Coaching for Chemo Brain and Other Conditions

For those whose professional identity has been impacted by illness or injury, we provide validation and support to help you understand and incorporate the meaning of your condition and develop behaviors to manage your health and performance:

  • Gaining understanding and acceptance of your condition

  • Developing measures to cope with and adapt to symptoms

  • Affirming your value as a person and employee

  • Reprioritizing career and personal goals

  • Adjusting the way you present yourself, communicate about your symptoms and ask for accommodation

  • Re-defining your purpose, meaning, and fulfillment

 

 
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What is Chemo Brain?

Chemo-brain (also known as chemo-fog) can be a challenging side effect for patients recovering from cancer treatment. Chemo-brain is characterized by a variety of changes in brain functions known as “executive functions”, including:

  • Impaired short-term memory,

  • Inability to multi-task, organize and plan,

  • Diminished motivation,

  • Challenges in initiating and following-through on tasks,

  • Impaired concentration,

  • Difficulty learning or retaining new tasks and skill sets,

  • Reduced processing speed and foggy thinking, and

  • Struggles with word-finding and articulation

Chemo-brain is also associated with sleep disturbances, depression, and anxiety. While for some people, the changes are subtle and not significantly life-altering, for those whose symptoms are severe or those who rely heavily on executive functioning in their profession or at home, the symptoms can be devastating and debilitative (See below for More on Chemo-brain). People who are severely affected are no longer able to function in their professional and personal lives. Many are unable to work in their prior profession and must find a new career. Others are forced into disability or retirement, or are laid off.  For some, lack of acknowledgement from friends, family and the medical community negatively impacts their relationships and leads to social stigma and isolation. Many cancer patients who experience chemo-brain report that the impairment significantly changed who they were, emotionally and mentally.  Sufferers experience frustration, low self-esteem, and feelings of helplessness, resignation, dependence, and worthlessness. They are no longer able to recognize themselves and no longer identify with the person they were prior to treatment. For some, the loss of self, credibility, respect of others, self-esteem and employment leads to an identity crisis.  I know this because I have chemo-brain and all of this happened to me.

My husband and I were on a dream trip in the Galapagos Islands when I found a lump in my breast. Fortunately, my tumor was small, caught early, and had not metastasized.  It was removed by a lumpectomy with an excellent result. I had what is known as a ++- tumor, which is the “best” kind of breast cancer to have because the chances of a recurrence can be significantly reduced by a regimen of chemotherapy, radiation and hormone-inhibiting medications.  My doctors told me that with this combination of treatment, the chances of my cancer recurring would be the same as my chances of having developed breast cancer in the first place (1 in 8).  By all accounts, I was lucky. 

And I felt lucky.  I didn’t see cancer as something that could take my life – mostly I saw it as a major inconvenience to my life.  As was my typical m.o., I powered through the chemo side effects, and went about my life as normally as possible.  I grocery shopped, cooked meals, walked the dog, and did laundry.  I worked in my job as a healthcare executive throughout my treatment, which necessitated long hours and a 5-hour per day commute.  I interviewed for and was offered a position as a Regional Vice President for a national healthcare company. Aside from a bad cold that sent me to the emergency room mid-way through my treatment, I juggled home and work responsibilities pretty much seamlessly.  I didn’t see my bout with cancer as life-altering – just another blip on my radar screen of life challenges that I had to get past.

When I finished my 6 months of treatment, I was over the moon.  My hair was growing back and my taste buds were returning to normal.  I could enjoy a glass of wine again! My energy and enthusiasm were back.  I started my new job and was loving the challenge and excitement of being in a new company and in the position I had been working so hard to reach. 

All of that changed about five months later when chemo-brain hit.  My new job required a fair amount of out-of-state driving, conference calls, learning large amounts of detailed information passed along orally, and calculating key metrics in real-time.  It also required a lot of relationship development, selling and presenting to our physician and hospital investors. I began to have trouble retaining information conveyed on calls, remembering key market information, keeping people’s names straight, taking notes at meetings and finding words. I would have to re-read even short emails several times because I would zone out midway through and realize that I didn’t remember anything I had read.  These were tasks and skills that I once performed with little effort.  At home, I could no longer multi-task my way through cooking dinner, doing laundry, and paying bills like I once could. I’d record a check in the register but fail to send the payment.  I no longer had the ability to be the seemingly 8-armed octopus I once was who could multitask, retain and recall huge amounts of information, and interact, speak, and present with ease.  I, the Type A personality who had prided myself on my organizational skills, efficiency, and ability to get more done by noon than most people accomplished all day, was scattered and sluggish.  It was taking much more than my usual efforts to keep on top of everything and I didn’t feel that the quality of my work was up to my usual perfectionist standards.  

The mental and physical energy required to try to keep up with my work and home responsibilities left me so exhausted that I didn’t have the energy to exercise.  My itinerant work schedule and overnight travel meant a lot of fast food.  I gained weight.  My hair was growing in, but a different color and very curly.  I didn’t look or feel like myself. 

While my boss, colleagues, and family didn’t really notice my mental lapses, I noticed!  When I would get tongue-tied trying to retrieve a word, miss an exit on the freeway, forget to join a conference call, arrive late for a meeting, misstate a fact, or draw a blank on what I was saying mid-sentence, it would feel like my knees had been taken out from under me.  The harder I tried to overcome my challenges, the more frustrated, discouraged and inept I felt.  My prior confidence and self-assurance eroded.  I was anxious, depressed and exhausted.  In short, I no longer recognized myself.  I didn’t look or feel like the person I was before.  When I would tell my family, friends and health care team about my challenges, they tried to be supportive by saying things like “you’re fine”, “now you’re just like the rest of us”, and my personal favorite, “at least you’re not dead”.  While all of these statements may have been true, the lack of empathy and support made me feel isolated and distraught.  I knew I should be grateful to be alive, but I felt like I was struggling to live. 

Thankfully, once again, I was lucky. My company provided executive coaches for its leaders.  I had the pleasure of working with an amazing coach, Erin Rocchio.  Initially in my work with Erin, true to my nature, I tried to get very tactical – working on being more organized, more deliberate in setting priorities, and more stringent in managing my schedule – thinking this would help me to overcome my chemo-brain and achieve the level of productivity and success I had attained in my career prior to cancer.  However, over the course of a few months, Erin helped me to discover that I was working to adapt to a job, and a whole lifestyle in fact, that no longer fit.  This sense of mismatch wasn’t just that the job required skills and an energy level that were zapped by chemo-brain, it was that my prior profession and mode of being in the world no longer served who I am.  I had spent the past 25 years working really hard and putting off until “someday” many of the things I had always wanted to do – volunteer with a non-profit organization, learn to speak Spanish, read the hundreds of books accumulated on my bookshelves, develop a regular practice of yoga and meditation, reconnect with high school friends on social media, cultivate my relationship with my stepdaughter, hike Mount Washington to name just a few.  My busy work schedule and long commute had always gotten in the way.  I realized I wanted to get off the hamster wheel. 

Over the next few months, Erin helped me to get clear on what I value, how I conduct myself, and what it takes for me to be at my best.  She helped me to take stock of my life experiences, accomplishments, and capabilities and to recognize the important contributions I could make even with chemo-brain.  Most importantly, she helped me to challenge my limiting beliefs – the assumptions and stories I had that made me feel limited in my choices, stuck and without options. As a skilled coach, Erin did all this not by giving me advice or direction, but by asking me questions that helped me examine who I was, what I wanted, and what I took for granted. I felt heard, validated, and supported.  My sense of confidence and self-efficacy returned. It was amazing how much coming to my own conclusions and saying things out loud made them more real and shifted my energy from unproductive to productive pursuits.  I gained a feeling of control over my life that I hadn’t felt in many, many years.  I felt like I was in the driver’s seat of my career and my life for the first time! 

The experience of working with a coach led me to discover a calling to become an Executive and Leadership coach. This new career allows me to use my talents and life experience to serve and support others in pursuing their own goals and purpose.  It also affords me sufficient flexibility and time to devote to my family, health, hobbies, and ongoing personal and professional learning and development.  It has set me on the path towards realizing two goals that have been my dream since I was a teenager – to own my own small business (Debra Doroni Leadership Partners, LLC) and to write a book.  Never could I have imagined that chemo-brain and coaching could have led to such profound and exciting changes in my life! (See below for Coaching for Chemo-brain)

Some cancer patients report that their chemo-brain symptoms are so disruptive to their lives that, had they been aware of the potential severity of its effects, they would have skipped chemo-therapy, and taken the chance of trading longevity for retaining their prior level of executive function.  Honestly, I’m not sure that I would have been that brave.  Most likely, my “bring it” attitude probably would have prevailed.  Besides, having chemo-brain led me to the opportunity to work with my Executive Coach, Erin.  Coaching led me to embrace my dreams and reinvent my life.  Now I get to spend the second half of my life doing more of what I love, personally and professionally. I know I wouldn’t have had the courage to make that leap without the support and encouragement of a coach!  If it had to take chemo-brain to get me there, it was worth it!

Debra Doroni is a certified executive and leadership coach. This article is for information purposes only and should not be seen as substitute for medical or therapeutic evaluation and advice.