Sunday, December 4, 2016

Cancer Scans, Mystery, Worry, Practice, Love, & Uncertainty

I had my annual PET scan last week, and the good news is that cancer has not taken up any new residences within me. How miraculous to be entering my 8th year of life post-diagnosis!

I had a challenging week after an overly casual radiologist over-interpreted my scan, which gave me the impression that cancer had reared its ugly head again. My wonderful oncologist, Kim went over my films with the radiologist, who admitted that what he sees "lighting up" now is no more intense than it ever has been before (gee thanks for that useless insight). He's not sure why he mentioned it. They looked at all my scans since 2009 and can see how “activity” in my bones frequently goes up and down with each scan, and what I have going on now is nothing new.

No one knows why these spots in my bones intermittently light up on a scan. It could be cancer still simmering, but it also could be arthritis, inflammation, post-exercise repair, or remodeling. As long as it isn't spreading to new areas, there's nothing to do but get on with living and just monitor the situation.

I hope that the findings on the scan might have something to do with the amount of time I spend doing wave motion on my forearms and knees, which puts a lot of pressure on my ribs and sternum. I also spend a fair amount of time in plank position. I can't bear weight on my wrists, so I do any activity (exercise or Continuum) that requires being on hands and knees on my forearms, which always makes my chest throb. Since the 3 places that light up on the scan are all places that hurt when I exercise, breathe deeply, tango, or do Continuum, it's probably some form of irritation or remodeling of the bone/cartilage. I think I'm going to ease up on my upper body activities.

(This paragraph is for you Continuum folks:)
Another thing that might stress the area that's lighting up is this: I've been finding the river whose headwaters originate in my sacrum and allowing it to meander up my spine as I move with the waves up into a bridge-like position. Then I suspend at the top of the bridge and wait for the tide to turn (yum, as only Continuum people can fully appreciate), and on the way downstream, I allow my sternum and heart to sink to the bottom of the riverbed as the river meanders back down. For those of you who know what I'm talking about, I do this with "O's on the way up and "Theta's on the way down. I got tired of always having my attention on my spine rolling down (the roll-down 1 vertebra at a time gets old), so I shifted my attention to sinking down through my anterior midline. Maybe I overdid it and my ribs and sternum are talking to me in some other language I don't understand.

If any of you think this sounds intriguing and interesting, please come to Kripalu in January and spend a week with me! https://kripalu.org/presenters-programs/transformative-self-care-continuum-movement-mindfulness-and-osteopathy

No change of treatment is in order. No new decisions are called for. Worry is optional, as always. We are just going to check my tumor markers, a simple blood test, every 3-4 months for the next while.

Every time I get a bad cold or flu I feel like it is practice for dying. It's great to get to practice on something that is relatively benign, but makes me feel like I'm going to die. Every time I have a scan, I feel like it's another dress rehearsal for the eventual downturn. I don't think I flailed too much this time.

This is what "practice" is about for me. It's not about quieting the mind, or being in a permanent state of bliss. For me, it's about not being overly identified with my thoughts, opinions, and preferences. There's a little space between my melodrama and what I identify as being, "me" that makes it all a little bit easier to bear. Even when I'm feeling fear of decrepitude acutely, I like to remind myself, "there I go again". My mind is an organ that secretes thoughts like my sweat glands secrete sweat; it’s just what the mind does. (By the way, some of you have heard me say this before, and I just want to let you know that I did not originate this great line, but I cannot remember who said it – most likely Jack Kornfield, Dan Siegel, or Tara Brach. So, thank you to whom ever made this great analogy.) Thinking is just what we all do, and I'm practicing to not be too tortured by my own mind before my body is ready to crap out.

Here is how I sit with uncertainty today:
I am the same person today as I was before last week’s scan. Nothing has changed. There is a lot of mystery about how to track cancer. It’s mostly unknown and unknowable. There are still many possible futures. I won't ruin the present by postulating about having a bad time with cancer in the future. It will be hard enough to cope with it if or when it happens. Why suffer prematurely?

I am loving my life, looking forward to winter, with its soups and sweaters, a few tangos, a good film, drinking hot brown liquids by our beloved fireplace (yes, after 14 months it's working!), becoming an expert on the spas of southern Quebec (here's our favorite, so far - https://www.balnea.ca/en/experience-thermale-2/, and sharing love and friendship with all of you... and so much more.

Monday, October 31, 2016

The Provocateur Is Undergoing Transformation...& My Next Kripalu Workshop

Once again, I have gone so long between blog entries that people are starting to contact me to see if I'm ok. I am. I'm fine, although I'm still having a great and challenging adventure living in my body. I have been sorting out my priorities, and I'm posting this notice to let those of you who also follow my Tango Provocateur blog that I am shutting it down. I will still write occasionally about tango, but I found that it requires too much time, energy, and expense to maintain a separate blog.

I will be writing more soon, but I wanted to let you all know that registration is open for my next workshop at Kripalu, Jan 29 - Feb 3, 2017.

Transformative Self-Care: Continuum Movement, Mindfulness, and Osteopathy

The winter season allows for time to slow down, turn inward, and cultivate deep listening, guiding you to care for yourself from a place of inner wisdom.

Osteopathic physician Bonnie Gintis has survived and thrived for more than seven years with advanced stage breast cancer and rheumatoid arthritis by being curious, listening to her body, and opening to life’s mysteries.  In this program, Bonnie shares:
  • Inner resources for resilience, adaptability, and change
  • Awareness of internal experience through breath, sound, guided and silent meditation, and movement
  • Our interconnectedness with each other and with nature
  • Cultivating curiosity, becoming comfortable with uncertainty, and radically reimagining how you care for yourself.
Discover the radical possibilities for health and well-being available when you combine fluid movement practices and mindfulness meditation with the principles of osteopathy.

Here's a link for more information:
https://kripalu.org/presenters-programs/transformative-self-care-continuum-movement-mindfulness-and-osteopathy

Sunday, April 24, 2016

Courageous Hospitality Towards The Difficult, Painful, And Unknown

"May you find in yourself a courageous hospitality towards what is difficult, painful and unknown."  John O'Donohue


I awoke today, as I do many mornings feeling pain and stiffness that makes staying in bed a little longer take priority over the need to get up. I go to bed each night hoping that the next day might be easier, and that easier might become a trend. I stay committed to being informed by the moment, and yet I hold a place in my future for the hope of feeling better. Feeling better may or may not materialize. I don't dwell on wanting things to be other than the way they are, but it's part of a healthy coping mechanism to be open to other possibilities. I can't not want to feel better. 

I'm always looking for ways to reframe this paradox of being in the moment versus hoping for the next moment to feel other than the way it is. The potency behind the desire to feel better fuels my curiosity and my underlying will to live. Learning how to hold that desire while still attending to the state of how things are is a complicated dance. I'm inspired by a story about 5-yr-old Guthrie, the grandson of the poet William Stafford, who presumably said after his favorite caterpillar was squashed, “You get what you don’t want and the spirit of what you want comes and helps you.”

I frequently revisit John O'Donohue's poem, A Blessing for a Friend on the Arrival of Illness for inspiration. Each day a different line grabs my attention. Today I'm pondering the "courageous hospitality" I have learned to extend towards the cancer and auto-immunity that have taken up residence in my body. If I courageously and graciously open the door to my life, all sorts of things wash in (and out) with the natural ebb and flow of the tide. Perhaps Guthrie's idea that the spirit of something I want (to live!) will help me as I face the reality of what illness has taken away from my life.

Being courageous doesn't mean that I'm never afraid. Sometimes I am, but when that fear taints my ideas about the future, I try to let go of the scenario that hasn't yet happened. Why worry now about some possible future where I'm unable to walk, hold a cup, or dance? Why worry about unimaginable cancer treatments or dying? I channel fear into fuel for the present where I need motivation to care for myself more deeply. This is courage; feeling fear, and still living my life doing the best that I can.

"Hospitality" is the harder part of the task. I think of being generous and welcoming as something that's easy with friends and loved ones. It's challenging to find a way to genuinely extend hospitality towards the way I feel this morning. Perhaps, like in Rumi's poem, The Guest House, an unexpected visitor has cleared me out, hopefully for some new delight. I don't have to stare directly at my diseases and invite them for an open-ended stay in my body. I can however, be hospitable towards "what is difficult, painful and unknown." The future is what is likely to be "difficult, painful and unknown." I know that the future contains the inevitability of death, but until that time comes, I can easily welcome the part of the future in which I'm alive, as the spirit of wanting to live and thrive comes to escort that future into each unfolding moment.

(I also posted an entry on my other blog, www.tangoprovocateur.com today on the topic of Generosity, Kindness, Gratitude, And Compassion In Tango.) 


Saturday, December 5, 2015

Introducing "The Tango Provocateur"

This is the first in a series of essays about my relationship to embodiment and movement through the unlikely (those of you who know me know how unlikely this is) pursuit of Argentine Tango. Some backstory is necessary for you to appreciate what I've learned from exploring the odd range of activities and circumstances in my life that includes Osteopathy, ice-skating, Continuum Movement, cancer, and tango. The way I encounter all of these things shares a philosophical common ground that applies to everything in my life. In the coming weeks I will be establishing a new blog, www.tangoprovocateur.com to explore this new frontier in my conscious embodiment, specifically in the context of tango. "Bonnie Gintis Health Update" will continue to be a way for me to communicate with you about my health and well-being, and as an exploration of the philosophy of life that has supported my surviving and thriving, even in the face of life-threatening and disabling disease.



On a chilly day in the fall of 1989 shortly after my 33rd birthday I realized that the burden I had been dragging around beneath my head was my body, and I began to suspect that it held wonders. I knew a lot about bodies; after all, I was not just a physician, but an Osteopath. It was convenient and interesting to have a body so nearby, but I tried to not let it get in the way of my life. It invariably did anyway, and did more so as I continued to get older. It even distracted me occasionally with something pleasant or even pleasurable, so when it got my attention that fall day, I chose to listen and follow where it led me.

My body led me to an ice-skating rink in downtown Poughkeepsie, New York. “Learn To Skate” is what the marquee on the front of the building commanded me to pursue, and in a moment of slipping out of character I thought, “that’s a good idea.” I went inside and inquired about how to learn to skate. I was coincidentally just in time for a beginner’s class. They collected seven dollars, asked my shoe size, handed me a pair of navy blue plastic skates and pointed to the far end of the ice, where traffic cones walled off a corridor. I was perplexed about how to get there. I asked if there was there a special walkway for beginners. Could I walk around to a backdoor that would let me in the far side of the rink by the lesson area? When they told me I had to skate to get there, I burst into tears, overwhelmed by the decades of ignored and unresolved fright, fragility, hopelessness, helplessness, and clumsiness of my physically awkward childhood.

I fumbled with my wobbly and extremely uncomfortable blue plastic rental skates. I managed to get them on, and then desperately gripping the railing, shuffled to the lesson area. I arrived red-in-the-face, tears dripping down my cheeks, to meet the instructor and the six other members of my class, all eight to twelve-year-old girls.

Within an hour I could push off with the side of my blade and glide on one foot. I could turn a corner by tilting my outstretched “airplane wing” arms. I realized that if I began gliding in the trajectory of a circle that I ended up spiraling in towards the center. I became fascinated with spiraling and spinning. It felt so good to glide on the ice and move in such unexpected ways that I forgot about being self-conscious. I stopped caring about what my teacher and classmates thought of me and the people watching us from the other side of the traffic cones disappeared.

The friction of a moving blade on the surface of the ice melts a drop of water beneath it. The skate blade sluices across the thin trace created by this freshly melted ice water between the blade and the rink’s frozen surface. The interface of the movement of my body, the blade, the liquid water, and the ice created sacred shapes. My mind quieted and all I could do was feel the emergence of circles and spirals between my body and the frozen water. What had been frozen into my body began to melt and move from me into the ice. I felt my past become the foundation on top of which I skated.

My intellect had objectified my body and walled “it” off from my experience for most of my life. There is no actual “it” in this story. I had fractured myself into pieces, dissociated, and objectified my own body. I’m not sure why I did this, but I trust that there was some good reason for my young survival mechanism to create this strategy and agenda. What once might have helped me get through something difficult was being perpetuated for too long, far beyond its necessity and was now hindering me from experiencing life fully. In moments of bliss on ice, I felt my sensation of embodiment shift back into phase with my sense of wholeness.

I regularly ice skated year-round for about 7 years, until I found myself living too far from ice to rationalize the drive. I became bored with the repetitive nature of the few things I had learned to do while balanced on a blade. Skating was technically so difficult to execute that I rarely felt free to express myself fully without risk of falling. I had reached a plateau of learning and creativity due to some combination of the limits of my free time, my body’s natural limits of strength, balance, and flexibility, and the threshold of my capacity to assimilate any more kinesthetic learning of this particular form. My interest faded, but I still yearned to listen deeply and feel my own movement unfold.  My relationship to my body was only beginning and I needed a new venue to explore embodiment.

This is around the time I met Emilie Conrad, and for those of you who don’t know that story, please read my book! (click here to buy a copy)

Twenty years later, lying in bed with breast cancer eating away at my bones, I did what many dying people do; I pondered my regrets. Astor Piazzola’s “Oblivion” (https://www.youtube.com/watch?v=0GaBi6jXNfc) could have been the soundtrack of this ordeal. In the early days after my diagnosis, the pain was so excruciating that I could barely breathe. I had to minimize the movements of my inhalation and exhalation. The tumors in my crumbling sternum and ribs wreaked havoc with this primal movement and I learned to adapt by breathing deeply into my belly without moving my chest. 

I silently pondered and surveyed my life. I had no serious regrets, but I wished I had learned to speak another language when I was young enough to have been fluent. Now it was too late and seemed somewhat irrelevant and not worth the energy.

I also wished I had learned to dance with a partner, but no dance ever called out to me. I could never get past the conventional gender roles with which you had to agree to participate. Most ballroom dances seemed exceedingly stiff and structured. Swing dance was too athletic and seemed frivolous. Salsa struck me as too fast and peppy for a zaftig Jewish girl like me. I tried Contact Improvisation, but it frequently led to what felt like a "puppy pile" and a lot of projection of people's needs on other dancers. Argentine Tango is what always got my attention. I found the music deeply moving. It’s probably best that I couldn’t understand Spanish so that I wasn’t turned off by many of the songs that have melodramatic and dated lyrics. Learning this very difficult dance seemed out of my limited reach as I contemplated my cancerous decline.

I told myself that these regrets were not so bad; I had lived a full life and done my best. I had loved well. I hadn’t done too badly in the thinking realm either. I achieved great things in my professional life. I was generous with my friends and family, and cared for other people for a living. It was in the domain of feeling that I had always been challenged. My tendency was to feel too much, too little, or the wrong thing for the situation at hand. Because physical and emotional pain so dominated the feeling realm of my early life I tended to avoid emotions and sensations that might bring my suffering into the forefront of my attention.

Perhaps it was this avoidance that allowed me to miss the growing presence of cancer as it spread. I quickly dismissed this possibility because it only led to more regrets during a time when I was soul-searching to decrease my burden. Why blame myself for the way things are? There's no way of knowing how or why some things happen. I realized that if I was going to make it through this ordeal I had to learn to be in a state of nonjudgmental acceptance without the emotional charge of self-blame. I have spent the past 6 years cultivating this state of acceptance. It has allowed me to live with the presence of cancer in my body without emotionally (and physically) decompensating. This acceptance of the way things are has guided the choices I make and the way I care for myself. Surrender to the course of my life has profoundly deepened my appreciation for each precious moment.

This acceptance has also allowed me to get curious about dancing Argentine Tango. My teacher, Tomás Howlin, likens tango to moving meditation, but points out that in meditation you can sit there sometimes looking as if you are meditating, while actually daydreaming and fooling yourself and others. In tango, if your attentiveness to the moment wavers for a second, the connection with your partner and the music is interrupted and the dance is lost. Tango is meditation with instant feedback. 

Tango requires a willingness to be uncomfortable and has increased my capacity to endure discomfort. This discomfort arises as you see all your habits and ways of being that don’t serve you in this dance where relationship, listening, and connection are foundational. The saying, “wherever you go, there you are” sums it up. All of your habits in relationship, compensations, and avoidances that you’ve made work in the rest of your life, show up as impediments to the dance. And in turn, the dance offers a chance to finally examine and let go of these strategies that don’t really work. The gift of tango is freedom, but you have to climb an extremely steep slope to obtain it.

Tango without courage and vulnerability is nothing but a technical performance, like a movie set that has striking visual effect, but no actual depth. This dance is spontaneous, improvisational, precise, and intimate, an unlikely combination of attributes. It has its awkward and occasionally painful moments, but the rewards make it all worthwhile. There is amazing pleasure in being able to communicate intention and movement and to share creativity within a constantly changing shape of space. Tango offers a way to live with uncertainty and meet the unknown with grace and fluidity. 

Occasionally and usually unexpectedly, a blissful and transcendent dance unfolds. Two dancers seamlessly communicate and respond to each other and the music joins them as a third and equal partner. This joy is the reward for patience, presence, and persistence. I don't mean the kind of transcendence in which you leave your body. What I mean is an embodied transcendence that transforms everything in its path to Grace. 

Osteopathy taught me to listen to and engage with other people's bodies. Ice skating awoke in me the desire to move. Continuum Movement taught me to listen to my own body and my environment, and to explore the mysteries of movement, stillness, breath and health. Cancer teaches me to stay and surrender to the necessity of the moment. Tango combines all this life experience as I learn to listen, to lead, and to follow in new and unexpected ways.

(In the coming weeks, you can find more about embodied tango as a personal and radical political act at www.TangoProvocateur.com)

Wednesday, September 9, 2015

I’m Great, But My Body Is Having A Hard Time


In Wendell Berry's poem, The Real Work, he writes,

     It may be that when we no longer know what to do
     we have come to our real work,
     and that when we no longer know which way to go
     we have come to our real journey.

It’s been another long stretch of time between blog entries and I’m starting to get emails and phone calls again from some of you asking if I’m okay. I like to answer that question by saying, “I am great, but my body is having a hard time.” I have definitely reached a new phase of no longer knowing what to do and no longer knowing which way to go. Here's my new conundrum...

This past March I began feeling worse, assuming it was the side effect from the anti-cancer, estrogen-blocking medication I was taking (Femara/letrozole). This is what prompted me to write the last entry, "Why Me?" Versus "Why Not Me?" I went off the medication and rather than feel better, I continued to get worse. It was apparent that there was something else going on. 

To make a long story short, I have been diagnosed with Rheumatoid Arthritis. My first response was, "really?!" This is an exasperated expression of shock. But it is followed by a regular, garden-variety "really?" which is an expression of momentary disbelief, followed by acceptance and curiosity. What is this new challenge about?

The twisted good news is that I have lived long enough with cancer that I have developed a new chronic disease! How ironic that I simultaneously have 2 diseases that behave at opposite ends of the immune spectrum. My immune system didn’t recognize and go after cancer, and now it thinks my own joints are foreign invaders that need to be destroyed. 

I am searching for ways to treat this auto-immune affliction. I like to think of it as a "reaction" more than a "disease." I spent 3 months trying all sorts of new diets, supplements, herbs, and alternative treatments, and I continued to deteriorate. I decided I needed relief and to halt what felt like a spreading wildfire before permanent damage was done. I went on a short course of prednisone and weekly methotrexate. After 9 weeks, I am beginning to respond to the methotrexate (which takes 8-12 weeks to kick in), with surprisingly no apparent side effects, and I am now weaning off prednisone. Prednisone is both miraculous and evil. I have great respect for its light and dark sides and hope to be off of it in a few weeks before I am confronted with any of it’s serious side effects. Over time, I hope that some of the other approaches, such as addressing my gut ecology, will support a remission or cure of this dreaded autoimmune arthritis.

I went back on a different anti-cancer drug. This time I am taking Tamoxifen, which has no muscle and joint side effects, and is thought to be just as effective as what I was previously taking. I'm not willing to stop taking an estrogen-blocker of some sort because 100% of women I have known with similar cancers that have tried to go off after 5 or 8 or 10 or 12 years and have had recurrences. I can't tell you if this is fear-based or just being practical. I'm not willing to find out, so I'm on Tamoxifen for now.

Even though I’ve been immersed in a health crisis since the spring, I have also managed to thrive, participate in the things I love, and find their therapeutic value. I somehow have managed to dance tango (even when I could only hobble for a 3 minute song before needing a rest), go to Kripalu, attend a silent retreat led by Jack Kornfield, go to the annual Osteopathic Cranial Academy conference, visit my brother, and take a day trip to Montreal. Steve and I did all of these things together. He has been amazing and with me all the way as we both explore how to move through life’s uncertainties. 

Leading a workshop at Kripalu on Transformative Self-Care was quite an energetic push. It was the workshop I really wanted to be taking. I taught it so that I could reap the benefit of having been a participant. I needed a few weeks to recover afterwards, but it was totally worth it! For those of you who want to join me next time, I'm offering it next year on Sunday, May 22 - Friday May 27, 2016. It's not listed on the Kripalu website yet, but it will be soon. I will post a blog entry as soon as it is open for registration.

Remaining curious about the paradoxical nature of my physiology, I can creatively cope with the challenges of my daily life. Perhaps in order to achieve balance my immune system has had to swing far in both directions. When I let go of needing to understand why and just explore what is, I find an unexpected vein of meaning. I immerse myself in contradiction until there is no duality. When I hold the reference point for these apparent opposites as the fulcrum of meaning, I can see that auto-immune reactivity and lack of immune recognition both share the same reference point - immune function. What if I shift my attention from the 2 ends of the spectrum, and move to the fulcrum that each malady shares? There I discover the power at the point of balance between these 2 states. I meditate in an open-ended state of inquiry about this each day, hoping for insight or relief. Like an Alchemist, I hold the tension of the two opposites and wait for the transformational (or should I say "transmutational") power to bring forth something new, an unexpected third state.

If only I could find a way to apply this practice to coping with my reaction to the predicament of refugees, racism, beheadings, police brutality, loss of privacy, the slaughter of Pakistani children, etc. The world is too big for me to take on. My heart is aching and my mind is baffled.

The final lines of the Wendell Berry poem I quoted in the opening are,

     The mind that is not baffled is not employed.
     The impeded stream is the one that sings.


I find these words encouraging. I don't have to solve the problems of the world.  I may no longer know what to do or know which way to go, but when I encounter a blockage of flow, I have an opportunity to be creative and find another way to allow my impeded life stream to sing.