Tools for Accountability
My therapist asked me once to consider why I am different from many people in my approach to my Cancer diagnosis. In that same session, she also asked me to think about my ultimate goal or priority for this journey. The answer to the latter question came much more easily; my priority is to have the best quality of life for as long as possible. I am happy to report that a year and a half into this journey (a year and a half into the expiration date the original Oncologist had given me) I am succeeding with the priority I established to have a good quality of life. I am stronger and more vigorous than I was when this all began. My stamina isn’t quite where I would like to see it, but I understand my body is still healing from the ravages of the Cancer.
The answer to the first question about why I am different from many people in my approach to Cancer was a slower realization; it took deeper reflection. The answer that rises to the top seems to be twofold:
As a problem-solver, I want to understand everything I can about the topic. In this case - Cancer - what the research says about what works and doesn’t work in the treatment of the disease so that I find a unique solution based on a hard, critical look at all of the available research. My years of researching has taught me how to discern the difference between valid research and research that is biased or financially driven.
I am a very data-driven individual. I believe this comes, in part, from my professional life where I learned to write goals, figure out the steps to achieve those goals, measure the progress toward those goals using specific criteria, and then modifying those goals when they are achieved/not achieved. I learned very early in my career how to write a measurable plan with highly specific goals and to review it on a regular basis in order to determine how well it is working. In my mind there is always a very logical progression on the road to resolution. The other factor driving this in my personality is I am a very competitive person, so in analyzing my metrics I learn where I stand.
So, what are the tools or metrics I use to measure my progress? They seem to fall into two different camps: those that depend on outside help and those that I can use myself on a daily basis.
Outside Help:
In general, these metrics are tied to my standard of care treatment through my Oncology Team. I am fortunate to be affiliated by a medical center that allows me access to the results of all of these tests. These include:
Routine (monthly) labs that examines specific metric such as my cancer tumor markers, my immune function, as well as my kidney and liver functions. The Oncology Team reviews all of this information with an eye toward trends that indicate improvement or the possibility of disease progression.
Routine (quarterly) scans in order to monitor the metastasis/healing of my bones.
Metrics I Measure Each Day:
These are daily metrics that I have included as part of my day so that I can measure how my habits effect me in real time and have enough data to see what trends are happening from the accumulation of my habits. Here are the tools I have discovered work well for me:
Fitbit - this tracking device allows me to track: my steps, my mileage, how many minutes a day my heart rate is above a resting level, the calories I burn, my level of stress (and areas of strength/weakness in terms of stress management), my sleep quality, my exercise and my weight.
Cronometer - this is an App that allows me to monitor my macronutrients. It is particularly helpful in monitoring the impact of foods and activity. It is an App that can be a little intimidating when you first begin using it but you have the ability to create your own foods/recipes, which makes adding information easier and quicker. I know there are other macronutrient tracking Apps that others find easier to use, this one is my preference.
Keto-Mojo - this device allows for monitoring blood glucose and ketone levels. The newer device/App allow you codetermine whether your glucose and ketone levels have you in a good range to manage your Cancer (this is called the Glucose-Ketone Index or GKI, a metric devised by the research of Dr. Thomas Seyfried).
Workout Logs - whenever I do a resistance, balance/stability, HITT or Pilates workout I record those workouts with specifics about the workout (e.g., weights used, circuits followed, Pilates movements, etc.). In this log I can keep track of how often I am doing certain types of workouts so there is a good and varied mixture to what I am doing. This allows for all different parts of my body to be worked in a functional way and presses different metabolic levers.
Daily Journal - for the past year I have been reading and journalling with the guidance of the Stoic philosophy. This allows me to keep a record of my deeper emotional and spiritual thoughts/feelings as well as how I am feeling physically.
I know this sounds like all I do is spend my time logging everything about my day. But that is not the case. It is in actuality just a small fraction of my time. But the time spent using these various tools allows me to truly know where I am with regard to my health. There is also a reduction in stress, knowing what is going on with my health from all different angles. I have spent many years (for a variety of reasons) learning to use these different tools and adding them one by one to my arsenal.
From my perspective, I would rather know for sure what’s going on instead of just guessing based on how I feel. Or just assuming that because I am eating a certain way I am in a level of ketosis to be of benefit to manage my Cancer.
If you are just starting this journey and using these tools sounds overwhelming, my suggestion is to look at your plan…what are your immediate priorities? Then based on those priorities determine which tool(s) would best help you measure your progress toward that. Start by using one tool and mastering its use; make it a habit. This will help you to follow a logical plan without jumping from one strategy to another.
I will close this long post with a thought from a recent Stoic reading (The Daily Stoic by Ryan Holiday and Stephen Hanselman, 2016) I had about life being a battlefield.
“Today, you’ll be fighting for your goal, fighting against impulses, fighting to be the person you want to be. So what are the attributes necessary to win these many wars?
Discipline
Fortitude
Courage
Clearheadedness
Selflessness
Sacrifice
~Ma halo
