Wednesday 8 April, 2020

Dealing with cancer

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Every week in the War On Cancer app we post War On Cancer ‘Take Overs’. The weekly take overs are done by professionals, sharing insights into their lives, work and what they have experienced. This week the War On Cancer weekly take over is done by UllaKarin Nyberg – Chief physician in psychiatry and breast cancer survivor who shares advice on how to deal with cancer and diagnosis.

Meet Ullakarin

My name is Ullakarin Nyberg. I’m a chief physician in psychiatry working with suicide prevention and support to bereaved and at a breast cancer oncology department in Stockholm, Sweden. I started as an oncologist, but haven’t exercised oncology for a long time since psychiatry immediately felt like the field for me. I meet patients and their loved ones, tutor the personnel, research on suicide prevention, give lectures and write books. It’s in the daily meetings with people that are struggling with their lives that I learn the most and I have the privilege to learn new things every day. My job is fantastic! One thing that I have learned over the years is that people differ less than they think when it comes to reactions to disasters. Despite of this, many feel lonely in that situation. I try to inspire people I meet to trust in the power of sharing. No one can solve all your problems, especially if it’s got to do with a disease, but people can listen and try to understand and that in itself is helpful. After all, we usually remember how people make us feel, not what they said or did. So, if you are experiencing psychological reactions that frightens you or that are hard to deal with on your own, always search for help, either professional or within you network. Ask at the nearest clinic.  

Ulla-Karin Nyberg, Chief physician in psychiatry and former oncologist
Life as a chief physician in psychiatry


For me, a normal Thursday at work begins with me tutoring the staff at the breast cancer oncology department where I have been a psychiatry consultant for more than twenty years. We discuss our work plan for each patient, constantly searching for improvements. Most of the time we manage to make a difference for our patients. The individuals with breast cancer that I meet are usually struggling with painful experiences (trauma) from the past that has become harder to deal and cope with after being diagnosed with cancer. Maybe you can relate to that. After lunch, I tutor at the foreign ministry of affairs. People who work at the foreign ministry of affairs usually meet a lot of individuals in distress. So when I tutor there it usually revolves a lot around how to cope and how to manage people in distress. Once I’m done there I usually head back home to write on my new book, prepare my lectures for next week and end my day by counseling a family that just lost their son in suicide. To manage hectic days like these, and to manage continuously supporting a lot of others, I immediately change focus after finishing work. The best way for me to change focus is through exercise or to practice with my choir, Maria Magdalena Kammarkör. When you work with supporting others you quickly realise that you need to take care of yourself in order to help others in the best possible way. Many of the women with breast cancer that I meet come to realize the same thing during their process. They are used to giving their own needs a low priority, but find that life with a demanding disease makes it necessary to also focus on things that they enjoy. Many of those who I met, who’ve gone through cancer, begin to properly take care of themselves when they are diagnosed. 

Ulla-Karin Nyberg and colleagues
When I was diagnosed with breast cancer

In December 2018 I was diagnosed with breast cancer myself. I was operated and then treated with chemo, radiotherapy and estrogen-blocking pills that I am now supposed to take for 10 years. There have of course been times when I wish that this had not happened to me, but at the same time the experience of being ill has been very useful in my work.  A few things that I learned, when dealing with cancer, that I will always bring with me are:

  • Realistic routines 
    My daily routines including sleep, food, physical activities, conversations with others and cultural activities have been extremely important and helpful. They served as a protection against the chaos that breast cancer causes by providing something normal that my body seemed to remember. There were countless times when I felt too sick to even move, but after ten minutes singing in my choir, lecturing or exercising, I felt almost normal. Of course, it´s a great advantage having routines beforehand and much more difficult to build new ones during the course of treatment. Therefore, routines should not be set at a level that is too high to be realistic, but rather at a level that is always possible to reach, no matter how sick you feel. That way you can avoid getting disappointed in yourself.
  • Ask and accept help
    I am used to dealing with my own problems and rarely ask for help. That is the way I was brought up and I know that I share this with many others. The disease made me realize how important it is to be able to ask for and accept help. I practice this by always saying: ”Yes, thank you” when someone offers to help, regardless of whether I find the help useful or not.
  • Accept your reactions 
    I try to accept the situation and my own reactions as they are. It is often a waste of energy trying to change or remove your feelings and you should avoid regarding yourself as an object that needs lifelong improvements. After all, if you don´t love and respect yourself, who can? Going through a difficult treatment means that a lot of things that happen cannot be changed. They are the way they are. Fighting your own reactions makes it more difficult to endure. Instead, I have tried talking to myself with compassion and interest. ”I am going through something that is really difficult and I am so proud of myself for doing this. My body is a hero!” If we don´t waste our energy trying to change things that cannot be changed, we can use that energy for activities that help us create a balance between negative and positive. Often my reactions are completely normal, it’s the situation that isn’t.
  • Don’t overdo 
    I try to respect my limits and avoid overstraining myself. I also avoid overexplaining. That includes sometimes feeling a bit selfish, since I am not used to saying no. It is often so much easier to say yes, wouldn’t you agree? I practice phrases like: ”Thanks for asking, but I am too tired.” ”I appreciate your interest in my situation, but I have decided not to talk about my disease for a while.” ” I understand how you are feeling, but you need to take care of that yourself right now. It´s enough for me dealing with my own problems.” ”No thanks, I need to prioritize differently right now.”
  • Try and communicate your needs
    People usually mean well, but most of us are bad at guessing what a person in distress needs. Therefore, I have tried to give clear instructions to those around me, at least when I have had the energy to do so. ”If you want to help, this is what I need right now.” My husband asked me: ”How do you want me to act?” My answer was, ”The same as always, but a little bit more”. This instruction was helpful to him.
  • Balance the good and bad 
    I have accepted the loneliness of being sick. No one can remove your pain completely or share everything with you, no matter how hard they try. Some burdens you have to carry alone, others you can share. This distinction is important and worth thinking about when dealing with cancer. It is useful to pay attention to activities and situations that make you feel a little bit better, even when you are really sick. Awareness of your own tools makes it possible to use them with greater awareness and that can be helpful. If we consider life for all of us as containing things that are a burden to you and other things that are helpful in different ways, it is often easier to strengthen what is helpful, rather than to remove what isn´t. It´s the balance between good and bad that decides how your life will be.

Lots of warmth,
Ullakarin

Join the conversation and ask questions to Ullakarin by downloading the War On Cancer app
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The information shared does not constitute a medical consultation and is not intended to replace professional medical advice, diagnosis, or treatment. Consult with your doctor or other qualified health provider for questions regarding a medical condition, especially during the active period of Corona / Covid19. Please do not disregard professional health provider advice or delay in seeking it because of something you have read here.  In the event of a medical emergency, call a doctor, 112 or 911 immediately.

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