He’s officially eligible for an AARP senior discount. I got excited when I thought about the discounts we might be able to get now that he has his ‘official’ seniors card. I told him it’s time to start testing and see what deals we can score. He rolled his eyes. I think I’m more excited. Crack me up.
55 is too young for a man to be battling metastatic prostate cancer. The median age of a man with stage 4 prostate cancer is in the mid-seventies. The median age at death from prostate cancer is 80 years old.
1 in 7 men will be diagnosed with prostate cancer in their lifetime.
Much of the literature and research on prostate cancer states that most men will die with prostate cancer; not from prostate cancer. In general prostate cancer has excellent survival rates, but death rates are higher in African-American men, men who have advanced stage cancer, and men who are between the ages of 75 and 84.
What the research is also showing is that when younger men, like Jeff, are diagnosed with prostate cancer, it tends to be a more rare, aggressive variant. Adding to the complexity is the lack of published research (there’s a lot of research underway) which creates challenges when determining the treatment protocol of someone with a rare subtype of prostate cancer. Fortunately, we’re tapping into the experts at Seattle Cancer Center Alliance with Fred Hutchinson Cancer Research, MD Anderson, and the Mayo Clinic.
“Early onset prostate cancer tends to be aggressive, striking down men in the prime of their life. These fast-growing tumors in young men might be entirely missed by screening because the timeframe is short before they start to show clinical symptoms,” says Kathleen A. Cooney, M.D., professor of internal medicine and urology at the University of Michigan.
There are quality resources online that provide prostate cancer support. Below are several we have found valuable.
So, nice try cancer. Today, we celebrate a milestone birthday together.
“You have a high level of Contentment – usually good natured and happy, grateful, optimistic and satisfied despite circumstances.”
That’s what the personality assessment said as we reviewed the results in class this week. After class, we were asked to dissect the results with fellow students.
Jen, how do you have a high level of Contentment when your husband has stage IV cancer?
There’s no doubt that what Jeff and I are going through sucks. If I allow myself to dwell on the cancer circus, I would walk through life an emotional mess. I’m watching the person I love, who I want to grow old with, battle an incurable disease.
Every time I see him wince from bone pain, hear him throw up or limp over to the sofa just to be in the same room with our family, I fight the instinct to fix it – to do something. I look at our wedding pictures or last year’s Halloween pics when he was 45 pounds heavier, active (and with hair) and I get tearful. And, I think about what life will be like when he’s gone.
Every day, Jeff and I have choices to make. Choices whether to do or not do treatment; choices around our attitudes, how we show up for each other, how to nourish ourselves and choices to make for the future. As a cancer caregiver, I have choices to make, many of which, when I dig deep – I don’t want to make. This is “heavy stuff”. Yet, I make them anyway, from a place of love and gratitude.
I’m sitting courtside and I am…for the most part, content.
When caring for someone with metastatic cancer, these feelings are normal. They are reasonable. It’s OK to grieve all of the changes in life that are happening as a result of cancer. It doesn’t mean I’m giving up, that I’ve lost hope or that I love him any less.
There are 2 ways Jeff and I can look at the situation:
1) He is dying of cancer.
2) He is living with cancer.
We’re choosing option #2 because #1 is too damn heavy and dark. It doesn’t mean we avoid getting sad or angry. We crawl under the blankets, feel the pain and we admit when we’re afraid. Yet, we’re also grateful we’ve been given the gift of time – time to sit on the deck, play with our dogs, visit close-to-home places on the bucket list, and time to just be with each other. He is living with cancer.
Caregiving is a 24/7 gig. Supporting Jeff’s wellbeing is always on my mind whether I’m physically doing something to help him or thinking about how to manage a particular issue we’re facing.
As a cancer caregiver, I watch for changes, dive into problem-solving and advocate for Jeff. The smallest change and we’re on it. I research side effects, co-create med schedules, seek out treatments, deal with insurance paperwork, make healthy meals – the list goes on.
I see cancer caregivers as hopeful detectives – seeking legit solutions that will provide comfort and improve the quality of life of our loved ones.
34 million adults in the U.S. are family caregivers and on average, spend 24.4 hours a week providing care. Nearly one-quarter provide 41 or more hours of care a week. (2015 Report: Caregiving in the U.S.)
The report states caregivers help on average with 4.2 out of 7 instrumental Activity of Daily Living (ADL) including transportation, grocery or other shopping, housework and personal care activities. This doesn’t include responsibilities such as coordinating and advocating for their loved one’s health with providers, insurance companies, and other professionals.
Knock, Knock, Who’s There? The Crankasaurus
The burden of care is wide not to mention the heightened emotional stress caregivers experience. 8 out of 10 caregivers state they could use more info or help on caregiving topics and 42% want info about managing their own stress. And, the average length of a family member in a caregiving role is 4 years with a quarter providing care for 5 years or more.
7 years. It started in 2006 when Jeff was diagnosed with head/neck cancer, followed by a multi-year recovery from the accident. The last 2 years have been the hardest.
I read and hear it often…“You need to take care of yourself so you’re better able to take care of your partner.”
Every article that provides caregiving guidance speaks to the importance of taking care of self. Tips to help with self-care; seeking support; organizing medical info to make appointments easier.
I like that I’m surrounded by ideas to inspire self-care. It reminds me not to let myself get so immersed in the chaos that I forget to do things I enjoy and that bring perspective, especially helpful as we face life-threatening stages of cancer.
When I don’t take care of myself…enter the Crankasaurus.
What’s a Crankasaurus? It’s when I get irritated…at everything. Irritated in the medical process, the waiting, the traffic to/from treatment. Unexpected and last minute changes find their way into an already packed day and put a thorn in my side. The shit show bubbles over and I get angry.
Taming the Crankasaurus
For my fellow Crankasauruses (Crankasauri?) it’s normal to have these surly moments. The key is to keep things from being a 24/7 cranky zone.
I am steadily self-nourishing.
This is my new mantra. The words “practice self-care” weren’t hitting a place that spurred action. So I came up with something else that triggers me to put my needs in front. It feels powerful, accountable and my choice.
As a “seasoned” caregiver, there’s no silver bullet. It’s challenging and undeniably stressful. Building flexibility and self-compassion into my life is how I’m trying to manage the unexpected. It’s the dig-deep commitment and choice I have made – and continue to make – that carries me through the tough days. No matter how many self-care tips I come across, I am the only one that knows what I need to refuel my mind, body, and spirit. My job is to recognize it and take action so that my Crankasaurus visits less often.
5:00am: I woke up to tiny groans. Jeff had his fourth round of chemotherapy Wednesday – Friday, so we decided to stay at SCCA House on Thursday. We thought it best to avoid the late night, hour+ drive home and “gift” ourselves time in the morning to relax and rest before Friday infusion.
Jeff was having a bad reaction to the chemo drugs (Cisplatin and Etoposide). His face was bright red, swollen and accompanied by a crushing jaw and headache. Jeff has a high pain threshold so when he told me the pain was an 8, we both knew we needed to take action.
I went into our overnight pack and realized…we forgot the thermometer. It’s one of the most important items to have on hand when someone is going through cancer treatment.
inside voice: I…can’t…believe…I…forgot…it.
Fever and chills can signal a possible infection. A cancer patient is super vulnerable to infection during chemo, radiation, immunotherapy or when blood counts are low. Whereas healthy individuals pop a Tylenol, cancer patients must connect with a doctor prior to taking steps to bringing down a fever. Redness or swelling of the skin, cold symptoms, back pain, toothache – all important signs to watch for possible infection.
I grabbed my phone and found a drug store a few miles away. It opened in 30 minutes.
6:00am: I explored the aisles of Bartell Drugs seeking a thermometer, Benadryl (you never know) and Gatorade (because you can never have enough on hand).
6:30am: No fever. Phew!
6:45am: Called the doctor. They recommended we head to the ER for testing.
Damn you cancer!
7:15am: We threw on clothes and I packed up. So long SCCA House.
8:00am: Arrive at the ER.
Anyone who has been to the ER knows the overall experience is challenging. Despite the extended visit, the care was thorough and compassionate. Most appreciated when navigating the complexities of cancer and how treatment affects each person individually.
1:30pm: Leave the ER.
Net-Net is that they 100% aren’t sure what caused the reaction. After IV hydration, 3 different pain meds, nausea meds, steroids and 3 dates with the vomit bags, we were on our way home with 3 new prescriptions to fill and add to the 20-pill daily intake.
Today, he’s sleeping (normal for 4-5 days post-chemo). The swelling and redness seem to be almost gone. Our attention now shifts to hydration and nutrition.
The Birth of the “Traveling Treatment” Toolbox
During the down time in the ER (aka waiting), I designed a Treatment Toolbox. It doesn’t replace the various bags we pack for treatment days. This toolbox can be kept in the car for easy access to key supplies used regularly during treatment and doctor appointments.
BONUS for CAREGIVERS: This toolkit will reduce early morning and late night trips to drugstores and it’s especially handy when treatment is miles away from home.
The Treatment Toolbox Includes:
Portable urinal or bedpan (ask the nurse for a few)
Toss in an empty Gatorade bottle for a 1-time use. It works in a pinch.
Hat or Head scarf (cancer patients are notoriously cold)
Refillable water bottle
Plush toy (I see more adults during treatments have a stuffed bear or other animal next to them. Hospitals state that stuffed toys soothe adults, especially elderly adults. It provides a distraction, helps with loneliness and is another small act of compassion)
++Some of these supplies are specific to those with prostate cancer or other genitourinary cancers. Modify the supplies in the toolbox so they work for you and your loved one.
I recommend an air-tight storage container that can be placed in the car – either back seat floor, cargo or trunk and can be easily moved into the house, garage or hotel room. Please use discretion when storing the toolbox in the trunk if you live in warm climates as some supplies may not hold up to high temperatures over an extended period of time. Always check expiration dates on food items and similar to a first aid kit – regularly check to make sure supplies are replenished after use.
Do you know someone touched by cancer?Make a Treatment Toolbox for their vehicle. It will save loads of time and minimize stress when unexpected challenge arise – which they do – often.
What’s missing from the Toolbox? Share your ideas!
Note: I am not being paid to recommend products. These are products we have found to be helpful.
Today is my parents 48th wedding anniversary. What a remarkable day to celebrate this special, and (frankly) uncommon milestone. Only they know all of the memories they’ve created over the last 48 years together. In sickness and in health, good times and bad, annoying habits and all. I am filled with love, admiration and respect for what they have created and I am grateful they are healthy, happy and continue to support and love each other. There’s so much to learn from relationships that have endured years together.
Today is also a pivotal day for Jeff and I. As I sign their anniversary card, I find myself feeling the tension between fear and hope. Today, we get the latest scan results. We’ve been through this several times – actually, every 3-4 months. We head to the hospital, meet with the oncologist and learn whether the current treatment is working. If it’s working, we continue. If it’s not, we switch to something else. I’ve been intentionally upping my FQ (fun quotient) and gratitude exercises the last few days to ward off the worry. Yoga, movies, playtime with the dogs have been great tools. And, it’s also helped that I’m in the middle of final exams which keeps my mind focused (most of the time).
Today, we greet the Y in the road.
When Jeff was diagnosed, the oncologist created with us, a roadmap of viable treatment options that outline levels of toxicity and impact on quality of life. We’ve been using that sheet of paper over the last 2 years, evaluating and selecting the best option, including clinical trials, based on scan results.
We’ve reached the end of that roadmap.
And, herein lies the tension between fear and hope.
Will we walk out of the oncologist and head into chemotherapy for the next 3 days?
Or – will we go back home to start a different set of discussions.
Last Friday, I found myself standing in the middle of a Seattle sidewalk, swimming in a sea of lanyards and I started to cry.
Hundreds of employees from the surrounding tech companies were breaking for lunch and bombarding the streets to hit their favorite eats. I watched these employees buzz by me with their prepared salads and curry bowls. At every bistro and coffee bar, there were long lines out the doors. I overheard a bit of shoptalk around the future of customer experience. I smiled. When we moved to Gig Harbor, I knew there would be times I would miss this energy yet our dream to create an intentional career shift and more simple life carried far greater benefits. What I didn’t expect was how incredibly out of sorts I felt in that very moment.
Literally, two streets over, was SCCA house, a temporary living stop for those going through cancer treatment. Jeff and I decided to stay there after chemotherapy that night. The place is filled with paperbacks, puzzles, a quiet room, and plenty of cancer literature. Instead of lanyards, this is the place of head scarves, ports and slow moving patients who seek a place of quiet rest. While a comfortable and well-designed space, one can’t escape the visions of illness throughout.
It’s hard to imagine a juxtaposition capturing so vividly the profound nature of what was and what is. Only 2 streets away, life looks – and is – drastically different.
In that very moment, the experience of walking between those two spaces, from the past to the present, was overwhelming.
I placed one foot in front of the other, walked intentionally through the sea of smartphones and stopped at a quiet corner. I stood there, took a deep breath, grabbed our bag of ‘chemo snacks’ and walked into SCCA house.
Between the shock of receiving a cancer diagnosis and the sh*tshow of treatment, you begin to share the news with loved ones. Since Jeff and I have been through this rodeo twice (head and neck cancer, 2006 and prostate cancer, 2014) we’ve learned that most people want to know as much about the details as you’re comfortable sharing: What stage? What are the treatment options? What are next steps?
This is about the time you start to hear all sorts of cancer stories and advice. Most are helpful, hopeful and supportive. And then, there’s the comment that leaves you wondering why.
Most of these were said with the best of intentions (I hope). And, I know not everyone knows what to say when faced with scary news. My hope is that this might help others stop. think. and then respond with a more supportive option.
Here’s the tour of our top 10:
#10. “Well, if you’re going to get cancer, at least it’s not (insert type of) cancer. I hear that type of cancer is really deadly.”
All cancers are capable of killing.
#9. “My (grandpa, uncle, etc.) died of cancer – it was really horrible. At the end, he was all bones and was in so much pain. It was just awful.”
#8. “I know what you mean. My neighbor’s son was just diagnosed with bone cancer and he’s 30 years old. Can you believe that? I mean that’s so young. I feel so bad for him.”
#7. “So, now that treatment is done, you guys can move on and forget this ever happened, right?”
No. And especially no when someone is battling metastatic disease.
#6. “Please call me and let me know how I can help”
To help a family battling cancer don’t wait for the phone to ring. Pick it up and put it out there. And keep calling. I promise it makes a big difference.
#5: “I don’t know how you guys are getting through all of this. It’s just so horrible.”
#4: “I hope things go well for you both with your cancer journey.”
Yeah, it’s a journey alright. Want to hop on for the ride?
#3: “Stay positive and focus on fighting”
Usually said in passing or at the end of a conversation. This is our favorite.
When someone we care about is battling cancer, we want to support them and their family. We want to do or say something that will make a difference, maybe make things easier.
What does support look like, sound like and will it really help?
When Jeff and I are at SCCA (Seattle Cancer Care Alliance), we meet families who are all trying to navigate and manage the challenges cancer drops into daily life. Below are the 5 common themes we consistently hear from other families – combined with our experiences with cancer over the last 10 years.
#1: Acknowledge the Situation.
Maybe it sounds crazy, maybe too basic? Helpful support comes in the form of thoughtful words that acknowledge the pain, fear, and difficulty the family is experiencing. It’s OK (and normal) if you aren’t sure what to say or you don’t fully understand what they are experiencing.
Families battling cancer aren’t looking for perfection – what’s important is that the words are heartfelt and honest and they know you are willing to walk beside them.
What it sounds like:
I’m so sorry. (yes, this is enough)
I love you and want to help in some way. What can I do to lighten the load? (see #2)
I’d like to stop by and chat (meet for coffee; go for a walk). What day works for you?
Call often, send cards or small goodies that remind of times spent together. (tea, books, movies)
#2: Go Beyond Offering to Help – Make It Happen.
Asking what you can do to help is a thoughtful gesture. What brings relief is taking steps to make it happen. Families battling cancer are focused on preparing questions for the doctors; scheduling treatments, making work, childcare and pet care arrangements. Life changes day-to-day and feels chaotic.
What it looks like:
Offer to arrange for house cleaning. (check local cleaning services – some offer free cleaning for families undergoing treatment.)
Make soups and bone broth and deliver in air-tight storage containers. (broth provides super-powered nutrients during chemotherapy!) See Recipe: Magic Mineral Broth from Rebecca Katz
Help with lawn care; walk the poochie; water plants while families are at the hospital.
Put together a ‘Fun Kit’ for the kids to keep them occupied during appointments. Or, create a Chemo Survival Kit to make surgery, radiation or chemotherapy a bit more manageable.
Treatment days are long and hospital food is well, hospital food. Coming home to a warm meal or a clean house provides practical, much-needed respite for families. Families comment how much they appreciate it when relief comes in the form of helping with day-to-day chores, allowing them to focus on more immediate issues.
#3: Remind Them They Are More Than Cancer.
When families are living with cancer, it’s easy for life to revolve around everything cancer. Life is different; however, they are still your unique friends, co-workers, and neighbors. Many times, relief comes in the form of reminding them that cancer is a (big) part of their life – yet not their entire life.
Share the story about the crazy boss, the funny neighbor and tell a funny story about the kids. We want to know what’s good and not so good in your life. And, we want to share non-cancer stories and give our minds a break. These normal conversations help everyone come up for air and create perspective.
What works for us:
Jeff and I have learned to limit our ‘cancer conversations’ to 10-15 minutes among ourselves and with others. The caveat is when we’re preparing for an upcoming oncologist appointment. Keeping the conversation short prevents us from diving into the rabbit hole of negative thoughts. It’s our way to maintain a positive state of mind and give time to talk through important items.
At the end of every day, we share 3 good things that happened that day. Whether it’s eating dinner together, keeping dinner down :), having an interesting client conversation or starting a new project – it’s a proven daily exercise to increase positivity and gratitude. Watch Video: Why 3 Good Things Works
#4: Don’t Disappear.
When a friend was diagnosed, her siblings never asked how she was doing throughout the entire year of treatment. She felt abandoned when she needed them most. What she wanted was to know they cared. What she felt was alone and hurt by their choices.
Sometimes, family and close friends disappear when they hear the word cancer. It hits too close to home, they feel helpless and they choose to leave the building. It happens more than you think.
Dr. Rainer from Georgia Southern University who studies grief and relationships describes this “kind of distancing as “stiff-arming” – creating as much space as possible from the possibility of trauma. It’s magical thinking in the service of denial: If bad things are happening to you and I stay away from you, then I’ll be safe.” Read the full New York Times article
#5: End of Treatment is NOT the End of Cancer.
When treatment is over, returning to life “pre-cancer” often doesn’t feel right. Many family members, especially the survivor, asks themselves: “What now?”. For those with metastatic disease, new concerns arise and the focus shifts to survivability and quality of life. Each family may celebrate the last day of (active) treatment in a specific way; however, the next morning, things are different.
Providing support to the family battling cancer is recognizing that life is different. Perspectives have changed; what was once important tends to shift and it will take some time to feel steady again.
What tips do you have for helping a family battling cancer? Share in the comments.
The other day, I walked by a small group of kids, standing outside of a shop. A little girl, about 8 years old, said to her friend: “You’re being a fun-sucker! I don’t want to be around you right now because you’re sucking out all of the fun!”.
Growing up, my friends and I used to create new words. Fun-sucker could have easily been one of ours. We also liked to create weird food combos like peanut butter, cheese, and mustard sandwiches. Sounds gross but if you like all three ingredients, the sandwich is pretty good.
“You’re being a fun-sucker!”
My immediate reaction was giggles. I was excited this little girl was leaning in and expressing herself. I felt sad for the little destroyer of fun who was apparently having a tough moment. As I kept walking, I thought about how some moments in life are downright fun-suckers. Cancer tops my list as King fun-sucker.
Making Cancer Fun?
It’s really important to me to have moments of fun as a way for Jeff and me to stay connected. There are plenty of ideas online to create “fun” during cancer treatment. Head shaving dates, wearing costumes to treatment or hosting end of treatment parties. I found a video of a patient dancing into her double mastectomy. She asked friends and family to dance to Beyoncé’s “Get Me Bodied” wherever they happened to be the morning of her surgery – a virtual dance party. I think these ideas help make cancer less scary, they create smiles, keep the hope engines revving and let family and friends know things are OK.
Fun with 3 C’s and a T: Champagne, Cartoons, Cards, and Travel
After initial diagnosis in 2014, Jeff and I celebrated with champagne after radiation treatment. Every day for 9 weeks, he signed into rads as a cartoon character. Marvin the Martian was the all-time team favorite. Every Friday, I gave him a little gift and card to mark another week down and sometimes, we’d hit our favorite bakery in Seattle and grab goodies for the weekend. My co-workers sent us a surprise box of FUN filled with toys – it was a great reminder to PLAY. When Jeff was able to travel, we went to Ireland. It was a bucket list adventure filled with fun. We didn’t talk about cancer once on the trip – not once. It felt normal.
When Jeff was re-staged with bone and liver mets, we had a head shaving date after his first chemotherapy session. During infusion, we listened to music and watched movies, played games and shared stories with the nurses. Friends sent cards (no flowers for chemo patients – immune system risk!) and a chemo survival kit to help us through the brutal treatment.
Jeff’s cancer isn’t slowing down (yet) and he’s struggling with daily pain, nausea, and fatigue. We seek fun. Walks, dinner out, hikes with the dogs, long trips – these are not possible right now.
When we define fun using our pre-cancer definition, we can get snarky and sad which doesn’t help. So we’ve decided to redefine fun as finding small, daily moments to connect.
UCLA’s Center for Integrative Oncology posted an article about “Fun Quotient” (FQ) and the importance of couples upping the FQ during cancer treatment. It basically says that improving your FQ is an important part of cancer treatment and that most people (cancer or not) could benefit from a higher FQ.
“Cancer treatment often requires a great deal of time and energy and must take priority over other activities. Life is reshuffled. It is not uncommon for patients and caregivers to become focused on the tasks of getting well as defined by their doctors and other medical professionals.
…Being involved with negative activities over time can whittle away at your sense of well-being and hope. This process also can arise for the same reasons and with the same intensity for family members and caregivers. Relationships that once were strong can be weakened if this negativity goes unchecked for long.”
Let’s Do This.
My coaching clients know I like visual triggers. They are helpful reminders when we want to accomplish something. So this morning, our trigger is front and center on the fridge:
“What’s our FQ for today? – Do It!”
Maybe tonight we’ll sit outside on the deck and play a fav song; watch a movie or catch up on a TV show. We also like to look at pictures from our travels and laugh about funny stories. We miss how active we used to be and are grateful there are many things we can still do to stay connected. We’re working on acceptance. But that’s another post 🙂
How are you upping your Fun Quotient? Leave me a comment!
When you live with someone battling cancer – you worry. You worry about treatment options, doctor appointments, getting things done, creating little moments of normal, seeing your loved one sick…there are times the worries seem endless. Thoughts pop while I’m driving, hiking with the dogs, working, even sitting outside enjoying a few minutes of solo time. Early morning is prime-time for the worry show as the house is quiet, the dogs are fed and my cup of tea is made. The moment just before the day starts, that’s when my worries kick into full gear.
I worry about…
seeing him in pain
watching him lose weight
a super active guy, now lying in bed for hours
the loss of our future dreams
hope – do I have enough? am I being realistic?
accepting that this IS happening
his wishes and whether I’m supporting them
having a plan
knowing what to do when he’s not here
the future – without him
celebrating and honoring the time we have together
Tea time 6:30am.
I asked my therapist for a tool to keep these worries from invading my every day. She recommended I invite them for tea 3-5 minutes daily to listen to and acknowledge the worries. The concept is called a “worry appointment”.
Basically, my worries are like a 3-year old toddler in my head that isn’t feeling heard. This little one is persistently nagging for the gummy bears in the check out line. And every time I give in, it’s taking me away from more productive thinking.
The goal of the worry appointment is to give my worries a few minutes of my time every day. Once they’re on the table and heard (note: I didn’t say solved) I get on with my day.
3 Easy Steps To Keep Worries In Check
The worry appointment must be at the same time every day to create stability; otherwise, the little one starts to get nervous and jerky as they aren’t sure when they will be heard. You can list your worries in your head, write them down or say them out loud. Whatever your preference.
Set the stopwatch for 5 minutes. If one day you get all of the worries out at 3 minutes, don’t stop. Keep at it and get everything out – be dramatic.
If a worry pops into your head later in the day, throw up the STOP sign and invite it to teatime tomorrow. Late attendees are no longer welcome. They are only allowed during the scheduled meeting time.
IMPORTANT: Where people go wrong (and I can validate this happens), is that they stop after 3-4 days when they feel less worried. If this happens, get back on schedule with a time that works.
Have A Persistent Worry? Tell It To Come Back Tomorrow!
I set the timer for 5 minutes every day. I download what’s in my head and give it the time it deserves. Once the 5 minutes is over, I remind myself that I’m trying my best to handle this challenging situation with grace. Then, I find it’s easier to shift gears to something more enjoyable and productive. If a worry creeps in while hiking the dogs, I tell it to come back tomorrow (sometimes I need to tell it a few times – stubborn thing).