I get asked the whole “So you’re OK now?” question a lot. And I don’t blame people for asking. We’re a big-picture society. We want the abridged version, the snapshot, the 60-second update, and then we want to move on.

“How’s the cancer?” “Well, I’m in remission but…” “Fantastic, that’s great news, so glad to hear” and so on and so forth until we land on a more pleasant conversational topic.

I’m more than a year and a half out from treatment and had my two-year diagnosiversary this past November. My hair has grown back to a socially acceptable length, and my surgeries are (for the most part) over with. No real physical remnants of treatment can be seen—unless you’re looking for them, and then you might spot some peculiar scars.

But I don’t really know if I’m OK. Sometimes I think I am; sometimes I think I’m falling into a pit of despair that I can’t get out of.

A lot goes into an early-stage cancer diagnosis, and I’m not sure the world recognizes the amount of recovery needed. So I’d like to outline some of the difficulties I face while in recovery. I’m going to break it down into the three categories symbolized in the tattoo on my arm: mind, body and soul.

Mind:

  • PTSD
  • Panic and anxiety attacks
  • Inability to sleep
  • Constant fear
  • Memory loss
  • Reduction in sharpness (chemo brain)
  • Inability to concentrate or multitask
  • Mood changes
  • Loss of self-confidence

Body:

  • Side effects of medications (weight gain, bloating)
  • Various scars
  • Phantom itching
  • Nerve pain
  • Reduced flexibility
  • Achy joints
  • Severe lethargy and chronic fatigue
  • Complete overhaul of sexual function

Soul:

  • Isolation and detachment
  • Fear of connecting (How do I explain this to a partner?)
  • Loss of identity (Who am I now?)
  • Loneliness (Who can understand me?)
  • Compassion fatigue on the part of friends and family

This list is depressing. But it is what it is. Every day I strive to work on solutions, possibilities, motivating chats with myself—to get through these difficulties and try to feel “OK” again. And there is so much promise that I am healing more and more every day. In fact, I trained for and completed the 2018 New York City Marathon, and I plan to run another one this year. But just because I’m in remission and I look more like I used to, I don’t necessarily know if I’m actually doing all right.

So my advice would be: Don’t ask me if I’m OK now. Just ask me how I’m doing. Ask me how I’m feeling. I promise to keep it short and sweet. And I promise to be honest. Because if you don’t want to hear it, you shouldn’t have asked.