Learning to Sit With Uncertainty

On an ordinary night this past September, I lost my ability to sleep.

The sun went down, it got late, I went to bed, but I never got sleepy. I was up all night.

One night of insomnia. It happens. It’s normal.

Two nights later, the sun went down again, and once again, sleep never came.

The pattern continued for another week. One night of sleep, one night of no sleep. Then the pattern changed: every night, no sleep.

Every night, I was physically exhausted, but I wouldn’t get sleepy. (There is a difference between tiredness and sleepiness, I have learned.)

I must have a brain tumor, I thought to myself. Or something else messing up the hormones in my body responsible for sleep.

I went to my primary care doctor. Blood tests, urine tests, EKG, stress test — they all came back normal. 

I went to a neurologist. Nothing wrong with me neurologically either.

It’s now November, and in addition to not sleeping, I now have acid reflux too. 

I do my own research and learn that the gold standard treatment for chronic insomnia is Cognitive Behavioral Therapy for Insomnia (CBT-I). So, I found a CBT-I therapist and began meeting with her.

After our third session, she tells me, “Adrian, you don’t have a sleep problem, you have an anxiety problem.”

“Of course I do,” I said. “Not sleeping is making me anxious and being anxious is preventing me from getting sleepy, so I’m trapped in a vicious cycle. How do I get out of it?”

It’s now December and I have lost 14 pounds.

It’s now mid January and I’m still not sleeping, my acid reflux is not getting better despite taking medication, and my anxiety has gotten worse.

Will I ever get better?

My wife, who has supported me throughout this whole ordeal with much love, patience, and advice, tells me, “I think it’s time you go to the hospital. You’ve been trying to fix this on your own, but I think you need more focused help from a team of doctors.”

The next day, we went together to our local hospital and I was admitted.

After being there for five days and undergoing a series of medical tests (more blood work, another EKG, chest x-ray, CT scans, ultrasound), I received a diagnosis: thyroid cancer.

I never imagined that receiving a cancer diagnosis would ever be a source of relief, but in this case it was. Not only because the prognosis is good, but because I finally had an answer, something that explained (at least in part) what I had been going through the past 5 months.

And here I am today. Thanks to the therapy I received and some medications, my sleeping has improved, my acid reflux has gone away, I’ve gained 4 pounds back, and my anxiety level has gone down.

Tomorrow is my surgery, where my thyroid and some lymph nodes will be removed. Am I anxious about it? Of course, who wouldn’t be anxious about a 5-hour surgery? But anxiety happens. It’s normal.

Why am I sharing this (greatly condensed and simplified) story? To share a few lessons I’ve learned on this journey in case it helps others:

When it comes to your health, never stop advocating for yourself.
Although all the medical tests kept saying there was nothing physically wrong with me, I somehow knew that something was still wrong. I know my body better than anybody else and I knew it was reacting to something. Of course, you have to trust your doctors and believe they are acting in your best interest. But at the same time, you have to remember that they are human too and sometimes they cannot see the forest for the trees. (See Maria Menounos’s story about her year-long journey to getting her pancreatic cancer diagnosis.)

Focus on your mental health as much as your physical health.
All of my adult life, I have been very focused on my physical health. I’m an
avid cyclist, I go to the gym regularly, I eat well, and I get annual medical checkups. But I had never invested any time or energy on my mental health. Simply put, until recently, I lacked the knowledge, skills, and tools to adequately manage stress and anxiety. I wish I had learned about (and practiced the skills of) Cognitive Behavior Therapy (CBT) and Acceptance and Commitment Therapy (ACT) years ago. If I had, I would have been better prepared to deal with the stress and anxiety of this insomnia-to-cancer experience.

Clearly define (and write down) your values and goals.
What things/actions should we focus our time and energy on each day? Which thoughts should we engage/wrestle with and which ones should we just let float away? To answer these questions, we need a frame of reference, something to help guide us. That “something” is our values and goals. 

“Values are your heart’s deepest desires for how you want to treat yourself and others and the world around you; personal qualities you want to bring into play in the things you say and do,” writes Russ Harris in “The Happiness Trap.” “Goals are the things you’re aiming for in the future: things you want to get, have, achieve, or do.” 

Of course, I have values and goals, but I’ve never taken the time to write them down and truly reflect on them. That is why I have historically wasted a lot of time and energy on things and actions (such as scrolling through social media and being on my phone instead of engaging with my family) that don’t move me toward the life I want to live. I’m in the process of writing down my values and goals, and reflecting on them each day, so that I live a more meaningful and purposeful life moving forward.

I am now trying to learn how to sit with uncertainty — that is, “to be okay with the unknown and lack of control.” One of the things I learned about myself during this journey is that I’m not good at sitting with uncertainty. I’m the type of person that needs to know the Who, Why, What, and When of almost everything. I also ask a lot of “What if?” questions and go down many rabbit holes looking for answers. This has served me well as a research analyst, but it’s really not a healthy way to approach life in general. 

As I’ve learned the past few months, sometimes the answer to “Why?” is “I don’t know” — and sometimes nobody knows either; it just is, and the more you try to find a different answer, the more lost you become.

So, here I am, sitting with uncertainty, but with newfound hope too. I have no idea what tomorrow will bring, but who does anyway? 

If you’re a longtime follower of mine, you know that I’m a big 80s music fan and I can always find a song that speaks to me. I rediscovered “The Flow” by The Fixx a few days ago. I’ve always loved this song, even though it’s not one of their popular ones. The final words of the song are just perfect for me right now:

Just look how far you’ve been
Look how far you’ve come
All the things you’ve achieved
Don’t try and find any reason get carried by it
Jump in the flow

To many more sunrises and destinations unknown.

One more personal revelation: how blessed I am to have the love and support of my wife, children, extended family, friends, and clients. Words cannot express how grateful I am to everyone in my life who has comforted me with their hugs, kisses, and well wishes, and given me the strength to journey on when I’ve needed it most. I love you all.