Arnie’s Rebounding World: The Idea Of The New Normal
The cancer world is full of clichés. We are inundated on a daily basis with expressions, such as “the long and courageous battle,” “stay positive,” “survivor,” “every day is precious,” and now of course, pink ribbons.
One of the most common cancer clichés is the idea of the “new normal.” After a cancer diagnosis or cancer treatments, people constantly toss around the term new normal. But what does this really mean?
When I was younger, in my twenties and thirties, I was an avid runner. It was what I did and part of how I defined and thought of myself. I could not think of myself as anything but a runner.
Because of arthritis in my knee from an old injury and surgery, pain began to make running very difficult, and I was forced to face the fact that I would not be able to continue doing it. I was depressed and disheartened but I did stop.
I was forced to find other outlets and began swimming and cycling. In a short time, these turned out to be equally enjoyable and, in the long run, much better for me.
Now I know that in the grand scheme of things this is trivial, but the point is that I, against my will, was forced to adapt to a new circumstance and in the long run was better off for it.
All of us, as we go through life on a certain course, we envision a future based upon that course. We plan and project things into the future based upon that vision: meeting certain career goals, working to a certain age, seeing children graduate and get married, having grand kids, and reaching a happy, active retirement.
But as everyone knows and certainly people who are reading this column are acutely aware, things don’t always go according to plan. Bad stuff happens, a serious accident, the death of a child or spouse, a diagnosis of cancer.
Suddenly we are faced with a new set of circumstances. Our ordered vision and expectations of the future are thrown into chaos. Goals, plans, and aspirations suddenly seem meaningless.
The first response can be anger or depression. It wasn’t supposed to be this way, and initially it’s difficult to see things being another way.
But it’s really about adjusting expectations. People are much more resilient than they might think, and the human mind has an incredible ability to adapt, adjusting to the new normal.
Dr. Jerome Groopman, one of my favorite medical writers, has written a great new book called ‘Your Medical Mind’ about how patients make complex medical decisions. In his book, he addresses the issue of how people adapt to serious medical conditions. “What we first imagine to be severely limiting can prove to be less destructive to quality of life because we find alternative sources of gratification…Many of us adapt to frustrating and debilitating situations to a degree that surprises us,” writes Dr. Groopman.
He goes on to note that research studies have shown over and over that, at least initially, people will overestimate the impact of their illness on their happiness. “We often underestimate the reservoir of our resilience, the fact that we can adapt and regress and adapt again. Over time, we learn to expand those parts of our life that will provide gratification and seek fulfillment in venues we had previously overlooked,” notes Dr Groopman.
I think that there are a couple of different aspects of this to look at. There is a gradual transition from accepting the new circumstances, the new normal, to actually adapting to them. And there are different types of adaptation that have to occur. There is a difference between adapting to living with the cancer diagnosis and living with the physical changes that go along with having cancer or are the results of treatment side effects.
Living with the cancer diagnosis is an emotional change and adjustment. You are faced with a whole new set of expectations and visions about what the future will be, new uncertainties, the constant elephant in the room.
The cancer and treatment side effects impose new physical limitations that need to be adjusted to as well. Working at your job may no longer be possible but there are many other avenues of being productive and finding self expression. Exotic adventure travel may no longer be possible but one might find satisfaction with armchair travel by reviewing great travel literature.
The new normal is not static. It’s not just a matter of all of a sudden after the diagnosis, everything changes and then we adjust to a new normal.
This new normal is in a constant state of flux. New results, new side effects, and medication changes are constantly changing the outlook and expectations. Multiple times over the course of my treatments, I have had to adjust to new results presenting new circumstances, both good and bad.
At the risk of sounding like the clichés I am trying to avoid, the new normal is an opportunity, a chance to view it as a positive. There are many avenues to feeling happy and fulfilled; they may just not be what we had originally envisioned.
Arnold Goodman is a multiple myeloma patient and columnist at The Myeloma Beacon.
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Thank you for a very real, very applicable article. As I face career decisions as to whether and how to continue my Gyn medical practice, your experience is a great guide. There are many opportunities, even blessings which have presented themselves since my MM dx in July. Now I face an ASTC next month, and am looking forward to using this exile from everyday life to seek answers and guidance for the next stage of my life, as precious as it is. I hope we can touch base; I would love to have a conversation with you. Happy holidays (Holy Days!), Jan
Thanks for a great article. I have shared it with my sister, Deana, who is Day 20 today.
Dear Dr. Goodman,
This a wonderful, insightful, and inspiring article! It spoke to me on a number of levels even though I'm just a "caregiver". (I consider it an honor to be my mother's caregiver!!) I'm printing your article to share with Mom, and I know that she'll appreciate it as much as I do!
Many thanks and blessings,
Lisa B.
Thanks for writing this article. Everything you said, I can relate to. I used to hike,backpack etc. I have had to adjust,like you said, and be happy I can walk 1 1/2 mile every other day. I've had a drug vacation for six months and it's been great, but next month will probably start rev/dex again. So let the fun begin .
Thanks Arnie for putting into words what we all need to hear.
Christina
Thanks Dr. Goodman, for your inspiring and very true article. We have not only to deal with age related changes as we get older, but also having MM makes it more challenging than it otherwise would have been. I used to jog and did a lot of 10K's and even half marathons, but quit because of osteoarthritis in the knees... have good memories of those days. Now we like to do short hikes, sometimes in the Rockies. We also have the opportunity to use a good swimming pool, walking/cycling pathways, and a gym, and try to stay as fit as possible, and we travel as much as we can, being mindful of health issues. Happy holidays to you and your family!
Hi Lisa, there is no such thing as 'just' a caregiver. Those of us who are lucky enough to have had wonderful caregivers in our lives know that you are ANGELS!! Sometimes I think it is harder to be a caregiver than a patient...you are so kind and caring, it is fantastic!
Having two of our children laid off from their jobs, I was impressed with how this article can apply to any troubled spots in our lives. I'm sending this off to them
Bumps in the road come in big and small sizes, and it is truly amazing the ability God gives us to adjust.
This Christmas let us pray not only for the cure, but for the grace to survive "well" while we wait.
Thanks to all care givers, Lisa, and especially to my husband.
Outstanding article.Often in introspective moments think about how life changes, sometimes very quickly. Regardless of the circumestances how we adapt will often be crucial to our future productivity and happiness.
Thank you for the inspiring article. I can really relate to it. I have been dealing will Multiple Myeloma for 1/12 years now, and just celebrated my 1 year stem cell anniversary.I only have had a partial response to the transplant.The new normal is just adapting to the present situation and moving with it. It is never easy, but as you said "People are much more resilient than they might think".I keep try to go with the changes of each new results, med, and programs. Having people around you that love and care for me is definetly half the battle. I enjoy your articles.
Happy Holidays,
Patrick
Dr. Goodman: Great insight into how MM affects all our lives. My husband's "new normal" is whatever he is able to do on any particular day, or at any time.
It has been quite an adjustment for both of us, but we're so happy for whatever he is now able to do.
Those of us that are caregivers know that it's often akin to a second job. So Lisa, you definitely aren't "just" a caregiver. How lucky your mom is to have you in her corner, taking care of her.
Wouldn't we all love to have those "normal" days back.....before MM. But how fortunate we are that there is terminology like "new normal" to define what our loved ones are able to do.
Happy holidays!
Wow, Dr Goodman, what a wonderful articulation of the reality we face on an ongoing basis. I don't think it is cliché nearly as much as it is ubiquitous... at some point we ALL have to deal with a "new normal" at a greater or lesser degree.
You are also spot-on when you write that we have an amazing capacity to adapt. I am now 15 months into this new normal, and the amount of change that has been part of my life over this period, and the level of acceptance of those changes, has been nothing short of remarkable to experience. If someone had told me 2 years ago that I would be bed-ridden for 5 months, and that I would thereafter never be able to do "real work" again (I spent my life doing physically demanding activities), and THAT I'D BE BY-AND-LARGE OK WITH THAT, I'd assuredly have at the least laughed at that person... yet that has in fact been the case. It's certainly a blessing to have that level of adaptability, I must say.
And Lisa: let me join the chorus above in telling you that caregivers are full-on heroes to us going through this. My Beloved has literally make it possible for me to live a normal (yes, New Normal) life that has dignity and meaning... I have often thought that going through this process alone would be a very difficult, even untenable, reality. So thank those of you who become so increasingly important to us who are temporarily disabled as we adjust!!
Your column was a real boost and certainly not a cliches. Strange world this MM cancer. The "new normal" is really like anyone waking up in the morning and beginning a new day because all of our normal is "new". Your insight was/is appreciated. Thank your for sharing.
Dr. Goodman: Thank you for taking time to write for this column! Since I have discovered this web site, I try to read everyday. My "new normal" is seeking support online, something I thought I would never do. I am adjusting...
The last few days have been medically trying - doctor visits lined up back to back, head to toe x-rays again, and an MRI on my brain. I try to find at least things to be grateful for each week so I don't get too negative: 1-It has been above freezing in Denver and the ice finally melted off my front steps. I walk with a cane, so icy steps are difficult for me. 2-My orchids I grow are all setting bloom spikes. I can look forward to their flowering soon. 3-My onocologist and his staff are exceptionally nice people.
Lisa B - Thank God for caregivers like you!!! Don't down play your contribution, your mother is lucky to have your support.
Thank you for this article. Life is life and I have learned to accept it for what it is. Having recently been diagnosed with MM I have a new and certainly, unforseen life changing event to deal with. My life has been difficult but I have come to a place before I was diagnosed with MM that I have now lived long enough to want to continue living. I have been chronically and clinically depressed all my life. That has changed since finding a twelve step support group for Adult Children of Alcoholics and dysfunctional families. It was through the support of fellow travelers that I learned to love myself just as I am. I no longer take anti-depressants or psychiatric therapy. I was taking my life back. Then two months ago I was diagnosed with MM. I'm still happy and though this is different from the depression I suffered I am up to the challenge. I am grateful for the support this forum and columns like yours give me. We don't have to do ths alone. There are fellow travelers here just as there are in my 12 step group. My life has never been this good. Depression is gone and I am not going to let it take over my life again. I will not give in to my new disease. I'm going to do what I can to survive. I'm learning about the disease. I've changed the way I eat. I have been juicing vegetables for the past two months and eating 80 percent raw organic. I feel good and just finished my first 21 days of Revlimid. I believe I tolerated it relatively well. I also take 80 mg.of dex and will have my first Zometa infusion this coming Tuesday. Life is a challenge andd at 69 I'm ready for a fight. Thank you again for the great insight on the new norm.
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