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Tambre (Complementary Care Expert (Verified) )
Communities: Breast Cancer Thank You's: 8
Member Since: May. 2011  Questions:  2
Answers:  25
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Professional Statement
I help cancer survivors and caregivers find the energy to move from surviving to thriving.
Professional Info
State Licenses: Nationally Certified Professional Coach (CPC)
Languages: English
Gender: Female
Professional memberships: International Coach Federation
Areas of expertise: Certified Professional Coach, Master of Communication Arts, Energy Leadership Index Master Practitioner, Reflexologist, Massage Therapist,Reiki Master
Hospital or other affiliation: Premiere Oncology Foundation, Cancer Treatment Centers of America Care Partner Provider,Thrive/Survive Los Angeles,

Tambre Activities
When possible, prior to treatment ending, patients should inquire as to what process their treatment center has for putting together a survivorship plan. Centers certified by the Commission on Cancer (www.facs.org/cancer/coc/cocar.html) are required to provide a plan to patients for transitioning post-treatment.

Some of these plans are, in my opinion, limited in that they sometimes only list future schedule of screenings/checkups or if they include wellness/lifestyle behavior changes it comes in the form of information but without strategies for implementation.

Cancer impacts almost every area of life. As a cancer survivorship coach, I help people take a clear inventory of what has changed and, where needed, generate a plan to manage that change. It is important for survivors to do understand that their priorities and even their core values can undergo shifts as a result of the experience. This can be confusing or overwhelming. Getting support to work through these issues as part of moving out of treatment and into the next phase of healing is very important. Practicing self-care, self-compassion and getting support to be empowered, make choices in alignment with new priorities and reduce stress of the change/transition are some ways survivors can begin to navigate what's next post-treatment. As patients complete treatment, they may have mixed feelings. Completing treatment means no longer having the stress that comes with frequent visits and the short-term side effects of treatment. Patients may experience a sense of relief and freedom during this time. However, some people also experience anxiety and worry about test results in the weeks and months before the next visit. After this period, annual check-ups and tests, then patients move into an even more undefined period after 5 years; long-term survivorship.

Research shows that more than 60 percent of cancer survivors report fear of their cancer returning. Cancer survivors also live with long-term physical and psychosocial concerns. A few of the most common concerns are fatigue, sleep difficulties, sexual concerns, and worry about financial resources. Patients can take an active role in this period of survivorship.

Here are a few ideas for patients:

- Stay informed by keeping track of the latest research on your cancer type. Stay in touch with your regular doctor, ask questions, get regular screening tests and keep track of your medical history. Find a survivor care plan that works for you and start to work on this with help from your care team.

- Be healthy by eating well, staying active and incorporating good strategies to deal with stress. Find resources for community cooking classes to learn new strategies to incorporate healthy food choices. Participate in physical activity that works for you (walk, bike or swim with a friend at least 3 times a week).

- Stay in touch with your emotions. Take note when you start to feel anxious or fearful of your future. Find ways to deal with the negative emotions. Explore relaxation techniques such as yoga, tai chi or meditation.

- Take control by seeking financial resources, asking for assistance with long-term planning and being proactive with planning for the future.

- Be aware of any changes in your body or health status. Don't wait until your next visit to have a new symptom or concern checked out. You're the one who understands your body best.
New answer by Tambre (Complementary Care Expert (Verified))
One of the most common challenges my clients face after diagnosis is feeling overwhelmed. This is often amplified by a sense of the clock ticking with regard to choosing a treatment center and/or treatment options. Becoming educated quickly can feel like trying to jump onto a speeding train. Often the solution my clients create for themselves is to put together a support team to share in things that need addressing immediately. Doing so also gives your community a chance to be in action during a time when they are often filled with great concern for the patient and want to make a difference.

While there is a limit to what we can or even want to learn via the internet, some research is often essential...even if it is just a list of questions to ask your doctor. Being prepared with just that alone can reduce stress and help acquire important information. Though coaching is not about advising, I do see that when patients build a web of support and allow others to contribute, it can not only help with their journey but also the journey of their loved ones since cancer is not a one person illness due to the ripple effect impact its diagnosis has on a community. When a patient is first diagnosed with cancer, it is like being on a roller coaster. It's normal to be emotional when you hear the words cancer. It can bring about feelings of shock and fear of the unknown. Take time to understand your diagnosis; don't be afraid to ask questions, seek information and resources until you are fully comfortable with your situation and the proposed treatment plan. Ask a close friend or family member to attend your appointments with you to take notes or keep track of your questions. Information sources should be reliable, ask your health care team for good sources and seek out the nearest cancer resource library to find an educator, patient navigator (a great resource is the American Cancer Society Navigator Program 1-800-2345) or social worker (ask about this at your Cancer Center). Remember that every person has an individual course of treatment and recovery. Focus on one step at a time. Most importantly, remember that you are not alone. Seek support along the way from those that love you.
New answer by Tambre (Complementary Care Expert (Verified))
I love the opportunities jensinger posted about...giving yourself permission to ask for help, modeling to your children that it takes a village and the support net is there and that allowing others to participate in the healing journey gives them a chance to make a difference. I often help my cancer survivorship clients work through natural feelings of guilt by identifying the qualities/meaning of the time spent with their children versus the actual activity.

So if, for awhile, treatment makes it impossible to attend their sports, do physical activities like riding bikes, etc. look to what do those experiences represent to you...fun, connection, a way to let them know you care and they are a priority? Once you identify the feeling you want to generate, get creative and see what activities you CAN do together that give you a similar feeling.

Also, being age-appropriate honest with them on days when you are challenged. One client helped her children by creating a scaling game where they could ask how much energy on a one to ten scale she had that day to _______ (walk, watch a movie, have friends over, help with school, etc.) This helped them adjust their expectations to be in alignment with what she could do and she also found often when she put her focus on whatever they were asking to do, the idea of participating with them gave her energy and she could show up more and do more with them without being drained. It also reduced feelings of guilt on days where she needed to rest as everyone had awareness that it was her energy level, not an unwillingness to join them, that had her sidelined for that moment. At first, I was focused on getting a diagnosis and proper treatment for a very aggressive cancer that had already grown to a 6-inch tumor.

When I wound up in the hospital for much of June, 2007, and Fourth of July week, I longed to be home with my kids. On the one hand, I was lucky; I had lots of help from family, friends and neighbors. So I knew the boys were getting to their swim team practices and having tons of playdates.

But as the weeks rolled by, I wished I could be the mom I had been -- soccer coach, class mom, playdate hostess. Yet I wasn't strong enough for that.

So I tried to use the times I felt good enough to simply spend time with the boys, playing board games, watching their puppet shows and renting movies together. We'd try on the wacky wigs that friends sent to use (Marge Simpson was a favorite), and we'd root through care packages, splitting up the goodies.

In hindsight, I see that I gave them a gift of letting other people help us. Too often, families with cancer -- and when one person has cancer, they all do -- circle the wagons and shut out everyone else. But cancer gives parents the opportunity to teach their kids that they are loved not just by their parents, but by many other people, too. It lets us teach them to ask for and accept help when you are in need and to pay it forward later. And that's nothing to feel guilty about.

New answer by Tambre (Complementary Care Expert (Verified))
Tambre     I am outraged at an article posted on CNN.com about recent recommendations that women go three years between pap smears due to risks involved...http://www.cnn.com/2012/03/14/health/brawley-cervical-cancer-screenings/index.html?hpt=hp_t3 Yet, according to the article more than 4,000 women who died of cervical cancer last year had not had pap smears or had gone ten years or more between screenings. Experts? Would love your feedback on this. I, personally, will continue my annual exams...in this fast changing world of politics and medical care this is still my choice, right? Right?!
Tambre
2 months ago  | 
Tambre     An incredible story of recovery and discovery in my blog interview today with survivor, Dr. Corinna Murray. http://coachingbytambre.com/cancer-survivorship/beauty-beyond/
Tambre
5 months ago  |  2 Replies
murray     Great story, thank you for sharing:)
murray
5 months ago
JKJones     Hopeful story for all us.
JKJones
5 months ago
Tambre     I've gathered a dozen experts from a wide range of modalities to create the i-Thrive! in Survivorship Telesummit for survivors & caregivers. Register free at www.tiny.cc/ithrivetelesummit and get short, 20 minute interviews emailed to you starting Nov. 28th. Tips on journaling, breathwork, relationships/dating, intimacy, skin care and more you can start using immediately to gain more energy and thrive.
Tambre
6 months ago  | 
Tambre     I thankfully have an amazingly booked fall and hope to be back more regularly soon. In the meantime, I am watching this community grow and just wanted to send out a "way to go" and thanks as the conversations and relationships expand! Love it!
Tambre
7 months ago  |  1 Reply
murray     Yes, what an amazing community! Thanks for being a part of it Tambre:)
murray
7 months ago
What a clear and comprehensive summary. I love it. This is a very unique and important aspect of coaching in the cancer community and so valuable especially during that moment where everything changes. And there are different times and different ways coaching can be utilized so I'd like to expand the conversation by sharing where I do my work with my clients...and would love to hear about other niches/aspects from more coaches as well to give people a menu, if you will, of what's possible.

Personally, my work as a coach to cancer survivors focuses more on the emotional life post treatment creating a bridge into the "new normal" - which we know is anything but normal. Most clients coming to me didn't have the benefit of working with someone like Elyn during diagnosis/treatment and beyond as she supports them into survivorship.

During treatment patients have a medical plan that is put in place. It is human nature to do and feel better when we have a plan, though being flexible, experimenting and allowing it to evolve as we proceed is highly beneficial. Post treatment it is often the case that the what now remains a big and sometimes scary question. When coaching is focused in this segment of the cancer continuum it is where I help my clients move from surviving to thriving, facing fears, questions, concerns and making choices that align with what can sometimes be a big shift in core values and priorities in all aspects of living.

The goals are something generated by the client as coaching is a client-centered model and I personally use assessment tools such as my i-Thrive! Whole Life Assessment tool and my i-Thrive! Factor Assessment to help the client see where they are just surviving and what's keeping them stuck there...often fear, overwhelm and low physical energy. Using core value work, we then come up with a plan, break it into steps, set up accountability and get into action. When a client hits a roadblock, we look at what got in the way...all along educating about how they can have choice in how they respond to challenges in their life in a way that empowers them.

It is awesome and profound work and it is wonderful that people can use coaching at different times in different ways to be supported in their healing journey. Love the work Elyn and other coaches are bringing to this community. It is so inspiring! Knowing your options and obtaining the necessary information is critical in order to make the right choices for you, for your cancer. My goal is to get this information to women and to empower them to make choices that fit their own individual needs. Many women find it a challenge to find a doctor who can hear and respond to her opinions and questions, and all too often women are pushed into a path for treatment that does not suit her core needs or desires. My mission is to ensure that my client’s voice is heard and my goal is to help women find the right treatment, doctor and post cancer care.

How do I do this? I meet with the person to discuss the diagnosis and to determine what her needs are. Surgery, radiation, chemotherapy are considered the standard, and for many, this is the route to take. It is important that she understand all the surgical options available.For others, surgery may be acceptable, but radiation and or chemotherapy either are not an option or are not acceptable to the patient. Many patients want to use supportive complementary therapies alongside conventional treatments. Still others reject allopathic and turn to alternative. My job is to listen and to support her in her wishes. Next we have to find a team. Many will come to me with a team in mind, others seek recommendations. I then accompany the woman to her doctors appointments, where I make sure the questions are asked and answered. I know that it is impossible to digest all that is said, so I take notes and ensure that communications flow. If this team is not the right fit, we move on to another, and in some cases a third. Once my client is confident she has the right team in place, I support her throughout the process.
New answer by Tambre (Complementary Care Expert (Verified)) in topic(s) Cancer Coach, Coach, Coaching
Tambre     I'll be attending the Livestrong/Harvard Medical Survivorship Conference in Boston with some of the top experts in survivorship. If you had their ear, what one question would you want to ask these experts? I'm making a list!
Tambre
7 months ago  |  1 Reply
murray     Looks great!
murray
7 months ago
Tambre     Need some tips and tools for overcoming overwhelm, being able to make decisions more clearly and re-assess priorities as you or your loved one navigates the "new normal"? I have a free i-Thrive! Starter Kit you can download for free on my website at www.coachingbytambre.com with short videos that coach you on tools and techniques to help you including my easy to use 3 Step O-O process.
Tambre
7 months ago  | 
My getaway to let it all go at the end of the day is dancing. I cannot think about anything while on the dance floor. During the day, I use quick centering exercises - as simple as taking 30 seconds to connect with my breathe, or a minute to close my eyes and do a mini visualization.

Great list of tips building here! Many times during the day I can get stressed out; teenagers, work and health issues are usually the cause. And many times there is just no time to grab an hour here or there to meditate uninterrupted! So I compiled a CD of some really "feel good" insirational songs I especially love to sing along with and play it in the car whenever I am feeling stressed or down. Works for me! :)
New answer by Tambre (Complementary Care Expert (Verified)) in topic(s) Recovery, Depression, Anxiety, Rejuvenation
Tambre     Who is on your board of directors...the team you build to support you as a caregiver or survivor? There is an empowering way to create this without feeling like you're giving up control. For more info check out "The Power of One+" at http://wp.me/pDajr-v8
Tambre
9 months ago  | 
You don't have to choose to do it alone! Because of my late husband's work in film and his desire to keep making movies while going through treatment, he chose to only share about his illness on a need to know basis. This meant keeping a lot of secrets. The miscalculation I made that led to be the verge of complete burnout was making that mean I had to do everything myself.

The reality is there were many people outside the business I could have delegated some areas where we needed help to and received support from. I wasn't aware of the extensive services by organizations such as the American Cancer Society. Identify specific needs and ask for help...it becomes an opportunity for others to give and make a difference. Susan_Beausang:

One thing you might also consider is giving your mother as much freedom to make choices as possible. Often we think we are efficiently helping by anticipating a need and meeting it, but we are seen as being "controlling" and "intrusive." Whenever possible, tell your mother what you would like to help her with and give her an "either-or" option. Try having a conversation like this:

"Mom, I'd really like to do something for you today, if you don't mind. I could either take the trash out or I can move your chair to the spot you choose in your bedroom. Which would you like me to do?"

This places her in the director's chair and helps her assert her independence. Give it a try and tell us how it works.
New answer by Tambre (Complementary Care Expert (Verified)) in topic(s) Caregiver Support, Support, Emotional Support, Caregivers, Tips
What a great example of choosing to see the opportunity in life changing moments. Mine was losing my mother when I was a teen to prescription drug abuse. I learned early on life is precious, underscored by losing my husband to cancer. It was harder to decide to build a life I could love without him but I finally stepped up to the challenge. So wonderful you are writing again.
Tambre (Complementary Care Expert (Verified)) replied to answer by jackiefox12 (Survivor (2 - 5 years))
What I hear from my clients and followers is that too often survivorship programs and events focus on highlighting and discussing the issues and fail to have a what's next in place ~ on the ground programs, resources and tools to address the issues. Most clients who come to coaching as a resource do so because they are overwhelmed, experiencing stress with managing a long list of changes and without support to generate a plan. They are already clear on their issues ~ they are looking for possible solutions or ways to work with, through or around the issues (as in a work around, not avoidance). Once they identify their goals and design the steps, survivorship becomes more manageable.

Because of the wide range of side effects and life changes generated, I feel survivors need access to a wide range of modalities so they can experiment and find what works for them ~ acupuncture, visualization tools, yoga, support groups, workshops, art therapy, journaling, reflexology, Reiki. Not everything is a fit for everyone - so survivorship programs that can offer a menu of integrative approaches to help with physical, emotional and spiritual (for those who want this) healing are the kind of programs I'm advocating for. People transitioning from cancer patient to survivor need programs that speak to their physical, emotional, spiritual and social needs. I took advantage of counseling, rehabilatative exercise, support groups and stress reduction classes. Interestingly, survivors don't always know what programs they need because the transition is so overwhelming. That's why access to a patient navigator is crucial to their success. I know from my own experience how important my navigator was to my healing.
New answer by Tambre (Complementary Care Expert (Verified)) in topic(s) Post Treatment, Survivorship, Support, Survivorship Program, Emotional Support
Creating your what's now and what's next via your points on reparenting, not giving away your time in ways that don't support your wellness but instead create stress & taking the wheel when it comes to feelings/emotions all really great tools and insights! Thank you for expanding the conversation further.
Tambre (Complementary Care Expert (Verified)) replied to answer by Tambre (Complementary Care Expert (Verified))
I was honored to be introduced recently to an artist, Clarity Haynes, who created "The Breast Project" as a way of healing her own body image issues. Since its inception in 1998, she has painted over 500 portraits including many breast cancer survivors. Clarity shares insights into the experience as well as her art in my blog post, "The Breast Project" ~ A Vision of Clarity. Part 1 available at: Don't miss seeing & reading @ the work of Clarity Haynes, creator of The Breast Project. http://wp.me/pDajr-1bI
Tambre (Complementary Care Expert (Verified)) replied to answer by Tambre (Complementary Care Expert (Verified))
Tambre     For survivors experiencing difficulty navigating the "new normal" or feeling isolated, I offer a No Fee monthly call to help address topics such as these or anything else you want to ask a survivorship coach. Survivors can get details and register at:
http://coachingbytambre.com/survivor-2-thriver-monthly-qa-call/
The next one is coming up on Sunday, August 14th.
Tambre
10 months ago  | 
Sorry to hear you feel you're not being heard about symptoms you are experiencing. There are several actions you can take to resolve this:
1. Write up a list ahead of time of each symptom including how often you're experiencing it, how it is impacting your life and then scale it on a scale of one to ten with ten being the most severe, how severely are you experiencing this. For example, if you have itching (my late husband went through months of his skin itching non-stop as a side effect of his treatment) on a scale of one to ten how severe is it? A five? A seven? A nine? This helps to create a point of reference -and as you experiment with possible solutions you can scale how well it is working - for example if you try a medication and the itching reduces to about a four from a nine this helps both you and the doctor understand the degree to which your symptom is responding in your experience of it.

2. If you feel applying communication tools isn't going to help with your doctor, talk to an oncology nurse or the clinical director at your treatment facility. Outline your symptoms and ask them to recommend who you should speak to about them. If they refer you back to your doctor, then let them know you've discussed them before but don't feel they've been addresses and ask for some coaching on how to clearly communicate to your doctor about them.

3. You can also look into hiring a patient advocate or having a loved one or friend come with you to help ensure you get what you need. When I was caregiving for my late husband, I served as his advocate. I had more freedom to be more vocal about helping him get his needs met. Sometimes some patients feel fear around rocking the boat with their oncologist or doctor because they are relying on this person to heal them. There are a couople of things I might add to this, having been a nurse.

1. Ask yourself how you will know when the doctor IS taking your symptoms seriously. What will you see or experience when that happens? Are you concerned you aren't getting proper treatment or enough treatment, or are you wishing for some compassion and emotional support from your doctor? Expect that you may not get 100% relief from all of your symptoms all of the time, but don't suffer in silence because you fear your doctor's wrath if you tell him about that pain or nausea again.

2. Doctors and nurses have a hard time quantifying how much a symptom is affecting a patient. That's why there is a scale for pain, for example, that runs from 0 to 10. Health Care professionals use this to try to create a level playing ground on which to communicate. Be as descriptive of the symptoms as you can be and let the health care professional know how the symptom is impacting you. "The pain is so bad I can't cook dinner for my family." "I'm so dizzy I can't walk down the hall when I need to urinate." These sorts of descriptions will let the professional know that it isn't just an annoyance, it's impairing your ability to function.

3. Not every symptom is related to what the health care professional may be treating you for. Sadly, our medical system is structured into silos; oncology, family medicine, internal medicine, gastro-intestinal, proctology... you get the idea. Specializations are great from the standpoint of getting expert care, but they don't help when patients have symptoms that might be outside a treating specialist's area. In cases like this you may need to ask, "Do you think this is related to what you are treating me for, or do I need to see a different sort of doctor?"

4. When people become anxious (which many people experiencing cancer diagnosis and treatment often times can), they may become hypersenstitive to what the body and mind tell them is going on. This is a natural effect of the fight/flight response that can be triggered by an accumulation of stress. Not to say that you don't experience the symptoms, but they may not be an indicator to the doctor of an urgent problem that needs to be treated. It might also be that treating a particular symptom might interfere with other treatment that is more urgent. Tell the doctor about your symptoms and then tell him what you just understood his response to be. Then ask if together you should alter the care you are receiving.

"Doctor, I feel pressure and pain at about an 8, especially when lifting. It's making it difficult to pick something up and move it."

"Well, I don't think that's anything to be concerned about. You should be resting. I'll see you next week."

"Doctor, I understand that you don't feel it's anything to be concerned about, but I brought it up because I AM concerned. Now, do you think there is some way we can decrease the pain without interfering with my treatment? I'd really like to be able to do as much as I can around the house. It helps me to feel normal."

5. Doctors, like any other experts, sometimes forget that their patients don't have the same level of knowledge about their conditions and need to be clued in to what they can expect and what may be "normal" symptoms/side-effects that are experienced during treatment. Keep asking and consider approaching other health professionals until you get an answer that puts your mind at ease. But be careful you don't end up doctor shopping until someone gives you a prescription. "Too many cooks spoils the broth." All your health care providers need to be aware of your medications and other treating physicians so that they don't end up over medicating you or prescribing treatment that is contra-indicated for another health problem.
New answer by Tambre (Complementary Care Expert (Verified)) in topic(s) Doctor Support, Symptoms, Physician, Conversations With Doctor, Patient Communication
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