One of the things I felt most acutely during my after cancer recovery period was overwhelmed. Although my life had come to a near standstill during my cancer treatment, when I was finished, I resumed the roles of partner, mother, doctor, writer, friend, community volunteer, and others. It didn't happen all at once, but it happened a bit more quickly than I was ready for. I began to feel what many working parents feel-the burden of too many things to do. But whereas before I became ill, I had the energy to manage the endless tasks, during my recovery I just felt that they were too much. About a year into my recovery, I had a conversation with a good friend and was explaining how I was feeling overwhelmed. She was surprised and remarked that it was impossible for her and others to tell that I wasn't completely "back to my old self." When you are undergoing treatment for cancer, it is usually obvious that you are ill. However, during the recovery phase, even your closest friends and relatives may not recognize that you are still healing. If you are feeling a bit overwhelmed, the thought of creating goals and working toward them may seem more than you can handle. As a rehabilitation doctor, I have had many, many opportunities to see how powerful it is to set goals and to reach for them during the recovery phase. For this reason and because I have seen how helpful goals have been to me, I encourage you to continue reading and to follow through with setting some goals for yourself.
Over the years I have talked to thousands of people who have faced serious illness. When I ask someone who is ill what he would most like to have in the world, the answer is never money. Instead it is some variation of having more time. It can mean more time during any given day or more time in terms of years of life. Often "having more time" is combined with "having more energy." I am convinced that people who have health issues understand in a special way the value of both time and energy. Of course, time and energy are two of the most important commodities for everyone.
So, before you become discouraged about adding new goals, and thus new responsibilities, to your daily routine, consider two things. First, the process of setting goals allows you to accomplish things that are important to you, because defining goals helps you decide what to concentrate on. What is most deserving of your time and attention as you go through this cancer experience? The second reason is that you may find that setting goals gives you more rather than less time. By choosing what to focus on, you are also making decisions about what is not a priority in your life right now.
When I talk to patients about setting goals and refocusing their priorities, they sometimes mistakenly believe that I am able to prioritize their activities. The best way I can help people to prioritize their daily tasks is to listen to them. I ask them a list of questions that you may want to consider too:
Some people are able to answer these questions easily because they have thought about them in the past. Others "just do what needs to be done" and don't spend a lot of time prioritizing what they want to do. I explain how to create a three-day log, which is something we encourage our patients to do so they can keep track of how their days are spent. It is helpful to write down what you do and how you do it, and to make a note when you are having problems. If you find yourself thinking that you don't have time to set goals or do anything new, then creating a log will be a helpful exercise for you. I talk about these things a lot with my patients; below is a typical conversation.
In reality when either I or one of the physical or occupational therapists at my center has a discussion like this with a patient, we usually have the advantage of knowing how the person is spending her time. This is where we use the three-day log. It is a great guide for us and for the patient.
I use discussions like this simply to point out that the things we do that we believe are essential tasks in our lives are sometimes not as necessary as we think. In this scenario, I used a rather stereotypical "mom/patient." This patient could have been anyone who has been doing tasks that drain his or her time and energy. I chose this particular conversation because I have had it so many times with my female patients who spend many hours each week on "preparation" tasks when what they really want to spend time on is "participation" tasks. What I mean is that for most people, the important part of the family meal is the conversation and connection that parents make with their children, rather than the preparation of the dinner.
Most parents who are recovering from a serious illness won't lose any status in the family by ordering groceries online or having dinner brought in a couple of times each week. In this scenario, I still have the mom cooking dinner most days of the week; thus, she sends the message to the children that she is caring for them in her usual manner. Usually kids don't know or care where the groceries come from, and ordering dinner in or having a special family member bring it over is a treat, not a sign of ongoing illness.
You may be thinking, "That sounds like my life," or you may not be able to relate to this scenario. The point is not whether you can save some time by ordering your groceries online but whether you can change some of the things that you are doing that drain your energy and use the time gained to help you reach your goals. If a patient tells me he is exhausted by keeping the house clean or doing the yard work, I ask him whether during this period of healing it might not be a worthwhile investment of a few hundred dollars to hire someone to help with these tasks. People tend to be self-sufficient and sometimes need to hear that it is okay not to do all the things they have done in the past. You are the best person to evaluate where your time and energy is spent. You are also the only person who can finally decide how to spend your time and energy.
Though I am sure you still have many family obligations and perhaps work responsibilities, consider the tasks that you can put aside to give yourself the time to heal. Also consider who can help you during your recovery. It often happens that friends and loved ones are in helping mode when they know someone is going through active treatment. They may bring over dinners, help with household chores, provide rides for children, and so on. When the treatment ends, the offers of support may end too-and it may happen simply because people don't understand or know how they can continue to be helpful. Rather than being "burned out," as so many cancer survivors fear, loved ones usually are happy to go on helping if they are given some direction. For example, a partner might be willing to take on additional chores around the house so that you can exercise regularly. Or a neighbor might become an exercise partner who encourages you to keep up your routine. Supportive friends are usually delighted to find ways to lessen your burden and let you focus on healing. Remember that the stronger and healthier you are, the better you can nurture loved ones when their own crises hit. Wherever you are in your recovery, thinking about some healing goals will almost certainly help you.
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