The term "acting out" is an expression meaning to express your feelings through behaviors. You can imagine during times of extreme stress, one might increase such unconscious behaviors. For instance, overeating was an unconscious way to "take in" love, thus reducing anxiety.

Earlier I referred to doing a self examination of your coping methods. When under high anxiety for a period of time, the methods we use to cope routinely in acute situations can actually create further stress, and worsen the situation. For instance, you have a drink before dinner each evening to relax. After a breast cancer diagnosis, one drink isn’t enough to relax you. You may find yourself having two or three drinks, or more. Perhaps, a drive in the country relaxes you. Has your speed increased? Are you paying attention to the road? Possibly, anxiety makes you loose your appetite? Are you receiving adequate nutrition? Discuss your nutritional intake with your physician and his nurses. Nutrition is an on-going concern as well as your overall weight. The dosage of your chemotherapy is determined by you body weight.

Sometimes, when depressed, people tend to increase or decrease their sleep. Losing a few night of sleep isn’t a big problem, but chronic sleep deprivation can increase depression, and decrease general alertness. Afternoon naps can help you make up for accumulating sleep loss. Excessive sleep may only be a problem if it interferes with your job or totally alters your home routine. Discuss your altered sleep pattern with your spouse, family nurses and doctor. You might be surprised at the useful advice you receive.

Some of the medications for nausea that you’ll receive will affect your sleep pattern. If you are aware of it you will deal with it better. Most days that I received chemotherapy, I slept little those nights. Medications given intravenously tend to reduce nausea and interfere with sleep. A few days following the chemotherapy, I would feel extremely tired and would nod out watching television during the early evening.

Be prepared to examine how you are coping. Discuss this with a close friend, family member or you spouse. Examine your feelings. Keeping a journal is very helpful. I went through periods of time when writing was helpful. Other times, it was the last thing I was interested in. I took walks, read, watched movies, talked with my friends, and did lots of neighborhood projects.

Each chemotherapy treatment was a challenge. I had to be someone besides "April" to face each scheduled day and time. I would miss my appointments if they weren’t scheduled for 10:30 am. Why? I can’t explain that.

My sister, Nancy, came from Houston for a visit the week of my first chemotherapy treatment. It was a tremendous moral support. Nancy and I have always enjoyed each others’ company. We can laugh a lot together about our human frailties and give each other strength during rough times. She had mustered all of her maturity and strength to provide me a shoulder of support. Typically, she also entertained me with her constant smile and stories. We spent pleasant times discussing our brother and sisters and parents and reminiscing about our childhood. Nancy has chasing away the bogy man down to a fine art. Well, I took her to the doctor’s office, and had missed the time and day. Nancy was pretty upset. I was amused. A psychiatrist had once told me that such memory lapses are subconsciously deliberate. I believe it. So, I got a half day reprieve! We returned a few hours later, after shopping.

Nurse Cathy escorted me into a room with five reclining chairs. Cathy double checked my medication order and weight and height. She started an IV in my left arm. She explained what I would be receiving, reviewed possible side effects, and gave me anti-nausea medications through the IV.