Open your eyes and look at the day.

"If you wake up and don't want to smile
If it take just a little while
Open your eyes and look at the day
You'll see things in a different way
Don't stop thinking about tomorrow"

The year is drawing to a close and like many I am casting my eye back and reflecting. As I made plans with my family for the year ahead I mentioned "I won't be having surgery this year" and I realise how this has punctuated my year-and the previous one. In a year where I faced major surgery and had times when I was investigated for lung and bone secondaries it's such a relief to say that. My recent visit to the clinic and negative mammogram means I now have a clear run for another year till my next appointment. This is partly because I have declined further treatment but I have done this with knowledge and its my decision which I can change at any time.

My decision not to have further surgery is to protect my wider health and perhaps because for 18 years I haven't been symmetrical, maybe it's just who I am now? The time it will matter most is when I buy a new bra. And readers , that time has come. Yesterday I did a bra amnesty. Ugh! I have one that fits and around 15 that don't. They reflect the ups and downs (!) of the last two years. There are functional ones ( pah) and attempts to cheer myself up ones but they don't fit. The best one I bought in breast cancer awareness month , when a significant donation went to Breakthrough. It seems fitting somehow, no pun intended...

So soon I must brace myself to get back into the lingerie department. And much though I dread it, want to scream at some one, want to punch attendants if they mention chicken fillets ( the women can explain if you don't know about these) ....I know I can't buy it on amazon. Perhaps this isn't the week as I am now on antibiotics for a chest infection and the emotions are close to the surface......be warned.

The other treatment I discussed was tamoxifen or similar. I was on it five years previously and know the side effects can really affect your quality of life. I stayed on it because I knew the research and my children were young, I took no risks. But recent research had pointed to the benefits of taking the drug for 10 years. So having declined it last year I thought I should revisit it.

And we talked it through. I learned there are some indications that smaller doses, different regimes and so on can reduce risk with less cost to the person. But that's not  common practice yet as the research isn't complete. How hard it must be to have that research funded. After all the drugs companies want us to use more not less, charity funders tend not to fund this kind of research, do governments then need to take up the mantel? After all this is about life, both quality and quantity and both are important. But in the end armed with the information, I still decided not to take it. My cancer was early and so on balance of risk to my wider health and quality of life ,I know it's the right decision.

The surgeon supported me with the words." The role of the doctor has changed, we no longer tell people what to do, we give them the information and support them to make the right decision for them". I wish we could clone him! He absolutely gets what person centred care is.We need more like him.

I am therefore approaching 2013 unfettered by imminent treatment and beginning to feel able to move on. That really feels good. As my life transitions into a new phase in January that knowledge is liberating. I can almost let myself be excited about the future again. But more of that in my new year blog.

Reasons to be cheerful. We had a wonderful run up to Christmas with family and Christmas itself was lovely. Good company, good food and beautiful walks on the beautiful Balmedie beach. Perfect. And Cara the pup was on charm offensive, she was indeed a wee star! And the quote I started with is a Fleetwood Mac one. Hope the song lifts your day as it did mine.
Vintage Fleetwood Mac

A heartful Christmas

It's been all quiet on the blogging front for me. A combination of rushing around, seeing family and a rotten virus. My creatives juices are in a hanky and my cough is frightening the puppy.....and me. My pre Christmas preparations have been fueled by paracetamol.And I have greeted friends with air kisses!

But there has still been lovely times with family and colleagues; I even managed to get some dancing in! Cheesy Christmas tunes in a venue overlooking the winter fair in Edinburgh sealed the deal. I loved it even if the evening may have secured me a new nickname following a comment from a dancer who chose to join our merry band. No ,not telling you, I was unwise enough to tell the family and am suffering the consequences!

And the week when ancient calendars predicted the end of the world , for some people their own world did end. I am thinking especially of the shooting of the children and teachers in Connecticut. I cant watch the news coverage of the town preparing for funerals rather than Christmas. Words aren't enough and I just hope that this tragedy is a beginning of change within the culture it represents.

Like many here it has triggered memories of similar and more local events  in Dunblane. A pretty town in central Scotland. Where such events should have been unimaginable. And I was working as a nurse in my own town when it happened. I found myself picking up the phone to the primary school my own children attended, in a very similar ordinary middle class town in Scotland, to check all was well. Even as I phoned I knew it made no sense but like every parent I thought well if it happened there it could happen anywhere. They were of course untouched in our town, but like us all, they were changed. It changed our gun laws and our child protection laws, we lost our sense of innocence as a nation.

And people's lives move on. Happily for Dunblane one such person is Andy Murray. Whose profile as a world leading tennis player has changed how people now know Dunblane and how welcome is that. Those affected got through by supporting each other, a lesson to us all in surviving hard times. I see such compassion and support in the breast cancer social media and blogging world and it lifts my heart.

The  run up to Christmas is always hard for those who grieve, who wonder how many Christmases lie ahead for them,  who worry about money, who are lonely. In our increasingly isolated worlds, single person households growing year on year, how many will spend this festive season on their own and shut out from a world of seemingly endless partying and excess? So ,if you can, reach out to someone you know who may be finding Christmas hard. If we all did it, what a difference that would make.

Reasons to be cheerful.
This weekend I have my family together and although I am frustrated by my current virus, I am really loving it. And Cara is currently sporting a rather jaunty neckerchief! How cool is she?

And finally wherever you are and whatever your beliefs i hope you have a heartful festive time.

A true partnership...or time to boogie?

Yes its beginning to look a lot like Christmas. The lights are on around town, the mulled wine is flowing and families tempted by excess, lured by snowmen to show love through their gifts, look in equal measure exited and stressed. Or is that just me? The juxtaposition of the Christmas pressures and the deepening economic challenges in the country make this a hard time for so many. And if you factor in serious illness or loss it’s a potent mix.

Every nurse can tell you of a patient who hung on against the odds to get to Christmas, to wait till a child arrives from Australia, to see a child perform a Christmas play…you get the drift. The poignancy of these occasions is without comparison. And people in the main do cling to life, their definition of quality shifting as illness advances ,but time with those we love are always top of the list.

And its this that drives much of the access to medicines discussion. But let me say this isn’t just about medicine. We know that surgery and radiotherapy are important parts of life saving or life improving treatment and lets not lose sight of that. But its access to medicines that have become the focus of recent times, particularly in Scotland. Amidst the complexity of the debate, there is consensus I believe that the current system isn’t working equitably across the piece. The bête noir of government-the post code lottery-remains, despite well intended efforts to change that. No one system changes that currently. But if we want to change it in the future my belief is following some key principles will help get it right:

1. Keep it simple! Healthcare teams are incredibly busy. Any system that overwhelms them further will create implementation fatigue and resistance.
2. Publish and be damned! To deal with issues of equity and implementation make it a transparent and a publicly accessible process.
3. Communication, communication, communication! Tell people about it, how to access the system and ask them (the recipients) if it’s working.

Ok maybe that’s a challenging approach but if this is a true partnership with people offering and receiving care there needs to be trust. As any fan of Strictly Come Dancing will tell you to succeed and develop you have to have confidence and the right steps in  the right order. And that trust needs to be earned by all involved. The research we fund at Breakthrough is all aimed at improving outcomes, either by preventing people getting breast cancer or stopping them dying from it. In order for that to be successful we need to ensure that the systems are such that they ensure people then get access to innovative treatments, wherever they are. Our loyal and hard working supporters and all people affected by breast cancer deserve no less.

Reasons to be cheerful: it's the all Breakthrough Christmas party this week. So we are off to London for the annual bash. If I say it costs a fiver then your expectations will be suitably modified. The unspoken rule that the senior team leave before drunkenness ensues ( no I didn't mean me!)  is worth adhering to. Usually I am close to the oldest there but my permanent state of denial means I hope to get a wee dance before the night is over. If you see me limping next week you'll know I succeeded. Don't blame it on the sunshine, don't blame it on the moonlight.......blame it on the boogie!

Nice to tweet you! Info about a new tweet chat...do join

I wanted to share with you something really special that is happening tomorrow evening. We have learned from our friends in the US the benefit of tweet chats to disseminate information and build community in the way that only social media can. The immediacy  and connection so powerful. And I have often read the conversations after the event but never had the stamina to join it ( it would be 2 am in the UK and Ireland). Consequently we are keen to try to connect across Europe and create the space and opportunity to explore the important issues you share with us.
As my blog and others have highlighted many times breast cancer has an impact on so many aspects of life. But perhaps parenting and parenthood can be one of the most emotive impacts. Consequently this is the subject of the first BCCEU. Here is more about the context.http://breastcancerchateu.wordpress.com/2012/11/27/parenting-with-breast-cancer

So please join us for this on line experiment and also let us know what you would want to discuss. I do realise parenting wont be the top of everyone's list but do let us know what is. I do know that for some women, breast cancer has robbed them of the opportunity to be a parent, a particularly cruel impact for too many. This kind of discussion helps to bring some of the hidden impacts into the open. That must help.
So looking forward to meeting and tweeting you on line tomorrow evening. And you don't even have to go out in the cold ( thank goodness) The hash tag is #bcceu and the start time is 8.30 UK time. Tell your friends!

"You have to find joy where you can".

And so it begins, the beginning of the endings......and the hankies have been out. Although the week started with a Geordie style celebration of the amazing efforts of two men. Robbie Elliot and Phil Gray who had completed a 3,500 mile cycle ride in aid of the Sir Bobby Robson foundation and Breakthrough Breast Cancer. Newcastle had come out in style and I even got to sit next to the legendary Jackie Charlton.Any football fans I mentioned this to since have been very excited. I managed to spend an evening talking about managing Ireland football team and fishing as well as defending my family from Sunderland! It's an eclectic skill set for this job, you see?

I did a short talk about why our work is so important. And I mentioned Angie who is much in my mind just now as the anniversary of her death approaches. The cold Edinburgh December evoking that sad day as we said our goodbye. And what I repeated was her reply to the question...are you scared of dying? "No nothing can scare me after living with this awful disease for so long".I wanted to let these two brave men know that their mammoth effort was for such an important reason and it would make such a difference. The Newcastle crowd were so generous.......but it was a tough gig for a Sunderland supporter!

The next day I set off to London and had a flood affected journey. Never quite sure if turning back would be the best option. But I did want to get there to attend my last board meeting with Breakthrough. Perhaps I didn't fully anticipate how emotional I would feel. I know I am making the right decision and I'm really excited about my future. And it was only when I read about a friend grieving for her Mum that I recognised the process I am going through. It's grieving and I need to give it space...not lock it away, tempting though that is.

Others have told me of their emotions leaving their jobs because of the impact of their cancer diagnosis and I recognise that's part of it for me. Perhaps I would have made this same decision without the cancer? But the fact is I didn't and so it's in the mix. But I also recognise how very very fortunate I am too , to have choices.

So many don't either through the extent of their illness or through circumstance. I have found myself thinking of my friend who had lived with breast cancer many years before she started to lose the fight.Her colleagues wanted to arrange a farewell lunch as she finally acknowledged she could not return to her much loved career. She was dying and she knew it. But she also knew she could not attend a farewell lunch and give a speech. She declined the well meant offer and I can only imagine her own loss having made that decision and its implications. These impacts aren't in the survival statistics, they are hidden away, but they are so very real.

It was the last of my 8 week mindfulness course this week. We spoke of acceptance and recognising the daily small achievements we make and honouring them, not always striving for more or feeling guilty about what we haven't done. Another tough gig for me! But I have loved it and know its sustained me through a difficult time. Hoping to sign up for more too.

Reasons to be cheerful!
Well the week ended on a high. Cara had a walk ( off the lead) on the beach at Cramond on a beautiful crisp winter day. Magical! And we went to see Karine Polwart. I have quoted her songs in an earlier blog. She was superb and I leave you with one of her haunting songs about grief....for all you who are grieving. In Karine's words.  " I can find joy in the sound of the rain. You have to find joy where you can." Hope you find joy this week.

Compassion and holding snakes lightly.

"Compassion is a muscle that gets stronger with use." Gandhi

If I say I am currently wrestling with the urge to open a packet of Percy pigs I was foolish enough to buy, my regular readers (ha!) will know all is not on an even keel. It's better than last week though, having survived a full on -and if I'm honest-emotional week.

On one day alone I went from carer of frail member of the family to chairing a key meeting in the afternoon with a considerable drive in between. That morning also included taking her to see the GP who was kind and competent but the star for me was the receptionist. She had gone out of her way to be kind and respectful in the face of frailty, with a strong dash of practical competence. I thank goodness for her...not just for my family but the many families she helps.

I was reminded of that when I attended the conference on person centred care the next day. Some key questions were posed like how do make make compassion reliable? And also important messages that person centred care is not just about choice, it's about control .Its about the how of care, not just the what. Food for thought indeed when you are living through this on so many levels. But as the day reminded me and many others, this isn't just about healthcare. It's about social care of course but more than that it's about the world we inhabit and the milk of human kindness.

In the week when Age UK has encouraged us to look out for our frail and elderly, who are so vulnerable in the winter, I have witnessed huge care and compassion from friends and neighbours. And seen the absolute difference that has made.

In addition an article in the Huffington post described research from the US that showed the difference a close support network made to breast cancer survival.  The take home message was  " if you know someone with breast cancer, show her as much as possible that you're there for her and will put in the time and effort to help. If the Kaiser Permanente study is right, it could make an even bigger difference than you thought possible."

Now I don't imagine this is only true in breast cancer but equally so in many conditions. In Scotland we are rightly focussed on achieving health and social care integration but let's not forget that the glue in that integration will be the third sector in its many hues, it will be communities,  it will friends, neighbours, families. And the smart money is on the communities and organisations that recognise ,empower, trust and value all those dimensions.

As I have mulled over these thoughts this week I came upon the article by Professor Phil Hanlon in the Scotsman called "Change one day at a time". It's challenging and far sighted and resonated with so much of my own thinking just now.

Reading this helped me value again the time spent developing Mindfulness. This weeks story was an allegorical tale which spoke of handling snakes - dealing with the difficult things by- holding them lightly, not denying them or ignoring them or battling with them, just holding them lightly. Like the snake in the story.
So in a week when I have not so much held the snake lightly , but have strangled it (oops!) instead I have been very glad of my own:

 Reasons to cheerful: Christmas is emerging and the lights in Covent Garden this week were so cheering when I visited with a friend. the fire has been on and Cara is loving it as you can see. She is now getting off the lead and seeing her run like the wind ( but still come back to us...phew!) is wonderful and exhilarating. She has to wear a coat in the cold which challenges my husbands sense of manly dog walking at times. But the final straw was when he noticed she was untypically composed walking along recently because she had picked up a babies dummy and was trotting along with it in her mouth...........street cred lost completely! You must admit its a hilarious image....keep smiling and hold those snakes lightly:-)

What doesnt kill you makes you stronger?

What doesn't kill you makes you stronger! A Scottish homily that reflects the stoicism in our culture. But is it true? Considering my recent decision to swallow brave pills and take a big step, it is certainly influenced by my recent illness. I know I'm not alone in making a decision following a cancer diagnosis-to make a long held wish a reality. And the knowledge that you have faced the hard stuff and survived is a powerful affirmation of life.so for me at least at one level its true.

But it's also influenced my health and that too affects my opportunities and decisions. Does one cancel out the other? I suppose that can only be weighed up be each of us. But the truth is for many a cancer diagnosis affects their employment, income and housing fundamentally so whilst it may be counter balanced by a bold decision for quality of life for some. For many there will be no choice, no long held ambition to realise, just a tougher reality to adapt to.

And physically there are often consequences of treatment, like radiotherapy and chemotherapy, while on average there will be chronic pain following surgery in over 30% of people. I am not saying this to depress you as I will also hear many say the cancer did them a favour, jolted them out of sleep walking through their lives but the truth is much much more complex for many.
So recently at a conference when we were asked to write some six word stories - to teach us to market our organisations succinctly-this one came to mind.

Breast cancer
Changes everything
For good.

But thats not the end of this weeks story as we had a family illness. And an older family member ended up suddenly in hospital. Now I cant fault their care in hospital, kind, thorough, informed. But the discharge procedure was woeful. Does it matter? Yes yes yes! A frail elderly person is not made stronger by illness, usually the opposite. Their confidence, strength and well-being  fundamentally changed. The person admitted not the same as the one who leaves. The future suddenly has new hue. But support systems have not. It's more than  drugs people need on discharge, its careful planning. And if you want to guarantee a readmission then don't plan a discharge. I guess leaving in the IV cannula wasn't planned either ( sorry I am angry!). So the six word story I thought that the hospital ward would write would be :

Discharged home
What next?
Don't care

Reasons to be cheerful. The care and compassion a family demonstrate in hard times is our greatest gift, no doubt.As you will see above, Cara the lurcher is settling really well now. Her ears are a different shape each day and the cat has almost forgiven us.......well I needed to end on a positive!

And look at these November skies we have had in Edinburgh of late! Wonderful:-)

A week for a big decision.....

" Dont ask yourself what the world needs, ask yourself what makes you come alive and then go and do that. Because what the world needs is people who have come alive"

This has been a week for a huge decision. Not one that snuck up on me of course. It's been building for some time. As you know I have had the reminder , for the second time in my life, that life and health is our greatest treasure. And now I am mostly recovered from my recent illness it's made me think...what next? 

Now, not in a," what if I am going to die sort of way". More of a ,"how do I want to live?"And the answer is there are some things I still really want to do in my career and there is some balance I would like to achieve in my life. In order to do that, I need to make changes.

 I came to my role in Breakthrough to set up the charity in Scotland. I was fortunate to recruit a great team who shared my desire to be the best we could to represent the people affected by breast cancer in Scotland. And if I can be permitted a little immodesty...that we have done with style. I am immensely proud of all that we have achieved and I now feel its the right time to move on. 

Just writing that of course gives me a huge lump in my throat, I will be sad when that time comes at the end of January. But I know it's right nonetheless. I will of course continue my blog as its my story and what is clear is this next chapter is a important part of that journey too. And I also will stay engaged with social media around breast cancer, with some exciting plans afoot even. So i will remain involved with the breast cancer community...its part of who i am after all. Breakthrough will always be special to me and I will remain involved where I can help...I even plan to become one of the Breakthrough 100!

So whats next for me? I am keen to play to my strengths and experience and develop a portfolio style career.  I have long held a desire to do leadership coaching and development work with individuals and organisations to use my experience to support them to grow and develop for those they serve.  Also throughout my career my passion has been improving health and social care and of course I will seek opportunities to continue that , not least through my work with the Alliance. And who knows what else ? But I would really love to do a bit more writing too.......

So you'll have gathered its not to go and potter in the garden! But I do hope that I can ,within in those plans,  find a bit more time than my current role allows , to smell the roses.....or even the puppy:-) This feels like a big step I'm sure you will understand. A step into the financial unknown in the world of the self employed. So I need cheerleaders and friends to support me through this....I hope you will travel alongside me and cheer me on! My blog will plot my course, reflect on these big decsions and as ever do my best to make a difference.

Reasons to be cheerful. I have the support of the great people  in my life to encourage me to create a future that offers further career challenge and satisfaction doing the things I am best at....and gives me ,I hope , a better balance to protect my longer term health. 

 And my son has returned safely from an aborted trip to New York. He was in Pittsburgh with his girlfriend, seeing his favourite American football team for the first time when Hurricane Sandy struck New York, their planned next stop. But they had a great time with the good folk of Pittsburgh  instead and watched the terrible impact not only on the fine city of New York but other states  in the US and of course the Caribbean too. Changing holiday plans are a small thing by comparison. I hope the people whose lives were shattered by these events get the support they need.

Settling arguments of breast cancer screening?

So at last we have it the results of the much heralded (in my world at least!) breast screening evidence review. It has been anticipated by the breast cancer community, in the hope that finally this is the one that settles the arguments. So does it? The UK breast cancer charities have looked at the outcome and feel ,yes, this is good news for women. The review has shown that breast screening can save lives-around 1300 a year in the UK, that’s around 130 here in Scotland.

But there are some downsides to screening reported in the review. The data suggests that 1 in 5 of those diagnosed through screening is over diagnosed. So some women are diagnosed and treated for a cancer that is at such an early stage it may not have caused them harm in their lifetimes. The problem is we don’t know at the moment which cancers will grow and become harmful so all women in this situation will be offered treatment.

But let’s not forget that also means 4 in 5 women who have a cancer diagnosed through screening are having treatment for a cancer that will cause them harm if left untreated, and may not have been found without screening.

But I guess a big question is how do women make sense of this report? What do you do if your screening appointment drops through the door this week? It’s vital to read the information to enable you to decide to attend screening –or not-armed with the facts and confident in your decision. In Breakthrough Breast Cancer we will continue to work with governments to get the leaflet as clear as possible and also provide and update the information ourselves to enable  informed choice at all times. And in the future work to ensure research offers us the ability to know which cancers will spread and which won’t ,therefore reducing the risk of over diagnosis. Does it settle the argument? Probably not, but it does move on the debate and offers access to updated information and that has to be a good thing.

At the heart of this debate is what’s at the heart of person centred care. It’s about giving people the right information, asking them the questions that help to explore what is a good outcome for them personally and then supporting them with that decision. Traditional approaches of - doctor knows best -has no place in modern health care.

As medicine becomes even more complex, with an increasing ability to look at individual’s risks, the skills of the healthcare professional need to evolve too. From my personal experience as someone who found making a decision on treatment this time around ,very complex and stressful, I know the value of a team who gave me the information,  tried as far as they could to explain my risk and supported me absolutely to make my own decision.

They also gave me time to make that decision. Often with a cancer diagnosis we panic and think there is no time..that’s not always the case so people should be given the time they need. To be honest sometimes I revisit that decision and think “did I get it right?” But I know it was right at the time and that’s ok. This blog apppears in the Holyrood Journal and the column is called Living with the C Word and the short answer is it is hard to do that at times and the recent controversy can make it harder.

 Some people may well now will feel stressed ,doubting their decisions or having difficulty making a decision that holds their life in the balance. Newspapers should remember that when they chose their headlines….

Reasons to be cheerful! The pup is getting out for walks. So trips to Cramond beach and Inverleith Park are making the transition to winter so much easier. But hello? What has happened to those ears!

"This is who we are and much much more."

In my mindful weeks holiday I have enjoyed time to reflect on some of life's paradoxes.And then I read the wonderful open letter to the woman who called Obama a retard on twitter,Letter from Special Olympian .Please do read it, you wont regret it. Its a dignified challenge full of grace and eloquence and I felt compelled to do this short blog after reading it.

 As it made me think of how often disability, illness, change in circumstance affects peoples perception of us. That somehow this difference makes us less then we were, different from others,in need of a different approach. The head tilt that says so much. Now of course that's not always bad, if the encounter is one of empathy and mutual respect.But I guess my plea is , see the person not the condition. And also remember that every experience in life makes us who we are.I loved one of the quotes from my Mindfulness class last week, "Pain is inevitable but suffering is optional". An important message to all of us i think, with the right support all challenges are surmountable,And they add to our strengths in the long run, they don't diminish them.

Reasons to be cheerful.Our lovely pup, Cara, has gone out for her first walk today. The wonders and smells of Inverleith park greeted her. En route she met a workman down a hole. As he popped up to say hello she kissed him.I hope he enjoyed it as much as she did!

Smile because it happened.

    

I was going to write about prevention and breast cancer this week.But I am on holiday and trying to practice my mindfulness more regularly so i have decided I might just do some mindfulness reflections instead.A little post regularly to enable my mindfulness practice.

"Dont cry because its over, smile because it happened." Dr Seuss

The quote above came to mind as I reflected on a really lovely family weekend, celebrating birthdays and seeing so many people I care about in one room, from new born babies to people 80 years plus. What a complete joy and how quickly it galloped passed. They have gone home now, the puppy is coming back down from hyper space and the cat has emerged back out from under the bed.And I have a week off to recover! So yes i feel a bit sad its over...of course I do.But mostly i'm really smiling with fine memories and looking forward to the next happy occasion to treasure.

Heartfulness?

" Live your life each day as you would climb a mountain. An occasional glance towards the summit keeps the goal in mind, but many beautiful scenes are to be observed from each new vantage point"

So this week saw day one of my eight week mindfulness class. Leading me through a process which I hope will help to embed  practice of being more mindful. It's a secular process aimed at increasing well being and reducing stress. Me stressed? I know, such a preposterous suggestion:/).

Our first week involved going around the room and describing our expectations and challenges currently. As I described my expectations and current challenges I found a strange sadness settle on me. I often talk about my experience of cancer but I usually bat it off with skill. I did say to the group I am well now but hoping mindfulness will help me achieve better balance at this stage of transition. But something in the admission to a group of strangers made it so much more real and it flattened me. I am mindfully aware of it now and just accepting it. ( ha!)

I know I am going to love the reflective and participative nature of this course. Mindfulness is paying attention non-judgmentally and with kindness. We learn it may also be called be called heartfulness. And this came back to me at a meeting  later in the week. We were describing what really good health and social care look like. Considering lots of examples that illustrated what made it excellent care was fascinating. And what became obvious was, importantly alongside evidenced based support and treatment, it was also care delivered with heart. 

And it struck me that the way to embed it in the system of health and social care is also about leadership;to lead with heart too. So freeing the leaders and practitioners to do what they instinctively know to be right and engage them with kindness and respect. What was shocking was some people, when asked, could not think of a good example of health or social care. So it needs to change urgently. We can agonise on what has brought us here in western culture but what's more important is that we need to bring the heart back. Mindfulness is one route, but only one.

Over the years the leaders, mentors, teachers,  healthcare professionals who have inspired me always demonstrated  impressive knowledge , wisdom and worked with their hearts.And it's what I aspire to! And yes i think it probably does cost but the returns are so rewarding for all concerned. More importantly too, is can we afford not to?

Reasons to be cheerful.
The dual therapy of mindfulness and puppy mayhem are keeping me on track. But as the image above suggests, I can probably learn to be more in the moment from Cara the mad pup!Both weeks ,so far ,of the mindfulness taster class and day one I have had to go straight from work. Being stressed going to a Mindfulness class, feels a little ironic....it's a busy week ahead so wish me luck. After this a family birthday party is coming up and then a holiday. Woo hoo!...Oh and is it just me but is the cats "bum" looking big(ger) in this?

Just dont ask me to wear pink, OK?

It's impossible not to know its breast cancer awareness month, with national landmarks fabulous in pink. Journals full of stories of women impacted on by breast cancer and numerous news items. And I am remembering that last year I began to feel a little overwhelmed by it. Bizarre given my job , but true none the less. And I notice in me a reluctance to wear pink , almost as I am surrounded by it, it's my last way to say this doesn't define me.

And as read others blogs and tweets on the subject I hear their own frustration. One in particular made a special plea to remember in the middle of all the pink awareness, that breast cancer isn't a pink and fluffy disease it's hellish and hard and steals lives for too many people. It's not I'm sure intended, but the constant awareness raising , without the balance of understanding the real impact , has the effect of perhaps disenfranchising those its meant to help.It's hard to escape it and sometimes you just need to.

So I have worn red and purple too this last week. Pink isn't the colour of anger or distress and that's what I feel when I see the evidence of lives shortened, families struggling, poor care or inequalities in outcomes for people.And its those emotions that drive me to do what i do.....just don't ask me to wear pink, OK?

This week as well ,the Robert Burns statue at Kilmarnock Cross was given a bit of a makeover in support of the detect cancer early national campaign to make women more aware of the different signs and symptoms of breast cancer. Images of real women’s breasts exhibiting the different signs of breast cancer were placed on the local monument this week to raise awareness of the Scottish Government’s Detect Cancer Early campaign amongst people in Ayrshire.
 
All good I hear you say, but lets be honest it’s caused a wee stushie!( NB Scots for a row!) Because the Bard himself was shown with these images and there are those who fear it dishonours him in some way.

Now in January on Burns night I wrote a blog when I plagiarised him terribly in my poem “Tae a Breast” I did apologise to his memory but pointed out as well, he was aye one to appreciate the subject matter! And let’s not forget we are still constantly bombarded with images of naked breasts in the media, except this time it is to help save lives. Using iconic Scottish images and celebrities is helping this ground-breaking campaign to maintain momentum and i say, well done!

So perhaps this is a small case of “The best laid schemes o’ mice an’ men, ganging aft agley.” But would the Bard himself have had a bit of a laugh…I think so... Will it help to reinforce the messages of this vital campaign, to let women know that breast cancer signs and symptoms are more than a lump and ultimately save lives….yes it will.

So lets not be too “Holy Willy” about this and accept that if we want to stop 1,000 women a year in Scotland alone we need to be bold. The detect cancer early campaign is that and its also saying clearly to women “ Don’t get scared, get checked.” It may have caused a bit of a storm in a "D" cup ( thanks to my colleague Myles for that pun!)but in my view its worth it.

Reasons to be cheerful:My friends daughter had a baby this week. She is simply beautiful and i got to go to see her today! a real joy. And Cara is thriving, full of cheek and intelligence.We had to wash her finally and she was unimpressed at first but she does smell better, thankfully. Now, does anyone know how to stop dogs trying to eat snails? ( don't ask!)

Simple acts of kindness can change a lot.

In a week that had the Breakthrough Breast Cancer Board come to Scotland, saw the launch of Breakthrough 100 and held a parliamentary reception to launch Breast cancer Awareness month I will admit to have shed a few tears. OK some may have been about how sore my feet were by the end of Thursday and others maybe on Monday when the alarm went off and I realised a new week had begun, but mostly it was because at all the events I attended last week there was raw honesty about the impact of breast cancer on people.

We hadn’t allowed a pink glow to prettify breast cancer and tidy up the traces. We faced it squarely and said we as group of people and as an organisation have the desire and ambition to change breast cancer for good.

 

And the pink explosion of October is a very important part of raising funds for all our work. So every pink item sold (not telling you what I just bought in M&S but it is very pretty!), every pink pin bought, every pink party enjoyed will help to save lives and I thank you all for the part you play. But let’s not pretend that raising awareness alone will do that. We need a call to action too and this month we are urging everyone to be aware of the 5 common signs of breast cancer. If you want a copy of our TLC campaign which you can have to remind you of them, then text SIGNS on 84424 and we will send it to you. As the twitter hashtag says the key message is #morethanalump.

 

I really met some fantastic women last week, all of them interested in our work and many immediately signing up as part of Breakthrough100 to raise their £1000 to support our work here in Scotland. Not all of them directly impacted on by breast cancer, but all of them understanding that this is a cause important to each and every woman. And through supporting us they in turn are part of a great network of women all united in a common cause and can enjoy that sense of community and purpose too. I suspect there will be the odd party along the way too. What could be better? We would love to hear from you if you would like to join us.

 

The parliamentary reception i mentioned was hosted by Jackie Baillie the health spokesperson for the Labour party and addressed by the new Cabinet secretary for Health and Wellbeing, Alex Neil but I think it was Elizabeth who stole the show. She told her tale of tough times including being widowed before her own breast cancer diagnosis. She had to check with a friend whether the symptom she had was something to worry about. Luckily her friend urged her to seek treatment straight away. Her tale was a harrowing one but if I am honest the part that was my undoing in her talk was the description of a very simple act of kindness by the theatre nurse who seeing her distress arranged for her to have her husbands photo by her side as she went into and came out of theatre. A simple act that gave her great comfort. We all found it hard to speak after that.

And it reminds us that simple acts can change so much. As the cabinet secretary said we can all make a difference, spreading the word about breast awareness. And we can all do simple acts of kindness too that change someone's life, however small.

Reasons to be cheerful. Simple it's the acts of kindness, goodness and passion to make a difference that cheer me each and every day.And cat and dog relations are improving, slightly.. Koshka has assumed position of King.

Whats the real story about breasts for the media?

Ok I admit it. I have been a bit angry this week! And that's because there has been a great deal about breasts in the press last week. Our media is almost as obsessed by them as they are with tales of the royals...and of course one of the stories had them both. I guess we aren't surprised that the Duchess of Cambridge has them? Are we ? Is it legitimate to photograph them and publish them without her consent...I don't think so.

But that's not the big story for me. This week a petition was launched to end page 3 in The Sun .3http://www.change.org/en-GB/petitions/dominic-mohan-take-the-bare-boobs-out-of-the-sun-nomorepage3. When I last looked it stood at over 30,000 signatures. By people who believe that showing women in this way diminishes all of us, male and female. It seems bizarre that we are still having this debate. How can women be seen as equals when popular newspapers portray them like this?

But that's still not the big story for me. THE story about breast is the fact that more and more women are being diagosed every year with breast cancer. And we need to address this! 
Just four years ago I started this role as Director of Breakthrough Breast Cancer in Scotland. At that time we said there were just over 4,000 women diagnosed with breast cancer each year. And this year it's more that 4,500 who will be diagnosed. Such an increase in such a short time. And yes it's still true that 1,000 women lose their lives to breast cancer each year. For every diagnosis there are so many lives affected and for every life lost there are so many other lives changed for ever. The money raised through a myriad of pink adorned fundraising events will help us fund our crucial work; the research , the campaigning the awareness raising, all aimed at ending the fear of breast cancer for good. Through all our work we want to stop women and men getting breast cancer and to stop them dying from it. Simple and vital as a goal but complex and challenging to achieve.But we have the ambition to do this and we cant do it without the help of so many who share our hope and ambition.

So thats why I am angry. Lets have the media talking about the real reason why breasts are so important. And even better join with us in trying to change breast cancer for good.

Reasons to be cheerful. It's a busy month ahead and a crucial for funding all our work and whats more we get to meet so many fantastic people wanting to make a difference. Thanks to all of you making a difference for so many people affected by breast cancer.
PS  Cara is settling in well. It's hard to remember life without her!

 

Cara...its Irish for friend

I had a dilemma about the title for this blog. Because I recently watched a TED talk called " Before I die I want to " which I really wanted to write about. My dilemma was if I call it that people will think I have had bad news, it's a breast cancer blog I write after all! And I guess the fear of dying before our time is the shared theme for many of us. But another theme is the sharp focus it gives on what you value in life. What in life you treasure most. I have touched before on my bucket -or my personal favourite -the "f*** it" list and I know that when the chips are down top of my list is time with those I love... my family and my friends.

What I loved about the talk is how the project in a very simple way brought a community together. And not only did it come together but they heard each others voices and enriched their community though it. Wonderful. Again it illustrates the power of hearing the voices of communities to build a future. I do know that one of my regrets should my time be shorter would be never to have another dog. That knowledge drove our recent decision to finally make the trip to Dublin, where my daughter works, for the new puppy and to call her Cara...its Irish for friend.

So meet Cara. She is a seven week old lurcher from Dublin. Indeed she really is a little miracle of the dog world. Her Mum, Fay ,gave birth to 15 pups...yes that's right 15! She had to have a Caesarian section as pup number two got stuck. And through her own amazing skills as a Mum and the love, dedication and commitment of the wonderful team at the Dogs Trust in Dublin, 12 of the 15 survived so far. And Cara is one. They are all beautiful brindle lurchers, almost impossible to tell apart. Her white paws and confidence helped her stand out. She coped with a long journey and is now here taking over our lives. She loves her bed and also has found she can climb on to the kitchen chair....this is not easy believe me and it's also rule number 1 that the new pup does not get on the furniture . Currently that feels like telling the tide not to come in. Lurchers have the reputation as loving, placid couch potatoes..... She is living up to that!

And she has already stolen our hearts. Koshka the cat's however remains locked away.  We are working on it and he is enjoying some additional treats too and milking it, let's be honest. There is no doubt that she is helping me already, distracting me with nonsense and cuddles. What's not to like.

Reasons to be cheerful......well of course the puppy, Cara.I am sure you will hear more of her. I must say a big thank you to the team at Dogs Trust Dublin, they couldn't have been more helpful...do pay them a visit if you are nearby. They have some fabulous dogs. And this week we are launching our Breakthrough 100, recruiting 100 very special women. Its a really great project but more about that next week....Now where is that puppy..........

From the coal face.....

I come from a mining area in Fife, not the area of pretty fishing villages or world leading universities. Its the one of chronic unemployment since the loss of its industrial past and with a legacy of serious and chronic disease from working in them. It's statistics are lost in the much larger challenges of the West of Scotland but  poverty in all it's  guises is no less of a reality for many communities there.

But why am I telling you this now? Well recently I attended a reception in the Scottish Parliament hosted by the Scottish Council of Voluntary Sector ( SCVO) and the important point was made that voluntary sector , with it's foundations in geographical or communities of interest has an important , crucial role to play in shaping future policy and strategy for change. But that role is sometimes not valued or allowed and the voices left unheard.

And it reminded me of a local tale from the village I grew up in. A decision was made ,before I was born , to build a mine in the vicinity. No real surprise as the area was surrounded by them, the coal was there. These were the days when coal was key source of energy. So the mine was built and opened by the Queen when I was a year old. It had closed before I started school. The Rothes Colliery was to be the show-piece of the great Fife coalfield but, unfortunately, it turned out to be probably the biggest disappointment in Fife's proud mining record, brought about by bad planning of the mining engineers of the time, who totally disregarded the advice from the experienced, local miners who knew the terrain very well indeed. They told them it would flood, it would never work. No one listened.

And so a whole town built in its honour felt a terrible impact, livelihoods were lost and lives changed for ever, 12 million pounds was wasted. And a heritage supposed to last 100 years, gone for good. They should have listened to the old, local miners, they could have saved their money. My own father knew this, he was a young man when he too lost his job when the mine closed, and shared with others the worry of unemployment and family to support.

So it's not just "politically correct" to involve those who know it from the coal face in the design and development of future projects. It's a sound economic and moral imperative. Working together new futures can be shaped, creativity can be captured, shared visions can be owned and committed to; lives can be changed.

Breakthough Breast Cancer has a Campaigns and Advocacy Network, service pledge volunteers, an army of supporters who all know the coal face of breast cancer and all help to shape our campaigning, research and education work. And this is how our sector works. A rich seam of potential to help shape health and social care, housing, welfare , economic development and so on. But why is it still a challenge for many to be heard? We can and should change this.

I haven't lived in the village for over 30 years and it's a forlorn looking place to return to. The busy, friendly village I grew up in is a changed place. The impact on a community whose time has gone is sad to see.  But it's there my own values were shaped and my recognition that I have been fortunate in my life was fostered. I'm gratefully for that and to all those who were part of that too.

Reasons to be grateful.
My family has gained from an excellent education which has helped them reach their potential , we have benefitted from a world class healthcare system, we have lived in good houses in fine parts of this beautiful country. But I won't forget the voices of those at the coal face wherever and whoever they are. They helped shape me after all.

Not a glamorous as a shark bite.

                     "Wisdom is simply pain that has healed."

Oh ok I admit it, I have been a wee bit obsessed watching the Paralympics and also fascinated by the individual stories of the athletes. One young man, describing how he lost part of his leg,  explained it was because of meningitis when he was five. Not as exciting as a shark bite said he.....I laughed with him as he said it and admired his attitude. Even more as I watched him win his gold on the track just 13 years after his amputation. And the photo of him hugging his Mum, says it all about how challenging his young life has been and the important role she has played.

But I have kept coming back to those words , not as exciting as a shark bite. So true of most illnesses. Often they aren't glamorous they are just hard , unpleasant, painful, distressing and in the main we hide that bit away. We don't want others to see it, we put on our brave faces, we say nothing. We are tempted by a more glamorous story too...our own version of a shark attack. Is that wrong? I don't know. But maybe at some point the reality becomes evident and that has to be OK.

That theme of showing what's usually hidden  has been prevalent this week for me. I helped to launch the Scottish Governments Detect Cancer Early campaign. It has been described as controversial. And that's because it's the first time naked breasts have been shown with the visible signs of breast cancer in a campaign like this. I shared it on twitter saying, yes this contains naked breasts but for once it's to help educate women. Because lets face it we do see many naked breasts in the media but that is to serve a different purpose. Strange that isn't called controversial isn't it?

And many women have expressed their support of the campaign, recognising their need for more information about breast cancer signs and symptoms. And the breasts shown are not those of a page three model. They are women of all ages and shapes and sizes and that makes it so real and relevant. So thanks to these brave women who have shared their images, who haven't hidden away.Here is the link so you can judge for yourself and do share with others too. It  WILL save lives. Lumps arent the only sign of cancer is the video from the campaign.The key message is "don't get scared get checked". The breast awareness video Indeed!

Reasons to be cheerful. It's  the weekend! It's been a long and busy week. We are doing some preparation for getting a pup soon and so this weekend will be checking out what we need and reading all the advice  on what to do. I am so excited! A friend shared this photo and caption last week. I think Koshka may have written it!

Going for Gold.

"To overcome difficulties is to experience the full delight of existence". 
Arthur Schopenhauer

In the same week I got advice on the physio to improve my back problem I have watched the Paralympians challenge themselves in quite extraordinary ways. From those whose disabilities from birth have meant they have always had the challenges integrating into a less than understanding world, to those whose lives have been absolutely changed by devastating events,  they exude courage and grim determination. I am awed and like many , moved by their passion to exceed.

The games give them a goal, an opportunity to challenge their situations and really reinforce that message to the world;  see the person not the disability. They can teach us so much. There is undoubtedly a mind set that helps them achieve but also I guess an ability to read their bodies and know when and where to push and when to adapt or ease off.

I know my own challenges are so small compared to theirs but their courage and resilience is inspiring me too. Alongside the advice not to be impatient ( me! ) and not to do too much I am also determined to get fitter again. It's an important mindset shift to being a recovering person, not an ill person. But I need to pace myself still to get to the final destination.

With every illness or change or disability there is the point where you have let go of your old reality with all the grieving that's part of that but then that is replaced by the new reality. The challenge is to celebrate that person , all the learning that has ensued and be all you can be from there.

But I know it's not easy , you only had to see Ellie Simmonds sobbing after her gold medal winning swim to see not only the joy but the cost of success against the odds but the message of these incredible athletes is look at what you can do...and go for it! Let's hope these games help to change attitudes for good towards people living with disabilities, not least the policy makers.

Reasons to be cheerful. A family Sunday lunch to look forward to and the end ( boo) of the festival fireworks are tonight. It's a 45 minute display set to music, always a fantastic way to start the week. Also I am supporting a key launch next week which I am really excited about, but more of that later...

Tales of the ordinary and pink castles!

It's wiser person who listens to advice than gives it.....I read that today and it made me think. How receptive am I to advice? The honest answer would be not always. I respond better when given choices . And challenge on my blinds spots , I do welcome....on a good day with the wind behind me! Am I tempted rather too often to give advice like Moses delivering the ten commandments? I hope not but I guess I need to check that out! So why did that resonate just now? Because I am trying at the moment to get the balance right on how to recover and get stronger and give my best to a busy job....and the realisation that the only person who can get that right is me.

We are all individuals and it's just as true when it comes to our healthcare.

A meeting I was part of recently explored the importance of holistic assessment as part of care. And as someone who trained as a nurse 30 years ago ( yes it's true, I had to count it on  my fingers to check if that could really be true!) I see the value of a holistic nursing assessment to inform treatment and care.  Not only do people with cancer  have other conditions like asthma or diabetes for example but also what is their social circumstance, what would be the best outcome for them? There is such an important role for nurses enabling person centred care, acting as advocates and sign posting for ongoing support. We have been talking about this for a long time...let's hope the focus on person centred care in the quality strategy in Scotland might actually help this became the bigger priority it needs to be. Care centred around the individual is the safest and most effective surely? 

 Earlier in the week I  attended a dinner for voluntary sector leaders on social media and the role of the CEO. It was a great presentation by Louise MacDonald CEO of Young Scot (@louisemac), encouraging others to get involved with twitter. Like i need persuaded! But i was keen to learn more.The aim is to be accessible and authentic she said and it struck me that that was also true of being a leader in any setting. And social media definitely enables that. Through my blog I have connected to people locally I couldn't have done in other ways i suspect. And I have connected with an amazing community across the world too. I love that. I am inspired and moved by all of you who I connect with.

Marie in her blog Journeying through Breast Cancer (@JBBC) has invited us to celebrate the ordinary each day this week. My energy and workload has stopped me doing anything other that enjoying others contributions, but they have been insightful, thought provoking and creative. Impressive indeed.

Reasons to be cheerful are in part celebrating the ordinary but also the special too. The ordinary is that in order to manage my energies I have allowed myself some pink dressing gown time and as regular readers will know, this makes Koshka very happy as you can see:-)

And the special is I attended the Edinburgh Military Tattoo. Now I am by instinct a pacifist but I  can't help but be moved by bands of pipers not just from Scotland but across the world too,  fabulous highland dancers, drummers from Switzerland and many more .The special moment for me was as the massed bands played Highland Cathedral, the castle was lit up pink, as the above photo shows. It triggered a memory of a very special evening when  breast cancer awareness month was launched from that very castle two years earlier. As I sat with my good friend who  has also had breast cancer , I reflected how important it is we continue to raise that awareness at Breakthrough Breast Cancer, so more of us are here in the future to share special times.

Is this person centred care?

A week is a long time when you are back from holiday is it not? And this one for me was a bit of a roller coaster I admit. It’s a tale of two halves, one of person centred care and another of being a tourist in your own town.

So are you sitting comfortably?

This story begins with back pain. A thing to fear for those with a history of breast cancer I think its fair to say (one of the many lets be honest). But I have been down this road before and know many other reasons exist for back pain and found a variety of solutions from pain relief, to physio’s, zumba(!) and yoga over the years when I have had a problem. But just prior to going back to work I could feel something build up. I went for massage and it nearly killed me (ok drama queen language there…but it felt a bit like that,honestly). And as I returned to work I could feel I was getting worse. I rationalised (just tired, getting match fitness back etc) and thought I would wait to see how I was on holiday. Worse again. Its swimming that’s doing it, again rationalised and made a plan for self referral to physio. My husband (he of the long suffering variety) suggested I needed a proper diagnosis first, instead of an Audrey knows best approach.

SO when I went to my follow up from surgery appointment with the plastic surgeon I asked if I might have a quick word with the breast care nurse. I thought she could help me think through how best to approach it. Mention it to the surgeon, she said. What the plastic surgeon? Yes indeed. Now I didn’t help matters as I turned up in the morning instead of the afternoon, not sure if that was a CRAFT (see previous blog for explanation) moment or their mistake. I offered to come back knowing the pressure on them all but no, they found the surgeon and he saw me. Sorry I cancelled my surgery, I grovelled. No worries was his reply…its totally lead by you. We can do it anytime or not at all. Really, said I, I am more concerned to get my back pain sorted than matching boobs at the moment (ok I might have phrased it differently but you get the gist). And so he examined me, reassured me he felt it was likely to be unrelated to the breast cancer, given my early diagnosis both times, but as we know breast cancer can behave unpredictably. The only way to know is a bone scan, what did I think. I admitted to having mixed feelings as I know this triggers anxieties and procedures that frankly aren’t much fun. But on balance the scan would give me information I could then act on. That’s when the breast care nurse again stepped up and she organised the scan.

It was two days later….I thought I would wait weeks. I was welcomed, talked through the procedure and put at ease. Drinking large quantities of tea, coffee and water is not something I normally find a challenge but somehow being told to in two hours makes it so. Also being radioactive and therefore having to avoid pregnant women and children is tricky in a hospital environment. I don’t suppose the woman I kept moving away from while I tried to get served with yet another cup of tea reads this blog, but just in case…its not you!

I am delighted to say all was well. Yes there is an underlying cause of the pain but nothing concerning. But what I really wanted to share with you was just how cared for and supported I felt yet again within that service. So what stood out? I was listened to, they didn’t trivialise my concerns, they were flexible, they didn’t make me feel bad turning up at the wrong time, they didn’t say “that’s not my job”, they engaged me in the decision making all along. The radiographers took me through a scary procedure with information and kindness. The breast care nurse warned me not to worry if they did two scans: they did, I didn’t…much! They provided a safety net with plans for information and follow up. This was a stressful time for me as you may guess but how they supported me through it made a huge difference. This is true person centred care. 

As part of the Quality Alliance Board for the NHS in Scotland I know there is an important focus to improve person centred care. It was good to experience it in action. Feedback in all its forms can enhance this. Breakthrough Breast Cancer’s Service Pledge gives feedback on what works well as well as what to improve; both are important drivers of change. The third sector has an important role to play in this, facilitating the patient voice to enable and to motivate. But for now, the breast cancer services in Lothian, take a bow!

So as the relief sets in with the outcome of the bone scan I now need to refresh my getting back to match fitness plan. The return from holiday was always a risky time, when my energies would not match my expectations. So I am building in ways to pace myself and also build my strength in my recovery. A marathon rather than a sprint I am learning.

Reasons to be cheerful. Our friends visit and the Edinburgh festival provided great distraction, fun and support while I awaited the result. We went to a fabulous exhibition about Catherine the Great, watched street theatre (the cheeky puppet above being my favourite), went to the art festival (tapestry exhibition at Dovecot studios was superb) and later after a rickshaw ride down the Mound (help!) found a free comedy show. The last act was a North London Jewish refugee (from south London) …his joke not mine… I leave you with my favourite joke of his: Older couple, the wife calls down to him, “will you come upstairs and make love to me”…his reply “I cant do both”. Laughter is great therapy, is it not?!

In search of mojo......

Two weeks in and its an ongoing search for the elusive mojo. But precious time with family, relaxation and time just to be ,is working some magic.  The days are lazy and evenings star filled, with some Olympics thrown in! In fact we have worked out how to sit outside and watch Olympics through a patio door as its so warm. Yes you guessed I am not in Scotland but rural Bulgaria, a very beautiful unspoiled part of the world. Our small house looks out to the Rila mountains and as I write a fine storm is rattling around the valley. Jacko the shepherds dog is a frequent visitor and is waiting at the door in the hope we will break our resolve and we will let him in because of the rain. Soft I may be but I haven’t lost my sense of smell…..so that would be a no my friend! As I mentioned last year Jacko has had one too few visits to  the poodle parlour and too many days shared with the sheep. A deep breath and you too could smell him I am sure!

But even if wet smelly dog is a step way too far , the rain is welcome. Its very barren here thanks to a very hot summer. The last week has seen temperatures of over 40 degrees. What I have really realised is how simple life becomes at these temperatures; the most important focus becomes access to water,  shade and a cool breeze. So its not party central as you will have guessed but a real chance to recharge and reassess the important things in life.

So I have mindfully taken in the views, listened to bird song and relaxed with those I love. And as give in to the different rhythms of life here it helps me also think about my own priorities and plans for the months ahead. A friend helpfully described recently that one of the benefits of the deep fatigue that illness and treatment can bring is enabling you to recognise what and who is important to you. And perhaps as important who and what you can let go of. Who and what does or doesn’t help you thrive as you need to, who and what makes your heart sink rather than sing, and who will always or never be there when you need them? A small consolation maybe but a valuable one so that you can move forward in your life with the people and things that enable rather than disable. This is so important when your energies are limited.

It does seem rather ironic to get lazier while watching our amazing Olympians. We managed to find somewhere we could both swim and watch Andy Murray in the fantastic rematch with the wonderful Mr Federer. I admit to shedding a tear as Andy won so convincingly and ran off to hug his girlfriend and his Mum. People like Jessica Ennis and Sir Chris Hoy are wonderful role models and if twitter is any reflection there are many bikes and running shoes being dusted off. But I would be lying if I said I was rescuing my lycra from the back of the charity bag.

So many people I know are facing their own personal marathons; be it chemotherapy , surgery, accepting new diagnoses and consequent changes to their life etc. They aren’t Olympic sports, there are no medals to win just long, often arduous months to get through. They too are my heroes, who do this while looking after families, keeping jobs going when possible, running businesses, caring for partners and parents too. So I cant sing your national anthems or present you all with flowers but I salute you all. And remember  don’t try to be heroes without help, after all the athletes did not achieve their success on their own. So surround yourself with your own cheerleaders and coaches to get you through would be today’s best advice.

I recently heard this tale about a friend, herself in the midst of challenging treatment. She apologised to a local shop keeper for forgetting her order, a senior moment she explained. A woman at the back of the queue piped up “ I call them my CRAFT moment”. Craft moment she asked? “ Cannae remember a f****n thing” she explained. It was pure Glasgow! As I return to work next week, following some extreme laziness I fear the odd CRAFT moment myself, be kind to me if you notice any please….
Reasons to be cheerful. The Edinburgh festival is taking over now and while that holds frustrations for locals it is manic and wonderful too. We have friends coming to share it with us too. Excellent!