again, I'm sure I'm not strong enough to face this again. And the next day there were problems with the phones. I didn't hear back until late in the afternoon.

Everything is normal.

Everything is normal. I should say, my body is perfectly normal. I don't feel normal after 24 hours of fear running around my brain. As I said (and many of you know), once you've had cancer, it's never routine again.

I wanted to be angry with the receptionist for putting me through that. But in fairness, she doesn't know. This is not one of my cancer doctors. She's just the receptionist doing her job. She can't leave more information in a message - patient privacy laws. And there had been some confusion - last year's Pap results were misfiled, I was never called - confusion. So they were making an effort to do things right - that's a good thing. Just bad luck that it spiked the Big Bad for me.

We all have fears, big and small. They rear their ugly heads from time to time. But what do we do with them? Do we let them define us? Keep us locked up inside, afraid to face our life? Or do we face them and use them to guide us to a better plan, to more strength?

I do my best to continue forward in spite of my fears. I swim and windsurf in spite of the fish (yes, I know it's a ridiculous fear). My heart does pound just a little faster when I get catapulted off the board out in the channel (the deepest point in Lake Michigan - you know there are BIG fish down there!). But I still go out. And I work very hard at improving my technique so that I'll fall off less often. 

And unfortunately, cancer is a real fear. I can't change that. But I won't be someone who refuses to go to doctors or have proper exams because I'm afraid of possible bad outcomes. There are people who do that, but I would rather face my fears and know. Instead, when I was in the midst of my fears, I started thinking about all my resources, gathering the tools I might need. That way I can face the challenge, make the best plan, and do my best to keep going. 

My Daily Tips on Life-Cise for the last 2 days express how I feel about my fears:

      Look your challenge square in the eye. Face it, and then form a plan. Nov. 29

      Don't let your fears define you. Use them to shape you and make you stronger. Nov. 30

Clearly the tips are sometimes just a reminder for me that I hope might also be useful to someone else. 

Julie

Happy Thanksgiving

As we express our gratitude, we must never forget that the highest appreciation is not to utter words, but to live by them. 

~ John F. Kennedy

Wishing you all peace, love, and a life full of gratitude. Happy Thanksgiving!

Julie

OT - Food in Cambodia:)

Going a little off topic.... Well, not too far OT. After all, food is an important part of a healthy lifestyle. And many of you know that I'm fairly obsessed with food - I am the person who talked about bacon when being interviewed for a profile in Fitness Magazine.

I love food - all aspects of food. I love eating. I love buying food to prepare a beautiful meal. I love attempting to grow some of my own food. I love the sight, smell, and sounds of food (the thump of a ripe melon, the sound of a sharp knife slicing through raw meat, the sizzle of food in a hot pan). I enjoy exploring what is fresh and local wherever I am. I love eating and I love feeding others. I love food.

My trip to Cambodia was a chance to explore new worlds of food. I was familiar with some flavors from other SE Asian cuisines. But, of course, food changes once it's transported to a new country. Asian food in New York is different than in Asia. In Cambodia there were new flavors and ingredients, and also new combinations of flavors.

One of the best culinary surprises came in Siem Reap, at a restaurant called Cuisine Wat Damnak. Chef Joannès Rivière uses fresh, locally sourced food to create beautiful Cambodian food. His inspiration is not only traditional Khmer food, but also the diverse culinary influences found throughout Cambodia, including Cham, Vietnamese, and Chinese. The beauty of his food comes from combining these flavors with flawless technique and balance.

Joannès came to Cambodia 8 years ago to teach cooking at the Sala Bai hotel school. The Sala Bai school is an NGO-funded school which fights poverty and human trafficking by providing training in the restaurant and hotel business for underprivileged youths. While working there, Joannes also wrote the school's cookbook, which I bought - all proceeds go to the school. (I had the chance to eat the food of one of his students when I visited Bantaey Chhmar, a small village near the Northwest border. It was quite good.) Joannès was Executive Chef at the Hotel de las Paix in Siem Reap for several years after leaving the school. Earlier this year, Joannès and his wife Carole opened Cuisine Wat Damnak.

Highlights of our meals there would have to be the braised pork shank and trotters with star anise, the frog legs with wing beans, fish soup with fish from the Tonle Sap lake, roast chicken with fire ant sauce. Oh, and I can't forget the roast eggplant, or the perfectly cooked scallops. The flavors of his dishes are bright and clear, and perfectly balanced.

I was interested in trying to get some cooking classes while in Cambodia to learn more about the ingredients and flavors. Unfortunately, Joannès does not offer classes, but he did invite me to join him for his morning trip to the market. Even better!! A trip to the market, getting to follow a terrific chef around, is much more useful and interesting to me. In a cooking class, I would watch someone else cook one dish, and write down a recipe (which I could easily read in a cookbook). But this way, I would get to know the local ingredients better and get a glimpse of some of the ways he thinks about food.

So the morning after our second meal at Cuisine Wat Damnak, I rode my bicycle to meet Joannes for coffee, and then we were off to the market. The souvenir stalls had not yet opened, but the market was bustling with food - all kinds of food. I followed along as Joannès bought his supplies for the day and checked for new items that might spark his interest.

I learned that a lot of the pork in Cambodia is imported. I was surprised to learn that almost all onions and cabbage are imported; it's not grown locally. The same is true of tomatoes. We visited the sellers who had local pork and the ones that had real, free range chickens (they're the ones that look like real birds, with legs large enough to walk on). We looked at vegetables and herbs. It was fun to match produce with flavors I had tasted the night before. I saw the wing beans I had eaten with the frog, and the local fish, which is actually just a bycatch, that had been beautifully grilled and offered as an amuse-bouche.

We looked at fish - lots of fish. There were fish imported from the coast. There were local fish from the Tonle Sap. There were bottom feeders and middle water fish, eels and shrimp. I saw buckets of tiny fresh-water shrimp which are washed and eaten whole, including the shells. I would have a chance to taste them a few nights later when we returned for our third and final meal at the restaurant. I also saw a large bowl filled with small turtles, not be eaten, but released at the temple for good blessings.

After shopping was finished, we sat down for breakfast - rice with fried pork, some lightly pickled vegetables, and soup. Delicious! And we continued talking about food and Cambodia, past and present. It was a fabulous morning - so much better than a cooking class.

When we said goodbye, I headed back in to the market to buy some fruit and some lovely young cauliflowers for snacks later while Ron and I  visited more temples. And all the while, I wished I had a kitchen. I wanted to taste, smell, and feel all of that food. I wanted to feel the textures. I wanted to smell it cooking.

I want to thank Joannès, not just for a wonderful morning, but for three of the more memorable meals I've eaten. Yes, we went three times. He changes the menu each week. After our first fabulous meal, we had to go back the next week to try the next menu. And then it seemed like the perfect place for our last meal in Siem Reap. It is slightly more expensive than some of the other restaurants in town, but it is truly a bargain for the quality of food. There are 2 fixed menus each week, a 4-course and a 5-course menu. Actually, I think a multi-course meal at just about any restaurant in town would end up costing about the same. But at Cuisine Wat Damnak, you will get something really special.

I am not in the habit of writing restaurant reviews here, but this is a very special place and a very special chef. I continued to think about each meal, the flavors and combinations, for days after. If any of you find yourself lucky enough to be traveling in Cambodia, please visit Cuisine Wat Damnak in Siem Reap.

Julie

Up In The Air

After 22-ish hours of travel - 19 of it in the air - I am home. That much air time is tough on anyone, but it can be especially problematic for those of us with or at high risk of lymphedema.

For long flights, I always wear my compression sleeve and glove (full fingered). It may not be the most comfortable clothing item I could sport, but it sure beats the discomfort of a lymphedema flare-up.

About a year after my surgery I had a couple of flare-ups. My hand and arm puffed up considerably. Luckily, I was able to get it under control by doing a lot of self-massage and exercises to stimulate the lymph system. But after the second time, my doctor had me get fitted for a sleeve. I don't need to wear it all the time, just when I'm doing some high-risk activity like being at high altitude or rock/ice climbing. Or on a long flight.

Besides wearing compression garments, there are several things we can do to help reduce the risk of edema when flying. And these things are good for general health when flying for anyone, too.

Drink plenty of water. Airplane air is dry. It's easy to get dehydrated when flying, causing the protein molecules in lymph to draw in and hold water, which can cause or worsen swelling. Drink non-alcoholic beverages often. This is also a good way to beat or lessen jet lag.

Get up and move. Sitting still for hours causes the lymph system to slow down, potentially allowing lymph to pool up in extremities. Get up (when it's allowable) and walk around a little. Do some stretching. Reach for the ceiling. Stretch your legs.

A great stretch to do on a plane is the psoas stretch. It can help counteract the effects of so many hours of sitting, which causes the psoas to tighten up and over-stretches the low back muscles....Stand up straight, step forward with one foot, keeping the back leg straight, heel on the ground. Your weight should be on the front, bent leg. The back leg should be straight with the heel down. Keep your torso up straight and push your hips slightly forward. You should feel a stretch in the fron of the hip of the back leg.

Exercise. There are a number of easy exercises you can do to stimulate your lymph system.

If you are at risk for upper-extremity lymphedema, do a lot of shoulder rolls. This can help relax you as well as help get the lymph flowing. Do some arm rotations: with your arms straight out to the side at shoulder height, make small circles to the back. Squeeze and stretch your hands. Do circles with your wrists. All of these movements will help to stimulate your lymph system. And moving your muscles helps to pump the lymph back up the arm and into your torso.

If your lower limbs are at risk, the same ideas apply. While seated, raise your heels, keeping your toes on the floor. Make small circles with your feet. Raise your feet off the ground and point and flex your feet. When you get up and walk around, spend some time standing on tip toes.

Most importantly, for both upper and lower limbs, do some ab work. If your trunk is congested, the lymph has nowhere to go. Do some tummy tucks while sitting in your chair. Sit up straight, gently draw your navel in toward your spine. Hold for a few seconds and release. You can add a rotation also. As you hold the tuck, rotate your torso 45 degrees to one side, then the other. Return to center and release the tuck. You can do the tummy tucks standing as well. Do some leg lifts. Sit up straight, slowly lift one leg, lower it, lift the other leg, repeat.

All of these exercises can easily be done in the cramped confines of economy class on a plane. Besides helping to reduce the risk of a lymphedema flare-up, they are good for your overall health. Moving as much as possible is a good way to prevent blood clots, and can help reduce jet lag. Getting a little exercise helps to keep your body functioning normally. And you'll feel less groggy at the other end of your trip.

Finally, if you have a layover, walk! You're tired and groggy, and it is so tempting to grab some food and slump down in a chair. But you'll feel so much better (really) if you just get up and walk.

I'm glad to have my 19 hours of air time behind me, and I'm wishing you healthy travels on your next trip.

Julie

Great American Smokeout - It's a choice!

Today is the American Cancer Society's Great American Smokeout. The Smokeout was started 36 years ago to encourage people to stop smoking. And this is why my Life-Cise Daily Tip for today is You have the power to choose.


It's a choice. It's not an easy choice. But it is a choice. And you do have the power to choose.

Or rather, I guess I should say it's a series of choices, because it's not a choice you will make just once. You will continue to have to make the choice. You will choose every day - many times. Each time you would normally reach for a cigarette you have a choice to make.

But you do have the power to make a better/healthier choice.

The ACS and other orgs. offer help. There are plans and tips to help you.

If you still smoke, I hope you will use this day to choose something better. Choose to quit or choose to make a plan to quit. It is the very best choice you can make for a healthier life.

I admit that I don't really know what this choice is like. I have never been a smoker. Well, there were 2 weeks in 7th grade when I tried to smoke because I thought it was cool. For the life of me, I can't understand how I ever thought it was cool. But, I was 12 - what did I know? I wasn't very good at it; I really kind of hated it. So I made a big point of "quitting".

So, no, I don't really understand the pull. But I've seen very many friends struggle with quitting. And from them I know it comes down to a choice. It's not easy, but it is a choice.

It's up to you. You have the power to choose.

Julie

Other Ideas For Staying In Shape

Stairs are not my only option for exercise on this vacation. We've been bicycling. This seemed like a good way to get around - once we got used to traffic. Riding through highway traffic at night took a little getting used to. Really it wasn't that bad once I got my courage up and just headed into the flow. Figuring out how to dodge motorbikes, tuk-tuks, food carts, and cars to make a left turn was a bit trickier. But probably the hardest thing was knowing witch side to take when faced with a motorbike or tuk-tuk coming at me on the wrong side of the road - do I take the outside or inside?

It was well worth it, though! Biking around the Angkor temples was magical.

It was also hot. So I really enjoyed my other form of exercise - swimming. My hotel had a lovely pool which I used every day. After sweating all day in upper-90 humid weather, it was great to come back and swim.

There was also some wading through rice paddies and tromping through forests in search of birds on a couple of birding trips.

I have no problem taking a little time off from training, but I've gotten used to choosing active, healthier choices for my life whenever possible. It's just become habit. If I have a choice between riding in a taxi or biking or walking, I'll make the active choice. It might not get me ready for a race, but it can help keep me healthy.

And if I run out of other things, there are always more stairs.

Julie

Keeping Up Some Leg Strength

When traveling, it can be tough to keep up an exercise regime. Sometimes running (for those of us who are runners) is not a very good option. This is certainly true for me right now. I'm in Cambodia - it is super hot, humid, LOTS of traffic. And now that I'm out of Phnom Penh, there are dogs - kind of mangy looking street dogs. They all seem pretty calm, but I don't want to test them by running past.

But since I'm visiting temples, I've got another option for keeping up leg strength: stairs. These temples are filled with stairs. Yesterday I visited Angkor Wat - still can't believe I was actually at Angkor Wat! Angkor Wat is taller than Notre Dame Cathedral. But's not just up & down once - it's up, down, up, down, up up up, down.

That should keep some muscle tone. It may not be what I would normally be doing for exercise, but it is what I can do. And it's super amazing!

Julie