Wednesday, February 21, 2018

PCL24: Progress with Prozac

Around the five month mark post chemo, I realized something was not quite right. It wasn’t my new fascination with discussing balls at every opportunity; it was more than that - my mood was not what it should have been. At first, I thought it was just the stress of returning to work and transitioning back to being a normal person instead of a cancer patient.

Upon closer inspection, I realized I was still feeling down, but it was summer, so the job reason didn’t make sense. If you’re not at regular reader of ABSOT, I am a teacher, and teachers don’t work in the summer - that’s the main reason we chose this, duh. (If you’re my principal and you’re reading this, please understand that this is a joke.)

"We Don't Make Excuses... We Make Changes"
My classroom and personal mantra
(Also, a rare smile selfie)
However, a new school year began, and I noticed that I was feeling off and just not as enthusiastic as I once was about teaching. It wasn’t that I hated my job; it was that something internally wasn’t quite right, and it was having an impact on my ability to teach to the best of my abilities. My students were still learning, growing, and seemingly enjoying themselves, so they didn’t appear to notice my internal struggle. Nor did my administrators, who are awesome and amazingly supportive of me, or my co-workers, who are also pretty great and put up with endless ball puns during team meetings. Regrettably, we don’t teach about spheres during the geometry unit.

In addition to feeling slightly off at work, I also realized I was feeling irritable and was much quicker to get angry at home. In October, I experienced a full on panic attack while watching an episode of Stranger Things on Netflix on the eve of my orchiectomyversary. Overall, hobbies like reading and cooking didn’t bring me as much pleasure as they once did, and I just felt generally pretty flat.

As I’ve alluded to numerous times through my writing on ABSOT, I battled with depression in high school. However, since my only job at that point in my life was to be a student (and school had never been a struggle for me, since I was in the gifted program), it didn’t have an impact on my “job.” It dawned on me that I was now feeling some of the same effects I did back them.

Knowing that having depression at a young age puts me at risk for a recurrence later in life, I decided to look into research about cancer survivors and PTSD/depression to fully understand just how stacked the cards were against me. It didn’t bode well when I first typed “cancer survivors and…” into Google, and “PTSD” and “depression” popped up as the first two suggested results (followed by “alcohol”).

As I researched more, I found this study from 2017 that said about 20% of cancer survivors experience PTSD symptoms within six months of diagnosis. The CDC also reports that cancer survivors take anxiety and depression medication at almost twice the rate of the general population.

After finding this information, I decided to ask for help, specifically in the form of antidepressants at my follow up visit in December. Dr. Maurer agreed to prescribe them, and I thought it would be all pretty rainbows and fluffy unicorns immediately.

However, about four weeks later, I felt no different. I knew antidepressants could take up to six weeks to show major changes, but I wasn’t feeling even slightly better. Perhaps I even felt worse, as I had these “happy pills” and I still felt down. Maybe something was just wrong with me - beyond the missing testicle.

I’ve learned to be open with my health and feelings, so at my med check up with NP Sullivan, I basically said, “Hey, I don’t think these are working.” Since I am obviously super medically qualified (read as: not qualified at all), I supported my theorem by saying I was on the same dosage I was in high school, and High School Justin was about fifty pounds lighter and ten years younger (and had a terrible taste in hairstyles and girls, but that’s a different story for another day).

NP Sullivan actually agreed with me and decided to increase my dosage. I wish I could say that this was the end of my frustration, but it wasn’t.

However, this new struggle wasn’t internal - it was externally driven towards insurance companies and American healthcare in general. If you’re an international reader (and I know you’re out there, since according to Blogger’s data I have readers on every continent, except Antarctica, which is a shame since it’s cold as ball(s) there), appreciate it if you have a better healthcare system.

The pills are blue and orange, so that's also pretty cool.
PS - Highly recommend Artemis. Halfway through and
it's fantastic.
When Dr. Maurer first prescribed the pills in December, my prescription was denied, since the pharmacy needed to get “pre-authorization” because apparently, a doctor’s orders aren’t enough. This wouldn’t have been a huge deal, but I was going out of town for a week and wanted to start the pills immediately. Out of desperation, I ended up paying out of pocket for that first fill. About two weeks after starting the pills, the pre-authorization came through, just in time for my dosage increase.

And just in time for another claim denial. Apparently, my original pre-auth covered me only for the original dose. The fact that insurance claims can be denied through an automated system by non-medical professionals is ridiculous to me. Insurance companies, do better.

Long story short, the insurance claim handlers at Dr. Maurer’s office are awesome, and I got pre-authorized for the new dose. (Maybe my mini-rant on Instagram story helped too!) This new pre-auth lasts for a year, and hopefully, I won’t need any more increases.

To be honest, I don’t think I will need it. I’m not really sure when I noticed that I was feeling better, but when I wrote my “12 Months Later” post in late-January, things were definitely looking up. I was getting more into the swing of lesson planning and teaching, minor things didn’t bother me as much, and I didn’t find myself complaining as often. I wish I could say that colors were suddenly more vivid, but I’m colorblind and colors don’t ever look bright.

It’s now the end of February, and I feel so much better than I did in September. (Side note - I really feel like Christopher Nolan with the amount of time jumps in this post. My bad.) While I would never say I hated work, I definitely have a better attitude when I walk through the doors of Room 31. Exercise, writing, reading, and cooking have become more enjoyable again. I've even developed a new hobby - Speed solving of Rubik's Cubes. I know, I am super cool and not nerdy at all.

While writing this post, I realized that this one has a better feel and tone, as compared to some of the posts I wrote between September to January, even though it’s about depression, I feel more like myself on a day-to-day basis. I haven’t resumed any sort of formal therapy program, but I know that is definitely recommended while on these pills. It’s on my to-do list to look into in the future.

My biggest takeaway from this all is to ask for help if you feel you need it. There seems to be such a stigma around mental health and this post is an effort to be open and transparent to help dispel it. Sometimes, mental health isn’t even viewed as a necessary thing to take care of or treat as a serious matter. We treat our bodies and help them to heal when we are sick or injured; why should our mental health and brains be different?

This mini rant on insurance doesn't even begin to
discuss how much everything costs
(A $600 balance from a CT scan I received)
The debacle with the insurance company and preauthorization helps to underscore this issue. When I had “probable strep” in January, although the test came back negative, the company had no problem approving amoxicillin, even though it probably wasn’t necessary. Any other prescription for my myriad of side effects during chemo was filled without an issue. But needing antidepressants? I had to jump through hoops to get those.

I recently saw a Tweet that said, “Depressed people don’t need Prozac. They need running shoes and fresh air.”

That’s a damaging narrative. I tried that, and continue to exercise, but it wasn’t that simple for me. If that’s your opinion, fine. Go run or whatever else works for you. But don’t shame other people for trying what might work for them. Just as I’m not going to fault you for trying homeopathic medicine, don’t go throwing crystals at me for what I’ve chosen. Positive thinking just isn’t enough sometimes.

I hope that this dosage continues to keep my mood elevated and on the upswing. I have no idea how long I’ll need to be on the antidepressants, but I’m not worried about it. What matters to me is that my emotional healing is beginning to catch up to my physical healing, the disparity between the two being something that has been nagging at me since I was cleared for remission.

However, this is something that I should have seen coming. They removed half of my “lower brain” and left my upper brain fully intact… no wonder it’s taking twice as long to heal!

Tuesday, January 30, 2018

PCL23: Twelve Months Later

Although it seems like ages ago, today marks twelve months (also known as one year) since I rang the bell and completed my chemotherapy. This time last year, I was apprehensive - had the chemo worked? Would I be cancer free now? When would the side effects end? Would my long, luscious locks grow back?

Spoiler alert: to answer all of those questions, yes, yes, in a few months, and yes.

I wrote “progress updates” at two months and five months (meant to be six, but I counted wrong) post-chemo. When preparing for today’s update, I reread those posts. I was struck how different in tone they were. While I was still experiencing a number of physical side effects two months after chemo, I was seemingly okay mentally. The inverse was true for the five month update - very few physical side effects but a lot of emotional turmoil.

My selfie game remains strong
Today, I am revisiting those “progress updates” for a twelve months later post. Physically, I’m 99.999% back to normal. I have not had any feelings of nausea since the perfect storm of the all-you-can-eat pizza buffet and imbibing on the night of my the bachelor party, but that’s not related to chemo in any way. My hair has completely grown back (but I’m contemplating a new style now). My fitness levels are through the roof - I recently ran a mile in less than seven minutes and thirty seconds, my bench press max is higher than it was in college, and I’ve lost over thirty pounds (the ten pounds I gained on chemo, the five on the honeymoon, and then some), making me the lightest since moving to Virginia in 2013. I know these sound like a lot of humblebrags (isn’t that the whole point of social media?), but it’s also a way to show my physical progress.

The only real remnant of a physical side effect (accounting for that 0.001%) is my continued disdain for plain water. This first stemmed from the metallic taste in my mouth during chemo and continued through recovery. I honestly have no idea if that’s even related to a lingering side effect, but I only take my water infused with lemon or cucumber… and shaken, not stirred.

On the mental and emotional side of things, I’m somewhere in between the two and five month updates. One of my biggest frustrations during chemo and beyond was my inability to read a book. I ended up completing 55 books in 2017, 3 fewer than 2016. Honestly, I was disappointed in myself that I didn’t match or surpass the previous year, but I also had to take into consideration that I only read for ten and a half months in 2017 versus nearly all year in 2016.

Now, I can read books with ease, finishing over ten books since the start of 2018 (with a goal of 60 total this year). It seems like a random achievement to strive for, but it’s an important one to me to prove to myself that my brain is fully functioning again.

Overall, chemo brain seems to have less power over me, as I have significantly less difficulty with memory and word retrieval now. At times, I do have some issues remembering what I was trying to do a few minutes prior. Usually, I just retrace my steps (sometimes literally), and that triggers my intention. Google Keep (I find it weirdly awesome to check things off my to-do list) and Alexa still keep me straight on a regular basis.

Upping from 10 mg to 20 mg in early Jan
Emotionally, I’m doing better than I was doing at five months (that was quite a dark place in hindsight), but I’m not quite to the level of the positive and chipper attitude I had two months after chemo. As I’ve shared, I started on antidepressants after my last CT scan, and I’ve been on them for about a month now. They say it takes about six weeks for them to fully take effect.

My doctor recently upped my dose to 30 milligrams a day instead of 20, since I was not feeling any different after four weeks. Since beginning the increased dose, I am noticing that my overall mood is improving. I am hoping that this is due to finding the right pill and not just a placebo effect. As time goes on, I will share another post focusing more on my experiences with these pills.

Overall, I’d say that twelve months later, I feel physically great, and my emotions are on the upswing for now. I’m sure the physical side of things will maintain its strength (pun fully intended), while the emotional side will be up and down as I travel through life. I wrote a post in October, to commemorate the one year anniversary of my orchiectomy, about how my goals, perspective, and focus have changed since beginning this journey, and it still holds true. I’m looking forward to next January’s edition of this post and seeing where life has taken me by then.

And for the record… my left testicle STILL has not grown back.

But I still have hope, even if that “definitely won’t happen naturally and we’ve asked you repeatedly to please stop calling us, Mr. Birckbichler.”

Tuesday, January 16, 2018

HBA17: How to Support a Caregiver

A cancer diagnosis doesn’t simply affect the patient - it affects many in their lives. Since the beginning of ABSOT, I gave voices to my loved ones in the Healthy, But Affected series. My mother and wife (then-fiancee), Mallory, were my two primary caregivers during treatment. Without them, I couldn’t have done it. Being a caregiver isn’t easy, so here they share some of the things that helped them get through the experience.

Support them at their workplace as they take on a second job as a caregiver.

Mom: “During Justin’s treatments, my job was very good to me – never made me feel guilty about going to Virginia for weeks at a time. We had a sub who did a great job and my boss never made me feel bad about missing so much work. The parents of the preschoolers really made me feel good when they would ask about Justin. They all understood why I needed to be away from the preschool and no one ever made me feel bad for not being there.”

Mallory: “My school administrators were very supportive. It was never a problem for me to leave early to take Justin to appointments, and they actively wanted to be kept in the loop with Justin’s status. If my grade level team noticed I was having a bad day, they would offer to take on some of my extra responsibilities, like recess duty, so I could take a moment to myself to breathe.”

Take things off their plate.


A bald rose between two thorns
Mallory: “Both Justin’s and my school organized for meals to be delivered, which was a blessing since Justin is the primary cook around our house, and he didn’t always have the stamina to cook. Neighbors chipped in to help with mowing the lawn, shoveling the driveway, and getting groceries for us, so I could focus on helping Justin. Justin’s mom would also help take care of him while I took care of the house, or vice versa, and it was extremely helpful to have two people managing the situation.”

Mom: “A group of friends organized who would bring food each week to my family in PA. It took a burden off any one person (or my family), and I think it helped people feel like they were doing something to help when there was little else they could do. I appreciated that the house was in good shape when I would come home for a week or a weekend - my family that I left behind at home really stepped up their game and took on the tasks that I generally do.”

Ask about their feelings, too.

While my mom said that people would ask her how I was feeling and Mallory said mostly close friends and family members would ask how she was doing, my little sister, Courtney, had a different perspective.

“When Justin was diagnosed, I started to tell people. After sharing, people began to ask me, ‘How’s Justin?’ or ‘How’s your brother doing?’ While it was very nice to ask how he was doing since he was the one doing the real work and the real fight, rarely was I ever asked how I was doing.

Honestly, I was not okay. I was 16 years old, and my older brother, who is only 25, had cancer. How in any way would I be okay!?

I was up in Pennsylvania over 3 hours away from him, and I didn’t always know what was going on. To make it even harder, since our mom was down in Virginia as his caregiver, I couldn’t even talk to her about it.

A cancer experience is primarily focused on the patient, and, in my experience, it seems that not as much thought is given to the family member of the cancer patient, especially if they’re not an immediate caregiver. Everyone is nice enough to ask how the cancer patient is doing, but if I counted how many times I was asked how I was doing, I could use one hand. This time was really hard for me, and no one seemed to care to ask about me. While Justin was the one going through it all, he has always been my best buddy and I was being affected by it in a different way.”

Small gifts go a long way.

Mom
: “Some of my friends put together a gift basket for me filled with things to do while sitting for hours at chemo or for my long drives to Virginia. Things like books, movies, books on CD, nail polish, lotions, bath bombs, coloring books, colored pencils and snacks. I loved coloring adult coloring books at chemo as it passed the time very quickly. Someone let me borrow their entire DVD collection of Downton Abbey, and that helped fill the time. Another friend gave me a gift certificate for two massages, which really helped me relieve stress.

While the massages helped provide physical relief, one of the most symbolic and special things I received during Justin’s treatment was an anchor charm for my Pandora charm bracelet from his dad. He said I am the anchor of this family. That meant a lot to me because I felt so torn in so many directions – I knew I wanted to be able to help Justin, but I also knew I was leaving the rest of the family behind to do the things I normally do for them. I had guilt when I was away from them and guilt when I was away from Justin. By Dad giving me the anchor, it made me realize that I was the anchor of the family and was needed everywhere, but I was doing ok by helping everywhere.”

Mallory: “I got a bracelet from Justin’s aunt that said, ‘Courage and strength,’ which helped me find a symbol of strength. Some co-workers got gifts for us to help give us something to do when Justin was having a good day, like a movie night basket. I also enjoyed coloring books, as they helped me to relieve anxiety in a calming way.”

Accept that cancer sucks, and it’s ok to say that to them...

Mom: “One of my good friends once told her after she had a stillborn that she needed to hear people say “this sucks,” rather than always hearing positive comments. Don’t get me wrong, positive comments are good too, but every now and then, it is ok to be down, and it is ok to hear that ‘this sucks’ because it really does. I have tried to remember that ever since she told me that she needed to hear that sometimes. So tell the patient that it is ok to have down days, and realize yourself that you can’t be positive all the time. But also my dad’s voice is always in my ear saying “just tell me what I have to do to take care of this and I will do it,” so I know I often said that during the course of Justin’s treatment.”

Mallory: “One of Justin’s former co-workers sent me a card that basically said that and it was nice to see that it’s ok to be angry about cancer. A colleague at my school even offered her classroom (which is secluded from the rest of the school) as a place I could come and scream to let out frustration. I never took her up on that offer, but it was nice to know the chance was there. People understood and embraced my feelings and never made me feel bad for saying when things weren’t great.”

...but remember to encourage them to find silver linings where they can.

Mom: “In a weird way it was a blessing because I feel like Justin and I got closer during that time and I also got to know my daughter-in-law much more than most mothers-in-law ever get to know their son’s wife. And she still even seems to like me after spending all those months together!”

Mallory: “I really got to know my mother-in-law better and now we have a deeper connection on a level that not many people do. [Author’s Note - I can attest to this, as they have a constant group text that I am needlessly included in]. Another silver lining was that I was able to find enough strength to pull myself together and let go of my worries and fears during the treatment process.”

While many of my posts are from my perspective as a patient or survivor, it’s equally as important to recognize the efforts and struggles the caregivers face. I’d like to thank Mom, Mallory, and Courtney for sharing their thoughts here, and I hope their words help you support a caregiver you know.



Sunday, January 7, 2018

HBA16: Courtney's Speech

Recently, my little sister (who isn’t so little anymore, but I refuse to accept that) gave a presentation to her class about testicular cancer. I’ll let her explain it more in her words below, but since she did such a good job with her original HBA, I asked her to write a piece about her speech. 

I had an assignment to give an informative speech for senior English, and one of the requirements was to pick a topic that you felt that you were an expert on. This requirement made my decision hard because I don’t feel that I am an expert on any one topic in particular.

When she's not talking about balls,
she's hitting field hockey ones
as a member of the All Division team 

and captain of her high school
team.
I decided to do my speech on testicular cancer and men’s health because of Justin. Since I look up to him and his efforts to spread men’s health awareness, I thought, “Why shouldn’t I help?” Even if it is only to twenty people in my class, it’s twenty more people that now have the knowledge they didn’t have before.

My four minute speech, which included important facts and statistics about men’s health, testicular cancer, and why no one should be afraid to talk about it, went off without a hitch, earning me a 98%. Following the speech, I handed out self check cards to all the boys in my class.

When I look back on this experience, I think, “Wow, I am proud of myself for discussing men’s health in front of my class.” This thought is followed with, “Wow, that was really weird to talk about men’s health and testicles in front of my class!” Being a girl made it somewhat uncomfortable to talk about this subject, but the more I spoke about it, the more comfortable I became. By the end of the speech, I realized I was no longer afraid to talk about men’s health with my classmates.

Now, I don’t think I will be nearly as afraid or uncomfortable to talk about men’s health and testicular cancer. Being a female should not make you afraid to talk about men’s health, as it could save a life. Going forward, if I have to do another assignment where I can choose the topic, I think I will choose to report on testicular cancer or men’s health again. Even if it is not an assignment, I would be open to talking about this topic again.

Thursday, December 21, 2017

PCL22: Looking for Clarity

I’ve made many mistakes in life, but a recent one that sent me on a troubling downspin was yesterday afternoon. I opened my radiology report from my CT scan on the patient portal from my oncologist’s office. Seeing as the June report was very clear in saying, “No pathologically enlarged lymph nodes [and] no metastatic disease,” I figured I could sneak a peek at the report during a grade level meeting (sorry teammates) and move along with my day.

However, these words did not appear anywhere in the report. In fact, it stated that one lymph node was 1.3 centimeters in size. In June, all of my nodes were subcentimeter in size. This December report didn’t even mention the June one and only compared it to February, which was a remission scan, too. I decided to stop checking it and wait until I met with Dr. Maurer.

12/21/17
Still in remission
and taking care of the emotional healing
Later that evening, my body must have realized the best thing for me was to go to sleep, as I fell asleep during Die Hard around 7:45 pm. I woke up the next morning, raring to go for my 8:00 am appointment, on the first day of winter break.

I got to the office and checked in with the friendly receptionist team who greeted me every day last year. (Throughout the visit to the office, I also got to see all my old medical team, including nurse Jen and my pharmacist buddy. They all got ABSOT bracelets.) After being taken into the exam room and having my blood pressure checked (which wasn’t very high, surprisingly), I was told Dr. Maurer was coming from the hospital and would be a few minutes late. That was fine, as I needed time to collect myself.

As I waited, I noticed that the touch screen billboard in the office said, “Treating cancer doesn’t have to be stressful.” I agree. Treating it wasn’t too stressful. Surviving it is.

Eventually, Dr. Maurer came in, clad in a green shirt and red tie. His subtle holiday attire instantly earned more points with me, since I do love this holiday season. The first words out of his mouth were, “The scan looked good. You’re still in remission.” He must have known I needed to hear that.

I then asked about the 1.3 centimeter node indicated on the report. He pulled up my December, June, February, and November 2016 scans and placed them all side-by-side. Like I’ve always said, I’m not a doctor, so I didn’t quite get what I was looking at, but he did a good job showing and explaining it to me. The 1.3 centimeter node from my December scan did appear to be larger than it was in June. Interestingly enough, and I hope I understood this correctly, my original affected area was along the right side of my body and this node appeared to be on my left (or vice versa).

I asked him what that meant and he sent a message directly to the radiologist who read the report for further clarification. That’s the mark of a good doctor in my opinion. He didn’t say he would do it later; he physically pulled out his phone and did it right then and there. Hopefully it's nothing, and I should have more answers in a week.

He did maintain that I can still be considered as in remission, but we’ll keep an eye on this particular node. My next scan will be in June, as I’m on a six-month scan rotation for the next few years. Six months is a long way off, and I really hope that node doesn't continue to increase in size in that time.

The results of the scan was only one of the main reasons I was anxiously awaiting the meeting. While my physical healing has more or less completely ended, my emotional healing still has a long way to go.

If I'm really honest with myself, a feeling of darkness began less than six months after chemo was over. Ever since the Stranger Things episode and all the recent anniversaries of the beginnings of my cancer journey, it's become more pronounced. I know this darkness well, as it’s not the first time this has happened in my life.

I’ve mentioned it in a few posts, but I suffered from severe clinical depression in high school. The extent was pretty brutal, but I ignored the signs and let it progress to a stage I wish I hadn’t. Recently, I realized I was experiencing many of those same feelings now:


General feelings of “flatness”


Irritability and random outbursts of anger

Difficulty sleeping

Loss of interest in activities

Moodiness


And many more signs that have come and gone throughout the past few months. Since I am almost 10 years older than I was in high school (holy cow I feel old typing that), I realized the warnings and knew I didn’t want to get to the point I was at when I was a teenager.

Some people are into positive thinking, holistic medicine, healing crystals, exercise (or shopping), or whatever else seems to be the flavor of the week as therapy. I go to the gym regularly, and I do find that helps, but I can’t live in the gym 24/7. I tried traditional therapy in the spring, to no real effect. The eTC program helped while I was in the course, but I needed something more. I try to maintain a positive outlook, but staring your mortality in the face derails that slightly. Writing is an outlet for me, but it’s not enough alone.

So I asked Dr. Maurer for antidepressants.

I’m not beneath asking for help and this is the help I need. I know from previous experience that I respond well to these medicines and they help balance me. On my drive home, I asked myself, “Is taking these pills a cop out?” Honestly, I didn’t have an answer at the time.

A few hours later, I was doing a Facebook Live video (watch below) with Nora McMahon of Cancer Grad, and I found my answer. It’s not a cop out. The pills are not going to be the only way I find happiness. Writing helps me process. The gym keeps me healthy, inside and out. These pills will just be another tool in my toolbox for helping me to maintain a positive outlook, which is something I have struggled with since the end of chemo.


I hope by sharing that I’m going on antidepressants, others will find that it’s ok to ask for this type of help. I compare it to needing chemo for cancer or a cast for a broken arm. You wouldn’t say no to either of those, but why are people hesitant to try medication for mental health? In my opinion, it is foolish to suffer due to the stigma that if you need medicine to help be happy, something is wrong with you.

I’m not broken. I’m not weak. I’m not a lesser person for taking these.

If I’ve ever felt brave along this journey, it’s now. I’m asking for help and advocating for my own needs. It’s a step in the right direction to putting me back onto a path of happiness.

Sunday, December 17, 2017

PCL21: How to Help a Cancer Patient During the Holidays

Have you checked your Christmas balls?
As I said last year, I absolutely love the holiday season. This year, I’m able to focus solely on embracing the joy and merriment, but that wasn’t necessarily the case last year. Despite the grueling days of chemo and all its side effects, I did my best to maintain my Christmas spirit. As I look back, I realized that there were certain things that helped me a lot during the holidays. The following list details ways loved ones can support a cancer patient during this time of year.

Do things for them

Cancer treatments take a lot out of you, both physically and mentally. I didn’t always have the strength to do things or the mental fortitude to carry out traditional holiday tasks. I needed help, but I didn’t necessarily want to admit defeat and ask.

My brother, Kyle, was still at my house after Thanksgiving, which is the only acceptable time to begin setting up for Christmas. Since I was still recovering from my orchiectomy, I physically couldn’t put up our wooden reindeer in my front yard. Kyle noticed this and asked if he could put them up for me. Unfortunately, I didn’t have an excuse for making him do it again this year.

Similarly, my ABSOT partner, Katie, knows that I watch a different Christmas movie (including Die Hard, Iron Man 3, and Lethal Weapon) leading up to the big day. Usually, I spent hours arranging the movies and making sure it made sense (Home Alone 2 can’t be watched before Home Alone). Knowing that my mind was focused elsewhere, Katie asked if she could make the list for me this year. She ended up creating a really cool digital advent calendar, complete with GIFs to represent movies each day. (This year, I wrapped the DVDs so it’s a surprise every day!)

In both cases, I appreciated that they asked me before doing it. In my post “How to Talk to a Cancer Patient,” I shared that it’s important to offer specific help, but I did appreciate having the final say on what was done for me. Furthermore, both of them accepted input on what I wanted. Kyle asked where I wanted the reindeer, while Katie asked if I had specific requests for certain movies on certain days (the only two concrete days are Muppets Christmas Carol on Christmas Eve and Christmas Story on Christmas Day).

What can you do for the cancer patient in your life? Think about what they have done to celebrate on past holidays and ask them if you can help create the same amount of cheer this year.

Do things with them

One big thing I struggled with during treatment was the feeling of total dependence. I’m sure I’m not alone in this, so help the patient regain their sense of independence by doing holidays activities alongside them.

Last year's tree
The day after Kyle set up the reindeer, it was time to decorate the tree. Since I was going to be spending most of my time in my bedroom, I wanted my Avengers themed tree up there. I wanted to decorate it myself, but I knew I couldn’t carry a tree upstairs, open the ornament boxes, and so on and so forth without getting exhausted. My mom, knowing how important this was to me, stepped in to help and said, “Do you want to do this together?” She brought the tree upstairs, opened the boxes, and then handed me the ornaments. I got to put the ornaments where I chose, including placing Iron Man so he looks like he’s battling Captain America.

Whether it's decorating the tree, making cookies, or something else, be on the lookout for something that you know your cancer patient wants to do and can do, but may need help completing. It’s a small gesture, but it will mean the world to them.


Let them do things for you

Another favorite of my many holiday traditions is creating an ugly Christmas sweater. I’ve made some doozies in the past, and last year I was determined to do the same. Mallory told me that her school was hosting a competition and asked if I wanted to help make hers. I told her that not only would I help, I wanted to do it myself.

Over the course of a few days, I designed and built a fireplace sweater, complete with a three-dimensional mantle, battery-operated lights, and fake candles. Spoiler - she won the competition.

A small gesture, like this or the time I made pizza from scratch for my mom and Mal, are moments I look back on as major wins. Cancer patients don’t always need everyone doing everything for them, so let them do something nice for you when they offer.

Bring on the presents


Last year's sweater
Chestnut roasting on an open fire
It wouldn’t be a Christmas post without the mention of presents. Small things can help brighten a patient’s whole day.

The gift that made me laugh most came from my friend Quinn. Along with a Kylo Ren care package, he sent what appeared to be a coin purse. Upon closer inspection, it was a dried kangaroo’s scrotum from Australia.

But not all gifts need to be cancer related. Another friend got me a memory foam body pillow upon hearing I had difficulty sleeping. Listen to what the cancer patient needs. We don’t all need another “Cancer Sucks” shirt, but there may be something else that we can use to help make life a little easier during chemo.

Be the cheer

I take Christmas cheer to insane levels, but not all cancer patients feel the same. Help them find the sense of joy. There are plenty of holiday song playlists to choose from, or maybe you can drive them through the neighborhood of lights.

One thing to possibly avoid - making every conversation about cancer. Sometimes we just want to forget and enjoy the spirit of the season. Sure, it’s ok to ask about it and how they’re doing, but don’t dwell on their diagnosis.

However...

Respect that they might not be so cheerful

The holidays can be tough for someone with cancer. Sometimes they have to be quarantined from from others due to germs, they may look differently than normal, or any number of reminders that life is anything but normal. These feelings are totally ok, and it’s also ok to not understand what a cancer patient is going through. Be cognizant of this and be the friend they need you to be. Don’t make a hard situation worse by demanding that they show Christmas cheer and positivity at all times.

Even though I love the Christmas season so much, I personally understand that it can be a trying time. I’m not currently in treatment, cancer is still never far from my mind. I’m about twelve days away from my twelve month scan, which is not as great of a gift as turtle doves or lords a-leapin’. I’m doing what I can to not dwell on these thoughts.

Nevertheless, Christmas is the most wonderful time of the year in my opinion and I hope these tips help others to find the same joy. I look forward to it all year round, and this year is no different. To be honest, I think it’s in my blood. I firmly believe that in a past life I truly believe I was a little drummer boy…

Pa rum pum pum pum


Saturday, December 2, 2017

PCL20: An Open Letter to Tim Howard and Cremo

Dear Tim Howard and Cremo Company,

From what I understand, one of you is an athlete of some sort and the other is a hair care company. Seeing as I'm not into sports and my shampoo comes from a grocery store, our paths most likely would have never crossed.

Until November.

Since I have no idea who you two are, I'm going to assume the same goes for you knowing me. Allow me to introduce myself. My name is Justin Birckbichler. Many words describe me - teacher, husband, cat and dog dad, brother, son, and testicular cancer survivor. The last label brings us to the point of letter.

November is commonly known as No Shave November, a month for men to grow their beards freely. What's less well-known, but infinitely more important, is the why. It was originally designed as a month to spread awareness about men's cancers and health. The creators? A family who lost a father and a husband to colon cancer.

Unfortunately, on social media, it's become an excuse for men to skip shaving their beards and to instead post vain pictures for a month. We must do better, and in fact I have a few ideas on how to get the ball rolling. But this letter isn't about me. It's about you.

You are part of the problem.

Mr. Howard, in the middle of November, you posted a picture showing off your beard and hashtagged it with #NoShaveNovember. A further look revealed that this was a sponsored post by Cremo that advertised their products. No mention was made of the true intentions of No Shave November. Instead, the only purpose the post served was to highlight your beard and to earn some money for Cremo.

Since I had just written a post about using social media for the original purpose of No Shave November, I left the comment to the left. I also followed up with an email to Cremo. But again, this isn't about me. This is about you.

It would be one thing to ignore the comment. I get it. I'm one person with less than two thousand followers, while you're an athlete with almost a million followers. I would have chalked up no answer to never seeing it.

But you did see it.

How do I know this? Less than 24 hours later, my comment disappeared. Gone. Vanished. Someone, maybe not specifically you, had deleted my comment.

Why? Why did someone take the effort to eliminate this pushback? Why couldn't have there been a mea culpa moment? A course correction? A changing of the ways?

We're not so different, you and I. We both have facial hair. We both have passions that have opened up new doors for us. We're both men. We both spend a great deal of time dealing with balls.

I'm not angry… I'm disappointed. One in 250 men will be diagnosed with testicular cancer in their lives. Nearly 200,000 people will be newly diagnosed with colon or prostate cancer in 2017 alone, with about 75,000 dying from those two diseases.

This post, and others, could have been used for good. Raised awareness. Provided self exam tips. Shared risk factors. Anything about health.

But instead we got an ad.

You're not escaping the blame either, Cremo. You commissioned this ad. You paid for it. You've got plenty of posts on your own page using the hashtag, too. None of them mention men’s health.

It's now December. Nothing changed in the remainder of November, despite an email response from you, Cremo, saying that “upcoming posts will explicitly mention the awareness campaign.” To be exact, you posted ten more pictures after our emails, none of which held true to your promise. In fact, a handful of them just tried to push your product yet again.

Another one of your favorite hashtags is #BeardBoldly. You know what would be really bold? Standing up for men's health and following through on your word.

Like I said, I'm not angry, but I am disappointed. More than that, I'm ready to take action. There are 11 months until No Shave November begins again. Guess what I'll be doing on November 1st? Looking at both of your accounts. And I'll repeat it on the 2nd, and the 3rd, and so on and so forth.

I'm hoping this letter makes it to you and that your posts next year are more meaningful.

But if not, I certainly hope I don't see more ads with the hashtag misused again. You have a huge audience. Use it for good. Use it to make a difference in something (other than your bank accounts).

I'm sure you're not the only company and celebrity endorser who have done this. Frankly, I didn't want to look further. But I will be in the future.

Be the change.

Be the leader.

Be better.

Sincerely,

Justin Birckbichler

Author's Note: Tim Howard has now blocked me on Instagram after posting this blog and tagging him.