How do you break the cycle of catastrophic thinking when faced with real crisis?

[lofwyr]

I have a pretty heavy surgery coming. I have infiltrative Basal Cell on my nose, and it is acting aggressively and is rather large at approximately 3cm. It is considered "high risk." Even so, it is extremely low probability of killing me, but I am going to potentially face getting a bit uglier with a major Mohs surgery on my nose. It isn't scheduled yet, but cannot come soon enough.

Add to this, it completely destroys plans my wife and I made to spend the winter in the southwest close to my 80 year-old folks. I will have to stay in the north and deal with this. Recovery appointments may take months, and it might be a month or two before the surgery.

I am so stressed. My ability to sleep is all but gone, and I try CBT but I feel like I am standing in front of a massive ocean wave in a rain poncho shouting into the wind. It is as close to a panic attack as I have felt in 20 years, and I have to say, I must have been doing a lot better, because I had forgotten how very low this feels.

I know many, many people face what I am facing and do just fine, and many people face much, much worse and do fine. I even found a support group on Facebook for it and received a lot of fantastic information and support. It is about the only thing that does help.

But I am having a lot of trouble reconciling what I use for anxiety against this very real issue.

Why can I not apply what works so well against fictional problems against the real ones?

[NervUs]

Oh no, lofwyr. I think it is perfectly understandable to feel scared and anxious under this situation.

I don't know what coping techniques you normally use.

For me, dealing with real issues requires acceptance and getting to a point of taking it as it comes. You are in that limbo state of not knowing yet what will happen to your face-- and the waiting is hard hard.

As you wait, there are so many ways you can go with this-- On one side, there is the NOT researching or googling, since all the stories in the world can't predict what will happen to you. Or on the other side immersing yourself in the worst terrible cases, thinking through how you would feel and react if the very worst happens until you have investigated it from so many angles that more investigation doesn't produce fear (and your brain stops wanting to replay it over and over). That is probably the route I would go with this, trying to limit the time I spend on it each day, and then having other engaging activities lined up for the hours in the day I was supposed to not be thinking on it. I would also cut myself some slack and let myself feel bummed out and celebrate moments of normalcy or feeling happy. I am not sure what your goal is, but I don't think keeping a completely even keel if a reasonable expectation under these circumstances.

At different times, I have gone in both directions, although I haven't faced anything as serious as you are facing right now.

Please keep us updated and I hope you can schedule this surgery ASAP.

[lofwyr]

That is actually phenomenal. I think when I got the news, I did what I did when my aneurysm was diagnosed and hit google. The problem is, aneurysms are fairly similar experiences in each case. The operation is the same, the results are usually the same. The whole thing is predictable, with few unknowns. The googling made that reassuring.

The case with this new problem is much different. Everyone has different experiences, and where the BCC is has as much an effect on the outcome as how big it is, and how deep it goes, etc. And in a hundred different patients, that will be a hundred different scenarios. I didn't think about that before googling this new issue, and it was a mistake. I backed away from google pretty quickly, and am sticking with this great support group I found. Some have similar situations. That has been helpful.

I will keep folks updated, thanks for the reply NervUs. Appreciated it, and good advice. I was admittedly in a low spot after being up since 4am panicked when I wrote the first post. I am in a better place now, far from perfect, and definitely far from relaxed, but I have pulled on my big boy panties and sucked it up a bit. Dealing with it as it comes, like you say, is about the best answer there is. Thanks for that reminder.

[Fishmanpa]

Lofwyr, coming from someone who has faced similar challenges medically, it's perfectly natural to catatrophize a bit when faced with real physical issues. When I was diagnosed, I had my moments of googling and reading the very negative odds in my case. All that said, when push came to shove, I hunkered down and fought my ass off. I'm sure, despite this low spot, you'll do the same and the odds are definitely in your favor

What I did when things felt hopeless was keep myself from googling and joined a cancer forum where the support was phenomenal. You might want to think about joining one for BCC. As you said, everyone has different experiences and that was a mantra repeated on the forum I was on. Heck, Dr. Google had me at less that 50/50 to make it 3 years let alone 5 and I'm over 6 years out.

Stay strong! You got this!

Positive thoughts

[lofwyr]

Thanks Fish. Your words have always carried a lot of resonance with me, when I was dealing with anxiety or real medical crap. I appreciate you chiming in. I found a support group for Mohs surgery, which is really my biggest concern. While it maybe a challenge, it is nothing I shouldn't be able to live through. Glad I am already married to someone who loves me enough to stick with me noseless for a bit, which is honestly the worst case scenario.

I mean, the odds of mestasis in basal cell are somewhere between .05% and .003%. I literally stand a better shot at dying using my bathtub. ;-)

So, with that in mind, I will deal with it. Hopefully it hasn't gone too deep, and it isn't as bad as it looks like it could be.

And for what its worth, I am damn glad you are 6 years out. I am hoping all your days ahead are cancer free too, brother.

[ErinKC]

I agree with what others have said. I think when something real is happening it's important to acknowledge that in a way that is not appropriate when you're facing anxiety alone. Finding out you have BCC and need surgery really, really sucks. And it's completely legitimate to feel shitty about it and anxious about it. But, unlike mere anxiety (as you know with your aneurysm), there is/will be a course of action with a beginning and an end. There will be some crappy and unpredictable things between now and then, but as you know the odds of an ultimately positive outcome are enormous. Let yourself feel pissed off, scared, and disappointed about the changes in plans this requires, but stick to the facts as much as you can, taking it one day at a time. Good luck!

[AntsyVee]

I do as much as I can to myself busy, and not alone... I reach out to my support system, including my therapist. I up my medication if I need to and use benzos for the really tough days.

[Sparky16]

I'm sorry to hear that it turned out to be BCC, Lofwyr. Will you at least be able to get away for a little while to visit your parents, even if you can't spend the winter with them?

I'll give another vote for the support group. I also think it helps to find other things to focus on, even if you can only manage to distract yourself for an hour or two. Have you had Mohs surgery before? The results can be quite good. I had a nodular BCC on my face a few years ago and had Mohs. I had a funny conversation about it with my brother this summer. He was asking where I had my skin cancer, because he hadn't noticed, even though the scar is on my face. I personally think it looks like I've been sword dueling, but apparently I'm the only one who notices it.

[lofwyr]

Hey thanks for the input guys. It is also amazing to hear from people on the other side of the thing you face. It does give some sense of "this isn't as horrible as it feels like it will be."

As an aside, I am not too worried about scars. I am pushing 50, married to a lovely woman who will take me with my lumps. I am more worried about bone infiltration and how much of my nose they will have to take etc. Just the usual "what-ifs." This is a pretty big one, so hoping it doesn't go too deep. In my brief googling episode when I felt it safe to research, I saw a few guys who had to have total nose rebuilds. Hoping to avoid that if I can.

Thanks again for the input guys, I am nervous, but in a better place at the moment. Just trying to go a day at a time. For whatever reason, mornings suck the worst for me anxiety wise.

[BlueIris]

I'm so very sorry.

Obviously I wasn't so badly affected as you were (I never needed Moh's), but I found the actual experience of being awake during surgery intensely interesting.

I did a lot of reading about this stuff back in the day; hope they don't have to take too many layers. Please PM me if you want? I can't necessarily offer any support you can't get elsewhere but I think I have an idea of all the conflicting feelings you must be having right now.