Keeping traditions “normal” while facing cancer can wear patients down.

It’s that time of year again — the holidays. This is the time when family traditions are repeated and enjoyed, and new traditions begin. Thanksgiving, Christmas, Hanukkah and all the other holidays from around the world are when we gather as families, both old and new, to celebrate.

But the holidays can be challenging as women with breast cancer try to “keep things normal” for children and family alike. They may also be reluctant to give up roles that defined them as the mother and planner of the family or the one who always made all the dinners and kept the lists up to date. Depending on where a woman is in her treatment, the holidays may come at the beginning, middle or end, with each bringing its own set of challenges.

My advice, and that of many women I know who have gone through the holidays with breast cancer, is to make it a clean slate. Start with the most important tasks that you want to continue, then decide if you have the energy.

For mothers this pressure may come from children who desperately want to repeat treasured traditions. If you want that too, it may mean brining in reinforcements to help or getting the kids involved.

The key here is communication. Depending on the age of the children, a conversation about their favorite moments in the holidays may give you a clue as to which traditions need to be performed at all costs.

You should also look at your motivation to make it all work during the holidays. Many women see this time of year as their preview and to get back to it indicates all is well. That is all well and good, unless you don’t have the energy to lift a fork. Then you need to understand that the message you give may be much more damaging than being honest with the family about your challenges. Maybe it is the year for Thanksgiving at a local cafeteria.

Every family handles the holidays differently. Going into them should take some thought about what would be different.

I received a diagnosis mid-October and began treatment immediately, so when Thanksgiving rolled around I was in the midst of the worst nausea and vomiting with the lack of energy that accompanied it.

I don’t have a clue what we did that year except that I was lying on the couch.

Thanksgiving is only the warm up for Christmas, the big holiday that can take down the best “Martha Stewart” mom, aunt or grandmother. If that’s you, remember that taking a year off from being the hero of Christmas won’t kill anyone. But trying to cook, host, clean up and go caroling could very well land you in the hospital with a case of not listening to your body.

The holidays have so many memories that for some it is hard to deal with them under the best of circumstances. Think about it, talk to the family, and go from there.

My favorite holiday story comes from a friend who approached Thanksgiving in the middle of treatment with a loving husband who owned his own company and could not take off much time. Her children, 3, 7 and 11, decided they would help make Thanksgiving dinner for the family, which included various aunts, cousins and grandparents.

On Thanksgiving Day, everything was ready to go. Mom had posted the menu on the door of the fridge, planning to let the kids take the easy tasks with each dish.

They had other ideas.

By the time family began arriving, my friend said she was lying on the kitchen floor trying to keep the children from setting the kitchen on fire. The cousins, the oldest age 17, had taken over. As the children finished preparing a dish, they walked down the line of adults now sitting on the floor and dished out the food.

This meant they had cake after the salad and the vegetables after the cake. The turkey didn’t look anything like the Norman Rockwell painting, which the children had used as reference.

The family dog had become a nuisance, so the children tied him to the leg of a chair, which he dragged around the house numerous times.

“It was the most wonderful Thanksgiving we ever had,” my friend said. “The next year we did it again with a few modifications. The dog was left outside, and the adults moved to the living room where they had more room to sit on the floor.”

The cousins began working on the menu in the summer and looked forward to it all year.

While writing this blog, I called her and found out they still eat on the floor and the kids do all the cooking just as it was the first year in 2003. Mom is doing well, and the cooks have begun with the second generation.

“From my cancer, the family created a tradition that has changed all of us and brought us closer together,” she said.

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