Tuesday 1 November, 2022

The Stages of Scanxiety

Valerie is an Actor and Writer based in New York, USA. She has been diagnosed with cancer three times and is currently living with stage IV metastatic breast cancer with no evidence of disease.

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Actor and writer, Valerie David, based in New York, USA, is no stranger to the anxious feelings that cancer can bring. A three-time cancer survivor, she is currently living with Stage IV metastatic breast cancer with no evidence of disease, and has regular scans and checkups to monitor her.

In this blog, guest written by Valerie, she takes us through how she dealt with the scanxiety at her most recent PET scan.


Stage 1: The Night Before…

On the eve of my PET scan, I reflect that this test is an ongoing occurrence for me, every three months, for the rest of my life.

As my diagnosis is Stage IV metastatic breast cancer, I am thankful that there is no evidence of disease –no trace of cancer – and that I can be treated with oral medications with few side effects. I am also a grateful three-time cancer survivor, first diagnosed with Stage III Non-Hodgkin’s lymphoma in 1998, followed by Stage II breast cancer in 2014, and then Stage IV breast cancer in 2018. My proud nickname among friends and family is “The Pink Hulk,” born of my award-winning solo show The Pink Hulk: One Woman’s Journey to Find the Superhero Within that I wrote and currently perform globally. Told with warmth, sass, and humour, the show chronicles my transformation into a Cancer Hulk, a fearless warrior, and a superhero patient advocate. 

So how do I cope with this PET scan, when I am really nervous about it and don’t feel like the Cancer Hulk-Warrior? How do I go on as if this is a normal week for me, when in the back of my mind, there is the worry of cancer showing up again? Many obsessive thoughts race in my head: Will my benign treatment protocol have to change? Will I have to have more aggressive treatment? And the most important anxiety tentacle of all…will I live?

My cancer has been dormant, under the radar, since April 1, 2019. Even though I have been dealing with cancer for almost 25 years, nearly half my life, I still ask myself, ‘How do I handle this scan?’. So many emotions swirl in my head. The great thing a PET scan brings, however, is a wakeup call telling me that less stress in my life is best. It allows me to revel in whole-heartedly saying yes to what I love and vehemently saying no to what does not bring me joy. I feel more appreciative of my family and friends, tell them I love them more, hold them closer—steadfast to stay positive. 

On a dime, I turn and become positively panicked about this scan. More swirls of emotions pop up. I’m a bit testy. A bit oversensitive. A bit short-tempered, impatient, feisty, angry when things don’t go my way. On the verge of snapping like a rubber band – and then I do. After the rubber band snaps, I start to think about my dad, who passed away earlier this year from prostate cancer. It hurts to the core that I am not able to talk to him, to get the boost he always gave me when I was down. But, I can still listen to him. I have my family history on tape, and I listen to my favorite section where he meets my mom for the first time. My dad says, “I met a beautiful girl, Rhoda, at the temple singles dance, and it was love at first sight.” I am comforted by hearing his voice on the eve of my scan.

I call that girl, my beautiful mother Rhoda, now 87, to tell her, “I am scared, Mom,” and she comforts me, too. “It will be alright, Valerie. You’ll see.” 

That’s my version of scanxiety. If you have it, you’re allowed to feel whatever you want to feel and no one should tell you otherwise. I know I let myself feel and accept whatever comes up. I let those ‘Tears for Fears’ stream when I feel like crying. 

My advice on how to cope on the eve of a scan: Watch the funniest movie or TV show you can find, listen to relaxing music, get a massage, take a walk in a park, exercise at the gym, keep your mind occupied by watching game shows. My personal favorites: “Family Feud,” where I could have won $20,000 a million times over playing fast money, and “Wheel of Fortune,” where I solved so many of those prize puzzles I could have traveled to Aruba a thousand times. 

And before I go to bed, I do a meditation from Insight Timer, an amazing free app I highly recommend, and fall asleep. 

Stage 2: The Day Of…

I wake with heart palpitations. I am nervous. Seven hours until the scan. So I lie in a warm, soothing bubble bath while I play another meditation from Insight Timer. I have to fast six hours before the test, so that means I have to eat something before 9 am. I have a nutritious bowl of yogurt with almonds, blueberries, bananas, and cinnamon. As 9 am comes and goes, I keep drinking water, the only thing permitted during this fast. I phone my friend, like the Millionaire lifeline “phone a friend”, and have her on standby if I start to get mega anxious. I journal, putting pen to paper of how I feel. Writing in a journal is always a source that helps me de-stress.

Before I head to the hospital, I pack a sandwich, so I have it ready to scarf down after the scan. I know I will be “hangry” by then. I wear a piece of jewellery that has significant meaning for this scan: an elephant pendant with the trunk turned up, which means good fortune will come. I need that good fortune today. 

I arrive at NewYork-Presbyterian/Columbia University Radiology Department, water bottle in hand on a beamingly bright, cloudless fall day. I am taken in for my appointment. I prepare for it by sipping the contrast medium and finishing it in 10 minutes. Then, I’m  given an injection and have to wait up to 50 minutes for the injection to take effect. I have to lie still. No using my phone to talk or text, nor any writing of any kind. So what do I do? I listen to calming, instrumental music while I wait and take slow, deep breaths: in for four counts, out for eight. 

Now in the PET scan machine, which looks like a giant donut hole, I close my eyes and picture a Virginia Beach sunrise in my head, a magical memory from where I grew up during my teenage years. My advice: find something to visualize that brings you happiness while you are in that donut hole. For me, it’s the beach. 

The scan lasts about 15 minutes. When I am finished, I go outside and eat my cracked pepper turkey and swiss cheese sandwich, drink more water, and then buy myself a treat—a big homemade cookie with giant dark chocolate chunks. 

Stage 3: The Next Day’s Wait…

Normally, I find out the results of the PET scan the next day. My wonderful oncologist always calls me to share them. To calm me in anticipation of hearing the results, I take another bath that morning, do a meditation, and start my day. I check the portal every hour to see if the results came in, but there’s nothing posted all day. By 6 pm, I still don’t know. I reach out to my oncologist to see if she has received the results. She immediately writes back to tell me that we won’t know until Monday. UGHHH! I have to wait a whole weekend? This waiting is the toughest. I go to sleep early, but I wake up in the middle of the night with my heart pounding – it’s 4 am. Oh no. Not good. I do an “oh-crap-you’re-up-in-the-middle-of-the-night-you-better-fall-back-to-sleep” meditation, and I do fall asleep. I wake up again with a pounding heart four hours later. So I take a bath, complete a morning meditation, and go outside to take a walk in the park by my apartment. This all makes me feel at peace. I also exercise at the gym, which helps take the edge off. 

As I finish this blog, I am still waiting, with my fingers and toes crossed, for a good outcome. Then something comes to mind that I mentioned earlier: ‘Tears for Fears’, and I think of the ’80s pop band Tears for Fears and the lyrics of their 1985 hit record “Shout.”

“Shout, shout, let it all out
These are the things I can do without
Come on, I’m talking to you, come on”

I know what we can all “do without” – the stress, the anxiety from these scans. But it is there, and it is real. I know first-hand the fear you feel. So I say, “Shout, shout, let it all out.” I do just that and suggest that for you, too: Let it all out. Let all those feelings out.

“Come on, I’m talking to you, come on.” Yes, I am talking to you. I’m here to tell you that we are in this together, there for each other, fighting side-by-side as cancer patients and cancer survivors. I am here for you. I see you. I understand you. I empathize with your worry. I feel your test trepidation.

I know I will get through this weekend, waiting for my PET scan results, by keeping up with and continuing these essential coping mechanisms I’ve described, and I welcome you to use them as a way to help alleviate your own scanxiety, too. With the support of family and friends, we will get through scanxiety.

Stage IV: Never Give Up Hope

I am Stage IV, and I am surviving cancer, and so will you. And as the “Shout” song says, “I hope we live to tell the tale.” I know we will! 

As I exclaim victoriously in the last line of my play: “Never, ever, ever give up!”

*As of this posting, Valerie found out her PET scan was clear showing no cancer.

Image by Lauren Adler Photography.

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