10/31/2014 02:13 pm ET Updated Dec 31, 2014

After the Wearing of the Pink, the Journey Continues

In my last post, "Finding the Way Back to Normal After Breast Cancer: A Lesson in Invisible Fences," I promised to continue where I left off and talk about the process of healing and of re-establishing physical, mental and emotional norms after treatment. Here, on the last day of Pink-tober, it seems right to raise awareness to the lonely journey of healing many survivors begin after treatment is over.

Perhaps you've been through several months of treatment; perhaps it's been a full year or more. Either way, you may be surprised to find that at the end, you feel anything but celebratory. This comes as a great surprise to many, catching them off-guard and ill-prepared for the difficult period that lies ahead. In fact, the three most difficult or anxiety-filled stages of the journey are: diagnosis, start of treatment and end of treatment. The last one strikes many, as it did me, as odd.

But many survivors find that only from the vantage point of the finish line can they begin to take what they've been through and what it has done (and meant) to them. As bewildering as the cancer journey may be, so too is letting it go. Learning to live without it can be just as hard as learning to live with it. In an odd and unlikely way, the cancer journey is so intensely personal, and drives us so deep into ourselves that a strange sort of intimacy, and a strong new identity develops around it (no matter if it is the 'kick cancer's butt' variety or the 'spiritual journey' approach). Survival becomes the single most important thing in life.

When the last day of treatment arrives, the release of tension is huge; no more fighting, no more bracing against the assaults on your body, no more indignities to your soul, no more feeling like a science project. Your body is once again your sacred domain and you can close the doors and begin to heal.

Begin to heal. While the rest of your circle is saying "thank God that's over," you are only beginning to take stock of the experience and sort through it all. Your journey continues, alone. Alone, because gone now is the incredible support, warmth and encouragement you received during treatment, gone is the medical team taking constant care of you and making you feel safe, gone are the cards in your mailbox from friends and family.

Many survivors characterize this time as feeling like falling off a cliff. It all comes to an abrupt end. Your flood of emotions has just begun, and you may feel alone and overwhelmed. You may bounce between joy and sadness, gratitude and grieving. You may feel at peace but also anxious about the future. You may be taking stock of the new you, and your new normal, on many levels.

Physically: You may be dealing with anything from scars, to the complications of a mastectomy, lymphadema or side effects of chemotherapy and radiation. You may have started hormone therapy following treatment, and if you were pre-menopausal, been catapulted into menopause. It's a big deal. You may not "bounce" back to where you were or be able to do what you used to do. In fact, the more you hold yourself up to that standard, the more likely it is that you will experience frustration. Rather, you need to begin by assessing your body's new aesthetic and new functional perimeters with kindness, patience and self-love. If you cannot do what you used to do, try new ways to move and to exercise. Walk instead of jog, incorporate stretching or yoga, do activities like gardening or dancing -- call it active play. Just learn to enjoy moving again, and the rest will follow.

Emotionally: For many people, this is an awkward and uncomfortable arena. Feelings, and the process through which we identify and resolve them, are generally not well understood. We get little to no education about how to decode our own emotions, patterns and responses, let alone anyone else's, and most of us fumble our way through. Some are taught to bury their feelings, especially bad ones, which only lets them take root, grow and branch out affecting other areas of life. In a cancer crisis, deep feelings of anger, fear, grieving, and shame may float to the surface. The weak links in your life will be tested and strained. That which was not working will scream to be resolved. Things might seem to fall apart. But remember, what looks like a breakdown can also be an opportunity for tremendous growth, excavation, for deep cleansing, and for spiritual rebuilding. Don't hesitate to reach out and get help, speak to a counselor or find a therapist. Many counselors, coaches or other survivors understand and can help.

On a smaller scale, you may find that emotional responses change. What used to be a relaxing and familiar trip to the salon for a pedicure or to school to pick up the kids or to a crowded social gathering might trigger an unexpected response of anxiety or overwhelm. Be patient, try to figure out what's underneath the reaction and honor what you need. Spend more quiet evenings at home, maybe avoid big crowds, whatever it is, trust that you need it for now and don't judge it. The feelings are telling you something needs attention so listen and give yourself the time and care you deserve.

Mentally: A few words about re-establishing intellect and mental acuity. Particularly for those who have been through chemotherapy, this can be quite an interesting ride. Chemotherapy can bring on a host of side effects, affecting thinking, memory and the ability to multi-task. The good news is that these affects are mostly temporary. However, you may discover there are some new 'quirks' in the system that you need to discover by staying aware, knowing where the new limits are, and responding accordingly. Take an active role in retraining and exercising your brain. Do word puzzles, take a class, learn something new. You can also try Lumosity, an iPad app that exercises different cognitive functions through daily interactive challenges and tracks your improvement.

While it can be surprisingly hard to say goodbye to the cancer experience, if you are a survivor, then you have much to be grateful for. Not just for your life, but perhaps also for how the experience reshaped and re-framed how you want to live it. It is not a gift anyone asks for, but the glimpse it provides is a gift all the same. Take that with you. Renew your commitment to caring for and about yourself. And don't worry if others don't understand. They will adjust to your new boundaries, and in time so will you.