Healthy and Fit After Cancer

Update

In an epilogue at the end of my book, "101 Things You Should Know About Breast Cancer" I shared that I had a recurrence of my breast cancer and would give an update from time to time on my blog. My book launch at the end of September into October was a time of celebration and joy. I couldn't have asked for a more perfect time in sharing.

However, that season was to change. What initially seemed like a regional recurrence, where I was filled with hope of snapping the cancer back into submission, turned into a very different scenario. In November I learned instead, that my cancer was spreading.

"Metastatic disease" is what I am dealing with now, where there is no cure but a space where we work to "manage" the cancer with one drug after another, until they stop working. It means that my life will likely be much shorter than it otherwise would have been… but then who knows how long any of our lives are going to be?

So far this journey has been filled with much emotion, highs and lows, many questions, and much uncertainty. It's a place I never really thought I would be, but here I am.

I hope to share some of this journey as I go through it… so stay tuned.

Wishing you love and peace,

Pam

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101 Things You Should Know About Breast Cancer/Shine on!

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Having fun posing as if I am a celebrity in front of the photo wall at this Hampton's International Film Festival after-party event (see the name of my company by my right elbow) at East Hampton Studio's!
It's fun to pretend, and being the actor I am, quickly had my friend with Athena's Cup snap a picture. Living far from the rich and famous, of which I am neither, I also enjoyed posing with the high end cars on display with Exotic Classics - another game of pretend (as salesman Jeffrey Merritt assisted). And I was interviewed by the fun-loving and wonderful team at Hampton's TV (VVH-TV) which has coverage from NYC to Montauk and was streaming live during the event. You can watch their interview with me here. Being a southern girl far from the big city, they were welcoming and gracious!

This picture and interview were mere fractions of seconds in the scheme of my life, but might appear as if I held a social status that I don't have. As I've told people who asked about how I was able to go there and to the Emmy's, I say, "Have cancer and be an advocate, and you, too, will have opportunities!" tongue in cheek. My friend Jean (to whom my book is dedicated), lived life fully with Stage IV breast cancer, and always said she was a star in her own life and encouraged others to do the same, shining wherever they were planted. She didn't like to travel and woke up every day, dressing as if she was on the red carpet and doing the things she loved. She didn't need Hollywood-she was Hollywood. She loved her life no matter where she was planted.

The fact is, we don't need a red carpet, status, or wealth to be a star. Embracing and savoring life, both the good and the bad, is what makes up the life of a star… the routine moments we often take for granted until a loved one is no longer there to share them-those moments.

So what matters most for me? My husband, sons/daughter-in-law, family, and friends! Opportunities to make a difference and help others comes in a close second, but don't think for a moment that mere seconds in a photograph make up a life. My life is far from perfect, but it's my life!

Facebook or Twitter postings and celebrity photo-ops of others may make us think everyone else is living the "good life" but us. What I know for sure is that behind every picture, Twitter, or FB post, there is a story and a life of relationships, joy and pain, success and failure… and not always what they seem! You need look no further than Demi and Ashton in what seemed like the perfect life.

When the camera stops rolling (as in our work or other roles) and we are home alone with our thoughts (and loved ones), what matters most? Only you know the answer, but one thing is for sure, you can shine wherever you are planted. Choose the life you want, make it happen, and star in your own life!

Shine on!

Wishing you peace, love, and strength,
Pam
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101 Things You Should Know About Breast Cancer

When I was diagnosed with breast cancer over 7 years ago, I never imagined that I would be writing my story in the form of a book. It was clearly a labor of love that took two years of extremely hard work. I wanted to quit so often, for so many reasons, I never imagined I would see the day it was complete!

But I was pulled by the desire to make a difference and had always been taught that when much is given, much is expected. I could not keep it all to myself. I was in a position to share what I had learned from leading experts in the field and my own personal and professional experience because not only was I asked to write the book with that title, I had nearly 30 years of professional experience in educating the public around health promotion, disease prevention, and had always been good at simplifying information (was a Special Education teacher early in my career).

To be diagnosed with a recurrence the day I was to submit the manuscript was ironic. I shared in the epilogue that I would continue the story here, which I will… but for now I am happy, healthy, and living life fully, launching a book I hope will make a difference.

I have been blessed by friends from coast to coast who have helped me launch the book and am extremely grateful. I have been in Los Angeles and Berkeley, back home to Raleigh, and off to New York this week again to share my message at the Hamptons International Film Festival. I have used social media (FB and Twitter) and every possible chance to share the message of the book. I won't review details of the book here (see synopsis at the links to the left about the book) but I will share some pictures and links to stories so far, below. My book is from a small publisher so there is no "official tour" …just me, spreading my message of hope and health. Please consider buying a book here on my website and share the message to all those you know and love. It's a resource no woman should be without!

I will be speaking locally at Rex Wellness Wakefield this Wednesday, next week at Rex Wellness in Raleigh on Monday, and back to Wakefield and Cary the following week.

With love for a beautiful fall season filled with all good things,
Pam

Television:
NBC's My Carolina Today at 6:50 mark
WRAL interview with Pam Salsby
Coming this week, another story (to be posted)

The Official Book Launch hosted and sponsored by Embassy Suites Brier Creek and Cary Magazine (more photos to come in their upcoming issue:
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A beautiful space called the Flight Deck at Embassy Suites Brier Creek, perfect for a book launch!!! It was a beautiful, fall evening!
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An incredibly delicious white cake with strawberry filling sponsored by Catering Works, the talk of the party! And co-founders Sharon Bigelow and Beth Roach with www.navigatecancerfoundation.org whose organization was the beneficiary of an awesome raffle at our launch party! And more delicious food sponsored by Phil and Pat Whitt (proud parents and supporters).
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With my biggest supporter, my husband Jerry with a gorgeous sunset behind us (thank you Jonathan Fredin with Cary Magazine for the photo)… and good friends Kristin Dill and Zane Creamer, among many others. Thanks for coming out!

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Dad signing in the guest register… and drawing at the end of the evening with my son, Jeremy and daughter-in-law Caroline in the foreground doing the drawing!

Below… more launches/book events:
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With my friend Susan Helmrich (Swim Across America.org) at the launch in Berkely and her friends.
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With my filmmaker son Dustin and hubby… and awesome friend, Suzanne Lindley (www.beatlivertumors.org) at Debbie Durkin's EcoEmmy's gifting suite.
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To a small but awesome group at 24 Hour Fitness in LA (with former classmate Joey Bullock) and another wonderful group at www.weSpark.org in Sherman Oaks (no picture)

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Mike's Way to A Cure Day at Jersey Mike's Wakefield (Wake Forest area) where 50% of proceeds went to Komen (food sales)-did a book signing and posed with the manager Marcus and Chris.

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Sorting out coaching in the cancer world

The term "coaching" is so often used to describe helping relationships, that when hearing the word "coach", one may assume it's just an adjective added to describe the help a person gives. However, this is not the case!

Over the last ten years the professional world of coaching has developed into a more rigorous field, with certifications and specific skill sets that are developed and tested to insure basic competencies. In some types of coaching, specific professional credentials/degrees are required. However, many coaches that are helping cancer survivors, may not have any credentials other than the desire to help others, which is fine, but when choosing a coach it's critical to know the difference. The term "coach" is often used when there is no professional coach training but is attached to describe a "helping" relationship like patient navigation, a growing field of its own.

Being on the international faculty for Wellcoaches® for many years, and bringing my background as a health and fitness professional (and a cancer diagnosis) to the table, I started the first health and wellness coaching program for cancer survivors back in 2004. The mission: optimal health, fitness, and well-being after a diagnosis of cancer, through wellness coaching. My work was the subject of research published in late 2009, showing significant results in various areas of health and well-being, including reduced depression and an increase in healthy behaviors (weight loss, fitness, nutrition) . And in 2006 and 2009, I was honored to present my work at the American College of Sports Medicine's Annual Meeting. I should add that thousands of professionals have been certified around the world as health and wellness coaches, through Wellcoaches®. Many work with chronic disease or other health issues, as well.

I share this, because the journey of being an accepted, credible practice in the world of oncology has been long. It is not based on my feelings or just the desire to help, but on expertise in getting results (evidence-based practice).

My experience has been that though the word "coaching" may be used in a title, such as "cancer coach" or "recovery coach", there may be little that is similar about those coaches. It could mean that the coach is essentially a patient navigator helping you navigate the treatment experience with the health care system (as a peer or professional), or it could mean they are life coaches (with or without credentials) that are helping with the emotional side of recovery. Even within the world of certified health or wellness coaches, one's professional background (nurse, dietitian, social worker, health and fitness professional, etc.) and philosophy can vary greatly. Looking at professional credentials can be helpful to understand what they will bring to the relationship.

Sometimes well-meaning people put a shingle out to help and are espousing beliefs, cures, and supplements (or herbal remedies) that are not grounded in science; meaning expensive and not effective. Research has shown that cancer survivors are particularly vulnerable to these things. That's why it is important to ask the questions I have listed below.

I choose to simply call my work "wellness coaching for cancer survivors", (through my program Healthy and Fit After Cancer®), because on the whole, we are not talking about cancer, but about working towards optimal health, fitness, and well-being, no matter the life circumstance.

Questions to answer before working with a coach:

What type of professional coach training have they had?
What are their professional credentials and background outside of the coach training?
What specific areas are they qualified to help you with?
What is their knowledge and training in those areas?
What experience have they had in the world of cancer?
Are they working with mainstream medicine (complementary) or are they mostly in the world of alternative medicine (working in areas they may not be evidenced based)?
What is their philosophy about the work they do? Do they see you as a problem to fix or as a partner to help you get where you want to be?
Most importantly, do you like the coach? Are they personable? A good coaching relationship begins with trust and rapport.

So before choosing a coach that is right for you and your situation, you might want to dig a little deeper to find the right fit! Here's to your health!

By the way, my favorite patient navigation program, which uses oncology nurses (and doesn't use the term coach): Navigate Cancer Foundation (a partner of LIVESTRONG)
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Flourishing in spite of great odds

Spring has brought great heartache and monumental devastation around the world, with earthquakes, floods, tornadoes, and storms. And yet in another moment has created the beautiful promise that life begins again with baby birds chirping, flowers blossoming, and renewal all around- giving us hope.

Time after time, we hear the thoughts of what really matters from survivors. Material, earthly possessions can be replaced. Having each other is what matters. The spirit of love and hope abounds, with human beings reaching out to one another bringing a sense of peace and gratitude.

Devastation comes in many forms. When our lives are turned upside down by some unforeseen event, we can't imagine that we can get through to the other side. Cancer is one of those events. When faced with more than we think we can handle, friends, acquaintances, and family come out in full force, to show us we are not alone, and that we can indeed, make it through.

We find new strength, new perspectives, new relationships, and love from our experiences. We appreciate what really matters, and life begins again.

I have watched cancer survivors build new lives after a diagnosis of cancer and thrive. I have watched people change the world, while living with cancer and treatment as a part of the rest of their lives, as if their life depended on it. I'm always amazed and inspired. They flourish with new meaning, engagement, new relationships, and accomplishment, because they know that life is short. It's not wasted or squandered on things that don't really matter.

The good news is that we don't have to wait for a disaster to flourish. Find gratitude in the small miracles of life- and write them down each night. Science tells us it makes a difference! Take the VIA Signature Strengths assessment at Authentic Happiness to learn what your strengths are-use them in a new way everyday for just one week. Science tells us you will thrive for months to come.

Discover what makes you flourish... and optimize your health and well-being. It's never too late!
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The story behind the story

Today, a press release was sent out to media outlets regarding the work I have been involved with for the last several years. As you can imagine, a press release can only say so much. There isn't enough time or space to adequately do it justice. There are stories behind stories, behind stories.

One of the most important stories behind the stories, are the individuals and the challenges they face. Treatment can be lifesaving, yet sometimes brutal, leaving patients weaker and more susceptible to other problems. There is great need for health care to help survivors heal and be healthy after those treatments. We can do the research, but we need the programs in place to follow through, and very little funding exists to do that.

As we've shown, wellness coaching provides one avenue to reach all parts of a person's life and help them move forward in doing the things they can do to heal and live fully. Even if patients must live with chronic issues, cancer, or other side effects, life can be improved. A wellness coach can support people to have a hopeful mindset, giving them a pathway up. Following through with healthy lifestyle recommendations and sustaining those habits are probably the most powerful results of coaching, all of which have the ability reduce a survivor's risk for recurrence.

Here's to the opportunity for doing just that!

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Gratitude and appreciation of beauty

It’s been an exciting month with little time to blog, though I have managed to Tweet here and there! The Liver Symposium in Chicago was filled with some incredible stories of survival. It was an honor to speak and be with survivors who live fully each day. I spoke about Embracing Happiness, something they know a lot about. I will attach a few photos. Suzanne Lindley, the director of the event, made it memorable for all.

This last week I presented our longitudinal research on
Wellness Coaching for Cancer Survivors at the American College of Sports Medicine’s Annual Meeting in Seattle. I never imagined that I would have such an opportunity, given that over 5,000 researchers from around the world attend. I’m what you might call an “honorary researcher” as the principle investigator calls me. I’m not a PhD, researcher, but a practitioner with passion! Several years of work has culminated in some great data showing significant improvement in survivors quality of life, depression, anxiety, and healthy lifestyle measures. Participants reduced their BMI (Body Mass Index) and weight, as well as ate more fruits and veggies, over the 3 months of coaching. The exciting part is that one year after the coaching ended, weight loss was either sustained or continued to go down!!! Fruit and vegetable consumption also continued or increased! Helping people live their healthiest, happiest lives, in their own way, is what I love to do and I’m thrilled to confirm that what I thought was working, IS!

I am so grateful for Dr. Mary Lou Galantino, who took on the project and continues to inspire those around her. She is also a cancer survivor and is passionate about doing research that will improve survivor’s quality of life. Stay tuned...

This wonderful month culminated in the opportunity to go to some beautiful locations in British Columbia, Canada...
Victoria, Vancouver, and Whistler (the site of the 2010 Winter Olympics). I’ll share some photos of it all.

I am grateful for the opportunities I’ve been able to take part in over the month. The beauty I experienced wasn’t just the beauty from the “sights” but in the hearts and minds of those I came in contact with. Wish I had some good photo’s to share of them. More to come!

Take a moment to think about what you appreciate today. Science is telling us it is one of the most important pieces of improving our happiness!

Chicago was beautiful in the spring!
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Reunion of LIVESTRONG Orange Monarchs (Leana May, Suzanne Lindley, and me) at the LIVER Symposium, Empire Room at the Palmer House where Jim Belushi and his Sacred Hearts Band performed for all.
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Presenting our research at ACSM
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Seattle... with Mt. Ranier in the background

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The drive between Vancouver and Whistler... breathtaking
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On Whistler... we did the Snowi Limo which is someone skiing you down the mountain while you sit in a chair... soooooo cool. It’s not available in the US because of our litigious society, by the way. insurance is unavailable :-( I took this little video (click here) as I sat in the limo and FLEW down the mountain...


The Fairmont Empress, turn of the century hotel l in Victoria... outside, inside, and the courtyard with my parents... then Bouchard Gardens. All beautiful!
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Buchard Gardens in Victoria
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I couldn’t talk about the last month, without showing a picture of our newest addition to the family :-)
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Dream come true for Suzanne

Next week Suzanne Lindley, the Stage IV colon-cancer survivor I interviewed in my last blog, will achieve a special dream. She has long wanted to bring together physicians and survivors in a special forum that will benefit both and bring hope to all. HOPE is the overriding purpose. She has worked tirelessly to make this global event happen. To learn more, go to www.TheLiverSymposium.com or read this informative press release from CNBC. In addition, a high profile celebrity performer will open the event in a performance that is said to bring people to their feet and bring the house down! Please share with anyone and everyone that might benefit.

I am honored to be a part of this and will be wrapping up one of the days with a talk about happiness. The title of my presentation is “Embracing Happiness: Five Simple Steps”, though a better name would be “Suzanne 101”. Watching her LIVE and thrive with great meaning and purpose, through what most would consider major obstacles everyday, is something that will stay with me forever.

Thank you, Suzanne, for the gift that you are!
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Support from the love of Jean

Many years ago at the age of 16, I met a woman who would come to be a big part of my life and ultimately, through her later diagnosis of cancer and untimely death, bring a special group of friends into my life. Today, we spent a few hours together laughing, crying, and reminiscing about the woman who brought us together and the individual journey’s of our lives.

We came to know each other because of Jean Pendergraft. Jean was the epitomy of Joie de Vivre. She loved life and her positive, spirited approach, no doubt, kept her alive many years with metastatic, or Stage IV, breast cancer. About five years before her death, she decided that she wanted to form her own support group, that would take turns taking her to her various treatments. She chose friends of different ages and backgrounds. We did not see each other except upon the occasions that Jean would bring us together to thank us. One time she rented a limo that picked us up and took us to a restaurant in Raleigh. We giggled the whole way there and back. Our ages ranged from 40-62. Jean liked hanging out with younger women because though she was in her 60’s, she had the spirit of a 20 year old. Another time she took us all in a van down to her beach house at Wrightsville Beach, for an afternoon and evening out. We got to know each other during these fun gatherings with her as the ring leader of fun.

We took care of her until the end, coming over and fixing her hair and make-up each day, as this was of vital importance to her. When she looked better, she felt better, something she made a priority her entire life (and a habit that rubbed off on me as an impressionable young woman when I met her). I kept her stocked with a special apple cake recipe that she insisted was keeping her alive in her final months. We did whatever we could to make it easier. We came to know each other in this supporting role. Jean told us we were going to need each other.

As she had predicted, we did need each other. Two years after she passed away, TWO of us were diagnosed with breast cancer within a month of each other. Amazing. I was one of them, the health and fitness professional who wasn’t supposed to get cancer! Who would have thought, only a few years later, we would again experience her journey in a very real way. I always said, “I thought I understood what she was going through, but I had NO IDEA.” But thank God for friends.

I was so blessed and privileged to be a part of Jean’s life. She left us many gifts. The gifts of friends she shared are among the greatest.



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A picture from the late 90’s of our group celebrating with Jean.
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A picture of laughter today as we gathered to reminisce and have lunch.
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International interest; Copenhagen

Yes, Copenhagen, Denmark. I was interviewed about the work I am doing with cancer survivors on National Public Radio in Copenhagen, Denmark. AMAZING! I was thrilled to know that people around the world have an interest in the health and well-being of survivors. It seems they have a weekly program around “coaching” and they heard about my Healthy and Fit After Cancer℠ program, coaching survivors, and the research we have participated in. I would post the interview, but I wasn’t allowed to-just a link. The web site where it was posted, http://www.dr.dk/ , was of course, in Danish, and didn’t offer much for my English speaking friends and colleagues. Anyway, the message here, is that there is international interest in SURVIVOR’S health and well-being!!! YES!
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Healing After Cancer Treatment

Coming back after surgery, injury, illness, chemotherapy, or radiation always seems to take longer than we anticipate! Remembering a few key principles will go a long way to helping you heal faster and come back better than before! Dr. Julie Silver’s books (Super Healing or After Cancer Treatment: Heal Better, Faster, Stronger) are great resources that give extensive detail about why these factors are so important and how to address them.

1. Sleep
2. Nutrition
3. Exercise

Sleeping is one of the most important factors in healing, as your body needs that time to recover and heal. Uninterrupted sleep of 7-8 hours, with little to no sleeping during the day are the recommendations. In addition, getting less sleep has been associated with a number of health problems, too numerous to mention here. The bottom line is to talk to your doctor and do whatever possible to sleep through the night.

Eating nutritious foods helps our bodies do the healing work needed within the cells. Healthy eating is never more important. See www.mypyramid.org for more information about what a healthy diet consists of.

Exercise is the most under-prescribed component of healing, but is probably the most important and beneficial. Therapeutic, cardiovascular exercise that gets your heart rate in your Target Heart Rate Zone (makes you breathe harder, breaking a sweat), is what can make a huge difference in energy levels, reduction of fatigue, and healing. Of course, one should always check with a doctor first. As you are able to progress from increasing daily activity, to walking for 20-30 minutes, exercise should progress to a more intense level for a minimum of 15-20 minutes at least 3 times each week, when possible. Oxygen consumption is increased and better utilized throughout the body to do a first class job of healing!

I had major surgery in August and can attest to the power of these three components. The first two (sleep and nutrition) are what most people think of for recovery. Exercise is almost never considered a major part of recovery in most people’s minds. I have to admit that in spite of being an exercise professional, and KNOWING this, I have been guilty of forgetting from time to time! I most notice the reduction in fatigue that comes from aerobic exercise. Exercise IS medicine, (www.exerciseismedicine.org) and can actually affect the other two categories in a positive way. More to come...
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Update

Pilot Study: A lot has happened in the last year! We are in the middle of a pilot study, through Richard Stockton College of New Jersey, Cancer Care Connection in Delaware, Rutland Regional Hospital in Vermont, and Northwest Community Hospital outside Chicago to study the benefits of wellness coaching for survivors. We hope to have a larger clinical trial in the near future, so we can prove the efficacy of wellness coaching for survivors. My personal hope is that with this data, we can apply for funding so that all survivors can have access to a wellness coach if they want one!
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