Trauma and Physical Health: My application to Above & Beyond Cancer

I wrote this this morning and wanted to share with those of you interested in my last blog as well as those who have supported me so beautifully through this journey.  My gratitude is deep and wide.  I hope that you'll stay with me on this new chapter.  As always, please feel free to be generous with comments, critique, suggestions.  Also, please share with your networks my message of destigmatization  of mental health issues, trauma, and certain health issues (e.g.HIV).

Summer 2010

My name is Holly Hanson.  I am 46 years old and live in Des Moines, Iowa.  I have two sons, ages 11 and 8.  I was born in Ames, Iowa, moved to Boone, Iowa when I was five, and then went to college in Iowa City.  My undergraduate degree is in Social Work.  Not being able to live off the wages of an entry level social worker, I became a travel agent and moved to Denver, Colorado in 1995.  After about three years as a travel agent and waitress, I began my Master of Arts in Counseling Psychology Counselor Education at the University of Colorado at Denver.

I’m also a 2-time cancer survivor.  I think that the “athlete profile” written in the October 2014 Momentum Magazine for the Des Moines Marathon packets, tells my “cancer story” the most succinctly:

“At 41, Holly was in the best shape of her life.  She was running 20 miles a week, doing yoga and kickboxing. She had a fully marathon under her belt.  And then, in 2010, she learned she had non-Hodgkin’s Lymphoma.  Her first thought was of her sons, then 3 and 6.  Her second thought: “After realizing that I probably wasn’t going to die, but that I had a hell of a fight ahead of me, I said, ‘$^%&^’, now I’m going to have to run another full marathon’ because I knew about Team in Training,” which raises money for blood cancer research.  Six months of treatment sent Holly’s cancer into remission, but in [August] 2011 she got a new diagnosis: early stage breast cancer. Still, she ran a marathon with Team in Training in November of that year.  “I didn’t go inside myself,” Holly says. “I fought off depression and anxiety through fitness (specifically running), and most importantly, I didn’t quit.”  Her goal now is to run a full, half or tri in all 50 states, and she’s 12 states in. [now 13]  “ I think what I would say to anybody facing ANY challenge, including cancer, is to face it head-on,” she says. “Be honest about your hopes and fears…Life is so beautiful, yet fragile and temporary.  Be present for it.”

While I was getting my masters in Colorado, the Columbine High School shootings occurred (April 20,1999).  I was working as a graduate assistant in the program’s campus counseling center at the time.  My supervisor there left to direct the agency that was created to assist in healing of the Columbine High School community in Littleton, Colorado (Columbine Connections).  She recruited me to assist.  Thus, began two of the most amazing years of my life.  My boss ensured that we were all trained in the most up-to-date trauma therapies as well as ensured there were ample opportunities for self-care in the face of being helpers in a traumatized community.  

When the grant for the agency was drawing to a close a couple of years later, I needed to start looking for other work.  I ended up coming back to Iowa in 2001 to manage the federally funded Ryan White Part B program (a program that provides medications and support services for low-income people living with HIV) for the state health department.  I have been there ever since.  When I first started almost fourteen years ago, it was blatantly clear to me the direct correlation between trauma and the acquisition of HIV as well as the ability for those living with HIV to adhere to their medication (an extremely critical component of remaining healthy as well as eliminating the transmission risk).  At that time, I didn’t have the support or the wherewithal to get traction on this concept. 

Fast forward 14 years.  Today there is a lot more evidence, specifically the 2012 analysis and subsequent report of Iowa Adverse Childhood Experiences (ACE’s) study, about the direct correlation between trauma and the susceptibility to disease and infection, as well as health outcomes. This includes cancer.

Read a summary of ACE’s here: 

http://www.idph.state.ia.us/hpcdp/common/pdf/family_health/2011_aces_data.pdf

As a result of a few public speaking opportunities surrounding the 2014 Des Moines Marathon and also attending the Above and Beyond Cancer’s (ABC) An Evening of Inspiration, I have finally determined and articulated how I should be using my voice and the generous gift of survival.  

Briefly, it is to work toward a greater public awareness, and associated policies and programming, to acknowledge and address the stigmatizing effects surrounding mental illness and trauma.  Inherently associated with these concepts are social determinants of health, but I believe it goes deeper-it’s more of a root cause.

My recent blog entry goes into this a little deeper.  You can find it here: 

http://www.solsticeowl.blogspot.com/2015/02/the-best-thing-about-having-cancer.html

Recently at the state health department, I have formed a group of managers from HIV, childhood health, cancer, tobacco, domestic violence, obesity, minority health, substance abuse and mental health to coordinate a response to recent studies confirming the relationship between trauma and physical health.  It’s probably the most exciting thing I’ve done in my entire life-combining almost all of my past professional and personal experiences into one vision and mission. From my understanding, my vision and mission for my life work beautifully aligns with ABC’s vision and mission. As such, I feel that I would greatly benefit from being a part of ABC’s organization and that ABC would likewise benefit from my participation.  

I hope that you’ll consider my application and choose to have me participate in your 2015 excursion… 

…and Beyond. 

The Best Thing About Having Cancer

Yet another example of how running can bring clarity and purpose to one’s life: While running the Des Moines half-marathon in October, I had an epiphany. The epiphany began to formulate at about mile four and by mile eleven, I finally knew what it means-to me-to be a “cancer survivor”, and what I need to do with that gift.

Those of you who know me, know that running another half-marathon is not, in and of itself, an earth shattering endeavor.  This time was a little different.  First of all, my “athlete profile” was in a local activity and the souvenir guide for the marathon.  It was a very well-written piece that talked about my two bouts with cancer and how running helped me get through the trials and tribulations of that time of my life.  The next momentous event was attending Above & Beyond Cancer’s “Evening of Inspiration” the Friday before the race.  The evening included a recap of the group’s trip earlier that month to Macchu Pichu in Peru.  It also included a small panel of cancer survivors.  They shared their stories. How cancer came into their lives and how it has impacted their lives.  They talked about their struggles, how they overcame them, and life-lessons learned.  All the while I’m thinking about wanting to go with this group on their next endeavor.  I was trying to figure out why I want to go to an exotic location with this group (could it be Nepal!?!?) and what I would say if I was on a panel of cancer survivors in 2015.  Is it just that I fancy myself a world traveler and athlete and that I just happened to have had cancer? Seems to be it should be a better reason than that.  I continued to imagine myself on next year’s panel.  Sure, I could share my story and lessons learned.  I’ve been told that it’s “inspirational”.  I love the idea and the possibility of helping and inspiring other people in difficult situations.  However, I also feel a little uncomfortable with it all.  I feel a little bit like, “hey, I had a couple nasty health issues, look at me, look at me”. That is to say, it feels a little narcissistic to go around touting my survivorship.  Lots of people don’t survive cancer.  Lots of people that I know personally don’t survive cancer. It was mostly luck of the draw that I found both my cancers early, had access to excellent health care, and am now cured of lymphoma and in remission from breast cancer.  I could feel that there must be an additional reason the universe is hurling me towards opportunities for my voice to be heard.  Speaking of opportunities for speaking about my experience; next, MediaCom’s channel 22 wanted to do an interview at the Expo the day before the race.  I agreed and had a lot of fun doing it. However, a lot of their questions stumped me.  Questions like: “How has cancer changed your life? What lessons have you learned by having cancer?” And, so on.  These questions are hard for me because cancer didn’t particularly change my life.  The lesson I learned about being present, of being mindful in everything you do, embracing life and those you love because everything could be gone in a moment’s notice (or lack thereof) started when one of my best high school friends was killed in a car accident when I was seventeen.  This knowledge and conviction to live a meaningful, heartfelt life grew when my dad dropped dead at 48 years old in the bathroom in the middle of the night five years later.   And, let me tell you, to have these things really hit home, there’s nothing like your own near death experience to add to it.  It wasn’t cancer that almost killed me.  It was child birth-over eleven years ago.  I’ll spare the details for this blog, but suffice it to say…I truly was knock knock knocking on heaven’s door.  I have never been so scared.  Not even when six years later, I was diagnosed with cancer. Twice.

But cancer is what people want to know about, and what I get to talk about.  So during the Des Moines half-marathon, I decided I needed to figure out what message I need to share since I have been given the gift of not only cancer survivorship, but the ears of others.  A hard run on a beautiful Iowa fall day did not disappoint. 

Now to the epiphany.

The Best Thing About Having Cancer is that there is little to no stigma attached to a cancer diagnosis anymore.  If you have family and friends, if you are part of a community, you will have support.  When I was first diagnosed with non-Hodgkin’s Lymphoma in June of 2010 and was in the hospital for five days, the plants and flowers that I received filled the room.  Cards of support showed up in my mailbox regularly from distant relatives, long lost friends, and high school classmates. My Facebook page was on fire with supportive, loving, and caring messages.  For the next three summer months, my neighbor mowed my lawn without being asked.  Four girlfriends came to thoroughly clean my house every two weeks.  A dear friend from church brought me homemade chicken noodle soup several times during the course of my chemotherapy.  When one of my best friends came over to bring me flowers, she caught me in the depths of sorrow as my hair was falling out in clumps.  She was there to support me by doing my hair for the last time in a long time.  I even had a hair-chopping party at my salon, attended by 20 of my closest friends, family, and supporters.  They bought me scarves, wigs, big earrings and wine.  They gave me their love, their hugs, their tears. 

The next summer when I was diagnosed with early stage breast cancer, the outpouring wasn’t quite as enthusiastic, but I most certainly felt supported. Many close friends and family checked in on my physical and mental health almost daily. The donations for my fundraising for the Leukemia and Lymphoma Society via Team-in-Training poured in.

During the same time, one of my best friends of over 20 years was suffering from severe depression.  The effect on her daily life was similar to mine.  We both suffered from extreme fatigue and spent a lot of time sleeping.  We both spent a fair share of time crying and scared of the future.  But, you guessed it…nobody sent her flowers, or cleaned her house, or mowed her lawn, or threw a support party to help her get through the dark days ahead.  She confided to a couple very close friends that she was struggling, but even that was exponentially more difficult for her to do than for me due to feelings of shame and a general stigmatized view of depression and other mental illnesses held by the society we live in.

Thanks to genetics and a pretty decent “Adverse Childhood Experiences” score (more on this indicator of trauma in a future blog), I’ve dabbled in both depression and anxiety.  Consequently, I feel qualified to draw a few conclusions having also had cancer twice. 

Here’s the punch line:  Major depression is a treatable illness that affects the way a person thinks, feels, behaves, and functions. At any point in time, 3 to 5 percent of people suffer from major depression; the lifetime risk is about 17 percent.

Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older (18% of U.S. population).

Anxiety and depression affects your friends, family, coworkers and neighbors. It affects you. It affects me.  It can easily lead to other ailments such as heart disease, as well as the abuse of tobacco, food, alcohol, and other drugs.  The great news is that treatment is available and effective.  The bad news is that only about 1/3 of those who suffer from anxiety and/or depression get the help they need.  The most common reason for not accessing treatment? Stigma. An outdated and harmful idea that we should use our willpower to get ourselves out of the predicament we’re in.  That asking for help is weak. 

Which brings me to my epiphany in October of 2014 during the Des Moines Half-Marathon.  I will use the opportunities presented to me as a two-time cancer survivor who likes to run to talk about the impact of trauma, depression, and anxiety on the public’s health and well-being.  I will fight to reduce the stigma and shame associated with these illnesses. 

I will urge you to reach out to your friends, your family, your co-workers who you suspect are suffering the aftermath of any trauma, anxiety, depression (or any mental illness)-anyone you would help if you found out they had cancer- and send them cards, make them dinners, clean their houses, and mow their lawns. 

Why Grandma's?

Why Grandma’s?

A Short Tale of Cancer, Divorce, Solstices, and Family.
And, Running. 
Of course.

I swore I’d never do it again.  No need to tax your body that much.  No need to take that much time out of your life to train.  Half-marathons.  Now that’s where it’s at!! Long enough to really be a challenge but short enough to not consume your life and wreak havoc on your body.

I’ve done two full marathons in my life. 

The first was Chicago in 1999. Trained for it while planning my wedding, getting married, and honeymooning. Ran it all wrong, finished in 4:47 and then didn’t run again for ten years.  I ran a 10k in 2010 and was surprised how fast I did it, was all set to do some more 10k’s (the other perfect distance), and then BOOM. Pow.  “You have cancer.”  This was shortly (3-weeks “shortly”) after Boom. Pow. You’re divorced.  Blech.

After finding out I had non-Hodgkin’s Lymphoma on the summer solstice in 2010, the first thing I said (after hyperventilating because I thought I was going to die at 41 and leave two boys, six and three, motherless) was, “Damn it, if I survive this, I’m going to have to run another marathon.”  Because I knew of the Leukemia and Lymphoma Society (LLS) and Team in Training (TNT). 

Sure enough…Summer 2011, I started training for the full marathon in Savannah, GA with TNT.  Raising money for an organization that most certainly had significant impact on the success of my cancer treatment.  In the midst of my training two things happened.  First, my grandpa died exactly 92 years after he was born-of lymphoma.  His memorial contributions were directed to the LLS, via me and TNT.  No going back now! I had to, had to, had to, finish this race.  Even if, and this is the second thing that happened, a month later I was diagnosed with early stage breast cancer, underwent two lumpectomies one week apart, and 6 ½ weeks of radiation.  I had my last radiation on a Thursday morning and then got on a plane to Savannah that afternoon.  I finished the race in 4:50. Twenty minutes slower than my goal.  I hated every step from mile 15 to the end.  Pain in my knees, my hip, and cursing for 11 miles.  Sometimes I can’t even believe I finished it. I was swearing for 11 miles that I would never, ever run a full marathon again.

But I AM running another full marathon.  Less than three years after Savannah.  It’s a popular race called “Grandma’s Marathon” that takes place along Lake Superior, near Duluth, MN.  This time is different though.  Just one reason is that I have run several (a lot actually) 10k’s and half marathons since Savannah.  When the Grandma’s Marathon’s race director sent an email asking for stories about why participants are running Grandma’s, I couldn’t resist submitting mine.  I love stories.  Here’s a passage I love from a novel I read a few months ago:

“Stories are people.  I’m a story, you’re a story…your father is a story.  Our stories go in every direction, but sometimes, if we’re lucky, our stories join into one, and for a while,

we’re less alone.”

From Beautiful Ruins, by Jess Walter

 

I was restricted to 300 words to describe why I’m running Grandma’s Marathon.  Here is what I submitted:

 June 21, 2014 will be exactly four years since being diagnosed with non-Hodgkin’s Lymphoma.  To celebrate surviving and thriving not only that cancer, but also breast cancer the following year, is not the only reason I’m running my third full marathon on the summer solstice.  It’s also because I was born on the winter solstice and I believe that the solstices are a powerful affirmation of life.  The dichotomy, the extreme, and the balance between darkness and light make me feel alive.  Running a “medal-producing race” in each state does too.  By the time I finish Grandma’s, it will be the 11^th state I’ve run a half or full marathon in, seven in 2014. 

But, probably the most important reason I’m running Grandma’s this year is for my brother.  The only time I have ever been in Duluth was with him and my dad for Father’s Day 1991.  Twenty-three years ago in June, my dad, brother and I road-tripped to Duluth from Ames, Iowa, spent the night in a hotel, and then meandered all the way north to Ely.  It was the only trip we ever really took with my dad.  He was elated to share with us the beauty he saw in the region.  The region him and my mother honeymooned in 1967.  My dad, then 48, died suddenly the next summer while I was backpacking in Europe. 

After a very difficult year, my brother is (re)learning about the significant healing power of running.  The power of having a goal.  And, the power of long runs with his sister.  Long, bonding runs in below zero temperatures with ice and snow, in the pouring down rain, and in the relative heat.  Culminating in a bonding summer vacation in a cabin by a lake.

 Oh, and 26.2 miles.

Today's Run in Rain, Sleet, and Snow

By the time the run was over, the snowflakes were big and beautiful.  The run was seven miles on an early March Sunday. It started out 35 degrees and raining.  By mile 3.46 it had turned into sleet. Sharp little bullets hitting my face, and sometimes, my eyeball.  By mile 5.37 it had started to snow. As I mentioned, big fluffy, beautiful flakes, slowly falling to the earth. I often think about how long runs are an excellent metaphor for survival. Surviving. Surviving anything.  Surviving a rotten childhood, a rocky relationship, a difficult workplace, or, today, I was thinking about surviving cancer.  Twice.  Now, as far as cancer survivors go, I have it pretty easy.  As far as two-time cancer survivors go, I have it ridiculously easy.  I mean really......just a little chemo for round one and a little radiation for round two.   So, okay, there was a 5-day extra credit hospital stay during round one, and a lumpectomy (ok, two) for round two.  Yes, I was scared. Yes, I was tired. And, Yes, I was truly very sick.  But, the outlook for survival seemed assured both times.  I clung to that, and for the most part never worried about cancer killing me.  And, lo and behold, the treatments worked flawlessly and I am a two-time survivor, just like that.  Ba da boom, Bob's yer Uncle, You're a rock star, You're in remission. 

But, alas, like a run, it seems a hell of a lot easier once it's done.  During a run, you can be cursing much or the whole time....oh my god! could this hill be any longer? How could I have managed to have to run up hill BOTH WAYS??? Oh, my shoes are soaking wet from that puddle, crap, I'm going to fall on that ice!! Ok, minivan lady, it's much more important for you to turn left onto Grand than me crossing the street in what's turned into a pretty respectable snowstorm.  No really, you go ahead.

Then you get home, stretch, take a shower. How was your run? Pretty good, thanks! Got 7 miles in! The last 1/2 mile was a bit tough, but other than that, pretty awesome!

Once somebody is diagnosed with cancer, they're a survivor. From Day One.  Pretty cool to think about it, really.  One day you can be walking along in the beautiful sunshine, going to kickboxing class, going to yoga, running10K's way faster than you thought you could, then suddenly, you can't walk because your guts are so bunged up you think you should eat more greens (like a truck full, cuz really, you already eat a lot) or you feel a lump (what the hell is that? Is there one on the other side????) then the clouds roll in like some weird cartoon or horror movie and it starts raining.

Running in the rain can seem peaceful. Almost refreshing.  It certainly can make you feel alive.  I think that's what I love most about any kind of severe weather.  It can take you by the shoulders and shake you.  Wake up! Notice your surroundings.  Yes, smell the roses.  The daffodils. The rain. The pine trees. Can you hear the birds? They can tell it's about to be full-on spring.  

Well, you guessed it.....a cancer diagnosis can do the same thing.  Slap you up side the head to remind you that you are currently alive.  but, hey, who knows how long that will last? Are you doing to best you can to have a meaningful life, chump? You've only got two.  Ah, you caught that.  Very clever. It's just the one, chump.  And, we can hope, pray, and meditate that we'll get to live until we're 102, but there are absolutely zippo, nada, naught, gaurantees that we'll live past tonight. 

Has cancer taught me these lessons? Yes. I think so. Not just cancer, but other things that I've battled and overcome. I have minimized or eliminated distractions as much as possible. I try to live fully most moments. Enjoy my children, love my lover, eat great food, engage with my community in meaningful ways. And, I run. I run in weather. I never used to run in weather. It had to be between 55 and 83, little to no wind, certainly no rain, sleet, or snow. Now, I run in anything between 10 and 95 degrees. The cold, the heat, the precipitation....it all makes me feel alive. Alive. AND WELL.