Shortly after I started a blog for this site last year, aspects of my personal and professional life were suddenly upturned in surprising ways, not unlike a till cutting into hard-packed soil.

On the dance floor one night, after many years being single, I met a new love. We enjoyed the summer, soaking in the most delirious stretch of warm sunshine I’ve known in Portland since moving here nearly 20 years ago. It was all hikes in the woods, lazing in the sun and melting into each other on the dance floor every Sunday.

In late July, I found a new office to share downtown in a building that appeals to my Old-World off-grid sensibilities: huge windows that open, radiant steam heaters and no wi-fi. Private practice being relatively mellow compared to my years in clinical work, I also started a gig on the side, doing crisis assessments two or three days a month to keep those skills sharp and continue the social justice work that is important to me.

By the start of September, I moved in with my new love, Marlene. Two weeks later, I got a brilliant idea for a novel about Death and started writing it. Although I heed author Michael Cunningham’s advice to “keep the magic” for oneself during the creative process, brief readings of its beginning chapters brought laughter and slack-jawed awe from friends, which is encouraging to a writer’s heart.

All good good good. Far better than words can convey.

Then the swell of balance came flushing up to our door.

My love’s father died rather unexpectedly, and grief’s heavy blanket came to rest on our new home life. Marlene’s energy took a nosedive. Her dance slowed down. The days darkened into late autumn, and I expected a grief-infused winter to bring the cold rainy days that usually turn my hand to writing — an obvious time to work on both blog and novel. But as we Portlanders know, the rain and cold never settled in like they normally do.

What’s more, seven months after our first dance, Marlene was diagnosed with endometrial cancer. After two long months of waiting for a spot in the oncologist’s schedule, treatment commenced with surgery. Though it was robot-assisted and “minimally invasive,” she suffered internal bleeding that resulted in life-threatening complications and two hospitalizations. Her cancer prognosis is good — caught early — but she suffered physically from infection, and recovery has been slow.

For two months, nearly every aspect of my personal and professional life took a back seat to caregiving in its various forms: administering medications and hypodermic injections, wound care, laundry, updating friends and family, providing direction to helpers, cooking, cleaning, recycling and trash, grocery shopping, dog walking, driving Mar to doctor appointments and acting as her medical advocate, prodding her to eat when she lacked appetite, taking her for more tests, providing emotional support and lifting every single object that might weigh more than 10 pounds. Just to name a few.

It may come as no surprise, then, that my own health started to falter. Years ago, while traveling in Central America, I fell victim to a nasty bug that did long-term damage to my digestive tract. Though I have done much over the years to counter its effects and heal my gut, under the strain of all this caregiving, and the psychological stress associated with cancer diagnosis and treatment, I quickly ran through my physical reserves, and a bout of iron-deficiency anemia reared its ugly head.

Suddenly, I could no longer keep up with my usual dance partners; I was short of breath and fatigued. Muscles hurt. Joints burned with stiffness. In the midst of conversation, my mind could become blank, words slipping from my grasp like a greased-up watermelon in the swimming pool. Even when I didn’t lose my words, I lost my verbal acuity. Ideas I can usually explain succinctly became like a circumnavigation of Mt. Hood on a dark and rainy night, familiar territory in which I felt lost. I started to ask, “Does that make sense?” with discouraging frequency. Classic brain fog. And I wanted nothing more than to nap.

Following a blood workup, I ended up at the hospital myself, receiving weekly IV iron infusions on an outpatient basis. I also took a friend’s recommendation for a great naturopath and started addressing, once again, the malabsorption issues, which had become worse since taking antibiotics last year. Supplementation, yoga, roller work, acupuncture and regular visits to the sauna now round out the course of treatment.

Marlene is mostly recovered, and I’m coming along, as well.

Like any of us, I can live without the stress and complications — be it a health crisis, death of a loved one, job loss or some other significant stressor — but the last several months have refreshed my memory, in a very personal way, around the features of resiliency practices.

I use that term — resiliency practices — with intention and acknowledgment. Even though the perception of resiliency — our ability to handle a crisis and “bounce back” into the course of “normal” life with ease — is affected by disparities in terms of inborn temperament, life experiences, social standing and financial resources, there are simple ways to improve our day-to-day experience of stress or crisis. Things we can actually do, or practice. The list is far longer, but here’s a start:

Top 5 Resiliency Practices When Facing a Health Crisis

No. 1: Stay in The Now.

When a phone call from the ER comes in the middle of the night or a “concerning” diagnosis is made, nothing torpedoes one’s resiliency potential quite like a trip into the morbid fantasies of what might occur. The Internet is awash with chat rooms, news stories, research articles and medical sites like WebMD and the Mayo Clinic, etc., all providing information of varying quality about disease progression, prognosis and treatment. It’s enough to send even the most astute and knowledgeable readers down the rabbit hole. Although I remain a solid advocate of being informed, it’s important to keep things in check, to keep life in perspective.

Checking in on how you are doing Right Now, at this very moment, is a great practice. You are breathing, aren’t you? If not, try this breath practice. And when you find your mind straying to that 18 percent chance of mortality from a particular cause, keep in mind that we live each and every day with a 100 percent chance of mortality. There is no value in worrying about the cause of death; live the life that is Here Now.

No. 2. Ask for Help — and Be Specific.

In our increasingly isolated techno-age, the landscape of supportive community is changing. You may have 700 friends on Facebook, but still not know who’s going to give you a ride home from the hospital following a procedure. No matter how big or small your social network might be, two things are likely true: 1) Somebody wants to help; and 2) They may have no idea what you need.

Rather than leaving supportive resources untapped or unfocused, take back some of the power in what might feel like a helpless situation and simply ask for what you need. Whether that’s someone to bring a decent meal to you in the hospital — where the food is notoriously bad — or someone to walk your dog, asking supportive family, friends and colleagues, even via a broad shout-out to your social networks, to do specific tasks is likely to net gains beyond your expectations. Sites like Lotsa Helping Hands use online calendars to organize helping communities without placing additional burdens on the caregivers. Similarly, fundraising sites like Go Fund Me are an excellent way to reduce the strain of health care expenses.

No. 3. Make and Communicate Good Boundaries.

Regardless of whether you’re a caregiver or the one who is ill, the rush of daily living continues. Some expectations, like showing up for work or paying the rent, have precious little wiggle room, but it’s important to realize: You CAN separate needs from desires and let go of optional expectations, and it’s useful to communicate these changes to others.

In the simplest example: While being Marlene’s caregiver, I continued dancing twice a week. It is one of my greatest pleasures and an important form of exercise, but as my own energy waned with the anemia, I could not keep the usual pace with my dance partners. I dealt with this by declining dances at times, dancing solo more than usual, and most often, speaking to my partners about the need to limit exertion. To a number, they respected my choices and did not push me for more. It might be a greater struggle for caregivers who also carry a heavy load of employment, household and family responsibilities, but I can assure you of one thing: If you don’t set limits, and you don’t speak up about them, you are likely to become, and remain, over-extended, stressed and exhausted. So set some boundaries and give yourself a break.

No. 4. Self-care is Never-Ending.

Whether one is wandering the hospital corridors awaiting test results or facing a stack of dishes and piles of laundry, “saving time and energy” by neglecting basic needs for food, water, rest and exercise is not the answer. Nutrition is the foundation of survival, so even when you lack appetite, getting wholesome and nourishing calories into your body is a priority.

Similarly, regular exercise and routine hygiene are crucial to feeling your best, having clarity of mind and tending effectively to emotions under difficult circumstances. This is why, in health and hard times, I continue to dance. This is also why, when illness requires recurrent hospitalizations, it’s useful to keep a “hospital pack” at home, loaded and ready-to-go with favorite non-perishable foods, toothbrush, dental floss, phone charger, a change of clothes and the like. Make sure you are taking care of yourself at all times.

No. 5. Live with Gratitude and Compassion.

In the midst of a health crisis, you’re tired, stressed and you don’t feel well. Doctor’s visits and treatment protocols seem to take over your life. The bills start rolling in, and perhaps the vacation you’ve been looking forward to suddenly hits the back burner. It can be hard to feel gratitude. But a crisis is precisely the time to count your blessings, as it can only speed healing and improve your state of mind to remember that good things continue to happen to you. Every night before you sleep, to set a helpful frame of mind for rest, try to find at least three things that occurred during the day for which you feel gratitude. These can be huge things — the relative who will donate a kidney — or small things, like getting a parking space near the hospital entrance or someone bringing you a delicious hot latte in the waiting room.

And when it comes to compassion, which is fundamentally necessary when dealing with sick or injured human beings, the most important place to start is with yourself. Under all this stress, you may feel the crushing weight of expectations, the heaviest ones often coming from within. It is important to remember: It is our natural state NOT to meet every external and internal expectation. Some things will simply not get done, and life will still go on. Be soft and kind to yourself. Allow for shortcomings and mistakes. Reach for flexibility, openness and forgiveness — around everything. Even the dastardly injury or illness that came along in the first place.

Namaste.

Tamara Webb, MA, LPC, LMHC, is a writer and psychotherapist in Portland, Oregon. Contact her at [email protected].