Stress

It seems that recent studies of baboons and humans have shown that the higher you are in the hierarchy, the less sick you are, the assumption being that you experience less stress. Stress hormones contribute to or produce life-threatening diseases. They even cause us to develop the dreaded metabolic syndrome with its telltale belly fat.

I'm very low on the totem pole when it comes to my occupations, music and college teaching. I have very little control over these jobs, but at least I have a good boss at the college I teach at. The occupations themselves are not high-stress, except for the self-imposed stress of performance anxiety and the stress of being the leader of your own group. Being a leader means "the buck stops here" and you are responsible for publicity/promotion, program, and behavior of group members. I have relatively few gigs as a leader anymore compared to the halcyon days of the 80s, 90s, and mid-2000s. From 1985 to 2004 I led my own group at the Four Seasons Hotel in Boston. The almost 20 years of stress (combined with second-hand cigarette and cigar smoke for most of the time) is undoubtedly causing some kind of bad illness which is now dormant but will soon leap up to bite me in the ass. I can only hope that my breast cancer was the worst of it.

Problem is, stress becomes a habit. Even when nothing is expected of me and I don't have to produce on a deadline (as I have been doing for a year now in preparing my book for publication) I still feel free-floating anxiety. All summer I was sidelined by a detached retina. I had nothing to do. Nothing that had to be done. This did not prevent me from compulsively doing things as soon as I was allowed to get up from my prone position. I began a practice schedule. I walked almost every day because it was the only form of exercise allowed. As soon as I could drive, I began doing chores and errands which could have been delegated to my boyfriend. When it comes to stress, I am my own worst enemy. If it doesn't come looking for me, I create it.

I stressed for over a week over the following:
a) my brother's upcoming prostate surgery for cancer (good news: lymph nodes are clear)
b) my own post-menopausal "spotting" and bloating which the Internet sternly informs me is never normal and needs to be seen to immediately
c) the ongoing stress of living with an invalid who is your boyfriend whom you love and have to see in pain and on disability
d) my gig at the Acton Jazz Cafe last Friday (good news: was a rousing success. Would it still have been so if I had stressed less?)

Now I am low-level stressing about the spotting and bloating, because as usual I trot out my logic in an effort to show my cortisol that it can relax. The gynecologist who examined me last Thursday did not appear to be unduly alarmed and could not find anything abnormal in the pelvic exam. Since I have a history of polyps, she set me up for an ultrasound in the next few days, after which presumably we can rule out several things and have a discussion. It's not the end of the problem, because there will still be a biopsy, the results of which I must wait for. (Waiting for lab test results is quite possibly the most stress-inducing thing in existence.) I could not stop myself from trolling the Internet health sites in search of reassuring statistics. Unfortunately, all female conditions involving uterus/ovaries have the same symptoms, whether the condition is benign or malignant. It appears, however, that ovarian or endometrial cancer are the least likely culprits statistically. This only lowers my stress a little because when my breast was biopsied I was told reluctantly by both internist and radiologist that 85% of biopsies are normal. I was in the unlucky 15% who had ductal carcinoma in situ which is as close to curable as cancer gets (95%) with surgery followed by radiation followed by 5 years of tamoxifen. You could argue that because I beat the odds and won the cancer lottery 6 years ago that the odds of beating them again when they are already similarly low are not good. But better than winning the Massachusetts state lottery.

Tamoxifen is an anti-breast cancer drug which has been studied for many years--it has been around since the 80s. My oncologist correctly decided that the (albeit low) risk of my cancer returning at about 10% outweighed the risks of taking the drug itself. Blood clots are a risk but really only in sedentary women older than me. The risk of endometrial cancer is about 4%, meaning that 96% of women on the drug do not develop the disease. Dr. Tabesh, whom I love, didn't prescribe a newer and less tested drug because it was newer and less tested. She always patiently answered my anxious queries. It impresses me no end that with her busy practice (she is now chief of oncology where she practices) and as the mother of 3 she has the time to keep up with the latest research papers. She also doesn't seem to be stressed out. But then she is high-ranking in the job hierarchy.

During my bout with breast cancer I also took the genetic test for BRCA1 and 2, which are sneaky cancer genes that show up in a small percentage of women who are mostly of Ashkenazic Jewish descent, as I am. Thank an inbred gene pool for that! These genes make women prone to ovarian cancer AND breast cancer. Well, I don't have the genes. But I do have 2 risk factors for the reproductive organ cancers: I am getting older and I took tamoxifen.

I have succeeded in convincing myself that my spotting/bloating (which has mysteriously disappeared over the past week) is either a) more polyps, which are usually benign but need to be removed or b) nothing (technically, the aging uterus sheds cells from its lining which is thinning out, which is a normal process.)
If it is more polyps, another surgical procedure is in order--thankfully, an in-office one--the last thing I want to see is the inside of another hospital. As I recall, it was not a pleasant procedure: the gyn refers to it as "crampy," but I would characterize the pain to be well over 5 on a scale of 1-10, 10 being labor pain.

To quote from Fight Club: Even the Mona Lisa is falling apart.

Though not the Mona Lisa by a long shot, the mirror and my boyfriend both tell me that I am a youthful, more attractive than average 58 year old. BF uses words like "beautiful," of course. I strive stressfully to exercise a lot even though I hate it (except for biking, hiking, and horseback riding) to stay on the Weight Watchers plan which enabled me to lose 30 lbs. I am not one of the 95% of Americans who do not eat enough fruits and vegetables; I easily get more than 5 a day. But cancer treacherously
laughs at fitness and healthy diet and gives Lance Armstrong a run for his money. Being at the top of his game and the sports hierarchy, he beats it, at least for now.
Cancer took the life of my clean-living, outdoors-loving mother at age 59. It cost my 48 year old boyfriend his stomach and his health. And it cost me about 1/3 of my right breast after 4 surgeries. It is a malevolent, sneaky, treacherous disease. Each time BF gets a CT scan--every few months--it has thus far shown no return of the cancer. But it has been known to return years later. So I share in his stress every time the test comes around. And using logic or reading about odds does very little to alleviate the stress.

Stress has been shown to actually kill brain cells, the only cells in the body which do not regenerate. This results in memory loss of the following type: I go into a room and forget what I went in there for. Or, as happened just now, I ask BF: What was the name of the bicyclist who won the Tour de France and got cancer? This after fruitlessly searching the recesses of my brain for a name that was just out of reach. My generation dreads Alzheimer's as people once dreaded the plague, and my friends are all convinced that they have the early-onset form of the disease. But maybe it's just stress. No--"just" is not a word that can be used with "stress" anymore. It's a killer.

I could write a lot more on this subject, but I am too stressed.