I had my annual checkup at the cardiologist’s office a few weeks ago and met with a new PA (physician assistant). She had clearly read my records (yeah!) and asked about my recent gallbladder surgery. Once she confirmed that I had recovered well from that, she asked about the mass they also found in my pancreas. She was not very interested in the mass and my level of risk of pancreatic cancer (which, as you probably know, is not a good thing to have). What she was interested in was how did I “feel” about it? And, while we were talking about it, how did I “feel” about the fact that I had just had another AFib episode after 3.5 months episode-free? In other words, what was my attitude toward the uncertainty of future health outcomes?
So, I’ve been doing a lot of thinking about this lately. Not knowing when I’m going to have another AFib episode or how debilitating it’s going to be is annoying, to put it mildly; terrifying and aggravating, if I’m going to be totally honest. Not knowing whether the mass in my pancreas will continue to grow, which will likely mean that it’s cancerous, can actually stop me in my tracks with fear. But really, I can’t live life that way, crippled by uncertainty.
When I first met my husband, Bob, I was an excellent worrier and catastrophizer. Full of “what ifs” and visions of the worst possible outcome, all of which consumed a lot of mental energy and probably didn’t help with my AFib. But I was in AFib 24/7, so what difference did it really make?! Over the years, Bob has helped me manage my catastrophizing tendencies by asking a few simple questions: Have you done everything you can do to manage/limit the imagined potential catastrophe? Do you have a plan of next steps if the catastrophe looms closer? Is there anything else you can do right now to prepare? If not, you need to let go of the worrying and let things play out without your emotional involvement. Easier said than done, but I’ve tried this strategy and found that it really does work.
So, how does this strategy play out for my AFib? I keep a chart of my AFib episodes and my theories on what might have triggered them, so I can spot trends. I know what to do when I have an episode (take things easy, take my pill-in-the-pocket until it resolves). And after this visit with the PA, we have a plan for what I’ll do if the episodes become more frequent and really start affecting my quality of life (start taking the pill-in-the-pocket daily, and I know which dose to start at). So, I’ve done all I can right now, and we have an action plan in the event the situation changes.
And how does this strategy play out for the mass in my pancreas? I’ve done a lot of Google research on the type of mass and pancreatic cancer in general, so I have a good sense of how big the catastrophe could be. That is both calming and anxiety-producing, but it’s better than ignorance. That said, I’m told the type of mass and its location make mine rarely malignant. Good! I’ve visited with the expert on this type of mass at the Huntsman Cancer Institute, and she’s not very worried. We have a plan to do an MRI of my pancreas every 6 months to see whether the mass is growing (or, hopefully, not growing), so that should reduce unwanted surprises. Meaning that yes, I’ve done all I can right now, and yes, I have an action plan.
When my mind moves into its well-worn worry track about either of these conditions, I practice my mindfulness techniques: breathe, acknowledge the thought (how interesting, I’m thinking about that again!), breathe, set the thought aside (physically push it away with my hand while saying “not now”), breathe some more. My mind still moves onto the worry track now and then, but I do believe it’s less often than if I had not implemented the preparation strategy.
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