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Although I have lived with poor mental health for most of my adult life, I have, thanks to therapy and self-reflection, been able to draw upon a broad toolkit to better manage my mood. However, in August this year something unexpected and devastating happened to me that I thought could only happen to other people. It all started when I unexpectedly developed pneumonia, and, after 4 days of shortness of breath and chest pain, I was admitted to hospital where I received IV antibiotics.
After two nights I started feeling much better and was ready to get back to work and to my normal life, however, the doctors at the hospital gave me a routine CT scan before discharge just to make sure that the pneumonia was under control. I received the scan, and returned to the ward where I prepared to go home. However, one of the doctors wanted to speak to me privately, and I could tell by the tone of her voice that something wasn’t right. She took me into a quiet room and said something to me which I could scarcely believe…
She explained that I had a large (20cm) tumour occupying the space at the top of my left lung, and it was probably cancerous. Now, having poor mental health meant that, in spite of my progress, I did have periods where I catastrophised, or thought that the worst would happen. Being told that I probably had cancer, with considerable uncertainty around the prognosis, was a further shock to the system.
I underwent a biopsy and a number of scans, which identified the tumour as a rare, fairly slow-growing neuroendocrine tumour. It was well-defined and had not spread anywhere else in my body. It was, however, highly vascular, meaning that it had an extensive supply of blood vessels. Given the size and type of the tumour, the only option for treating it was to have it surgically removed. However, given its blood supply and position, the surgeon mentioned to me that the operation was ‘high risk’. At the same time, doing nothing was not an option, as the tumour was slowly starting to put pressure on my internal organs.
However, the operation went well, and after five nights recovering in hospital, I was deemed well enough to go back home. At home, I received support from my family while I slowly recovered, and, after a few weeks, I was able to walk several miles without getting breathless, and the pain had improved significantly. At the time of writing this, six weeks have passed since my operation, and I’m feeling around 90% better. Of course, things are still in their early days. While the surgeon thinks that he managed to remove all of the tumour (which weighed 1.5kg!) I will need to have tests for the next few years to monitor this.
How does my story fit the idea of recovery? Well, just like when managing poor mental health, I feel that when dealing with events of considerable uncertainty, challenging how we react can really help our resilience. But remember that it is normal to feel overwhelmed, frightened, or daunted by something like this! Nevertheless, a concept that I found useful was the CHIME framework, which considers five factors associated with recovery: Connectedness, Hope, Identity, Meaning, and Empowerment.
The first of the CHIME factors is ‘Connection’. This can mean a connection to people, pets, or even hobbies and interests. In the weeks between my diagnosis and my operation, I spent a considerable amount of time with people close to me, such as my family and close friends. I also made sure I set aside time for continuing my hobbies and interests; for example, I enjoy photography, which in turn helps me maintain a connection to nature and the world around me.
Hope is the second CHIME factor, and one of the most important. To have hope is to think that things will be better in the future. It is easy to lose hope, both when dealing with poor mental health and a cancer diagnosis, and a combination of the two can make the future seem very bleak indeed. However, the hospital where I had my operation was considered to be one of the best in the world, so trusting in the knowledge and skills of the surgeon and his team was vital. While, at times, my mind slipped back towards catastrophic thinking, having hope helped to guide my thinking processes back towards the positive.
Identity is about who we are. When dealing with a long-term condition, it is easy to identify ourselves in terms of our condition, be it an ‘anxious person’, or someone ‘suffering with cancer’. However, identity is more than this, comprising our work, hobbies and interests, and acknowledging all our positive characteristics. This links into the fourth CHIME factor, meaning. Engaging with tasks that provided me with meaning, be it photography, employment, or my postgraduate study, helped me maintain a positive sense of identity in the run up to my surgery, and gave me something to occupy my mind.
Finally, there is empowerment. When we are empowered, we are free to shape our own lives, express our needs and wants, and plan for the future. When dealing with a cancer diagnosis, we might often feel disempowered – after all, we may feel helpless, not knowing what will happen or what the future may being. However, while we want to be in control of all aspects of our lives, a lot of the time ‘control’ is an illusion, and that this is something that we should always try to remind ourselves. For example, when we go on a plane, we trust that the pilot will deliver us safely to our destination – here we aren’t piloting the aircraft ourselves.
Alternatively, we can acknowledge those things that we can control, and incorporate more of them into our lives. While we don’t choose to have depression, cancer, or a physical disability, to give a few examples, we can, however, with the right help and support, choose to respond to challenges and obstacles in a more empowering way. Instead of thinking about what we are unable to do, we consider and exercise those choices that are available to us.
The last few months have been difficult for me, and I suspect that anyone with a cancer diagnosis would feel the same! However, I feel that this whole journey has, ultimately, made me stronger, and has helped me realise the importance of things such as friends, family, and health, which previously I had taken for granted. I wouldn’t wish this on anyone, and we all will respond differently to life’s challenges such as these, but I believe that the CHIME framework offers a good basis on how to approach these challenges, much like how it can help us in our recovery journey from poor mental health.