[2021-01-13] Expectations and stress
I'm scheduled to receive my last chemotherapy tomorrow morning.
But...
My neutrophils are currently too low. They're at 0.8, but need to be at 1.0 or higher for the procedure to go ahead. I'll have to do another blood test at The Ottawa Hospital first thing tomorrow morning.
But unlike previous neutrophil results that threatened to delay my chemotherapy, I'm taking this result in stride. Rather than be disappointed, I'm accepting my current situation. Here's why.
I've learned a few things since the start of chemotherapy. First, my neutrophil levels—reflected in the table below—have always been higher the day of chemotherapy than two days prior, when I've needed to repeat the test.
Scheduled chemo date | Neutrophil levels two days before chemo | Neutrophil levels morning of chemo |
Oct 1 | 4.8 | - |
Oct 22 | 2.0 | - |
Nov 13 | 1.1 | 1.2 |
Dec 3 | 0.7 | 1.2 |
Dec 24 | 1.0 | - |
Jan 14 | 0.8 | ? |
Originally, the Cancer Centre required a neutrophil level of 1.2, but later modified that to 1.0. That's why I needed to repeat my blood test in November but not December. But I figure that if I could go from 0.7 to 1.2 between December 1 and 3, odds are that I can go from 0.8 to 1.0 between January 12 and 14.
What I've also learned since the start of chemotherapy is that delays in scheduled treatment because of low white blood cell counts are normal. This knowledge has helped me to adjust my expectations. While I'll be a little sad if my final treatment is delayed by a week, I'll know that there was nothing I could have done to change the outcome and that it won't ultimately have a negative impact on my treatment.
For years, I've known that disappointment occurs when there is a gap between our expectations and reality. For example, I thought that the schedule for my chemotherapy treatments was to be adhered to, without fail. And so I was disappointed when it looked like my treatments might be delayed—until I realized that such delays are normal and not of concern.
The stress caused by a mismatch between expectations and reality is something I wrote about many years ago. My blog post was based on this article: The Best Strategy for Reducing Stress. Author Peter Bregman provides tips for how to deal with the stress and frustration of unmet expectations. The first step, he says, is to recognize that we have two choices:
Either change the reality around you or change your expectations.
In many cases, we can't change reality, so changing our expectations is the only option. I was able to change my expectations by getting information from both healthcare professionals and fellow cancer patients, who advised me that delays are normal.
If changing your expectations is too difficult, says Bregman, try changing your perspective. He says:
Imagine a scale from 1-10 with 10 being the worst reality you can imagine. Like living in a war zone or being in the World Trade Center on 9/11. Maybe 9 is a serious illness that most probably will result in death. Perhaps 8 is something that will forever alter your life, like going to jail or an accident that puts you in a wheelchair. Let’s say 7 is something that temporarily alters your life like losing your job or having to move out of a home you can no longer afford....
Almost everything we freak out about is somewhere in the 1-2 range of dashed expectations. In other words, our moods and our stress levels are determined by events that actually matter remarkably little.
Again, good information goes a long way to alleviating stress. Knowing that a one-week delay in my treatment wasn't a big deal moved a potential delay way down the worry scale.
With luck, my final chemotherapy will proceed as planned tomorrow. Go Neuts Go! If not, then I'll practice a little patience.
